National Service Framework for Children (Hansard, 11 February 2003)

§ Lord Hunt of Kings Heath
My Lords, the first standard of the national service framework, covering children in hospital, will be published very shortly. The 561 full NSF will follow by the end of 2003. It will be a 10-year strategy for improving the delivery of health and social services for children, young people and maternity services.

§ Baroness Massey of Darwen
My Lords, I thank my noble friend the Minister for that interesting and encouraging reply. What consultation took place in developing the framework, in particular were children, young people and disabled people consulted?

§ Lord Hunt of Kings Heath
My Lords, there has been widespread consultation. External working groups composed of people from the services and from the voluntary sector are involved in developing policy. A series of events have been conducted with professionals and with young people and children. I am keen to encourage my department to engage more with young people in the development of policies in the future.

§ Lord Chan
My Lords, is the Minister aware that because the National Service Framework for Children will arrive so long after the five others on coronary heart disease, cancer, diabetes, mental health and older people, some NHS managers do not accord it the priority that they ought to, particularly for this year and even for next? If that is the case, what does the Minister advise the Department of Health to do to correct that serious misunderstanding, particularly in the light of the inquiry of the noble Lord, Lord Laming, into Victoria Climbié?

§ Lord Hunt of Kings Heath
My Lords, I understand the noble Lord's anxiety to see the national service framework brought into being as soon as possible and for dispositions to be made accordingly at local level. However, one has to consider the issue of capacity within the National Health Service to deal with each national service framework. There is a 10-year programme leading to considerable change. We have to time it right. For that reason we cannot produce all the NSFs in one go. The publication of the children in hospital report soon, and of the NSF at the end of the year, will set the framework in which we shall expect the health service and local government to make decisions in terms of both resources and service delivery.

§ Baroness Barker
My Lords, will the national service framework make clear at what age a person is determined to be a child? Will it cover issues of transition to adulthood? Will the Government follow the advice of the Wanless report that NSFs cannot be effective unless there are resources to support their implementation?

§ Lord Hunt of Kings Heath
My Lords, I cannot answer those questions as, in doing so, I would anticipate the work that is taking place at the moment. It is important to remember that much work has to be undertaken between now and the end of the year. We have delivered a five-year programme of very large 562 expenditure and expansion in the NHS. We have also allocated to local government a large increase in expenditure over the next three years. I am confident that those authorities will be able to embrace the NSF. We should remember also that NSFs are not simply about new measures costing more money but are often about how to use existing resources more effectively.

§ Lord Skelmersdale
My Lords, in answer to the noble Lord, Lord Chan, the Minister mentioned overload in the National Health Service. What other national service frameworks are in the pipeline? Does the Minister accept that for each new one there is a new priority accepted by the health service although not necessarily given to it, and that overload is a very real problem?

§ Lord Hunt of Kings Heath
My Lords, I cannot give a programme for future NSFs because decisions have still to be made about that. We have produced a number of NSFs so far, including those for mental health, coronary heart disease, cancer, older people and diabetes. We are also working in the area of long-term conditions at the moment. I accept that there is a risk that if you produce too many too quickly the service will not be able to respond. However, on most occasions that I discuss these matters in this House noble Lords urge me to adopt many more national service frameworks because they wish the particular service in which they are interested to be given a push as regards better service. We must get the balance right. I believe that we have the balance right in terms of the number of such frameworks that we have so far, but we shall have to watch the position carefully.

§ Baroness Howarth of Breckland
My Lords, how will the framework enhance partnerships between professionals and working together between departments, bearing in mind the outcome of the Climbié inquiry?

§ Lord Hunt of Kings Heath
My Lords, the national service framework will address both the health service and local government. We shall address partnership issues. I believe that the report of the noble Lord, Lord Laming, on the tragic events surrounding Victoria Climbié will act very much as a catalyst for improving cross-collaboration between different agencies, but will also make it clear at whose door accountability ultimately lies.

§ Baroness Gardner of Parkes
My Lords, is the Minister aware that primary care trusts always seem to favour allocating the budget to those parts of the health service that are already covered by the national service frameworks? That is why people—noble Lords voiced this concern last week—are so concerned that sexually transmitted diseases are not included in such a framework. I refer also to concern about progress on the National Service Framework for Children. Those 563 two matters are closely linked in terms of giving birth and the transmission of diseases. Can anything be done to persuade primary care trusts to allocate funding to aspects of medical treatment other than those covered by the frameworks?

§ Lord Hunt of Kings Heath
My Lords, here we see the dilemma of maintaining a balance between ensuring that national policy is implemented and giving enough discretion at local level to primary care trusts and others to make local decisions. As regards sexually transmitted diseases and sexual health services generally, we are anxious that primary care trusts invest the correct sums of money in that regard. We are looking at the whole performance indicator and performance management framework to see whether we should embrace indicators to reflect that. But at the end of the day it is better to have a programme that introduces NSFs gradually and allows them to be incorporated within the financial and planning frameworks. Such a programme enables the health service to absorb more NSFs when it has dealt with those it has been given. It is difficult to get the balance right but I believe that we have done so.

§ Earl Howe
My Lords, how will the Government's announcement of a Green Paper on children's issues affect the timetable and the content of the National Service Framework for Children?

§ Lord Hunt of Kings Heath
My Lords, I do not expect it to affect the timetable that I have already announced in terms of the publication of the full NSF by the end of this year. The Green Paper addresses children at risk. We expect to publish it in the spring. We expect it to be consistent with the national service framework, but the national service framework embraces a much wider category of children and young people.