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Lord Lucas: My Lords, I am delighted that the noble Lord raised that question. As a result of all our reforms, school governors are taking a very active and personal interest in the health of their schools. We are delighted that that is the case. It is a development which the party opposite would never have allowed had they been in power.
Lord Morris of Castle Morris: My Lords, I thank the Minister for that answer. Perhaps I may now ask him to answer the question that I put. Why are school governors threatening to resign in such significant numbers?
Lord Lucas: My Lords, I do not believe that they are threatening to resign in significant numbers. Certainly, some are threatening to resign. They are concerned about the level of the funding settlement, as expressed to them by their local authorities. It has been a tough spending round, but local authorities have a great deal of flexibility to ameliorate the general level of funding. One tough year after 15 good years is not so hard to take.
Baroness Lockwood: My Lords, is the Minister familiar with the latest figures which indicate that a higher number of children left school last year without any qualifications? If so, is he satisfied that the Government's policy will now help children across the board? I refer to those who are not gaining qualifications as well as the more gifted children.
Lord Lucas: My Lords, I am familiar with that report. Of course, the Government are not satisfied that that should be the situation. As the noble Baroness will be aware, when the results for the first tests for 14 year-olds were published recently, they showed that around 20 to 25 per cent. of the school population were producing results that were worse
Lord Peston: My Lords, did I misunderstand the Minister? Did he say that variations in class sizes did not affect educational performance? Is that his department's view? Before he answers, I should perhaps point out that I have only just looked at the latest research which appears to show precisely the oppositethat is, that lowering class sizes is highly advantageous. That is evidenced also by the fact that those parents whose children go to fee-paying schools are extremely keen on small class sizes. If it makes no difference, why are they wasting their money?
Lord Lucas: My Lords, research shows that when class sizes are reduced to around 15, the effect begins to be noticed. Class reductions to that level, involving double the expenditure compared with present levels, would produce benefits. But that additional expenditure can be much better spent in producing advantages in other ways.
Lord Stoddart of Swindon: My Lords, the Minister said that local authorities have a great deal of flexibility. He admitted that the Government were engaged in a strong spending round. However, does he agree that many local authorities and local communities want to spend more money on education? In those circumstances, and bearing in mind that the Government believe that people should have as much freedom as possible, will he remove the capping levels from local authorities?
Baroness Cumberlege: My Lords, I deeply regret the death of Mr Abel and extend my deepest sympathy to his family. It is for health authorities to identify local needs, including provision for emergency admissions, intensive care and neurosurgery. It is they and not central government who are in the best position to do that.
Baroness Cumberlege: My Lords, some patients with severe brain haemorrhaging may not be able to withstand major brain surgery and we know that doctors have to make agonising decisions whether or not to operate. I am not saying that Mr Abel was such a patient. He was 68 years oldI am sure your Lordships will agree that that is not so old these daysand was receiving treatment with anti-coagulant drugs. I fear that that told against him.
The scan results available within 30 minutes of admission showed that he had suffered a large haemorrhage; he was deeply unconscious and needed medical assistance to breathe. It would be wrong to judge the whole of the National Health Service from one single case. Inevitably clinical judgments are made and many neurosurgeons are reluctant to intervene unless they believe that there will be a positive result.
Lord Strabolgi: My Lords, is the noble Baroness aware that over 3,500 patients recently had operations cancelled, with all the anxiety that causes, due to a shortage of beds in London and the South East? Is she further aware that a three year-old girl, suffering an asthma attack, had to be driven 60 miles to Cambridge because there was no hospital bed available in London, although doctors had telephoned 14 hospitals? Are the Government prepared to take some responsibility for that?
Baroness Cumberlege: My Lords, we recently had a full report on a survey undertaken on intensive care beds. The report showed that although there were sufficient beds, they were not necessarily in the right place and were not being used in the correct way. One in six cases in those intensive care beds were inappropriately placed. We have drawn the attention of all health authorities to the report. We circulated it and asked them to consider it carefully when purchasing services for their populations.
Baroness Robson of Kiddington: My Lords, does the Minister agree that in circumstances such as those we have just heard about, when no emergency beds are available, NHS hospitals should be entitled to contact the nearest private hospital with beds available rather than leaving it to a relative of the person suffering from the haemorrhage to arrange for his
Baroness Cumberlege: My Lords, in the case cited it was not an emergency bed that was needed; it was a bed in a neurosurgical unit. We have since contacted all the hospitals approached. We found that in two hospitals there was a place and that in one case the senior registrar felt that it was inappropriate that a patient who was so ill should be transferred.
Lord Bruce of Donington: My Lords, the noble Baroness cannot have it both ways. In her first Answer she suggested that the prognosis was that the patient would not respond to treatment because of his age and his specific situation. That may well have been the case. If so, why did the same people go to all the trouble of trying to find a hospital in which a neurosurgeon could be found? The two answers do not tie up.
Baroness Cumberlege: My Lords, there is a difference between referring a patient and accepting a patient. In this case the doctors felt that it was appropriate to refer the patient. However, those in the neurosurgical units in some casesnot in all casesfelt that it was inappropriate for that patient to travel that far for that operation.
Baroness Jay of Paddington: My Lords, is the Minister aware that whatever the specific clinical circumstances of that tragic case, it is not an isolated instance? Is she aware of the reply given to my right honourable friend Mrs. Beckett by the Minister for Health on 3rd February in another place in which she was told that the attendance at casualty and emergency departments throughout Greater London had risen by 2 per cent. in the recent past? If that is the case and those figures are available, why do not the Government take direct action?
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