HL Deb 08 January 2002 vol 630 cc440-2

2.52 p.m.

Lord Campbell of Croy asked Her Majesty's Government:

Whether they intend to act upon all the recommendations on disability equipment services in the report of the Audit Commission, published in 2000, Fully Equipped: The provision of equipment to older or disabled people by the National Health Service and Social Services in England and Wales.

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)

My Lords, from 2001 to 2004, £105 million is being provided to the NHS to modernise community equipment services, along with funding for local authorities to contribute their share. Four million pounds is being invested in prosthetic services and siliconecosmesis. In the next financial year, access to digital hearing aids will be extended. Work to improve orthotics and wheelchair services will take account of relevant recommendations in the Audit Commission report.

Lord Campbell of Croy

My Lords, I thank the Minister for that Answer. Does he agree that this was another excellent report by the Audit Commission on a disablement subject? Does he accept that disabled people, even in this century and even in this country, still experience needless difficulties caused by ignorance or lack of imagination?

Lord Hunt of Kings Heath

My Lords, while I am sure that the House will agree with the noble Lord's general sentiments, I do believe that in a number of ways the Government have developed policies and actions to try to overcome some of that ignorance. So far as concerns the Audit Commission report, I agree that it was very helpful. It highlighted achievements and shortcomings in current services. We are making progress and I hope that, over the next few years, disabled people will feel that the services they receive have been radically improved.

Lord Addington

My Lords, does the Minister agree that, overall, the report was damning? Its main thrust was that matters were carrying on as normal. It was not about resources but about the way the system worked. Can the Minister give an assurance that matters such as allowing young people who need prostheses to have sports limbs will be taken into account, if only on the grounds that the long-term cost savings in regard to their general health will more than compensate for the initial outlay?

Lord Hunt of Kings Heath

My Lords, the Government are giving urgent consideration to that matter. As to the noble Lord's general points, I agree that the Audit Commission report raised a number of serious shortcomings in the way that services were provided. I also agree that while resource is important—and we are putting extra resources into these five services—much of the Audit Commission report concerned organisation and the way in which services were being run. We are keen to ensure that the NHS—and, where appropriate, local government—improves the commissioning of future services. We are working with users and the national procurement service within the NHS to develop specifications and contracts which will lead to improvements in the areas identified by the noble Lord.

Lord Ashley of Stoke

My Lords, does my noble friend agree that the Audit Commission report not only identified shortcomings but was scathing about the five services which are so vital to disabled people? It recommended that each service should be scrutinised separately. Can my noble friend tell the House whether the progress made so far has been satisfactory or disappointing for each of the five services? Can he also tell the House which target dates have been set for which service?

Lord Hunt of Kings Heath

My Lords, my noble friend is right—the Audit Commission was not entirely complimentary about the state of the services it discovered. He is also right to suggest that we need to look at the five services separately, although lessons can be learnt in terms of proper organisation which can apply to most of those services. I do not say that, in the months since the report was published in March 2000, everything has been put right, but we have made steady progress. As I have said, we are putting extra resources into those services and we are involving users in the planning and commissioning of those services for the future. With the national procurement agency working alongside users of services, we will be in a position to produce better specifications in the future and there will be a better integrated approach to commissioning at local level.

Baroness Gardner of Parkes

My Lords, in relation to the cost of treatments or appliances, does the same division arise between NHS provided services and social services provided services? Are some means tested and others not? What is the situation?

Lord Hunt of Kings Heath

My Lords, I suspect that the noble Baroness is referring to community equipment services. The Audit Commission report suggested that they should be brought together between health authorities and local authorities, and we agree with that. We have set targets for community equipment services to be integrated by 2004. As to charges, only a small amount of social services expenditure on equipment is recovered through charges. We will ensure that local councils retain the right to charge for disability equipment because it is within their current powers so to do, but we would also ask them to consider whether it would be cost effective to do so within the new integrated community equipment services. I take the noble Baroness's point, but, ultimately, it will be for individual local authorities to decide.

Forward to