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4. Mr. Graham Allen (Nottingham, North) (Lab): What the percentage change in waiting lists and waiting times for hospital in-patient treatment in Nottingham has been since 1997; and if he will make a statement. 
The Minister of State, Department of Health (Mr. John Hutton): In March 1997, there were 3,444 patients waiting more than nine months for in-patient treatment at the two NHS trusts in Nottingham. Latest figures show that there are now no patients waiting more than nine months at either trust.
Mr. Allen: That is a fantastic and very welcome statistic, as is the 50 per cent. reduction in the number of people on the waiting list from 15,000 to 7,500. Will the Minister take this opportunity to thank and congratulate all in the health servicenot just doctors and nurses, but the health workers, administrators and managers who ensure that waiting lists are managed property? Will he also guarantee that funds for the health service will not be reduced, and will he venture to speculate on what might happen in the event of, for instance, a £50 billion Budget cuts package?
I certainly agree with what my hon. Friend has said about the fantastic work done by NHS staff in Nottingham. They are doing a brilliant job, as I saw for myself when I was there last week. I am sure that everyone in Nottingham would join him in praising the work of NHS staff in that great city.
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Mr. Andrew Lansley (South Cambridgeshire) (Con): I, too, congratulate NHS staff in Nottingham. I had an opportunity to visit maternity staff at Nottingham City hospital, who deliver 6,000 babies a year and provide a very good service. Perhaps, however, the Minister will now answer the question, and deal with the reference to waiting times. Will he tell us how long, on average, patients waited to be admitted for treatment during the last financial year?
Mr. Hutton: I did answer my hon. Friend's question, and I am sure that he was happy with my answer. In asking his own question, the hon. Gentleman wants to do one thing above all else: he wants to claim, as do his hon. Friends, that the NHS is not making progressthat waiting times are not falling but rising. He is wrong on that count, and also in what he says about average waiting times. The facts are set out in the statistical supplement to the chief executive's annual report. If he would like to study it in more detail, I shall arrange for him to have a copy.
Mr. Lansley: I am grateful to the Minister, but I have a copy of the chief executive's report. It claims that NHS patients are waiting less long for treatment, but what the chief executive did not publishindeed, they were not published until this morningare statistics showing how long patients waited during the last financial year. The average waiting time was 90 days in 19992000, and 95 days in 200304.
Let us be accurate. The Minister is right in saying that the number of people waiting for more than nine months has fallen, but he should also admit that the average time for which people are waiting has increased. Both those facts are true.
One thing is clear from this exchange, and from the other exchanges that we have had on this subject. The hon. Gentleman and his hon. Friends want to trash and ignore all the progress that the NHS is making, and all the hard work of NHS staff in Nottingham and elsewhere. The truth is that the national health service is getting better and waiting times are falling. Their policies would reverse that progress, take money out of the NHS and allow well-off people to jump the queue. That is totally unacceptable.
John Mann (Bassetlaw) (Lab): A 400 per cent. reduction in the number of in-patient bed stays for drug addicts has been achieved at Bassetlaw hospital. So that hospitals in Nottingham can benefit from a similar reduction, will the Minister conduct an audit to establish how the fall in hospital costs was achieved?
5. Mr. Michael Wills (North Swindon) (Lab): What representations he has received on the practice of care homes and nursing homes charging fees after the death of a resident in lieu of notice; and if he will make a statement. 
The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): A search of the Department's correspondence database has revealed only one representation on the issue. Under the care home regulations, each resident is required to have a contract with the care home. The contract should specify conditions relating to payment and notice required.
Mr. Wills: As my hon. Friend knows, one of my constituents was deeply distressed recently when his mother died and the care home where she had been staying charged her estate two weeks' fees in lieu of notice. My constituent went to the Daily Mail, and the home then refunded the charges and took the offending clause out of the contract for the benefit of future residents. But the problem still remains for others and is particularly unfair on those who fund themselves. As I understand it, social services departments' contracts do not include such clauses. I recognise that Ministers cannot intervene in individual contracts, but given that social services departments and the Daily Mail seem able to secure more dignified and civilised behaviour from nursing homes at such a sensitive time, will the Government look into what more they can do?
Dr. Ladyman: First and foremost, anybody who goes into a care home needs to understand that they should have a clear contract telling them what will happen in the event of their death. Secondly, my hon. Friend is right in that, when local government negotiates bulk contracts with care homes, it can often get much better terms and conditions than individuals can because it is buying in bulk. I have been encouraging local government to use its power to ensure that such terms and conditions are passed on to people who are self-funding. Thirdly, there will soon be an opportunity to carry out the review that my hon. Friend seeks through the review of the national minimum standards, which I have already announced. I shall certainly take that opportunity to see whether we can do anything further to help.
Mr. Peter Luff (Mid-Worcestershire)
(Con): I certainly share the concern expressed by the hon. Member for North Swindon (Mr. Wills) about this particularly distasteful practice. But is it not true that nursing homes and care homes have to do such things because they are under huge financial pressure, brought about in part by the overly bureaucratic and prescriptive regulations imposed on them by the Government? Is it not also true that nursing homes and care homes in Worcestershire might have to resort to such practicesI hope that they do notbecause of the underfunding of Worcestershire's social services? I invite the Minister to join the cross-party campaign for the area cost adjustment that would provide a fairer share of national funding for Worcestershire's social services department.
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Dr. Ladyman: That was yet another demand from the Conservatives for money that they are singularly unprepared to provide themselves. In fact, adult social services has received a 30 per cent. above-inflation increase since 1997, and local government has more than enough money to pay the market rate for care home places, which is what I always encourage it to do. It would be entirely inappropriate for us to force local government to pay more than the market rate simply to keep open places in care homes that people do not want to be in. The Government want people to be able to choose where they spend their retirement, while the Conservatives want everyone to be banged up in a care home.
Mr. David Hinchliffe (Wakefield) (Lab): Does the Minister recall that when he came before the Health Committee to discuss elder abuse, concern was expressed about the current arrangements for the certification of deaths in care homes and nursing homes, whereby a single doctor can certify a death without actually seeing the body? The Minister shared the Committee's concern about that practice. Have any steps been taken to deal with this issue?
Dr. Ladyman: My hon. Friend is right; I do indeed share his concern. Since the meeting to which he refers, the Home Office has produced new guidance on the certification of deaths in care homes and on the tightening of regulations. In conjunction with the Home Office, I am reviewing those guidelines to see whether they will actually meet the concerns that he and I expressed. I would very much welcome his views in an effort to come up with a system that we can be confident will work better in future.
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