NKF Campaigns Zone:
Letter from Rosie Winterton (Health Minister at the Dept. of Health) to Michael Hill and Gary Lloyd (NKF Co-Chairmen) in response to their letter of 20 May 2004 to the Rt. Hon. John Reid, (Secretary of State for Health): 12 June 2004 Mr Michael Hill and Mr Gary Lloyd, Dear Mr Hill and Mr Lloyd, Thank you for your letter of 20 May to John Reid about the treatment of haemodialysis patients during periods away from home. I am replying as the Minister responsible for this policy area. I would like to reassure you that I am sympathetic to the needs of kidney patients who want to take holidays. That is why the National Service Framework for Renal Services makes it clear that patients on haemodialysis need to be able to dialyse away from home, not only for holidays but for a variety of other reasons. We have also clarified the current arrangements for dialysing in the UK and in other parts of the world, and this is available on the Department of Health’s website at www.dh.gov.uk by searching under Policy and Guidance for Renal. ‘Holiday Dialysis’ is funded under arrangements between NHS Trusts. Primary Care Trusts (PCTs), whilst responsible for commissioning and planning renal services, may not be directly involved in these arrangements on a regular basis. We are aware that some NHS Trusts have set time limits, often in order to ensure there is equity among their own patients. In the past, of course, there may have been insufficient capacity in the system for many kidney patients to have their dialysis in other units, particularly those close to popular holiday destinations. We fully appreciate the value of a holiday, for patients and for their families. However we have to accept there is a cost when patients dialyse at another unit, and decisions about how much time each patient should be able to take for holidays is a matter for the local NHS Trust, taking account of all the issues including available resources. Having said that, I would expect NHS Trusts that set limits also to be reasonably flexible and to consider each case on its individual merits. Most of the issues you have raised in your letter are concerned with local service delivery for kidney patients. It is important to explain that our job in Government is to set the national agenda, to put in place national standards and to provide the overall health service funding. Responsibility for deciding how the national agenda is delivered locally, the local priorities for implementing the national standards and how the money is spent rest with local health communities. We do not interfere in that process and we have not issued any guidance about the amount of ‘holiday dialysis’ people can expect. The emphasis has shifted away from detailed Government direction to more direct forms of engagement between those providing health services and those using them. So rather than trying to drive change simply through top-down pressure, it is now being driven through greater local autonomy, in which the inspiration for change comes from NHS Trusts, PCT commissioning (and in the case of renal services, specialised commissioning) and the choices patients make about their treatment. We believe these are principal drivers of public service improvement. As I have indicated, power has shifted to local health communities, and I believe that local Kidney Patient Associations are best placed to raise any concerns about time limits with their local NHS Trust management. Yours sincerely,
Rosie Winterton |