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Topical Questions

Volume 503: debated on Tuesday 12 January 2010

Today, Sir Michael Parkinson has published his report on his year as the national dignity ambassador. I thank him on behalf of the Government for the time that he has given to raising awareness of the issues that affect us all and for the personal insight that he has brought to considering how we can improve care for older people. The fact that there are now 12,000 dignity champions working at a local level illustrates the difference that Sir Michael has made, and we will look to build on that.

As the cold weather continues, staff across the NHS, particularly ambulance services and accident and emergency staff, have been working extremely hard to minimise the impact on patients. Although it is under greater pressure, I can tell the House that the NHS in all parts of the country is coping well. I am sure that Members on both sides of the House will want to join me in thanking health and social care staff for their efforts to help to protect vulnerable people at this time.

I certainly endorse the last part of the Secretary of State’s comments. May I bring to his attention the rather long waiting list that people who suffer from acute back pain have to go through before they see a consultant? As a long-standing and regular sufferer myself, I know that it is no laughing matter. The waiting time is such that if the problem is serious, it can progress a great deal in that time. If it is a less serious problem, it will no doubt have corrected itself in that time. Whichever situation applies, the waiting time is far too long. Can the Government do anything about that?

The hon. Gentleman is right to say that back pain creates many problems, not just for the people involved but for the economy in general. That is why we now have a system of self-referral to a physiotherapist. I believe that all patients should have that right. We will also be looking at the development in the chief medical officer’s recent report on pain clinics and how chronic pain is managed, including how chronic and acute back problems can be managed.

T4. In 1997, there were 284,000 people waiting more than six months for NHS treatment. What is the figure today, and what are the Government doing to prevent the situation from sliding back to the bad old days when the Conservatives were in power? (310045)

My hon. Friend is quite right: we must prevent a drift back to the bad old days. In his area, Yorkshire and Humberside, in 1997, there were 26,719 people waiting more than 26 weeks. In November—these are the latest figures I have—the number was zero, so nobody was waiting. Whereas we will lock in that achievement as a right, the Conservative party would remove the guarantee. The Conservatives will have to explain to the public why they would do that.

T2. This morning, I faxed to the Public Health Minister’s office some documents provided to me by the investigative journalist Jane Symons. Those documents show that the Human Fertilisation and Embryology Authority has not only spent millions of pounds pursuing, ultimately failingly, an individual clinician, but that the new chief executive who was brought in to sort out the problem had argued for an externally led inquiry last year. Why has that inquiry not happened? Does the Minister have any proposals to ensure that we know why millions of pounds of taxpayers’ money was wasted in that way? (310042)

I am grateful to the hon. Gentleman for his courtesy in forwarding the documents, but I remain of the view that it would not be in the public interest to pursue an inquiry. There have been a number of significant changes at the authority since the time of the incidents covered in the memo, which I would be happy to write to him about. However, the interim chief executive has acknowledged that the authority is not free from criticism, and there is to be an internal governance review to consider all these issues.

T5. Given the very harsh winter that we are suffering at present, I have no doubt that my right hon. and learned Friend the Minister of State will recall the annual winter crises that we used to have more than a decade ago. People—mainly elderly people—were lying on trolleys in our hospitals for days before they died, after which their bodies were stuffed in refrigerated vans outside. What can he do to assure me that those crises will never return to this country, and how do we manage to cure that problem? (310046)

Elderly people are of course now able to benefit from flu jabs, winter fuel payments, pension credits and, when it gets very cold, cold weather payments. In 1997, the NHS spent £426 per person on health, but today it spends £1,612. Whereas the Tories were frozen in the ice of their own indifference to older people, this Government actually care.

T3. Will the Minister match the very helpful answer that I had from the Minister of State at the Department for Transport on Thursday about how that Department and the Department of Health have been working closely together to provide the preventive medicine of road gritting, so that hospitals receive fewer people with fractures? In Croydon’s Mayday hospital, fractures are currently up 40 per cent., but at the beginning of the crisis they were up 316 per cent. (310044)

It is certainly the case that we need to ensure that the NHS works with local authorities to make sure that ambulances can get through, that ambulance crews can get to their ambulances, and also that the service is geared up to deal with the various problems arising from the recent very bad weather. We need to make sure that the various bodies work together, and the information that we have so far suggests that they are doing so.

