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Mental Health

12. Sir Nicholas Winterton (Macclesfield) (Con): If he will make a statement on the future provision of care for mentally ill mothers with babies in the north-west of England. [195010]
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The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): Mental health services throughout England are going through a radical programme of modernisation to improve access to effective treatment and care, reduce unfair variation and raise standards. National standards for mental health have been set through the mental health national service framework and the standard of care for mothers in the children's national service framework.

Sir Nicholas Winterton: Will the Minister give some indication of what assessment he has made of the effect on patients and their families of the proposed closure of the mother and baby unit in the mental health unit of Leighton hospital, which serves the Macclesfield constituency? With the closure of that facility, will he confirm what specialised provision there would be for mentally ill mothers with babies in Cheshire, Wirral, Merseyside, north Wales, Shropshire and the north Staffordshire area? That matter is very important to my constituents.

Dr. Ladyman: I am sure it is, but it is also very important that mothers with such problems in the hon. Gentleman's constituency receive the right sort of care, and usually that is best provided at home. The decisions that have to be taken are local and my understanding is that the local trusts are increasing provision at home, which means that there has been decreasing demand for those beds, so trusts have to take a view as to how best to provide in-patient services. That is what they are doing and I encourage the hon. Gentleman to engage in that consultation.

General Practitioners (Bedfordshire and Hertfordshire)

13. Alistair Burt (North-East Bedfordshire) (Con): What his estimate is of the number of general practitioners needed in the Bedfordshire and Hertfordshire strategic health authority over the next 20 years. [195011]

The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): It is the responsibility of Bedfordshire and Hertfordshire strategic health authority to analyse the local situation regarding GP numbers and vacancies and to develop plans to provide the best possible primary care services for its residents. That process began in April 2004. Currently, there are 957 GPs in the SHA area, an increase of 74 since 1997.

Alistair Burt: The Minister's brief may also tell him that an internal paper from the Bedfordshire and Hertfordshire strategic health authority states that the number of vacant GP posts in the area, currently 72, is expected to rise to 139 within three years and to 233 by 2011, and that over the next three years the SHA needs to recruit and retain the equivalent of 332 full-time GPs. That is long before the completion of the 160,000 new houses anticipated for the area by 2031. Where will those GPs come from, and is not the pressure to build new houses in the area so great that it is stretching precious infrastructure—physical and human—just too far?
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Dr. Ladyman: If the hon. Gentleman had bothered to read the report to which he referred a little further, he would have seen that there are detailed plans on where the GPs will come from. The plan was produced because the local primary care trust was doing its job and forward planning to ensure that it could meet the challenges in his constituency.

Barbara Follett (Stevenage) (Lab): I know that my local primary care trust congratulates the Minister on his forward planning in this area. It is certainly aware of the need to provide extra GPs to meet the requirements of extra housing. However, it is worried about the effect that section two of the new GP contract—the provisions on payments for meeting quality targets—will have on
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its ability to fund GPs in the future. With that in mind, will my hon. Friend have another look at how the payments are funded?

Dr. Ladyman: The payments have been agreed and about 80 per cent. of GPs voted for the new contract. The financing of the specific provision in the contract is being fully resourced and an extra £1.8 billion is being provided from the centre to ensure that quality requirements can be met with the contract fully funded. The local primary care trust is predicting the challenges that it will face in the years ahead and ensuring that it can respond to them, and I am delighted that my hon. Friend accepts that such planning is being done appropriately.

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Post Offices (Pensions and Benefits)

12.31 pm

Sir Robert Smith (West Aberdeenshire and Kincardine) (LD): I beg to move,

The Bill would provide for a simpler process for opening a Post Office card account, prohibit pressure from being put on those who opt for such an account to switch to using a high street bank and ensure that all applicants clearly understand that an exceptions service is available.

These are times of great change not only in terms of the way in which our constituents receive their pensions and benefits, but for the Post Office, because the changes introduced by the Government have an impact on our post offices' economics and how they operate. Traditionally, our constituents have been able to use girobooks to collect their pensions and benefits from a post office, but the Government are withdrawing that system in favour of direct payment. The method of direct payment according to which people may go directly to a post office to access payments is the Post Office card account, which is a substitute for the girobook, but the Government are encouraging people to switch to using bank accounts, although they offer an exceptions service for those who cannot cope with either service.

The Government are forcing the pace of change because, as we know, people had the option to use their bank accounts prior to the Government's encouragement of that method, but they chose not to exercise it. We should respect the way in which our constituents wish to receive their pensions and benefits. We should understand that they have their own ways of budgeting and running their lives instead of forcing the pace of change for ministerial convenience. It is important to legislate on the matter to allow choice given the many other ways in which we have tried to persuade the Government to see the error of their ways and understand our constituents' need for genuine choice, rather than forcing choice on them.

