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11 Feb 2003 : Column 751—continued
Health Provision
4. Peter Bradley (The Wrekin): What progress he has made in reducing the postcode lottery in health provision. [96676]
The Secretary of State for Health (Mr. Alan Milburn): New national standards and the work of the National Institute for Clinical Excellence are spearheading our attack on the postcode lottery of care. However, the biggest lottery in health care is between patients who have to wait for treatment on the NHS and those who can afford to pay for it privately. I can tell the House today that, building on the choices already offered to NHS heart patients, it is my intention to make choice of hospital available to more NHS patients who need an operation, so that by December 2005 all NHS patients will have choice within the health service, instead of having to opt out.
Peter Bradley : I thank my right hon. Friend for that answer, but I wish to direct his attention to a different kind of postcode lottery. I acknowledge the significant increase in funding for the Telford and Wrekin primary care trust of 34 per cent. revenue and 14 per cent. capital over the next three years, which is the top of the range in both orders. However, will he acknowledge that Telford and Wrekin start from the position of having £719 to spend per patient per year, compared with an average nationally of £819, and that we start £12 million, or 9 per cent., behind our fair shares target? In three years' time we will have closed that gap to £10.5 million, or 6 per cent., but will he use targeted funding to help Telford and Wrekin and other PCTs to close that gap more quickly?
Mr. Milburn: My hon. Friend makes a good point about the problems that his local health service and primary care trust face. As he knows, that is why we adjusted the formula for redistributing cash, and I made a statement to the House in December announcing new resources and a new formula. Those will inevitably take time to kick in, but he is right to say that the PCT in his area has received a well above the national average share of resources—more than 30 per cent.—which will allow the local health service to plan to meet needs in the local community. It is better that such decisions are taken at a local level, instead of through extra targeted funding that we could provide nationally.
Dr. Richard Taylor (Wyre Forest): When will the document on configuring hospital services, which will have the aim of preventing inequalities and the postcode lottery, be published?
Dr. Brian Iddon (Bolton, South-East): My right hon. Friend will know that the Royal Bolton hospital is very short of capacity, and I hope that he will come to see that for himself before too long. Does he agree, therefore, that the introduction of the Greater Manchester choice
programme will alleviate some of that pressure and help my constituents to access operations in the hospitals in the Greater Manchester conurbation?
Mr. Milburn: Yes, I hope to visit the Bolton area before too long to fulfil a promise that I gave to my hon. Friend. He will be aware that parts of the north-west, including his own, have some of the highest waiting times for hospital treatment. Overall, waiting times are falling, but they are still too long in some areas. That is why we will announce plans today for patients to exercise choice. If they cannot get a short waiting time at their local hospital, they will be able to choose another hospital. That will be the case in Greater Manchester and in other parts of the country, so that we can test the new approach and ensure that patients can exercise informed choice in elective surgery in all parts of the NHS. We intend to bring forward that scheme in July and to extend it to the whole country next year.
Mr. Andrew Rosindell (Romford): Will the Secretary of State acknowledge that one of the worst aspects of the postcode lottery is that relating to coronary heart disease? Has he had time to see the figures published by the British Heart Foundation, which were printed in last week's Romford Recorder, showing that the London borough of Havering has one of the worst records for that? Will he outline what the Government intend to do to improve that service?
Mr. Milburn: I regret to say that I have not read the Romford Recorder—
Mr. Milburn: If the hon. Gentleman insists and provided that he is not in it. He is right to raise the issue. Coronary heart disease is the biggest killer in our country—it kills between 125,00 and 150,000 people a year. We know two things: first, many of the deaths and morbidity are preventable if action is taken, which is why I am pleased that, over the course of the last three years, the prescribing of cholesterol-lowering drugs, which prevent heart attacks, has doubled because of extra resources going in. Secondly, in too many parts of the country, where the incidence of coronary heart disease is highest, the rates of heart surgery have been lowest. That is why targeted funding is being made available to ensure that we close the health gap between the poorest areas and the more prosperous parts of the country. All that I would say to the hon. Gentleman, in all candour, is that if we want to achieve a 20 per cent. cut in heart surgery waiting times, that cannot be achieved by making 20 per cent. cuts in funding.
