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Medical Laboratory Staff (Pay)

8. Mr. Hilary Benn (Leeds, Central): If he will make a statement on the pay of medical laboratory staff working in hospitals. [119061]

The Minister of State, Department of Health (Mr. John Denham): For the first time, we have offered all medical laboratory scientific officers--MLSOs--a guarantee of rises above projected underlying inflation, not just for one year, but for three years. In addition, trainees have been offered increases of up to 26 per cent. for last year, all MLSO1s have been offered 7.1 per cent., and we have offered to increase the minimum national starting pay for MLSO2s by 7.1 per cent. If accepted, all that would be backdated to 1 April 1999. We are also discussing positively with the NHS trade unions proposals to reform and modernise NHS pay, as we outlined last year in "Agenda for Change".

Mr. Benn: When I recently visited the pathology laboratories at St. James's hospital in my constituency,I met staff there who are committed to the work that they are doing, but concerned about the reward that they receive for that job, and about the difficulties that they face in recruiting adequate staff. I welcome the step that the Government have taken to recognise that problem through "Agenda for Change". Can my hon. Friend tell the House how soon he expects proposals to be forthcoming so that those staff, a vital group of backroom staff in the NHS, receive the reward that they feel is long overdue?

Mr. Denham: We are making good progress with the NHS trade unions, and I hope that we continue to do so. We hope to reach broad agreement about how the proposals would be implemented this summer or later this year. They would then have to be implemented effectively and properly by NHS employers throughout the country. On our side, we are determined to make good progress with the trade unions and, with good will on their side, I am sure that we can do that.

Sir Sydney Chapman (Chipping Barnet): I welcome the Minister's announcement today. Does he accept that there is still a pretty wide disparity in pay between medical laboratory staff and other professionals in the NHS, particularly after four years' service, when the disparity is about £4,000? Does he agree that there is an overwhelming case for medical laboratory staff to be included in pay review body reports?

Mr. Denham: As I should have said earlier, I pay tribute to the work done by all our medical laboratory staff, to whom hon. Members on both sides have referred. They do a tremendous job and are a key part of the health team. With regard to the disparity in salaries between those jobs and other professions, any existing disparities certainly did not begin to emerge over the past three years, but are a much more long-standing part of the pay system. It is possible, and it is envisaged in "Agenda for Change", that some professional staff groups might become members of the pay review body system. It is too early in the process to have reached agreement on which groups those might be. That is part of the overall package of

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measures that we are negotiating under "Agenda for Change" and on which we are keen to make progress in the next few months.

Dr. Liam Fox (Woodspring): The Minister knows that there is a crisis of confidence in the laboratory service and a major problem with recruitment and retention. Why will he not give the simple undertaking, which the Conservative party is happy to provide, that in future all medical laboratory staff will be included in the full pay review structure?

Mr. Denham: The hon. Gentleman is unbelievable. His party was in power for 18 years and had the opportunity to implement his proposal. That the hon. Gentleman makes such a suggestion without prior notice or discussion shows that nothing that he says can be taken seriously. We have made it clear that some professional groups can join the review bodies. However, that needs to be part of a negotiated package of changes to the national health service pay system, which will benefit not only staff but patients. The hon. Gentleman's proposal to announce one part of the negotiation as Opposition policy is not credible. He shows no understanding of what is necessary to provide a modern pay system for the national health service.

Osteoporosis

10. Mr. Dafydd Wigley (Caernarfon): What steps he is taking to improve facilities for identifying and treating those suffering from osteoporosis. [119063]

The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart): The Government take osteoporosis very seriously. Significant progress has been made in highlighting the importance of preventing osteoporosis and resulting fractures since the launch of the national strategy in June 1998. That provides a solid foundation for health authorities to develop local strategies. The Government expect to publish the national service framework for older people in the autumn. That will focus on areas of greatest concern to older people including falls and fractures partly in the context of osteoporosis.

Mr. Wigley: I thank the Minister for that hopeful answer. The cost of osteoporosis amounts to £4 million a day because of fractures. Will the Government provide specific funding for primary care groups to manage osteoporosis, especially for elderly people?

Ms Stuart: The causes and treatments of osteoporosis are complex. Medical conditions that result from osteoporosis, such as fractures, are fully funded and treated by the national health service. Several health authorities have adopted a strategy for prevention. Primary care trusts will continue to receive basic guidelines, which will be taken up with more enthusiasm in some areas than in others. To be frank, the response in some areas has not been as encouraging as we would wish.

It is important to note that the Care Standards Bill will set minimum standards in all care homes because elderly people are most at risk. Those standards have not yet been defined, but the consultation document, "Fit for

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the Future", makes it clear that facilities such as grab rails should be provided in homes. For the first time, minimum standards will apply throughout the country in homes, which house many of those most at risk.

