Skip to main content

Topical Questions

Volume 475: debated on Tuesday 6 May 2008

The responsibilities of my Department embrace the whole range of NHS social care, mental health and public health service delivery, all of which are of equal importance.

May I ask my right hon. Friend why, in connection with the consultation on the framework for the registration of health and adult social care providers, which is due to end shortly, he has decided to exclude non-urgent patient transport services from the services that will come under the remit of the Care Quality Commission? Those services—including taking people who need dialysis to hospital, for example—are a seamless part of the health and social services that we provide, so it seems perverse that they should not be included. Would the Secretary of State consider, at this late stage, including those services within the remit of the proper standards of care regulation?

This matter is out to consultation, and the consultation finishes on 7 June. Our view is that it is in the interests of good regulation that we should split away the high-dependency patient transport service from the non-urgent, as my hon. Friend the Member for Stoke-on-Trent, North (Joan Walley) rightly says. There is an issue about the balance of regulation, and we thought that that was the best idea. The issue is out to consultation. My hon. Friend will obviously make her views known, as will others, and we will consider them at the end of the consultation period.

T3. I declare an interest as honorary vice-president of the Royal College of Midwives. What steps have the Government taken to ensure that there are sufficient places for student midwives and midwifery educators in England to meet the Department’s target of 4,000 more NHS midwives by 2012? It is a simple question; I hope that I can get a good, positive answer. (203421)

The hon. Gentleman is a hero of the Royal College of Midwives, let alone a patron. He raises an important point. We wish to recruit 4,000 new midwives. Some of them will return to practice, but a large group will require extra training places. We are working on that, and I believe that there might be an announcement around the time of the annual conference of the Royal College of Midwives.

T6. Will the Secretary of State tell us what impact health can have on reducing crime and on ensuring that youngsters get good qualifications and do not spend a lifetime on benefits? Does he agree that early intervention by the health service, particularly through the nurse-family partnership, sets young people on the way forward, and—to ensure the topicality of this question—may I also ask him whether he welcomes those initiatives being applied to Nottingham? (203424)

The nurse-family partnership is undergoing a £30 million expansion, which includes Nottingham. The most important point in what my hon. Friend said about the link between crime and health relates to mental health. I believe that the recruitment of 3,600 psychological therapists, based on the pilot in east London and Doncaster, will have a startling effect on the mental health problems that have previously consigned many youngsters to less fulfilling lives than those of those fortunate enough not to suffer from such problems.

Just weeks ago, the Secretary of State’s Department received a report from an expert group on clostridium difficile infection that said:

“We consider that, more than any other factor, it is the failure to implement the existing guidelines described in the 1994 report that has contributed to the recent rise.”

Can the Secretary of State explain why, 11 years into a Labour Government, existing guidelines from before 1997 have not been implemented?

No, of course I cannot cover the course of 11 years in this answer. What I would say is that there was a period at the end of the 1990s when, if the problem had been tackled, we could have seen the elimination of MRSA before it took root, as happened in many other European countries. However, there has been a 30 per cent. reduction in MRSA since this time last year and a 23 per cent. reduction in clostridium difficile. The important elements are hand washing, isolation with cohort nursing, and the responsible prescription of antibiotics. We are acting on all three.

The complacency of the Secretary of State’s answer explains exactly why there is a wreckage of the Labour party across the country following last Thursday’s election results. Perhaps he can explain why, 11 years into a Labour Government, the report says that half the hospitals in England have C. difficile infection rates 10 times those reported in other countries. People know that the experience of Labour government has been of a top-down, target-led, bureaucracy-obsessed culture that is preventing the NHS from delivering high-quality care, and which has led directly to an inability to focus on patient safety. Will the Secretary of State explain that?

The hon. Gentleman’s problem is that people have long memories. They remember waiting lists such that people waiting for fairly routine operations wrote to ask whether their place in the queue could be bequeathed in their will to their children or their nephews, because the queues sometimes lasted four or five years. They remember the lack of capital investment in hospitals and equipment, they remember that there were too few doctors and nurses, and they remember that the health service was on its knees when we came to power in 1997.

May I commend my right hon. Friend’s decision to move services into the local community? I want to draw his attention to a consultation that I held about my local primary care trust’s proposal to open a cottage hospital in Eltham, to which the response rate was more than 10 per cent. More than 1,400 people responded, virtually 100 per cent. of whom were in favour of having a cottage hospital in the middle of our community, bringing services into the heart of Eltham. I commend the Secretary of State’s approach, and I commend my PCT’s proposal to him.

I am happy to be commended on that proposal. I believe that the consultation taking place in London about what kind of health service people want is revealing that the majority of people see the sense in the review conducted by NHS London. They see cottage hospitals and polyclinics—I see, today, that the public in London have overwhelmingly said that polyclinics are a good thing—as a sign that we are going in the right direction.

