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That, for the purposes of any Act resulting from the Childcare Bill, it is expedient to authorise the charging of fees by Her Majesty's Chief Inspector of Schools in England under provisions of the Act relating to the registration of persons providing childcare.[Mr. Coaker.]
James Brokenshire (Hornchurch) (Con): The issue that I wish to highlight during this Adjournment debate relates to the state of health services in my local area in the London borough of Havering. In opening this debate, I pay tribute to the tremendous hard work of NHS staff in my constituency and more widely in the borough. I put on record and highlight at the outset their professionalism and commitment and the skill that they show in providing high-quality care for my constituents. However, there are a number of concerns and developments in the local health service, which I hope to highlight and which need to be given greater attention by local health care professionals and the Department of Health when seeking to ensure the provision of the high-quality health service that my constituents rightly deserve.
The backdrop to this debate is the fact that Havering primary care trust, which administers health care at primary level in the borough, currently has a deficit of about £3 million. That has raised questions about whether some health service provision is being rationalised and the impact that that is having on local health services. I note in particular a press report at the weekend attributed to the Department of Health about overspends and PCT budgets, which said:
That is why organisations posting a pre-audit deficit received a letter from the Secretary of State and the NHS chief executive making it very clear that this is not acceptable and that performance must improve."
Obviously, we are looking for high-quality care and efficiencies in the health service, but such comments raise concern about the pressure that is being brought to bear on health service executives and what that means for immediate carewhether decisions are being made responsibly for the long term and in order to ensure that we maintain high-quality care for everyone in the local community. I know that my PCT works very hard. I have great respect for the management of the Havering PCT. However, they are under tremendous pressure and that is leading to careful consideration of the future provision of a number of services.
I know that the Minister is aware of my concerns about the podiatry servicethe foot care clinic that is made available to older members of my community. I am grateful to the Minister for her reply to me in the past day or so about some of the issues that I have been highlighting. I noted in her letter a recognition of the fact that
Given such concerns, I am worried about the impact of the measure on older people in my constituency who are not lucky enough to have high incomes so that, in the case of that particular constituent, they cannot afford to access those services. The most vulnerable members of society may not necessarily receive the attention that they deserve. In such cases, there will be an impact on people's mobility. If it is too painful for them to walk they may not be able to leave their home, which could lead to a deterioration in their mental health, depression and many other problems. I am therefore worried about people who cannot afford to obtain such a service elsewhere or who they feel barred from using it.
I have highlighted the issue of mental health. In the past few months, the Duchess of Kent day hospital, which provided services, particularly psychological therapies, to people suffering from mental health conditions, has closed. A decision was made earlier this year to re-examine those services and provide them in a different way, because the facility was not close to Havering. The review concluded that the Duchess of Kent day hospital should close on 30 September this year and that new provision would be put in place in the next financial year. The problem is that there is a gap between 30 September and the beginning of the next financial year. Services provided at the Duchess of Kent hospital are no longer being made available, and my understanding is that no long-term psychological therapies are available to mental health patients in my constituency and in the London borough of Havering, who must wait for new tier 3 mental health services to be put in place in the next financial year.
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