Mr. Tam Dalyell (Linlithgow): The Minister has been candid. Why do differences exist in the response to the serious matter of osteoporosis in various parts of country?

Ms Stuart: When local health authorities decide priorities, prevention of osteoporosis may be higher on the agenda in some areas than in others. However, the national health service framework for the elderly and the Care Standards Bill will highlight osteoporosis and prevention. Prevention is a long-term issue, and our strategy includes work on better nutrition because vitamin D deficiencies and an unhealthy life style can cause osteoporosis. Health action zones have taken up those matters, and we are dealing with the differences in several ways.

Miss Anne McIntosh (Vale of York): The Minister rightly referred to the importance of prevention of osteoporosis. Has she had time during the recess to assess the evidence that shows that light gardening by the over-50s can prevent the onset of osteoporosis?

Ms Stuart: If the hon. Lady wants me to support gardening and exercise in the open air as measures to prevent osteoporosis, I am more than happy to do so.

Breast Cancer Unit, Nottingham

11. Mr. Vernon Coaker (Gedling): What discussions he has had with Trent regional health authority about the building of a new breast cancer unit at Nottingham City hospital. [119064]

The Parliamentary Under-Secretary of State for Health (Yvette Cooper): The national health service executive's Trent regional office is working with Nottingham City Hospital NHS trust to take forward its proposal for a new breast care centre. The case is considered to be of high priority by both the regional office and the Nottingham health community. The project will be considered by Ministers, along with other priorities, when the capital allocations for the next year are announced shortly.

Mr. Coaker: Is the Minister aware that the development of a new breast cancer unit at Nottingham City hospital is a huge local priority? I have visited the breast cancer unit and the work of Professor Blamey, Dr. Robin Wilson and the staff is well appreciated by the local community, but for too long they have had to work in substandard accommodation. With the extra money that we have made available, there are high hopes that they will soon have the first-class accommodation and facilities that they should expect for the first-class service and professionalism that they provide at the hospital.

Yvette Cooper: I shall certainly take on board the points that my hon. Friend makes. He has been a strong advocate for the new breast care centre and I can tell him

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that the regional office and Ministers will note his argument that it is considered to be a regional priority. We shall bear what he says in mind when we make a decision.

Domiciliary Care Agencies

12. Mrs. Sylvia Heal (Halesowen and Rowley Regis): If he will make a statement on his plans to regulate and inspect domiciliary care agencies. [119065]

The Minister of State, Department of Health (Mr. John Hutton): The Care Standards Bill will introduce a new regulatory framework for home care services. We have amended it to ensure that all domiciliary care agencies--not only those contracting with local authorities--will be required to register and be inspected annually by the National Care Standards Commission. A consultation version of the proposed regulations and standards will be published later this year.

Mrs. Heal: I welcome what my hon. Friend says about including all domiciliary care agencies in the proposed regulations, but can he provide an assurance on domiciliary care workers in particular, many of whom do an excellent job, provide a high standard of care and enable people to remain in their homes, which is usually their choice? Sadly, there have been cases of care workers abusing or taking advantage of the people for whom they care. Will the regulations take into account not only quality of service, but the recruitment and training of staff employed by the agency?

Mr. Hutton: I can give my hon. Friend that assurance and she is right to say that enabling more people to stay longer at home is one of the principal objectives that we have set for social services. If we are to succeed, we need higher-quality domiciliary care services. A key part of that is making sure that the right people with the right training and the right supervision are employed in domiciliary care agencies. I give her an absolute assurance that, as we develop those new national standards, we will put a premium on ensuring that domiciliary care workers are properly vetted, trained and supervised in future.

Mr. Paul Burstow (Sutton and Cheam): During the drafting of the domiciliary care regulations, will the Minister consider the difficulties that many private sector providers of such services face with the contracts and spot contracts that they are being given by local authorities? They are set at such unrealistically low prices that even now they find it difficult to provide a quality service: we know that many are leaving the residential sector and are beginning to abandon the provision of services at home. Insufficient resources are being allocated to guarantee the quality that he and I both want to be provided.

Mr. Hutton: I will consider the point that the hon. Gentleman raises, but I remind him that social services are being resourced at a record level. There is a significant increase year on year--more than twice the rate of inflation is going in--but how local authorities decide to use those additional resources and the rates at which they contract are matters for them. We have made it clear that we do not want rates to be set mechanistically, but we will look into those issues. I am sure he agrees that we

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need high-quality domiciliary care and residential care services and we expect local authorities to make sure that those services are available locally.


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