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The Minister of State, Department of Health (Mr. Mike OBrien): NHS Gloucestershire has identified the Littlecombe south site at Dursley for the relocation of Berkeley hospital. Heads of terms for the site are to be agreed by the end of October and the project is expected to be completed in 2011-12, with services transferring to the new hospital in spring 2012. It has been suggested in initial discussions that the existing site should be used for mixed residential and retail purposes.
Mr. Drew: I thank my right hon. and learned Friend for that response, and it is good to hear that a site has been identified. Does he agree that we need to make rapid progress on this excellent project, and that it is essential to ring-fence its funding to make sure that it goes forward? Will he allow me to discuss with local people how the existing Berkeley site could be used most appropriately?
Mr. OBrien: Obviously, the use of the existing site is a matter for local decision, and I have no doubt that my hon. Friend will be involved in that. As for the projects funding, it has been allocated from the community hospitals programme already and I understand that it is secure.
The Parliamentary Under-Secretary of State for Health (Ann Keen): The most recent NHS work force census was published in March this year, and it shows that, as at 30 September 2008, there were 1,368,186 staff employed by the NHS in England. That is equivalent to 1,124,818 staff working full time.
Ann Winterton: I acknowledge the huge increase in expenditure on the NHS, but does the Minister accept that many non-clinical staff have been needed because of the services top-down style of management and bureaucracy, as well as what I would call its tick-box culture? In these straitened economic times, will she ensure that front-line clinical services and staff will be protectednot least in maternity services, given the increasing birth rate due to immigration
Ann Keen: I can assure the hon. Lady that front-line clinical staff will be protected at all times, as quality and safety are this Governments priorities. Managerial staff are of course always required to run an efficient and progressive health service, but the front-line clinical staff will be there to provide the quality service that we have grown to respect and need.
David Taylor (North-West Leicestershire) (Lab/Co-op):
The Royal College of Surgeons conducted a large-scale survey of its members this summer, and it found that
two thirds of surgeons felt that the quality of care given to patients had been reduced because of the European working time regulations. Will the Minister say whether there are enough surgeons to cope? Should we not have rather more in the NHS work force?
Ann Keen: Our overriding priority will always be to continue to ensure that patients experience high-quality, safe and effective care in the NHS, which of course we have provided by our surgeons. Hospitals such as Homerton in London have been working a 48-hour week for more than two years, and have produced evidence that the change has decreased hospital mortality. There is no evidence of harm being caused to patients. I think we all want our surgeons to be rested and to have had a nights sleep, to be well equipped for the job ahead.
The Minister of State, Department of Health (Mr. Mike OBrien): Clearly, it is for the local NHS to determine the best way to reconfigure services to meet the needs of local people, but changes to existing service provision should be initiated only where there is a clear and strong clinical case for doing so in the best interests of patients.
Mr. Hands: I welcome news from the Imperial College trust that the new hyper-acute stroke unit is to be based at Charing Cross hospital in my constituency. However, hidden in the small print of the consultation document there is already a proposal to move those new facilities to St. Marys in Paddington. Does the Minister share my concern about the continual transfer of services from Charing Cross hospital to others, including renal, obstetrics, gynaecology and now vascular surgery, and the detrimental impact that will have on my constituents and those across west London?
Mr. OBrien: That is a somewhat churlish way of welcoming the fact that the hon. Gentleman is having a new facility located in his constituency at Charing Cross. I should have thought he would welcome that. As far as Charing Cross hospital is concerned, the aim is to retain a full range of health services for the people of Hammersmith and Fulham, including 24-hour full accident and emergency and maternity services. The trust will continue to provide neurology and stroke services at Charing Cross. That is the long-term programme, but we want to have a project at St. Marys as well, so I do not think the hon. Gentleman needs to get overly worriedthere will continue to be stroke services at his hospital.
The Secretary of State for Health (Andy Burnham):
On Thursday, the Care Quality Commission will publish its NHS performance ratings for 2009. On the same day, the chief medical officer will give an update on swine
flu, including further details about the vaccination programme. Following last nights vote on the Health Bill, the Government are assessing how best to take that important policy forward and will make a further statement in due course.
