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Mr. Bone: I am very grateful for the Ministers response. To reduce the rate of the superbug clostridium difficile, there must be a hospital bed occupancy rate of 85 per cent. or less. Kettering general hospital had the worst C. difficile rate in the whole country. It has a hospital bed occupancy rate of 92 per cent. Would not the Minister agree that the way to solve the problem is to build a new hospital in my constituency in order to reduce the bed occupancy ratio in Kettering?
Mr. Bradshaw: I am afraid that I have to correct the hon. Gentlemans figures. My information from the local trust is that the bed occupancy rate in Kettering general hospital in the latest year for which figures are available was 81 per cent., whereas at Northampton general hospital it was 85.6 per cent. It is interesting that, according to the figures, although the occupancy rate in Northampton was higher, it has been even more successful than Kettering in reducing C. diff rates. In Northamptons case, they went down by 61.3 per cent. between 2006 and 2007; in Kettering, they went down by 64.1 per cent. in the same perioda great achievement by his local hospital.
Alan Simpson (Nottingham, South) (Lab): Without getting drawn into the relative merits of various claims for new hospital building, will the Minister look carefully at the arguments in favour of reducing occupancy rates? As I understand it, in France there is a presumption that a 70 per cent. occupancy rate is the tipping point beyond which the gains begin to be overtaken by hospital infections, re-admissions and staff turnover. May we have a similar independent study in the UK that would identify the tipping point at which we move from efficiency to absurdity?
We had such a report a few years ago, which stated that the optimal bed occupancy rate was 82 to 85 per cent. The latest figures available suggest
that the rate has come down to below 85 per cent. on average, which we welcome. It is coming down slightly all the time, although we do not think it is our job to dictate to local hospitals how to run their affairs. If one examines the latest bed occupancy rates and superbug rates, there is no correlation between them. Other issues are much more important in the way in which hospitals manage disease outbreaks.
Norman Lamb (North Norfolk) (LD): The Minister will be aware that Professor Barry Cookson of the Health Protection Agency has advocated an occupancy rate of about 85 per cent., yet about 50 per cent. of hospitals are running at above that level. He also highlighted the potential risk to patient safety if that level is exceeded. Despite a promise in the NHS plan that there would be 7,000 extra beds, there has been a reduction in beds of about 13 per cent. since 1997. With so many hospitals often in a state of crisis because they are completely full, is it not time for an urgent review of the number of beds in the system and the way in which those beds are used, to ensure that we do not put patient safety at risk?
Mr. Bradshaw: Again, I must correct the hon. Gentleman. In the past there was a stronger correlation between bed occupancy rates and infection rates, but as infection rates and bed occupancy rates have come down, we have looked into the matter in great detail in the past two or three years and we cannot find the correlation that the hon. Gentleman points to. There are hospitals with a higher bed occupancy rate than 85 per cent. that have very good records on infection and other matters. What is much more important is how well the hospital is managed and what its overall anti-disease measures are, rather than the bed occupancy rates. Although we have said and I repeat that we think the optimal level is between 82 and 85 per cent., we do not think it is sensible to dictate to well performing hospitals that may have bed occupancy rates over 85 per cent. that they should bring those rates down. That is for them to manage, and it is for them to be answerable to their local communities.
Ann Coffey (Stockport) (Lab): A bid has been made by Stockport primary care trust for a community hospital in Shaw Heath, in one of the most deprived wards in my area. It is an exciting and innovative project. Does my hon. Friend agree that a community hospital on the site would enable better use of NHS beds at Stepping Hill, and at the same time would tackle health inequalities in the area?
I certainly would, and I was going on to say in response to the hon. Member for North Norfolk (Norman Lamb), who speaks for the Liberal Democrats, that one of the reasons for the decline in beds in acute hospitals is that more and more people are staying in community hospitals and then being cared for in their own homes, which I think is welcomed by Members in all parts of the House. My hon. Friend will be pleased to know that I am informed that the board of the North West strategic health authority is meeting tomorrow to make a final decision on the community hospital for which she has been a long and doughty campaigner. We think the scheme is a visionary and innovative one that meets national and
local health objectives and will enhance community health services. I congratulate my hon. Friend on her successful campaign.
Anne Milton (Guildford) (Con): The Minister may well argue that other measures are important, but there is no doubt that an internal policy review from the Department of Health showed that reducing bed occupancy to a maximum of 85 per cent. could save about 1,000 cases of methicillin-resistant Staphylococcus aureusMRSAa year. The aim should undoubtedly be nearer 82 per cent. Does the Minister agree that while bed occupancy rates remain unacceptably high, consequences on the scale that we saw at Maidstone and Tunbridge Wells remain a real threat?
Mr. Bradshaw: What was wrong in Maidstone and Tunbridge Wells was a totally incompetent management. As I have pointed out, there has been no correlation in the past two or three years between bed occupancy rates and infection rates. I would have expected that, rather than making the same old points time and again, the hon. Lady might have welcomed the fact that the latest national figures show a 30 per cent. reduction in MRSA rates and a 23 per cent. reduction in C. difficile rates in the past year. She should congratulate the Government on our action, rather than constantly criticise us.
