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House of Commons

Tuesday 18 March 2003

The House met at half-past Eleven o'clock


[Mr. Speaker in the Chair]

Oral Answers to Questions


The Secretary of State was asked—

Mental Health (Barnet)

1. Mr. Andrew Dismore (Hendon): If he will make a statement on mental health services in Barnet. [103193]

The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): Local mental health services in Barnet are making good progress against the national service framework targets, but they face considerable challenges in meeting additional demands and improving further services for patients. Public and staff are being involved in the plans for future developments.

Mr. Dismore : I am grateful to my hon. Friend for that response, but I am sure that she is aware of the long waiting times for intensive out-patient care. I wish to raise in particular the matter of the Barnet psychiatric unit, which closed temporarily more than five years ago, with a view to being reopened. Nothing has happened yet and the result is that the temporary ward at Edgware hospital is under considerable strain. What will happen in terms of reproviding the Barnet psychiatric unit, and when may we expect to see some progress on the issue? The present situation is unsustainable, and perhaps the money could be found from the modernisation fund.

Ms Blears: My hon. Friend will be aware that the outline business case to reprovide the acute in-patient service at Barnet was considered by the primary care trust in December. The acute unit will now provide 54 beds and will bring acute mental health services on to the same site as the rest of the acute services. That will be a real improvement for patients. The extra revenue costs are likely to be some £350,000 and the PCT has confirmed that it will be able to afford that. We need now to make swift progress in relocating those services to Barnet to serve people in that community.

Sir Sydney Chapman (Chipping Barnet): In supporting the hon. Member for Hendon (Mr. Dismore) about the need for that acute service, may I ask the Minister to confirm that the social service inspectorate's report of May 2002 was selectively damning? It said that mental health services in Barnet

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had been allowed to drift, service users were losing out and carers were not being supported. May we have her assurance that the Government are addressing the matter and taking the necessary actions to put things right quickly?

Ms Blears: The hon. Gentleman is too harsh on those local services. The area has lower than average suicide rates, admission rates and readmission rates, as well as good user involvement, a good relationship with Barnet Voice for Mental Health and good carer involvement. Local people are working hard to ensure that mental health services in the area serve the needs of patients. They are setting up new assertive out-reach and crisis intervention teams, and much good work is being done. Further improvements do need to be made, but significant progress has already been achieved.

Mrs. Patsy Calton (Cheadle): May I first pay tribute to Lord Hunt of Kings Heath, who left the Government today? He was effective, well respected and well known to those who work in, and care about, the NHS. The child and adolescent mental health services report zero weeks waiting time—in other words, no waiting time—for first out-patient appointments—[Hon. Members: "In Barnet?"] Yes, in Barnet. What does Barnet have that other areas, such as my own of Stockport, do not; or is that another case of inaccurately reported waiting times?

Ms Blears: I thank the hon. Lady for her kind remarks about Lord Hunt. He was an able Minister and a close colleague who will be severely missed in our Department. The hon. Lady should know that we will commit £300 million to the national service framework, including £93.5 million this year. The children's national service framework will also address the issue of waiting times, which is a major priority in the planning and priorities framework for this year. Out-patient waiting times are too long, but clear action will be taken and the necessary investment made in the service to ensure that we reduce them.

Hospital Private Finance Initiative

2. James Purnell (Stalybridge and Hyde): If he will make a statement on the private finance initiative in hospitals. [103194]

The Secretary of State for Health (Mr. Alan Milburn): The private finance initiative is helping to deliver the biggest hospital building programme in the history of the national health service. Of the 104 PFI hospital schemes announced since 1997, 25 are already operational and a further 23 are under construction.

James Purnell : I thank my right hon. Friend for that answer. Over the past few years the doctors, nurses and administrators at Tameside general have done fantastic work, despite the fact that the hospital site is spread across many buildings, many of them old Victorian workhouses, and that patients still have to be ferried between buildings by ambulance. Without PFI we would have to wait decades for another hospital. Can

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my right hon. Friend tell me when we can expect completion of a new hospital if Tameside is successful in the current application process?

Mr. Milburn: I am aware of the problems in Tameside because my hon. Friend has been to see me to talk about them and to present me with a petition that he and other members of the local community organised. We will make progress as soon as possible, but the process takes some time. Once building begins, we may be confident that the new development will be built on time and to cost. It is worth saying that, as a consequence of PFI, major capital investment is now going into the national health service. Since 1997, capital spending in the NHS has risen by 63 per cent., partly as a result of PFI. To give hon. Members a point of reference, investment fell by more than 20 per cent. under the Conservative Government between 1992 and 1997.

As a result of the extra investment that will come on line from April, over the course of the next four years capital spending in the NHS will rise by a further 144 per cent., to give the NHS, its staff and its patients precisely the sort of modern working environment and modern facilities that they need. People will draw a clear contrast between a Labour party that is committed to investment and the Conservative party.

