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Lord Campbell of Croy: My Lords, since speech therapists were accepted as a profession supplementary to medicine, does the noble Lord agree that there has been an increasing demand for them and never enough of them, particularly because they can perform important functions, for example, when someone has a sudden paralysing stroke and all means of communication come to an end?

Lord Hunt of Kings Heath: My Lords, I do not disagree at all with what the noble Lord has said. There is no doubt that communication is vital to everyone's lives in this country. Speech and language therapists work with people of all ages, not just children. They have a valuable role to play. I am sure that in the future we will need even more speech therapists than we have at the moment. That is why, alongside a review of the training places, we shall be working with the appropriate professional body to examine our future requirements to make sure that the NHS is in a position to take advantage of the profession.

Lord Rix: My Lords, is the Minister aware of the extreme difficulty faced by adults, as opposed to children, with a learning disability in accessing the services of people concerned with speech therapy? If the Minister is so aware, can he suggest solution to the problem?

Lord Hunt of Kings Heath: My Lords, I am well aware of the issues that are being faced and of the waiting that some members of the public undergo in order to access speech and language therapists. We are making progress. We have seen an increase in the numbers of therapists employed in the past two years. We shall be increasing the number of training places. Most importantly, we have commissioned a labour market analysis of speech and language therapists. The result of that project, which is expected next spring, will be used to inform recommendations on future training places. Clearly, that takes time. I want to ensure that in the meantime we do everything we can to recruit more people back into the profession.

Lord Clinton-Davis: My Lords, I declare an interest as someone who suffered a stroke and has had invaluable help from a speech therapist. While the Government certainly deserve a great deal of praise for what they have done, does my noble friend agree that there is a housing problem for NHS staff in London and the South East? What steps are the Government taking to deal with that problem?

Lord Hunt of Kings Heath: My Lords, my noble friend is absolutely right. The long-term vacancies for speech therapists in London are 5.9 per cent compared with the English average of 3.4 per cent. We are exercised in relation to the facilitation of affordable

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accommodation for NHS staff in London. We have appointed Mr John Yates to help us develop schemes to arrange affordable accommodation for such staff. Those will include speech therapists.

NHS Plan

3.1 p.m.

Baroness Carnegy of Lour asked Her Majesty's Government:

    What is their reaction to the statement by the Chairman of the British Medical Association that the National Health Service Plan is not deliverable in the timescale envisaged.

Lord Hunt of Kings Heath: My Lords, we are determined to ensure that the NHS Plan represents a step-change for the health service that is both affordable and deliverable. I am confident that the plan can and will be delivered within the set timescales.

Baroness Carnegy of Lour: My Lords, it has been suggested that what the British Medical Association has been saying is simply a spin designed to affect the pay review for doctors which is presently under way. Can the Minister confirm that, far from that being the case, the BMA gave detailed views as to its anxieties on the day the plan was announced--at the end of July--and that since then other bodies have confirmed very much the same view? I refer to the Royal College of General Practitioners, the National Health Service Alliance and the National Association of Primary Care. All those bodies have detailed anxieties. Will the Government pay attention to the views of general practitioners?

Lord Hunt of Kings Heath: My Lords, I suppose it depends on which Dr Bogle we are listening to. Is it the Dr Bogle to whom the noble Baroness refers, or is it the Dr Bogle who said on 7th September 2000:


    "Overall, the NHS plan is an exceedingly good document. It shows a desire from Government, patients and those working in the health service to achieve the best health service in the world"?

That was a fairly strong commendation of the NHS plan. Of course we will listen to what organisations such as the BMA have to say to us, but we are confident that the figures in the NHS Plan are robust. We see primary care as an integral part of the development of the plan. I am confident that the targets we have set of 2,000 extra GPs by 2004 will be met.

Lord Clement-Jones: My Lords, is not one of the ways of relieving pressure on GPs to allow much more nurse prescribing in primary care? The Government issued a paper in August but consultation is still going on. At a time when the Government are facing demands for more GPs, why are the Government dragging their heels in the area of nurse prescribing?

