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The Minister of State, Department of Health (Andy Burnham): There have been three parliamentary questions and the hon. Gentleman has written to the Secretary of State and to me on this matter. The Department has also received correspondence from other hon. Members and from members of the public. In addition, my right hon. Friend the Secretary of State visited the trust on 4 October and discussed these issues with staff.
Alistair Burt: I have also had a letter from the Minister’s permanent secretary apologising for a misleading written answer that was given to me earlier. Is the Minister aware that, since the new year, Bedford hospital has had to instruct its doctors that no non-emergency case can be operated on in less than the maximum allowed time frame, that outpatient clinics are being restricted and that bed shortages are causing real concerns? All that is happening because of a need to fulfil an arbitrary time scale to combat an arbitrary calculated deficit. When my constituents pay so much for their NHS, why are they and all who work so hard at the hospital being put through such downright misery, and why is it so often the case that Government targets dictate to patients, rather than patients’ needs driving the targets?
Andy Burnham: I acknowledge that the hospital has had a difficult time and that difficult decisions have been taken to get it back into financial balance. However, I hope that the hon. Gentleman welcomes the fact that the hospital is now in monthly run-rate balance—it is in balance or better on what is coming into the hospital. The hospital is also forecasting a year-end financial position that is close to break-even. I did not hear any mention of that in his question and nor did he acknowledge that no waiting time target will be breached. The waiting times that are being met in his constituency are significantly better than those with which he left us when his party left government.
Patrick Hall (Bedford) (Lab): Does my hon. Friend recognise that an agreement has been reached between Bedford Hospital NHS Trust and Bedfordshire PCT on moving to a 20-week maximum wait? An additional £500,000 has been allocated to the hospital for planning purposes to enable it to do that, which will represent steady progress towards the national target of an 18-week maximum referral time from GP to intervention. Is that not part of the progress that is being made in the NHS in not only Bedfordshire, but throughout the country, which is in sharp contrast to some of the negative stories that we have heard of late?
Andy Burnham: I pay tribute to my hon. Friend because he has supported and encouraged his NHS to make the kind of progress that he has described. The NHS in his constituency is making progress towards the 18-week target, as is the NHS in other constituencies throughout the country. Instead of celebrating the hard work of managers and staff in his area to make such improvements, Conservative Members simply decry their efforts and demoralise staff by making exaggerated claims of the difficulties. We hear talk of a save Bedford—
Mrs. Nadine Dorries (Mid-Bedfordshire) (Con): It has been reported in the local press that Bedford Hospital NHS Trust will be asking GPs to take over the provision of genito-urinary medicine and sexual health services. We know that reported cases of chlamydia, gonorrhoea and HIV are on the rise, and my GPs say that they have neither the training nor the facilities that would be required. More importantly, patients want to go to a hospital where they can have guaranteed anonymity. Will the Minister send out a letter to Bedford Hospital NHS Trust saying that GUM services must not be closed down at Bedford hospital and devolved to GPs?
Andy Burnham: I would just ask the hon. Lady and her Conservative colleagues to stop setting their face against any change to the way in which services are delivered in the national health service. They should consider the possibility—this might just be possible—that it might be in the interests of patients for some services to be delivered out of the hospital setting and closer to their homes. I encourage the hon. Lady to open her mind to a thriving future for Bedford hospital and to accept the possibility that some services might be better delivered in the community.
York Hospitals NHS Trust
9. Hugh Bayley (City of York) (Lab): What assessment she has made of the likely effect of the North Yorkshire primary care trust deficit on health services provided by York Hospitals NHS Trust. [113233]
The Parliamentary Under-Secretary of State for Health (Mr. Ivan Lewis): As my hon. Friend is aware, the PCT is working closely with the trust and the strategic health authority to agree changes that will lead to more cost-effective services. These changes will lead to a better use of resources, with some patients being treated more appropriately closer to home.
