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Hospices
3. Sir Nicholas Winterton (Macclesfield): What proposals he has to increase his Department's funding for hospices. [59120]
The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): I congratulate the hon. Gentleman on the honour that he received at the weekend. [Hon. Members: "Hear, hear."] I am sure that it is a timely acknowledgement of his work over many years in Parliament and elsewhere in the community.
The Government have pledged in the NHS cancer plan that funding for specialist palliative care services, including hospices, will increase by £50 million a year by 2004. We announced recently that the full basic salary costs of specialist registrars in palliative care in voluntary hospices will now be met centrally, and we clarified that the NHS should not charge hospices for support services, such as pathology and ambulance services, and that agreed drug costs should also be reimbursed by the NHS.
Sir Nicholas Winterton: I thank the Minister and the House for their generous and kind sentiments.
May I advise the House that, 12 years ago, my wife, the hon. Member for Congleton (Mrs. Winterton), and I jointly opened East Cheshire hospice in the presence of the then Bishop of Chester? Sadly, the council of the hospice very recently announced that it will have to close four of its 15 beds, because it can no longer afford to pay the staff necessary to man a 15-bed hospice. Will the Government look at the matter urgently and make proposals to speed up the release of additional funds to the hospice movement—not least the East Cheshire hospice—because the beds and the services that hospices provide are urgently needed?
Ms Blears: I thank everyone in the hospice movement up and down the country for their tremendous work, which has made the United Kingdom a world leader in palliative care. I am aware that East Cheshire hospice has an excellent, nationally recognised facility for specialist child bereavement counselling.
In 2001–02, the hospice received funding of £292,000, which increased this year to £302,000, and an additional £20,000 is available from the palliative care strategy funds. Therefore, there has been a 10 per cent. uplift, but I acknowledge the increasing pressures on hospice services. I shall certainly ensure that we see whether we can do more to ensure that the increased investment announced as part of the cancer plan reaches front-line services, where it is desperately needed. Statutory funding
for hospices has increased in by 14 per cent. over the past two years. We are making progress, but I acknowledge that there is much more to do.
Mr. Andy Reed (Loughborough): I am sure that my hon. Friend is aware of the excellent work of Rainbows children's hospice, which is in my constituency but which looks after the east midlands. Is she aware of the difficulties faced by such hospices, which receive only about 10 per cent. of their funding from the NHS, with the remainder coming from the generous support of people in Leicestershire and the east midlands? Hospices find it difficult to work with the increased number of primary care trusts, so will she ensure that a co-ordinated approach is taken to the problems? It would be easy for a small number of hospices to drop out of the system, because their PCT might think that they were not absolutely necessary in any particular financial year. That, of course, would have an enormous knock-on effect on the fund-raising activities of places such as Rainbows.
Ms Blears: My hon. Friend makes the important point that the voluntary sector needs to be properly co-ordinated to make sure that its voice is heard in its negotiations with PCTs. We gave the national hospice movement funding of £54,000 last year to make sure that the voluntary sector's voice is heard and that PCTs are fully aware of its needs. PCTs are now drawing up proper service level agreements to ensure a more formal relationship between the hospice sector and the NHS.
Children's hospices are relatively new. They have developed in the past 20 years and are now getting on to a proper footing. Increasingly, however, more funds are available through the "quality protects" programme and through the carers grant, which funds short-term care in children's hospices. The situation is improving.
Lady Hermon (North Down): Will the Minister kindly explain what progress has been made in exempting hospices, such as those run by Marie Curie Cancer Care, from VAT?
Ms Blears: The issue of irrecoverable VAT that faces cancer charities, such as Macmillan, and the voluntary sector as a whole is currently being considered by Customs and Excise and the Treasury. Macmillan has specifically brought the matter to my attention and I am currently in discussions and considering the issue extremely closely. I know of the difficult effect on the future investment decisions that Macmillan is considering, and I am keen and anxious that we enter into close negotiations with the Treasury and Customs and Excise to see whether progress can be made.
Mr. Bill O'Brien (Normanton): I welcome my hon. Friend's statement on the additional support that is being given to the hospice movement, but may I appeal to her to release money immediately? About £60 million has been requested to help to save some of the beds that will be closed if additional resources are not available within a short time. The PCTs cannot provide additional resources at the moment and Wakefield hospice in my constituency faces the threat of bed closures if additional resources
cannot be made available. I therefore appeal to my hon. Friend to look generously at the release of additional funding immediately.
Ms Blears: I am aware of the excellent work of Wakefield hospice and of how much that hospice is valued by the local community. My hon. Friend makes an important point. As I said to the hon. Member for Macclesfield (Sir Nicholas Winterton), there is concern about getting the funds announced in the cancer plan, which are in the NHS baseline, through to the front line. I intend to see whether we can put further mechanisms in place to strengthen the release and availability of that money. However, my hon. Friend should also be aware that the moneys for palliative care services are not confined to hospices. Importantly, they are also used to provide care at home and in the community—services that are increasingly valued. People ought to have a choice in such delicate and sensitive matters.
