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9.49 pm

The Parliamentary Under-Secretary of State for Health (Yvette Cooper): I congratulate the hon. Member for North-East Bedfordshire (Alistair Burt) on securing a debate on this important matter. I welcome his concern to see high-quality social and health care being provided for his constituents. That is clearly what the Government seek and we are investing in and modernising the services in order to provide it. I shall try to respond to all his concerns.

The hon. Gentleman raised particular concerns about delayed discharges in Bedfordshire. I am advised that the percentage rate of delayed discharges in Bedfordshire has, in general, compared relatively favourably with those of other health authorities in the region. For example, in September, the rate fell below 3 per cent. However, there have been rising rates more recently, with figures closer to 6 or 7 per cent. Since the beginning of the new year, the position on delayed discharges throughout Bedfordshire and at Bedford hospital has improved considerably, thanks to the efforts of health and social services. I am informed that the latest figures show a total of 41 blocked beds, which is down from 65 in the first week of January and leaves Bedfordshire on track to reduce delayed discharges to its target of 23 beds by the end of March.

The hon. Gentleman made a series of points about the NHS, social services, local capacity and local funding. In trying to address them, I shall begin with some of the issues about resources. Of course, he will be aware that tackling bed blocking is not merely about resources, but about having the right systems in place to ensure that the resources that are available are best spent. As he will know, Bedfordshire health authority, like health authorities throughout the country, has benefited from substantial real increases in investment in the past few

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years. Last year, it received a real increase of 7.1 per cent. and this year, it received a real increase of 6.3 per cent. Next year it will receive a real increase of 7.8 per cent.—a cash increase of 10.5 per cent. and the fourth largest in the country. He will also be aware that, nationally, increases are currently averaging more than 6 per cent. in real terms, compared with an historic average of about 3 per cent. Those increases put Bedfordshire in a much better position to respond to winter pressures.

I recognise the points that the hon. Gentleman made about the increasing population in Bedfordshire. The matter has been discussed in response to concerns raised by my hon. Friend the Member for Bedford (Mr. Hall), who is sitting behind me. These factors are already taken into account in the NHS formula. It is true that Bedfordshire remains below target. The formula is currently being reviewed and all the factors will be taken into account. It is worth pointing out that, while population has grown by 2 per cent. in the past three years, funding in Bedfordshire has increased by 33 per cent. during the same period. Other areas have also received large increases which are greater than the corresponding rise in their populations. The problem for Bedfordshire, however, is that its increased funding has not been sufficient to meet its population's needs.

As the hon. Gentleman will know, in December, we announced next year's £53.4 billion NHS budget and explained how it would be distributed among health authorities. For Bedfordshire, the cash increase means a total budget of £414.9 million. In addition, an extra £425 million of earmarked NHS funding is available for 2002–03 to enable capacity to be built up across the health and social care system. Together with the additional £200 million being allocated to councils next year for tackling delayed transfers of care, the funding means that a total of £625 million will be available to health and social service communities for tackling these capacity issues. In Bedfordshire, as in other parts of the country, the NHS is therefore better placed than ever before to respond to winter pressures.

The hon. Gentleman is right that the matter is about not only the NHS, but social services, where investment has also been growing substantially in real terms under this Government. Bedfordshire has benefited from that investment. This year, it has received an increase of more than 9 per cent. in its total personal social services resources. It will receive substantial extra funds for personal social services next year. Overall next year, personal social services will continue to increase by a further £680 million, or 6.5 per cent. in real terms. Resources for personal social services have increased between 1996-97 and 2002-03 by an average real-terms rate of 3.2 per cent. a year. That compares with average annual real terms growth of 0.1 per cent. per annum between 1992-93 and 1996-97 under the previous Government. Bedfordshire's personal social services standard spending assessment will increase by a further 6 per cent., the carers' grant by a further 22 per cent. and its children's grant by a further 14 per cent.

The hon. Gentleman said that Bedfordshire social services face difficulties this year through financial pressures. I acknowledge that the council has experienced budgetary problems. I understand that the county council expects an overspend this year of more than £3 million and that the council's financial problems primarily relate to children's services and services for adults with learning

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difficulties. The council has had to fund external placements, which have proved expensive. However, I am pleased to learn that, following staff changes and recruitment, the council is developing a five-year children's strategy, in which the voluntary sector, including NCH, is expected to play a key role. The strategy aims to reduce the council's external spending and make a bigger shift to family support. There has also been a review of financial systems to ensure clear accountability for budgets.

Bedfordshire has also benefited from additional money specifically to reduce bed blocking. In October, the Government announced a further £300 million of new funding for social care over two years. An agreement, entitled "Building Capacity and Partnership in Care" was published on 9 October. We expect local social services and health authorities to adopt it. It will lead to genuine improvements in planning and commissioning services, and ensure continuing good quality care for those who currently use them.

We all agree that we need to solve the problems that lead to people waiting in acute hospital beds when they could be better cared for elsewhere. That problem is not new; the proportion of older people who have had to wait while their discharge is arranged has fallen steadily in the past four years. However, we need to continue to improve the overall quality and range of care to older people so that they receive the right care at the right time.

Alistair Burt: I do not intend to pick up on every point that the Minister has made, but will she deal more fully with the last point that she mentioned? Like the county and the NHS trust, I welcomed and was grateful for the amount of money to help with bed blocking. However, I made the point that the money was time limited and could not therefore be included in future budgets. That is worrying. The solutions cannot contribute to long-term changes unless there is some certainty about the future. The Minister may not be able to make a commitment about that now, but I should be grateful if she appreciated the point and said something about the longer-term availability of such funding. As she observed from the figures, we are not considering a short-term problem that will easily go away.

Yvette Cooper: I acknowledge the hon. Gentleman's point about the need to increase the amount of forward planning that local areas are able to make. That is why we have moved towards giving local health authorities greater certainty about the sort of allocations that they can expect in future. It is also why we specified the funding out of the £300 million not only for this year but for next year. Clearly, we need to continue to provide greater long-term certainty. However, it is also important to allocate additional money without being too hidebound by the need to plan every single extra penny for the future and end up not allocating the money that we have in the short term.

Of the £200 million that is available next year, Bedfordshire's allocation is £943,000, as the hon. Gentleman said. Those are significant sums, and I understand that the council plans to use the extra funds for more long-term, residential and nursing home care, to increase home care and intermediate care capacity and to increase rehabilitation outside hospital. The council is also

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funding a recruitment drive for residential care staff, and I believe that those initiatives will make a genuine difference to local people who receive services.

Throughout the country, councils are using the money to invest in a wide range of new services to extend the range of services available to maintain the independence of people leaving hospital. They are setting up innovative schemes to provide additional care in sheltered housing, buying additional places in care homes for those who need such care, investing in specialist equipment and extra support for informal carers to enable people to return to their homes. Many councils have also extended their rapid response teams.

Nationally, we have already seen about a 6 per cent. drop since September in the number of delays, and most councils are on target to deliver their contribution to the national reduction of more than 1,000 beds blocked by March 2002.

It being Ten o'clock, the motion for the Adjournment of the House lapsed, without Question put.

Motion made, and Question proposed, That this House do now adjourn.—[Dan Norris.]

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