Mr. John Randall (Uxbridge): The Secretary of State will no doubt be aware of the bureaucratic blunders in the Paddington basin project, which resulted in a 17.5 per cent. shortfall in space. People forgot to take note of the new regulations on elderly patients in hospital. Does the Secretary of State agree that it is time to reconsider the relocation of Harefield hospital to the Paddington basin? It is time to reinvest in Harefield and so save everybody money.

Mr. Milburn: I can always rely on the hon. Gentleman to accentuate the positive. On the subject of the Paddington basin, we have been through the process and, indeed, I have been to Harefield. As the hon. Gentleman knows, I met local people and members of staff, including Sir Magdi Yacoub. The decisions were difficult but I believe that they are right, not just for Harefield but for health services in the area. As a consequence of the extra investment that is now going into the NHS in the area, we will get modern hospital facilities that are long overdue.

Foster Carers

3. Jonathan Shaw (Chatham and Aylesford): How many children are looked after by private foster carers. [103195]

The Minister of State, Department of Health (Jacqui Smith): Data on the number of children looked after by private foster carers are not collected centrally. The Children Act 1989 places a duty on local authorities to

Jonathan Shaw : The Minister will know that the social services inspectorate wrote to Departments and estimated that as many as 40,000 or 50,000 children are

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privately fostered. Those children are afforded less protection than children who are child-minded. She will also know that Lord Laming had little to add on safeguards for children who are privately fostered, other than the recommendations that came from the Utting inquiry on children living away from home. Will she tell us when a Green Paper will arise from the Laming inquiry into the Victoria Climbié case? Why are the Government so reluctant to introduce a registration scheme for privately fostered children, as recommended by Utting?

Jacqui Smith: I pay to tribute to my hon. Friend for his continued concern about the protection of privately fostered children. Although I share his objective, I have not always shared his view on the most effective way of ensuring that protection. As he has suggested, we have taken action to ensure that the legal responsibilities that already exist for private fosterers and local authorities are taken forward. A letter from the chief inspector has outlined that, and there have been an SSI inspection and a leaflet campaign to raise awareness. As my right hon. Friend the Secretary of State made clear when we published the report of the Climbié inquiry, we will give a full response to Lord Laming's recommendation that we should review legislation in this area at the time of the children's Green Paper. I believe that that Green Paper will be published later in the spring.

Mr. David Cameron (Witney): Does the Minister agree that many children in foster care will go on to be adults in adult placement care? Is she aware that the number of adult placement carers is falling because of the Government's decision to have them regulated by the National Care Standards Commission? When will the Government announce the decision of their review of that matter? Does the Minister accept that adult placement carers are looking after vulnerable adults in their own homes? Those homes are not care homes and they should not be regulated by the NCSC and made subject to all manner of rules and bureaucracy that are completely unnecessary.

Jacqui Smith: The hon. Gentleman raises the issue of adult placements, which has also been raised by several of my hon. Friends, and by at least one of his hon. Friends, who visited me, along with representatives of the National Association of Adult Placement Services. As a result of that meeting, we are undertaking a consultation on how to ensure that, in putting in place the necessary regulation to ensure that vulnerable people who are cared for in adult placements get the protection that they deserve, we also continue to recognise the specific circumstances of those who care for vulnerable people in their own homes. It is not true that the conditions for adult placement schemes are the same as for care homes; indeed, they never have been. What we have done is to listen to the genuine concerns of those who undertake this very important role, to undertake a consultation, and to make changes that will help to promote the work of those who care for vulnerable people in their own homes.

Mr. Hilton Dawson (Lancaster and Wyre): To return to the subject of private fostering, I well understand that my hon. Friend often has to wrestle with huge problems

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that require major investment, organisational change and cultural reorganisation within complex health and social care systems. Does she agree that, by contrast, private fostering would be simple to crack, would require almost no investment, and would provide great protection for children? Indeed, it is the sort of job that she could knock off before breakfast one morning. Will she therefore join me in looking forward to the blithe new morning when she will have the opportunity to do that?

Jacqui Smith: Perhaps I should point out to my hon. Friend that one of the things that I am wrestling with, as he puts it, is what we need to do to ensure that the changes that we make really do make a practical difference to vulnerable children. As my right hon. Friend made clear in responding to the Climbié inquiry, our consideration of the issues arising from private foster care will be based on what will make a practical difference to the protection of those children, on how we can ensure that the considerable protection already provided in legislation is carried through properly, and—perhaps most importantly—on how we can ensure that local authorities fulfil their responsibilities to those children. We discovered that, even under the current legislative framework, Gloucestershire local authority, for example, has taken action and increased the number of notifications of private foster carers from 11 to 224 in the past three years. That is—

Mr. Speaker: Order. The answers are a bit on the long side today.

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