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PCTs (Local Services)

Volume 453: debated on Tuesday 28 November 2006

5. What steps she is taking to safeguard the provision of small local services affected by the changes to primary care trust boundaries. (103771)

It is for primary care trusts, in consultation with local people, to decide what small, localised services are needed in their areas.

I thank my hon. Friend for that answer. In particular, I want to raise the issue of toenail-cutting services for elderly people. It is an important service and it should be raised. Because of the redrawing of the boundaries of the primary care trusts, I am seriously worried that small local services that are vital for elderly people—such as those who cannot reach their feet—are not being safeguarded. I would very much like the Minister to give an answer that reassures me that such small, vital services are being safeguarded in PCT funding.

My hon. Friend raises an important issue: toenail-cutting services are important for older people, particularly those with diabetes or vascular problems. In such circumstances there is a commitment to maintain those services. However, I must also say to my hon. Friend that one of the reasons why a review is taking place is that some people have been receiving those services for more than 10 years, and although that might be entirely appropriate for some older people, it might not be necessary for others. The objective is to make sure that those services are protected where there is clinical need, because they are an important lifeline for many older people, but we must also make sure that resources are used appropriately.

Is the Minister aware that among the worst affected small local services are the integrated health care services of chiropractic, homeopathy and herbal medicine? Is he also aware that his right hon. Friend the Secretary of State for Health, when she was presenting the Acorn award for integrated health care at the NHS Alliance conference last week, said that they are what patients want? Why, therefore, are there cuts across the board in primary care trusts, and why are the Tunbridge Wells and Royal London homeopathic hospitals under threat? Will he and the right hon. Lady—

I know that the hon. Gentleman has a long-standing interest in, and commitment to, complementary medicine, as Members in all parts of the House will acknowledge, but the fact is that more than 50 per cent. of GPs do use complementary medicine and make sure that it is available to their patients in some circumstances. The hon. Gentleman asks me to intervene in local PCT decision making, but I should point out that his own Front Benchers are suggesting that we have complete operational independence for the health service, where local decision making will be the norm.

Has my hon. Friend heard from the Minister, my hon. Friend the Member for Don Valley (Caroline Flint), about the interest that she has taken in Trevi house, which is a unique drug rehabilitation centre in my constituency for young mothers and children? Indeed, I thank her for the help that she has recently offered to them. However, will he and his colleagues give serious consideration to issuing guidance to PCTs about the position of such small services? Two or three places are provided for the Plymouth PCT area, but a regional and a national service is also provided.

My hon. Friend the Minister has made me aware of the excellent work that Trevi house does. I believe that my hon. Friend the Member for Plymouth, Sutton (Linda Gilroy) has visited the service, and she makes a really important point. An holistic approach is taken there, and the rehabilitation services that are available not only for women who have had drug-related problems, but for their children and other family members, are incredibly important. In issuing commissioning guidance to PCTs, one of the things that we are most concerned about is rehabilitation outcomes and the needs of those women and children and the families as a whole. Where such quality services are being provided in the voluntary sector or perhaps by social enterprises, we will try to ensure that commissioners understand that we expect them to commission such services against the outcomes that we specify.

One way to conserve and perhaps develop local services is to realise redundant assets. Will the Minister therefore look at the situation of the Queen Camel doctors’ surgery, which has lain empty for several years since the new surgery was built? It is situated right in the middle of a village, is vandalised regularly and is an eyesore, yet my repeated approaches to the South Somerset primary care trust, and now to the Somerset PCT, have failed to lead to its being sold. Will the Minister look into this issue, find out why probably £500,000 of NHS assets is being wasted, and write to me?

I am more than willing to ask the PCT to have a look at this issue, which is exactly the sort with which the Member of Parliament concerned, the local authority, the PCT and, indeed, the local voluntary sector should engage, in order to come up with a solution that meets the needs of the local population. However, this is not necessarily a job for me, sitting in an office in Westminster or Whitehall, but I am willing to contact the PCT and to ask it to engage properly with the hon. Gentleman in an effort to resolve the issue.