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House of Commons

Tuesday 3 December 2002

The House met at half-past Two o'clock


[Mr. Speaker in the Chair]

Oral Answers to Questions


The Secretary of State was asked—

NHS Legal Costs

1. Mr. Clive Soley (Ealing, Acton and Shepherd's Bush): What estimate he has made of legal costs to the NHS incurred by patients taking legal action in the last five years. [82616]

The Parliamentary Under-Secretary of State for Health (Mr. David Lammy): The NHS Litigation Authority has only collected information on legal costs incurred by the NHS in respect of all clinical negligence claims since April 2002.

Mr. Soley : In view of the amount of money and time taken, including that of professional staff in those cases, could we not find a way in which people can avoid suing, possibly by having a no-fault system? Alternatively, my hon. Friend may remember that some months ago a Mr. and Mrs. Maude chose not to sue, but put their money into a charitable fund, which was used to set up an online diagnostic service. My own constituent Mrs. Braganza also wanted to give money to a hospital despite the fact that it had made a mistake. We need to find a way of doing so that would alleviate both costs and time.

Mr. Lammy: I thank my hon. Friend for his comment. He may be aware that I was a clinical negligence lawyer before coming to the House—[Interruption.] I therefore know a little about the matter. The chief medical officer is currently reviewing clinical negligence and will report to Ministers shortly. As with all the options, a no-fault compensation scheme is one of the many things that he is considering.

Mrs. Marion Roe (Broxbourne): Does the Minister agree that prevention is better than cure, particularly in the national health service, and that in the past the role of community health councils has been extremely helpful in raising patients' concerns before legal action may have been necessary? Will he tell the House what measures the Government are taking to ensure the

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transfer of skills, knowledge and experience of staff and members of community health councils to the new structures for patient and public involvement in health?

Mr. Lammy: The hon. Lady will be aware that we are setting up the Commission for Patient and Public Involvement in Health, which will cover patients forums in all our primary care trusts across the country. We set up patient advice and liaison services to liaise with our constituents in hospitals, and a measure to establish a new inspectorate is going through Parliament. We are in close dialogue with the chair and new chief executive of the commission and I hope that I can make announcements shortly about the interim arrangements.

Mr. Michael Clapham (Barnsley, West and Penistone): Does my hon. Friend intend to make an assessment of the cost of needle stick injuries to the NHS? Will he consider introducing a directive to encourage hospitals to follow Barnsley district general hospital in having a needle stick injury strategy?

Mr. Lammy: My hon. Friend raises a serious issue, which the Department keeps under review. Guidance has recently been issued, but he is right to raise what is an important issue in all our hospitals.

Children's Hospices

2. Mr. Mark Simmonds (Boston and Skegness): If he will make a statement on levels of funding for children's hospices. [82617]

The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): Funding levels for children's hospices are determined through negotiation between hospices and primary care trusts. In addition, the new opportunities fund is considering applications from children's hospices to undertake a range of projects in support of children with life-threatening illnesses, for which funding starts next year.

Mr. Simmonds : I am grateful for the Minister's response. Despite the Government's rhetoric on palliative care, is it not true that only £4 million of the £50 million payout allocated by the Government has reached the hospice movement? Even more disgracefully, in many areas of England, is it not true that no moneys have been received whatsoever? If that is coupled with the employers' national insurance increase, which will impact on hospices from April next year, when will the Government get their act together and what will they do to expedite the payment of that well-deserved and much needed funding?

Ms Blears: The hon. Gentleman's question was about children's hospices, but he has clearly asked questions relating to adult specialist palliative care. I am delighted to bring him up to date, as his information is a little out of date. He will know that the Secretary of State announced an extra £10 million of funding for this year, in addition to the £50 million of funding that will be going in next year. If he was in touch with his voluntary

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sector organisations, he would know that they are delighted to be working in partnership with us to make sure that we get a new funding mechanism.

Mr. Lindsay Hoyle (Chorley): I am sure that my hon. Friend knows of the reputation of Derian house in Chorley and the care that is provided there. However, children and young people go there from all over the north-west and beyond, and it is difficult to get primary care trusts from a wider area to contribute money. Finance is always a problem. What help and support can the Under-Secretary provide?

Ms Blears: My hon. Friend is right. I am well aware of the excellent services of the hospice to which he referred. He is also right that because hospices provide services for children from a wide area, we need to get PCTs working together. New funding from the new opportunities fund can help to pump-prime new and innovative services, often for palliative care at home and in the community as well as in hospices.

Mr. Paul Marsden (Shrewsbury and Atcham): The Government's

They are not my words but those of Barbara Gelb of the Association of Children's Hospices. Are not the Government letting down the most vulnerable children in our society?

Ms Blears: Not at all. The Government are absolutely committed to helping children with life-threatening illnesses. That does not simply mean hospice care, although that is an important component. We are also dramatically increasing the carer's grant, which helps disabled children. The Diana Community Children's Nursing Network operates throughout the country and provides community nurses to help children with a range of life-threatening conditions. The Government take such an important issue extremely seriously.

Ian Lucas (Wrexham): Is not it clear that there needs to be a step change in our approach to funding the hospice movement? The level of care and the specialisms that hospices provide nowadays mean that they can no longer rely solely on voluntary contributions. Can we please have a more planned and integrated approach that involves the NHS in the provision of hospice services?

Ms Blears: My hon. Friend is right. We have embarked on exactly that course. Producing the National Institute for Clinical Excellence guidelines means that, at long last, we will have a proper service for palliative care. In the past, palliative care has been on the outside of the NHS. We aim to ensure that it is as much a part of the NHS as the rest of our treatment services.

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Avon and Wiltshire Mental Health Trust

3. Mr. James Gray (North Wiltshire): What discussions he has had about funding for the Avon and Wiltshire Mental Health Care Trust. [82618]

The Minister of State, Department of Health (Jacqui Smith): At the request of my hon. Friend the Member for South Swindon (Ms Drown), I met representatives of Avon and Wiltshire mental health care trust, the strategic health authority and local Members of Parliament on 29 October. The meeting enabled us to discuss both the financial pressures that confront the mental health care trust and national and local work to tackle the financial position.

Mr. Gray : I attended that meeting, and it was deeply unsatisfactory. The mental health care trust and the other local PCTs are starting life with debt of £100 million that they inherited from previous organisations. They are trying to live within their means, but that will mean closures of beds at the Cameron mental health care ward in Chippenham, of the day care facility in Malmesbury and at Rowden Hill, and of the rehabilitation centre at Devizes. Does the Under-Secretary agree that there is precious little point in her paying out funds to the trust if they have to be paid back in debt repayment? Is not there a strong argument for considering a moratorium on debt repayment so that the trusts can start their lives sensibly?

Jacqui Smith: Clearly, it is important that local health services live within their means. I know that much work is happening locally in the hon. Gentleman's constituency to ensure that we safeguard services.

Mr. Gray: Cuts.

Jacqui Smith: The hon. Gentleman mentions cuts, but the mental health care trust received 12.8 per cent. more income in 2002–03 than in 2001–02. That is why it has been able to improve services, with six more crisis resolution teams, eight more assertive outreach teams, at least 12 more community gateway staff and at least 14 more staff to give carers breaks. It is a bit rich for the hon. Gentleman to argue for more money now; he did not vote for it when he had the opportunity to do so.

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