Health Bill

The noble Earl took the words right out of my brief. The amendment would provide a perverse incentive to trusts to fail to comply with the code of practice, which would be a slightly strange outcome. The code will bring together existing guidance and good practice, so there is no question of it imposing significant new requirements or financial burdens on trusts, certainly when it is first published. Many trusts up and down the country operate in accordance with much of this good practice within their existing budgets—I will come back to the issue of the size of and increases in their budgets in a moment. Furthermore, so far as future changes to the code are concerned, there must be an expectation that NHS bodies to which the code will apply will keep up with, and will want to keep up with, good practice using the resources that are available at the time. That is true in any area where good practice is involved. Practice changes over time and there is an expectation that the NHS will keep up with those changes in order to protect the patients of successive generations. Historically, under successive Governments, NHS budgets have gone up in real terms over the long haul. If you look back over time, you see that the increase has been, give or take, about 2.5 to 3 per cent in real terms across successive Governments. The NHS budget tends to maintain its real value. Under this Government, there have been unprecedented increases in the resources available. The noble Baroness will know the broad figures only too well, as she has heard me repeat them many times in the Chamber, but I will just say for the record that the NHS budget will have gone up from about £34 billion a year in 1996–97 to more than £90 billion a year in 2007–08. This current year and next year, the NHS will receive large increases of about 9.5 per cent. The idea that the NHS cannot cope with this code with that level of budget increase does not stand up to close examination. There cannot be any expectation that NHS bodies must be individually funded for every development in best practice, whether it results in a change to the code or is simply part of the wider field of changes in healthcare dictated by improvements in good practice. The only thing that is predictable in healthcare is that technologies and good practice will change over time. It is set out clearly in the standards for the NHS that patient safety is of paramount importance, which is one of the issues that concerns the Healthcare Commission in its performance ratings of health bodies. The noble Baroness raised the issue of isolation facilities. Many trusts have modified their isolation facilities over time. I have just given the revenue figures, but there have also been and continue to be substantial increases in public capital if hospitals need capital in this area. In terms of cleaning, we have consistently made it clear to the NHS that patient safety is paramount and must be taken into account when assessing the cost of providing good-quality cleaning services. I do not believe that it makes any sense to provide for special funding arrangements in relation to the code of practice. The NHS is well funded. Moreover, these provisions do not impose new standards; they are the standards that should be applied across the health service if good practice measures are being adhered to.