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Madam Deputy Speaker (Sylvia Heal): I have received no such notice of any Minister wishing to make a statement to the House this evening. The hon. Gentleman's remarks are, of course, now on the record.
Mr. John Horam (Orpington) (Con): The House will be aware that there is great concern about the rising level of council tax throughout the whole country. Indeed, the nature of such protest is indicated by the fact that there are now rumours that the increase next year might be in the order of 10 per cent. I am thus delighted to present a petition on behalf of the IsItFair council tax protest campaign that is supported by more than 500 of my constituents in all parts of Orpington.
Declares that the year-on-year, above-inflation increases in Council Tax are causing hardship to many and take no account of ability to pay; further that the proposed property revaluation and re-banding exercise will make an already flawed system even worse.
The Petitioners therefore request that the House of Commons vote to replace Council Tax with a fair and equitable tax that, without recourse to any supplementary benefit, takes into account ability to pay from disposable income. Such tax to be based on a system that is free from any geographically or politically motivated discrimination, and that clearly identifies the fiscal and managerial responsibilities of all involved parties.
Declares that the year-on-year inflation-busting increases in Council Tax are causing hardship to many and take no account of ability to pay; further that the proposed property revaluation and re-banding exercise will make an already flawed system even worse.
The Petitioners therefore request that the House of Commons vote to replace Council Tax with a fair and equitable tax that, without recourse to any supplementary benefit, takes into account ability to pay from disposable income. Such tax to be based on a system that is free from any geographically or politically motivated discrimination, and that clearly identifies the fiscal and managerial responsibilities of all parties involved.
Mr. Robert Flello (Stoke-on-Trent, South) (Lab): I am most grateful for being given the opportunity to initiate this debate on an extremely important subject. At the same time, I am disappointed that I need to join the long line of right hon. and hon. Members in speaking to and questioning Ministers about the funding of children's hospices. Such hospices have been in our communities for almost 25 years but there is still no proper means of funding their vital work.
The current situation is disgraceful. We have a national health service that is being transformed for the better by reform and new investment. It is a transformation that is designed to give local communities a proper say in how NHS money is used. It is a transformation that means that primary care trusts are receiving record amounts of money. I believe that the average PCT budget will grow by almost £42 million by 200607.
In previous debates and questions Ministers have made various excuses for why children's hospices have not been funded. For example, it has been said that children's hospices are badly supported by the NHS because they are relatively recent. After 23 years, that excuse can be dismissed.
The single and most often repeated reason has been that it is not up to the Government to dictate to PCTs how much funding should be given to children's hospices. It has been said that there is no upper limit on how much money PCTs can give, but that it is up to the individual hospice to negotiate with the PCT on service delivery.
Lynda Waltho (Stourbridge) (Lab): I am pleased that my hon. Friend has been able to secure the debate on such an important subject. I wonder whether my hon. Friend has shared my experience when speaking to people involved with children's hospices; there is a feeling of utter frustration. On the one hand, Ministers say that money is available, but the problem appears to be that it is allocated to the primary care trusts. That is where it gets stuck. Only today I was told by the chief executive of a hospice that there needs to be joined-up thinking and joined-up working between the Department and the PCTs. That is where the biggest problem is.
Mr. Flello: I am grateful to my hon. Friend for raising those issues, which I hope to cover in my speech. It is incredibly frustrating that staff who do a fantastic job in this sector do not receive the recognition and support that they need from the PCTs whereas our communities are supporting them all the way.
I shall take a typical example, that of the engagement of Treetops children's hospice which is in my constituency, with the 10 PCTs in the area that the hospice serves. For the record, I am delighted to have been asked to serve as an unpaid member of the Donna Louise trust, which supports the work of Treetops.
The Government have an excellent record on working to meet the needs of children. Indeed, they introduced the excellent national service framework for children as part of
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the "Every Child Matters" initiative. That document set out a requirement for local statutory services to work with organisations such as children's hospices on the planning, funding and commissioning of local services. In practice, however, of the 10 PCTs contacted by Treetopsit was Treetops that initiated the contact, not the PCTsonly five agreed to face-to-face contact. One PCT has not replied to any letters and, in some cases, it took many months before a reply was extracted from the remaining four. Those replies basically said that the PCT was not interested. So much for full engagement by PCTs with service providers.
