Patients have a choice of four or more local hospitals for elective care and 114 other hospitals through extended choice. From April 2008, patients can choose any hospital that meets NHS standards and cost, beginning with orthopaedics this month. In June we launched the groundbreaking NHS choices information service.
I thank the Secretary of State for that reply and for writing to me about the regulation of Chinese medicine, which was helpful in setting a timetable. Does he accept that real problems are caused by the fact that demand from patients is out of sync with the supply of services, especially in complementary and alternative medicine? Primary care trusts are not listening to patient demand. The situation is well illustrated in London, where the Royal London homeopathic hospital, which provides a range of services that go way beyond homeopathy, is being cut. If the Secretary of State really believes in patient choice, which is to be his flagship with his new broom Front Benchers—[Interruption.] Well, there are some new brooms, because all the old Ministers were sacked—[Interruption.] Well, most of them—a large proportion—were fired. Will the Secretary of State please consider issuing guidelines to primary care trusts to take patient choice into consideration?
In preparing to reply to this Adjournment debate, I looked carefully at the points the hon. Gentleman made in his letter to me but I am not persuaded of the need to issue guidelines at this time. It is clear to me that many more patients want the benefit of complementary and alternative medicine and therapies; indeed, the most recent survey showed a high percentage of patients looking for that. What general practitioners do is very much a matter for them; for instance, I understand that in the Newcastle primary care trust area 69 per cent. of GPs deal with complementary and alternative medicines, so I see no need to issue guidelines at this stage, but I agree with the hon. Gentleman that such medicines are becoming an increasingly important part of GP prescriptions.
The technology driving some of the new health service systems has started to bite and is having a huge impact on our ability to improve patient choice, as well as delivering many other health benefit outcomes. With the departure, shortly, of Richard Granger, who has done such a splendid job on behalf of the NHS, will my right hon. Friend ensure that his replacement is of that calibre and that there is no shift in the Government’s drive to improve health IT systems?
I shall meet Richard Granger just before his departure. My hon. Friend refers to an important area, where, as he says, we can extend patient choice and use new technology for the greater convenience of patients, citizens and clinicians, which is why it is important that we get the right person to replace Richard Granger.
How does the Secretary of State square his Government’s supposed notion of choice with the large-scale closure of maternity units, especially midwife-led units, thereby depriving many women of choice, particularly in Romsey and the New Forest?
There are two issues, the first of which is choice, which we want to extend. An important GP survey was published today and I made a written statement about it this morning. The second issue is maternity care, and recently, with the full support of the profession, we published “Maternity Matters”, which makes it absolutely clear that—as in so many other aspects of medical care—we cannot simply defend the status quo. We need to ensure that we configure our services so that we save the lives of more babies; for instance, in Manchester—although there is still an issue of contention that has yet to be concluded—there are proposals by local health care specialists and local clinicians to save the lives of 40 babies a year. Such evidence cannot be disregarded.
Are not more than 90 per cent. of people who use our hospitals satisfied and think that the service is good? Those who have criticisms want basic things such as better catering and cleaner facilities?
Yes, I agree with my hon. Friend. In addition, many patients would like to choose how they are operated on—for instance, non-invasive surgery. If their consultant is not au fait with the latest techniques and cannot carry out non-invasive surgery, the patient should be able to say, “I’m sorry but that’s the kind of operation I want”. That would be good not only for patient choice but for driving up standards among clinicians.
As the Secretary of State knows, it is the Government’s promise that in two years’ time every mother should be able to exercise full choice about the circumstances in which they give birth, be it in a consultant-led maternity unit, a midwife-led birth unit or at home. Will the Secretary of State tell us how many additional midwives he believes will be necessary over the next two years to deliver that promise of choice?
I cannot say that at this stage because it depends on how things pan out in every area, but it is clear that an increase in the number of midwives will be needed. If we are offering that choice to every woman in the country, we must ensure that we deliver on it with the right staffing in the right places, which means that we cannot pull a figure out of the air, but there is an area of consensus—even between the Treasury Bench and the Opposition Front Bench—on which we can work to make sure that things are properly implemented.
I am grateful to the Secretary of State, but I am afraid that I cannot see how, locally, primary care trusts and hospitals can deliver the number of midwives that are necessary unless there is at least some work force planning to make that happen. The number of midwives, and the number of training places in midwifery, went down in each of the past two years, and the Secretary of State must know that in the past five years the number of live births has gone up by 13 per cent., whereas the number of full-time-equivalent midwives has gone up by only 5 per cent. We are therefore more than 1,000 short of where we need to be now, let alone where we need to be in order to extend choice in two years’ time. So will the Secretary of State promise today that he will go back and look at “Maternity Matters” and put some of the work force planning into “Maternity Matters” that simply was not there?
I think the hon. Gentleman is right in his assumption that we will need to get the work force right. He is also right that this is non-negotiable; it has to be in place by the end of 2009. He is also right in pointing out that there has been an increase in the number of midwives since we entered government. Putting all that together, I undertake to ensure that we have the proper work force planning in place at the right time to ensure that we can meet the commitments set out in “Maternity Matters”.