My responsibility is to lead the NHS in delivering improved health outcomes in England, to lead a public health service that improves the health of the nation and reduces health inequalities, and to lead the reform of adult social care, which supports and protects vulnerable people.
In the light of the 0.5% real cut in the NHS after the social care switch, to which my right hon. Friend the Member for Wentworth and Dearne (John Healey) referred, may I ask when the Secretary of State decided to break his promise on a real-terms funding increase for the NHS? Does he accept that that is not what my constituents expected when they heard the Prime Minister promise real increases for the NHS?
The hon. Lady’s constituents expect the truth, which is that we are providing increased resources for the NHS in real terms, taking it from £104 billion to £114 billion. That is completely contrary to what we were advised to do by the Labour party, which said that we should cut the NHS budget. We did not do that; we increased it.
T2. The all-party group on multiple sclerosis held an all-day seminar last week on the subject of drug pricing, during which it broadly welcomed the end of the risk-sharing scheme and looked forward to value-based pricing, which will be introduced shortly. That welcome is subject to two important conditions: first, that NICE clinical guidelines should be updated and continued; and secondly, that the NICE risk appraisal should be abandoned. Does the Secretary of State agree with me on those two conditions? (20954)
Yes; my hon. Friend is absolutely right. As we implement our plans for the value-based pricing of medicines from 2014, NICE’s role will change. It will focus on advising how best to use treatments and to develop quality standards for the NHS, rather than recommending whether patients should be able to access particular drugs. We want patients to have access to the medicines that their clinicians believe are best for them.
I wonder whether the Secretary of State can provide some reassurance to residents of Cleadon Park estate in my constituency who are concerned about the consequences of primary care trust abolition for the PCT-owned, PCT-organised and PCT-financed health centre that brings together primary and secondary care, and local authority and community services. Is there not a real danger of the sort of expensive “anarchy” of which Professor Tony Travers of the London School of Economics has warned?
Happily, I can offer the right hon. Gentleman’s constituents great reassurance that not only will the relationship between community health care and specialist health care in hospitals be improved by general practice-led commissioning—because clinicians will speak to clinicians—but the services they rely on will be improved, because we will no longer spend so much money on PCT administration. He will know that in 10 years under his Government the number of managers in the NHS increased by more than 60%.
T4. NHS Warwickshire is consulting on the future of Bramcote hospital, which serves my constituency and the wider north Warwickshire area. That could lead to the closure of the hospital which has provided valuable intermediate care to my constituents over many years. To close the hospital, NHS Warwickshire requires the Department of Health to meet substantial impairment costs. Can the Secretary of State assure my constituents that before any decision is made by the Department to pay any such costs, the views of the local GP consortiums and local people will be taken into account? (20956)
As my hon. Friend says, NHS Warwickshire is consulting on the future of intermediate care at Bramcote hospital. I hope that he will engage with that consultation and that the views of local people will be taken fully into account by NHS Warwickshire in deciding the way forward. As he knows, the Secretary of State has set out various tests and NHS Warwickshire’s decision must have the support of the GP commissioners; must strengthen public-patient engagement; and must be based on sound clinical evidence. I hope that my hon. Friend is reassured that those tests will be fully taken into account as part of the consultation process.
T8. Following the coalition Government’s announcement that the NHS budget was to be protected and, indeed, increased, can the Secretary of State tell me why a ward will be closed at Calderdale Royal hospital? Will he reverse that crazy decision immediately for the safety of my constituents? (20960)
I cannot tell the hon. Lady precisely why that proposal has been made, but I will investigate and write to her. Increasing resources overall for the NHS does not mean that everything will stay the same in every particular. There will be change, including the redirection of resources towards providing services in the community rather than in hospitals.
T5. Occupational therapists are crucial in effective rehabilitation. Will the Minister advise me on what role he sees for occupational therapists in using the £70 million investment in reablement announced by the Government? (20957)
I am grateful to the hon. Gentleman for drawing attention to the Government’s commitment to develop reablement services, especially the win, win, win that they can deliver for the individual who gets back on his feet, gets his confidence back and leads his life independently; for the social services departments, which do not have to provide ongoing support; and for the NHS, which does not have to deal with readmissions. Occupational therapists have a vital role to play in providing good quality support following discharge and are therefore critical players in the development of reablement services around the country.
I take it that the hon. Gentleman is not referring to me in those respects, although I can probably claim one or two of those epithets. We are none of us looking to lecture anybody: we are trying to lead a public health strategy that enables everybody to make healthier choices and lead healthier lives.
T6. May I invite the Minister to congratulate my local newspaper, the Northamptonshire Evening Telegraph, on running a successful campaign to encourage people to sign up to become organ donors? Given the success of that campaign, perhaps the Department might like to encourage other local newspapers to do the same. (20958)
I would certainly like to join my hon. Friend in extending those congratulations. Local papers can have a huge impact in raising the issue of organ donation. Donor rates have risen in this country by 20% since 2007-08, which happened on the back of the organ donation taskforce, which looked at the system in 2008. The issue is complicated and quite sensitive in some areas, but the most important thing is to raise awareness in local communities. Local papers are an ideal vehicle for that.
Since when has handing over the running of any service to a powerful producer interest been good for the consumer—that is, the public? In the absence of primary care trusts, who will do the difficult but important job of performance-managing underperforming GPs and, where necessary, weeding out incompetent ones?
