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Mr. Lammy: The responsibility is that of the national health service. I make a distinction, which is not a mere semantic distinction—it may represent a fundamental difference of position, but I need to articulate it. The hon. Lady referred to the Department of Health. I have made it clear that the £148 billion is not Department of Health money; it has been allocated to primary care trusts.
There is a great dichotomy. I have responsibility for diabetes, renal failure, pharmacy and dentistry. As the hon. Lady knows, in any health care economy, there are a range of important illnesses and conditions. Primary care trusts, with strategic health authorities providing performance management, must decide how that money is spent in a locality. As a Minister, I can tell the hon. Lady that it would be unusual if I had a meeting in my office and a group interested in a particular health issue did not say to me, "Minister, can you ring-fence the money when it gets down to the primary care trust, so that we know we will get it?"
Sue Doughty: I understand the point about not ring-fencing money. I am still having difficulty in understanding why a child who dies in a national health hospital has their nursing and medical care paid for, but a child who dies in a hospice from the same illness or renal failure or whatever does not.
Mr. Lammy: The Department of Health acknowledges that hospices are arriving on the doorsteps of primary care trusts every year. The national service framework is the lever that will bring about change. I said that the Department of Health was not in the business of giving out that £143 billion, but we are in the business of setting clear standards and saying what we expect. I am advised by officials that the children's hospice movement eagerly awaits the national service framework, because it wants those standards as the basis on which to begin a dialogue with the primary care trust and the strategic health authority about the ways in which they can assist hospices.
I hope that there is not too much distance between us. I understand the hon. Lady's frustration. As a Back Bencher, I raised similar frustrations with regard to my local hospice. My Department's responsibility is to set a clear direction of travel, but the picture today is much better than it has been in the past because of the New Opportunities Fund. The hon. Lady will know that St. Christopher's received £650,000, a significant amount of money, plus—
Sue Doughty: For the record, is the Minister referring to St. Christopher's hospice, which is different from Christopher's hospice?
Mr. Lammy: The hon. Lady is quite right. Christopher's hospice received £650,000, and the CHASE Children's Hospice Service received £74,000 in bereavement and palliative care awards. The hon. Lady says that that money may be used for capital spending and other costs, and I understand that. The Department expects high standards and we continue to work with children's hospices to support them as best we can.What is said in the House is on the record and is available for the hospice movement and for children's hospices to use when they are discussing such matters with colleagues locally.
The emerging findings highlight a compelling body of evidence from research and inspection reports that disabled children and their families do not always receive the support that they need. Moreover, there are particular concerns about services for children with life-limiting and life-threatening conditions. More flexible child care and short-term breaks are needed, and more co-ordination is needed in planning. To improve co-operation between social services, the health service, schools and local education authorities, some areas have multi-agency groups at a senior level to plan and commission services. Some groups also involve housing, transport and leisure services to promote inclusion in the community and report to local strategic partnerships.
The NSF is a 10-year strategy for improving the delivery of health and social services for children and young people, and maternity services. The outcome will be a coherent and integrated approach to services for sick and disabled children. It is already having an impact and that will grow with more funding coming on stream in successive years and the development of a better and more comprehensive understanding of the range and quality of services necessary to support our most vulnerable children and their families.
I emphasise that we are sincere in our wish to achieve that. I do not think that the distance between the hon. Lady and the Government is too great. In the past, as they have sprung up children's hospices have suffered from a funding lacuna, partly as a result of not being able fully to access ongoing revenue. However, I believe that the money that has been allocated down and the establishment of the NSF and NOF represent a much stronger position than we have been in for some time. Any NSF should project forward 10 years. Throughout the House, we all accept—this is not a party political issue—that there have been historical capacity constraints and issues in the NHS. Today, on May day, only a very short period has passed since the 1 per cent. increase in national insurance contributions, which will feed its way down.
I believe that through the standards that have been set and the work of patients forums and scrutiny panels at a local level, as well as through the inspection regime that we have introduced, there is a more positive
environment for the children's hospice movement. I am sure that the hon. Lady will continue to raise the issue, which the Government will continue to take seriously.
- Adjourned accordingly at ten minutes to Six o'clock.
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