There are consequences of a system that forces people to switch the way in which they handle their cash and finances from that with which they grew up. It is extremely dangerous for the Government to push people who are used to weekly budgeting with cash into using bank accounts against their wishes. Many people who currently collect cash from a post office have a bank account, but use it only for saving or to draw rainy-day amounts, rather than for day-to-day budgeting. If such people prematurely switch to receiving their pensions in their bank accounts, owing to the way in which the Department for Work and Pensions handles those people, and try to manage all their weekly budgeting through those accounts, they could get into any kind of muddle. That could lead to an overdraft, and they would thus be faced with letters from banks costing £20 or £30. A Post Office card account, however, cannot be overdrawn. It is a simple replacement for the girobook. People who use the account may still use their post offices and budget with cash.

The changes to the system also have consequences for our post offices—both rural and urban. The Government have had to recognise the additional
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pressures on rural post offices as they lose their traditional business of handling girobooks and they have had to come up with a subsidy of £150 million a year. That will continue until 2008 as an attempt to protect the rural post office network.

The Post Office has also had to undergo a major reorganisation of its urban branches. Only this week we have learned that Crown post offices are to face reorganisation. It is concerning to our constituents that the urban reinvention programme—the re-planning of the urban network of sub-post offices—went ahead without including the Crown reorganisation, as many will have assumed that, having lost their traditional urban post office, a Crown post office would provide the safety net.

For many communities, the post office is the last vital link with public services. It is the last meeting point and the last shop in many a rural village. People collecting their pensions also give such shops business. Using the post office sustains any other economic enterprise in the branch. The Government have promised that people will be able to continue to use their post office to collect pensions and benefits, but that will be a hollow promise if the post office is no longer there to use. It is therefore extremely important that we maintain the economic viability of post offices.

Primarily, my Bill aims to protect individuals. Following an inquiry last year by the Trade and Industry Committee into the way in which the Government handled the transition to direct payment, I am extremely worried about the way in which our constituents appear to be pressurised into switching to the use of bank accounts—the Government's preferred method—to receive their pensions or benefits. I seek to redress the balance.

The danger of switching to a bank account is not only that people might become overdrawn but the fact that many bank accounts cannot be accessed at a post office. HSBC, Halifax Bank of Scotland and the Royal Bank of Scotland group still have not provided a link to their current accounts through the Post Office. Therefore, encouraging the use of bank accounts—especially those I have just mentioned—automatically means that people can no longer use their post office. The Bill sets out a procedure to enable a neutral choice to be made.

The National Federation of Sub-Postmasters has highlighted such a choice in its 2004–05 manifesto. Hon. Members will find the document extremely useful in understanding the needs of our sub-postmasters and how best we can take forward a viable post office network. My Bill addresses the key part in the document on access to pensions and benefits in which the federation requests that the system be simplified. Currently, there are about eight steps to opening a Post Office card account. On receipt of a letter from the Government asking whether one wants to switch from the girobook, one has only to fill in one's bank details in order to use a bank account, but eight hurdles must be crossed in order to open a Post Office card account.

The claimant receives an invitation pack for direct payment from the Department for Work and Pensions. The claimant then has to phone the Department's euphemistically named customer conversion centre where, as many of our constituents will attest, they have to fight quite hard to insist on their right to a card
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account. The Department then sends the claimant a personal invitation document; the claimant takes the personal invitation document to the post office; the post office gives the claimant a card account application form; the claimant completes the application form and returns it to the sub-postmaster, who sends it to Post Office Ltd; Post Office Ltd then sends the claimant account details, a personal identification number and a pick-up notice for the claimant to pick up the card at the branch.

The Government slightly improved the service over the summer. The claimant used to have to fill in the account details from the Department's direct payment invitation pack, but at least the Government have short-circuited that last stage, and details can now be sent directly to the sub-post office, where the form will have already been filled in.

The federation suggests a far simpler system. When mailed at the end of the girobook system, the constituent is presented with a simple choice of whether to tick the box to say that they want to use an account at the post office, and to take the pre-completed form that has arrived at the same time to the local sub-post office to open an account. Alternatively, they can tick a box to indicate that they want to use a bank or building society account, in which case they may fill in a bank mandate. Thirdly and importantly, the federation suggests a third option of the exceptions service, under which someone may receive regular payments by girocheque through the post. It suggests that it should be made clear that if the constituent fails to respond, the
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latter option will automatically be enabled. Many constituents find the new system worrying and may well prefer to use the exceptions service.

It is vital to have a simple process for the future, because conversion applies not only to current claimants; all new claimants will have to consider their options and it is essential that they are aware that they can still use the Post Office and open a card account. There will be a clear statement in the Bill on the procedures to be followed for a DWP customer to open a card account. Hon. Members on both sides of the House have concerns about the pressure that is being put on people to switch to bank accounts and the Bill will state clearly that no pressure should be put on people using the service to switch from a Post Office card account. The Post Office should be driven by customer choice, not departmental convenience.

The House must exert its authority and insist that pensioners and those on benefits have a fair choice as to how they collect their cash in future. I commend the Bill to the House.

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