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I was pleased that the hon. Member for South-East Cambridgeshire did not chide me for not having yet made my visit to Bottisham; I am looking forward to doing so in the near future. He referred to the East of England Development Agency grant funding, but I do not think that we should look to such initiatives to deal with problems in the long term and as pilots to work out how to do things. We need to move towards normal commercial arrangements in rural areas, just as in urban areas, so that we provide the services that businesses and others need so much.
The hon. Member for Blaby and my hon. Friend the Member for Milton Keynes, North-East made interesting comparisons with the way in which things operate in other countries. Germany certainly has many more broadband connections than in the United Kingdom. However, as they pointed out, Deutsche Telekom has 90 per cent. of the market in Germany and prices there are drifting up and the growth of the German broadband installed base is very slow at present. Prices in the United Kingdom are coming downthey are already lower than those in Germanyand growth is very fast. My opposite number in Germany was keen to find out more about how we are managing matters in the UK because he wants more competition in the German market. There is no doubt that that is the way forward.
I am grateful to all hon. Members who participated in this important debate. There is a significant economic challenge for the UK. We have identified ways to address the challenges, especially by ensuring that rural areas throughout the UK, as well as urban areas, will have the benefit of broadband services. I hope that I made clear the Government's determination to address those challenges and that hon. Members will follow progress in the critical few months ahead with great interest.
Ian Stewart (Eccles): On 1 May, as we celebrate the sixth year since the magnificent Labour victory in 1997, I present a petition signed by about 2,100 of my constituents. It says that the Office of Fair Trading's proposals for the unrestricted opening of pharmacies that are able to dispense national health service prescriptions will have a serious and detrimental effect on pharmacies and the communities that they serve.
Local community pharmacies play an important role in our communities, and their clinical involvement is recognised in the Government's NHS plan. They play a much wider role in our local communities than most people think, even to the extent that my local pharmacy will take prescriptions to the houses of people who are disabled, infirm or elderly. That provides a further contact for those people, who are sometimes dislocated in their communities.
Declares that we, the undersigned, urge the Government to reject proposals that would allow unrestricted opening of pharmacies able to dispense NHS prescriptions, and to preserve local pharmacies and safeguard their continued services to local communities,
And the Petitioners remain, etc.
Sue Doughty (Guildford): I am glad to have the opportunity to debate such an important issue. It must be the lot of all newly elected Members to wonder why good causes do not get the support that they are promised and deserve. We secure Adjournment debates that may result in a new way forward or merely provide the Minister with another opportunity to tell us how much is being done while failing to deal with the core issue that gave rise to the debate in the first place. I hope that the Minister will answer my questions, deal with the realities of the situation and give a strong commitment to resolve the problems that Christopher's faces along with other children's hospices.
Christopher's is a hospice for life-limited children. It is based in Guildford and run by CHASE, the children's hospice service. It is a regional centre for palliative care, providing support to children and their families in an area that includes south and south-west London, Surrey and West Sussex. It is a special place for the children and their families. The Minister will understand that as time is limited, I cannot describe all the services that it provides or the sort of place that it is, but I hope that he will accept an invitation to visit the hospice to see for himself the work that is being done.
CHASE currently provides support in the community and at the hospice for 160 families. Its target is to support 300 families that are spread across 25 primary care trusts and those local authorities that have responsibility for children's services. The hospice is a success. It was built at a cost of £3.8 million with enormous fundraising support from the community, which it continues to receive. It opened its doors in November 2001, around the same time that PCTs were beginning to find their own way with their budgets.
Like any facility in the south-east, the hospice faces the usual problems in the health service of recruitment and retention of staff, a shortage of children's nurses, which is a specialised field, and difficulty with finding accommodation in the area. Fortunately, we have had some help from St. Faith's charity to mitigate that because medical staff at Christopher's do not qualify for key-worker housing. Five out of the nine beds are occupied and that will rise to seven in July. One must ask, however, when free nursing care will be provided for life-limited children.
The Minister will be aware that it is easier to obtain corporate support for the capital costs for building a hospice than it is for the running costs of any charity. Indeed, there has been a downturn in charity funding as a result of the downturn in the stock market. Money is in short supply. Although CHASE receives money from the New Opportunities Fund, that covers only 10 per cent. of its running costs for each of the next three years and has to cover its community services, palliative care, respite care and the end-of-life services. Will the Minister confirm that lottery money will not replace Government money for essential health care?