Miss McIntosh: The Secretary of State will be aware that the out-of-hours service is becoming increasingly dependent, particularly at night-time, on non-British doctors. As he will be aware, the UK is unique in the European Union in having a general practice provision. What precautions is he taking to ensure that non-British doctors coming from other countries are suitably qualified to perform the out-of-hours service, and are fully acquainted with the level of drugs that should be issued to patients in their care?
The Minister of State, Department of Health (Mr. Mike OBrien): The hon. Lady raises a very important point. It is important that primary care trusts ensure that the providers of out-of-hours services are conducting a proper, full assessment of those who carry out those services, that they understand the way the NHS works and how drugs are allocated and prescribed in this country, and that they can speak adequate English.
T3.  John Robertson (Glasgow, North-West) (Lab): According to the National Autistic Society, in a report in the summer, people aged 40 to 50 are not being diagnosed with autism, and the BBC recently said that GPs feel that they do not receive the training necessary to give patients that service. Can my hon. Friend tell me what he intends to do to ensure that GPs get that training so that those 40 to 50-year-olds have the diagnosis they require?
The Minister of State, Department of Health (Phil Hope): I thank my hon. Friend for his very important question. First, autism is actually mentioned in the GP curriculum statements on mental health and on children and young people, so we already expect all GPs to have a general understanding of first principles, but I fully agree that more professional training is a key area for development. It is one of the features of our recent consultation on the first-ever national strategy for adults with autism, which focused on a range of areas, including health and training. That will have a direct impact on GPs and their training, and that national strategy will be backed in law.
T2.  Mr. Edward Timpson (Crewe and Nantwich) (Con): In the north-west only 53 per cent. of children receiving treatment for substance misuse complete the course. What are the Government doing to improve that alarming figure?
The Minister of State, Department of Health (Gillian Merron): We have to look at all ways of reducing the harm caused to children by addictive substances, including drugs. Our campaign under the tag FRANK is one of the ways. We are also increasing access to services across the country, but we are tailoring them to ensure that we meet the needs of all groups.
T8.  Mr. Lindsay Hoyle (Chorley) (Lab):
I wonder whether my right hon. Friend would like to come and visit Chorley hospital, one of the best hospitals
in the country, and support a walk-in treatment centre beside the accident and emergency department, which will give new life to Chorley.
Andy Burnham: I understand that my right hon. Friend the present Home Secretary visited not long ago when he was in the post that I now hold. I am not sure whether my hon. Friend the Member for Chorley (Mr. Hoyle) got something new on the occasion of that visit, or whether he wants something new on the occasion of another visit, but as he knows, I am not far down the M6, so I will bear his kind invitation in mind.
T4.  Simon Hughes (North Southwark and Bermondsey) (LD): Returning to the subject of carers, do Ministers accept the figures in todays report from the Princess Royal Trust for Carers and Crossroads Care that only one pound in five of the money allocated this year for carers has been spent? Will they publish, for each trust, the amount that has been allocated and ask each trust to publish by the end of this month how they intend to spend the money on carers this year?
Phil Hope: I understand and fully appreciate the concern that carers organisations have about the fact that the Government have put £150 million over two years into PCT budgets to pay for respite care and other support for carers. The Government have played their part in responding to the needs that we recognise among carers. The question is how that money is spent by local PCTs. The hon. Gentleman knows that those primary care trusts make these decisions based on an assessment of their own areas. He knows, too, that the Department is producing a document to assist primary trusts and local authority commissioners to understand how the needs of carers may be effectively identified, and that we will seek to publicise that guidance as widely as possible. That, I think, will have an impact on the primary care trusts delivering the money that we provided to meet the needs of carers and those for whom they are caring.
T9. Jacqui Smith (Redditch) (Lab): Worcestershire Acute Hospitals Trust has recently reported to me on the huge progress that it is making in reducing hospital-related infectionsonly seven MRSA infections so far this year, well inside the rightly tough target that has been set for them. Given that that progress saves lives and saves money, how can we ensure, first, that it continues, and secondly, that money saved in Worcestershire is reinvested in improving patient care even further in Worcestershire?
The Parliamentary Under-Secretary of State for Health (Ann Keen):
I welcome my right hon. Friends question because it gives me the opportunity to congratulate the health service on the achievement of the national target for MRSA, which has reduced by 50 per cent. the number of MRSA bloodstream infections, in comparison with the number in 2003-04. The latest data for April show that MRSA bloodstream infections are down 74 per cent., but we can never be complacent in relation to these infections. We are tremendously pleased with the progress that has been made. While constantly keeping our eye on those figures, we are reinvesting money in the knowledge that we already acquired because
knowing how to reduce infection rates is so important. I welcome all the improvements that have been made and look forward to discussing them in my right hon. Friends constituency.
