NHS Communities (Hansard, 23 July 2002)

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)
My Lords, we have asked health authorities to draw up capacity plans which assess the physical and workforce capacity required to meet the targets in the NHS Plan. This process will include reviewing existing schemes which may either need to be brought forward or alternatives provided to bridge any likely gap.

§ Baroness Lockwood
My Lords, I thank my noble friend for that reply. Does it mean that there will be a review of financial and staffing considerations? Furthermore, does my noble friend agree that in order to get the best out of the welcome additional funding for the NHS, we need financial flexibility?
Finally, what advice would my noble friend give to Bradford Hospitals Trust? That trust has consistently received a three-star rating and has met its previous targets by using its resources, including the private sector, to full capacity. However, it will not be able to meet its new targets unless it has up-front new funding immediately in order to provide temporary theatres and additional diagnostic equipment.

§ Lord Hunt of Kings Heath
My Lords, I congratulate my noble friend on championing the cause of Bradford Hospitals Trust. It is a good trust which during the past few years has been run effectively. I am aware of the issues it is facing as regards the long-term project for a new hospital and the immediate need to raise capacity. The best option for the trust is to continue to discuss these matters with the primary care trusts and the local strategic health authority. As a health community, it is required to draw up capacity plans which can consider the issues raised by my noble friend. I have confidence that the Bradford health community will once again rise to that challenge.

§ Baroness Gardner of Parkes
My Lords, is the Minister aware that I and other noble Lords have found the Question difficult to understand? Will he define his interpretation of "National Health Service 182 community"? Secondly, what kind of investment in additional capacity does he envisage those communities making?

§ Lord Hunt of Kings Heath
My Lords, "National Health Service community" would probably mean the health authority, the primary care trust and the other trusts within the boundary of a strategic health authority, of which there are 28 in England. As regards the second question, we have a major capital 10-year programme to produce 100 new hospitals in the NHS. Not all of them will come on stream within the next year or two. In the interim, the NHS needs to raise its capacity in order to reduce the number of patients waiting for treatment. The issue faced by Bradford Hospitals Trust is that while developing a major new hospital it must increase capacity now and in the next few years in order to meet waiting list targets.

§ Baroness Gale
My Lords, what additional control will the proposed foundation hospitals have over their development policies and finances?

§ Lord Hunt of Kings Heath
My Lords, my noble friend has raised the question of foundation trusts, which we intend to develop as a way of giving more local discretion and control to those NHS trusts that have a proven track record of providing good high-quality services to their local communities. We are working on the very issues raised by my noble friend. I am not yet in a position to make a statement, but will do so in due course.

§ Baroness Thomas of Walliswood
My Lords, one of the objectives of the new NHS Plan was to reduce health inequalities. What progress has been made in access to GP resources and services, particularly in poorer areas where single-practitioner GP surgeries are still common?

§ Lord Hunt of Kings Heath
My Lords, we must be careful not automatically to conclude that every single-handed GP practice is a poor one—many are of high quality. In those circumstances, we would encourage single-handed practices to work with other single-handed practices so that they are able to provide a complete range of primary care services.
Secondly, as regards health inequalities, since the passage of a Bill in the previous Session we have been able to develop the funding formula. Those parts of the country in which there are fewer GPs than the national average will receive additional growth in order to develop services in primary care. That may be to recruit more general practitioners, but it may also be to recruit more nurses who, if encouraged to do so, can take on major responsibilities within primary care.

§ Baroness Noakes
My Lords, perhaps I may direct the Minister to the clear targets set by the Government for access to primary care. Does the Minister accept the judgment of Dr John Chisholm of the BMA that if sufficient money is not put into primary care and the 183 GP contract, primary care will crumble and general practice will collapse? Will he commit the Government to providing sufficient funding?

§ Lord Hunt of Kings Heath
My Lords, those comments, if they are accurate, are somewhat overstated. Of course primary care is of great importance to the future development of the NHS. That is why primary care trusts have been formed and why, by 2004, 75 per cent of the entire NHS budget will be devolved to those trusts. It will then be for primary care trusts to decide where to invest their resources. They will be able to make decisions leading to greater investment in primary care. Indeed, if we return to the circumstances in Bradford, one reason why the trust wishes to reappraise its proposals for a large, acute hospital is the recognition that a greater investment in primary and community care may have a dramatic effect on the range of services that would need to be provided in a new hospital.

§ Lord Taylor of Blackburn
My Lords, my noble friend raised the question of a proven track record. What happens in a case where an amalgamation has taken place; that is, where two health authorities are brought together and one has performed well while the other has performed only reasonably well? How is the track record of such an amalgamation assessed?

§ Lord Hunt of Kings Heath
My Lords, we have experience of that kind of case. Within the next few days we shall publish our latest performance ratings of NHS trusts. That will deal with the circumstances where two trusts have merged.
As regards foundation trusts and the criteria set for successful applicants to become foundation trusts, we shall take into account a whole host of factors. If one trust merged with another because it was thought that that could bring to the second trust a great deal of quality management, surely that would be a factor in determining whether the merged trust was a suitable candidate to become a foundation trust—if the overall performance of the two merged organisations showed improvements over a specified period.