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The Secretary of State for Health (Mr. Alan Milburn): We urgently need to reverse almost two decades of underinvestment and failed attempts to modernise the core IT infrastructure. Later this summer we will provide details about a nationally run IT programme for the NHS backed by large-scale investment.
Dr. Pugh: Given that the Wanless report stated that getting IT strategy right was essential to fulfil NHS targets, and given that the Government have had three reports about it and three attempts at doing that, what guarantees can they give that the available resources will be used to meet the Government targets and will not be re-routed, which happened previously?
Mr. Milburn: There are some important lessons to be learned, not only in the NHS but throughout the public sector and in large private sector organisations that have tried to implement new IT programmes. First, we need proper standardisation of IT procurement. Secondly, we need competent leadership, which we now have and can take further forward. We are currently advertising for a national IT director. Thirdly and crucially, we must ensure that IT investment reaches those whom it needs to reach. It is fair to say that that has not always happened in the past. I assure hon. Members that the programme will be centrally run in future so that we can ensure that we avoid some of the piecemeal solutions of the past.
Mr. Milburn: No, it is more than five. I believe that 98 per cent. of GP practices are now connected to the NHS net, thanks to the investment in improved health service IT. We have made the investment available. Would the hon. Gentleman match it?
Dr. Fox: The Secretary of State has been promising for five years to meet the investment targets for putting into the health service the IT necessary to deliver many of the pledges that he set out in the national plan. I can give him the answer to my question, as he is unable to provide it. Only five trusts appear set to meet their targets, although the initial target was 35 per cent. of trusts by April 2002. The right hon. Gentleman is well behind that target. This problem has been reported on round the country, not least by Mr. Howell Huws, the IT director at Hammersmith hospitals NHS trust, who said that, last year, many health authorities raided supposedly ring-fenced IT budgets to meet service pressures and political imperatives, and that suggestions were emerging that the pattern may be repeated this year.
Under political pressure from the Secretary of State, money is being taken out of IT programmes, mental health, and many other areas that deserve investment, to meet abstract ministerial targets and to distort the figures to make things look better for Ministers. Under this Government, the control of information, the setting of targets and the health of the Government are more important than the health of the public.
Mr. Milburn: I do not think that that is the case. It is certainly true that there have been some problems with IT investment. That is why it is important that, when we direct investment into parts of the national health service,
Almost 3 million accidents requiring medical treatment occur in the home each year. Some involve serious injuries resulting in long-term disabilities, and each of those represents a personal tragedy for the person involved, and for their family and friends. These accidents also place a huge burden on our health service, and particularly on our emergency services.
Many of the deaths resulting from accidents in the home could have been prevented if householders had followed simple rules or installed safety equipment. Some of the worst tragedies are accidents suffered by children, and it is worth noting that this is child safety week. Every day, 10 under-five-year-olds are severely burned, and the disfigurement and pain that result can cause terrible mental and physical trauma in a child throughout the rest of his or her life.
Every parent knows how difficult it is to keep a constant eye on a two-year-old and how quickly their hands can reach the flex of a kettle or the handle of a pan of boiling water or milk. It is easy to give simple reminders to parents to keep all pans to the back of the hob and kettle flexes secured, but the figures suggest that too many children are still being badly hurt.
The Bill would place a statutory requirement on local authorities to promote safety awareness in the home. This could be done by means of public information being sent to every home annually, with the council tax notices. Local authorities could co-ordinate the work of other agencies to ensure that homes in which there is a higher risk, such as those in multiple occupation, or those where elderly residents or children live, were targeted with advice and offered the installation of safety devices at a discounted cost.
By introducing a Bill that will reduce the cost of safety measures, I hope that we can reduce the number of accidents and deaths. Statistics complied by the Royal Society for the Prevention of Accidents suggest that the number of accidents in the home can be clearly linked to income and deprivation levels. For example, the injury death rate for children in unskilled families is five times greater than that for children from professional families. Residential fire deaths are 15 times greater for children in social class V than for children in social class I. Houses in multiple occupation tend to have low incomes, and are also more likely to have fires and suffer resulting loss of life.