The right hon. Gentleman was a member of a Government who said that they would introduce practice-based commissioning, but who then let primary care trusts override the general practice role in determining not only the proper care of patients, but how resources should best be used to make that happen. If he is defending primary care trusts, he is making a very sad choice, because in reality they know that they simply increased their management but did not succeed when it came to commissioning. The right hon. Member for Rother Valley (Mr Barron), the former Health Committee Chairman, produced a report showing that, and it is very clear that—
T7. My right hon. Friend has shown great interest in the reconfiguration plans for Enfield hospitals, culminating in the moratorium announcement outside Chase Farm hospital in May. Would he expect the outcome of the clinical review to be simply an endorsement of the present clinical strategy, which is based on previous models of care for emergency and maternity services, or should it embrace future health care choices, opening up to GPs, patients and the public? (20959)
I am grateful to my hon. Friend. He knows that the criteria that I set out, which were repeated earlier during questions, must be applied, not only to the strategies that were previously presented, but to potential new strategies that Barnet and Chase Farm hospitals might wish to present, in order to ensure that GP commissioning intentions, future patient choice and public views are properly reflected.
The hon. Lady will forgive me, but I do not propose to make that available, as it would be a great deal more expensive. Each year, and on an international basis, the World Health Organisation advises on what the seasonal flu vaccine should consist of, and it almost always consists of the three most likely strains combined together into one vaccine.
Is the Secretary of State prepared to make a statement on the vital work of the co-ordination of organ donation at the hospital level, particularly given that under the current system there is no specified organ donation co-ordinator at the Westmorland general hospital in Kendal?
Organ donation co-ordinators are a vital part of the team in increasing organ donation rates. The organ donation taskforce recommended 100 extra organ donation co-ordinators, but we must not forget that there are other things. For example, training for staff who are likely to come into contact with potential organ donors is vital. We have got to get those rates up.
I am not sure whether the hon. Gentleman was here earlier, but we explained in great detail about the target that never existed. The latest figures show that the median time has gone from 1.7 weeks to 1.9 weeks, but that is because those figures were for the period between June and August—the holiday time—when many people changed their bookings or appointments to fit in with the school holidays or their own holidays. The figures for September are already on course to get us back to the median for that time of the year.
I know that the Secretary of State is aware of the high level of teenage pregnancies in this country, and particularly in Hastings in my constituency. What action are we going to take to support those young women? We all know of the negative health outcomes that come with those young pregnancies.
Yes, indeed I do. It is sad to report that we have the highest rate of teenage pregnancies in western Europe. At the heart of this is the fact that we must have community strategies that are geared not least to improving the self-confidence and self-esteem of young people, so that they are able to make better decisions. We must assist them in doing that, but I would also mention the importance of ensuring that we have long-acting reversible contraception available for young people.
The hon. Gentleman will know that the White Paper is yet to be published, so I will not pre-empt it, but it will be important to ensuring that there is a clear strategy for improving sexual health services. He will share our view that we want to deal with the extent of undiagnosed HIV and the extent to which people coming into contact with health care services are not offered HIV tests.
I recently met a group of Bournemouth and Poole college health and social care students whose research indicated that the average age for repeated sexual activity in the UK is now 16. With that and other information, they have set up a campaign to reduce the age for cervical screening to 20. What action will the Minister take?
I thank the hon. Lady for her question. She is right to raise the issue of the reducing age of sexual activity, and certainly the public health White Paper that we will publish later this year will have a significant impact on that. Cervical screening must be addressed, and it is important to raise the uptake rate to a much higher level to ensure early diagnosis.
Dr Clive Peedell, a consultant oncologist at James Cook university hospital in Middlesbrough, said that the coalition Government’s plans for the NHS
“are a roadmap to privatisation”.
That was his reaction to the King’s Fund report, which argues that the plans to make savings in direct NHS expenditure while dismantling local PCTs has the support of fewer than one in four doctors. What is the Secretary of State’s response to that overwhelming opposition from local doctors to the Government’s plans?
We will, of course, respond to the consultation in due course, but support for the principles of the White Paper was widespread and came from local government and the medical and nursing professions. The issues that we will address in the consultation were mainly about implementation of the principles, but support for the principles was widespread.
Will my right hon. Friend confirm that the Government’s policy is to ensure that over the next four years we deliver efficiency gains from the health service, valued by the chief executive at between £15 billion and £20 billion? As that target was first set out by the Labour party when it was in government, will my right hon. Friend take an early opportunity to invite the new shadow Secretary of State to endorse that programme, and to support its specific execution as each change is introduced?
My right hon. Friend makes an excellent point, and I invite the shadow Secretary of State to respond to it in due course. We will ensure that the NHS uses resources more efficiently to meet increasing demand and costs in the NHS. Savings of that order are required, and the NHS is on track to make them.
I would like to return to the subject raised by my hon. Friend the Member for North East Derbyshire (Natascha Engel) about the national hereditary breast cancer helpline. The Minister’s response was inept. She said that a national service will be funded by tons of different GP commissioning groups. That just will not happen. She said nice words about Wendy Watson, but her Government’s policies will see the end of that helpline unless she intervenes. Will she please ensure national funding for a national service?
As I said earlier, the cancer networks are working on an interim solution for funding the helpline through the transition period to the new commissioning arrangements. I remind the hon. Gentleman that the Labour party tried to tell people what to do from the centre and micro-managed everything. What happened was that no local decisions were made. I do not doubt the value of the helpline. It is crucial that emotional and practical support for those at high risk of breast cancer is available, and the helpline is one way of doing that. It is extremely important that such decisions are made locally. Telling people what to do from the centre does not work.