Hugh Bayley: The national health service is based on the principle that care is provided on the basis of patients’ clinical needs, not their ability to pay, so will the Minister reassure the House that the rights of patients in north Yorkshire will be protected, despite the PCT’s deficit, and that they will retain access to the same range of NHS treatments, and experience the same waiting times, as NHS patients from other parts of Yorkshire and the Humber?
Mr. Lewis: I agree with my hon. Friend and congratulate him on adopting a constructive approach towards the difficult financial circumstances that his PCT faces. As difficult decisions are made to ensure that we get that organisation back into balance, it is important that patients continue to enjoy access to high-quality services. However, it sometimes might be more appropriate to provide those services in the community, so this might be an opportunity to make some of the changes that frankly should have been made anyway, irrespective of the financial pressures that the organisation faces. Of course, the interests and needs of patients must remain at centre stage, and the trust must maintain the national standards that are set down on the quality of patient care.
Mr. Robert Goodwill (Scarborough and Whitby) (Con): Does the Minister think that it is fair that while NHS workers in York are bearing the brunt of the £77 million deficit in north Yorkshire, the nature of the contracts imposed on the PCT by the Government means that the new private Capio hospital in York escapes relatively unscathed?
Mr. Lewis: What is important is the fact that patients in the hon. Gentleman’s area have access to high-quality services and are required to wait for as short a period as possible. If that means allowing constructive engagement between the NHS as a direct provider and the independent sector, leading to better treatment for patients in his community, I would have thought that he would welcome it.
Miss Anne McIntosh (Vale of York) (Con): I am delighted that Capio is enabling us to reduce waiting times for certain operations, but will the Minister respond to the question asked by the hon. Member for City of York (Hugh Bayley), with whom I entirely concur? The issue is not about having services delivered by other providers in the hospital trust, but about unacceptable delays and clinical need being put on the back foot. Will the Minister please respond to that question?
Mr. Lewis: The waiting time targets apply in the same way in the hon. Lady’s constituency as in the rest of the country. Indeed, if we look at the facts, we see that no patient is waiting longer than 26 weeks for in-patient treatment, compared with 1,317 patients who did so when we came into Government in 1997. I hope that she will acknowledge the two new CT scanners that have been delivered to the hospital, the replacement MRI scanner, the fully modernised accident and emergency department, the additional cardiac catheter laboratory, and the new day unit, which was opened only in December last year, not to mention the £6.1 million integrated breast unit on the York hospital site. These are difficult times, and there are difficult decisions to be made, but there have been massively increased levels of investment and performance since 1997.
Health Care (East Cheshire)
10. Sir Nicholas Winterton (Macclesfield) (Con): If she will make a statement on future access to health care services in east Cheshire. [113234]
The Minister of State, Department of Health (Ms Rosie Winterton): Central and Eastern Cheshire primary care trust is developing new health services that will enable patients to receive treatment closer to home.
Sir Nicholas Winterton:
I am surprised that my namesake did not refer to maternity services, because they are the subject of my question. Is the Minister aware that birth rates in east Cheshire, which is served by the Macclesfield district general hospital, have increased for three years in a row? Women are opting to come to Macclesfield, in increasing numbers, to have their babies. Does she not agree that if women show that preference, it is essential to keep in-patient
paediatrics, maternity, obstetrics and other children’s services in the Macclesfield district general hospital, in accordance with that decision? Will she ensure that those services in the hospital, which serves a predominantly rural area, are fully, properly and fairly funded?
Ms Winterton: I was not aware of the massive increase in the birth rate that has taken place, but I am now. I also know that the PCT is exploring the possibility of linking some of the maternity and paediatric services in the Cheshire area. Obviously, in doing so, the PCT will have to satisfy the strategic health authority that it is meeting clinical standards, such as those set by the Royal College of Midwives, and can still provide a full range of local services. I understand that the hon. Gentleman is meeting Mike Farrar, the chief executive of the North West strategic health authority, on 12 January, and I am sure that he will make his views clear at that meeting.
