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Mr. Milburn: We have increased the funding for Barnsley health authority by 8.7 per cent., which is an increase of just under £15 million. That will help to address some of those very real health problems. As the local constituency MP who is very active on health issues, my hon. Friend will know that some of these problems are pretty intractable and structural, and it will take time to deal with them. That is why it is important that we get an appropriate level of health service expenditure into the local NHS, and that we sustain that funding over a period of years. It is terribly important to do what we have done today, which is not just to make available a one-year allocation, but to give health authorities a sense of where they will be in two or three years' time.

Mr. David Heath (Somerton and Frome): I, too, welcome the extra spending. I want to return to the point made by the hon. Member for Crawley (Laura Moffatt). I presume that the welcome target that the Secretary of State has announced for administering thrombolytic drugs is within 30 minutes from the point of arrival at accident and emergency units. In my constituency and in much of the west country, it can take twice that long to get from the scene of the event to the accident and emergency unit, partly because of the distances involved and partly because of the overstretched ambulance service and the lack of air cover. Will he consider precisely how drugs and treatment can be administered at the earliest possible point for people who live in rural areas that are not easily reached by ambulance crews?

Mr. Milburn: The hon. Gentleman makes an extremely good point. It is self-evident that it is far more sensible, especially in rural areas, to take the drug to the patient than to expect the patient to travel to the drug. We need to do both. We need to improve the time that patients have to wait in accident and emergency departments to be

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given thrombolysis, and we also need to ensure that more and more paramedics are trained so that they can administer the clot-busting agent on the spot.

Ann Keen (Brentford and Isleworth): I welcome my right hon. Friend's statement, and it will be very welcome to my constituents and to people in west London. So as to bring senior nurses back into the health service, has my right hon. Friend considered the senior clinical nurses who were evicted overnight from sites around the country and who went into higher education, which is what nurse education should be in my opinion? We should find ways of using their clinical expertise and knowledge, and perhaps give them joint roles in the health service. Many of those clinical leaders are now stuck in higher education and do not have the same right to enter hospital sites and hospital trusts.

Mr. Milburn: I am grateful to my hon. Friend, who is extremely knowledgable about these issues. I agree with her that we must provide the right incentives, the right education and training and the right employment opportunities to ensure that we not only recruit more nurses back into the NHS, but retain them once they are working for the health service. We cannot have more nurses coming back into the service and an excess of nurses leaving it. We are moving in the right direction. We are turning the corner: there are now more nurses working in the NHS than there were just a year or so ago, but there is a lot more work to do.

With regard to nursing careers becoming more academic, we must get the balance right. We must give nurses who will become nurse consultants and operate at a high clinical level appropriate academic training, but we must not lose the fundamental caring nursing skills that are the backbone of the nursing profession.

Mr. Roger Gale (North Thanet): I welcome the 8.4 per cent. increase that has been re-announced for east Kent. By January slightly more, not fewer, beds would have been available in east Kent, but they will not be available because they will be blocked. Nothing that the Secretary of State has said this afternoon will change that.

Broomfield Lodge nursing home in my constituency is one of Kent county council's preferred providers for the elderly and senile, but because it is underfunded by about £100 to £150 per week per client, and because it is competing with NHS agencies for nurses in terms of costs, it is likely to close. If it does, the 18 clients who are there now will join the others who are blocking beds in hospitals, and add to the problems caused by the loss of 200 beds in the private nursing sector until April. There is nowhere for those patients to go this winter. What are the right hon. Gentleman and the Secretary of State for Social Security going to do about it?

Mr. Milburn: I am grateful to the hon. Gentleman for giving at least a modicum of welcome to the extra resources provided for his health authority area. As for delayed discharges and the position in the care home sector, it is true that there are problems in some parts of

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the country. That is largely a product--especially in the south-east--of rising property prices, and of people getting out of the business because--

Mr. Philip Hammond (Runnymede and Weybridge): Because of the Care Standards Act.

Mr. Milburn: It has absolutely nothing to do with the Care Standards Act 2000, as the hon. Gentleman knows fine well. We have given care home owners seven years in which to introduce the new standards. The idea that they are suddenly walking away from their businesses today is ludicrous.

As I have said, there are problems in some parts of the country. That is precisely why social services departments--I hope this applies to the area represented by the hon. Member for North Thanet (Mr. Gale); if it does not, perhaps he will take up the matter with Conservative-controlled Kent county council--have increased the number of intensive home care packages of support in order to provide people with more care at home this winter than was provided last winter. Moreover, social services expenditure, which rose by an average of 0.1 per cent. under the last Government, has been rising by 3.1 per cent. over the past few years.

Mr. Paul Flynn (Newport, West): The Secretary of State is gradually giving real hope to all who use the health service that intractable problems will now be tackled. One such problem, in regard to which this country has performed very badly, is the huge number of hospital-acquired infections. What will the Secretary of State do to tackle that? It is claimed that up to 5,000 deaths a year arise from hospital-acquired infections. That leads to a huge waste of resources because patients are staying in hospital beds for much longer than would otherwise be necessary. The problem has been tackled with great success in the Netherlands--when can we follow its example?

Mr. Milburn: My hon. Friend is right. Although we are making a lot of money available to the NHS, and although the NHS has a clear reform programme and a good deal of commitment to making changes, real and intractable problems nevertheless exist.

There is no quick-fix solution to the problems of the NHS. The issue of hospital-acquired infection is very serious: as my hon. Friend says, it affects many patients, and it also costs the taxpayer a pretty penny. That is why the Minister of State, Department of Health, my hon. Friend the Member for Southampton, Itchen (Mr. Denham), recently issued clear guidance to all NHS hospitals saying that they must improve their standards of cleanliness and decontamination.

I can tell my hon. Friend that we intend to publish all the standards reports that we receive from hospitals by April next year, so that the public can see the progress we are beginning to make. It will not be easy, however, and it will take some time.

Mr. Paul Burstow (Sutton and Cheam): Will the Secretary of State comment on reports in yesterday's Evening Standard that winter pressures now appear to be

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becoming autumn pressures in Greater London? Already people have been exported from Greater London because no intensive care beds are available, and because there are still not enough intensive care nurses. Can the right hon. Gentleman assure us that we shall have extra nurses this winter, so that we do not experience the same crisis in London that we experienced last year?

Mr. Milburn: To say that the figures that were quoted in yesterday's Evening Standard are evidence of a crisis is fundamentally misleading. The number of intensive care transfers is slightly down compared with the same period last year, and the figures have fallen since September this year. I hope that the hon. Gentleman will not fall into the same trap as the official Opposition--they are looking for, and are determined to foment, a winter crisis. Indeed, they are determined to declare war on the national health service this winter. I hope that he realises that there are people--and newspapers--in this country, and some Members of Parliament, who are no friend of the NHS.

Mr. Jonathan Shaw (Chatham and Aylesford): Tomorrow I will meet primary care staff in my constituency. I am sure that they, like me, welcome the extra cash for the west Kent health area. In tackling some of the inequalities that my right hon. Friend mentioned, especially in respect of mental health and coronary heart disease, does he agree that it is essential for primary care trusts to identify the people at the greatest risk in a community? In his next announcement on capital expenditure, will there be an allocation for investment in information technology? Such preventive measures require primary trusts to have access to good IT in order to carry out that essential work.

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