Lower-income households often have to choose between investing in safety equipment or purchasing the other necessities of life. Given the correlation between income and accidents in the home, it seems that the choice is not always made in favour of the equipment. Too many people assume that accidents will never happen to them. Each year, there are 45,000 accident and emergency admissions for under-five-year-olds who have fallen down stairs. A safety gate can be used to restrict the movement of young children around the home, particularly into the kitchen area, and thereby help to reduce the number of accidents. Such a gate costs about £20, which is roughly 20 per cent. of the weekly income of a single parent on benefit with one child. The removal or reduction of VAT would offer a further incentive to purchasing this essential equipment. Further statistics from RoSPA suggest that more than 10,000 accidents each year involve a fireplace, a grate or a fender. A fireguard costs a minimum of £20.
It is not just children who can fall victim to accidents in the home: the elderly and disabled are also vulnerable. Each year, about 1,100 over-75-year-olds die as a result of accidental falls in the home. In addition, there is the risk of hip fracture and the resulting loss of mobility and restriction on quality of life. That risk is especially high in older women, who are more likely to suffer from osteoporosis and to live on their own. A useful piece of equipment is a hip protector, worn by those most at risk from a fall, which disperses a fall's impact on the hip bone. Hip protectors have proved highly effective in reducing the number of injuries, but they are also fairly expensive, as each person requires three or four sets. An average cost of £30 per set can be a significant sum for many pensioners or disabled people.
Each year, nearly 500 people in the UK are killed in house fires. The numbers have fallen in recent years, but even one preventable death is too many. More than 18,000 people are injured as a result of fires. Most fires occur in the home, most are avoidable and most affect those who are society's vulnerable. The installation of domestic smoke alarms has significantly reduced the number of deaths. Where a functioning detector is present, early warning of a fire is given and the likelihood of escape is dramatically increased. However, in some cases it was discovered that, although a smoke alarm was present, the battery had been removed or was no longer working. Reducing VAT on smoke alarms would help to promote alarms that are tamper-proof or mains-wired.
The final element of the Bill is the requirement that all new domestic properties be fitted with a fire sprinkler system. As a condition of building permission, developers would have to fit sprinklers as well as smoke alarms. I suspect that the construction industry would raise the issue of cost, but who can put a price on a person's life? We know that no one in the UK has ever lost their life through a fire when a full sprinkler system was present, which surely shows that the benefits outweigh the costs. Furthermore, if the Bill's other provisions were approved, the removal or reduction of VAT on such systems would be of great assistance.
Sprinklers are a proven method of reducing the number of deaths caused by fires. Automatic sprinkler systems are used more than any other fixed fire protection system, with more than 40 million sprinklers fitted worldwide every year.
In June 1986, the city of Scottsdale, Arizona in the USA passed a local regulation requiring all new residential and commercial property to have sprinkler protection. A report was published 10 years later on the impact of the regulation. The findings concluded that 35 per cent. of single-family homes and 50 per cent. of multi-family homes in Scottsdale had sprinkler protection. Over that period 598 fires broke out in homes in the city. Of those, 44 resulted in sprinkler activation. The fire was contained by only one or two sprinkler heads in 41 of the 44 cases. There were no fatalities in the sprinkler- protected homes. In the other dwelling fires, 10 deaths occurred in eight fires. The average cost of a sprinkler fire was $1,544 and that of other fires was $11,624. The facts speak for themselves.
The Government have a target of reducing the number of fire deaths by 20 per cent. by March 2003. The Bill could help to achieve that. I realise that my right hon. Friend the Chancellor may not be enthusiastic about any measure that would reduce VAT and hence the revenue over which he has control. However, I hope that he and the Government will recognise that the Bill would encourage and stimulate demand for safety measures, as a means of reducing the millions of accidents that occur each year, and that he will take this opportunity to discuss the matter with the EU to review the lists of goods and services that could benefit from a reduction in VAT.
I wish to thank the Royal Society for the Prevention of Accidents and the Fire Protection Association for their assistance in the preparation of the Bill, and the fire and rescue service, especially in Hertfordshire, for its support for the Bill.