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Domiciliary Care
7. Mr. Mark Prisk (Hertford and Stortford) (Con): If he will make a statement on the availability of domiciliary care. [162782]
The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): Domiciliary care provision was 14 per cent. higher in 2002 compared with 1997.
Mr. Prisk : I am grateful for that short response from the Minister, but he omitted to mention the simple fact that there has been a 20 per cent. fall in the number of
households receiving domiciliary care since 1997. Given that, can he explain why the Government intend to waste £100 million on fines for delayed hospital discharges when most experts agree that that money would be far better spent on more home help and more care for the elderly?
Dr. Ladyman: First, let us consider the hon. Gentleman's notion that the number of people receiving care has gone down. If we look at the full range of services, including respite care and meals, the number of people receiving care has gone up from 925,000 to 988,000. He might have liked to announce the fact that his own social services department has had a 67 per cent. increase in its adult social services budget and that the Government's actions to combat delayed discharges are saving 1.25 million bed days a year.
Mr. Peter Pike (Burnley) (Lab): Does my hon. Friend agree that, although we still have a long way to go, we have made great progress towards achieving better co-ordination between social services and the NHS in Lancashire and almost everywhere else in the country since the Government were elected, and that we shall continue to work towards that?
Dr. Ladyman: My hon. Friend is absolutely right. As he is aware, we have increased the number of people who are receiving intensive home care and able to stay in their own home by 30 per cent.
Sandra Gidley (Romsey) (LD): On 19 January, I received an answer to a parliamentary question informing me that 62 of the 243 fully registered domiciliary care providers did not meet the standards. Twenty years after 1984, it appears that we have our own Ministry of Truth, because imagine my surprise when I saw in Hansard that the number 62 had been altered to two. The Minister is keen to see more vulnerable older people accessing domiciliary care services. Is that why the figure seems to have changed? The real scandal is the fact that a quarter of domiciliary care agencies are below standard. Is he satisfied that there is no end-date by which all agencies must achieve satisfactory standards?
Dr. Ladyman: I obviously have no way of knowing what is in Hansard without checking it myself, and I will certainly look at the figures that the hon. Lay has mentioned. All domiciliary care agencies meet the regulations, that is, the legal requirement, but many of them are not yet up to the national minimum standards that we have set. That is wrong —indeed, that is why we set those standards—and that is why we are driving up standards. What a pity that she and her hon. Friends keep opposing us as we do that.
NHS Dentists (West Cumbria)
8. Tony Cunningham (Workington) (Lab): What plans he has to increase the number of NHS dentists in west Cumbria. [162784]
The Minister of State, Department of Health (Ms Rosie Winterton): Primary care trusts in my hon. Friend's area plan to increase the number of NHS
dentists by expanding the dental access centre in Egremont, using new access funds to double the number of practices offering additional day-time emergency sessions, and recruiting more dentists from the UK and overseas.
Tony Cunningham : I thank the Minister for that reply. For quite a considerable time, we have been waiting for a pilot scheme in west Cumbria to increase the number of NHS dentists. Will she take a personal interest in that initiative, as that could go some way to resolving many of the problems associated with lack of access to NHS dentists?
Ms Winterton: I know that my hon. Friend has taken a close interest in the pilot project on behalf of his constituents. It will mean that the PCT will directly employ the dentists and staff to increase NHS dentistry in the area. There were some problems in agreeing the final arrangements for that pilot, but I am delighted to be able to tell him that it will be up and running by 1 May.
Paddington Health Campus
9. Ms Karen Buck (Regent's Park and Kensington, North) (Lab): If he will make a statement on progress on the Paddington health campus development. [162785]
The Minister of State, Department of Health (Mr. John Hutton): The proposals for the Paddington health campus scheme are being reviewed by my Department in conjunction with local health bodies. We expect to make an announcement about the future of the scheme before the end of this month.
Ms Buck : My right hon. Friend will know that I believe that it is absolutely right to review the business case and to ensure that we get value for money from the scheme, but yesterday afternoon I and other hon. Members met senior clinicians from Royal Brompton and Harefield hospitals, Imperial college medical school and St. Mary's hospital, who made it clear that to do nothing is not an option. When my right hon. Friend considers the review of the business case, will he bear in mind the costs of reprovisioning for Royal Brompton and Harefield hospitals, Imperial college medical school and St. Mary's hospital, should there be any further delay in the Paddington campus site?
Mr. Hutton: I am grateful to my hon. Friend for her support of our work on the scheme, and I strongly agree that what she described as the do-nothing option is not a serious possibility for us. We recognise the need for improvement and investment, not just in the St. Mary's site but in specialist heart services across west London. I am confident that she will support us in ensuring that we get the investment in the right place at the right time.
