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Norfolk and Norwich Hospital (Access Road)

12. Mr. Richard Bacon (South Norfolk): What discussions he has had with the Department for Transport, Local Government and the Regions and the Highways Agency concerning the provision of an access road for the new Norfolk and Norwich hospital; and if he will make a statement. [26371]

The Minister of State, Department of Health (Mr. John Hutton): My noble Friend Lord Hunt of Kings Heath has raised the issue of access to the new Norfolk and Norwich university hospital with the Department for Transport, Local Government and the Regions. The Highways Agency has confirmed that the direct access road from the A47 to the new hospital cannot be approved, on grounds of safety.

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The national health service has so far spent more than £4 million on improving road access to the new hospital site, and an additional £1 million has been earmarked for further improvements. Norfolk county council is now urgently considering other options for improving access.

Mr. Bacon: Does the Minister agree, while recognising that he is in no sense to blame, that it is unacceptable to spend £229 million of public money building a major new hospital and then not ensure that high-quality road access is provided as an integral part of the development? Will he use his good offices to apply every possible pressure to those responsible, to ensure that a speedy solution is found to that very important problem?

Mr. Hutton: Yes, I am happy to give the hon. Gentleman that assurance and we are working very hard to ensure that there is a sensible outcome. There is widespread consensus that improved and better access to the hospital site is needed. A taskforce of the four local authorities concerned has been set up. I understand that its first meeting is next week and I am sure that the hon. Gentleman, if he is able to attend, would be welcome. If he cannot come, I will ensure that he is kept properly informed of progress.

Mr. Henry Bellingham (North-West Norfolk): When looking at the road links, will the Minister also look at the A and E department of that hospital, which depends crucially on those road links? Did he see an article in the local newspaper the other day, headed, "Delays at A & E"? It said:

Is it not a sad reflection on the Government that they cannot even build a brand new hospital and deliver for that hospital a proper, functioning, A and E department?

Mr. Hutton: That is a very disappointing response from the hon. Gentleman. We do not want to stray too far into this territory, but his party had 18 years in which to build a new hospital for Norwich and it never quite managed to do it. We have built a new hospital. Yes, issues still need to be addressed, but my right hon. and hon. Friends and I have yet to hear one word of welcome for the new hospital from the hon. Gentleman.

Disabled People (Croydon)

13. Geraint Davies (Croydon, Central): What plans his Department has to support the provision of sustainable jobs for those with mental and physical disabilities in Croydon. [26372]

The Minister of State, Department of Health (Jacqui Smith): Participation in employment is an important factor in promoting well-being and social inclusion. The Department of Health contributes to work in this area through a range of initiatives such as the welfare-to-work joint investment plans for disabled people, and the

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prominence given to employment issues in the national service framework for mental health and the learning disability White Paper, "Valuing People".

Geraint Davies: My hon. Friend will be aware of the very valuable work done by Crosfield Industries, which employs more than 100 people with disabilities, turns over more than £3 million of commercial revenue—

Michael Fabricant (Lichfield): Calm down. [Laughter.]

Geraint Davies: Thank you very much. It turns over more than £3 million of commercial revenue from windows, assembly and electrical work. It is supported by Government and council subsidy. Will my hon. Friend give her backing to continued Government support for providing sustainable jobs for people with disabilities—jobs which support them by caring for their physical and emotional needs and giving them a stake in the economy and society?

Jacqui Smith: I thank my hon. Friend for that question. Unlike Opposition Members, who have reacted to it with such hilarity, I think that providing work opportunities and the support necessary for disabled people is a pretty important and serious issue. I certainly would commend the work that Crosfield and Crosslink do with disabled people. That is part of the Government's workstep programme, which helps and supports 22,000 people throughout the country, enabling them to get or keep a job, and I understand that at least 90 people in my hon. Friend's constituency are supported in that way. I hope that he continues his support for that important work in his constituency; the Government certainly will.

Residential Care

14. Mr. Nick Gibb (Bognor Regis and Littlehampton): How many beds for elderly people have been lost in residential homes between May 1997 and the latest available date. [26373]

The Minister of State, Department of Health (Jacqui Smith): The Department's figures show that there were 261,600 residential care home places for older people in March 1997. That figure had fallen by 1,500, to 260,100, in March 2001.

Mr. Gibb: It is strange that the hon. Lady cites those figures, because experts appointed by her Department—Laing and Buisson—show 49,000 fewer beds in residential care homes since 1997, as a consequence of which almost 6,500 beds are now being blocked in NHS hospitals. Is not that an absurd misallocation of scarce NHS resources?

Jacqui Smith: There are pressures on the care home sector. That, of course, is part of the reason why the Government are investing £300 million this year and next year, partly to help to stabilise the care home sector; but I really do not think that a discussion about this important issue is helped by Opposition Members' consistent misuse of figures. Laing and Buisson has no axe to grind, and the Laing and Buisson figures actually showed a net loss of 19,000 beds since 1996—a period in which there has also

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been a considerable increase in the number of older people receiving intensive care packages at home. In other words, we are doing what older people want us to do—helping them to be independent.

Kevin Brennan (Cardiff, West): My hon. Friend is right to concentrate on intensive home care packages. Is she aware of the report in this month's British Medical Journal that suggests that, if the NHS could reduce the acute bed/day average down to levels such as those in the Kaiser organisation in California, we could save up to 17 per cent. of the NHS budget? Does not that send the message that it is important to have such acute home care packages and that we should concentrate on reform, rather than just pouring money into the health service?

Jacqui Smith: My hon. Friend is absolutely right. That is why the investment that has already gone into intermediate care and the £300 million that the Government are providing over this year and next year is buying not only more care home places, but more intermediate care to keep people out of hospital and help them move more quickly from acute beds to independence. It is also buying more intensive home care, so more people are receiving nursing and other support to stay at home. This is a time of transition in the care that we provide to our older people, and a mature debate recognises that and the extra support that the Government are providing to help to promote independence and to maintain capacity in the care home sector; it does not focus on misusing statistics to the benefit of no one.

Mr. Nicholas Winterton (Macclesfield): Although I appreciate the content of the Minister's replies to the questions that she has been asked on this subject, does she not agree that there is a problem with residential care for the elderly and that a number of elderly people require residential care? Although home care packages can play a very important part, there is a problem because of the increased costs that residential care proprietors have to incur. Will she not accept that there is a problem with the costs incurred in certain areas of the country, not least in my own, where a residential care home provided by an independent body—County Lifestyle Services—has closed in Cheshire? Will she not take account of the fact that some people require care homes for their retirement?

Jacqui Smith: I agree with the hon. Gentleman. Some people need care homes, and the fees and commissioning arrangements at local authority and local health service level are important for the publicly funded residents in those homes. That is why my predecessor set up a strategic commissioning group, to bring together representatives of local authorities and of independent health care and residential home providers to develop an agreement which the Government published at the same time as we invested £300 million in the system. The group also addressed the need for better commissioning and explicitly said that, when local authorities make decisions about fees, they should bear in mind the costs faced by care homes and the quality that we want for residential care provision.

Decisions about fees are rightly made at local authority level. However, with the guidance and extra investment that the Government are putting into social services, it is

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possible to remodel our services and to maintain the necessary high-quality capacity in residential care to give a real choice to our older people.

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