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House of Commons

Tuesday 26 March 2002

The House met at half-past Eleven o'clock


[Mr. Speaker in the Chair]


City of London (Ward Elections) Bill (By Order)

Order for further consideration, as amended, read.

To be further considered on Tuesday 9 April.

Mersey Tunnels Bill (By Order)

Order for Second Reading read.

To be read a Second time on Wednesday 10 April.

London Development Agency Bill (By Order)

Order for Second Reading read.

To be read a Second time on Thursday 11 April.

Oral Answers to Questions


The Secretary of State was asked—

Nurse Recruitment (London)

1. Joan Ryan (Enfield, North): If he will make a statement on the latest figures on nurse recruitment in London. [43715]

The Minister of State, Department of Health (Mr. John Hutton): There are currently 52,480 qualified nurses working within the national health service in London. That represents an increase of 5,330 compared with 1997. In the last year alone, an extra 3,250 qualified nurses began working for the NHS in London.

Joan Ryan: I thank my right hon. Friend for that welcome news on nurse numbers in London. He will know that access to affordable housing is an important factor in the recruitment and retention of key workers, especially nurses, in London. What progress are the Government making in tackling that issue?

Mr. Hutton: I agree strongly that housing is a key issue and that it will have a bearing on the success of our recruitment and retention initiatives. My hon. Friend will be aware that my right hon. Friend the Secretary of State for Transport, Local Government and the Regions announced significant additional resources for the starter homes initiative, and next year 2,300 NHS staff will be given an opportunity to get on the property ladder in London. That is a start.

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In addition, we are on track to meet our NHS plan commitment of an extra 2,000 units of affordable low-cost subsidised rented accommodation for NHS staff in London. Nearly 1,000 of those units have recently been commissioned. We have also introduced a new cost of living supplement for staff who are coping with the high cost of living in inner London. There is clearly more to do to tackle the problems, but the vacancy rate for nurses in London is decreasing and we are getting more nurses into training. Overall, we have a solid platform on which to build for the future.

Mr. John Wilkinson (Ruislip-Northwood): As it costs some £35,000 to train a nurse, can Her Majesty's Government place real emphasis on retention of skilled and experienced nursing staff? In that connection, can the Government bear it in mind that it is most important to have stability in nursing careers? For example, proposals to move the cancer centre from Mount Vernon hospital can only cause a disturbance, a loss in morale and a haemorrhaging of nursing jobs. Can the Minister also bear it in mind that the proposed transfer of Harefield to inner London was also unpopular with nursing staff?

Mr. Hutton: I understand the hon. Gentleman's general point. That is why we have introduced a number of changes, which we will continue to pursue. First and foremost, the way to produce the stability that he and others would like is to keep the investment going into the NHS, and there is a message in that for his Front-Bench spokesmen and party.

We have made a significant investment to improve the working terms and conditions of staff. Hundreds of nurses who left the NHS have returned to work in it in London since 1997. That is in no small part to do with the substantial increases in the salaries of nurses who work in London and the growing investment that is helping to improve child care facilities. Those two factors are likely to make a positive contribution in the future as well.

Mr. Andrew Robathan (Blaby): What recruitment has taken place in the developing world for nurses in London? On a recent visit to Ghana, we were told that agencies, not trusts, were recruiting "jumbo jet loads" of nurses to fly to London and elsewhere in the country, thereby denuding the developing world of the health staff that it needs? It is important that those nurses are recruited locally. Will the Minister comment on that?

Mr. Hutton: I agree that it is important to protect health services in developing nations. I simply point out to the hon. Gentleman that given 18 years in which to do that, his party never quite managed to take the opportunity to do anything positive to resolve the problem. We now have a firm set of arrangements with commercial agencies. The NHS is not recruiting, and will not recruit, in developing third-world countries because that is unfair to the people there. The hon. Gentleman's description of jumbo jet loads of nurses coming from Ghana is somewhat exaggerated.

