HL Deb 25 May 1988 vol 497 cc889-90

The Countess of Mar asked Her Majesty's Government:

Whether the West Midlands Regional Health Authority has allocated sufficient funds to the Queen Elizabeth Hospital, Birmingham, renal dialysis unit for 1988–89 to ensure that funding problems which occurred in 1987 do not recur.

The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Skelmersdale)

My Lords, the renal unit at the Queen Elizabeth Hospital is one of seven such units serving the West Midlands health region and it is for the regional health authority to decide how to allocate resources between them. I understand however that the regional health authority has already decided to increase its renal programme funding by £320,000 over last year's level and is considering the possibility of increasing this still further.

The Countess of Mar

My Lords, I thank the noble Lord for that quite helpful reply. Is he aware that despite the fact that this £320,000 is to be allocated shortfalls are forecast of £120,000 at the Queen Elizabeth Hospital and of £300,000 at the other renal units in the region? Can the noble Lord give some assurance that what happened last year when the Secretary of State suddenly had to provide £250,000 in the autumn to save an estimated 100 lives will not occur again and that consultants will not be put in the position as they were when my brother suffered kidney failure in 1967, when I was told that they would have to play God—that as my brother had no dependants, he would have to die?

Lord Skelmersdale

My Lords, I am afraid that I am unable to answer a hypothetical question reaching into the future. However, I can say that the West Midlands Regional Health Authority is reviewing the region's renal services and is looking very carefully at the complex issues involved in defining the appropriate level of funds required at each of the seven centres I mentioned, including of course the Queen Elizabeth Hospital. In addition, the regional health authority is considering how best to utilise the funds released by the recent announcement of the full funding of the pay review body awards. I understand that the region considers it prudent to release some £3.6 million from its pay reserve at this stage. Extra funding for renal services is high on the list of the region's priorities for use of that money.

Baroness Macleod of Borve

My Lords, is my noble friend satisfied that within the figures he has given there is sufficient funding for the renal care of children?

Lord Skelmersdale

Yes, my Lords. I am indeed satisfied. We believe that both in the West Midlands and in England as a whole services have now been developed to the stage where they meet the needs of all children with chronic renal failure. Fortunately the number of children who develop this distressing condition is very small. We understand for example that in 1987 the West Midlands region took on only 11 patients below the age of 16.

Lord Ennals

My Lords, is the Minister aware that naturally I welcome the additional funds that have been found? Will he say when the report will be available indicating what the situation will be like for the other centres in the region to which he made reference? Can he also say how a decision is taken by doctors as to who should be refused renal dialysis when it is known that the outcome will be death?

Lord Skelmersdale

My Lords, my understanding is that renal dialysis is something which can be used and does not necessarily have to start as it were on day one. Therefore there is quite a strong element of clinical judgment involved. As regards the policy review on renal services, the West Midlands health authority is getting on with that review, but I do not know what point the review has reached.

Lord Morris

My Lords, following on the question of my noble friend, is my noble friend the Minister aware that routine examination of the kidneys of children of approximately one year by the simplest of ultrasound techniques would save hundreds upon thousands of pounds in treatment in later years—a vast amount in terms of resources in the National Health Service?

Lord Skelmersdale

My Lords, I am interested in that. I was not aware of that technique. But I repeat what I said earlier. The number of children who develop chronic renal failure is indeed very small, although obviously one would like to get it down by earlier tests if at all possible.

Lord Northfield

My Lords, there has been a general problem of underfunding for the West Midlands health authority. Has the noble Lord any figures to show to what extent the region has been helped by a reallocation of funds? If not, can he write to me and let me know in particular whether any extra funds have been made available for Shropshire where there has been a considerable problem?

Lord Skelmersdale

My Lords, the best thing I can do is to refer the noble Lord to the Hansard record of yesterday's proceedings when we discussed this matter extensively at Question Time. I shall have to write to the noble Lord with the figures for Shropshire.

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