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11 Feb 2003 : Column 762—continued
Foundation Trusts
12. Ms Julia Drown (South Swindon): What non-financial freedom will be given to foundation trusts. [96684]
The Minister of State, Department of Health (Mr. John Hutton): The non-financial freedoms that will be open to NHS foundation trusts were set out in "A Guide to NHS Foundation Trusts", which was published on 11 December 2002.
Ms Drown : That guide said that foundation trusts would not have to have patients forums, but it did not mention much else. Some of the trusts that hope to gain foundation status are hoping that they will not have to supply information to the Department of Health and that they will be able to abandon Government initiatives such as modern matrons. Will that be the case, and if so, how will we deal with parliamentary answers? For example, will we no longer be able to say how many nurses the NHS has because we can only say how many there are in non-foundation trust hospitals?
Mr. Hutton: It is important that we strike a better balance between what is done at the centre in the NHS and what is done on the front line. That is very much what our proposals on foundation trusts are designed to do. It is perfectly possible to strike that better balance without compromising what my hon. Friend rightly identified as very important information about the performance of the NHS that all hon. Members would want to have. Those data will not be compromised or lost. That is one issue on which I hope I can at least reassure her.
Sir Nicholas Winterton (Macclesfield): I hope that the Macclesfield district general hospital, which has a three-star rating, will apply for foundation status. Is it the Government's view that that new status will give hospitals an opportunity to respond more quickly and positively to local needs? Is it not very important that the hospital trusts have a very close liaison with the primary care trusts? Otherwise, conflict could occur between them.
Mr. Hutton: Yes; I can certainly say to the hon. Gentleman that local service delivery and responsiveness are very much what we want NHS foundation trusts to be able to provide. We want them to be able to respond more effectively and quickly because less weight from the centre is bearing down on them. Generally, it has been my experience that, in all the hospitals that I have visited, people are able to identify problems, but it is usually local people who are
best able and best placed to design solutions. I think that we should let that happen wherever possible. The Macclesfield hospital is an excellent hospital and the staff there are doing a brilliant job and thoroughly deserve their three stars. Of course, precisely what happens in relation to its application for foundation status is a matter for the trust and the local community.
Mr. David Hinchliffe (Wakefield): As part of the Government's proposals on foundation trusts, the idea of local governance has been brought forward, which is very interesting. In developing that idea, will my right hon. Friend assure me that local communities will have a say in whether applications for foundation trusts will be made in the first instance? In an area such as west Yorkshire, for example, where the three-star Bradford trust may well be a foundation applicant, would it not be appropriate for my constituents in Wakefield to have a say in the process?
Mr. Hutton: We spelt out in the guide a clear process whereby applications would be made. I think that I can give my hon. Friend a very clear assurance on the point on which he sought clarification.
Ambulance Services
13. Sir Patrick Cormack (South Staffordshire): If he will make a statement on ambulance services in England and Wales. [96685]
The Parliamentary Under-Secretary of State for Health (Mr. David Lammy): The ambulance service in England has made real progress. Compared with 1997, trusts are responding significantly more quickly to a significantly larger number of calls. Ambulances are better equipped and paramedics better trained. The service still faces challenges, but with support and investment it will continue to succeed.
Sir Patrick Cormack : I thank the Minister for that rather general answer, but does he agree that the Staffordshire ambulance service, both in response time and general efficiency, has an exemplary performance? [Interruption.] I am glad that the Secretary of State is echoing those remarks from the Front Bench. What is the Minister doing specifically to encourage Staffordshire and to encourage other services to be as good as Staffordshire?
Mr. Lammy: The hon. Gentleman is right: Staffordshire has done particularly well, especially given the outbreak of a diarrhoea and vomiting bug last month. What is happening in Staffordshire is that the emergency care networks are requiring the ambulance trust to work with the primary care trust, the A and E department and also the emergency care collaborative, bringing best practice to Staffordshire as to the rest of the country.