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Lord Hunt of Kings Heath: My Lords, the Government are certainly not dragging their heels. Nurse prescribing has proved to be very important indeed. We are keen to develop it as soon as we can. I can assure the noble Lord that we will be bringing our conclusions to the House as soon as we possibly can.

Baroness Trumpington: My Lords, I heard what the Minister said about 2,000 extra GPs by 2004. Does he agree that that still puts us in the third division of world health systems? If he so wishes, I can refer to Greece, Germany and France. How does the noble Lord equate the figure of an extra 2,000 GPs with the plan's idea of a patient being able to see his GP within 48 hours, which I understand the BMA says is totally unrealistic?

Lord Hunt of Kings Heath: My Lords, I do not agree with the noble Baroness. She may be referring to the number of doctors employed in each healthcare system. If she is, I would certainly acknowledge that this country has traditionally employed fewer doctors than many other healthcare systems. That is one of the reasons why we are committed to increasing the number of GPs and hospital consultants. But I would also say that in this country we have a very good record of using other staff, such as nurses, to do work that might be done in other healthcare systems by doctors. The noble Lord, Lord Clement-Jones, has already referred to the potential of nurse prescribing.

The noble Baroness referred to the 48-hour limit. Perhaps I may quote from Dr Adrian Attard, whose practice is participating in a primary care collaborative. The practice has cut its waiting times from five to six days to the Government's target time of 48 hours. Dr Attard said:


    "We are not doing any extra surgeries and we are not working harder than before, we are just working in a different way".

Many of the ways in which we can achieve the 48-hour limit will be by GPs working more effectively.

Lord Winston: My Lords, can my noble friend confirm that a number of senior members of the British Medical Association, having read the national plan, signed an endorsement of it before it was published, as did many major leaders in the healthcare professions? Does he not agree that the great majority of the medical professions welcome the national plan and intend to work with it?

Lord Hunt of Kings Heath: My Lords, there is no doubt about that. The 150 or so people who were involved in writing the NHS plan included many doctors. Many distinguished doctors signed up to the core values at the beginning of the NHS Plan. I can do no better than to quote from The Times, which is always to be believed in these matters. It quoted Sir George Alberti, President of the Royal College of Physicians, who urged Dr Bogle on 21st November to "stop belly-aching" and start innovating.

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Business

Lord Carter: My Lords, after the Third Reading of the Freedom of Information Bill, my noble friend Lady Symons of Vernham Dean will, with the leave of the House, repeat a Statement being made in another place on European defence co-operation.

Freedom of Information Bill

3.7 p.m.

Read a third time.

Clause 2 [Effect of the exemptions in Part II]:

Lord Lucas moved Amendment No. 1:


    Page 2, leave out line 31.

The noble Lord said: My Lords, if it does not trouble the noble and learned Lord, Lord Falconer, too much, I should like further to shorten our proceedings today by speaking not only to Amendment No. 1 but also to Amendment No. 7. My point on the two amendments is the same.

The Bill will come into force in 2005. That is also the year when we are promised that we will have full electronic government. Other Bills that have been before us this Session--notably those coming out of the Department of the Environment, Transport and the Regions--have made full provision for the coming electronic nature of government and of government information. The Bill, which is all about information, still does not.

In these two amendments I offer two ways in which the Government can remedy that defect. Amendment No. 1 removes the inability of an applicant to receive information in electronic form if it is information which is already published in some other form--in other words, just because some ancient statute prescribes that information should be published in writing, and that is what the public authority does, there will be no right to receive it in electronic form. The other way is to put something in the statement of good practice to make it clear that, by the time the Bill comes into force, we would expect information generally to be made available in electronic form.

The Government promise a great deal in this area; indeed, they have always done so. However, as the noble Lord, Lord McIntosh, will confirm, they still do not send Answers to my Parliamentary Questions by e-mail. I hope that, one day, the Government will get around to fulfilling the promises they have made. At the very least, they ought to be consistent in their promises. I beg to move.


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