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House of Commons

Tuesday 9 January 2001

The House met at half-past Two o'clock


[Mr. Speaker in the Chair]


Kent County Council Bill [Lords]


Message to the Lords to acquaint them therewith.

Medway Council Bill [Lords]


Message to the Lords to acquaint them therewith.

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Oral Answers to Questions


The Secretary of State was asked--

Modernisation Fund

1. Mr. Nick St. Aubyn (Guildford): If he will make a statement on allocations under the modernisation fund. [142896]

The Secretary of State for Health (Mr. Alan Milburn): In the last two years, £4 billion worth of extra investment for the national health service has been provided through the modernisation fund. It has been used to expand critical care, cancer and heart services. Among other purposes, it has been used to cut waiting times for treatment and to increase the number of nurses in training.

Mr. St. Aubyn: On how many occasions have the Secretary of State and his ministerial colleagues overridden the advice of civil servants on the allocation of money to bids for the fund?

Mr. Milburn: I think that the hon. Gentleman has confused the modernisation fund and the special assistance fund--perhaps he is starting the year as he means to go on. He appears to be alluding to the special assistance fund in calling for extra money for his health authority. It is true that we received advice suggesting that we put more money into West Surrey health authority than we initially put in under the special assistance fund, but we have agreed with official advice on how much money we should put into general allocations for that health authority. This year, £30 million extra will go to West Surrey as a consequence of the investment that we are making, and next year there will be extra investment of £31 million.

Dr. Jack Cunningham (Copeland): I welcome my right hon. Friend's determination to modernise the national health service, especially in west Cumbria and my constituency. I also welcome the substantial increase in the budget of North Cumbria health authority. However, does he recognise that money is not the sole issue? Will he examine specifically and urgently the collapse of breast services at the West Cumberland hospital in Copeland? There is widespread concern, not because the resources to sustain the service are not available but because it is proving very difficult to recruit radiologists of sufficient standing to fill the posts. When he considers the problem, will he also ensure that the solution is designed for the convenience and better health care of the women who need such services, and not for the convenience of administrators and consultants?

Mr. Milburn: I shall gladly consider the concerns that my right hon. Friend has raised. He has already raised them informally with me and I shall be glad to examine the specific problem. It is true that we have a problem with the recruitment of radiologists and surgeons for oncology services. That is the position throughout the country and, in large part, it reflects the problems that the

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NHS faces today, which are no longer problems of cash, but problems of capacity. There is a shortage of trained and skilled nurses and doctors. Over time, we will put that right. As a result of the record levels of investment that we are making, over the next four or five years, the six major specialties that deal with cancer services will see a 25 per cent. increase in numbers.

Mr. Philip Hammond (Runnymede and Weybridge): I am glad that the Secretary of State has come clean about his intervention to reduce the amount of money recommended by his officials for West Surrey health authority under transitional funding arrangements, but does he not understand that if he fails to answer the questions of my hon. Friend the Member for Guildford (Mr. St. Aubyn) about how, when and why he departs from official recommendations when making allocations under the modernisation fund, he will not dispel the suspicion that it is being used as a multibillion-pound slush fund, dispensed at his whim in an attempt to buy friends and influence in the run-up to the general election?

Mr. Milburn: I honestly do not know to what the hon. Gentleman and the hon. Member for Guildford (Mr. St. Aubyn) are alluding. Let me give them some examples of the use to which we have put the modernisation fund, then let the hon. Member for Runnymede and Weybridge (Mr. Hammond) substantiate his allegation.

In 1999-2000, to get waiting times down, we put an extra £260 million into the local health service through the modernisation fund; we also put extra money into cancer and coronary heart disease services. I think that, in the last financial year and the current one, we have put an extra £150 million into critical care services. The hon. Gentleman always bleats about lack of investment in such services, but I should have thought that he would welcome the fact that critical care, heart disease and cancer services, and efforts to cut waiting and modernise accident and emergency services are precisely the priorities of the national health service and the modernisation fund.

Primary Care

2. Helen Jackson (Sheffield, Hillsborough): What progress has been made in involving patients in primary care groups. [142897]

The Minister of State, Department of Health (Mr. John Denham): Excellent progress in involving patients has been made by primary care groups and primary care trusts. Those new organisations reflect and represent the interests of the community that they serve, partly through the lay membership, but largely by working together to engage and involve local people.

Helen Jackson: Sheffield has a good community health council that has stimulated an excellent community health forum in my constituency, but there is concern that, in the new system, the patients and public who participate in it will not have the same opportunities to get their voices heard. During the transition from community health councils to the new patients forums, how will my hon.

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Friend ensure that there will be no break in continuity when good initiatives, such as the one that I have mentioned, are in place?

Mr. Denham: My hon. Friend makes a very important point. The establishment of primary care groups has, so far as we can tell, led to an explosion in the number of patients forums throughout the country. Some are supported by CHCs and others are directly supported by the primary care group. The primary care group in my hon. Friend's constituency is one of several that want to become primary care trusts from April this year, and will therefore benefit from the proposals in the Health and Social Care Bill for every trust to have a statutory independent patients forum, which will not be appointed by Ministers, to represent patients' interests.

During the transition to the new arrangement, it will be important to ensure that valuable local forums are properly supported, and we will look to the health authority to do that. I understand that the primary care group wants Stocksbridge community health forum to continue. It is at an early stage of planning next year's budget and has not been able to make firm commitments, but it recognises the forum's value.

Mrs. Marion Roe (Broxbourne): Does the Minister agree that the Government are introducing new mechanisms for public involvement in the national health service because of their policy unnecessarily to abolish community health councils? If the councils are unsuited to represent patients' needs, will he tell the House why the National Assembly for Wales will not be abolishing them?

Mr. Denham: Many CHCs have done a good job, but that has largely been owing to the qualities of the individuals involved as officers and lay members rather than to their legal structure and powers. We want a step change and improvement in patient influence in the NHS. That is why the Health and Social Care Bill will, for the first time, put a statutory duty on every NHS organisation to involve and consult patients. It will establish for every trust an independent patients forum with the power to oversee the advocacy and liaison service in each trust. We shall ensure that there is an effective complaints system for individual patients and an independent source of advice and support for patients who want to take their complaint through that system. We shall give democratic local government the role that it should have had of overseeing the local health service. All those measures give patients a greater say in the future of the NHS. The functions carried out by CHCs will be performed by other bodies and new functions added. That is a step forward.

Helen Jones (Warrington, North): I am pleased to hear about that progress, but can my hon. Friend assure me that the new system will not replicate the problems of health authorities and trusts in which the poorest and most health-deprived areas are consistently under-represented in the forums, as they are in my area? Will he ensure that people with the greatest health needs get their proper say?

Mr. Denham: We hope to achieve that through a number of mechanisms. First, an independent appointments commission will appoint members of the patients forums, and we will look to those bodies to

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ensure that they are properly representative of the communities that they serve. Secondly, we propose--I am sure that we shall discuss this in detail in Standing Committee--to find arrangements to draw on a representative cross-section of people who have recently used the NHS to be members of the patients forums. Both those methods will allow us to achieve the aim that my hon. Friend sets out.

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