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Topical Questions

Volume 477: debated on Tuesday 17 June 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.

My supplementary question is on mental health advocacy. What measures is my right hon. Friend putting in place to ensure that there will be adequate resources in April 2009 when measures in the Mental Health Act 2007 on independent advocacy are implemented? How will he ensure that non-statutory services will be safeguarded and improved?

Negotiations on the comprehensive spending review included the introduction of those services in April 2009. The funding is already available for that. Non-statutory funding—assistance of the voluntary sector and so on—is crucial to the success of this project. I give my hon. Friend the assurances that I believe she is seeking.

On the subject of dentistry, in February 2008, the Secretary of State said:

“Access to NHS dentistry is getting better all the time.”—[Official Report, 5 February 2008; Vol. 471, c. 772.]

I do not think my constituents, constituents around the country or dentists are quite certain what figures the Secretary of State was referring to. Recent figures since his contribution in 2008 show that nearly 1 million British members of the public no longer have access to NHS dentistry. Will he now retract his comments and scrap this ludicrous contract?

No, I will not.

“It’s getting better all the time”,

to quote a line from a track on “Sgt. Pepper”. It is getting better in dentistry because the original contract, which the hon. Gentleman seems to want us to reintroduce, was wrong in every respect.

But we are being asked to withdraw the current contract. It replaced the contract that encouraged drill and fill. It meant that when dentists left the local vicinity, the money went with them. Of course, there was a period when dentists did not sign up to the new contract. Gradually, they are coming back and gradually we are getting to a situation in which dentistry is provided not just on the basis of drill and fill, but on a preventive basis, with a much simpler structure and much better access. The money that we are putting into dentistry this year, next year and the year after has gone up, and primary care trusts are commissioning more dental practices as a result.

T4. As my right hon. Friend will know, back in 1997, the construction industry was on the point of collapse. I am proud of the health service’s commitments to new hospitals and clinics, which have revitalised the industry, but I want to ensure that its significant investment leads to training opportunities for young people as part of their apprenticeship programmes. What is my right hon. Friend doing to ensure that those public sector funds are spent on delivering better skills and better-qualified young people? (211318)

My hon. Friend has been a champion of apprenticeships. I think she will accept that what the Department is doing is exemplary in Whitehall terms. Indeed, I hope she will accept that we are “Top of the Pops” in terms of the number of apprentices we are recruiting.

As for what we are doing in the country more generally, my right hon. Friend the Secretary of State for Innovation, Universities and Skills is running an integrated project to establish how we can use the huge public sector investments that we are making in, for instance, hospital-building programmes to ensure that apprenticeships are provided in the construction industry, and also in education, so that we do not waste the valuable opportunity provided by our capital investment to increase the number of apprentices again. It needs to be raised to the level suggested in the Leitch review by 2015.

T3. Would the Minister of State like to have another go at answering my earlier question about HIV/AIDS? Given the increasing number of cases of HIV/AIDS and, indeed, TB in this country, many of them brought in by people from sub-Saharan Africa, will she tell us whether she believes that selective pre-screening of those people before they enter the United Kingdom, not while they are here, is a good idea for Britain? (211317)

I believe that I have already answered the question, but I will answer it again. No, the Government do not consider pre-screening to be necessary. Our policy is to encourage the highest-risk groups to come forward voluntarily for screening. The group that the hon. Gentleman has identified is not the highest-risk group, but it is one of the groups that we are addressing.

T5. The report “Aiming high for disabled children: better support for families” led to additional resources. Can my hon. Friend the Under-Secretary of State assure me that they are being used to enable the services identified in the report to benefit disabled children and their families, and for no other purpose? (211319)

I pay tribute to my right hon. Friend for the work that he did in the House in championing the needs of disabled children and their families, as a result of which we are investing an unprecedented amount to support those families—and so we should.

The money from the Department for Children, Schools and Families is ring-fenced, and amounts to £370 million over three years. In the autumn of this year, the Department of Health will announce the overall sum that we will invest in child health over the next three years. It will include a specific figure to be put into primary care trust baselines to increase support for children with special needs and provide short breaks and support for children with palliative care needs. It is crucial, in all parts of the United Kingdom, for us to prioritise the needs of disabled children and their families, and to ensure that the money allocated for the purpose is spent on improving their quality of life.

Although the number of people admitted to hospital suffering from under-nutrition has increased by 85 per cent. since 1997, I understand that the Minister is scrapping the Nutrition Action Plan Delivery Board that he established last year. What reassurance can he give us that he takes malnutrition in the elderly seriously?

As I have only just established the board, I am hardly likely to be scrapping it. The hon. Lady’s information is completely untrue.

The nutrition action plan is overseen by the director general of Age Concern. It has independence, and is being overseen by someone who has passionately championed the importance of nutrition, particularly in relation to older people. What we have said, as the hon. Lady knows full well, is that the board will do its work for 12 months and then we will review where it goes from there. There has been absolutely no suggestion that we intend to scrap it.

