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Lord Molloy: My Lords, in circumstances where hospitals suddenly experience grave difficulties which are not necessarily of their making, would they receive complete assistance from the Minister's department when they need such help?
Baroness Cumberlege: My Lords, clearly we try to assist anyone in the health service who requires help from central sources. But in this context there are occasions when there are fires, floods or severe epidemics of 'flu when mixed-sex accommodation must be used because the accommodation has to be used as flexibly as possible in order to keep down waiting times.
Lord Stoddart of Swindon: My Lords, does the noble Baroness recall that, on 18th January 1995 when we had a debate on Second Reading of my Bill, she said:
- "I have no doubt that we shall fulfil the demands of the Bill even more quickly than the noble Lord expects".--[Official Report, 18/1/95; col. 745.]
Is the noble Baroness aware also that I nobbled the Secretary of State in the Tea Room of the House of Commons only last week and he is just as concerned and angry about this matter as I am? Are we not now in a position in which nurses, Secretaries of State, Ministers, the Opposition and the whole of Parliament want mixed-sex wards to be phased out but are being
frustrated by people on the ground who appear not to understand that patients want dignity and privacy when they are being treated in hospital?
Baroness Cumberlege: My Lords, of course the Government, my right honourable friend and indeed myself share the anxiety and concern expressed by the noble Lord. We expected the review to be published much sooner than it has been. As the noble Lord will be aware, since he received a letter from my right honourable friend on 20th December, the results of the review will be published very soon indeed and will give us more information. In the meantime we are, and shall be, taking action. But there is a trade-off here in relation to clinical expertise. Clearly, there are some wards where the specialty is so esoteric that it is essential that we use clinical skills and equipment to the best advantage. That means that sometimes it will be necessary to have mixed-sex wards, as will be the case as regards emergency admissions and intensive care, where, clearly, accommodation must be used as effectively as possible.
Baroness Masham of Ilton: My Lords, is the Minister aware that most young men these days do not wear or own pyjamas? Do hospitals keep spare pyjamas?
Baroness Cumberlege: My Lords, I wonder whether the noble Baroness is suggesting that we carry out yet another survey but this time of a different nature. Indeed, I have been prompted to say that we should perhaps start with my noble friend Lord Swinton but I believe that to be an improper suggestion. I really do not know but, clearly, if clothing is needed in any context I am sure that the NHS does its best.
Baroness Strange: My Lords, can my noble friend the Minister say whether there is anyone who does prefer mixed-sex wards?
Baroness Cumberlege: Yes, my Lords, there are some people who like mixed sex wards, especially, I am told, adolescents, because they are gregarious people who sometimes find that it aids recovery when the opposite sex are in the same area.
Baroness Hayman: My Lords, is it not correct that the Government have cynically raised patients' expectations in this area? Is it not true that the majority of patients in beds in hospitals today are admitted as emergency patients and therefore have no rights about a choice of single sex accommodation? Are not the Government guilty of never having properly assessed what the difficulties would be for hospitals with old and ill-designed buildings operating at huge pressures of bed occupancy--as has been the case this winter--and of not actually delivering on the promises that were so rashly made?
Baroness Cumberlege: My Lords, I strongly refute the fact that this has been a cynical exercise. The noble Baroness will know that many of those wards are being
phased out. However, many trusts are putting considerable investment into refurbishing nightingale wards to divide them into two halves and put sanitary facilities at either end. I am sure that the noble Baroness is trying to do that in her own hospital. Indeed, as the chairman of a trust, she will know about patients' expectations.However, there is also an issue here about old hospitals. We are replacing them at the most amazing rate. We have a huge capital building programme. It would be ridiculous to put huge investment into refurbishing old wards when they are going to be replaced by new accommodation, new buildings and, indeed, new hospitals.
Baroness Jay of Paddington: My Lords, the Minister referred to the letter written by her right honourable friend the Secretary of State to my noble friend Lord Stoddart. Can the noble Baroness tell us what he meant when he referred to setting health authority chief executives challenging standards on this matter? Surely, that should have been done two years ago. What is the extra challenge now being suggested?
Baroness Cumberlege: My Lords, when the Patient's Charter was first published it was written in fairly general terms. I have told the House today that we share the disappointment that progress has not been made at a quicker rate. Therefore, the chief executive will be setting challenging standards which will be monitored in much greater detail than we initially thought necessary.
Road Safety: Minor Works
3.23 p.m.
Lord Berkeley asked Her Majesty's Government:
- What provision has been made in the 1997-98 local transport settlement for local authorities to fund minor works (such as bus priority schemes, cycle routes, pedestrian crossings, safe routes to schools and traffic calming) which are not package schemes.
The Parliamentary Under-Secretary of State, Department of Transport (Viscount Goschen): My Lords, the Government allocated £60 million for 1997-98 to local authorities for minor works designed to improve road safety. That may be used for schemes both outside and within areas covered by transport packages. New or improved pedestrian crossings, safe routes to school and traffic calming may qualify for funding as road safety schemes if they are designed to deal with locations where there is a record of accidents.
Lord Berkeley: My Lords, I thank the Minister for that detailed reply. Can the noble Viscount confirm that the budget for minor works not included in packages, which in fact encompasses cycle routes, bus priorities, pedestrian crossings, safe routes to schools and traffic calming, has actually been reduced from £44 million last year to zero this year?
Viscount Goschen: My Lords, as I said in my original Answer, some of the types of schemes which the noble Lord mentioned are classified as "safety schemes". If they come within that classification then money from the allocation of £60 million, which represents an increase of over 10 per cent. on the year before, can be used towards such schemes. It is a matter of deciding priorities. We have decided that safety should be such a priority.
Lord Dormand of Easington: My Lords, is the Minister aware that when some of us were in another place we pressed the Government to have a senior civil servant in each region specifically responsible for cycling matters? I am glad to say that they agreed and that it has been very successful. Can the Minister say whether that still operates? Surely the case for cycling--for example, good exercise, non-polluting, and so on--is already made. Can the noble Viscount tell me whether the budgets are being cut and also what is happening in the northern region? If he cannot give specific information on the latter today, perhaps he will write to me in that respect.
Viscount Goschen: My Lords, I shall be delighted to write with any level of detail that the noble Lord requires. Fundamentally the noble Lord is quite right; the Government do take cycling seriously. Indeed, we now have a cycling strategy and there is a document on the subject, a copy of which I shall be pleased to send to the noble Lord.
Lord Berkeley: My Lords, the Minister and I obviously disagree on the breakdown of the budget. I was referring to minor schemes only which are not packages. Will the Minister confirm that at the same time as the £44 million has been cut to zero the local authority budget for road schemes has been increased by £36 million? Further, can the noble Viscount say why the Government have allowed such a major increase for road schemes but have not allowed any increase for London Underground for the Jubilee Line which, after all, is a similar transport project?
Viscount Goschen: My Lords, the noble Lord is missing the fact that, as I said, there is a category for minor works concerned with safety. There is also a category for minor works within package bids which, again, we have discussed. The pressure came specifically from existing local authority commitments for major projects. That has reduced the amount available for minor works. Within that reduced total, we feel that safety projects, and those within package schemes with associated environmental benefits, should be the priority.
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