The Secretary of State for Health (Alan Johnson): In recognition of the challenges presented by an ageing society, the Government are committed to fundamental reform of the adult social care and support system. We intend to hold a national consultation, which will lead to the publication of a Green Paper, to identify options for a new system that will be fair to all and sustainable for the long term.
Mr. Allen: I understand that the first consultation meeting on the Green Paper will take place next week. Will the Secretary of State ensure that one of the key considerations will be the interface between the national health service and social services, particularly when assessments are required for conditions such as incontinence or for the care package? Will the Secretary of State make a point of asking Members of the House for their experience around that interface? Perhaps he could publish a list of Labour and Opposition Members interested enough to respond to that consultation.
Alan Johnson: My hon. Friend is right; the interface will be a crucial element of the exercise. We need to knit adult social care, local authorities and the NHS much more closely together. That is happening in many parts of the world, and my hon. Friend should take credit for what he has done in Nottingham. In the meantime, £510 million is available for the adult social care grant and it is specifically to encourage much greater integration in the next three years. The review is more long term, but we have immediate action and resources to back it up.
Greg Mulholland (Leeds, North-West) (LD): One of the issues in respect of standards of care relates to people with dementia. Is the Secretary of State aware of the butterfly scheme, which is being trialled in Leeds? It was the brainchild of my constituent Mrs. Barbara Hodkinson, and it has been extremely successful in allowing patients to be identified without stigmatisation and allowing their care needs to be addressed. Does he agree that we should roll the scheme out nationally? Will he or the Minister with responsibility for care come to Leeds to speak to Mrs. Hodkinson and Sister Christine Tall, who implemented the scheme, to see whether it could improve standards for dementia sufferers nationally?
Alan Johnson: I am aware of the important butterfly scheme in Leeds, and I would be pleased to nip over from Hull to Leeds to see it. It is an important part of how we can make progress, deal with the issue and use best practice to develop our strategy on that debilitating disease.
Mrs. Madeleine Moon (Bridgend) (Lab): There tends to be a lack of uniformity in the care provided by child and adolescent mental health services and in the standardisation of and access to services across the UK. Is it not time that we had a more standard service so that young people who are at the difficult transition into adulthood and face mental health problems, and their parents, could access a service that catered for people aged up to 25, rather than 16, 17 or 18?
Alan Johnson: My hon. Friend is absolutely right; a review on that specific issue is under way at the moment. The Green Paper and the public debate cannot be only about adult social care for older people, which was the subject of the 2006 Wanless review; they have to embrace the entire adult population. That is not least because, as I know from my own constituency casebook, many people are alive today who would previously probably not have survived childhood. Such people need far greater care. That must be integrated into the social care system and it is a very important part of the review.
John Bercow (Buckingham) (Con): In seconding the proposition made by the hon. Member for Bridgend (Mrs. Moon), may I put it to the Secretary of State that the requirement for joined-up and continuing care is marked among those on the autistic spectrum? The right hon. Gentleman will know that I and others are looking at provision for children and young people from birth to age 19. However, there is also a significant issue for the Government in respect of assisting people well beyond age 19sometimes throughout lifeas they negotiate the difficulties that they encounter. Such people have the opportunity, if helped, to contribute to the country through employment. However, they do need some help.
The hon. Gentleman has taken a huge interest in these issues and is doing some very good work on speech and language therapy. I completely agree with him. This whole area would probably not have been very high up the political agenda as recently as 10 years ago, but it is now much more of a crucial issue. That is why announcements on it will be made very shortly, not least for the reason that he touched
onthat there is such a huge waste of talent out there because we consign these young people to being the passive recipients of benefits for the rest of their lives instead of using the opportunity to make them active citizens in our society.
The Parliamentary Under-Secretary of State for Health (Ann Keen): Improving outcomes for children is a priority across the range of responsibilities of the Government. The recently published childrens plan set out how the work is focused towards achieving a long-term vision of England as the best place in the world for children to grow up.
Ms Butler: Ten years ago there were no childrens centres in Brent; now we have 12. That has vastly improved the well-being of children and young mums. By 2010, there will be a childrens centre in every constituency. In the meantime, however, does my hon. Friend agree that baby and toddler centres like the one that my constituent, Sarah Green, is fighting for should be kept open by primary care trusts and local authorities?
Ann Keen: My hon. Friend is right. The importance of these centres in the early years is paramount, not only for children but for parents. We are very proud of our Governments initiative in introducing them and increasing support in the community. This morning, I saw on Beavers Lane estate in Hounslow a hub where all the integrated services are working closely together. That makes a huge difference to the future lives of children, who will be our young people, and their parents. All health professionals are to be congratulated. I urge people in my hon. Friends local area to take note of this.