Andy Burnham (Leigh): May I warmly welcome today's extension of the choice programme to patients in Greater Manchester? In doing so, will the Secretary of State assure me that all patients across Greater Manchester will be included under that scheme, and not just those nearest the available capacity? In the long term, will he consider developing sufficient diagnostic
and treatment capacity in the west of the Greater Manchester area, closer to the homes of my constituents?
Mr. Milburn: We will certainly consider that latter issue. As my hon. Friend is aware, late last year, we issued invitations both to the national health service and to private sector providers to build new diagnostic and treatment centres in those parts of the country where waiting times are longest. The DTCs—which are surgery centres—separate emergency work from elective work so that operations are not cancelled and waiting times can be brought down. On my hon. Friend's first point, choice for waiting, whether for an orthopaedic operation or for an eye operation, will apply from the summer of this year in all parts of Greater Manchester, and will apply in all parts of the country from next year.
Carers
5. Andrew Selous (South-West Bedfordshire): What assessment he has made of the needs of carers before introducing the Community Care (Delayed Discharges Bill). [96677]
The Minister of State, Department of Health (Jacqui Smith): We have considered the needs of carers carefully when developing policy on delayed discharges. Patients being in hospital when they would be more appropriately cared for in the community is bad for them and their families and carers. At the Report stage of the Community Care (Delayed Discharges etc.) Bill, several Government amendments were accepted that will bring services to carers within the scope of the Bill.
Andrew Selous : I thank the Minister for that reply, but does she accept the real distress caused to carers by the omission of any reference to their needs in the draft Bill? Can she assure the House that as a result of this legislation there will be no repetition of the type of incident that happened in my constituency recently, in which a mentally ill patient was sent home from hospital without his carer even knowing, causing a great deal of distress, as the gentleman could not be found for some considerable time?
Jacqui Smith: Both through the Bill and the hospital discharge workbook that we have published recently, we are improving and building on good practice and ensuring that, as the hon. Gentleman rightly points out, carers are involved in the important decisions about discharge and the services that need to be put in place afterwards. I agree with him that that is a priority. That is why Carers UK welcomed the amendments to the Bill and said that they are
- "an important step forward for carers' rights."
Dr. Phyllis Starkey (Milton Keynes, South-West): While welcoming the huge contribution that carers make, does the Minister agree that relatives should not be forced into an excessive commitment of care because of a lack of adequate social services support? In that context, does she agree that the decision of the Liberal Democrat-controlled Milton Keynes council to increase maximum home care charges from £21.25 a week to £100 a week is not helpful? If my constituents are unable to afford those charges, what does she advise them to do?
Jacqui Smith: My hon. Friend makes an important point. I have no doubt that, as she usually does, she is campaigning on behalf of people in her constituency who need those social care services. I hope that all local authorities, when taking decisions on provision and charging, will bear in mind the considerable extra investment that the Government have put into social services. There will be a doubling of the real-terms increase over the next three years. I hope that local authorities will ensure that that is reflected in better services and better access for vulnerable people.
Sir George Young (North-West Hampshire): Does the Minister recall that this Bill had a rough time in this House, being criticised on Second and Third Reading by hon. Members on her side of the House as well as on this side; and does she realise that it was mauled on Second Reading in another place? There is now little prospect of it reaching the statute book by 1 April. Would it not be best to withdraw the Bill?
Jacqui Smith: No. My hon. Friend the Parliamentary Under-Secretary of State for Health, the hon. Member for Tottenham (Mr. Lammy), pointed out that our considerable extra investment has already brought about reductions in delayed discharge. We believe in the need to back up that investment with reforms to the system. Those reforms should put the needs of people—especially the older people who are currently trapped in hospital—at the centre of our system. I am disappointed that Opposition Members talk a lot about delayed discharge and the needs of older people but fail to support the investment and reforms that will ensure that progress can continue.
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