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Stroke Services

7. Sandra Gidley (Romsey) (LD): What the latest average waiting time is for a scan for patients with a suspected stroke. [142548]

The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson): The information is not collected centrally. The target in this area is to achieve a CT or MRI scan in less than 48 hours. The 2001–02 national sentinel stroke audit reported that more patients than ever had had brain imaging, with at least 83 per cent. meeting that target.

Sandra Gidley : I hope that the Minister is not complacent about those figures because they mean that almost 20,000 people did not receive the required service in the required time. As such targets are part of the national service framework, does the fact that the information is not monitored centrally mean that NSFs are not worth the paper that they are written on?

Miss Johnson: I do not think anyone in the Chamber or outside it will give any credence to that line. One

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target in the priorities and planning framework for 2003 to 2006 requires the establishment of specialist stroke services by April 2004, which are important in all hospitals that care for people who have a stroke. At least three quarters of hospitals already have specialist stroke services. The local delivery plans show that 94 per cent. aim to meet that target soon.

Mr. Richard Bacon (South Norfolk) (Con): Will the latest average waiting time for a scan for patients with a suspected stroke be recorded in the national programme for IT in the health service, the contracts for which have been signed with unseemly haste despite the concerns of many in the industry? Can the Minister confirm whether a significant financial bonus has been given to the director general of IT, Mr. Richard Granger, for signing the contracts by a specific date?

Miss Johnson: I am surprised at the hon. Gentleman's line of questioning. The third national sentinel stroke audit said:


Those are not the words of the Department of Health, but come from the audit on patients with stroke. Of course we want to improve services to patients through the IT investment that we are making. I should have thought that hon. Members would universally welcome that.

Mr. Harry Barnes (North-East Derbyshire) (Lab): Is the Minister aware that if someone has a stroke at the back of the head, it affects their balance, and that the test for that reveals whether someone has multiple sclerosis or has had a stroke? It is assumed that if a person is young, he has MS, and that if he is old, he has had a stroke. That is not exactly scientific because there are other possibilities. The proper way to diagnose people in those circumstances is to do a scan. It is important that that service is developed throughout the country.

Miss Johnson: I am enormously grateful to my hon. Friend for improving my medical education further. That is a useful point. The number of scanners has grown considerably since 1997. Altogether, the number of MRI scanners is expected to increase from 110 in 1997 to 276 by 2004. That is an increase of 151 per cent.

Mr. Andrew Lansley (South Cambridgeshire) (Con): The Minister referred to the national sentinel stroke audit, which said that only 27 per cent. of stroke patients spent the majority of their time in a specialist stroke unit. Does she agree that what matters most is the character of the specialist unit and whether patients spend time in it? What milestones or targets does the priorities and planning framework suggest for the proportion of patients who receive specialist care?

Miss Johnson: By next April, 95 per cent. of all hospitals will have specialist stroke services. I agree that it is important that services are appropriately tailored to meet patients' needs. We are investing in the NHS to make such provision available, which we base on best practice, spread across the service by the Modernisation Agency. That allows patients to receive the standard of care that Labour Members think they deserve, backed by the investment that will deliver that standard of care.

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Care Homes

8. Mrs. Marion Roe (Broxbourne) (Con): If he will make a statement on the change in the number of care home beds since 1997. [142549]

The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): In 1997, there were 534,410 care home beds. In 2001, there were 528,000 beds in England. Data on care home capacity have not been collected by the Department of Health since 2001, but data collected independently by Laing and Buisson indicate that at July 2003 there were about 10,000 vacant care home places in the United Kingdom.

Mrs. Roe: Does the Minister acknowledge the figures published by Laing and Buisson last summer, which show that capacity in the care home sector—throughout all sectors—was 74,000 places lower than the peak in 1996? Does he really believe that this catastrophic loss of care home places is of the care sector's own choosing? When will he admit that care homes are closing because the Labour Government's illthought-through policies are forcing them to do so?

Dr. Ladyman: Care home places are being lost because older people do not want to go in them. We are giving people choice. There are 81,500 people receiving intensive care home packages so that they can stay at home. If the hon. Lady studies the performance indicators published only a couple of weeks ago, she will find that we have increased the number of people being supported at home by 30 per cent. since 1998. We are giving older people choice. The Conservative party wants to force them all, against their will, into care homes.

Mr. George Stevenson (Stoke-on-Trent, South) (Lab): Does my hon. Friend agree that a continuing concern about the provision of care for the elderly—particularly in respect of elderly care beds—is the artificial divisions that exist between the national health service and social services? Is it not time that the Government redoubled their efforts to encourage these authorities to merge and to establish care trusts for the elderly so that the necessary focus can be placed on the comprehensive requirements of the elderly when they are in need of care?

Dr. Ladyman: I very much agree with my hon. Friend. Care trusts to support older people are a valuable tool. I encourage any local council and primary care trust looking for opportunities to improve care for older people to think carefully about building up the partnerships, co-operation and trust that are necessary to improve working, and then to cement those partnerships by forming a care trust that can deliver the comprehensive service that I know my hon. Friend supports.

Mr. Simon Burns (West Chelmsford) (Con): The care home sector will be deeply distressed that the Minister seems to be in total denial of the crisis in care. At a time when care homes are under severe financial pressures, will he tell us what justification there is for the fact that an enhanced check fee that was £12 per check in April

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2002 will, by next April, have risen 175 per cent. to £33, placing more financial burdens on care homes? It will be seen by many as another stealth tax.

Dr. Ladyman: I am surprised at the hon. Gentleman and his constant attacks on Criminal Records Bureau checks. If we ever needed any confirmation of why such checks are necessary, we saw it recently in the "Panorama" programme. That is what the Government have implemented—[Interruption.]

Mr. Speaker: Order. Let the Minister answer in his own way.

Dr. Ladyman: Thank you, Mr. Speaker.

The cost has increased because we consulted the industry and made it clear to it that we would expect full cost recovery over a period. We are moving to that. The industry can pass on the costs to those to whom it sells its services. The Government fully fund that through local councils.

Mrs. Anne Campbell (Cambridge) (Lab): May I encourage my hon. Friend to concentrate on the care that most of my elderly constituents prefer to receive—domiciliary care? Will he ensure that social services departments are capable of providing the high-quality care that people need when they are living at home?

Dr. Ladyman: My hon. Friend is right. I am glad that at least on the Government Benches we are consistent in our support for the choice that 80 per cent. of elderly people tell us that they want to make, which is to stay in their own homes. We must work much harder to ensure that social services are aware that people want to make choices and that they have all the facilities that they need at their disposal to make such choices a reality for everybody.

Mr. Archie Norman (Tunbridge Wells) (Con): Does the Minister realise that his claim that care homes are closing because elderly people do not want to go into them will sound risible to people in west Kent, where all the care homes are full and elderly people have to be shipped off to the south coast because homes are still closing? Does he acknowledge that one reason why they are closing is the pattern of condescending regulation imposed on care home managers, such as the requirement for experienced care home owners and managers to do a four-year national vocational qualification in management, despite the fact that they have been running perfectly good homes for many years?

Dr. Ladyman: It is our intention to drive up standards in care homes. The hon. Gentleman represents Tunbridge Wells, so may I suggest that he read the last edition of Caring Times, in which he will see a report from a property consultant saying that the care home market has turned around, and that a care home in his constituency was recently sold for far more than the asking price because serious investors are coming back into what they regard as a healthy marketplace. I am sure that the shadow Secretary of State, the hon. Member for South Suffolk (Mr. Yeo), will confirm that

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fact, because he has a declared interest in the care home industry and is presumably making good money out of it.


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