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Mr. Chaytor: If a reconfiguration of services currently under way did not take full account of the new national service framework, would my hon. Friend be inclined to allow that to continue or would he use his Department's influence to encourage local service providers to take
 
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account of the new framework? What leeway will local trusts and health authorities have in the period leading up to 2014?

Dr. Ladyman: Clearly, a configuration beginning now ought fully to take into account the national service framework. If my hon. Friend is asking whether Ministers will be able to intervene in that process, I should point out that, under the terms of "Shifting the Balance of Power", they have the power to intervene in local configuration issues only if local agreement cannot be reached. I would be very surprised if a reconfiguration that ignored the lessons of the NSF reached the general agreements that would be necessary. Under such circumstances, it is likely that my right hon. Friend the Secretary of State for Health would be asked to intervene in the process. Clearly, I would expect any reconfiguration starting now to take as much account as possible of the national service framework. There would have to be some pretty good local reasons why any part of it was ignored in any such reconfiguration.

Mr. Lansley: The national service framework for hospital services has been available since April last year. If we were conducting a reconfiguration of children's services, it should clearly take account of that framework. It should already have been applied to that extent. Will the Minister explain why Sir Ian Kennedy's report on the Bristol royal infirmary tragedies recommended that service models should be made part of the NSFs—at least, he recommended certain experiments in service models and the Government responded by acknowledging that they would be set out in the NSF—but they do not appear in it? For configuration purposes, there seem to be no alternative or optional service models for acute services in the framework.

Dr. Ladyman: The hon. Gentleman is right that we produced the hospital standard early in response to Professor Kennedy's initial concerns. The approach that we have adopted in the NSF is to set out as clearly as we can and in line with all the guidance of the experts—experts not limited to civil servants, but including people from the medical profession, nursing and maternity services, social care and the whole gamut of services—the targets that we believe people should follow in designing the services. If we were to move to the extent that the hon. Gentleman hints that he would like and set out specific models, I would put back to him the problem that it might prove too restrictive and centralist an approach.

Mr. Lansley: I shall return to the key point later. I asked the Minister that question simply because when the Government responded to the Kennedy report in January 2002, they said:

"We will commission an evaluation of alternative models for the management of children's services and publish the findings as part of the NSF."

That relates specifically to the configuration of acute children's hospital services, but it has not happened.

Dr. Ladyman: All I can say to reassure the hon. Gentleman is that Professor Kennedy is now chairman
 
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of the Healthcare Commission and he has said that the information that we provided in the NSF is sufficient for him to be able to carry out his work and inspect against the framework. In other words, he is content with the approach taken in the NSF.

The approach of devolving responsibility to the NSFs at the front line is deliberately different from most previous NSFs—those for cancer and coronary heart disease, for example, which relied on detailed targets and milestones. As we have transformed, since 1997, the ethos of the NHS and begun to ensure that it has the capacity, skill and motivation to modernise, so it has become less necessary for us to set targets centrally. We know that people working at the front line best understand their local needs, so we are increasingly empowering them to take local decisions locally. That means that the NSF is fully consistent with the Government's wider public sector reform, devolving power and responsibility to local agencies. If any hon. Member feels that 10 years is too long to see the NSF fully implemented everywhere, I would say that the key to implementing the NSF is change in culture. For the implementation of the NSF to be a success, early and sustained action will be required and 10 years is not a long time to achieve what we have asked.

How are we going to pay for this transformation of children's services? The NHS has already received substantial year-on-year increases in general funding, and that is set to increase by an average of 7.2 per cent. in real terms each year until 2007–08. We have also provided £300 million for child and adolescent mental health services to 2006 to meet the CAMHS public service agreement target. That will also support the CAMHS standard in the NSF.

All that funding was provided to drive up the quality of the totality of health services, including children's services. There is no more money to give, and everything that we do has to be done within that spending envelope. However, let no one doubt for a second that it is more than enough to cover the progress that we must make up to 2008.

If any hon. Member says that we should ring-fence part of that money exclusively for children, I say that they have missed the whole point of the NSF. The NSF is about mainstreaming children's services so that PCTs develop those services, not as an afterthought or add-on, but as a key priority in the commissioning of services. PCTs will therefore need to allocate funding according to local priorities and to strike the right balance between children's services and general services, but must retain the development of children's services at the core of their thinking when they do so.

If we do not have traditional targets and old-fashioned ring fences, how will we guarantee delivery? The recently published health and social care standards and the planning and priorities framework both stress the importance of planning for children by health services, local authorities and the voluntary sector. Therefore, over the next three-year planning period, the different inspectorate bodies will start to inspect services against the NSF standards. They will require agencies to demonstrate progress towards the levels of service set out in the NSF. That is why we can be confident about delivery.
 
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Given that integrated working across agencies is so important to successful implementation of the NSF, the key inspectorates must also work together to develop a method for joint inspections. That means that, from 2005, Ofsted, the Healthcare Commission and the Commission for Social Care Inspection will undertake joint area reviews. They will also contribute to thematic inspections of children's services.

With this emphasis on inter-agency working at the front line, it is incredibly important that we send the right messages from the centre, demonstrating joined-up government and integrated policies. That starts at the top, which is why, although the NSF began life in the Department of Health, it is now jointly sponsored by the Department of Health and the Department for Education and Skills. It is also why my right hon. Friend the Minister for Children, Young People and Families and I work so closely together to develop children's policy. The NSF was jointly published, but it is now jointly owned.

On the ground, the Children Bill will provide a spur to action for the joint delivery of the NSF. If the Bill is passed, key local service providers—including PCTs and strategic health authorities—will be placed under a duty to co-operate with local partners to drive up the standard of care for children in their areas.

Equally important will be the duty to safeguard and promote the welfare of children, and the new director of children's services—a post that we are proposing for each area—will be a key player in ensuring that the NSF is delivered locally.

Tim Loughton (East Worthing and Shoreham) (Con): On that point, will the Minister say why the NSF for children is not mentioned in the Children Bill?

Dr. Ladyman: It is not mentioned because it does not need to be. The Bill is based on the five outcomes that children told us were important. One of those outcomes was the requirement for health and well-being and the ability to thrive, to which the NSF speaks directly. Therefore, the NSF does not need to be mentioned in the Bill.

Mr. Chaytor: My hon. Friend mentioned the importance of consulting the local director of children's services in connection with a proposed reconfiguration. However, if no such director has been appointed, does he agree that that proposed reconfiguration should be suspended until the director has been appointed and can be consulted?

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