Commons Hansard(7 Feb 2006)
House of Commons Hansard Debates for 7 Feb 2006 (pt 12)

Mr. Andrew Smith (Oxford, East) (Lab): I am very pleased to have this opportunity to debate mental health services. As has been noted already, they are enormously important to the lives of service users and their families. It is good to see a measure of agreement across the House that it is important to put the stigma associated with poor mental health behind us, and that the mental health services should get the attention and priority that they deserve.

Too often in the past, mental health care has been a poor relation, but there is no doubt that the extra money provided by this Labour Government has made a big difference. Although more needs to be done, it is no exaggeration to say that mental health care in Oxfordshire has been transformed over the past nine years. That is thanks to investment, the achievement of NHS staff at all levels and to the work of excellent local community groups such as Restore. The local trust has made great strides in providing better services and more facilities for patients. Tangible improvements are clear for all to see, and patients appreciate the improved standards of care that they receive. A recent survey of the Oxfordshire Mental Healthcare NHS Trust's service users showed that more than three quarters of the respondents rated the standard of their overall care as excellent, very good or good.

Smart new buildings, wards and facilities have been provided, and more are on the way. Wards at the Warneford hospital in my constituency are being upgraded, extended and refurbished, and the extension to the Highfield unit for young people with mental

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health problems will open up more places and allow the trust to provide separate areas for boys and girls. More services are being made available. In the past, people with a personality disorder had a choice between hospital and repeated GP appointments. Now, they have access to dedicated out-patient and day-care support.

My constituents can now receive in-patient care in Oxford for eating disorders, instead of having to be transferred to faraway hospitals. The new forensic pre-discharge service helps people who have been mentally ill and in secure hospital care to take the first steps towards living in their own community again. That is just the kind of gradual supported approach for people going back into the community that patients and the public want to see. Those and other developments, coupled with careful financial management, enabled the Oxfordshire Mental Healthcare NHS Trust to progress from one star in 2003 to three stars in 2005. No praise is high enough for the dedication of the staff at all levels who made that possible.

Despite all this outstanding work, however, local mental health services face the enormous challenges arising from cuts that are being made to tackle the financial deficit in the Oxfordshire health economy—a deficit, moreover, that was not of their making. My right hon. Friend the Minister quite reasonably gave the House the relevant figures earlier. However, what this means financially for Oxfordshire is that, whereas in 2004-05, Oxfordshire Mental Healthcare NHS Trust spent £51.2 million and budgeted £53.7 million to meet this year's expenditure, it is now being asked this year to cut £1.1 million from its spending, even after having received £1.5 million one-off help from the strategic health authority, which it may yet have to repay over the next two years. All in all, the trust has almost 10 per cent. less than it says that it needs to meet service and cost pressures. We can argue about these figures—and about what proportion of them represent legitimate efficiency gains, and so on—but however we measure them, the cuts are damaging to the trust and its services, and deeply worrying for patients, their families and staff, as the many letters that I have received from my constituents make clear.

What this means for services is that the trust is having to look at bringing forward the closure of in-patient beds, leading to a real rush to put in place the 24-hour crisis community cover that is needed. It would have been much better to plan and carry through such a change in a measured way. The trust is also having to consider the closure of the psychiatry liaison service at the John Radcliffe hospital, which provides support in the accident and emergency unit to people who have attempted suicide and which also supports people in acute beds who are suffering from chronic illnesses such as cancer. The trust is also considering the closure of an in-patient unit for older adults where patients are assessed for depression and Alzheimer's disease. It is also now unable to invest sufficiently in support for older people in the community or to ensure that early intervention is available to help young people at the first onset of mental illness.

The seriousness of the position is compounded by cuts in the Supporting People programme budget locally, as well as by the current state of NHS funding mechanisms, which is a more general problem for mental health care
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trusts. Whereas additional work for other acute hospital trusts is funded according to the national tariff, additional work at mental health care trusts has to be absorbed within the block allocation, which puts skewed pressure on their share of overall expenditure. This makes it more important that we all speak up for the needs of our mental health care services, both here and in our constituencies, so that they do not get squeezed out by competing demands.

All of that poses a real danger of damaging and obscuring the excellent progress that has been made in mental health care locally and nationally. However, it also puts a question mark over exciting developments planned for the future in preventive community provision in partnership with social services, round-the-clock community crisis support, the development of the complex needs service and the pre-discharge unit for mentally ill offenders, which addresses the issues raised by the hon. Member for Northavon (Steve Webb).

To build on what has been achieved rather than put it at risk, and to make the most of opportunities to improve mental health care in our community, I urge Ministers to consider again what can be done to ease the financial pressures in Oxfordshire, particularly in the mental health care trust, even now in the remaining weeks of the financial year. The mental health care trust is working with the rest of the local NHS to address the underlying financial problems that affect services in Oxfordshire. However, a more measured view needs to be taken of the trust's ability to bear the funding cuts, considering that it has a high proportion of vulnerable service users, many of whom are in no position to speak up for themselves.

In addition, given the body blow that services have suffered this year, Ministers need to assure us that they are taking action to avoid any repetition of this financial fiasco next year, and that budgets across PCTs and hospitals will be properly planned so that those in mental health and other services in the NHS can look ahead with confidence and work with patients and their families to make the most of the huge extra investment that this Labour Government have made and continue to make in the NHS. That has made a terrific difference to the quality of care available to patients and the wider community locally. Let us keep up that good work and carry it forward, not put it at risk as has sadly happened this year.

5.7 pm

12 Jan 2006 : Column 860W—continued

Departmental Assets

Mr. Ian Austin: To ask the Secretary of State for Health if she will make a statement clarifying what the 10 most valuable (a) movable and (b) immovable assets owned by her Department are. [36306]

Mr. Byrne: The following table lists the top ten moveable and top ten immoveable fixed assets in the books of the Department of Health.

Description of asset / £
Immoveable fixed assets
HarperburyHospital, Radlett / 76,700,608
Richmond House, London / 39,441,362
St.JamesHospital, Portsmouth / 37,082,361
WestParkHospital, Epsom / 34,300,000
Land-WarnefordHospital, Oxford / 30,900,000
RunwellHospital, Wickford / 24,459,790
St Ebbas Hospital, Epsom / 23,283,855
Wellington House, London / 18,677,010
Little PlumsteadHospital, Little Plumstead / 14,844,777
ClampHillHospital, Harrow, London / 14,500,000
Moveable fixed assets
Electronic Staff Records 2004-05-Country-wide-Asset Under Construction / 79,852,333
Software Licences from Microsoft / 75,583,418
Local Service Provider North West / 57,310,442
Spine Project-the core NHS Care Records Service to ensure highly available and highly resilient live Systems delivered in several phases / 44,835,458
Spine Project-the core NHS Care Records Service to ensure highly available and highly resilient live Systems delivered in several phases / 21,250,000
Software Licences-Oracle-National Programme For Information Technology / 21,197,152
Spine Project-the core NHS Care Records Service to ensure highly available and highly resilient live Systems delivered in several phases / 20,887,632
National Software Licences from Microsoft / 17,290,037
Picture Archive Communication System (PACS)-Assets Under Construction / 10,127,000
Connecting for Health-Electronic Booking-Assets Under Construction / 8,000,000

Notes:
1.Immoveable assets are land and buildings and any plant and machinery that form an integral part of the land and buildings (such as central heating and air conditioning systems, for example)
2.Moveable assets are any asset that is not an immoveable asset.
3.The amounts are stated at net current cost adjusted to net current replacement cost as at 31 October 2005.
Source:
Department of Health Fixed Assets Register