Mike O'Brien (Minister of State (Health Services), Department of Health; North Warwickshire, Labour)

I cannot give the hon. Gentleman a precise period. Assuming that we stay in office and the other lot do not get in—sadly for him, I am not talking about his lot—we will steadily increase NHS funding. We all know about the issues in relation to the wider political debate and the fact that the main Opposition party does not have a good record on the NHS, so it depends to some extent on what happens in the future. However, we are committed to moving towards the targets. We accept the funding formula that has been agreed, and as a result, over a period of time, Cornwall will steadily benefit from those changes.

The hon. Gentleman raised several other issues apart from finance, including dentistry and midwifery. On midwifery, Cornwall and Isles of Scilly PCT has invested an extra £1.6 million in maternity services in the three years from 2008-09. Women in Cornwall ought to have the choice as to where they have their baby, whether at a midwifery-led unit or at home, and in the years ahead we want to ensure that they do have that choice. He says that it is not always available, but in my experience that is sometimes because people have not been informed or simply do not know that they have a degree of choice about where they can give birth. There is a real need for better information and better engagement with local communities. We need to ensure that PCTs are out there telling people about the choices that they can have. Sometimes those choices are not exercised for the convenience of the system—because it is easier, safer and so on to have children in hospitals, or so some think. Choice should be given to women, and it is important that it is available and publicised.

As for dentistry, people in Cornwall are still unable to access an NHS dentist as quickly as they would like. The latest figures show that Cornwall and Isles of Scilly PCT saw fewer patients in the past two years than the national average. I can see that there is an issue in that regard, because that represents 51 per cent. of the population as against 53 per cent for England as a whole. The PCT knows that access to NHS dentistry is an important issue for it. In 2007, it produced an oral health strategy, and it is working further to grow its services and to promote oral health. We can already see the difference being made. In March 2008, the PCT had 1,800 patients waiting for an NHS dentist; now, there are only 160 patients. That is 160 too many, but progress is being made.

The PCT is committed to making sure that everyone who wants NHS treatment is able to get it, and its current and future plans will provide services for around 33,800 additional patients. The PCT has received an additional £2.5 million—an 11 per cent. increase—in its dental allocation. That is a pretty good increase. The hon. Gentleman is right to say that we are looking forward to the report of Professor Jimmy Steele in the not-too-distant future. I hope that as a result of that we will see even further improvements in how dentistry is dealt with.

Recent new dentistry investments include the appointment of three new dentists in Truro and one in Falmouth in July and August 2008, and the opening of a new practice in Launceston with capacity for 5,000 patients in February 2009. March saw another tranche of new practices opened, providing services for 7,000 new patients in Newquay, 2,000 in Bodmin and 4,500 in Torpoint. In April, a new practice opened in St. Austell with capacity for 7,000 patients. I understand that it will be officially opened by the chief dental officer, Barry Cockcroft, later this month. The PCT is continuing that programme of expansion, and over the next 12 months it will provide dental services for an additional 8,160 patients across Liskeard, Tregony, St. Ives, Bodmin, Threemilestone and Truro. That represents a fair amount of work and investment being put into the area.

The hon. Member for North Cornwall made a couple of points that I wish to engage him on. The first was about hospital transport, and he was absolutely right about rural areas. I represent an area that has a large rural hinterland, and it is enormously important that people can get access to transport to a hospital. We need to work harder to ensure that PCTs recognise the importance of ensuring that transport arrangements are in place, particularly when services are located in tertiary and high-skill hospitals, as is often safer. The distance involved needs to be taken into account to ensure that we do not increase risk. It is all very well to say that a patient is safer when they get to such a hospital, but getting them there is also a problem, particularly if access to transport is not easy. It is important that PCTs recognise that they need to take serious account of transport in rural areas.

The hon. Gentleman also mentioned car parking, and he made the fair point that patients and primarily visitors complain that they have to pay for parking when they go to a hospital. They ask, "Isn't this supposed to be a free NHS?" I, too, have had constituents come and complain to me, asking, "Why are we paying for car park charges in the local hospital?" As he said, they get very annoyed, particularly if they are making long visits, perhaps to a child who has to stay in for a long time.

The hon. Gentleman's point was fair, and there is a reasonable debate to be had about the matter, but I would respond that there is still a choice to be made on budgets. He and others have talked about budget limitations, and there will always be such limitations. We all know that NHS inflation is a particular problem in relation to the costs of medicine. There will therefore always be pressures on NHS budgets, despite the fact that we have tripled the amount of money going in.

There will always be decisions to be made, and it is important that they are made locally. PCTs must recognise that there is a choice, and that they are better off spending money on patient care than on car parks. There is a high cost to car parks through building, maintenance, servicing, safeguarding, insurance and so on. In principle, it is better that the funding goes to patient care. However, there is always a balance to be struck, and the costs that visitors and patients pay should be reasonable, with account taken of the pressures on people who have to go to hospitals regularly. The charging of very large sums to people who have to visit on a daily basis for a prolonged period because of their circumstances is often unfair. PCTs have to examine that in the context of the pressures on a local hospital.

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