T9. The Autism Act 2009 was a great success for Back Benchers across the House, in co-operation with a caring and receptive Government. It calls for the autism strategy for helping adults with autism and Asperger’s syndrome to be published. Will my hon. Friend the Minister of State make sure that it is published before we are diverted by other matters a little later in the year? (310050)

I am grateful to my hon. Friend for his comments. The 2009 Act was a landmark piece of legislation, which was passed on a cross-party basis. I can reassure him that the autism strategy is due to be published before 1 April this year. Discussions on the strategy are going on as we speak. Indeed, the external reference group that has been advising us on it—and which involves service users, family carers, voluntary organisations, professionals and so on—met only today to consider its contents. The strategy will be backed up by a clear delivery plan, and further guidance for health and social care providers later this year. So yes, the Government are going to deliver on autism.

T6. What does the Secretary of State consider will be the most effective way to reduce binge drinking in the young? (310047)

I recognise that the public mood is changing when it comes to alcohol—not just binge drinking, but the general intake of alcohol by the wider population. There is rising public concern, as reflected in last week’s report from the Health Committee. The hon. Gentleman will remember the report on obesity that was published when I used to serve on the Committee with him. That report changed the nature of the debate, and it is possible that last week’s report will come to do the same. We are looking at the next steps on tackling alcohol, and considering the consultation on the mandatory code and the measures to combat the irresponsible promotion of alcohol. We are also considering going further on labelling, but of course I remain open to further discussions with him and the Committee on how we may go even further.

Order. I want to get several more colleagues in, so I need very short questions and short answers.

I thank the Secretary of State for agreeing to meet the Chief Minister of the Isle of Man about the future of the reciprocal health agreement. Will he get his officials to look particularly at the impact that that decision could have on his and my constituents who are TT enthusiasts—motorcyclists—and the impact that it would have on NHS North West if the Isle of Man took its elective surgery purchases away from there to Edinburgh, Belfast or Dublin?

As the Minister of State, my right hon. and learned Friend the Member for North Warwickshire (Mr. O'Brien), mentioned a moment ago, I have agreed to meet the Manx Health Minister to discuss these issues. As a north-west MP, I know that the island has a long-standing relationship with the north-west of England and its health service, and I will commission the work that my hon. Friend mentions on the potential effect of purchasing being switched. I am not minded at present to change our position but I will, of course, listen to what the Minister has to say.

T7. I thank the Minister of State, the right hon. and learned Member for North Warwickshire (Mr. O'Brien), for his support for the Better Healthcare Closer to Home project so far. Is the Department on track to complete the review of the project by the end of this month, and is the Treasury ready to pick up the baton immediately afterwards? (310048)

We want to move the project on as fast as we reasonably can, and we hope to be able to get things sorted through by the end of the month. Let us remember that there are some local decisions to be made over which we do not have entire control, but the objective is to get the project moving.

Has my right hon. and learned Friend received any recent requests from the Ministry of Justice for up-to-date estimates of the increase in the number of secondary pleural plaques in order to enable it to come to a decision on a compensation package?

My hon. Friend has indicated that she wants to ensure that we are working with the Ministry of Justice on the matter. I assure her that we will be in regular contact in future with the Ministry of Justice to develop the Government’s strategy as a whole in relation to pleural plaques.

T8. I strongly endorse the question asked by my hon. Friend the Member for Carshalton and Wallington (Tom Brake), but may I ask the Minister about another matter, which is related to autism, which has been raised already? Eight out of 10 GPs confirm that they feel they need more training so that they can better understand autism and care for the condition better. What will the Government do to ensure that there are sufficient resources, will and determination to deliver that extra training? (310049)

The consultations that we have had and the development of the strategy, which we will publish shortly, have made clear the importance of the GP understanding, knowing, diagnosing and being able to refer on appropriately individuals who may have any condition on the autism spectrum. An important part of the strategy that we wish to pursue is the training of professionals—not only GPs, although they are a key and vital part of the front-line services. Training of professionals and raising awareness among professionals of what autism is, how to respond to it and what services are available is a critical part of the strategy going forward.

At the last Health questions, I raised the issue of lab technicians who make dentures and crowns for dentists, and I thank my hon. Friend the Under-Secretary of State for agreeing to meet me and my constituent, Andrew Taylor, this afternoon. In advance of that meeting, can she confirm what her Department is doing to encourage UK dentists to use UK lab technicians?

I look forward to meeting my hon. Friend in the next half-hour to discuss that in more detail with officials.

It is estimated that there are more than 20,000 men and women in this country who are HIV-positive, and who have not been tested or diagnosed and therefore do not know that they are HIV-positive. Does my hon. Friend agree that the Department should aim to reduce that figure by at least 50 per cent.? What action is the Department taking to achieve that objective?

Obviously, early identification is crucial. We have talked at some length with the all-party group on AIDS about measures that we can take, and I am happy to continue those conversations.

