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House of Commons

Tuesday 4 July 2000

The House met at half-past Two o'clock


[Madam Speaker in the Chair]


Alliance and Leicester Group Treasury plc (Transfer) Bill [Lords]

Order for Second Reading read.

To be read a Second time on Tuesday 11 July.

City of Newcastle Upon Tyne Bill [Lords] (By Order)

Order for Third Reading read.

To be read the Third time on Tuesday 11 July.

Greenham and Crookham Commons Bill (By Order)

Order for Second Reading read.

To be read a Second time on Monday 10 July at 7 o'clock.

Oral Answers to Questions


The Secretary of State was asked--

Children's Hospices

1. Mr. Lindsay Hoyle (Chorley): If he will make resources available to ensure that children's hospices receive the same level of funding as other hospices. [127508]

The Parliamentary Under-Secretary of State for Health (Yvette Cooper): Children's hospices are on the same footing as adult hospices. We are increasing the resources available to the national health service across the board, and we expect local areas to put in place palliative care strategies; that includes support for children, and families too.

Mr. Hoyle: I do not think that that is quite the case--far from it. In fact, Derian house, based in Chorley, does not get the same funding as an adult hospice would. All that we are asking for is equal funding. Quite rightly, my neighbour, Mr. Leo Duffy, who is the treasurer to Derian house, came to see me and asked me why children's hospices do not receive the same amount. I could not give him an answer, but I promised that I would raise that with my hon. Friend the Minister. I do hope that we can change the situation and that funding can be found, especially as children's hospices--particularly the one in Chorley--

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take children from all over the country, and therefore the burden should be spread and there should be direct funding from the Government.

Yvette Cooper: It is a matter for local commissioners to develop palliative care in each area and to set up appropriate commissioning arrangements. We expect that to include support for children as well as for adults. We are aware that, where children have illnesses that are life-threatening, there are specific additional needs for support for such children and their families. That is exactly why we have introduced the Diana's children's community nursing teams, who often work with hospices to provide extra support directly for those children and families in need.

Mrs. Marion Roe (Broxbourne): As chairman of the all-party parliamentary hospice group, I am aware that not just children's hospices but many other hospices are finding it extremely difficult to meet their revenue costs mainly from voluntary subscription, and that some are facing serious financial problems. Will the Minister undertake to review the resourcing from the Government for hospices, to ensure that they remain viable and continue to provide such a worthwhile service in our community?

Yvette Cooper: We recognise the huge contribution that the hospice movement makes to palliative care. We have identified the need for more systematic support for palliative care, especially for cancer; that is why Professor Mike Richards is currently developing a supportive care strategy for palliative care that includes suggestions of how we can improve that across the board.

Commission for Health Improvement

2. Mr. David Borrow (South Ribble): If he will make a statement on the role of the Commission for Health Improvement. [127509]

4. Mr. Jim Cunningham (Coventry, South): If he will make a statement on the role of the Commission for Health Improvement. [127511]

The Secretary of State for Health (Mr. Alan Milburn): The commission's role is set out in section 20 of the Health Act 1999. The Commission for Health Improvement is the health service's first independent inspectorate. It began its programme of hospital reviews last week. The commission will help to raise standards in all parts of the NHS as part of the Government's drive to tackle unacceptable variations in performance across the NHS.

Mr. Borrow: As a Member of Parliament representing an area where postcode medicine is at its worst, I welcome that statement by my right hon. Friend. Does he agree that users of the NHS attach much more importance to the raising of standards within the NHS than they do to the policy of the Conservative party, which is to promote private health insurance and the use of the private sector?

Mr. Milburn: My hon. Friend is right. The country has a fundamental choice to make. The Conservatives seem

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to have made their choice. The hon. Member for Woodspring (Dr. Fox) confirmed in the House last week--and on television earlier last week--that their policy is now to contemplate spending about £468 million on subsidising people who already have private health insurance, in company-based schemes, out of the taxpayer's pocket. I believe that it is also the case that, earlier this year, the hon. Gentleman and, indeed, the Leader of the Opposition explored the possibility of the taxpayer subsidising individuals who had private health insurance policies. The deadweight cost of that alone would come to £1 billion. That is more than the costs of this year's nurses' pay rise and of the modernisation, in which we are investing, in casualty departments in every part of the country.

The Conservatives have made their choice; we have made a different choice. Our choice is for the national health service--free, fair, funded from general taxation and based on need, not ability to pay. I believe that that will be the choice of the British people at the next general election.

Mr. Jim Cunningham: Will my right hon. Friend ensure that the commission raises standards in such a way that it will be impossible for the Conservative party to introduce a two-tier system in the national health service and, more important, for things such as hip replacements and so on; and that it will ensure that the private sector, as supported by the Conservative party, will not get a foot in the door?

Mr. Milburn: The Commission for Health Improvement has a very important role to play in the NHS. Although regrettably the Opposition voted against the establishment of the commission in the Health Act 1999, many people agree that it is about time that we had some form of independent inspectorate for the national service. We all know from our constituents that the quality of care, standards of service and even the services on offer vary immensely according to the part of the country in which people live. That is unfair and it has to change. One of the ways that we can best do that is through an independent inspectorate such as the Commission for Health Improvement.

My hon. Friend is right. Our ambition as a Government is to raise the standards of care, so that patients everywhere--and not just in some places--get first-class health services.

Mr. Peter Lilley (Hitchin and Harpenden): Does the Secretary of State accept that what drives up quality in most services is not just inspectorates--important though they are--but the choice of users within the service? Are we not fighting with one hand tied behind our back by depriving users of the national health service of choice between different hospitals? Should not that choice be restored?

Mr. Milburn: I have heard the right hon. Gentleman make such comments before both in this place and in the articles that he has written for newspapers. We have made the point before that he is wrong. In fact, if he cared to examine the history of choice in the national health service, he would know that, prior to the introduction of the Conservatives' internal market in the early 1990s, there was freedom to refer for individual general practitioners.

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Unfortunately, the internal market mechanisms, and particularly the establishment of GP fundholding, meant that that choice was denied to 50 per cent. of GPs. We have restored the right to refer, because every primary care group now has the choice of where best its patients should receive the care that they need.

Mr. Philip Hammond (Runnymede and Weybridge): The Government have announced plans for a proper watchdog for independent hospitals--a watchdog that will have teeth and the power to inspect the hospitals and to deregister them if they are not safe and satisfactory. By comparison, the Commission for Health Improvement is a toothless tiger with no sanctions available to it. Given the Government's policy of treating increasing numbers of NHS patients in the private sector, is it not time to establish a single, unified regulatory and inspection body that is responsible for monitoring standards across all hospitals, so that people can be confident of the quality of health care that is being delivered to them wherever it is delivered and however it is financed?

Mr. Milburn: I hear what the hon. Gentleman says, and I know that he has been exploring some of these issues in Committee with my hon. Friends. The Commission for Health Improvement and the National Care Standards Commission have very different functions. The Commission for Health Improvement is intended to act as an independent inspectorate for the national health service as a managed care system, which is what it is. The National Care Standards Commission has a quite different function. However, the hon. Gentleman is aware, as my hon. Friends are aware, that we introduced an amendment during the passage of the Care Standards Bill through the House to ensure that there is much closer co-operation and flexibility between the two commissions. That is the right thing to do, and it will help to ensure that wherever people receive care--whether in the health and social care system or in the public or private sectors--the quality of care that they receive is always of the highest possible standard.

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