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The Minister of State, Department of Health (Mr. John Hutton): The NHS is fully committed to providing access to health care on the basis of need. The health care requirements of homeless people are being addressed through local health improvement plans, personal medical services pilots focusing specifically on the homeless, and general medical services development schemes. In addition, the Department has provided additional funding to support the needs of homeless people with mental health problems in London.
Ms Buck: Is my hon. Friend aware of the significant contribution that has been made by Kensington, Chelsea and Westminster health authority to the work of the rough sleepers unit, especially in the provision of much needed mental health services? That has come at a considerable cost to the health authority, which has sustained the bill for mental health services, sometimes at the cost of displacing local people from those services. Will he undertake to give sympathetic consideration to the bid that the health authority is putting together to provide a long-term answer to mental health services, partly to relieve the strain on my local health authority but also to guarantee the long-term sustainability of the action to tackle rough sleeping?
Mr. Hutton: I can give my hon. Friend the assurance that we will look sympathetically at those proposals. The more work we do on homelessness and mental health, the more we uncover substantial unmet need. It is part and parcel of the work that the Government are doing to ensure that the resources are in place to respond to the need once it has been identified. My understanding is that the regional office is already in discussions with the trust to consider the question of how additional resources might be used to help to deal with the problem. I will take my hon. Friend's comments seriously and get in touch with her in the near future.
Mr. Henry Bellingham (North-West Norfolk): Is the Minister aware that one of the problems that homeless people face is the time it takes to get a CT scan in hospital? I have had many letters from constituents who complain about how long it has taken to get a scan in the Queen Elizabeth hospital in King's Lynn. What will the right hon. Gentleman do about it?
Mr. Hutton: It will be a combination of things, as I am sure the hon. Gentleman understands, including more investment, more staff and more training. We are making significant resources available to improve the range of diagnostic equipment that supports the needs of his and all our constituents.
The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): Since it became operational on 2 July 2001, the NHS Appointments Commission has announced 613 appointments, of which 37 were to posts in the north-east. All those appointments were made in accordance with the commission's procedures, which have been endorsed by the Commissioner for Public Appointments, Dame Rennie Fritchie.
Mr. Jones: I thank my hon. Friend for that reply. In the recent appointment of the chair of North Durham NHS trust, a method of selecting candidates was used that was not in the published procedure. I have also raised concerns about the method of consultation of Members of Parliament in the appointment of NHS board members. In her reply to my Adjournment debate last week, my hon. Friend gave assurances that she would look into those matters and ask the NHS Appointments Commission to update its published procedures. What progress has been made in that, so that the people of North Durham can have confidence that the process is open and transparent?
Ms Blears: I have, indeed, had the pleasure of discussing the issues at some length with my hon. Friend at some late hour last week, and I did undertake to consider whether all the steps in the appointments process would be made transparent on the website and in the written documentation. I have asked Sir William Wells, the NHS Appointments Commissioner, to ensure that that happens. I have also expressed the concern that Members of Parliament should be properly notified when appointments are made that are relevant to their constituencies. That procedure has not been as tight as it might have been, but we are all entitled to have the best up-to-date information on the people who will lead our trusts and authorities and provide leadership for the NHS. I am grateful to my hon. Friend for raising the matter and I am sure that he will go on to support the people who have been appointed in his area to do an excellent job in providing high quality services for local people.
On community hospitals and community ownership, it is important that, as we move towards a more decentralised and more devolved NHS, we strengthen the relationships between local communities and the local hospitals and the local health service that are there to serve.
Dr. Phyllis Starkey (Milton Keynes, South-West): My patients who have been treated for cataracts on the NHS but in a local private clinic are grateful that that capacity has been used. However, there are concerns about potential conflicts of interest arising when consultants operate in one place on both private sector and NHS patients and when consultants refer patients to one sector or the other. Will the Secretary of State assure me that such conflicts of interest will be investigated and that they will not be allowed to arise?
Mr. Milburn: If my hon. Friend's constituents have raised specific concerns, I shall be very happy to consider them. It is important that such conflicts of interest do not arise and that the appropriate safeguards are in place. However, if we can use the additional spare capacity available in private sector hospitals for the benefit of NHS patientswhether to provide cataract or cardiac operationsit is sensible to take the position that that is precisely what we should do provided that safeguards are in place, that we have the appropriate clinical standards and and that we obtain good value for money for the taxpayer.
Dr. Julian Lewis (New Forest, East): Given that the BUPA hospital in Redhill is negotiating with the NHS to set up a dedicated surgical centre to provide for an anticipated 5,000 hip and knee replacement operations, will the Secretary of State tell us whether the medical staff carrying out those operations will be employed by BUPA or by the NHS?
Mr. Milburn: I think that the hon. Gentleman will be aware that negotiations are currently taking place and that they are going extremely well. I hope that we can resolve them satisfactorily from both points of view before too long. The arrangement that we have in mind is for BUPA to continue to employ its own staff. It may have a limited number of medical staff on its books and it will certainly have some nursing staff. The intention is for NHS doctors, nurses and other staff to work in the current private hospital on NHS terms and conditions, but they will be managed by BUPA.
Today, the hospital almost exclusively treats patients according to their ability to pay. If negotiations go well, in a year's time, it will be exclusively treating patients, not according to the size of their wallets, but according to the scale of their needs.
Mr. Milburn: We will continue to monitor all those issues. As I said, it is important that both patients and taxpayers receive a good deal. I can give my hon. Friend the assurance that not only will we seek to drive a good financial bargain for the taxpayer but, even more important, we shall want to ensure that, if people are treated in a private hospital or a NHS hospital, they will be provided with the highest clinical standards possible.
Mr. Milburn: In terms of cost, the hon. Gentleman is well aware that I told the Select Committee on Health about a month ago that we would make about £40 million available precisely to fund more operations, using the spare capacity of private sector hospitals to treat NHS patients. That is double the level provided last year. If local primary care trusts want to contract for more operations from private sector providers, that is a matter for them. The great divide between the Labour party and the Conservative party is not whether the NHS patient is treated in an NHS hospital or a private sector hospital; it is whether we provide them with more choices, which is what we want to do, or impose more charges on them, which is what the hon. Gentleman wants to do.
Dr. Fox: The great division is not between our parties; it is between members of the Government. The Secretary of State said that he wanted a hypothecated health tax, and the Chancellor said no way. The Prime Minister wanted European Union spending levels, and the Chancellor said forget it. The Secretary of State wanted an NHS monopoly, the Prime Minister wanted no barriers to delivery, but the Chancellor simply wants to get closer to Downing street. When the Secretary of State is not consulted about announcements and called useless and sidelined, who in the Governmentif anyoneis making health policy?
Mr. Milburn: I am not sure how the hon. Gentleman's question is relevant to use of the private sector. If we can take advantage of spare private sector capacity in BUPA hospitals, General Healthcare Group hospitals and BMI Healthcare hospitals for the benefit of NHS patients, that is precisely what we will do. At the same time, we will continue to invest extra resources in NHS hospitals. The great divide is between the Labour Government saying that there should be more investment and the hon. Gentleman's party saying that there should be less.