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Topical Questions

Volume 506: debated on Tuesday 23 February 2010

Today the Government are launching their consultation on a strategy for treating chronic obstructive pulmonary disease, which is the UK’s fifth largest killer. The strategy seeks to improve diagnosis and treatment of the condition, which affects more than 3.2 million people in England. Tomorrow we will publish the independent inquiry by Robert Francis QC into failures at the Mid Staffordshire NHS Foundation Trust. On Thursday, we will hold the first dignity action day.

I welcome the strategy on COPD, but let me return to cancer. The Secretary of State will be aware that the incidence of cancers is higher than average in parts of north-east London such as my constituency. That is the case for prostate and bowel cancers. What significant plans do the Government have to improve early detection, treatment and care for those who are most affected?

Waltham Forest was one of the early adopters of the Government’s bowel cancer screening programme, ahead of national implementation. We take these matters incredibly seriously, and, as my hon. Friend will know, we have extended the bowel cancer screening programme to men and women aged between 70 and 75.

When we came to government, we set ourselves the objective of reducing deaths from cancer among under-75s by 20 per cent. The latest report from the national cancer director says that we are well on the way to meeting that target, as the figures have come down by 19.3 per cent. We hope that we can make further progress, and my hon. Friend is absolutely right to say that this issue is a top priority for the Department and the Government. Going forward, we will have a one-week entitlement to tests for suspected cancers, because we believe that early diagnosis is absolutely fundamental to cutting premature deaths from cancer.

Order. May I remind the House that during topical questions, quick-fire questions and answers are required to enable me to maximise the number of people who can participate?

T2. Primary care trusts in the north-west currently have a year-to-date deficit of £15.3 million. Will the Secretary of State tell us, or give us a guarantee, that important services to patients will not be sacrificed in trying to reduce those deficits? (317497)

We have made it very clear that managers need to focus on ensuring that they deliver the best quality of care. The issue of finance comes second to quality. I can assure the hon. Gentleman that managers have been given that very clear guidance.

T5. Last year, a constituent of mine paid £4,000 for a private operation that she required to save her sight. A few months later, the operation was made available on the NHS by the National Institute for Health and Clinical Excellence. My constituent has obviously lost out. Will the Minister look again at the NICE appraisal system, and improve its transparency and speed of decision making, to avoid this situation in future? (317500)

I agree that transparency is important in all aspects of NICE’s work. Full details of its forward work programme are readily available on its website, wherever possible accompanied by expected publication dates for specific pieces of guidance. NICE consults publicly on each piece of draft guidance before making a recommendation.

Do Ministers agree that the work of the Health Protection Agency Centre for Emergency Preparedness and Response at Porton Down is absolutely crucial to the security of our country? In view of the work that that extraordinary organisation has done on swine flu and vaccinations, why on earth are they proposing to move it? Not only does it do research into the most dangerous pathogens that might afflict our country, but it puts practical science to work in making vaccinations against them. Why are Ministers proposing to move the establishment and its pathogens to Harlow in Essex?

I can assure the hon. Gentleman that no final decision has been taken, and I certainly share his views about the excellent work done by his constituents and others at Porton Down. I also understand that he had a very useful meeting to discuss the future there. I know he will understand that the HPA has to look at all options to further and develop the very important work being done for the future.

Since 2003, the median waiting time for in-patient treatment at York hospital has fallen from 15 weeks to five. Does the Minister agree that setting targets for waiting times has helped to bring them down and that abandoning the targets, as the Conservatives suggest, would cause waits to increase?

My hon. Friend will know that at the last election we set a challenge for the NHS to ensure that no patients waited longer than 18 weeks, other than those who opted out for clinical reasons or by choice. We have made amazing progress towards that goal. The NHS has risen to the challenge and 18 weeks is now the outside, with many patients being treated, as he says, on a much shorter timetable. In my view, removing the target would bring about the return of differential waiting standards across the country—what the public would describe as postcode prescribing or a postcode lottery. We will enshrine the right to treatment within 18 weeks in the NHS constitution as a patient guarantee.

