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Dual Diagnosis
3. Ms Oona King (Bethnal Green and Bow): If he will make a statement on services provided to patients with dual diagnosis of mental health and addiction problems. [109802]
The Minister of State, Department of Health (Jacqui Smith): As part of the work to modernise mental health services, the "Dual Diagnosis Good Practice Guide" was issued last year. Following the publication of the national service framework for mental health, we have embarked on a radical modernisation of services to improve access to effective treatment and care, to reduce unfair variation, to raise standards and to provide quicker and more convenient services to all people with mental health problems including those with a dual diagnosis of addiction.
Ms King: Does the Minister agree that such patients have a particular need for supported accommodation and ongoing social services support? However, because they have the greatest problems, they are often the ones who fall through the safety net. Will she consider increasing resources for programmes such as assertive outreach and ensuring that patients with dual diagnosis problems are taken into account?
Jacqui Smith: My hon. Friend raises an important point. Despite the considerable extra investment in our mental health services and staffing increases, we nevertheless need to examine new ways in which to organise the services. I strongly agree with her, as we spelt out in the national service framework, that assertive outreach teams are particularly able to get to some of the people who have fallen out of touch with services in the past, perhaps because they had additional problems such as drug or alcohol addiction, which had knock-on bad effects for their health and for communities as a whole. That is why I am pleased that extra investment for assertive outreach teams is being considered in Tower Hamlets. The existing investment in our mental health system means that 191 additional assertive outreach teams are operating throughout the country to bring people who had lost touch with mental health services back in touch.
Tim Loughton (East Worthing and Shoreham): A lesson from the first Gulf conflict was that many returning service personnel were susceptible to mental health problems, which were often combined with addiction problems, especially alcohol addiction. Given that fewer than 20 per cent. of the Government's required crisis resolution teams are in place, how can the Minister justify her claim on 6 March that there is
- "operational flexibility within the system"
-
to enable the NHS to deal with the mental health needs of servicemen and women returning from the Gulf, many of whom are likely to be given a dual diagnosis? Is it not the truth that the Department of Health and the Ministry of Defence are woefully unprepared?
The hon. Gentleman seemed to suggest that we need more investment and an expansion of capacity. As I have said, there are already 191 extra assertive outreach teams. We have 62 more crisis resolution teams, 22 more early intervention teams and there are 25 per cent. more community psychiatric nurses working in the system than in 1997. There are problems and the only way in which to address them is to continue with the investment that the hon. Gentleman and his colleagues have opposed far too often.
John Mann (Bassetlaw): Fewer than 3 per cent. of people with an addiction to heroin are receiving medical treatment. How long will we allow a presumption in favour of dual diagnosis to be a smokescreen for stopping proper medical treatment for such people?
Jacqui Smith: The dual diagnosis guidance that we issued made it clear that treatment for the significant number of people who have both a serious mental illness and a drug addiction is part of the mainstream business of mental health services. We need to do work, especially to ensure that we reduce waiting times for people who need specialist treatment services, which also have specialist mental health services alongside. We are making progress on extra capacity and new ways in which to deliver those services. I agree with my hon. Friend that it is unacceptable if people do not receive suitable treatment. We will ensure that we address the problems through the additional investment and new forms of treatment that we are implementing. However, only the investment that we are undertaking will ensure that that happens.
Needlestick Injuries
4. Mr. Ben Chapman (Wirral, South): If he will make a statement on needlestick injuries. [109803]
The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): The Government recognise that the number of needlestick injuries occurring in the NHS is still too high. The Minister of State, my right hon. Friend the Member for Barrow and Furness (Mr. Hutton), recently met the all-party parliamentary group on occupational safety and health and agreed that new guidance will be issued to the service in the autumn.
Mr. Chapman : Given that the annual cost of treating NHS workers who have suffered needlestick injuries is
estimated to be in the order of £300 million and that the estimated saving from acquiring safer needles could be about £140 million, and given that even when needlestick injuries are subsequently shown not to have caused serious physical harm they almost always cause immense emotional trauma, will my hon. Friend join me in supporting the objectives of the Needle Stick Injury Bill promoted by my hon. Friend the Member for Crawley (Laura Moffatt)?
Ms Blears: My hon. Friend is right that needlestick injuries are a serious issue in the NHS. They cause immense distress to staff, especially when they are waiting for the test results to discover whether they have been infected. That is why we support the work of the safer needles network and why the Department works with trade unions and staff on that issue. Safer devices have a role to play. Equally important, however, is excellent training for staff on how to use those devices, and refresher training has been proven to reduce the number of incidents dramatically. On the Bill, health and safety legislation requires incidents to be reported. We want those regulations to be used as much as possible to ensure that we have the fullest possible information so that we can support staff in those difficult conditions.
