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Long-term Care

3. Sir Nicholas Winterton (Macclesfield): If he will take steps to increase funding for the provision of long-term care. [129950]

The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): The Government are committed to providing the investment that is needed to secure real improvements in long-term care. We are determined to see that older people get the support that they need to lead life with respect and dignity. We have announced an overall real-terms increase of £1 billion for older people's social services by 2006.

Sir Nicholas Winterton : Does the Minister not accept that capacity across all sectors is approximately 74,000 places lower than it was at the peak of provision in 1996, and that in the 15 months leading up to April this year 13,400 elderly persons' places have been lost in residential homes—primarily independent and private homes? While the new minimum standards have clearly made a contribution to that by placing substantial burdens on small homes, the Minister must surely admit that underfunding is part of the problem. Will he please direct further attention to the situation, and try to ensure that the places that are required are provided?

Dr. Ladyman: I can give the hon. Gentleman an absolute assurance that we will look at the issues carefully; but the market contains 10,000 more care home places than there are people waiting for them, according to Laing and Buisson's figures.

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As the hon. Gentleman says, there has been a contraction of the care home market since 1996. The implementation in the early 1990s of the National Health Service and Community Care Act 1990 created a change in the market, which has continued to contract at a fairly steady pace ever since.

If the hon. Gentleman would like some advice, let me refer him to the Minister who oversaw the start of the contraction—the hon. Member for West Chelmsford (Mr. Burns).

Mr. Mark Todd (South Derbyshire): Aston Hall hospital in my constituency provides long-term care for people with learning disabilities. I have corresponded with my hon. Friend about delays in its reprovisioning programme. Will he ask his officials to turn their minds again to the need for urgent solutions and assistance for a reprovisioning process that, although tortuously and complexly designed, has won the support of all concerned?

Dr. Ladyman: I will certainly undertake to look again at the details of that case. Support for learning-disabled people is one of my highest priorities in my new portfolio, and I intend to ensure that the substantial extra resources made available by the Government for their care will indeed go to them.

Mr. Andrew Mitchell (Sutton Coldfield): Does the Minister think it right for Birmingham city council to pay twice as much for places in its own residential homes as it pays for places in the private sector? Is that not a massive abuse of the taxpayer, as well as an abuse of the hard-working small business people employed in that sector?

Dr. Ladyman: We trust local authorities to make decisions about their areas. It is they who are in a position to assess the needs of their local care home markets, and they will pay the price set by those markets for the services that they require. They will tender for places, the marketplace will offer a price, and they will deal at that price. Why should they be expected to pay more than the market is asking them to pay?

Mr. Harry Barnes (North-East Derbyshire): Will my hon. Friend ensure that any increased funding that finds its way into private care homes leads to extra controls and regulations governing the standards operating in those homes? Is he happy that we are currently receiving value for money?

Dr. Ladyman: If my hon. Friend can give specific examples of our not receiving value for money, I shall be pleased if he brings them to me and I shall take them up with him. I am happy that in general we are receiving value for money. I think that the new standards we have set are a vital resource, ensuring that we drive up the quality of care for older people and for anyone who must live in a care home or nursing home. They are, I believe, an essential tool in the Government's armoury, enabling us to improve services for everyone everywhere.

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Paddington Health Campus

4. Mr. John Randall (Uxbridge): What the latest estimate is of the costs of the Paddington Health Campus. [129951]

The Minister of State, Department of Health (Mr. John Hutton): £800 million.

Mr. Randall : The Minister will be aware that three years ago the estimated cost was £360 million. Three years later, when we have still not even seen outlined planning permission, why have the costs spiralled out of control?

Mr. Hutton: Costs have risen because the new development at Paddington Health Campus will be bigger than the one originally proposed in 2000, so that we can provide more treatment for NHS patients in London—including in the hon. Gentleman's own constituency—better facilities and expanded research facilities. Most people in London will surely regard an £800 million investment in the NHS as good news.

