District general hospitals provide a vital range of services for local people, and the level and range of their activities have expanded significantly in recent years. At the same time, some treatments that used to be provided in hospitals can now be provided in the community and smaller local hospitals, GP practices or even people's homes, while some specialisms and acute treatments are best provided in specialist centres, which can offer the necessary round-the-clock professional and technical expertise and capacity.
After last year's scare stories from some quarters about mass closures of district general hospitals, I thank the Minister for a reassuring answer. Does he agree that to be truly effective in serving their public in future, those hospitals need very strong links with their primary health care, social services, housing providers and the third sector, and that that is especially important against the background of an ageing and growing population, if they are to keep to a minimum admissions to hospitals in the first place and re-admissions after discharge into the community?
My hon. Friend is right, although a hospital's role is, of course, mainly to help deal with people when they fail to prevent an illness for one reason or another. It is important that hospitals work closely with primary care trusts, social services and others on the public health agenda, and one of the things that the next stage review published by my noble Friend Lord Darzi made clear last year is that we now expect every primary care trust in the country to commission comprehensive well-being and prevention services based on local needs, but including delivery on a number of important issues, such as mental health, obesity, alcohol, smoking and sexual health, which I hope are being provided for in my hon. Friend's constituency.
Can the Minister please explain to my constituents what positive contribution there can be to improving health care from the Mid-Essex Hospital Services NHS Trust receiving about £1 million a year in car park fees, which many of my constituents regard as a tax on health care?
The hon. Gentleman should be aware that the shadow spokesman on health supports the freedom of hospitals in England to levy acceptable charges to help cover the cost of hospitals; if they did not levy those amounts, they would have to take them away from patient care. I often get questions on the subject from hon. Members such as "What about Scotland?" or "What about Wales?" In Scotland and Wales, people wait much, much longer for their operation. If the hon. Gentleman has a particular problem with his local hospital's policy, he should take that up with the hospital, which is supposed to offer concessions to people who need to visit regularly. If he is suggesting that everyone at his local hospital should be able to park freely, regardless of what they are doing there, that is a very foolish approach and it would take money away from essential medical need.
One of the issues that is affecting district general hospitals such as mine in Barnsley is their inability to attract sufficient numbers of doctors. The postgraduate dean at the Yorkshire and the Humber NHS Deanery has done some work on the issue, which shows that in certain areas of the country, including Yorkshire and Humberside, we are under-provided for in almost every discipline in health. I have written to my right hon. Friend the Secretary of State for a meeting to discuss this, but will my hon. Friend look into the matter to try to determine what we can do to redress the balance between Yorkshire and Humberside and other areas of the country, such as London and the south-east?
We have record numbers of doctors, health care professionals and health services, as my hon. Friend knows. I will certainly look into the concern that he raises about Barnsley and his local area. I would find it surprising, however, if it was even more challenging for Barnsley and the surrounding area to attract good doctors and staff than it is in London, where attracting them can be a particular challenge, for a number of reasons which most hon. Members understand. I will have a word with the strategic health authority covering Barnsley, which is responsible for ensuring that work-force planning is carried out effectively and that the needs of local hospitals, including his own, are fully appreciated.
Does the Minister acknowledge the excellence of our local district general hospital at Macclesfield? It has retained superb maternity and accident and emergency units and is applying for NHS foundation status. Does he recognise that it serves not only the towns of Macclesfield and Congleton, but a huge rural area? Patients come from Derbyshire and Staffordshire as well as Cheshire. Such district general hospitals must be retained for the future health care needs of a very large area.
I am pleased to acknowledge the very good work done by Macclesfield hospital and I wish it all the best with its application for foundation trust status.
One under-recognised aspect of the role that district hospitals can play is nutritional standards and food procurement policies. In that context, will the Minister add his own congratulations to those given to the Nottingham University Hospitals NHS Trust on the award that it is to receive from the Soil Association on
My hon. Friend raises an important point, and I congratulate Nottingham on the work that it has done. Such work is replicated in a number of other hospitals around the country, including the Royal Brompton hospital and including in Cornwall. In those hospitals, good local food procurement policies have not only saved money but—the evidence gives this impression—helped to improve recovery rates and general patient satisfaction. We are working actively in the Department and the NHS to see whether that good practice can be spread. We are also consulting on the registration requirements for NHS providers, including hospitals. It is likely that those requirements will include good performance on nutrition.
Further to the Minister's initial answer, will he give a little more detail on what is being done to encourage primary care trusts and district general hospitals to work together to provide more services closer to where people live? He will be aware that in my very rural constituency, people live some distance from a district general hospital. What is being done to ensure that people can be treated closer to home?
Rather than reel off a long list, I shall give the hon. Gentleman a concrete example from my own area. Until recently, people in the area needing renal dialysis had to come to the Royal Devon and Exeter hospital in Exeter to have it done. The service has now been devolved out to the community hospitals, including one in Honiton. People who used to have to travel into Exeter no longer have to travel such distances. That is just one example of a range of services, including in Cornwall. People in Cornwall used to have to access such services by going to Plymouth or Torbay; now they can stay in Cornwall and get them. That is the direction of travel in the health service, and it is absolutely right that it should be. Where possible, people should be treated in their home or community, but when a specialist or acute need can best be met in the safety of a specialist and centralised environment, that is where it should happen.