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Yvette Cooper: The hon. Gentleman raised the issue of care home capacity. Residential care and nursing home capacity cross the country is roughly the same today as it was four years ago. It is important to look beyond the headline figures on closures of homes, and to consider the number of beds and the capacity provided as well. The position in Bedfordshire shows that, although the number of residential homes has fallen slightly from 130 in 1998 to 129 in 2001, this has resulted in only four fewer beds.

The position in the nursing care sector is even better. There were 40 nursing homes in 2001, compared with 38 in 1998, and the number of available beds increased from 1,146 in 1998 to 1,520 in 2001. All this, together with increases in the amount of home care provided—from 460,000 hours to 600,000 hours in the last year—and in the development of additional intermediate care services increases the capacity to help to deal with the problem of needing to move people out of the acute sector in Bedfordshire.

The issue is not simply one of resources. It is also a question of how the money is used. I understand that one of the factors involved in the rising number of blocked beds in Bedford hospital was weakness in the planning and operational processes at the trust, which did not come to light while there were fewer winter pressures. I am

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informed that the new chief executive is assembling a new management team, with the emphasis on improving operational management planning and involving clinical staff. The trust's modernisation team is also busy redesigning services to streamline them and to increase capacity.

There has also been considerable support for local areas across the country to help them to modernise and reform, and to reduce delayed discharges. The NHS's performance management at national, regional and local level has a key role to play in managing the reduction of the numbers of delayed transfers of care. The 2001–02 planning and priorities guidance made specific reference to what the NHS is required to do, and by when, to reduce delayed transfers of care.

Mr. Patrick Hall (Bedford): I support the point that my hon. Friend was making about the new management team at Bedford hospital trust wishing to improve management systems to make maximum use of the capacity at the hospital. None the less, will she accept that there is a need for additional capacity, both in the hospital and out in the community—for example, in relation to the John Bunyan ward in the former north wing site and to intermediate care outside?

Yvette Cooper: My hon. Friend is absolutely right to say that there is a need for increased capacity right across the NHS, as well as in the community. That is why we have been investing ever greater resources in expanding the NHS and social care provision; we clearly need to go on doing so.

The hon. Member for North-East Bedfordshire was right to say that there was an increase in bed blocking in Bedfordshire at the beginning of this month. Action has been taken to bring the number of delayed discharges down. Bedfordshire is now better placed, as a result of the additional resources and the support that it has received, to plan to cope with the winter pressures. Clearly social services and health will need to go further, and I welcome the plans that they have put in place to progress that. As my hon. Friend the Member for Bedford has also said, they will also need the new investment that will be forthcoming next year, but that new investment must be used for modernisation as well, so that they can best deal with delayed discharges this year and improve the situation further for next year, to ensure that every patient in Bedfordshire gets the best possible treatment in the NHS and in social care.

Question put and agreed to.



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