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The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): We want to see a new lease of life for community hospitals. Our guidance on service change, "Keeping the NHS Local", was published in February last year. It emphasised the important role community hospitals can play in a network of care across the whole health and social care system.
Mr. Luff : Will the Minister join me in congratulating my hon. Friend the Member for West Worcestershire (Sir Michael Spicer) on his successful campaign to create a new community hospital at Pershore, financed by Wychavon district council and built in partnership with the South Worcestershire primary care trust? Will the hon. Gentleman also reassure me that when the time comes, as it must, to redevelop and renew Evesham community hospital, its crucial role in support of the county's acute hospital will be fully recognised, and there will be no reduction in services when that redevelopment takes place?
Dr. Ladyman: The development of community hospitals has to be a matter for local discussion, and I am not prepared to intervene in what is still clearly a local issue. I entirely agree with the hon. Gentleman that the community hospitals in his area have an important role to play. It is important that the trust develops that role, but does so in conjunction with, and in discussion with, local people.
Mr. Michael Foster (Worcester) (Lab): The community hospitals in south Worcestershire predominantly serve the rural areas to the east, south and west of the city of Worcester. As a result, my constituents in the city, as well as people north of the area in Droitwich in the constituency of Mid-Worcestershire, do not get the benefits that can be provided by community hospitals. Will my hon. Friend look favourably on any plans that may come his way to provide community hospitals in areas that cover patients in my constituency and in the north of south Worcestershire?
Dr. Ladyman: My hon. Friend identifies exactly why those have to be local decisions and plans must be developed locally. We have to balance the needs of different parts of any particular area to ensure that everyone is getting the services that they require. Of course I will look favourably on any plans that are put to me, but only once they have been developed by the local population to meet local needs.
The Minister of State, Department of Health (Ms Rosie Winterton): Since this Government came to power in 1997, the number of consultant psychiatrists employed by the NHS has increased by 31 per cent. Nevertheless, we recognise that we still have a long way to go to make up for the deficit that we inherited. That is why we are planning a further increase of 8 per cent. between March 2004 and March 2006.
Dr. Pugh : Sadly, I am not much comforted by that response. Does the Minister recognise that in areas such as Merseyside the shortage of psychiatrists is now so acute that it seriously threatens the community health programme?
Ms Winterton: I certainly recognise that there are challenges ahead. We are doing a lot of work with the Royal College of Psychiatrists and others to increase training places and to ensure that different working practices ease some of the burden on psychiatrists. I should also say, however, that the number of consultant psychiatrists in Cheshire and Merseyside strategic health authority has risen by 45 per cent. while the national average has been 31 per cent., and that the number of vacancies is lower there than in other parts of the country.
The Minister of State, Department of Health (Mr. John Hutton): NHS franchising is a way of introducing new senior management teams to poorly performing NHS organisations as a means of improving their performance.
Mr. Gray : We are all in favour of improving performance. However, when the Royal United hospital in Bath was failing and it was announced that senior management was to be franchised, that was widely perceived as being a kind of stealth privatisation, the senior management all resigned, and the franchise proposals were pulled, yet when the chief executive of the Kennet and North Wiltshire primary care trust resigned through overwork and stress, it was announced that her job was to be franchised, which apparently means a job-sharing agreement with the next-door PCT. Is franchising privatisation or job-sharingor is it just new Labour drivel?
Mr. Hutton: None of the above. What a load of complete poppycock from the hon. Gentleman, who has nothing positive to say about the national health service. What happened in Bath and Bristol took place on the advice of the chief executive of the strategic health authority. The hon. Gentleman and his motley crew of Front Benchers are always complaining about micro-management by Ministers, but this was a case of the local NHS deciding how it wanted to proceed, and that is precisely how it should be done. As for the hon. Gentleman's local primary care trust, I agreethis is one issue on which I can agree with himthat we have to tackle poor performance, which we are doing by looking to strengthen management teams.
The suggestion that franchising is privatisation is a complete red herring. The ownership of trusts stays with my right hon. Friend the Secretary of State, the trust boards remain in place, and NHS patients will continue to receive a service that is free at the point of need. Even in the hon. Gentleman's world, that cannot be described as privatisation.
Mr. Gardiner : I am sure that, like me, my right hon. Friend wishes to pay tribute to the general practitioners who came here in the 1970s from east AfricaIndian doctors who provided the backbone of the national health service. They are now approaching retirement. In the next five years, especially in towns where there was a large immigration of those doctors in the early 1970s, there will be a genuine problem. Will my right hon. Friend do all that he can, not only to pay tribute to those
Mr. Hutton: I certainly join my hon. Friend in paying tribute to the work of doctors in the NHS. They have done a brilliant job over many decadesindeed, many continue to do thatand we all owe them a significant vote of thanks. My hon. Friend is right that in many parts of Britain they are the backbone of primary care in the NHS. He knows the steps that Brent primary care trust has taken to expand primary care in his constituency, and I hope that he can support them. The NHS in London faces specific challenges in expanding primary carehe will be aware of that. The major capital investment programme£350 million for London primary care services in the next two yearswill help to resolve some of the difficulties that he described.
We are examining carefully the regulations about who can practise here, to facilitate wider entry into the NHS in England, but above all, we must keep the investment flowing into it. That is the sure way to ensure that we can provide the service that our constituents and patients want. We should not follow the advice of others, who would like investment in the NHS to be cut by 20 per cent.
Mr. Dominic Grieve (Beaconsfield) (Con) (urgent question): To ask the Solicitor-General to make a statement on the review of criminal cases resulting from the decision of the Court of Appeal in the case of Angela Cannings.
The Solicitor-General (Ms Harriet Harman): Yesterday's judgment in the Court of Appeal in the appeal against conviction of Angela Cannings has serious and far-reaching implications. The Court of Appeal said that, in relation to unexplained infant deaths when the outcome of the trial depended exclusively or almost exclusively on a serious disagreement between distinguished and reputable experts, it would often be unsafe to proceed. We are acting on that judgment.
In December, when the Court of Appeal freed Angela Cannings, we asked for all cases that potentially involved sudden infant death syndrome to be identified as quickly as possible. To date, some 258 convictions, reaching back over the past 10 years, for murder, manslaughter or infanticide of an infant aged under two years by its parent, have been identified. Those cases will be considered further as a matter of urgency to establish how many were convictions that the Court of Appeal judgment yesterday indicated may be unsafe. We expect the process to be completed swiftly in the coming weeks.
We propose that in all cases that appear to fulfil the criteria that the Court of Appeal laid down, the convicted person will be informed of developments immediately. There are then two possible routes. Either the case will be referred to the Criminal Cases Review Commission or the convicted person, with legal advice, can appeal out of time to the Court of Appeal. Under the Criminal Appeal Act 1995, the CCRC has the power to consider whether the convictions should be referred to the Court of Appeal.
The Attorney-General has made it clear that we are especially concerned about cases in which the convicted person is still in prison. So far, we have identified 54 prisoners whose cases may involve sudden infant death syndrome. They will receive the highest priority. The Attorney-General has already spoken to the chair of the CCRC and will meet him on Friday to discuss further the way in which the review of the cases can be expedited. We have also asked the Crown Prosecution Service to conduct a review of the 15 current cases that involve prosecutions for unexplained infant death.