T4. Will the Secretary of State tackle more vigorously the waste of medicines in the NHS, which is enormous and scandalous? Will he look specifically into the issue of repeat prescriptions going uncollected by patients in pharmacies? That problem needs ministerial intervention, and could be tackled by better liaison between prescribing doctors and pharmacists. The current situation is completely unacceptable and an enormous waste of public money, and it needs his attention urgently. (203422)

I will look into this issue personally. There is evidence that there is a great deal of waste involving medicines and prescription, but I would not say that it is as bad as in some other European Union countries: France is one example. Nevertheless, any waste needs to be addressed. We have a target, over this comprehensive spending review period, of making 3 per cent. year-on-year efficiency savings. One part of achieving that should be tackling the waste of medicines.

The hepatitis C action plan for England was published four years ago, but a report that has just been published by the all-party group on hepatology shows that there are still big gaps between the diagnosis and treatment of hepatitis C. Will my right hon. Friend look at the report and do what he can to improve, in particular, the treatment of carriers who have been diagnosed with hepatitis C?

I will, but it says here—in my brief—that the results of the audit are encouraging and show marked improvement since 2006. The results indicate that progress made in implementing the action plan has been sustained. Nevertheless, I accept my hon. Friend’s point, and we will look to see how much we can improve the situation.

T5. With abortion at near industrial levels—there were nearly 200,000 in England and Wales last year—does the Secretary of State accept that although the original Act, as amended by the Human Fertilisation and Embryology Act 1990, set out a range of medical reasons for abortion, it is increasingly, and in far too many cases, being used for social reasons? Does he agree that that has to stop? (203423)

I struggle to understand the definition of “industrial” in this context. This is a matter for all Members of Parliament to address individually. I personally, as an individual, believe that that legislation has stood the test of time, and I would not want to see any change to it.

Can my right hon. Friend tell us when he is likely to publish the outcome of the review of prescription charges that he announced in July last year?

We are likely to publish in the summer—a period that I accept can, in political terms, stretch from April to December. However, I expect publication to take place in what could be called the summer by most reasonable people’s definition.

T7. Having had the worst hospital-acquired infection rates in the whole country in 2006, Kettering general hospital has now halved its rates of infection for C. difficile and MRSA, and met all its major NHS targets this year. In congratulating all those who work at the hospital on this tremendous achievement, will the Secretary of State encourage the strategic health authority to look favourably on Kettering general hospital’s application for foundation trust status, which is due to be submitted shortly? (203425)

I think that the hon. Members for Kettering (Mr. Hollobone) and for Wellingborough (Mr. Bone) should go and have a cup of tea together and compare notes, because we are getting a different picture of what is happening in the health service in their area from each of them. The hon. Member for Kettering has raised an important point, and we should congratulate all the health service workers in his hospital on such a fantastic result. The issues are clear: they involve good hand-washing policy, good isolation facilities with cohort nursing, and the responsible prescription of antibiotics. There are a lot of other things that I could talk about, but those are the three most important messages, and they have obviously been hammered home in the hospital in the hon. Gentleman’s constituency.

Can the Secretary of State explain why existing GP practices are being excluded from the new GP posts being established in areas that are under-doctored? Is this another attempt to privatise the NHS?

After a battle to get to the Dispatch Box, may I say to the hon. Gentleman that existing practices are not being excluded? He is absolutely wrong on that point. I did have a representation from a social enterprise to say that it was being excluded. The first contract went to a social enterprise, and I have no doubt that the majority of the contracts will go to existing GP practices. Those practices are not being excluded. They are, however, being asked to go through a rigorous process, because if we are spending £250 million of taxpayers’ money in under-doctored areas—some of the poorest areas in the country—we want to ensure that patients and the public in those areas get the service to which they are entitled.

T8. Given that there were more than 4,000 stillbirths in England and Wales last year, why is there still no national stillbirth strategy? (203426)

The hon. Gentleman has raised a point that I have raised myself in response to questions that I have been asked while going around the country. We should be looking at the situation across the country, because I hear that some places deal with such issues brilliantly, while other places could learn from those centres of excellence. Whether we turn that into a national strategy, with all that that entails, or whether we simply seek to spread the best practice, the hon. Gentleman is right to raise this issue; indeed, I have raised it myself.

Audiologists have expressed concern about the potential hearing impairment brought about by young people wearing personal music centres plugged into their ears. Does the Secretary of State agree that there is a serious likelihood of hearing impairment affecting those young people at a much earlier stage of their lives, and that there should be an inquiry into what action can be taken to prevent the danger of hearing impairment being brought about by those items of social fashion?

The hon. Gentleman has an interest in this subject. I believe that he was the chair of the all-party group on noise—[Interruption]of which he has made quite a bit in this Chamber over the years. I do not think that this issue can be near the top of our agenda, but it does need to be looked at. I increasingly find that people, not just young people, have developed problems—sometimes mental health problems—because they live in an environment of constant noise. In the workplace, for example, noise levels can be huge. Some people think that playing a radio station featuring the inane chatter of a disc jockey all day is good for calming the nerves, whereas actually it does the opposite—[Interruption.] The hon. Gentleman has started me off—but yes, I do think that we should look into that issue.