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House of Lords

Monday, 31st March 2003.

The House met at half-past two of the clock: The LORD CHANCELLOR on the Woolsack.

Prayers—Read by the Lord Bishop of Guildford.

The Lord Chancellor: Leave of Absence

The Lord Chancellor (Lord Irvine of Lairg): My Lords, before business begins, I take the opportunity to inform the House that I will be undertaking a ministerial visit to the Channel Islands on Monday 7th, Tuesday 8th and Wednesday 9th April. Accordingly, I trust that the House will grant me leave of absence.

NHS: Sports Facilities

2.36 p.m.

Lord Addington asked Her Majesty's Government:

    What steps they are taking to ensure that primary care trusts, health authorities and National Health Service trusts promote and safeguard facilities for physical activity and sport.

Baroness Andrews: My Lords, primary care trusts have an important role in the delivery of local and effective policies to increase physical activity. They are supported in that by the wider NHS and work with other organisations through local strategic partnerships to ensure the best possible local infrastructure for physical activity and sport.

Lord Addington: My Lords, is it not slightly strange that there is no statutory right of consultation for the NHS in any of its facilities to advise on recreational physical activity, especially when we consider that it often prescribes physical activity as a treatment? Does that not display a considerable lack of joined-up government and imply increased costs in future?

Baroness Andrews: My Lords, the noble Lord is right to say that there is no statutory responsibility, but the NHS is proactively involved in many different ways. For example, 93 per cent of local strategic partnerships, which are responsible for developing local infrastructure, now have the chief executive of the local PCT on the board.

Another example relates to the sale of school playing fields, which has significantly reduced as a result of the Government's regulations in 1998. We have there seen that the third criterion, which means that community interests must be served, invites the PCT to have a view. Its role may not be statutory, but

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the PCT can certainly play a role by saying that such open spaces are important for a community for health reasons.

Baroness Billingham: My Lords, can the Minister update us on the impact of the New Opportunities Fund programme—especially its positive effect on promoting sport across all age groups and in all communities? It has been especially successful in that area.

Baroness Andrews: My Lords, sport has been a major priority for the Government and the NOF programme has taken a significant lead. For example, 581 million has been provided for infrastructure and development—school playing fields, sports halls, and so forth—and 300 million has been provided for healthy learning centres, which are a splendid innovation driven by the community. They invite people in to discuss how their health needs can best be met through diet, activity, and so on. My favourite is the out-of-school learning programme, whereby major expansion of after-school and out-of-school activities for young people has been taking place, especially in sport.

Hospitals: Single-Sex Accommodation

2.39 p.m.

Baroness Noakes asked Her Majesty's Government:

    Why they will not publish the names of National Health Service trusts which have not met the single- sex accommodation standards.

Baroness Andrews: My Lords, the majority of NHS trusts were successful in eliminating mixed-sex accommodation by the target date. More than 98 per cent of wards now meet our guidelines; the remainder will comply once private finance initiative and other building projects are completed. Those projects affect only 2 per cent of 10,000 wards. To name those would give a false impression that the whole trust was not compliant when that is clearly not the case.

Baroness Noakes: My Lords, I thank the Minister for that reply. I remind her that in February 1998, the noble Baroness, Lady Jay, then a health Minister, said:

    "We promised we would end the unacceptable practice of mixed sex hospital accommodation, and we stand by that promise".

Has not that promise been broken? Have not wards been excluded from the Government's figures on a massive scale by allowing screens and other dubious devices to mask the real picture? Is not that the real reason for not disclosing non-compliant hospitals?

Baroness Andrews: Absolutely not, my Lords; I could not disagree more. The overall target set stated that we should have eliminated 95 per cent of mixed-sex accommodation by December 2002. That meant complying with three standards: single-sex sleeping accommodation, bathroom and toilet facilities, and

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additional safety for patients who are mentally ill. Our figures now show that 98 per cent of trusts have met the first standard; 93 per cent have met the second; and 95 per cent have met the third. Huge effort has gone into meeting those targets and we are pleased with the result.

The most important figure I can give the House is that 164 wards out of 10,000 do not meet the guidelines. What constitutes segregation is not flimsy screens but strong segregated facilities which mean that patients are not overheard or overlooked.

Lord Clement-Jones: My Lords, it is now nearly six years since the Government made their pledge on single-sex accommodation. Why is it not now 100 per cent? Successive Ministers have made that pledge. The extra 2 per cent surely cannot be far away. There is confusion about whether the target relates to single-sex wards or single-sex accommodation. Can the Minister clarify that?

Baroness Andrews: My Lords, two big questions have been asked. The first is why we are not now at 100 per cent. Of the 24 trusts that remain outstanding, 22 are involved in major-scale conversion or building programmes. Those take time. We are expecting 97 per cent compliance by April 2004, but a few hospitals have even bigger projects scheduled after that.

On definitions, we use the term accommodation rather than wards because accommodation involves not just wards but single bedrooms, groups of single bedrooms and mental health units—the whole range. By single sex, we mean proper segregation within all those different forms of accommodation.

Lord Stoddart of Swindon: My Lords, is the noble Baroness aware that it is now well over seven years since I introduced a Bill to the House, which it was good enough to pass through all its stages, to outlaw mixed-sex wards throughout the National Health Service? That has still not been achieved, because, I believe, of resistance within some trusts and hospitals. Even if only 164 wards remain, we should surely be told in what hospitals so that pressure can be brought on the trusts to eliminate them forthwith.

Baroness Andrews: My Lords, it pains me to disagree with the noble Lord, but there is no question of resistance. As I explained, the 164 wards remain mixed sex because of the new build coming on stream. The noble Lord will admit that we have made extremely good progress considering the position on single-sex accommodation that we inherited seven years ago.

Baroness O'Cathain: My Lords, does the Minister not think there is good reason for naming and shaming the national health trusts? The Government name and shame everyone else—schools, et cetera—so why not trusts? I am sure that it would create the impetus whereby there would be only single-sex wards after very few months.

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Baroness Andrews: My Lords, as I explained, we do not name and shame because there is no shame attached. Twenty-two trusts are involved in new build conversions and major development programmes, which is something to be proud of. The issue of the remaining wards is not being neglected. Privacy and decency are high priorities. We attempt to provide patients with what they want in different ways, not least by having modern matrons and ward housekeepers. The fact that 164 wards are outstanding is not neglect.

Baroness Gibson of Market Rasen: My Lords, my noble friend mentioned privacy and dignity. Having just come out of hospital, I have heartfelt views on that. Can the Minister say more about what has been happening in relation to privacy and dignity?

Baroness Andrews: My Lords, privacy and dignity do not depend entirely on single-sex accommodation, although it is an important factor. The training given to nurses and the success of the role of the almost 2,000 modern matrons now in place make a difference to the dignity accorded patients. A benchmarking document, The Essence of Care, helps nurses, patients and everyone else on a ward to understand the importance of respecting patients' feelings, their particular concerns and how they wish to be addressed. Standards in that respect are being driven up significantly.

Earl Howe: My Lords, when the noble Lord, Lord Hunt of Kings Heath, announced earlier this year that 98 per cent of NHS trusts met the single-sex accommodation standards, he added the rider that that achievement was in relation to planned admissions. What about unplanned, emergency admissions?

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