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Topical Questions

Volume 524: debated on Tuesday 8 March 2011

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.

Prostate cancer is the most common form of cancer in men, with a quarter of a million men currently affected and one man dying every hour. This month is prostate cancer awareness month. What action is my right hon. Friend taking to help raise awareness of prostate cancer?

As the Minister of State, my hon. Friend the Member for Sutton and Cheam (Paul Burstow), has set out in previous answers, our cancer outcome strategy commits more than £450 million a year over the spending review period to achieving earlier diagnosis of cancer, including access for GPs in the community to diagnostic tests such as non-obstetric ultrasound. At the heart of the strategy is the need to improve awareness and early diagnosis of all cancers, and we are working with the prostate cancer advisory group to help men who do not have symptoms to make decisions about whether to have a prostate-specific antigen test.

The Prime Minister promised to protect the NHS. What does the Health Secretary say to the people who are not getting the hip, knee and cataract operations that they need, and to the patients who are now having to wait longer for tests and treatment?

I will say three things. First, we did protect the NHS, contrary to the recommendations of the Opposition, who said that we should cut the NHS budget. Next year, primary care trusts across England will receive an average increase of 3% in cash. I went to Wales at the weekend, to Cardiff. The people of Wales are seeing a Labour-led Assembly Government cutting their NHS budget in real terms. That was what the Opposition recommended we should do, and we are not doing it.

Secondly, the number of hip and knee replacement operations went up in 2010 compared with 2009—the Patients Association figures were wrong about that. Thirdly, waiting times are stable, as we have set out, and the latest figures show that the average waiting time for diagnostic tests has gone down.

The Secretary of State is a man in denial. What does he say to the chief executive of the Patients Association, who has said:

“It is a disgrace that patients are being denied access to surgical procedures that they would have had if they had needed them a year ago”?

What the Government are doing on the NHS is making things worse, not better. The Secretary of State is axing Labour’s patient guarantee on waiting times, he is breaking the promise of a real rise in NHS funding, he is wasting £2 billion on the Government’s top-down reorganisation and he is forcing market competition into all parts of the NHS. Does he not see that the NHS is rapidly becoming the Prime Minister’s biggest broken promise?

I can tell the right hon. Gentleman and the House exactly what we are doing. We are increasing the budget for the NHS by £10.7 billion over the next four years, contrary to what the Opposition told us they would do and what a Labour-led Assembly Government in Wales are doing. They are cutting the NHS budget in real terms.

Let me take one example. The number of hip operations in the first half of this financial year was 41,863, whereas in the previous period it was 39,114, and waiting times are stable, so the right hon. Gentleman’s assertion simply is not true. We are delivering an improving quality of care.

Let me give the right hon. Gentleman another example. As the Minister of State, my right hon. Friend the Member for Chelmsford (Mr Burns), said, not only are waiting times stable but infections are going down, with a reduction of 29% in C. diff rates and 35% in MRSA rates in our hospitals. Safer, higher-quality care—

Order. I am very grateful, but from now on we do need briefer answers—[Interruption.] No, we need briefer answers, because I want to accommodate Back-Bench Members. It is about them that I am concerned.

T2. I believe that the introduction of plain packaging for cigarettes would be gesture politics of the worst kind, that it would have no basis in evidence and that it would simply be a triumph for the nanny state—and an absurd one at that. Given that, does the Secretary of State believe that I am still a Conservative, and if so, is he? (44502)

I am happy to believe that we are both Conservatives. The coalition Government made a commitment in our public health White Paper to publishing a tobacco control plan. We will do so shortly, and the purpose will be very clear: to secure a further reduction in the number of people smoking, and as a consequence, a reduction in avoidable deaths and disease.

