The Lord Commissioner of Her Majesty's Treasury (Angela Watkinson)
May I start by saying that I appreciate the waiving of my customary Whiply silence, albeit temporarily, to enable me to participate in this debate?
I thank my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) for raising the important issue of the loneliness and isolation that can affect older people. I welcome the good work done by Independent Age, Age UK Oxfordshire, Counsel and Care, and the WRVS on the campaign to end loneliness. We are living longer, healthier lives. We should celebrate that, and seek to unlock the rich potential of our older population, as well as promoting their well-being.
We recognise the terrible impact that isolation and loneliness can have on people’s health and well-being. We know that multi-professional collaboration from a health and social care perspective on the needs of older people—including recognising isolation and those at risk from it—will make a huge contribution to keeping older people well and independent in their own homes, and to helping to maintain a decent quality of life for them. Of course, combating loneliness and isolation cannot be the job of health and care services alone. A range of services must be involved, including transport, housing and leisure.
We recently concluded the caring for our future engagement exercise, and we will produce a White Paper and a progress report on funding. That is planned for spring 2012. The engagement exercise considered six areas: quality and work force; personalisation and choice; shaping local care services; prevention and early intervention: integration; and the role of financial services. Throughout this engagement exercise we heard from a wide range of organisations, carers and people who use services, and the issue of loneliness and isolation among older people was raised.
Under the provisions of the Health and Social Care Bill currently before Parliament, local health and wellbeing boards will take responsibility for producing the joint strategic needs assessment and a local health and well-being strategy. I pay tribute to the London borough of Havering; it has shown great commitment in setting up its health and wellbeing board and it has already made significant arrangements for taking on this important new role. I also applaud the good work done by Age Action Alliance, an independent alliance of organisations working together to improve the lives of older people. It is aiming to prevent deprivation in later life, as well as challenging age discrimination and seeking to make older people feel valued and able to contribute to their local communities and the wider society. We look forward to the ideas that will emerge from that alliance.
We are doing everything we can, and we also support the efforts of others, to ensure that older people have access to all the help they need to reduce social isolation. I hope that that reassures my hon. Friend.
The hon. Member for Plymouth, Moor View (Alison Seabeck) made a thoughtful contribution about the understanding, patience and sympathy people with hearing loss need but do not always receive. She described the limitations on everyday activities such as using the telephone, and the absence of subtitles on television, which greatly disadvantage those with hearing loss. I shall refer those matters to the relevant Minister. We hope to improve the quality of life of people with hearing loss.
My hon. Friend the Member for Mid Derbyshire (Pauline Latham) raised concerns about two constituents who were unable to receive specific cancer drugs under their NHS treatment from the East Midlands strategic health authority. She has made her feelings very clear. The health authority will have heard her and will wish to respond with some urgency; and the Secretary of State will, I am sure, expect that to happen.
I thank the right hon. Member for Leicester East (Keith Vaz) for his question and his continued support for diabetes prevention and improving outcomes for people with diabetes. We pay particular tribute to his work through Silver Star, a charity he founded in Leicestershire that is invaluable in tackling diabetes within south Asian communities. As president of the Havering branch of Diabetes UK, I should like to take this opportunity to pay tribute to the late Sue Braeger, who sadly died recently. As chairman of the Havering branch, Sue was a formidable campaigner on diabetes issues, especially the management of diabetes medication for pupils in schools. She will be a hard act to follow.
We have learned this year—in the last few months, in fact—that nearly 3 million people in the United Kingdom have diabetes, a number that grows year on year. Worse, 24,000 people each year die unnecessarily from the disease—deaths that could have been prevented with better management and care. Much progress has been made in diabetes care since the publication of the national service framework in 2001, but prevention and early diagnosis remain a Government priority.
Next year, the National Audit Office and the NHS leadership team will be reviewing progress and considering whether there is need for further work, co-ordinated at a national level. Any such work would of course seek to reinforce and support activity led by clinicians at local level to improve outcomes for people living with diabetes.
We will also depend on the NHS health check programme, which has the potential to prevent many cases of type 2 diabetes and identify thousands more cases earlier. We will be continuing the change for life campaign, which raises awareness of the importance of maintaining a healthy weight and being physically active. As type 2 diabetes is linked to both obesity and inactivity, these public health initiatives are crucial.
For people diagnosed with diabetes, our priorities for treatment and care are to improve quality of life and reduce complications, and as a result to reduce cost. People with diabetes account for 15% of in-patient hospital beds in England. Their hospital treatment costs £600 million a year more than that for patients admitted without diabetes. Poor management of diabetes and insulin leads to emergency admissions and readmissions, and increased lengths of hospital stay. Poor care can also lead to deaths and permanent disability, with an estimated 80% of the 73 lower-limb amputations suffered each week by people with diabetes considered preventable.
The NAO will be reporting next summer on its study of the management of diabetes services. We expect it to provide robust recommendations on improving services and outcomes for patients and the public, and we look forward to seeing the results.
My hon. Friend the Member for Totnes (Dr Wollaston) raised the important issue of the role of community hospitals and leagues of friends. I should like to assure her that the Government are committed to helping the NHS work better by extending best practice on improving discharge from acute hospitals, and increasing access to care and treatment in the community. Community hospitals can be an important part of delivering this, especially in rural areas, providing both planned and unplanned acute care and diagnostic services closer to home. Community hospitals support best practice in admission avoidance and provide a range of services, from treating minor injuries to intensive rehabilitation. Subject to the passage of the Health and Social Care Bill through Parliament, clinical commissioning groups will be responsible for securing the best health care and health outcomes for their patients and locality.
The Department announced on 4 August that NHS trusts and NHS foundation trusts will also be given the chance to acquire estate from primary care trusts, including the community hospital estate. PCTs have reviewed and provisionally agreed lists of property for transfer to NHS bodies, and those will shortly be approved by the Department of Health. It is expected that the actual transfers of estate will commence in 2012. I know that this is a concern of my hon. Friend, but it is not expected that these changes will affect the role or function of local league of friends’ volunteers, who provide such valuable and important services in community hospitals around the country
The Government are also committed to increasing the scope of a more transparent rules-based funding system, where money follows the patient. Since its introduction, the payment by results national tariff has been mainly restricted to treatments provided in acute hospitals. We want to change that, but in a way that supports the delivery of high-quality services. That will not be easy, as there are significant challenges for us to overcome, such as making sure that activity that takes place in community settings is recorded and reported, as this is essential to plan services and drive payments, but we are making good progress. From April 2012, we will introduce the first ever tariffs for post-discharge care, with transparent prices to give more certainty about funding. I hope that that sets my hon. Friend’s mind at rest.
Finally, may I take this opportunity, Mr Deputy Speaker, to wish everybody the season’s greetings?
Mr Deputy Speaker (Mr Lindsay Hoyle)
Absolutely, and I am sure that it is warmly welcomed with Christmas and the new year upon us.
May I say that we have reduced the time limit to five minutes as we come to the general debate?