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House of Commons

Tuesday 14 September 2004

The House met at half-past Eleven o'clock

PRAYERS

[Mr. Speaker in the Chair]

Oral Answers to Questions

HEALTH

The Secretary of State was asked—

Mental Health Care Hospitals

1. Tony Baldry (Banbury) (Con): What the Government's policy is on the optimum size of mental health care hospitals. [188501]

The Minister of State, Department of Health (Ms Rosie Winterton): It is for local trusts to determine the configuration of their provision according to their assessment of the needs of their population, the range of community and residential services already in place, and the resources available to them.

Tony Baldry: For many years, Banbury has had residential community mental health care, but that facility is being closed and will in future be centralised in Oxford. My constituents and many people in Oxfordshire want to understand how these ever-larger mental health care units are compatible with the concept of care in the community.

Ms Winterton: As the hon. Gentleman knows, it is for local primary care trusts to commission appropriate services for their population needs in the light of national guidance and the resources available. Care for people with mental health needs is increasingly being provided by the crisis resolution teams, home treatment teams and assertive outreach teams that are developing in all areas. The idea is as far as possible to keep people out of hospital and to provide care in people's homes, which is where they and their carers wish to have it.

Dr. Brian Iddon (Bolton, South-East) (Lab): Does my hon. Friend agree that there is a need to separate men from women and older patients from younger patients where they have incompatible lifestyles? Does she also agree that drug addicts and alcoholics can be a nuisance on wards, and that a larger hospital should be able to achieve such separations better than a smaller one?

Ms Winterton: I agree with my hon. Friend. Our evidence is that more than 99 per cent. of NHS trusts now provide single-sex sleeping accommodation. Obviously,
 
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patient safety is paramount, and we have recently issued further guidance on that matter. Since 1997, about £720 million has been spent on upgrading psychiatric facilities to deal with the points that my hon. Friend raises. Later this week, my right hon. Friend the Secretary of State, with the Secretary of State for Education and Skills, will publish information on these issues, including children's services.

Sir Michael Spicer (West Worcestershire) (Con): What is the budgeted cost of the Mental Health Bill?

Ms Winterton: Overall, we have spent around £300 million extra on mental health over the past three years. "Shifting the Balance of Power" provides for local primary care trusts to use the massive amount of extra investment that is being made available as they see fit within the national service framework. That investment will have increased by up to £90 billion by 2007. Within that, an extra £300 million has already been spent on mental health services, and we expect that amount to increase within the next few years.

Tim Loughton (East Worthing and Shoreham) (Con): Notwithstanding the answer that the Minister gave just now, if she is taking the whole subject of hospital mental health services seriously, can she explain why Mind, in its report "Ward Watch", which was published last week, found that 23 per cent. of recent and current in-patient respondents were accommodated in mixed-sex wards a year after the Government claimed 99 per cent. compliance, that a third of patients did not have access to single-sex bathroom facilities, and that a climate of fear, harassment and abuse exists on mental health wards, with cleanliness leaving a lot to be desired? When are the Government going to treat mental health patients on an equal basis with everyone else in the NHS?

Ms Winterton: Perhaps the hon. Gentleman did not hear some of the facts that I stated earlier. I accept that Mind issued its "Ward Watch" campaign document. Its survey was fairly small, covering 4 per cent. of people with experience of mental services, approximately only 2 per cent. of whom were being treated by mental health services when it was conducted.

The hon. Gentleman needs to recognise the additional investment—£720 million extra—to upgrade psychiatric facilities that has been made since the Government came to power. We believe that 99 per cent. of wards now provide single-sex sleeping accommodation. However, when I met Mind representatives last week, I said that if they wished to provide information in relation to wards where that was not happening, we would take the matter up. They accepted that their figures did not tally with ours, but I promised to look into any instances that they provided of mixed-sex sleeping accommodation.

Children's Hospices

2. Mr. Peter Luff (Mid-Worcestershire) (Con): What assessment he has made of the contribution that children's hospices make to palliative care. [188502]
 
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The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): Children's hospices make a very important contribution to the support of children with life-threatening illnesses and their families, and in providing emergency, respite and end-of-life care.

Mr. Luff: I am sure that the movement will be pleased to hear the Under-Secretary's endorsement in advance of next week's children's hospice week. However, does he share my concern about the much lower amount of funding that children's hospices receive from statutory sources, as compared with adult hospices? Does he understand that a hospice such as Acorns children's hospice, which will open in Worcester next year and serve a large geographical area—most of the south-west midlands and Gloucestershire—has to look for funding packages from up to 33 different primary care trusts? Has the time not come to consider again the quantum and management of funding for children's hospices?

Dr. Ladyman: First, the hon. Gentleman mentioned the children's national service framework, which we intend to publish tomorrow, not next week.

Mr. Luff: No, I mentioned children's hospice week.

Dr. Ladyman: My apologies—I thought that the hon. Gentleman referred to the children's NSF.

Acorns Children's Hospice Trust is currently in discussion with the local primary care trust, which is being supportive. I hope that the hon. Gentleman will be happily surprised by the outcome of the discussions. He made a point about a general uplift in funding. He must realise that children's hospices provide one of a range of services of which children with palliative care needs may make use, which include home care and hospital care. We could set a blanket figure for the proportion of funding that comes from the national health service only in one of two ways: either by unbalancing the mix of care, which would mean that some children who currently receive home care would no longer receive it, or by providing more money. The hon. Gentleman's commitment to 40 per cent. funding for hospices might make an interesting press release, but he does not intend to provide that extra money for the health service.

Mr. Michael Foster (Worcester) (Lab): Further to the comments of the hon. Member for Mid-Worcestershire (Mr. Luff) about the Acorns trust in Worcester, and given that it serves the three counties of Worcestershire, Herefordshire and Gloucestershire, will my hon. Friend write to the range of primary care trusts and local authorities in those counties to ensure that they do what they can to provide a more secure statutory funding basis for it, thereby making sure that it is there for children who will need it in future?

Dr. Ladyman: I am happy to ensure that the primary care trusts in those areas realise what their responsibilities are—I shall certainly do that for my hon. Friend. However, I assure him that they do understand those responsibilities. They are in active negotiation with the Acorns trust, have a close relationship with it as regards its two existing hospices, and are in discussion, which I hope will prove fruitful, about the one that is proposed for the near future.

Mr. Lindsay Hoyle (Chorley) (Lab): My hon. Friend makes a reasoned case, but he should examine the
 
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inconsistency between the funding for adult hospices and that for children's hospices. The poor relationship between the two in getting direct funding is the important issue. Derian house gets so little funding. We get some from the local primary care trust, and although children come from as far away as Scotland and London, the funding must be raised locally. We should ensure that we get equal match funding as between adult and children's hospices directly from the NHS. The sooner that happens, the better. It will ensure that the required service continues.

Dr. Ladyman: While I share my hon. Friend's desire to see the children's hospice movement succeed, I cannot agree with the solution that he proposes. That is because children's palliative care is a very different proposition from adult palliative care. Adult palliative care tends to involve end-of-life provision, whereas children's palliative care tends to involve long-term provision, respite or emergency care, and managing chronic conditions. It is therefore important that primary care trusts ensure that there is proper balanced provision and full availability of home care in their area. It might not be appropriate to have the same level of funding for an adult hospice as for a children's hospice in any particular area, so I cannot agree with my hon. Friend's solution to the problem.

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