Chris Grayling (Epsom and Ewell): While echoing the compliments paid by my hon. Friend to the Staffordshire ambulance service, hon. Members should be aware that in almost every part of the country ambulances with patients inside are sitting outside accident and emergency departments that are unable to
admit them because managers will not take them in order to meet the four-hour waiting targets. At an extreme, we have discovered that ambulances have had to wait for 414 minutes for a patient to be admitted. Two weeks ago, in the west midlands, 50 per cent. of ambulances were tied up at A and E departments. Ambulance services have warned that they may not always be able to answer 999 calls. The situation is a scandal. Will the Minister say what he is going to do to put a stop to it? Will he explain why he has told ambulance service chief executives—
Mr. Lammy: I have to ask the hon. Gentleman not to talk down the ambulance service in that way. He is mistaken about the target—the clock starts to run after 15 minutes, so there is no incentive to wait outside in the manner that he suggests. What are we doing about the situation? The emergency care network requires our primary care trusts to work with the community, ambulance trusts, A and E departments and emergency care collaboratives. I recommend that the hon. Gentleman goes to see the collaboratives and the network at work.
Andrew Mackinlay (Thurrock): Will the Minister write to all ambulance trusts to ensure that they are complying with the Department's requirements on combating methicillin-resistant staphylococcus aureus—MRSA—given that corners are being cut regarding ambulances' cleanliness because they are being used so intensively?
Mr. Lammy: My hon. Friend may know that the chief medical officer is considering that matter and issuing best practice advice. At the same time, we are attempting to collect the right data across the NHS so that we can measure the incidence of hospital-acquired infection.
Hywel Williams (Caernarfon): As regards ambulance services in England and Wales, in the last quarter the average response rate for category 8 calls—eight minutes in urban areas—was 51.8 per cent. For the best area it was 70 per cent. and for the very worst it was 38.5 per cent. Does not that suggest to the Minister that his colleague in Cardiff is either not doing her job or is not up to her job?
Mr. Lammy: That is very much a matter for Wales.
Hospital Treatment (Waiting Times)
14. Mr. Bill O'Brien (Normanton): If he will make a statement on progress with the reduction of time for patients waiting for admission to hospital for treatment. [96686]
The Secretary of State for Health (Mr. Alan Milburn): Waiting times on virtually every indicator continue to fall. The latest figures show that the number of patients waiting more than 12 months for hospital admission has fallen by 62 per cent. in the last year. Almost half of
NHS trusts now have no patient waiting more than 12 months for hospital admission, which is ahead of the target set for April this year.
Mr. O'Brien : I thank my right hon. Friend for his response. Although there have been drastic improvements in waiting times, there are still areas that require greater attention. Will he examine the situation, especially in west Yorkshire and in my constituency? Will he also consider the problem of delays for people who are waiting for digital hearing aids, as it could be two years before my constituents receive that service?
Mr. Milburn: First, on digital hearing aids, my hon. Friend will be aware that last week I announced that an extra £94 million will be made available so that the 1.8 million people who are hard of hearing or deaf will get access to digital hearing aids on the national health service, for free.
Secondly, on waiting times for treatment, my hon. Friend is right to say that although waiting times across the piece are falling, there are pockets where they remain too long. As a consequence of the announcements that
I will make today, from July this year, in his area of west Yorkshire, patients needing eye operations will have the choice of an alternative hospital where the waiting time for treatment is shorter. That will apply not only in parts of the north, but in parts of the south.
Mr. David Cameron (Witney): Is the Secretary of State aware that the reason for delayed admission to hospital in Oxfordshire is our dreadful shortage of nurses? Does he realise that we are short of approximately 400 nurses—a vacancy rate of 14 per cent.? When will he extend the freedoms that he plans for foundation hospitals to all hospitals so that we can pay the right rate for recruiting, motivating and retaining nurses? Without that, we shall never make progress.
Mr. Milburn: We want as many NHS hospitals and trusts as possible to gain the advantages of foundation status. However, the increase in resources is the main reason for the fall in waiting times in the NHS. The hon. Gentleman cannot acknowledge that because the Conservative party wants to decrease rather than increase NHS resources.
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