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Road Accident Victims
10. Mr. David Taylor (North-West Leicestershire): If he will make a statement on his policy on emergency treatment fees in the NHS for road accident victims. [62452]
The Parliamentary Under-Secretary of State for Health (Mr. John Hutton): The Government intend to end collection of the emergency treatment fee by national health service trusts. An amendment to section 158 of the Road Traffic Act 1988, removing the right of NHS trusts to the fee, is contained in the Road Traffic (NHS Charges) Bill which was introduced in the House of Commons on 27 November 1998 and which was given a Second Reading on 8 December.
Mr. Taylor: I thank the Minister for that reply. Is he aware, that on 12 March 1991, the right hon. Member for Charnwood (Mr. Dorrell), who was then a junior Health Minister, stated in a written answer that the Conservative Government intended to abolish the emergency treatment fee
- "as soon as a suitable legislative vehicle becomes available"?--[Official Report, 12 March 1991; Vol. 187, c. 493.]
In the light of that, how does my hon. Friend react to the Opposition's criticism of what the Government intend to do, and how does he rate, on a scale of one to 20, the utter political hypocrisy of that criticism?
Mr. Hutton:
I am grateful for that question. It is probably another example of hot air as regards the Opposition's promises when they were in government--promises on which they conspicuously failed to deliver. On this occasion, as on many others, it has taken a Labour Government to clear up the mess that they left behind.
11. Mrs. Teresa Gorman (Billericay):
If he will make a statement on his plans for the future management of children's homes. [62453]
The Secretary of State for Health (Mr. Frank Dobson):
On 5 November, I spelled out to the House our plans for the future management of children's homes to ensure that children are better looked after and to protect them from abuse, exploitation and neglect. Further details were given in our White Paper, "Modernising Social Services", which I announced to the House on 30 November.
Mrs. Gorman:
I thank the Minister for his reply. I sympathise with the view he takes, and admire the fact that he intends to do something about that serious matter. Given the risk that is posed by men running some care homes, which is obvious from the number of cases of abuse, he might consider recycling grannies--women who have raised families and who are good at spotting when something is going on. If such people were in charge of homes, the children in them would have a naturally sympathetic character to whom to turn. Will he consider that as a practical and serious proposition?
Mr. Dobson:
The short answer is yes, I will consider it, as it seems to be a perfectly sensible proposition. My only point on the hon. Lady's introductory remarks is that for boys in homes, as in schools, it is a good idea to have safe men around to provide role models of how grown-up males should behave. However, we need to ensure that they are not among the abusers and exploiters of children. The hon. Lady's point is practical and sensible, and I will look into it.
Mr. Hilton Dawson (Lancaster and Wyre):
May I commend my right hon. Friend's commitment to the radical reform of the care system and the ending of abuse in it, to improve a situation that has brought great shame on this country? Perhaps he will reconsider his recent remarks. Surely men can play a tremendous role in the care system, in children's homes, in foster care and in social work with children. We have to get the protection of children in the system right, and we have to ensure that we have the right people in it, rather than making facile judgments based on gender.
Mr. Dobson:
My hon. Friend may have misheard me. I said that, provided that the men are safe, it is as well to have men around, because they set a proper example to young people of the way in which decent adult males should behave. That certainly applies to boys, and to some extent it may also apply to girls, some of whom may have come from homes in which the adult male has knocked about and battered the women of the household. It is
Health Trusts
13. Mr. David Kidney (Stafford): How many health trusts have become technically insolvent. [62455]
The Minister of State, Department of Health (Mr. Alan Milburn): None.
Mr. Kidney: Do I thank my hon. Friend for that answer? He is aware that there are some health trusts, such as the Mid-Staffordshire General Hospitals NHS trust in my constituency, whose finances are sufficiently precarious to need special monitoring by his officials. Does he agree that national health service staff in such trusts work in a dedicated and committed way and yet sometimes feel that the financial position is such that they are working with one hand tied behind their backs? Can he assure us that the monitoring is sufficiently robust to ensure that the full range and quality of services that the local populace, including trust employees, require will be available in those trusts?
Mr. Milburn: Of course staff in organisations that have been landed in debt as a consequence of the policies carried out by the previous Government are at the sharp end of a host of dilemmas. When we came to power, two thirds of health authorities were in debt and the national health service as a whole was in debt to the tune of £450 million, thanks to the lacklustre and reckless performance of the Conservatives. We have halved that debt and are well on target to get the NHS back into financial balance. That is largely a consequence of the record levels of investment that we are now making in the NHS, including the extra £38 million that has gone into the South Staffordshire area.
