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Epilepsy Nurses
4. Mr. George Osborne (Tatton) (Con): If he will make a statement on the provision of specialist children's epilepsy nurses. [142545]
The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): We do not collect this information centrally, but we understand that there are around 100 epilepsy specialist nurses supporting the treatment and management of children and adults with epilepsy. In February 2003, we published the Department of Health's epilepsy action plan, and primary care trusts are able to develop more epilepsy specialist nursing posts to support the delivery of local epilepsy services.
Mr. Osborne : A consultant paediatrician in my local hospital, Dr. Owens, has vividly described to me the enormous benefit that specialist epilepsy nurses can bring to families with epileptic children. Yet in my area, as in many others, those specialist services do not exist. Before putting all the responsibility on primary care trusts, would the Minister listen to what Dr. Owens has to tell us—indeed, I forwarded this letter to him a month ago—
- "Whilst the present Government has undoubtedly increased funding for the NHS, moneys are centrally controlled and streamed into specific areas. There is not much funding reaching children's services in district general hospitals."
Dr. Ladyman: First, there is less ring-fencing of money now than ever before. Eight-five per cent. of the money is passed on to primary care trusts, which can make decisions about how they want to deliver epilepsy services in the best interests of local people. It is
ridiculous to suggest that specialist nurses—important though they are—represent the totality of the delivery of services for children with epilepsy. I would refer the hon. Gentleman's constituent to the complete and comprehensive improvement in the priority that this Government have given to epilepsy compared with our predecessors. We have the epilepsy action plan, the national service frameworks for children and long-term conditions that are being produced next year, and two sets of NICE guidelines being produced that are also of direct relevance to epilepsy.
Tim Loughton (East Worthing and Shoreham) (Con): The lack of children's epilepsy nurses is another example of the chronic shortage of specialist children's nurses highlighted in the study by the Royal College of Nursing and the Royal College of Paediatrics and Child Health, and has been identified as a major factor in avoidable death. It underlines how children's health does not fit into this Government's target priorities. Does the Minister acknowledge the figures from the royal colleges, which point to the fact that another 2,700 children's nurses are needed just to meet demand? Can he now tell the House the number of pre-registration children's nursing training places being made available to overcome that deficiency? Will that serious problem be addressed in the children's national service framework, when we eventually get it?
Dr. Ladyman: First, there are now 48,000 more nurses in the national health service as a result of the investment made by this Government. How many would there be if we were cutting expenditure on the national health service by 20 per cent? Out of those 48,000 will come a substantial number of specialist children's nurses, including those for epilepsy. If the hon. Gentleman were genuinely reflecting the views of people working in children's health, he would be saying that this Government are dramatically improving prospects for children's health in this country, and that the national service framework is going to be one of the biggest steps forward in children's health in the history of the national health service.
GP Premises (East London)
5. Ms Oona King (Bethnal Green and Bow) (Lab): What measures he is taking to improve general practitioner premises in east London. [142546]
The Secretary of State for Health (Dr. John Reid): We have begun to transform the face of primary care in east London. In my hon. Friend's constituency, the local primary care trust is investing more than £1 million in opening, renewing and refurbishing general practice premises. By early next year, Tower Hamlets PCT will have opened three additional practices, bringing much-needed general practitioners to east London.
Ms King : I thank my right hon. Friend for that reply. Clearly, I warmly welcome the new premises that are being replaced, refurbished and reopened. In places such as east London, however, many older GPs, often operating from single practices that were inadequately housed, are retiring, and we are having something of a problem in ensuring that the new premises are duly
improved and in the right places. Can the Secretary of State write to me outlining what measures his Department might take to work more closely with developers, the Office of the Deputy Prime Minister and others involved in regeneration initiatives to ensure that we have improved premises in the areas that need them?
Dr. Reid: I will certainly undertake to write to my hon. Friend. In the meantime, I can say that she is absolutely right that we need to unleash the capacity that exists in the public or private sector to bring together all capabilities to address health care, whether that relates to buildings or other matters. She may know that we have developed a groundbreaking initiative for the NHS that is referred to as LIFT—the local improvement finance trust—to develop and encourage a new market for investment in primary care facilities. East London contains two LIFT projects, in Barking and Havering, which are bringing investment worth more than £47 million to London. Included in the east London scheme is a £4.9 million one-stop primary care centre in Church road, a £2.6 million primary care centre in Barking road and a £12 million one-stop primary care centre in Vicarage lane. All of that is vitally important, because if we do not put capacity into the NHS, we cannot give people the quality or choice that they should have.
Mr. Richard Bacon (South Norfolk) (Con) rose—
Mr. Speaker: Order. I have no wish to ignore the hon. Gentleman, but South Norfolk does not exactly come under east London.
Nurse Practitioners
6. Helen Jones (Warrington, North) (Lab): What progress has been made in developing the role of nurse practitioners; and if he will make a statement. [142547]
The Minister of State, Department of Health (Mr. John Hutton): Over the past five years, the number of nurses working in primary care has increased by 18 per cent., and many of them work as nurse practitioners. Their roles have expanded to include prescribing and ordering some diagnostic tests for patients. The Department also remains committed to developing further the role of nurses in secondary care through the establishment of new modern matrons, nurse consultant posts and greater clinical responsibility for nurses.
Helen Jones : I am grateful to the Minister for that reply, but will he tell the House how he proposes to extend further the role of nurse practitioners in primary care? Many patients find that extremely useful—it is very popular in my area. How might the arrangements for the new GP contract impinge on that process?
Mr. Hutton: I agree with my hon. Friend that nurses have a hugely important role to play in delivering an improved range of services in the community and primary care. I know that she assiduously follows such events, so she knows that the new general medical services contract that we successfully concluded with the British Medical Association will allow nurse-led practices to be developed in GMS for the first time. That
will allow nurses to continue expanding and developing their role to improve services for patients in all parts of the country, including those of my hon. Friend.
Mr. David Tredinnick (Bosworth) (Con): Will the right hon. Gentleman ensure that nurses who have trained in therapies such as acupuncture, herbal remedies and perhaps even homeopathy will not be discriminated against in hospitals? Will they be able to use such therapies as they should—to assist patients and reduce the pressure on doctors and other nurses?
Mr. Hutton: I certainly would not want to dismiss that. I have recently become something of a convert to some of those treatments. I had some reflexology recently and it was very nice indeed—I do not really want to say any more about that.
The hon. Gentleman raises a fair and important point. He might not have had a chance to read the command paper that has been published today on how we can make the NHS more responsive and equitable with choice. It deals with complementary medicines and I hope that he will find that our statements today take the issue further forward in a way he could support.
Syd Rapson (Portsmouth, North) (Lab): May I first, through you, Mr. Speaker, thank the Secretary of State for his morale-boosting visit to Portsmouth last week, which was welcomed by everyone? In welcoming the development of nurse practitioners, may I ask the Minister whether that will give nurses the authority to cope with the MRSA problem that affects most hospitals?
Mr. Hutton: My right hon. Friend the Secretary of State raises the morale of everyone in the NHS wherever he goes. My hon. Friend makes an important point about MRSA. The chief medical officer published a set of proposals last week that will help us to get on top of what we accept is a serious problem for the NHS. I agree that a key way in which we could make a significant improvement would be to develop the authority and role of nurses, which is precisely what modern matrons are doing in our hospitals today.
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