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3. Mr. Michael Jack (Fylde): What data his Department receives from hospital trusts on the number of nurses each employs. [119056]

The Minister of State, Department of Health (Mr. John Denham): The Department receives information from national health service trusts on all nurses employed as part of the annual non-medical work force census. The census contains details of area of work, hours worked, age, gender and ethnicity. Data of that sort enable us to know that, in the year until last September, the number of nurses employed by the national health service increased by 5,580.

Mr. Jack: I thank the Minister for that information, but it is a great pity that some of the nurse numbers that he mentioned have not made their way to the Blackpool Victoria hospital, which has, since 1997, been struggling with a shortage of nurses. Thankfully, it appears that that problem is being solved, but in making its case for greater nurse numbers, the trust had difficulty in obtaining comparative benchmark nurse numbers from other local hospitals to help it to make its case to the North West Lancashire health authority to ensure that nurse numbers and activity moved upwards together. What assurances can the Minister give me that that problem will not occur again?

Mr. Denham: The right hon. Gentleman says, rightly, that the problem is being tackled. Indeed, as the House meets, a meeting is taking place between Blackpool Victoria hospital and the health authority to consider nursing numbers, and I understand that there are proposals for additional funds for additional nurses to meet that hospital's needs.

The right hon. Gentleman asks for an assurance that the problem will not occur again. One thing that makes that possible is the fact that the health authority has received a 6.23 per cent. real-terms increase in finances for the coming year--part of the record level of additional resources that my right hon. Friend the Secretary of State mentioned. It is that, together with the fact that we have increased the number of nurses in training where the Conservative party cut them, that makes it possible to address the need for nurses in NHS hospitals.

Mr. Nick Harvey (North Devon): Understandably, the Government are claiming to have brought more nurses back into the profession, which is very welcome, but are they not concerned that there are still nearly 15,000 vacancies? As they look forward to the future, are they not concerned that things might get considerably worse before they get better, given the new emphasis that they have been placing on intermediate care and caring for people in the community? Are they not concerned that the age profile of community nurses, occupational therapists and health visitors--some of the very professions on whom the burden of caring for people outside hospitals will fall--is very top-heavy, and that there will be a real problem of recruitment in those areas in the next

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few years? What further steps will the Government take to increase dramatically the number of nurses entering the profession and to reform the pay and conditions to keep the people who are already there?

Mr. Denham: The work force needs of the new, modern national health service is one of the key issues to be addressed by the modernisation action teams set up by the Prime Minister following the Budget announcement. They will obviously address the numbers of staff that we need and the expanded roles that we want nurses and other health professionals to take on board.

However, may I remind the hon. Gentleman of what we have already achieved? We inherited a difficult situation. The previous Government cut the number of nurses in training. As a result, there were about 15,000 fewer nurses available to recruit than there otherwise would have been.

The number of hard-to-fill vacancies--those that have been empty for more than three months--is about 7,000. Against that background, we got more than 5,500 extra nurses back into the national health service last year; we were able to attract more than 5,000 new nurses who were qualified but not nursing, either straight back into the national health service or into return-to-practice courses. There was a 73 per cent. increase in applications for nurse training courses last year.

All those figures show that, although there are challenges ahead, we have begun to turn the corner on the problem of nurse shortages, which has bedevilled the national health service for so long.

Mr. William Ross (East Londonderry): The Secretary of State said earlier that it was essential to use national health service capacity to the full. Does he agree that one of the great bottlenecks is the shortage of nurses trained for intensive care, because that ties up an awful lot of people in bed blocking when they should be out and about?

Mr. Denham: The hon. Gentleman is absolutely right. We did increase the number of critical care beds last winter, but there was still significant pressure on the national health service. I believe that the national health service, and the trusts and hospitals within it, know that we need to do more to address that problem in the coming winter. Obviously, one of the issues that the health service is now looking at actively throughout the country is the need to ensure that we have more trained intensive care nurses.

