HC Deb 22 April 1999 vol 329 cc650-1W
Mr. Efford

To ask the Secretary of State for Health what representations he has received regarding geographical inequality in renal provision; and what measures he plans to address the problem in the next three years. [81439]

Mr. Hutton

We have received a number of representations and are aware of the variations in provision. We acknowledge the concerns which have been expressed and we are taking steps to address them.

Centrally issued guidance on specialist commissioning and the National Priorities Guidance have both emphasised the need for health authorities and National Health Service trusts to review the existing provision of renal services and to plan for and to commission increased and equitable high-quality provision.

We are planning to issue guidance shortly which will be designed to provide further advice and assistance to health authorities and National Health Service trusts. This guidance will include information from a survey of renal services which is being carried out to ascertain the current position.

Mr. Efford

To ask the Secretary of State for Health what representations he has received regarding the establishment of a national renal service framework; and if he will make a statement. [81441]

Mr. Hutton

A rolling programme of national service frameworks (NSFs) was launched in April 1998. The first two frameworks being developed are on coronary heart disease and on mental health; these will be followed by NSFs on older people (spring 2000) and diabetes (spring 2001).

The suggestion that renal services should be the subject of a national service framework was raised by representatives of the National Kidney Federation at their meeting last year with my noble Friend the Baroness Hayman. Since then, an Early Day Motion supporting this proposal has been tabled by the hon. Member for Oxford, West and Abingdon (Dr. Harris). There have also been twenty-one letters of support from hon. Members to Ministers. There are currently no plans for a national service framework for kidney disease. It is likely, however, that the diabetes NSF will look at some aspects of renal provision as renal failure is a complication of diabetes.

We will continue to work with the professional and voluntary groups concerned to look at ways in which we can develop and improve the provision of services for people with kidney disease.

Mr. Efford

To ask the Secretary of State for Health what is the projected increase in the next three years in the number of kidney patients(a) nationally, (b) regionally and (c) in Bexley and Greenwich District; and what steps he intends to take to meet such increases in demand. [81440]

Mr. Hutton

The provision of renal replacement therapy (dialysis and transplantation) for people with end-stage renal failure (ESRF) has increased year on year. From 1993 to 1995 the number of patients in England receiving treatment for ESRF rose by 20 per cent.—nearly 4,000 additional patients.

The projected increase in demand for such services is estimated at 9 per cent. per annum. Though this figure is not broken down by region, it is likely to be higher in areas where there is a high population of elderly people or a high proportion of people from ethnic minorities. A revision of the epidemiological needs assessment (published in 1994) will be issued soon, setting out the current level of need and taking ethnicity into account.

Guidance issued in October 1998 on commissioning arrangements for specialist services identified renal services as a priority, and emphasised the need for health authorities to plan on a long-term basis for the needs of their populations. In addition, a Health Service Circular on renal services will be published in the next few months; this will make clear the need for Health Authorities to review levels of renal services and to plan to meet the expected increase in demand.

Bexley and Greenwich Health Authority is a constituent member of the South East Thames Renal Steering Group. The group has carried out a study into the projected demand for renal services across the south east Thames area. Its work has resulted in the decision to open a satellite renal unit at Greenwich, and a further satellite unit at Lewisham is planned.