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8. Dr. Julian Lewis (New Forest, East): Pursuant to his letter to the hon. Member for New Forest, East of 7 December, what progress his Department has made in making artificial limbs with lifelike silicone coatings available to NHS patients. [142903]

The Minister of State, Department of Health (Mr. John Hutton): In cases in which silicone cosmesis is clinically appropriate, we wish to see equitable access across the country. In 2001-02 and recurrently, funding will therefore be provided for the NHS to increase existing provision of high to low definition cosmesis which, in future, will be available through a new contract from the NHS Purchasing and Supply Agency.

Dr. Lewis: I welcome the Minister's response, but may I express concern about whether that provision will ever appear? Does he recall the case of my constituent, a little girl called Laura Giddings, whose lower leg was blown off in the Planet Hollywood terrorist outrage in South Africa? Does he recall the campaign that was waged throughout the second half of 1999 to enable the parents of children in that position to get realistic-looking limbs for them? Does he recall the meeting that we had in October that year, and the letter that he wrote in November 1999? In that letter, he said:

If the Minister is saying that silicone cosmesis is going to come, but that he does not know when that will be, so far down the line and so close to a general election, will he at least reconsider a proposal which he always refused to consider in the past, and allow parents who choose to get more lifelike limbs for their children to at least be given the value of the free limb as a contribution to the cost of the more expensive limb, which gives the child a chance to look normal? Otherwise, it is just more warm words and more great headlines for the Government, but no real action whatever.

Mr. Hutton: We have just had a classic example of an hon. Member reading out a pre-rehearsed question and completely disregarding the answer given by a Minister from the Dispatch Box. The hon. Gentleman was clearly not expecting me to announce that, from April 2001 onwards, the new high definition/low definition cosmesis will be available on the NHS--[Interruption.] I am sorry, but that is going to happen. I know that the hon.

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Gentleman and his right hon. and hon. Friends do not like that, but I must point out to him that his party had nearly 20 years in which to make that provision available, but they never did. I have just announced that the new cosmesis will be available on the NHS, and it is a great shame that the hon. Gentleman could not find any words to welcome that important announcement.

Dr. Alan Whitehead (Southampton, Test): I pay tribute to the response of the Department of Health to the campaign that was waged locally by the hon. Member for New Forest, East (Dr. Lewis), a number of other people and me on lifelike prosthetic limbs, and which was supported by our local newspaper, The Southern Daily Echo. Does my hon. Friend accept that the provision will make a tremendous difference to the life chances of children for whom this treatment will now be available, as it will enable them to wear lifelike limbs out and about, to school and wherever they go? I assure him that Justin Gregory and Hannah Rideout, who are children of my constituents, will benefit directly from the change and will regard the provision as a great step forward, enabling them to lead a life enhanced by this change in NHS policy.

Mr. Hutton: I am grateful to my hon. Friend, and pay tribute to the work that he and others have done in drawing attention to this issue. Making the new equipment available is an important step change for the NHS. It is long overdue, but we are now taking action. It is obviously important, especially for young people, but also for everyone who has had a limb amputated, as they should have access to the latest technology and the widest range of choice in prosthetic limbs. We are taking action, and this is a good example of what we mean by modernising the NHS. It is a great pity that the Opposition do not recognise that.

Domiciliary Care

9. Mrs. Anne Campbell (Cambridge): If he will make a statement on the availability of domiciliary care for the elderly. [142904]

The Minister of State, Department of Health (Mr. John Hutton): The NHS plan is providing an extra £900 million by 2003-04 for investment in intermediate care and related services to promote independence and improve quality of care for older people. These additional resources will enable 50,000 more people to live independently at home through additional home care and other support services. In 1999-2000, the number of people aged 65 and over who were helped to live at home rose by 20,000 compared with the previous year. Overall, the total revenue provision for social services in 2001-02 will be £9.848 billion, which represents an increase on provision in 2000-01 of 6.2 per cent. in cash terms.