Mr. Nicholas Soames (Mid-Sussex) (Con): Does the hon. Lady agree that childrens health starts with a happy and successful birth, and that it therefore makes no sense at all for the Government to press primary care trusts all over country, including those in West Sussex, to close and diminish the number of maternity services, particularly at Princess Royal hospital in Haywards Heathan area of exceptional growth with an enormous new population expected? It makes no sense whatever to downgrade valued and cherished maternity services at an excellent hospital.
Ann Keen: The hon. Gentleman has raised this issue with me before in Adjournment debates in Westminster Hall, and he has campaigned strongly for his area. However, what is happening is not to downgrade but to improve. The Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists would agree that we want children to have the best possible start in life, and the first few minutes are critical, for obvious reasons. As we know, this is happening with the consent of clinicians and the local community. I am sure that the hon. Gentleman will continue to engage with his constituents on this important issue.
Mrs. Maria Miller (Basingstoke) (Con): Does the Minister agree that under-age binge drinking is a growing and alarming health problem for children? Police, ambulance workers and accident and emergency workers would certainly agree with that. Why has so little progress been made in the past eight years in cutting the amount of alcohol that school-age children drink, and what confidence can we have in the Government having more success in that area in the future?
Ann Keen: The evidence shows that we are making improvements as regards this very difficult issue, which the hon. Lady rightly raises. It is a serious issue for all of us in this House to address because, as was said in questions and answers earlier, the consequences are so severe. In particular, our hard-pressed health professionals do not wish to have to spend their professional time and resources dealing with it. All of us, across Government and across this House, should take it very seriously.
The Minister of State, Department of Health (Mr. Ben Bradshaw): Data held electronically can be secured using encryption and other measures not applicable to old paper-based systems. The health services national programme for IT has particularly high levels of security because of the sensitivity of data held, and individual health organisations are responsible for complying with data protection rules.
Christopher Fraser: Three hundred thousand patient prescription forms have been lost, junior doctor job applications have been found on the internet, a laptop with thousands of patients details has been stolen, and child benefit information affecting millions has gone missing. Does the Minister accept that patients do not have faith in the Governments plans to put their personal details on an NHS database?
Mr. Bradshaw: No. As I have already explained to the hon. Gentleman, the level of security on the national NHS IT system is second to none in the world. In fact, we get regular complaints from people saying that it is too secure, because it does not enable them to exchange the information that they need to make sure that patients are cared for properly. I also have to tell him that child benefit is not the responsibility of our Department. None the less, we do take data losses extremely seriously.
Since the problems experienced by Her Majestys Revenue and Customs, the chief executive of the national health service has reminded the managers of every trust in the country of their legal responsibility to comply with data protection rules. They are now obliged to publish quarterly reports on any serious data losses and to say what action they have taken to ensure that such losses do not happen again. The vast majority of the data losses that have happened, including the ones the hon. Gentleman referred to in his question, would not have happened under the level of security used by the national NHS system for IT.
Mr. Kevin Barron (Rother Valley) (Lab): Does my hon. Friend agree that the major problem we have with the NHS database is not the database itself, which is secureprobably more secure than the local bankbut the people who misuse it by downloading information and then carelessly leaving it in the backs of cars? Millions of our constituents have had their records stored electronically for decades, and it is about time we moved away from this negative debate about it, took the issue out of party politics, and recognised the work that it can do to help people, particularly those with chronic illnesses.
Mr. Bradshaw: My right hon. Friend, who has done a number of reports on this issue and knows a great deal about it, is absolutely right. I regret that all too often in the debates we have about the subject, we lose sight of the enormous benefits of the good exchange of data on patient care. Patients get quicker, more reliable and much safer care, while the NHS saves a lot of money through not using the old, expensive and cumbersome paper-based systems.
My right hon. Friend is right. In an organisation that employs 1.3 million peoplethe biggest organisation in the world, I think, after the Indian railways and the Chinese red armyit is impossible to conceive of a situation in which some human failure could not lead to data loss. That is why it is important that every NHS employee is aware of their responsibilities. It is also important that those in hospital management are aware of their responsibilities, and make those clear to staff.
10. Mr. Graham Brady (Altrincham and Sale, West) (Con): What the average waiting time was for access to primary care psychological services in the most recent period for which figures are available. 
The Parliamentary Under-Secretary of State for Health (Mr. Ivan Lewis): Information about average waiting times for access to primary care psychological services is not collected centrally, but we are investing significantly in improving access to psychological therapy over the next three years, with funding rising to £173 million in 2010-11, to train 3,600 therapists and to treat up to 900,000 people.
Mr. Brady: In June last year, when I raised this question with the previous Secretary of State, she was good enough to agree that waiting times were far too long. For many of my constituents, the waiting time for such vital services is still 16 months or longer. Does the Minister agree that such a wait can allow conditions that would otherwise have been treated to get worse, and will he take urgent steps to deal with the issue?
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