Miss Julie Kirkbride (Bromsgrove): I am sure that the Minister is aware that the way he is tackling the funding problem in Worcestershire is to close Kidderminster general hospital and to downgrade the accident and emergency departments at Kidderminster hospital and at the Alexandra hospital, Redditch, to the status of glorified minor injuries units. That is the policy of the Labour Government, whereas, for 18 years under the previous Conservative Administration, those facilities remained open.
The Minister might not be aware that, during the last general election, his hon. Friend the Member for Wyre Forest (Mr. Lock) campaigned saying that a Labour Government would keep Kidderminster general hospital open; or that his hon. Friend the Member for Redditch (Jacqui Smith) campaigned on the basis that the accident and emergency department at Alexandra hospital would not be downgraded. However, both those things have come to pass under a Labour Government who promised to improve our national health service.
All we in north Worcestershire have experienced are cuts. I should be grateful if, instead of conversing with other hon. Members, the Minister answered the real concerns of the people of north Worcestershire who are finding that the Labour Government, who promised to improve the NHS, are cutting it.
Mr. Milburn:
The hon. Lady must be the only person in Worcestershire who thinks that Kidderminster general
15. Mr. Gareth R. Thomas (Harrow, West):
What roles and responsibilities he proposes for regional commissions for care standards. [62457]
16. Mr. Michael Jabez Foster (Hastings and Rye):
What roles and responsibilities he plans to give the regional commissions for care standards. [62458]
The Secretary of State for Health (Mr. Frank Dobson):
The current system for checking on children's homes and residential and nursing homes for adults is simply not up to the task. Some places are not regulated at all and there is no check on the standard of care delivered to people in their own homes. The commissions for care standards in each region will change all that. Their job will be to check on every aspect of social care, and to ensure that top-quality services are delivered and that no one is abused, exploited or neglected by the people who are supposed to be looking after them.
Mr. Thomas:
I thank my right hon. Friend for that answer. I warmly welcome the commissions on care standards and many of the other measures contained in the White Paper, not least the general social care council and the new national performance framework. Does my right hon. Friend agree that those measures to increase openness and accountability are vital if we are to deliver better services to carers and their families and to the staff who work in those vital services?
Mr. Dobson:
I certainly agree with my hon. Friend's point. The system we inherited is a shambles--it does not work. It leaves small children's homes and local authority homes uninspected; and in some cases, it leaves people of extremely dubious background delivering services into the homes of people who are often elderly or disabled. We believe that those arrangements need to be better regulated than they have been in the past, and I am confident that our proposals will do the job.
Mr. Foster:
I, too, thank my right hon. Friend for his comments. Will the regulatory arrangements go beyond residential centres, such as nursing homes and children's homes, and extend into the community to cover those services that are carried out in the community?
Mr. Dobson:
Yes. As I have already said, we want to make sure that the standard of care delivered in the homes of individuals who are living in their own home is checked on and raised. Organisations such as fostering agencies also need to be checked on. The fact is that nearly everyone who provides social care to people in residential settings, in their own homes or through
Mr. Andrew Robathan (Blaby):
What flash of inspiration led to both the previous questions being identical? Were they planted?
Mr. Dobson:
I think they reflect the degree of concern on this side of the House about the appalling state of regulation, which we inherited from the previous Government, governing children's homes, old people's homes and other domiciliary services. I think they also indicate the extent to which my hon. Friends are determined to put the matter right and stick up and speak up for the people whom they were elected to represent. If one or two Opposition Members had been interested, they might have put down similar questions.
Mr. Ian Bruce (South Dorset):
Will we have to wait until the regional commissions are in place before we are told how mental hostels in places such as Weymouth are to be funded? The Secretary of State will know that, before he moved to the Home Office, his hon. Friend the Member for Brent, South (Mr. Boateng) was working to ensure that people with mental illness who did not need medical care could be looked after in the community in the types of hostels that we pioneered in Weymouth decades ago.
We have not received any information about the funding of those hostel--whether it be through housing benefit, the health service or social services. Will the Secretary of State please resolve that difficult problem, which he and his hon. Friends have acknowledged is real, and help the mentally ill whom his White Paper was supposed to assist?
Mr. Dobson:
If the hon. Gentleman will provide details of the particular circumstances in Weymouth, I shall do my best to sort them out.
Mr. Dobson:
It is no good the hon. Gentleman jumping up in the Chamber and expecting me to know the details of what is going on in Weymouth. I am very sympathetic to the problem as he has outlined it. I shall look into the matter and try to sort out the problem, if there is one.
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