Mr. John Randall (Uxbridge) (Con): The word "progress" is a bit of a contradiction in terms in respect of the Paddington health campus, for seldom has so little been done by so many at such great cost to the public purse. Could the Minister give us some idea of when the outline planning application, which has been necessary since February 2003, will be lodged with Westminster city council?
Mr. Hutton: As I said, all those issues are being looked at as part of the current review. It is fair to point out that the hon. Gentleman is not a supporter of the Paddington health campus and does not want to see it progress. The rest of us, on the Labour Benches, need to judge his comments in that context.
Psychiatry Services
10. Mr. Colin Challen (Morley and Rothwell) (Lab): What plans he has to improve psychiatry services. [162787]
The Minister of State, Department of Health (Ms Rosie Winterton): Mental health services for all age groups are being modernised in line with the standards set out in the national service frameworks and the commitments and additional funds announced in the NHS plan.
Mr. Challen : I am grateful to my hon. Friend for that answer, which shows that the Government are committed to improving psychiatric services. My particular concern today is for the 750,000 people who are suffering from dementia—a figure that is bound to increase as people live longer. There must be an almost equal number of people caring for those suffering from dementia, and I imagine that many of those people will suffer from depression occasionally. All that will put a great demand on mental health services. Is my hon. Friend confident that we will match the expectations of older people in our delivery of mental health services to them?
Ms Winterton: My hon. Friend is quite right to say that dementia is one of the most important health and social care issues of our time. In the past there have been unacceptable variations in the quality of care delivered to those suffering from dementia and those caring for them. That is why a key element of the national service framework for older people is an examination of how we can improve the early diagnosis of dementia and so provide better treatment and better access to care plans. At the same time, I am sure that my hon. Friend will join me in welcoming the statement that the Secretary of State made yesterday, in which he announced extra funding for medical research into conditions such as dementia and Alzheimer's.
Sir Nicholas Winterton (Macclesfield) (Con): It is a sad fact that many people languishing today in Her Majesty's prisons have been sent there by the courts because there are inadequate beds or places in psychiatric hospitals. That was discovered many years ago by the Select Committee on Social Services when it undertook an inquiry into the prison medical service. Will the Minister tell us what improvements are taking place in the provision of psychiatry and psychiatric services to those who commit crimes and are sent to prison, but who should in fact be in psychiatric hospitals?
Ms Winterton: Extra investment for psychiatric care has gone into prison in-patient services. At the same time, we are addressing how we can provide treatment earlier to people in that community through a series of
measures, such as assertive outreach and crisis resolution teams, so that we can ensure that people do not get to the stage that the hon. Gentleman has outlined. He will know that we also considered various measures in the draft mental health Bill, and we will make further announcements on that shortly.
Dr. Doug Naysmith (Bristol, North-West) (Lab/Co-op): My hon. Friend will be aware that when choice and improvement in mental health services are discussed, one of the highest priorities for patients is their ability to choose the lead health professional who will be concerned with their case. That can involve choosing from among psychiatrists, or choosing a psychologist or a trained psychiatric nurse instead of a psychiatrist. Does my hon. Friend feel that access to such choice could be accommodated in the improvements that are certainly taking place today in mental health services?
Ms Winterton: My hon. Friend is absolutely right to say that the choice agenda for mental health is vital if we are to improve services for those with mental health problems. The new home resolution teams and home treatment teams are examples of the need to look at new ways of working for professionals. We also need to ensure that the most appropriate person is available to the service user—a person to whom they can relate when discussing their care plans.
Tim Loughton (East Worthing and Shoreham) (Con): Does the Minister agree with the vast majority of psychiatrists who claimed in a recent survey that it now takes more than six months, following an initial presentation at a general practitioner's surgery, to be referred to a psychiatrist, and that the situation has got worse because of the recruitment crisis among psychiatric staff? Worryingly, a number of such staff are themselves on long-term sick leave for stress-related conditions. Most worryingly, the survey showed that some 40 per cent. of black and ethnic minority mental health service users who asked for help in the past three years were turned away, compared with a figure of 28 per cent. for the white population. Moreover, 28 black people per 100,000 of population end up in secure units, compared with just four per 100,000 of the white population. How many full-time psychiatrists are working in the NHS compared with seven years ago, and what specifically is the Minister doing to address the appalling two-tier system, which militates against the prospects for ethnic minority patients?
Mr. Speaker: Order. There were several questions from the hon. Gentleman but there should be only one supplementary. The Minister will answer one of the supplementary questions.
Ms Winterton: Since 1997, the number of psychiatric consultants has increased by almost a third—from 2,447 in 1997 to 3,217 in 2003.
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