Mr. John Wilkinson (Ruislip-Northwood): Does the Minister realise that this is the most grotesque waste of public money, inasmuch as facilities of outstanding excellence exist at Harefield hospital, which the local community continues to support? As my hon. Friend the Member for South-West Hertfordshire (Mr. Page) knows, only yesterday the Moor Park Lions gave £37,000 of their own money to the Heart Science Foundation. It would cost only £18 million fully to modernise Harefield hospital; is that not what the people want and deserve?

Mr. Hutton: I genuinely understand the concern of the hon. Gentleman and of the hon. Member for South-West Hertfordshire (Mr. Page) about Harefield hospital; indeed, all hon. Members will have some sympathy with the points made. However, the Government have to decide what is best for the NHS across the capital as a whole, and I have absolutely no doubt whatsoever that the investment in the Paddington Health Campus will produce for the NHS in London some of the best facilities to be found anywhere in the world. That is money well spent.

Ambulatory Care Units

5. Kevin Brennan (Cardiff, West): If he will make a statement on the development of ambulatory care units in the NHS. [129952]

The Secretary of State for Health (Dr. John Reid): The prevention of preventable pain for patients will always be this Government's top priority. That is why the national health service is developing a large number of new treatment centres, which will enable more patients to receive more operations more quickly. Some will be run by NHS providers and others by independent sector providers under contract with the NHS, but all will contribute to the relief of preventable pain.

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Kevin Brennan : I am grateful to the Secretary of State for that answer. In developing his plans for England, will he look at the example of the ambulatory care centre in the University hospital of Wales, in Cardiff, which is providing excellent, state-of-the-art treatment for patients very quickly? That is an example of the treatment that all of us would like to see from a world-class national health service. If the centres that he is developing in England are of the same standard as the one serving my Cardiff constituents, I am sure that hon. Members throughout the House will welcome this development.

Dr. Reid: I am grateful for those comments. What my hon. Friend says is true, and I have seen with my own eyes the results that treatment centres can produce. A centre in Bradford—it is part of the NHS; it is not in the independent sector—has reduced the waiting time for minor operations from about 12 months to six weeks. If we consider the vast reduction in the time that 22,000 patients in the Thames valley needing cataract operations will have to wait in pain, we can see the real benefits.

All these new systems are being introduced on top of the huge investment in resources that we are making in the NHS itself, which is already producing more doctors, more nurses and more staff. I am delighted to tell the House that, according to figures released this morning, in the past three months the number of GPs increased by another 293, and the number of consultants rose by 321. We still have a long way to go, but we are getting there.

Dr. Richard Taylor (Wyre Forest): Will the Secretary of State explain the dual tariff, whereby the NHS pays more for operations and procedures in privately run treatment centres than in NHS treatment centres?

Dr. Reid: If such an unfair tariff existed, I would explain it; it does not, but I shall explain the mechanism, which has perhaps confused the hon. Gentleman. The tariff that will be paid to treatment centres, whether they are NHS treatment centres or centres in the independent sector, will be exactly the same as that paid by primary care trusts to normal, traditional hospitals inside the NHS. It is true that in the case of NHS establishments, we also pay other costs, including building costs; but we will pay the independent sector an additional premium from the centre, in order that it can set up quickly, acquire staff and maintain the buildings.

So the tariff is exactly the same, and the important point that I ask the hon. Gentleman to stress is this. In the past week, I have heard the views of consultants, some of whom appear not to want us to reduce waiting lists. I can understand why, because doing so reduces the demand for private care. I have heard some trade union leaders standing up against these changes and I have heard a range of producers and providers doing the same. For goodness sake, could we for once think of the people whom the health service exists to serve—the patients? About 250,000 of them will have extra operations from the new treatment centres, in addition to the 300,000 more operations that the NHS is already providing, so many people are suffering much less pain as a result of our changes.

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