There are costs of care that Christopher's meets which, under other circumstances, would be met by the health service. It pays fees to the local doctors' surgery for two named doctors to visit part time four times a week and for call-out services. That ensures continuity so that the families and doctors know one another when the children visit or stay there. At the moment, that costs £48,000 a year and we expect a substantial increase next year, but we must remember that that is for a national health service.
In a debate in 2001 the hon. Member for North-West Leicestershire (David Taylor) said that children's hospices receive, on average, only 5 per cent. of their running costs. Christopher's does not even get that. As I have pointed out in the House on other occasions, the NHS saves money through the work of Christopher's. When a child leaves the Royal Marsden hospital, possibly at the end of its life, freeing up a place for another child, the funding for that child stops, but the child's health needs do not.
Last year51 weeks ago in facthaving followed up this issue on behalf of CHASE, the hon. Member for Putney (Mr. Colman) and I met the then Minister, the hon. Member for Pontefract and Castleford (Yvette Cooper). That was a useful meeting, but another year has passed. We explained why primary care trusts do not fund children's hospices: there might be 25 trusts covering 160 children using the services in a population of 3 million. The Minister understood that hospices cannot go to PCTs for funding for just one or two children in the area. We agreed that children's hospices should be regionally based to use resources wisely, so as not to duplicate. Indeed, CHASE sited Christopher's in Guildford so that it could be the provider for the region, not just for the town.
The hospice had its formal, royal opening last October, and having heard nothing after the meeting, I wrote in November to the Minister of State responsible for children's health, the hon. Member for Redditch (Jacqui Smith). It took until March to get a reply from the Under-Secretary of State for Health, the hon. Member for Salford (Ms Blears). She stated that funding is available from the PCTs, which are responsible for delivering services locally. It is as if none of that correspondence made any difference. A London PCT will not pay for a child in Guildfordthat is a fact.
Thankfully, the number of life-limited children in any PCT area is likely to be small. We do not even know how many there are. However, CHASE has approached trusts, and it does not get an answer. With so few children, the costs do not even register on their budget lines. The Under-Secretary suggested in her letter that
Both Christopher's and CHASE are brilliantly run by first-rate people. The chief executive of Christopher's knows exactly what he is doing, and the chair of the trustees knows exactly what she is doing. The fund-raising goes on, and we are fortunate that it does. We should be able to expect money from the cancer plan, but we will not get cancer cash. The good news for the children is that most of them get better or die from other conditions, so it is no good our looking to the cancer plan for funding.
The first child who died in Christopher's was Matthew Ashton of Camberley. He died of a brain tumour on 5 January 2002. Eight days before, just after Christmas, he came from the Royal Marsden hospital, which could do nothing more for him medically. He needed 24-hour morphine, and he came to Christopher's. He was visited by Gianfranco Zola, which was lovely for him and the hospice. That visit was very much appreciated and it made a lot of difference to everyone. His family were able to stay, and because Christopher's has special facilities for the care of children after they have died, the family stayed a further eight days so that other family and friends could come and say goodbye to him in the Mistral suite. However, when Matthew left the Royal Marsden, even though he needed 24-hour care, the NHS funding stopped, as it did for the five children receiving end-of-life care who died in March this year.
It has been suggested that we wait for the national service framework for children. There is a sub-committee for children with disabilities on which the Association of Children's Hospices has one representative, so no doubt the report will contain a short paragraph; but will it deliver any funding? It appears that the care of dying children is not important enough to be funded by the taxpayer. What do the Government plan to do about funding the health care of dying children?
I want to know how the initiatives described in the letter from the Under-Secretary of State for Health, the hon. Member for Salford, will deliver the funds for that health care. We cannot find out. Are there case studies to show how it happens? The Association of Children's Hospices cannot see it happening and we cannot find anything. We want to know how much longer children's hospices have to wait until they are told what is available, while in reality little is received. I want to know why children in hospices do not receive free nursing care.
How can I explain to all those people who raised £2 million for CHASE last year that the Government are not prepared to fund the health care of dying children? I want an assurance that their motives are not cynical. Is it because those people are good fund raisers and CHASE raises money itself that we do not get national health service money? I hope not, because that would be an insult to those hard-working fund raisers.
In using such phrases, it is not my intention to play a big emotional cardthat would be easy, but wrongbut we do not seem to be making our case. Ahead of the debate, I made it clear to the Minister's office that I need real answers. I do not want a recitation of the good works of the Governmentwe have had that, and it is not working. I am not here to score political points. All I want to know is what support the Government plan to provide for the health care of the children at Christopher's.