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The Secretary of State for Health (Ms Patricia Hewitt): I take this opportunity to pay tribute to the work of the muscular dystrophy society Parent Project UK in supporting children suffering from Duchenne muscular dystrophy. The Minister of State, my right hon. Friend the Member for Liverpool, Wavertree (Jane Kennedy), will meet a delegation from the group shortly. Some 2.1 million people visited NHS walk-in centres in the year to this March. That represents a 31 per cent. increase over the previous year and demonstrates that NHS walk-in centres are now established as a mainstream NHS service that increases patient choice.
Andrew Gwynne: Walk-in centres are a key component in ensuring better access to health services and play a major role in addressing health inequalities. Will she say what discussions her Department will have with the Tameside and Glossop primary care trust, and the Stockport PCT, to ensure that the benefits of those excellent facilities are extended to the communities in Denton and Reddish, where they are not currently available?
Ms Hewitt: I note that there are no NHS walk-in centres in my hon. Friend's constituency at present. Neither Tameside and Glossop PCT nor Stockport PCT has chosen to develop proposals for such a centre, although I am sure that both would welcome the opportunity to discuss the matter with him. I draw to his attention, and that of the local PCTs, the fact that £18 million remains of the investment of £50 million that we made available in 2003 to provide more walk-in centres. PCTs are welcome to bid for money to expand walk-in centre provision.
Tony Baldry (Banbury) (Con): Why was the Public Accounts Committee told that the simple cost of treatment for a person who goes to a general practitioner was £15, whereas walk-in centre treatment cost £25? Can the Secretary of State be confident that she is getting the best value for money out of walk-in centres?
I certainly can be confident that we are getting increasing value for money out of walk-in centres. When they were first opened, the usage of walk-
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in centres was lower than that of GP services, but that is to be expected with a new service. As a result, the cost per consultation was higher, but the cost per patient has been falling as awareness, and therefore usage, of walk-in centres has risen. I am confident that that trend will continue, because walk-in centres are popular and patients very satisfied with the service that they provide.
Mr. Sadiq Khan (Tooting) (Lab): Will my right hon. Friend join me in congratulating the walk-in centre at St. George's hospital in Tooting and its staff? They have worked hard since the centre opened and treated many thousands of local patients. That has freed up resources at the local accident and emergency department, and among local GPs, who think that such centres represent good value for money.
Ms Hewitt: I entirely agree with my hon. Friend and readily join him in congratulating the excellent staff at the walk-in centre, the hospital and throughout the local health service. The great merit of walk-in centres is that they are open from 7 am to 10 pm, 365 days a year. They therefore extend access to NHS care to people who often find it difficult to go to a GP or who, in some cases, are not yet registered with one.
Dr. Andrew Murrison (Westbury) (Con): The uniqueness of our primary care is the enduring relationship that GPs have with patients, families and communities. That is especially important in the context of people with chronic disease. Most patients know that instinctively and would rather see their own doctor in their own community. Moreover, they would rather see their GP on a Saturday morning or in the evening than go and see someone who iswith the greatest respectan anonymous technician off a railway station platform. Why are the Secretary of State's priorities so different from the priorities of patients?
Ms Hewitt: Although this is my first appearance as Secretary of State for Health at Health questions, I fear that the hon. Gentleman's question is sadly typical of the willingness of Opposition Members to denigrate NHS staff. Perhaps he would like to join me on a visit to a walk-in centre, such as the excellent one at New Cross in south London that I visited a couple of weeks ago. The nurse practitioners staffing that centre, with the back-up of a GP, do superb work, to the great satisfaction of patientsand I spoke to all of them.
Of course, it is important that we ensure continuity of care and the integration of walk-in centre care with GP care. That is why a record of treatment provided by a walk-in centre is, with the patient's consent, made available to that patient's GP. However, in nine cases out of 10, it is not necessary for the walk-in centre to refer a patient back to a GP, as treatment can be provided on the spot. That is why walk-in centres are so popular, and why they are continuing to improve the quality of health service care.
The Parliamentary Under-Secretary of State for Health (Mr. Liam Byrne): We have a clearly understood approach to funding for children's hospices. It is for local NHS commissioners to determine the need for hospice provision for children in their local areas and to fund services accordingly. We will publish best practice guidance in the area shortly.