How much have the five PCTs that met Treetops contributed to the hospice services that are recognised as important by the framework? One PCT chief executive asked that very question, and was suitably shame-faced when he was told, "Absolutely nothing." Incidentally, he has not put the situation right. How much do PCTs pay Treetops for supporting about 135 life-limited children and their families, more than half of whom are referrals from the PCTs themselves?
Lynda Waltho: Does my hon. Friend acknowledge that there is an additional problem for hospices that cover a larger area? Acorns children's hospice covers the west midlands, Shropshire, Herefordshire, Gloucestershire, Warwickshire and Worcestershire, so it has the tremendous problem of negotiating with 33 separate PCTs. I appreciate the problem my hon. Friend has raised, but in fact it can be even larger.
Mr. Flello: My hon. Friend has highlighted the fact that hospices are dealing with a vast number of PCTs. It is a huge effort to extract any reply at all from some of them, and that problem is exacerbated if hospices have to write to even more PCTs.
PCTs do not pay Treetops anything for supporting life-limited children and their families, more than half of whom are referrals from the PCTs. The hospice is funded almost entirely by public donations, and has also received some money from the New Opportunities Fund over a three-year period. The picture is the same up and down the country.
Adam Afriyie (Windsor) (Con): Like the hon. Gentleman I serve on a hospice committee, and I support the Sebastian Gates action trust in my constituency. He alluded to the voluntary sector and the private donations that help to keep children's hospices going. Will he join me in commending the people who donate their time, energy and resources to those private trusts and hospices, because that fills the gap in Government funding?
Mr. Flello: The hon. Gentleman is quite right, and I join him in commending the work done by many people who put themselves out no matter what the weather, and who work hard to raise much-needed money from communities that want those services.
It goes on to say that co-ordination and close liaison between agencies, including children's hospices, is thus essential. There is therefore strong Government commitment, which has been utterly ignored by PCTs.
As for adult palliative care commitments by the Government, in the Labour election manifesto we gave a commitment to increase funding for palliative care, but that does not extend to children. We have the perverse situation at the moment whereby a 17-year-old with cancer is not deemed suitable to fund, whereas an adult is. Can we really say that a child under 18 cannot be funded to die with all the support that a hospice can give, whereas a young person over 18 can have funded support? Does the Minister not agree that our manifesto commitment should cover children as well as adults?
I am not, as the Minister might think, standing here asking for unlimited funding for all children's hospices, despite the Government recognising that there is no upper limit on the money that could be available, but I am standing here asking for fairness. It is quite simply shameful that PCTs can decide who to talk to and who to fund, and yet pay no heed either to what the Government are asking them to do with taxpayers' money, or to those taxpayers themselves.
The Government have previously said that they cannot blanket fund all the costs of running children's hospices. But, again, that is not what I am asking for. The cost of running all the services, using my example of Treetops, is around £4,000 a day, a figure that I believe is comparable across the country, and yet the cost of medical care for each child is just £240 a night. Is it really too much to ask the NHS to pay for medical care? Is not that part of its remit?
In some parts of the country, PCTs are at least going some way towards meeting their obligations to the communities that they serve by providing up to 10 per cent. of running costs for some hospices. But I am looking for a directive from the Government to primary care trusts, not asking them perhaps to think about it and if they cannot be bothered even to reply to letters, not to worry, but ordering them to instigate a process whereby PCTs must passport the medical costs of children using hospices to the hospice in question.
To return to Treetops, let us take the example of a wonderful little girl who was telling me recently all about her visit to see "Disney on Ice". If she chooses, with her parents, to go to a hospice for respite care, the cost of the medical element should be met by the PCT covering the area where she lives. It does not need to be complicated; it just needs to happen. Where is the NHS free at the point of need for our children?
I urge the Government, through the Minister, first to widen the scope of additional palliative care funding to include children; secondly, to put in place a process that will force PCTs to engage properly with children's hospices in accordance with the national service framework; and thirdly, to put in place a process that forces PCTs to commission properly children's hospice services in a manner that passports the funding for medical care.
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