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18 Mar 2003 : Column 743—continued

NHS Dentists

4. Mr. Peter Pike (Burnley): What estimate he has made of the number of people in the north-west who are no longer able to get on the list of an NHS dentist. [103196]

The Parliamentary Under-Secretary of State for Health (Mr. David Lammy): National health service dental registrations in the north-west have been stable for several years. The region has the second highest registration rate for adults in England, at 49 per cent., which is significantly above the England average. More than 60 per cent. of children in the region are registered with a dentist. This is broadly in line with the national average.

Mr. Pike : Will my hon. Friend recognise that I get letters every week from people in Burnley who cannot get on an NHS dentist's list, and that advising them to phone NHS Direct is not the way forward? The primary care trust informs me that another dentist is transferring his patients to Denplan, and that a further one will follow shortly. An NHS dental service is no longer available to the majority of people in my constituency, and that is not acceptable.

Mr. Lammy: I sympathise with the problems that some of my hon. Friend's constituents are experiencing, and I understand that there are particular recruitment problems in Burnley. However, that is why there are a number of primary dental service pilots and a new dental unit in Burnley. I am also advised that my hon.

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Friend's NHS managers are talking to Manchester dental school, to ensure that students want to come to Burnley to work. At the same time, my officials and I are holding discussions with the British Dental Association to ensure that we have support teams in our access problem areas. I will ensure that my hon. Friend's constituency is considered as part of that programme.

Primary Health Care

5. Mr. Andrew Stunell (Hazel Grove): If he will make a statement on budget deficits in primary health care services. [103197]

The Minister of State, Department of Health (Mr. John Hutton): In both of the last two financial years, the national health service has reported a break-even position, an improvement on the deficit of £459 million in 1996–97. For this financial year, discussions are currently taking place between primary care trusts and strategic health authorities on managing their end-of-year financial positions.

Mr. Stunell : I thank the Minister for that reply. When the Department wrote to me recently boasting about the additional money for Stockport primary care trust, was the right hon. Gentleman aware that £5 million of that was needed for deficit reduction and that, as a result, the trust's board tells me that it is now required to make real-terms reductions of £1.3 million in the next financial year? As audiology, child psychiatry and mental health services are under real pressure in Stockport, may I encourage the right hon. Gentleman, when he writes to hon. Members boasting about increases in money, to avoid the spin and state the facts?

Mr. Hutton: We always state the facts and we have done that on this occasion. I am grateful to the hon. Gentleman for pointing out the difficulties that his PCT is experiencing, and I shall certainly look into those issues on his behalf, but a certain reciprocity would be welcome. I am happy to go in for that, if the hon. Gentleman would like to welcome the 26 per cent. cash increase that Stockport PCT received over the past three years and the 29 per cent. increase to which it can look forward over the next three years.

Mr. Simon Burns (West Chelmsford): I am not sure whether the Minister fully understands what a fact is. If he cut out the spin and actually answered the question put by the hon. Member for Hazel Grove (Mr. Stunell), he would be aware that a number of PCTs will have deficits at the end of the current financial year. For example, my PCT in Chelmsford will have a deficit of £1 million. I wrote to 50 per cent. of PCTs, and a significant number wrote back to say that they will not break even at the end of this year and will have deficits. Instead of spinning and citing figures, why does the Minister not face up to reality, answer the question straightforwardly and explain how PCTs with deficits at the beginning of the next financial year will deal with them?

Mr. Hutton: I did answer the question put by the hon. Member for Hazel Grove fairly and fully, but there is a wider issue. Of course, we shall look into the end-of-year position; it is the job of SHAs and PCTs to do that.

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There is, however, a certain credibility gap when the hon. Member for West Chelmsford (Mr. Burns) comes to this place demanding, in effect, more resources for the NHS when his policy is to take money away from the NHS.

Community Hospitals

6. Mr. John Grogan (Selby): If he will make a statement on the Government's policy on smaller community hospitals. [103198]

The Secretary of State for Health (Mr. Alan Milburn): We want to see a new lease of life for community hospitals. Our new guidance, "Keeping the NHS Local", issued last month, emphasises the important role that community hospitals can play in providing locally based health services.

Mr. Grogan : I thank my right hon. Friend for that very encouraging reply. In the light of it, will he join me in urging the North and East Yorkshire and North Lincolnshire strategic health authority to give urgent and careful consideration to the outline business case that it will receive later this month from the Selby and York primary care trust for the complete rebuilding of Selby War Memorial hospital, not only because of the role played by the hospital in the community but also because that exciting project is one of the first to come from a PCT?

Mr. Milburn: I very much enjoyed meeting my hon. Friend and representatives of his local PCT about a month ago to talk about the proposed development. As he remembers, I visited the hospital two or three years ago and was most impressed by what I saw. There is a strong case for redevelopment. Obviously that will take investment and it will need a good case, but I know that the PCT will make a good case to the SHA. Equally, I am sure that my hon. Friend will remind his constituents that such developments are possible only because of the investment that the Labour Government are making.

Mr. Roger Gale (North Thanet): On the assumption that the Secretary of State will give the go-ahead to the reorganisation of health care in east Kent, and given the excellent coastal and cottage hospitals in that area, will he tell us what financial assistance he will give the PCT so that hospitals such as the Queen Victoria Memorial hospital in Herne Bay can have the minor injuries and accident and illness units and telemedicine that they need, which would help patients to be treated closer to home without having to travel at all?

Mr. Milburn: As the hon. Gentleman is well aware, not least because he has been one of the protagonists in the whole sorry affair vis-à-vis east Kent, decisions have to made, and most members of the community now want a final decision so that we can make progress. What is absolutely clear across the country, not just in east Kent, however, is that community hospitals have a very important part to play. Indeed, technological change and medical advance are driving many of the treatments that were previously available only in the big tertiary centres and making them available much more locally, provided, of course, that we invest in the

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necessary information technology and make the necessary capital investment and resources available for staff and training. That is precisely what the Government want to do—but whether the Conservative party agrees with those proposals is a moot point.

Phil Sawford (Kettering): On 10 February, I attended the official opening of the new £1 million skin care unit at Kettering general hospital, which will deal with the increasing number of problems with eczema, skin cancer and other dermatological conditions. I welcome that investment in our local health service. Does my right hon. Friend believe that smaller hospitals would benefit from that kind of investment if we adopted a policy of cutting public spending by 20 per cent., like the Conservative party has?

Mr. Milburn: I take the very simple view—I think that my hon. Friend shares it—that if we want more out of the national health service, we simply have to put more in. That is what the Government are committed to; it is what the Conservative party opposes.

Chris Grayling (Epsom and Ewell): According to the logic of the document published by the Secretary of State's Department on 14 February and, indeed, the strategies of many local NHS trusts, services would move from district general hospitals to community hospitals; but does the Secretary of State acknowledge that, if that happens, many parts of the country are likely to have fewer district general hospitals?

Mr. Milburn: No, I do not think that that is the case. Although change will always be necessary in the NHS—change is often a very positive thing because it is driven by medical advance and technological improvement and it makes more treatments available to more patients—we have to move away from the idea that the "biggest is best" philosophy will always work for NHS patients, especially in local communities.

Rather than presuming that biggest is always best and that the only way to solve a problem with local health services is to centralise those services, the new guidance rightly says that the starting point for examining what is needed in the local community should be the presumption of keeping as many services as locally based and locally accessible as possible. That is what we want to do, but it can only be done—I repeat this point—provided that we make the necessary investment in IT, technology, training, staff, buildings and equipment. We are prepared to make that investment. Of course, the hon. Gentleman's party voted against it.

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