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Health Care (Deprived Areas)

2. Helen Jones (Warrington, North): What steps he is taking to improve health care for those living in deprived areas. [43716]

The Secretary of State for Health (Mr. Alan Milburn): Extra resources and staff are being provided in many deprived areas. Alongside that, there is a better focus on preventing ill health rather than just on treating it.

Helen Jones: I am grateful to my right hon. Friend for that reply. Within Warrington's boundaries are examples of precisely the sort of health inequalities that the Government are tackling. What assurances can he give me that, when it is set up, the new Warrington primary care trust will direct extra resources to those health deprived areas of my constituency? What monitoring arrangements will the Government put in place to check that that is happening and to ensure that we get the outcomes we want?

Mr. Milburn: My hon. Friend is right about her constituency—of course she is; she probably knows it better than I do, although I have visited it on occasion.

David Taylor (North-West Leicestershire): It's by the sea, you know.

Mr. Milburn: My hon. Friend is being helpful, as he sometimes is.

My hon. Friend the Member for Warrington, North (Helen Jones) is well aware that there is in her area a problem of health inequalities. That problem is the reason why extra money has been made available through the health inequalities adjustment.

Primary health care trusts, which are to come online in factors from next week, provide a better opportunity to focus on public health and health inequalities than the previous structures, which were to some extent distant from the local communities they were intended to serve. Health authorities are somewhat at a distance, whereas PCTs will be much more local and will be able to forge closer working relationships with local authorities, local businesses, voluntary sector providers and others precisely to deal with the problems my hon. Friend identifies. We will take care to ensure that PCTs do not merely commission good services, but do all within their power to ensure that health inequalities, which are a problem in her part of the world and mine, are dealt with properly.

Mr. George Osborne (Tatton): How will health inequalities be tackled by the massive bureaucratic reorganisation currently taking place within the health service? My constituency faces a new mental health trust, a new primary care trust and a new strategic health authority—all at the same time. There is concern in Cheshire, for example, that being lumped in with Merseyside, which has very different health needs, will result in different health inequalities not being properly dealt with by the new bureaucracy.

Mr. Milburn: I do not think that there will be more bureaucracy—far from it. In fact, we have taken money out of the bureaucracy that was, as the hon. Gentleman

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well remembers, introduced under the Conservatives' internal market, of which he is a passionate supporter but which has now gone from the national health service. The Conservatives constantly urge the Government to be less centralising and less interventionist and to ensure that our health service is built more from the bottom up than from the top down, and that is precisely what the new primary care trusts are designed to achieve. I hope that the hon. Gentleman will reflect on his remarks and, for once, learn something.

Mr. Neil Turner (Wigan): I welcome the 50 per cent. real-terms increase in health funding that we in Wigan have received since 1997. However, more than 20 of the 24 wards in the borough of Wigan are in the worst 20 per cent. of this country's wards in terms of health. Unfortunately, when the weighting is applied, the current formula reduces the amount of money we get. That works against the Government's plans to sort out both health inequalities and social exclusion. Is my right hon. Friend going to make progress on creating a new formula that recognises real health needs and ensures that PCTs get the funding they require to tackle those needs?

Mr. Milburn: Yes, that is precisely what we want to do. Two things have happened, the first of which is that we made some interim changes to the formula for distributing NHS cash to local health authorities. We introduced the health inequalities adjustment, which is about £130 million this financial year, and is £148 million next financial year, starting 1 April. That is designed to recognise the particular problems faced by deprived communities in many parts of the country in dealing with ill health and some of its root causes.

Secondly, we are now in the process of reviewing the whole way in which NHS cash is distributed to local communities. In future, it will be important to ensure that health cash goes to those areas with the greatest health need. That is right and it is part and parcel of what we need to do generally in our country: of course we must improve the health of the population overall, but as a Government and as a nation we legitimately have the objective of securing faster improvements in health among the poorest people in our society.

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