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NHS Charging

9. Dr. Phyllis Starkey (Milton Keynes, South-West) (Lab): If he will make a statement on charging of patients in the NHS. [223086]

The Secretary of State for Health (Dr. John Reid): I refer my hon. Friend to the answer that I gave earlier to my hon. Friend the Member for Birmingham, Hall Green (Mr. McCabe).

Dr. Starkey: In my constituency, waiting times for operations are much lower than they used to be, thanks to investment by this Government. When I was first elected in 1997, I was besieged by constituents waiting for hip operations. The choice that faced them was between using their hard-earned savings to jump the queue and pay for a private operation, and waiting even longer for NHS treatment that required the same
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surgery, often by the same surgeon. I am disturbed by reports that hip operations will attract charges of £6,000. Has my right hon. Friend made an assessment of how soon those charges—

Mr. Speaker: Order. That point has already been mentioned in questions today. The hon. Lady took far too long on her supplementary question. I call Mr. McLoughlin.

Mr. Patrick McLoughlin (West Derbyshire) (Con): Can the Secretary of State confirm some figures that I saw at the weekend? They showed that seven years ago only 1 per cent. of BUPA's business came via the national health service, but that the figure is now 10 per cent. I congratulate the Government on that, but can he tell me who is paying and how much?

Dr. Reid: Yes, I can tell the hon. Gentleman. The NHS is prepared to purchase in bulk operations from the independent sector to complement an expanding NHS, and every one of those operations is delivered free to patients in the NHS. I will continue both to expand the NHS and to purchase from the independent sector where appropriate, but I give the hon. Gentleman a guarantee that patients will never be charged, not £6,000, but £7,750 for a hip operation. One of the reasons why there is such affection for that uniquely British institution, the national health service, is precisely because it enshrines the uniquely British sense of fair play, which dictates that people's access to operations and the speed of their treatment is determined solely by clinical need, never by the size of their wallet. As long as the Labour Government are in power that will remain the case.

Mr. Keith Bradley (Manchester, Withington) (Lab): The people of south Manchester will welcome the fact that they will not be charged for their care at the magnificent new Withington community hospital, which opens its doors next week. I invite the Secretary of State to visit Withington at the earliest opportunity, to pay tribute to the thousands of people who campaigned for the hospital and to the officers of South Manchester primary care trust, especially the project director Joe Ranson, who delivered the project on time.

Will my right hon. Friend also consider carefully the capital scheme—

Mr. Speaker: Order. That is more than one supplementary.

Dr. Reid: I congratulate my right hon. Friend on the work being done by NHS staff in his constituency, and I will certainly consider his courteous invitation. Too often it is only what goes wrong in the NHS that is mentioned, but we should always be prepared to recognise the huge reservoir of comfort that the NHS brings to so many people. As far as patients are concerned, we will continue to expand the NHS, we will continue to purchase outside the NHS and deliver those operations free, and we will continue to extend choice. I make this promise: the only thing that patients will have to take to their doctor under our proposals is their diary, to fit in appointments that are convenient for them, not their cheque book.
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Child and Adolescent Mental Health Services

10. Mr. Edward Leigh (Gainsborough) (Con): What improvements to child and adolescent mental health services have been put in place since 1997. [223087]

The Minister of State, Department of Health (Ms   Rosie Winterton): Increased investment in and reform of child and adolescent mental health services has led to a 6 per cent. increase in staff and an 18 per cent. increase in funding between 2002 and 2003. To improve services further we are allocating an extra £300 million between 2003 and 2006.

Mr. Leigh: Can the Minister explain why in the past eight years, although spending in the NHS has increased by 63 per cent. in real terms, the number of child and adolescent psychiatrists has increased by only 22 per cent., which is, interestingly, the same rate of increase as in the last eight years of Conservative government? What will she do to ensure that increased spending on the NHS really does get to the front line?

Ms Winterton: As well as the increases that the hon. Gentleman outlined, a third more nurses are working in the community than in 1997, a quarter more psychologists and 60 per cent. more clinical psychologists. Child and adolescent mental health services are improving, but there is patchiness throughout the country, so with the extra money that we are putting in, we are considering what further support can be given in individual areas. The hon. Gentleman's area is spending £1.3 million on CAMHS, but through the children's national service framework we want to ensure that there are equal standards throughout the country. That is about investment and reform, not about cuts and charges.

Mr. Huw Edwards (Monmouth) (Lab): Will my hon. Friend acknowledge that for adolescents with eating disorders there is a lack of specialist provision within the NHS, and that while some of my constituents have benefited from the provision at the Priory in Bristol there is a need for greater specialist treatment for young adolescents, especially young girls, with bulimia, anorexia and other eating disorders? We would be grateful for any discussion that my hon. Friend can have with the new Welsh Minister for Health and Social Services about this.

Ms Winterton: The provision of treatment for people with eating disorders has improved, but there is still a long way to go. We have tried, for example through community teams, to ensure that people are specifically trained in the treatment of eating disorders, and Professor Louis Appleby is considering specialist service provision with a view to seeing how we can increase such support. If I have any discussions with the Welsh Minister, I will pass on the changes that we are making and discuss any changes that may be made in Wales.

Tim Loughton (East Worthing and Shoreham) (Con): Despite the Minister's claims, she knows full well that mental health, particularly child and adolescent mental health, remains a Cinderella service of the NHS. Why after eight years under her Government of the problem
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growing—she knows that the growth in the number of   consultants is at exactly the same rate as it was in the    previous eight years under the Conservative Government—are there only six CAMHS in-patient beds per 100,000 children? Why did the Mental Health Act Commission report that 82 per cent. of 16 to 18-year-olds are placed in inappropriate adult facilities? Why are one in six consultant psychiatric posts still unfilled, especially in CAMHS and why, with 24,000 teenagers self-harming a year, is her Department withdrawing funds that will result in the closure of Saneline, which is unique in offering a lifeline to children and their carers experiencing mental illness?

Ms Winterton: The hon. Gentleman knows very well, because I am sure that he will have studied carefully Louis Appleby's report "The NSF for Mental Health—Five Years On", that £728 million extra has been spent on mental health services since the Government made them one of their top three health care priorities. He also knows that the numbers of consultants, clinical psychologists and nurses working in the community have risen, as I have already outlined, and we have crisis resolution teams and early intervention teams. At the same time, there are vacancies, and we are considering with the Royal College of Psychiatrists new ways in which psychiatrists can work. If he visited some of the community teams that have been set up, he would find that psychologists, psychiatrists and community teams are working together in a totally new approach, involving investment and reform. As I am sure he knows well, we gave £2 million to Saneline over two years. That contract was always going to come to an end; it was not for ongoing support. We have put all the telephone helplines together in one association, backed up by £5 million of support, for which Saneline can apply. The Government have made vast improvements in mental health services, which were neglected for 18 years under the previous Administration.

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