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Topical Questions

Volume 497: debated on Tuesday 13 October 2009

On Thursday, the Care Quality Commission will publish its NHS performance ratings for 2009. On the same day, the chief medical officer will give an update on swine flu, including further details about the vaccination programme. Following last night’s vote on the Health Bill, the Government are assessing how best to take that important policy forward and will make a further statement in due course.

The Secretary of State will be aware that the out-of-hours service is becoming increasingly dependent, particularly at night-time, on non-British doctors. As he will be aware, the UK is unique in the European Union in having a general practice provision. What precautions is he taking to ensure that non-British doctors coming from other countries are suitably qualified to perform the out-of-hours service, and are fully acquainted with the level of drugs that should be issued to patients in their care?

The hon. Lady raises a very important point. It is important that primary care trusts ensure that the providers of out-of-hours services are conducting a proper, full assessment of those who carry out those services, that they understand the way the NHS works and how drugs are allocated and prescribed in this country, and that they can speak adequate English.

T3. According to the National Autistic Society, in a report in the summer, people aged 40 to 50 are not being diagnosed with autism, and the BBC recently said that GPs feel that they do not receive the training necessary to give patients that service. Can my hon. Friend tell me what he intends to do to ensure that GPs get that training so that those 40 to 50-year-olds have the diagnosis they require? (292255)

I thank my hon. Friend for his very important question. First, autism is actually mentioned in the GP curriculum statements on mental health and on children and young people, so we already expect all GPs to have a general understanding of first principles, but I fully agree that more professional training is a key area for development. It is one of the features of our recent consultation on the first-ever national strategy for adults with autism, which focused on a range of areas, including health and training. That will have a direct impact on GPs and their training, and that national strategy will be backed in law.

T2. In the north-west only 53 per cent. of children receiving treatment for substance misuse complete the course. What are the Government doing to improve that alarming figure? (292254)

We have to look at all ways of reducing the harm caused to children by addictive substances, including drugs. Our campaign under the tag FRANK is one of the ways. We are also increasing access to services across the country, but we are tailoring them to ensure that we meet the needs of all groups.

T8. I wonder whether my right hon. Friend would like to come and visit Chorley hospital, one of the best hospitals in the country, and support a walk-in treatment centre beside the accident and emergency department, which will give new life to Chorley. (292260)

I understand that my right hon. Friend the present Home Secretary visited not long ago when he was in the post that I now hold. I am not sure whether my hon. Friend the Member for Chorley (Mr. Hoyle) got something new on the occasion of that visit, or whether he wants something new on the occasion of another visit, but as he knows, I am not far down the M6, so I will bear his kind invitation in mind.

T4. Returning to the subject of carers, do Ministers accept the figures in today’s report from the Princess Royal Trust for Carers and Crossroads Care that only one pound in five of the money allocated this year for carers has been spent? Will they publish, for each trust, the amount that has been allocated and ask each trust to publish by the end of this month how they intend to spend the money on carers this year? (292256)

I understand and fully appreciate the concern that carers organisations have about the fact that the Government have put £150 million over two years into PCT budgets to pay for respite care and other support for carers. The Government have played their part in responding to the needs that we recognise among carers. The question is how that money is spent by local PCTs. The hon. Gentleman knows that those primary care trusts make these decisions based on an assessment of their own areas. He knows, too, that the Department is producing a document to assist primary trusts and local authority commissioners to understand how the needs of carers may be effectively identified, and that we will seek to publicise that guidance as widely as possible. That, I think, will have an impact on the primary care trusts delivering the money that we provided to meet the needs of carers and those for whom they are caring.

T9. Worcestershire Acute Hospitals Trust has recently reported to me on the huge progress that it is making in reducing hospital-related infections—only seven MRSA infections so far this year, well inside the rightly tough target that has been set for them. Given that that progress saves lives and saves money, how can we ensure, first, that it continues, and secondly, that money saved in Worcestershire is reinvested in improving patient care even further in Worcestershire? (292261)

I welcome my right hon. Friend’s question because it gives me the opportunity to congratulate the health service on the achievement of the national target for MRSA, which has reduced by 50 per cent. the number of MRSA bloodstream infections, in comparison with the number in 2003-04. The latest data for April show that MRSA bloodstream infections are down 74 per cent., but we can never be complacent in relation to these infections. We are tremendously pleased with the progress that has been made. While constantly keeping our eye on those figures, we are reinvesting money in the knowledge that we already acquired because knowing how to reduce infection rates is so important. I welcome all the improvements that have been made and look forward to discussing them in my right hon. Friend’s constituency.

T5. The Secretary of State has announced recently his policy aspiration to abolish car park charges in NHS hospitals for patients. He did not mention in his speech ancillary workers and nurses and doctors. Will that policy, if he ever has the possibility of bringing it in, apply to that group, and if not, why not? (292257)

I hear the hon. Gentleman, but of course the policy has to be affordable, and I think it fair to say that when a family has somebody in hospital, particularly if that person is in for a long time, we should make it easy for the family to visit as much as possible. To go further still and provide free parking for everybody would be a difficult policy to introduce, because it would provide an incentive for everybody in the locality to park for free at the hospital. We think it right to prioritise in-patients, but, if the hon. Gentleman is making a spending bid to go further, perhaps he should direct it to his Front-Bench team.