T3. I am bearing in mind your stricture, Mr. Speaker. Will the Secretary of State rule out a death tax? A simple yes or no will do. (317498)

We published a Green Paper and are looking at all the options for building a lasting consensus on this issue, which is one of the most important facing the country. We would welcome Opposition Members rejoining the search for a national consensus, rather than making cheap points at Health questions today. It is a complicated issue that deserves a considered approach. I do not believe that making cheap remarks like that will help.

To ensure that GPs maintain their clinical skills, they undergo appraisal every year. Starting from next year, of course, that will lead to reaccreditation by the General Medical Council, but unfortunately the NHS appraisals toolkit has gone offline at the critical time in the year when GPs need to get their appraisals sorted out. Will the Minister make a statement to the House on where we are with that website, so GPs can be reassured that their skills will be tested in the right way and in due time?

It was found that the toolkit had the potential to be compromised. We therefore took the view that it needed to be examined properly and in effect repaired, to ensure that it cannot be accessed by hackers. Work is now ongoing: it is on schedule at the moment, but I will keep GPs and my hon. Friend informed about its progress.

T4. Following a seminar on Lyme disease that I hosted in the House in October 2008 and a question that I raised in the House in December 2008, the Under-Secretary of State offered to host a meeting about Lyme disease. I followed that up with three telephone calls to her office and one letter. Given the fact that there has been an increase of 90 per cent. in cases of Lyme disease since 2006, what kind of message are the Government trying to send to people suffering from the disease? (317499)

Am I the only one here to be concerned that primary care trusts are to lose their role as direct providers of health services?

We want to ensure that primary care trusts are the main way that patients ensure they get the services that they deserve. Sometimes it is better to ensure that those services are provided by organisations with which the PCT can act at arm’s length to supervise properly and ensure that they are acting on behalf of the patient and the taxpayer.

T6. The Secretary of State has often talked about phasing out car parking charges at hospitals like the Royal United Hospital Bath and the Great Western hospital, which serve my constituency. On the face of it, that is perfectly welcome. Will he tell us how that will be funded without cutting into front-line medical services, and how that will result in more parking spaces, which is what we need? (317501)

A consultation on our proposals to change car parking rules in the NHS closed last week. I hope the hon. Gentleman found time to contribute to that. The proposal is to phase out charges for in-patients. I believe it is unfair that people should not receive visits while they are in hospital from those who cannot afford the charges. The introduction of charges symbolised the NHS moving away from the patient and the public. If we can come up with a workable and fundable scheme, I believe it will be widely welcomed by patients and the wider public.

Are my constituents in Biddulph right to be concerned that, owing to design delays, their Biddulph health centre could become the victim of NHS capital funding cuts if the Conservatives were to win the general election?

I am afraid my hon. Friend will have to have discussions. I understand that the newly elected Conservative Staffordshire county council pulled the library out of the project at Biddulph and as a result there have been delays. If a Conservative Government were elected, I would be very fearful about the likelihood of any such project getting consent.

T7. What are Ministers doing to ensure that money which has been earmarked for PCTs for respite care for carers is getting to carers for respite care? (317502)

The hon. Gentleman and others have raised this issue. As part of the national carers strategy the Government have placed more than £150 million in primary care trusts’ budgets to ensure that those primary care trusts could complement the money that we have given to local councils—some £720 million over the past three years—to provide respite care. The combined funding to the PCTs and to local councils for respite care is some £975 million last year, this year and the next. It is a matter for local decision making to assess local needs, but I hope that the hon. Gentleman and others will ask their primary care trusts and their local authorities to do better in delivering the resources that the Government have allocated to provide respite care for carers, who do such an important job in the community.

Is the proportion of hospital trusts with anticipated deficits greater among those with significant private finance initiative funding than among those that wisely avoided significant PFI, such as the well managed and solvent New Cross hospital in Wolverhampton?