NHS Dentistry (South Devon)
5. Mr. Anthony Steen (Totnes): If he will review the level of provision of NHS dentistry in South Devon. [109804]
The Parliamentary Under-Secretary of State for Health (Mr. David Lammy): We are committed to rebuilding and restoring NHS dentistry to continue to improve the oral health of the nation. Alongside the proposals in the Health and Social Care (Community Health and Standards) Bill, 26 field sites covering 50 different locations are being set up to test different ways of providing NHS dentistry. One of the largest of these field sites covers the south-west peninsula and builds on the successful personal dental services pilot in Cornwall.
Mr. Steen : In spite of that answer, is the Minister aware that no dentist in Totnes is taking newly registered patients and that it takes a whole day on public transport to go to and to be treated by an NHS dentist, which is not possible for many people? Would it help if we ring-fenced the dentistry part of the primary care trust budget to relocate dentists into south Devon?
Mr. Lammy: I know that there are problems of access in south Devon because of rurality. If one dentist leaves a town or village, it can mean that people cannot get registered. That is why we are putting in dental support teams across the country where there are still access problems and the hon. Gentleman's area will of course be considered for that. I hope that he will support the Bill that I mentioned to ensure that primary care trusts can commission dental services in the way that he suggests.
Care Workers (Kent)
6. Jonathan Shaw (Chatham and Aylesford): What plans he has to increase the number of care workers being trained in Kent. [109805]
The Minister of State, Department of Health (Jacqui Smith): Training of care workers supports and protects vulnerable people and helps to recruit and retain important staff. That is why we are providing more than £2 million of additional money to councils in Kent this year specifically for training and work-force development, as well as funding through Topss England, formerly the National Training Organisation for Social Care, to help the staff of all social care employers in Kent to undertake training and qualifications.
Jonathan Shaw : I welcome that extra investment for Kent. I know that my hon. Friend takes a close interest in all Kentish matters and she is welcome in the garden of England any time.
In addition to that investment, £750,000 has been secured from the Learning and Skills Council by the Kent community care association, working in partnership with Unison and local authorities to train some 40,000 care staff throughout the county. Is it not the case that quality training is crucial to recruitment and retention of care staff? What is my hon. Friend doing to monitor and evaluate the situation? It is all very well getting the cash, but it is essential that it is used to good effect for the benefit of older people throughout the county.
Jacqui Smith: My hon. Friend is right. I enjoyed our meeting with the Kent community care association, which, as an employer in the voluntary, independent and private sector, has clearly showed its commitment to training staff. However, it has also recognised that in the past it has sometimes been difficult, even when additional resources have gone to local authorities, for a significant number of employers in the independent sector to get access to those funds. That is why we will be putting a condition on the additional money that we will make available over the next three years requiring 50 per cent. of it to be spent in the independent sector.
My hon. Friend rightly said that that will clearly make a difference to the number of people being trained, which is why the national minimum standards, particularly in domiciliary care and care homes for older people, now include requirements that people who are caring for the most vulnerable people in our communities receive the necessary training. That will be monitored by the National Care Standards Commission and will play an important role in improving the status of people who work in care, thus helping us to recruit into that work.
Mr. Simon Burns (West Chelmsford): Does the Minister accept that one of the problems facing trainees and care workers in Kent and elsewhere is the fiasco over the past 12 months with the Criminal Records Bureau? Does she accept that notwithstanding the two U-turns that the Government have had to make there are still considerable problems? Does she not feel that it was unwise not to accept the advice of the Opposition prior
to the implementation of checks, to the effect that the bureau was over-ambitious in seeking to check everyone from the outset? What is happening to the backlog, as opposed to current applicants requiring a check? The evidence suggests that there is a considerable problem with that backlog despite the fact that current applicants are being dealt with quicker.
Jacqui Smith: I think that the hon. Gentleman and I will have a chance to pursue that at greater length later this afternoon, but I can offer him reassurance now. I share his concern about the performance of the Criminal Records Bureau, which is why my right hon. Friend the Home Secretary instituted a significant review of its operations and why we, along with other colleagues in government announced last November a delay in implementing some of the bureau's checks for certain groups of workers. We wanted to make sure that we could get the bureau back into the shape necessary to provide protection for vulnerable people—a role in which I believe it plays an important part.
I can assure the hon. Gentleman not only that there are now substantially more checks every week than last summer but that significant inroads are being made into the older applications that had got stuck in the system. My understanding is that the vast majority of those have now been worked through. Not only has the old problem been solved but the bureau is now operating far more efficiently. I am sure that the hon. Gentleman will join me in recognising the important contribution that that will make to safeguarding vulnerable people.
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