Monitor produced early this year a damning report on the governance of Heatherwood and Wexham Park Hospitals NHS Foundation Trust in my constituency. This week, at last, the chairman of the trust resigned. What can the Department do to ensure that when there is a failure of governance, the consequences of the past poor actions by the board and by executive officers are not taken out on staff, who may face redundancy now?

As my hon. Friend knows, in the Health Bill yesterday we made some amendments that will enable de-authorisation to occur in particular circumstances, with the consent of Monitor. We need to ensure that when trusts are not foundation trusts, we are able to act quickly to ensure that people who are responsible for ineffective administration of the health service are dealt with; and that the strategic health authority bears in mind that there might be financial implications that it would have to consider as part of the overall regional budget.

T6. A memorandum of understanding has been reached between Sutton and Merton primary care trust and the London borough of Sutton over the sale of land that is needed for Stanley Park high school. May I urge the Secretary of State to intervene and ensure that, as soon as possible, the memorandum of understanding is converted into a firm contract, so that this fantastic project to build a new school can proceed as soon as possible? (292258)

I hear the hon. Gentleman, and I am very happy to have a look at the project, but, as the memorandum of understanding has already been signed, some progress is clearly being made.

My right hon. Friend the Secretary of State has announced that the Care Quality Commission will be reporting in due course. He will not be surprised to hear that in a meeting with Charnwood carers group, I found that the quality of care in the community and in care homes is high on people’s agenda. In fact, many were in tears at their own experiences, despite the tick-box reality of the commission’s work. Will Ministers ensure that there is genuine personal care in such places? That is what people really want, for the dignity of their elderly relatives.

My hon. Friend is right to highlight issues of concern about the quality of care, whether it is care of people in their own home or in residential care homes. The Care Quality Commission plays an essential role in monitoring and inspecting care homes to ensure that standards are sufficient. We need to go further and ensure that all care, whether in a care home or in a person’s own home, is personal and tailored to meet individual needs. The Prime Minister’s announcement of free personal care for everybody who is looked after in their own home and has the highest level of critical need is a major step forward and—

T7. Following the recent death from swine flu of Louise Jones from Leigh, what steps is the Secretary of State taking to increase the number of extracorporeal membrane oxygenation—ECMO—beds, especially in the north? The UK has only five, whereas there are 23 in Australia. (292259)

Of course, the case of the 24-year-old woman, who did not live directly in my constituency but in Tyldesley, which is nearby and, as the hon. Gentleman knows, not so far from his constituency, was incredibly sad. I am led to understand that, in that case, the clinicians did not think it possible for the patient to travel. However, a decision was taken recently to expand ECMO provision in Leicester. The clinical advisory group advised that it was right to concentrate provision in that area, given the huge amount of training and intensive support that the unit needs. The decision has been taken, we recognise that such technology has a very important role to play and I hope that the hon. Gentleman welcomes that decision.

Some of the big pharmacy wholesalers, such as Phoenix Healthcare and Alliance Healthcare, are also retailers and so refuse to supply wholesale to small, new and independent pharmacy retailers. Will the Minister look into that apparent restraint of trade, please?

The answer is yes, I am doing that. There are concerns about the way in which wholesalers are now using, in effect, funnels to restrict the ability of some of the pharmacy retailers to get access to drugs, thereby driving up the price. I am concerned about this, and we need to watch it very carefully.

T10. During the summer recess another NHS dentist in my constituency left the NHS and went private. The provision of NHS dentistry is getting worse year by year in Cornwall generally. When are the Government going to do something about it? (292262)

NHS dentistry provision has improved in the past few months in most areas of the country. PCTs are given the priority to secure access to such provision for all who seek it. All 10 SHAs have now set themselves the aim of achieving that by March 2011 at the very latest.

Can my right hon. Friend ensure that PCTs in areas where first-cousin marriages are the norm will provide genetic screening and counselling and ensure that the communities are aware of that provision?

My hon. Friend raises a very important point. Before giving a firm assurance on that, we need to take some advice on the clinical implications from those whom we would call upon to carry out such tests.

Many cancer patients complain of feeling isolated during their treatments, citing lack of appropriate information and support. The Department’s “Cancer Reform Strategy” promised the introduction of cancer patient experience surveys to help to monitor better-quality care that is given to cancer patients. Could the Minister explain why this measure still has not been introduced, two years after it was first promised, and what is he going to do about it?

I agree that it is very important to help people to live with cancer. In this financial year, we are providing some £1.6 million to Macmillan for precisely that purpose—to help people to get on with their lives and deal with the effects of living with cancer. On the specific issue that the hon. Gentleman raised, I will write to him.

Yesterday was world arthritis day. What is being done to ensure earlier diagnosis of rheumatoid arthritis, which is a very painful and disabling condition if it is not detected early, often leading to people being unable to work?

That is a very important point in relation to rheumatoid arthritis. As has been stated, this week is world arthritis week. We are having a discussion with Dame Carol Black on how we can enable the health work force, particularly GPs and others, to be aware of the early detection of this painful crippling, which obviously has many implications for the patient’s quality of life.