That is an interesting question. I will have to look up the detail. However, PFI has brought forward a series of projects and enabled us to undertake the redevelopment of more than 100 hospitals so that we now have a better health service with more modern hospitals than we have ever had in the history of the country. That is the result of the investment provided by the Labour Government.

T8. If national health service funding is meant to be allocated to trusts locally according to need, and if wards such as that which I visited in St. Thomas’ hospital at the weekend are clearly overstretched, why was Southwark primary care trust top-sliced? Six million pounds was taken back three years ago; it was told that another £8 million of its proper allocation would have to be taken back in the coming year; and it was threatened with more money being taken away from what it is told it needs. (317503)

Order. I am trying to help hon. and right hon. Members, but I need them to help me to help them—with short questions and short answers.

NHS London is well funded, and we want to ensure that it delivers for patients throughout London, including those at St. Thomas’ hospital.

The waiting list on south Tyneside for treatment by an orthodontist is more than three years, and 600 people are on the waiting list. The wait will be reduced to six months, because a new contract is being entered into, but achieving that will take three years. Will the Minister look into the situation and help?

T9. Does the Minister agree that a good way to control binge drinking is to try to highlight and publicise the amount of kilocalories in a drink? Red wine contains 171 kilocalories, alcopops 187 kilocalories and a pint of lager 287—more than the doughnut that I have here, which I just got in the Tea Room. When will the Minister start to publicise those facts? (317504)

I thank the hon. Gentleman for bringing his snacks into the Chamber. The important point is what is on labels for alcoholic products, and we have just launched a consultation on that very matter. There has been huge success in making units better understood, and I regret the proposal from the hon. Gentleman’s party, which is to replace them with something unknown—that is, centilitres.

North Central London strategic health authority is planning massive cuts, a £500 million reduction in its budget and the closure of A and E departments, including one at the Whittington hospital. Many of us find those decisions unpalatable and wrong, but above all we have great difficulty bringing to account the people who are making those plans and decisions. Will the Secretary of State tell me how we can make those officials accountable to the public for their decisions and planning?

As I understand it, those reviews are at an early stage and there are no clear and firm proposals. Local clinicians need to be at the heart of those recommendations, and any changes need to, and must, be the subject of full local consultation.

Will the Minister ensure that when GPs in rural practices support community hospitals, no restrictions will be put on their rights to refer patients to those community hospitals?

GPs will need to work with their primary care trusts to ensure that hospitals referrals are made appropriately. GPs have a broad range of clinical freedoms in order to decide where they want to refer their patients.

A number of consultants at Wexham Park hospital have sent me a letter, which I have forwarded to the Secretary of State, expressing their belief and concern that the hospital’s accounts were rearranged to ensure that it achieved foundation trust status. Will the Secretary of State look into that question and ensure that the consultants’ concerns are responded to as quickly as possible?

My hon. Friend raises a serious issue, and I shall of course look into it closely and report back to her.

T10. Further to the question that my hon. Friend the Member for North Wiltshire (Mr. Gray) asked, is the Secretary of State aware of the great controversy about car parking at the Queen Elizabeth hospital in King’s Lynn, involving the displacement of cars on to quiet residential roads in neighbouring communities? Surely one way forward is for hospitals to charge on exit, rather than on a pay and display basis, so that people pay for the car parking that they use. (317505)

I know that this issue raises strong feelings throughout the NHS. Indeed, at many of our surgeries it is one of the issues on which we receive most representations. The NHS needs to pay a little more attention to the price and availability of car parking, and that is what I am encouraging it to do.

Given the success of the Government’s breast cancer screening programme in reducing mortality in London by some 30 per cent. in the past 10 years, and given that breast cancer remains the UK’s most common cancer, affecting one woman in nine, will the Minister ensure that there is a continued high rate of research in order to improve the survival rates and quality of life for cancer sufferers?

Why are the Government pressing ahead with the closure of small maternity facilities and increasing the size of those that are left when the evidence suggests that smaller units offer better services to expectant mothers?

At all times the safety of the mother and baby is taken into account. Any discussion in relation to closures or openings is always undertaken with the safety of the mother in mind, and that is done by clinicians.