Patient Representation

4. Mr. Syd Rapson (Portsmouth, North): What steps he is taking to strengthen the system for representation of patients' views in the NHS. [119057]

The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart): The patient care empowerment modernisation action team and the wider consultation exercise with patients and the public on the national plan will develop and strengthen the representation of patients' views in the national health service.

Mr. Rapson: We have excellent hospitals in Portsmouth, but concerns have been expressed to me,

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mainly by elderly patients. They need more care, and extra effort must be made to ensure that they understand their rights. There is some confusion, so will the Minister make that extra effort to ensure that elderly patients and organisations that support them, such as Age Concern, understand their rights?

Ms Stuart: We are committed to developing a service that is sensitive to patients' needs. As part of the national plan development, we shall consult regionally and locally and ensure that all representative groups have an opportunity to comment and feed in their opinions. In addition, the action teams have considerable patient representation, which we hope will cover the whole spectrum of needs. We shall, of course, pay particular attention to the needs of the elderly within that framework.

Mr. Peter Lilley (Hitchin and Harpenden): Is not the best means of representing patients' views the right of their GP to refer them to the hospital of their choice? Why, therefore, have the Government effectively curtailed that right, and not even mentioned it in the circular on out-of-area treatments? What is the Minister's response to the president of the Royal College of Surgeons who, in last week's New Statesman, said:

Ms Stuart: I do not agree that the right of GPs to make referrals has been restricted in a way that will adversely affect patients' treatment. It is absolutely important that we end up with a system in which patients see the right doctor at the right time in the right place, and many of the modernisation programmes are geared towards that. That means that there must be some reconfiguration of services, but I do not agree that the system of GP referral is in any way under threat.

Mrs. Eileen Gordon (Romford): Will my hon. Friend join me in congratulating community health councils on the work that they do to represent patients and inform them of their rights? Does she agree that with more resources they could do much more work and represent many more patients?

Ms Stuart: Community health councils have an important statutory function, but some groups of patients and parts of the community may not have a sufficiently well-structured input into service reconfiguration. We are keen to broaden that base and to involve the community health councils. We want to build on the model of CHCs in certain areas that have been very innovative, and we should recognise their role in involving the local community and build on that success.

Dr. Liam Fox (Woodspring): Given that one of the roles of the House is to ensure that the rights of the weakest and most vulnerable are protected, what specific plans does the Minister have to improve representation for the mentally ill? In the light of yesterday's announcement, what specific ideas do Ministers have about advocacy for the elderly in the health care system?

Ms Stuart: It is, of course, extremely important that the most vulnerable have the greatest protection.

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The advocacy system is being examined as part of the national plan for development of patient empowerment, which can mean empowering individual patients themselves or their carers or those who speak for the patient. That remit also includes the mentally ill.

Dr. Fox: The Minister might like to write to me with a fuller answer, which can be put in the Library, as this issue is obviously important to hon. Members on both sides of the House. I welcome yesterday's announcement and the Government's conversion to a public-private partnership in rehabilitation of the elderly, but what representations can patients make in such a system of treatment, and what say will they have? What safeguards will be put in place to guarantee minimum standards of care? Given that NHS treatments are subject to the Commission for Health Improvement, what changes will be required to the Care Standards Bill as a result?

Ms Stuart: The hon. Gentleman's question rightly covers a range of issues, which I shall take one by one. Mental health patients will be taken much more into care. We have spent an extra £100,000 on NHS Direct for a special line for mental health service patients. The Care Standards Bill will strengthen services within the social care sector. As for evidence of greater involvement, I ask the hon. Gentleman to wait for the national plan, which will shortly be published. It will refer to real actions rather than aspirations.

Mr. Peter L. Pike (Burnley): A few moments ago, my hon. Friend referred to the important work of community health councils. Will the Government ensure that the councils can represent patients' views at local level? It is essential that they remain local and do not become remote, which is what the previous Government were threatening.

Ms Stuart: It is absolutely essential that representation and consultation always take place at local level. That is why we are strengthening the role of health authorities and considering closely ways of broadening the base of that representation, which may not always be through the community health councils. The councils play a vital statutory role and we are committed to widening their base, but always with a focus on local delivery and local input to serve local patients.

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