I have a young mum in my constituency dying of breast cancer and desperate to prolong her life, with two young daughters who rely on her. She has been prescribed Herceptin. It is not working because of the size of the molecules. She is told by her specialist that Lapatinib would work for her. It costs less than two thirds of the cost of Herceptin, yet she is being denied it. I wrote to the Secretary of State on 19 November and I have chased him twice since, but I have still not had a reply. Will he please look at the matter urgently?

I have indeed been looking into the issue of Herceptin, and I am aware of the way in which the National Institute for Health and Clinical Excellence has approached it. These are important and difficult issues, and I can assure the hon. Gentleman that, if he has an outstanding letter on this matter, I will chase it up with my officials.

I was listening to what the Minister said about ambulance response times. They are of course important, but more important are patient outcomes—whether a patient lives or dies and what actually happens to them. What progress is the Department making on ways of measuring patient outcomes so that ambulance trusts can be more sophisticated in the way they deploy their resources?

I have heard the term “outcomes” being bandied about, but it is not always entirely clear what the Opposition mean by it; they seem to have different views of what it means at different times. As far as the Government are concerned, the important thing is that we ensure that the ambulance service is there when patients need it, that its response times are within the criteria that we have set for it, and that targets are met. The Opposition would get rid of the targets that save lives; we would keep them.

Was the threat of 65,000 British swine flu deaths an unscientific exaggeration that has cost the country dearly, not only financially but in terms of stress and distorted NHS priorities?

We had to take every possible step to keep the country safe through what was declared a world health pandemic, not by this Government but by the World Health Organisation. We saw the events in Mexico in the spring, followed by the exceptional spike in flu cases in this country in the summer. There were understandably high levels of public concern, and I make no apology for making all the necessary preparations to keep the public safe through that. We have come through the pandemic because of the strength of the plans and preparations that this Government put in place.

Does the Secretary of State agree that, to allow waiting times for cancer treatment to be monitored, specific data should be collected individually for each of the most common cancers, so that a better picture can be seen? I was not sure from his previous answer.

I refer the hon. Gentleman to the report issued by the national cancer director at the end of last year. He will see in it the publication of data, primary care trust by primary care trust, that have not been published in this form before. The report shows how many patients are being referred on the two-week urgent referral pathway, and there is a whole wealth of data on survival rates. I am always prepared to go further, however. The complaint from the Opposition is always that we collect too much data, but if the hon. Gentleman wants me to go further, I am prepared to consider doing so.

On Saturday, I met the Plymouth and South Devon Dystonia Support Group, which was celebrating its first anniversary. Will the appropriate Minister please meet me to discuss research and development, and treatment and support for that group of sufferers?

The Minister of State, Department of Health, the right hon. and learned Member for North Warwickshire (Mr. O’Brien), made a welcome announcement over the Christmas break about payments to the Thalidomide Trust. Did I miss the statement to the House confirming that announcement? The news was very welcome, but I would just like to know whether it is now on the record.

The Secretary of State knows that I have raised concerns about the awarding of the contract for the Eccleshill independent sector treatment centre in Bradford. He will now be aware that the decision to award that contract has been suspended for another five months. I have said that it should not go ahead in the light of the concerns, and that there should be a public consultation. Can he tell me why that decision was made, and whether we will now get that consultation?

We are still looking at that matter and I hope that I will be able to give the hon. Gentleman a fuller answer on the details in due course.

Earlier, the Secretary of State referred to the Health Committee’s report on alcohol, and said that he was open-minded about it. Does that mean that the Government are prepared to consider minimum pricing for a unit of alcohol?

I suggest that the hon. Gentleman look at this Government’s record on tackling tobacco over the past decade. That shows that we will continue to take the bold steps necessary to improve the health of the nation. I have said that we will do more on labelling, and on our mandatory code. Pricing is of course a key issue in this debate. I do not know whether he has concluded that minimum unit pricing is now essential, but we must also consider the issues of deep discounting and selling below cost price, which also form part of the equation. This is a time not for shouting across the Floor of the House but for both parties to address the issues and to ask whether the public mood has changed and whether we need to take a different approach to alcohol in our communities.

The Royal British Legion says that little effective progress has been made on the veterans’ NHS priority treatment scheme. What steps is the Minister taking to ensure that PCTs and hospitals monitor progress on this and that veterans get the care to which they are entitled?

Yesterday I was able to make an announcement, together with Combat Stress, one of the veterans’ organisations, to ensure that we deal in particular with some of the issues that arise as a result of people being involved in combat. We also want to ensure that GPs are more fully aware of the rights of veterans. We have asked that all PCTs ensure that they have somebody at a director level who is responsible for ensuring that this information gets out, and that strategic health authorities have someone in place at a director level—on the board—who is responsible for ensuring that this sort of information gets out and that veterans, who have served their country, get the service from the NHS that they deserve.