Mrs. Gwyneth Dunwoody (Crewe and Nantwich) (Lab): Is my right hon. Friend aware that in my constituency, which is part of the Central and Eastern Cheshire primary care trust, for the first time in 30 years, we shall have a totally new health centre in the middle of Crewe, an entirely new health centre in the middle of Nantwich, and a new centre in the middle of Sharington? That is a remarkable feat, and I hope that she will give credit to the remarkable negotiating skills of Professor Dr. Ong, who has managed the normally unachievable feat of getting vast numbers of general practitioners to work together.
Ms Winterton: My hon. Friend is right to highlight some of the results of the Government’s increased investment in the national health service, and the real benefits that it can bring to patients. I am glad to hear her praise the work of NHS professionals, too; perhaps the Opposition would like to take her lead.
Mr. John Baron (Billericay) (Con): Further to the comments of my hon. Friend the Member for Macclesfield (Sir Nicholas Winterton), the fact remains that maternity services in Macclesfield, like those in Salford and Bury, have not been selected to become centres of excellence in the “Making it Better” reconfiguration across the north-west. It has not escaped public notice that some Ministers are trying to have it both ways by pushing for service redesign at a national level while opposing closures that affect their constituencies. Is not the reason for that embarrassing inconsistency the fact that those reconfigurations take place in the absence of an evidence-based model of safe and accessible maternity care? Will the Minister respond to our call for the Government to engage in a national debate about such a model, so that much loved local services do not face closure without good reason?
Ms Winterton:
The hon. Gentleman will be aware that people who make decisions on the organisation of local NHS services consider what is the best care for patients in the light of the best value for money. We have produced national guidelines and a national plan for maternity services. There is a well established process for service changes, which naturally includes
hon. Members expressing views on behalf of their constituents. In the case of maternity services in Greater Manchester, a final decision has not been made, but hon. Members are free to express their views and those of their constituents.
Andrew Miller (Ellesmere Port and Neston) (Lab): The hon. Member for Macclesfield (Sir Nicholas Winterton) and Members representing Cheshire and Wirral share an excellent mental health trust which, my right hon. Friend knows, has made a bid to become a foundation trust. When will we know the outcome of that bid, and can she assure us that services in east and west Cheshire and Wirral—an area covered by two separate primary care trusts—will be maintained at the same level or, indeed, improved in the new structure if foundation trust status is awarded?
Ms Winterton: It is obviously a great credit to the mental health trust in my hon. Friend’s constituency that it has been considered for foundation trust status, as that will allow it extra freedom to expand its services. The bids are being examined and a decision will be made as quickly as possible. I am glad that he supports his local mental health trust, which has made genuine improvements for patients in recent years.
Recruitment
12. Mr. Andrew Mackay (Bracknell) (Con): What recent estimate she has made of graduate unemployment among (a) nurses, (b) midwives and (c) physiotherapists. [113236]
14. Jeff Ennis (Barnsley, East and Mexborough) (Lab): How many newly qualified physiotherapists there are; and how many of them are employed in the NHS. [113238]
The Minister of State, Department of Health (Andy Burnham): Between May and September 2006, about 16,000 graduates qualified. Latest estimates suggest that about 60 per cent. of nurses, midwives and allied health professionals have found jobs, and the situation is improving. About 1,600 physiotherapists completed their training in 2006, and we are working with the Chartered Society of Physiotherapy to address local recruitment problems.
Mr. Mackay: I am pleased that the Minister acknowledged that there are local recruitment problems and difficulties, but he will be aware that in my constituency and elsewhere many physiotherapy graduates have failed to secure jobs, which is a huge worry, both for them and their parents. What else will be done to put that matter right, as it is a great waste of resources?
