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Mr. Deputy Speaker (Sir Michael Lord): Order. I am afraid that the right hon. and learned Gentleman's time is up.

5.58 pm

Ian Stewart (Eccles): I should like to return the debate to fact rather than opinion.

In recent years, Salford has seen a decline in population—some would even say a haemorrhage. That, coupled with reduced unemployment and a welcome reduction in the number of benefit recipients, means that in the past two years Salford has received the second-lowest and the fifth-lowest increase in its standing spending assessment of all metropolitan districts. At the same time, its council tax base has been reduced.

The paradox is that authorities such as Salford, which are facing population decline, need additional resources to attract new people to ensure that regeneration through capital resources is not undermined by a lack of revenue. They also need to provide high-quality services for the people who remain in urban areas who tend to be more needy. We do not have contingency funds or flexible mechanisms for dealing with unforeseen and unpredictable pressures, such as the dramatic increase in the number of looked-after children which Salford has experienced in recent years.

Currently, Salford council has considerable concern about funding for social services. Salford supports the function changes that the Government are introducing in 2002–03, particularly in relation to the care of the elderly. However, it believes that, to stay within Government allocated budgets, it will have to restrict eligibility criteria and reduce the number of elderly people receiving council support. This will have a detrimental effect on the Government's important objective of reducing bed blocking in the NHS.

In total, Salford estimates a shortfall of £1.4 million in its social services budget for 2002–03, yet, over the last three years, Salford social services has introduced significant efficiency measures. Furthermore, it was congratulated in October last year on being one of the top 15 performing authorities, and its social services director, Ann Williams, has been nominated and shortlisted for a public sector leadership award. That is a compliment to Ann and to all city of Salford workers.

Nevertheless, under pressure, Salford is now planning to reduce the number of residential and nursing home placements and community support. This will have an immediate effect on the council's ability to help people move from acute hospitals back into the community when they no longer need full-time nursing care.

Last year, the council met its target reduction for delayed discharges from hospitals. It wants to build on this achievement. Grant conditions under the building care capacity grant, however, require a further 20 per cent. reduction this year, and all of Salford's allocation for this year would be needed to meet the ongoing costs of placements and fee increases from 2001–02. It therefore currently anticipates a minimum of 158 delayed transfers from care.

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Last month, my hon. Friend the Member for Bolton, North-East (Mr. Crausby) organised a meeting with Social Services North West and all the local authorities present identified the same problems. The Association of Directors of Social Services and the Local Government Association have lobbied hard to get more money for social services, and I and many other MPs have raised the issue with Ministers and the Chancellor. Although I am very pleased that the Government are providing additional funding to the tune of a 6 per cent. real increase in spending over the next three years to help local authorities provide the high standard of care in the community that we all want, we must accept that, like the health service, social services have also been historically underfunded.

I was staggered at the structural underfund that was imposed on social services in Salford when the Tories transferred care from health to local social services— I suspect that it was as much as 3 or 4 per cent. Clearly, money must be made available both to sustain community placements for people already in local authority care and to fund new placements for people waiting to leave hospital. All of this is in a climate in which there is a problem in the supply of residential care for which local councils are not responsible.

Social services now receive a number of specific grants such as building care capacity and quality protects for children's services, and I trust that the additional 6 per cent. funding will be on top of those specific grants and general funding. I am sure that the Government will have extensive consultation with social services authorities about proposed penalties for authorities that do not meet their targets for reducing blocked beds. Although it is important that the Government ensure that health services and social services provide an efficient transition of patients from hospital to care or home, I am concerned that authorities could be punished for failing to provide services for which they have not been given sufficient or appropriate resources, or when there is a problem in the supply of residential care over which the local authority has no control.

What we must do is build on good existing partnership relations between health and social services authorities in my area and throughout the country. We must nurture co-operation and the dissemination of good practice. Different authorities may have different criteria to determine when a patient is fit for discharge. Delayed hospital discharges are not just a matter of funding: the availability of residential places or housing adaptations are just two factors that must be considered. There are also complex reasons for people being readmitted to hospital. What we must avoid is patients being caught in a game of ping-pong between different authorities that are anxious to avoid penalties. Notwithstanding those concerns, I believe the Government have taken a very important step in reducing the funding gap between health and social services and giving social services assured resources to enable them to plan for the medium term.

I warmly welcome the broad package of NHS audit and accountability reforms announced by the Chancellor and fleshed out by the Secretary of State for Health. They will make it easier for the public to see how the money is being spent and what is being achieved. More transparency is always healthy. Of course, I also loudly applaud the considerable additional funding to be made available to the NHS—an average annual increase of 7.4 per cent. in each of the next five years. This, of course,

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builds on the substantial foundations established in Labour's first Administration, under which my local area of Salford benefited from investment in modernisation. Under the local capital modernisation fund, the Salford Royal Hospitals NHS trust received £675,000. In terms of accident and emergency modernisation, £660,000 went to the Manchester Children's Hospitals NHS trust for the Royal Manchester Children's hospital and £755,000 to the Salford Royal Hospitals NHS trust's Hope hospital. An additional £200,000 was invested in an existing scheme to improve the layout of the accident and emergency department. Action has been taken to reduce waiting lists and times: £499,000 was provided to aid early delivery of the maximum in-patient waiting time target of 15 months during 2001–02. In addition, there has been major capital investment in my area as the lead authority for the £114 million fourth wave scheme at the Salford Royal Hospitals NHS trust. Work to develop that scheme is due to start in 2001.

The link between poverty and poor health is well established. I therefore welcome not only the Budget investment in health but the more generous tax credit system that the Chancellor is introducing, which I am sure will play a part in reducing health inequalities.

As I am on my feet, I cannot pass up the opportunity to make a special plea. I hope that some of this extra money will be made available to voluntary hospices. The cost of running one of our local hospices is £7 million per annum, of which only 28 per cent. comes from public funds. The remaining £5 million has to be raised every year from the people of Salford, Manchester and elsewhere. A recent survey undertaken by the Independent Hospice Representative Committee, entitled "NHS Funding of Independent Hospices 2001", found that hospices in the south and in coastal areas fare a lot better than those in the north and in deprived communities. I hope that the Government will take action to reduce regional inequalities and to ensure that all patients have access to the highest quality of service.

This Budget is a significant morale booster for all health and social services workers. The Government have given us the framework and the monitoring procedures to deliver a high-quality service to patients and local authority residents. A sustained commitment has been given to the NHS, which will allow long-term plans to be developed and realised. Managers, doctors and patients have wanted that—and waited for it—for years.

Labour is delivering on its election promise and I am confident that the electorate will support our measures to deliver a national service that is responsive to local needs, which people can count on if they have a minor, chronic or life-threatening condition. The service that I want for my family is the one that I want for every family. Only Labour can guarantee equality of access and a service that is free to everyone. I am confident that this is what my constituents in Eccles in the city of Salford want.

We need only look at France this week to see the awful consequences of public disengagement from politics and the apathy that can result when people feel that they are not presented with real choice. The shadow Secretary of State for Health says that there is a debate to be had. I relish taking on the Tories on the choice that Labour has

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made, and I am confident that people will recognise that a publicly funded NHS is the best health insurance system around. I shall vote for that tonight.

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