T5.  Mr. Simon Burns (West Chelmsford) (Con): The Secretary of State has announced recently his policy aspiration to abolish car park charges in NHS hospitals for patients. He did not mention in his speech ancillary workers and nurses and doctors. Will that policy, if he ever has the possibility of bringing it in, apply to that group, and if not, why not?
Andy Burnham: I hear the hon. Gentleman, but of course the policy has to be affordable, and I think it fair to say that when a family has somebody in hospital, particularly if that person is in for a long time, we should make it easy for the family to visit as much as possible. To go further still and provide free parking for everybody would be a difficult policy to introduce, because it would provide an incentive for everybody in the locality to park for free at the hospital. We think it right to prioritise in-patients, but, if the hon. Gentleman is making a spending bid to go further, perhaps he should direct it to his Front-Bench team.
Fiona Mactaggart (Slough) (Lab): Monitor produced early this year a damning report on the governance of Heatherwood and Wexham Park Hospitals NHS Foundation Trust in my constituency. This week, at last, the chairman of the trust resigned. What can the Department do to ensure that when there is a failure of governance, the past poor actions by the board and by executive officers are not taken out on staff, who may face redundancy now?
Mr. Mike OBrien: As my hon. Friend knows, in the Health Bill yesterday we made some amendments that will enable de-authorisation to occur in particular circumstances, with the consent of Monitor. We need to ensure that when trusts are not foundation trusts, we are able to act quickly to ensure that people who are responsible for ineffective administration of the health service are dealt with; and that the strategic health authority bears in mind that there might be financial implications that it would have to consider as part of the overall regional budget.
T6.  Tom Brake (Carshalton and Wallington) (LD): A memorandum of understanding has been reached between Sutton and Merton primary care trust and the London borough of Sutton over the sale of land that is needed for Stanley Park high school. May I urge the Secretary of State to intervene and ensure that, as soon as possible, the memorandum of understanding is converted into a firm contract, so that this fantastic project to build a new school can proceed as soon as possible?
Mr. Andy Reed (Loughborough) (Lab/Co-op): My right hon. Friend the Secretary of State has announced that the Care Quality Commission will be reporting in due course. He will not be surprised to hear that in a meeting with Charnwood carers group, I found that the quality of care in the community and in care homes is high on peoples agenda. In fact, many were in tears at their own experiences, despite the tick-box reality of the commissions work. Will Ministers ensure that there is genuine personal care in such places? That is what people really want, for the dignity of their elderly relatives.
Phil Hope: My hon. Friend is right to highlight issues of concern about the quality of care, whether it is care of people in their own home or in residential care homes. The Care Quality Commission plays an essential role in monitoring and inspecting care homes to ensure that standards are sufficient. We need to go further and ensure that all care, whether in a care home or in a persons own home, is personal and tailored to meet individual needs. The Prime Ministers announcement of free personal care for everybody who is looked after in their own home and has the highest level of critical need is a major step forward and
T7.  Paul Rowen (Rochdale) (LD): Following the recent death from swine flu of Louise Jones from Leigh, what steps is the Secretary of State taking to increase the number of extracorporeal membrane oxygenationECMObeds, especially in the north? The UK has only five, whereas there are 23 in Australia.
Andy Burnham: Of course, the case of the 24-year-old woman, who did not live directly in my constituency but in Tyldesley, which is nearby and, as the hon. Gentleman knows, not so far from his constituency, was incredibly sad. I am led to understand that, in that case, the clinicians did not think it possible for the patient to travel. However, a decision was taken recently to expand ECMO provision in Leicester. The clinical advisory group advised that it was right to concentrate provision in that area, given the huge amount of training and intensive support that the unit needs. The decision has been taken, we recognise that such technology has a very important role to play and I hope that the hon. Gentleman welcomes that decision.
Rob Marris (Wolverhampton, South-West) (Lab): Some of the big pharmacy wholesalers, such as Phoenix Healthcare and Alliance Healthcare, are also retailers and so refuse to supply wholesale to small, new and independent pharmacy retailers. Will the Minister look into that apparent restraint of trade, please?
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