Jeff Ennis: I welcome my hon. Friend to his new position on the Front Bench. Is he aware of early-day motion 220, which notes that adults' and children's hospices are funded by the NHS through the same mechanism, via the local lead primary care trusts? In many respects, that funding mechanism lends itself more to adults' hospices than to children's hospices. With that in mind, will he agree to meet me and representatives from the Association of Children's Hospices to discuss that important matter further?
Mr. Byrne: I congratulate my hon. Friend on his tireless work on behalf of the hospice movement. I understand that Bluebell Wood hospice will shortly open in Dinnington, near his constituency, and he can take some pride in that achievement. Children's hospices and adults' hospices are very different. In an adults' hospice, 95 per cent. of patients suffer with cancer and their average stay is about 13 days. In a children's hospice, children may suffer from one of 14 different life-threatening conditions and may live for many years, and therefore the range of services they neededucational, recreational, respite care or hospice careis very different. That is why local primary care commissioners need some flexibility in providing the right package of care. We need to take two further steps. We need to ensure that primary care trusts are clear about how to execute their responsibilities properly, and that is why we will publish national guidance very soon. Hospices also need to engage with primary care trusts, and I am pleased to say that the Association of Children's Hospices, supported by the Department of Health, will also publish guidance in that area.
Mr. Richard Bacon (South Norfolk) (Con): Quidenham children's hospice in Norfolk treats children with Duchenne muscular dystrophy, which the Secretary of State mentioned earlier. Is the Minister aware that age discrimination may be being practised against people who suffer from that tragic condition? If they are fortunate enough to reach the age of 21, which many do not, they can no longer be treated by a children's hospice, and adequate alternatives are not in place. He will know that there is a lobby on Duchenne muscular dystrophy today, and I was glad to hear the Secretary of State say that the Minister of State, the right hon. Member for Liverpool, Wavertree (Jane Kennedy), would meet people from that campaign later. Will the Minister look into my point and see what can be done?
I would be happy to do that. Our strategy in that area of policy is clear. The national service frameworks for children's health, and more broadly, set clear service standards. It is important that those promises are backed by the record extra investment in primary care. The average primary care trust will have an extra £45 million or so in investment over the next two or three years, and that level of investment will make those standards real.
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Mr. Lindsay Hoyle (Chorley) (Lab): I, too, welcome my hon. Friend to the Front Bench, but will he recognise that funding should not be down to the local primary care commissioners alone? The Derian House children's hospice in Chorley takes children from as far away as London and Scotland, so the whole burden should not be on local primary care and we should ensure more direct funding from the NHS to ease the burden locally. That would be only right, as hospices are the poor relation when it comes to direct funding from Government.
Mr. Byrne: My hon. Friend has also been a champion for the hospice movement, on which I congratulate him. There are some 35 hospices around the country, which is an increase of 20 per cent. on 2004. The hospice movement is growing, but the fact that such a small number serve the entire country gives some the opportunity to specialise in particular conditions. That is why there will always be local specialisms that need to be plugged into primary care trust funding nationally. It is important that primary care trusts understand how best to commission services in those complex and sensitive areas. That is why national guidance is needed. I will take that national guidance out to several regional events to ensure that the new policy is bedded down on the ground.
Mr. Simon Burns (West Chelmsford) (Con): I add my welcome to the Minister to what is probably one of the best jobs in government. Why is it that adult hospices receive on average about 35 per cent. of their funding from the Department of Health while children's hospices receive just under 5 per cent.? What justifies paying children's hospices from the funding of the Department of Health so significantly less than adult hospices, notwithstanding the standard answer that he gave earlier? Why can they not receive significantly more from Department of Health funding so that they are more on a par with adult hospices, given the overriding need for those services for suffering children?
Mr. Byrne: The needs of adult hospices are so different from the needs of children's hospices that it would be a mistake for me to stand here at Westminster and write a prescription for how that mixture of services should be delivered up and down the country. The needs of communities in Cumbria are different from the needs of communities in Kensington and Chelsea. The needs of people with different conditions are also very different. That means that there will always be differences in the way in which education services are combined with respite services and hospice services. It would simply be wrong for us to dictate to local communities the right mixture of funding. It is important that we set out what people are entitled to when it comes to palliative care for children with life-threatening conditions. It is even more important that we back that promise with realistic investment, and that is exactly what we have done.
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