Mr. Simon Burns (West Chelmsford): Does not the Minister see the paradox? The Government might be increasing the amount of money for hospices—albeit too slowly to stop bed closures and to prevent them from refusing to take some terminally ill people because of a lack of money—but from next April they will increase the burden on hospices through national insurance contributions. Has the Minister calculated what it will cost the hospice movement to pay those increased contributions?
Ms Blears: National insurance contributions are not simply an issue for hospices—
Ms Blears: I take the point. National insurance contributions will be an issue for many organisations that contract with the health service. We have said that primary care trusts need to take account in their commissioning arrangements of the fact that hospices and other organisations will face increased costs. That needs to be included in their negotiations for the services that will be available to them. We are contemplating that matter, which will be dealt with by the primary care trusts.
Ms Blears: I understand that it is 0.7 per cent. of the current funding for hospices.
Digital Hearing Aids
4. Mr. Ben Chapman (Wirral, South): If he will make a statement on the availability of digital hearing aids on the NHS. [59121]
The Minister of State, Department of Health (Jacqui Smith): We are committed to extending the benefits of digital hearing aids provided as part of a modernised service. We have invested more than £30 million in the modernising hearing aids services project over the past three years. This will bring the number of sites providing the service to 50 by the end of this financial year, with a
further 15 ready to start from April 2003. By the end of April this year, the services had fitted more than 30,000 digital hearing aids.
Mr. Chapman: I thank the Minister for that response; it will be welcome news to my constituents. However, can she say when the hearing aids will be available and whether her Department plans to issue guidance to PCTs on funding modernised hearing aids so that national roll-out can proceed as quickly as possible? Will she comment on the steps she has taken to ensure that there are sufficient trained audiology staff to deliver the service in all regions?
Jacqui Smith: I am sure that my hon. Friend is pleased and reassured to hear that Wirral hospital is part of the second wave of those included in the project. The project management team, which is managed on behalf of the Department by the Royal National Institute for Deaf People, has contacted each of the 30 sites that will join the project this calendar year and is in the process of visiting each service.
To assess the current service—obtaining, for example, details of the sites involved, staffing and information technology needs—the team will discuss the new service and implement the timetable for modernisation, including the timetables to ensure that new technological systems and new staff training are in place so that the necessary staff are available to fit digital hearing aids. I assure my hon. Friend that the first of the new-wave sites will be fitting digital hearing aids by the beginning of October and all 30 will be fitting them by the end of March 2003.
Mr. James Gray (North Wiltshire): Would the Minister care to tell the House when VAT first became payable on digital hearing aids?
Jacqui Smith: The important point is that whereas a Tory Government would introduce charges, when, under this Government, people receive a hearing aid on the NHS, it is free.
Mr. Tom Levitt (High Peak): The NHS is the largest purchaser of hearing aids in the whole world, so it can get a good deal by bulk-buying digital hearing aids, which reinforces my hon. Friend's point. Is she aware, however, that some PCTs do not provide their own hearing aids but buy them from trusts outside their local area? Even when those neighbouring trusts are within the new wave and are providing digital hearing aids, they are not available to people who live outside the trust area. It is therefore vital that the roll-out continues. Will the Minister tell the House the time scale for the national roll-out so that we know when those services will be made available to people who do not live in an area where the PCT currently provides them? Some 4 million people could benefit from that.
Jacqui Smith: My hon. Friend makes an important point about the purchasing power of the NHS. We have worked very closely with the RNID on contracting, and we have had some success in reducing the price of hearing aids to the NHS, ensuring that we will be able to develop that roll-out as quickly as possible.
My hon. Friend will know that introducing a modernised hearing aid service is not just about changing from an analogue to a digital hearing aid. It is also about
ensuring that the new methods necessary for fitting digital hearing aids are in place. That is why we are working with the Institute of Hearing Research to evaluate the current programme, so as to ensure that we are able to roll it out as quickly as possible, while giving the best service to people who will receive digital hearing aids in future.
Dr. Vincent Cable (Twickenham): Will the Minister confirm that by next March it will still be the case that only one third of people in England will have access to digital hearing aids through their local hospitals? When will the national roll-out be completed so that all our constituents have access to that vital service?
Jacqui Smith: I can confirm that in just three years it has been possible to ensure that digital hearing aids will be available on the NHS for a third of patients. As I pointed out to my hon. Friend the Member for High Peak (Mr. Levitt), however, this is not a simple process of shifting from one type of hearing aid to another; it is important that the trained staff and necessary infrastructure are in place so that we can make sure that people get the quality service from the NHS that they expect. I certainly want the success of the pilot scheme to be rolled out as quickly as possible, and clearly we will consider investment for that as part of the spending review, but we must ensure that quality is maintained as we roll out the service.
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