HC Deb 06 July 2004 vol 423 cc672-3
4. Dr. Phyllis Starkey (Milton Keynes, South-West) (Lab)

What plans he has to improve services for patients with chronic diseases. [182184]

The Secretary of State for Health (Dr. John Reid)

The NHS improvement plan sets out the Government's plans for providing personalised support for the millions of people with long-term or chronic conditions. All that will of course be free: there will be no charges for anyone.

Dr. Starkey

I welcome the increased emphasis on managing patients with chronic diseases, but a significant number suffer from more than one chronic disease. One of my constituents who has Crohn's disease was recently in hospital for an unrelated operation and there was clearly a lack of communication between the different specialties involved in her care. What is being done to encourage clinicians to co-operate more across clinical specialties in the management of patients with chronic diseases?

Dr. Reid

That is an important and pertinent question. The plans that we outlined last week will ensure that, over the next four years, we provide more support for patients, especially those who suffer from a number of conditions and therefore have the most complex health and social care needs.

The focus will be on improving care in three main ways: by supporting all patients so that they can care for themselves and manage their conditions better whenever possible, by ensuring that all patients have access to the care that they need, and—this is particularly relevant to my hon. Friend's question—by providing personalised, co-ordinated care for the most vulnerable patients with the most complex conditions.

Angela Watkinson (Upminster) (Con)

The Secretary of State will be aware of the importance of respite care for those who care for family members with long-term conditions, but is he aware that no such care is available to many parents of children on the autistic spectrum because of the very specific needs of those children? What plans has he made to ensure that it becomes available?

Dr. Reid

The hon. Lady makes yet another important point. It is true that, in addition to the extra resources that we are putting in and the extra people to provide chronic care in the localities, I announced that an additional 3,000 community matrons—specialised nurses—would be provided to help out. We try wherever possible to provide for respite care. She has drawn attention to a particular illness with particular problems in respect of respite care for the carers. I promise to look at that and perhaps to write to her on it.

Mr. Andrew Lansley (South Cambridgeshire) (Con)

The Secretary of State just said that he is planning to provide additional community matrons. He might like to explain why, after seven years of a Government who have failed to deliver community nursing care, there are 800 fewer district nurses than there were seven years ago; why there are 15 per cent. fewer episodes of care from district nurses than there were seven years ago; and why there are 20 per cent. fewer episodes of care from health visitors than there were seven years ago.

The Government have only just discovered the needs of those with long-term diseases. Even now, the Government's approach is not to design services around the needs and choices of patients but to put in place some community nursing without necessarily understanding how that meshes together with the role of general practitioners. Perhaps the Secretary of State would like to explain where community nursing has gone over the past seven years.

Dr. Reid

I confess that I would like to have turned to this as a first priority seven years ago. Had we inherited something other than an impoverished and undernourished NHS in which there had been under-investment—[HON. MEMBERS: "Oh!"] The hon. Gentleman asked me what we did for seven years before we got the 3,000 community matrons. It is a fair question.

Mr. Simon Burns (West Chelmsford) (Con)

Answer it then.

Dr. Reid

I will answer it, if the hon. Gentleman will be courteous enough to contain his excitement. We have been providing 67,500 more nurses, 18,000 of them, incidentally, in primary care, exactly the sector to which the hon. Member for South Cambridgeshire (Mr. Lansley) referred. We have more than 19,400 new doctors. Sixty-eight major new hospitals have been built, are under way or have been improved, and 2,200 GP premises have been improved. In the past three years alone, we have provided 1,600 more general and acute beds than we inherited. We have 265 one-stop services. We have slashed the waiting lists and improved the health care of millions. On top of that, we are providing yet more facilities, including 3,000 community matrons. I wish that we could have done more but we followed a Government who could not have done less for the health service.

Forward to