Mrs. Campbell: I thank my hon. Friend for that reply, which will be warmly received in Cambridge, which has a huge domiciliary care shortage that causes severe problems, especially for elderly people. Will he tell me whether the Government plan to ease recruitment and retention problems in places such as Cambridge? Will he

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also comment on the situation that might arise if we had, say, £24 million worth of cuts in the constituency? Would he like to say how that might impact on the situation?

Mr. Hutton: Yes, I might like to say how that would impact. We all recognise that we need to do much more to support and promote independence, especially to allow older people to stay at home for longer, and we are beginning to take that action. I pay tribute to the work that has been done in Cambridgeshire, where the council provided home care support to an extra 6 per cent. of people this year.

I hear what my hon. Friend says about local recruitment difficulties. We are working with the Local Government Association and others to ease recruitment and retention problems. The new single status agreement that has been negotiated for local authority employees will allow authorities to tailor their pay rates to meet local labour market conditions. We have a great deal more to do, but it is clear that all the progress that we have made would be compromised and jeopardised by the return to government of a Conservative party that is not pledged to match our expenditure on social services, which would cut social services spending and which would threaten the independence and health of many older people in our country.

Mr. Nick Harvey (North Devon): Ministers have said several times in recent weeks--indeed, the Prime Minister made the same comment before Christmas--that there has been a big rise in the number of domiciliary care packages during the past year and that that offsets the loss in care home places. If that is so, and 20,000 new domiciliary care packages are available, will the Minister tell us where the packages are and how they are being costed and paid for? Will he publish an area-by-area list showing where they are? Even at this late stage, on the eve of introducing legislation, will the Government reconsider the report of their royal commission on the matter? It recommended that all personal care, whether provided on a domiciliary basis or in residential care homes, should be paid for. Is the hon. Gentleman genuinely satisfied with the current circumstances, which are so illogical that those with long-term chronic conditions do not get their personal care paid for, while those with acute conditions do? That cannot be right or just, so will the Government reconsider the matter before introducing legislation?

Mr. Hutton: The initial figures that the hon. Gentleman wants have already been made available by the publication of the performance assessment framework. The collection of the statistics was overseen by the Office for National Statistics. Figures are available by authority, so he and other Liberal Democrat Members might wish to consider those statistics. I am sure that he will find the information that he seeks.

The hon. Gentleman's other point concerned personal and nursing care. We and our society have a choice to make. The Government have decided to make available nearly £1 billion of new investment to support a wider range of health and social care services that will benefit hundreds of thousands of older people in our society. Of course, we could have spent that money in the manner proposed by the royal commission, but that would have benefited relatively few people. We have decided to benefit the many, not the few. It is not true when the hon.

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Gentleman says that people do not receive help for their personal care costs when they are in residential care. Seven out of 10 people in nursing homes already receive help with all or some of their personal care costs.

Mr. George Stevenson (Stoke-on-Trent, South): Will my hon. Friend tell me whether Ministers have concluded their response to Professor Edwards's report into elderly care provision in north Staffordshire? If they have done so, when will the response be available?

Mr. Hutton: I am afraid that I cannot answer that question specifically, but I shall ensure that my hon. Friend receives an answer as soon as possible.

Dr. Liam Fox (Woodspring): Now that the Prime Minister has started to count the beds of patients who are receiving domiciliary care as NHS beds, can the Minister confirm that the Prime Minister believes that he has potentially created 20 million beds? Will he also tell us whether a double bed now counts as two beds and whether a room with two beds now constitutes a ward in the Prime Minister's fantasy NHS?

Mr. Hutton: What a bunch of hypocrites members of the modern Tory party are!

The hon. Gentleman is completely wrong in all that he says. We are not counting the extra 20,000 home care packages as NHS beds; that is completely untrue. We are providing more beds in the NHS.

I think most Labour Members will take the hon. Gentleman's complaints about bed losses with a pinch of salt. He might like to know how many beds were lost when his party was in government. [Hon. Members: "Tell us."] I will: 40,000.

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