T9. A constituent of mine with cystitis has received treatment for acute episodes at the nurse-led walk-in centre in Milton Keynes, but she has been unable to get an appointment with her GP in order to be referred to a consultant because she is a shift worker and because of the booking system at the surgery. Will the Minister point out to the British Medical Association and the Opposition that this is exactly the sort of problem that could be addressed by the new seven-day surgery proposed by the PCT in Milton Keynes? (211323)

T6. If GP-led health centres are in the interests of patients, does not the Secretary of State believe that primary care trusts will procure them anyway? Why is he running the show like a command economy and requiring 121 PCTs outside London to procure them? (211320)

Because, No. 1, we believe that we ought to enhance capacity in primary care; No. 2, we do not believe that PCTs should be paying for extra facilities from money we have already allocated—we will provide that from the centre; No. 3, we think patients such as the constituent of my hon. Friend the Member for Milton Keynes, South-West (Dr. Starkey) should be able to access a GP surgery from 8 am to 8 pm, seven days a week, 365 days a year; and, No. 4, we believe that people who cannot get to their GP because, for example, they work in the centre of town or in another town should be able to access primary care. For all those reasons, it is extraordinary that Opposition Members, including the Parliamentary Private Secretary to the Leader of the Opposition, oppose this extra investment in primary care. They will live to rue the day.

T7. I met Dr. Goel at his Carshalton fields surgery a couple of weeks ago and he presented me with a petition with 570 signatures from patients who are very worried about the future of their local family GP practice. Can the Secretary of State confirm that that practice will not be forced to merge with a polytechnic—or a polyclinic, rather—at some point in the future? (211321)

It certainly will not be forced to merge with a polytechnic; I can give the hon. Gentleman that assurance very firmly. Our proposals are for additional GP-led health centres. The name should give the Opposition a bit of a clue as to who will lead these health centres. They will be GP-led, and there is no intention whatever of removing existing services.

Does my hon. Friend have a view on the Council for Healthcare Regulatory Excellence report on the Nursing and Midwifery Council?

We welcome the report and accept its recommendations. It makes some very serious criticisms of the functioning and leadership of the NMC, saying it has failed to carry out its statutory duties to the standard the public have the right to expect and it has lost the confidence of its stakeholders. It is our view and that of the CHRE, the trade unions and other stakeholders that it would be in the best interests of the NMC and the individuals involved if all three senior figures stepped down from their current positions. We welcome the leadership shown by the president and chief executive today in indicating their intentions to resign.

T8. I am sure that the Secretary of State will agree that many of our hospital accident and emergency departments are full of people whose ailments would be better treated elsewhere. On the basis that all of us are in favour of preventive health measures, will the Secretary of State discuss with the Secretary of State for Children, Schools and Families the possibility of introducing first-aid training as part of the school curriculum, in accordance with my excellent ten-minute Bill? (211322)

I will have another look at the hon. Gentleman’s excellent ten-minute Bill, and will doubtless talk about it in the many meetings I have with the Secretary of State for Children, Schools and Families. The hon. Gentleman makes an important point, and one of the fundamental reasons why the NHS in London is proposing polyclinics in London is the number of people clogging up accident and emergency departments who should really be in primary care.

T10. Is the Secretary of State aware that some hospitals have banned people from bringing in flowers for patients on health and safety grounds, and what guidance, if any, does he have for these hospitals? (211324)

I have a full briefing with me that relates to every issue under the sun, but not this one. I do not think that it is a matter for me; I think it is for the local trusts, and I would be very surprised if they took that decision on any grounds other than patient safety. I believe that health care-acquired infections may well be the reason these flowers have been banned, but I will find out, perhaps, and write to the hon. Gentleman.

Does the Secretary of State share my concern that 1 million people appear to have been treated under NHS dentistry since the new contract came in, and that there also appear to be perverse incentives within the contract so that dentists are encouraged by the financial set-up not to treat those with the greatest oral health need? Could we not have a perverse outcome whereby those with least in our society will be able to tell their social class by the state of their teeth—and under a Labour Government?

The hon. Gentleman was probably mistaken in saying that he thinks that there are 1 million more dentist appointments now, because he probably meant the reverse—I do not accept what he says either way. I believe that this is a big issue in relation to heath inequalities, which is why I announced to Parliament our intention to introduce fluoride in more areas. That is the single biggest contribution that we can make to tackling health inequalities. On the dental health of young children in this country, our 12-year-olds have the healthiest teeth in the whole of Europe. That is a great tribute to the dental profession, and I would think that it is not detrimental to the amount of investment that this Government are putting into dental care.

I welcome the fact that the Government are finally talking about reform of our system of care for the elderly. Given the urgency of the crisis—Help the Aged describes our system as being in crisis, Age Concern calls it a disgrace and the Local Government Association yesterday said that it is coming apart at the seams—will the reform, and the legislation to enable it, be brought before the House before the next general election?

May I say to my good friend that as well as the long-term review, we have, from April, been introducing a transformation programme in every local authority area, supported by £500 million of reform money over three years? We will soon be publishing the first ever national dementia strategy and end-of-life strategy; we have announced the extension of our “Dignity in Care” campaign; the Secretary of State has announced a new package of preventive health measures specifically to support older people; we are extending the Human Rights Act 1998 to publicly funded residents of private care homes; and we have announced a new 10-year strategy to support carers. I am not sure that the hon. Gentleman’s party has anything else to offer on this issue.