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Health Investment (Staffordshire)

6. Paul Farrelly (Newcastle-under-Lyme) (Lab): What investment is being made in the national health service in north Staffordshire. [177290]

The Secretary of State for Health (Dr. John Reid): For the current financial year, 2004–05, the four primary care trusts in north Staffordshire have been allocated a total of £478 million, an increase of £41.4 million, or 9.49 per cent., since the previous year. For the next financial year, 2005–06, the increase will be a further 9.06 per cent., taking the total allocation to £521.4 million.

Paul Farrelly: The NHS is indeed making great strides in north Staffordshire, including a brand new hospital, a new medical school at Keele university and brand new health centres across the whole area. However, after the next election, will it be the Government's policy to continue to invest in that way in the NHS, in north Staffordshire and across the country, or to drive the NHS out of existence within five years?

Dr. Reid: My hon. Friend makes the point that there is a need for long-term and sustained investment in the national health service to make up for the 20 years of under-investment before this Government came to office. We will continue that investment at the present level for another four years. We will not return to the days of under-investment and starvation of our hospitals with the previous number of nurses, nor do we intend to charge patients to allow them to jump the queues on the basis of how much money they have in
 
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their pockets to contribute towards doing so. The degree of power and choice for NHS patients should depend not on the size of their wallets, but on exactly what their medical needs are. The Labour party will always defend that principle.

Mr. Tim Yeo (South Suffolk) (Con): I pay a warm tribute to the staff at the North Staffordshire hospital, but will the Secretary of State confirm that, despite their best efforts, three out of 10 out-patients at that hospital wait longer than 13 weeks for an appointment? Will he confirm that that hospital has under-achieved in readmitting patients whose operations were cancelled for non-clinical reasons? Will he confirm that, in the past year, MRSA rates have increased at the North Staffordshire hospital? In that respect, will he confirm that the problems that they face are typical of the whole NHS—that more operations are cancelled than in 1997, that the number of hospital-acquired infections is much higher than in 1997 and that far more people are waiting far longer for serious treatments, such as radiotherapy, than before? Is it not the case that, under Labour, administrators are being hired at three times the rate at which doctors are being hired? It is no surprise that, under Labour, taxpayers have paid for a 37 per cent. rise in spending and seen a 5 per cent. rise in activity.

Dr. Reid: Five minutes ago, Opposition Members talked about their affection for NHS staff. Now, once again, they brand them all as useless bureaucrats. That is the nature of the Opposition's commitment to the NHS. I cannot confirm any of the points that the hon. Gentleman made about North Staffordshire hospital. I can confirm, however, that, under this Government, that hospital has had two new theatres, additional critical care beds, a ward for surgical patients, a doubling in its capacity for cardiothoracic surgery with a new theatre and critical care beds for that purpose, a new catheter laboratory and a dramatic reduction in diagnostic waiting times for cardiac patients and that more than 90 per cent. of patients now receive accident and emergency care within the world standard of four hours. He talks about the national picture, which is represented there, but we have 67,500 more nurses, 14,000 more doctors, the biggest building programme in the history of the NHS, a 10 per cent. cut in premature deaths from cancer, and a 23 per cent. cut in premature deaths from cardiac heart disease. All that would be ruined if that lot ever got into power again.

Mr. Dennis Turner (Wolverhampton, South-East) (Lab/Co-op): The information that we have just heard regarding north Staffordshire is very good news for the people of that area and for the people of Wolverhampton, because North Staffordshire hospital is very close to my constituency and the whole of Wolverhampton. Irrespective of the Opposition's carping, I congratulate our Government on that investment. May I add that we have also had major investment in Wolverhampton? We have a state-of-the-art, 21st-century heart and lung unit ready to be opened as I speak. I want the Secretary of State to assure me that it will operate to full capacity, when we have the official opening.

Dr. Reid: I can confirm that to my hon. Friend. Indeed, I think from memory that there is a new cardiac
 
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centre at Wolverhampton, but of course there will be more. The project in the North Staffordshire hospital, which the hon. Member for South Suffolk (Mr. Yeo) forgot to mention, involves another £350 million to develop a new acute hospital on the site of the city's general hospital and a new community hospital in north Stoke. All that, of course, is representative of the biggest building programme in the history of the NHS. When the hon. Gentleman and his colleagues left office, more than half the buildings in the NHS were older than the NHS. If the Government, by grace of the electorate, survive another term, by the end of it, almost half the buildings in the NHS will have been built by this Labour Government—something to be proud of.

Mr. John Redwood (Wokingham) (Con): How much extra money could North Staffordshire hospital get for its health service if it had foundation status; and what would be the extra costs of the bureaucracy and corporate governance of a foundation hospital?