Andy Burnham:
I appreciate the point made by the right hon. Gentleman. There have been problems in certain parts of the country in the recruitment of physiotherapists who have graduated in the past 12 months. We need to do more to find roles in the community for physiotherapists, but I am confident that there is a need for more physios around the country to help, as we keep saying, to provide care at the local level, to keep people out of hospital and to
reduce delayed discharges from hospital. I therefore accept the right hon. Gentleman’s general point, but the most recent returns to the Department of Health for his area show that 71 per cent. of nursing graduates and all midwifery graduates have found employment.
Jeff Ennis: Following the point made by the right hon. Member for Bracknell (Mr. Mackay), is the Minister aware of the predicament of my constituent, Rachel Smith from Shafton in Barnsley, who last year qualified as one of more than 90 physiotherapists at Sheffield Hallam university? The vast majority of those students have still not found gainful employment with the NHS. Nationally, 75 per cent. of last year’s physiotherapy graduates have yet to find employment. Next year, Sheffield Hallam university will train another 120-plus physiotherapists, and my constituent would like to know from the Minister what is the point of continuing to train physiotherapists if the NHS is not going to employ them.
Andy Burnham:
I am aware of the case that my hon. Friend mentions, and I accept his general point, as I did in answer to the right hon. Member for Bracknell (Mr. Mackay). There is pressure and a particular difficulty for people graduating in physiotherapy this year. My hon. Friend’s PCT recently recruited six newly qualified physios, and a further six bank staff to provide on-call services, so there is evidence of investment in physiotherapy in his local area. However, we need to do more to help people find jobs, whether in social care or in health care. In some parts of the country, consideration is being given to a combined job
bank of vacancies in social care and health care. Perhaps we can explore that in his region.
Mr. Stephen O'Brien (Eddisbury) (Con): Graduate unemployment among physiotherapists stands at 68 per cent.—a waste of nearly £40 million on training. Two thirds of midwifery units are understaffed, yet 40 per cent. are taking on fewer graduates, and 70 per cent. of graduate nurses have not found jobs. Furthermore, we learn that the Secretary of State is planning cuts of 37,000 to NHS staff, dwarfing even our estimates of her staffing cuts, which the Government have, incredibly, tried to refute. Will the Minister tell the House whether graduate unemployment and consequent cuts to patient care are due to shoddy work force planning or short-sighted reaction to the massive cash crisis engendered in the NHS by the Government?
Andy Burnham: I read the nonsense about staff shortages that the Conservative party put out before the Christmas break—a fantastic piece of Christmas fiction. It claimed that 16,000 graduates could not find work. That is the total number of people who completed training last year. As I said in my answer, 60 per cent. of them say, in reply to the Department of Health, that they have found jobs. The Conservatives should stop scaremongering on these matters. They are trying to frighten graduates and NHS staff by exaggerated talk of NHS job cuts around the country. They are trying to frighten local communities with talk of accident and emergency closures, and maternity—
Speaker’s Statement
3.32 pm
Mr. Speaker: The hon. Member for Hendon (Mr. Dismore) has sought the exercise of my discretion to allow him to make reference in his speech to a relevant case which is to be heard later this week by the Court of Appeal. In order to assist the hon. Gentleman, I have agreed to exercise my discretion in this case to allow him a passing reference. I remind the House that I judge each such application on its merits.
Human Rights Act 1998 (Meaning of Public Authority)
3.33 pm
Mr. Andrew Dismore (Hendon) (Lab): I beg to move,
That leave be given to being in a Bill to clarify the meaning of ‘public authority’ in section 6 of the Human Rights Act 1998.
It has been immensely important that the Human Rights Act brought home, so to speak, the rights set out in the European convention. Before the Act came into force, British people had to go to Strasbourg to redress breaches of their human rights. However, in one respect the protection afforded by the Act has been less comprehensive than intended by Parliament. The problem has arisen because of the development of case law interpreting the meaning of “public authority” in the Act.
Under section 6, it is unlawful for a public authority to act in a way that is
“incompatible with a Convention right”.
The Act does not provide a list of public authorities to which the Act is applicable. Instead, it states in section 6(3)(b) that a “public authority” includes
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