Dr. Reid: The right hon. Gentleman misunderstands foundation status. Such hospitals will not get any extra money. What they will get is greater freedom to deploy their money without constantly having to obtain ratification and permission from Ministers and bureaucrats in Whitehall.

Delayed Discharges

7. Ms Ann Coffey (Stockport) (Lab): What action he is taking to reduce delayed discharges. [177291]

The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): In January 2004, the Community Care (Delayed Discharges etc.) Act 2003 introduced a financial incentive to avoid delayed discharges. That is supported by the delayed discharges grant. The total number of patients delayed in an acute hospital bed on any one day is now about 2,900—a reduction of nearly 60 per cent. since September 2001.

Ms Coffey: The figures from my local hospital, Stepping Hill, indicate that the policy has been a great success in relation to acute wards. Essentially, that is because it has led to much better co-operation between local health and social services. However, delays in discharge are now occurring in intermediate and rehabilitation beds. Will the Minister consider making delays in discharge from non-acute beds subject to the same financial penalties as delays in discharge from acute beds, so that there is effective local co-operation for all discharges?

Dr. Ladyman: The delayed discharges reimbursement system has been such a huge success and has driven down delayed discharges to such a remarkable extent that, to be frank, it would be madness if we were not looking very closely at the suggestion that we extend it, not only to intermediate care facilities, but to mental health facilities. We have started that work and planning, and we shall make announcements to the House as soon as possible.
 
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Mr. Paul Burstow (Sutton and Cheam) (LD): Does the Minister agree that in planning hospital discharges, it is important to ensure that the rules governing eligibility for free NHS continuing care are applied consistently and fairly across the country? Why has it taken the Government so long to begin to get to grips with the fact that 28 different sets of rules are applied in entirely different ways, with the result that people are, in effect, subject to a postcode lottery in relation to eligibility for free continuing care—care that should be available to them on the basis of their need, not of their means?

Dr. Ladyman: The hon. Gentleman might at least have started his question by pointing out that he was entirely wrong about the 2003 Act, which is now saving 1.5 million bed nights a year—equivalent to eight district hospitals—and which he is committed to repealing should the electorate ever be foolish enough to put his party into government. He was wrong from the start and he is wrong now. As for NHS continuing care, now before anyone is discharged from hospital they must go through the single assessment process, which includes consideration for NHS continuing care. For the first time, we will know whether anyone is entitled to such care before they are discharged.

Ms Meg Munn (Sheffield, Heeley) (Lab/Co-op): The legislation is making a real difference to reducing delayed discharges and improving the discharge process in Sheffield. Does my hon. Friend recall that, during debate on the Bill, the Opposition spokesperson referred to it as a "nasty and flawed measure" and the Liberal Democrat spokesperson said that it "put beds before patients"? Is not the truth that the measure puts patients' needs first and only the Labour Government are prepared to take the action that puts patients first?

Dr. Ladyman: My hon. Friend is absolutely right. Every extra day that an older person in particular spends in an acute setting when they no longer need to be there makes it less likely that they will be able to retain their independence and return home, which is where most of them want to be. Conservative party dogma is that ending up in a care home is the inevitable consequence of old age, but we want to maintain people's independence.

Mr. Simon Burns (West Chelmsford) (Con): If one strips all the spin and gloss from the Minister's words, one can see that the Government are fiddling the figures, basically by categorising more and more beds as intermediate and placing patients in them to meet their political targets. If his policy is working so well, why has the number of people receiving domiciliary care been reduced by 2 per cent. in the past year and by 10 per cent. over the past three years? Surely, more should be done to make sure that patients whose discharge is delayed receive appropriate domiciliary care after hospital, rather than being sidelined in an intermediate ward.

Dr. Ladyman: The hon. Gentleman is another person who was entirely wrong about the Community Care (Delayed Discharges etc.) Act, and has been made to look foolish for preaching doom and gloom. He said that the success of the scheme is entirely due to the roll-
 
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out of intermediate care beds, but in the six months since the shadow scheme came into effect we have reduced delayed discharges by another 1,000. How can he tie that purely to intermediate care beds, unless he thinks that we have suddenly magicked up tens of thousands of such beds around the country? The fact of the matter is that he and his party would not match our proposed spending—

Mr. Speaker: Order.

Mr. David Watts (St. Helens, North) (Lab): Does the Minister agree that delays are partly caused by lack of funds in social services departments? Does he also agree that the massive increase in health funding has not been matched by increases in social services funding, and will he look at that problem?

Dr. Ladyman: In fact, since 1997, the average increase in personal social services funding by the Government has been 30 per cent. above the level of inflation. Another 6 per cent. real-terms increase is promised for next year, so we are making money available and making sure that it is being used to provide intensive home care. Contrary to what the hon. Member for West Chelmsford (Mr. Burns) said, there has been a 30 per cent. increase in the number of people receiving intensive care at home—people who would otherwise be forced into care homes.

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