T4. What assessment has the Secretary of State made of epilepsy helplines in helping to save NHS costs? I have constituents who are able to live happy and fulfilled lives by talking with epilepsy specialist nurses on the phone rather than going into hospital, but unfortunately, it seems as if that service is under threat from the University hospital of North Staffordshire. What is Government policy, and will he look at the situation in north Staffordshire? (44504)

The hon. Gentleman is absolutely right to say that telephone services of the sort he describes play an invaluable role in giving people support. Again, we are at that point in the year when there are budget arguments between PCTs and hospitals, to which he refers. If he supplies me with further details on this case, I will happily write to him.

T3. The Secretary of State has visited Milton Keynes, so he will be well aware of the historical problems at the maternity unit there and, following the intervention of his Department, of the positive outcomes that have been achieved with one-to-one supervision for all mothers. I am convinced that the increased training of midwives has contributed to those outcomes, but may I press him to reassure the House that that level of training will continue? (44503)

Yes, I am very grateful to my hon. Friend and I share his wish for continuing improvement in the maternity services at Milton Keynes hospital. I can tell him and the House that we are delivering on our commitment to improve maternity services, which is at the heart of that wish. The number of midwifery training places commissioned for next year—2011-12—will be no less than this year, sustaining a record number of midwives in training. That will be on top of an increase between May and November 2010—after the coalition Government came in—of 296 additional midwives employed in the NHS.

T6. Following on from the question asked by my right hon. Friend the Member for Wentworth and Dearne (John Healey) on the £2 billion that the Secretary of State is using for his top-down reorganisation, does the Minister feel that that kind of money, which was not mentioned in the Conservative manifesto, would be better spent on health care and on building new hospitals? (44506)

May I tell the hon. Gentleman that his figures are wrong? The cost of the modernisation of the NHS is £1.4 billion by 2012-13. That will be recouped in savings that by the end of this Parliament will be £1.7 billion a year, every year till the end of the decade, of which every single penny will be reinvested in front-line services and for patients.

T5. A new primary care hospital opened in Redcar at the end of 2009. So far, the endoscopy unit and the two operating theatres are completely unused, and a state-of-the-art hydrotherapy pool has hardly been used. Will the Minister meet me to discuss that commissioning failure and to see how we can bring those facilities into use for the local community? (44505)

I understand that the PCT will continue to work with health care providers to develop existing and future services at Redcar primary care hospital, and to promote the availability of services, but I would be more than delighted to meet the hon. Gentleman to discuss that issue.

T7. Every 23 minutes, someone in the UK is diagnosed with a blood cancer disorder—that is 23,600 people per year, including many children. Survival often depends on a donor match. Today until 6 pm, the Anthony Nolan trust has a stand in Portcullis House, where people can get more information, and where those under 40 can register. Will the Minister join me in promoting the donor register and in encouraging MPs and staff to visit the stand? (44507)

I think that more than one of us wanted to do just that, because the Anthony Nolan trust does a fantastic job. The hon. Gentleman is right to raise awareness of it, and all hon. Members should take the opportunity to visit its stand today.

T8. Witham town council and my constituents are deeply concerned about the lack of local medical facilities serving our town. Will the Secretary of State reassure my constituents that under the new commissioning arrangements medical provision in our town will be able to expand? (44508)

I can give my hon. Friend the reassurance that in future her local general practices—together in a commissioning consortium—and their other health care professionals, meeting with the health and wellbeing board in the local authority, will be able to bring democratic accountability in order to ensure that they have in her town and surrounding area the necessary services, based on a strategic assessment of need in their area.

T9. The NHS in north-west London is facing a £1 billion shortfall in funding over the spending period. Is the Secretary of State surprised, therefore, that yesterday’s NHS Confederation survey of managers found that just 13% of managers thought that supporting GP commissioning was the highest priority, compared with 63% who thought that the cash crisis was the highest priority? Is it not the case that financial pressures are dictating the NHS reform agenda, rather than the other way around? (44509)

I remind the hon. Lady again that next year we are increasing NHS resources in real terms. There will be a 3% increase across England in resources for primary care trusts, and as she will know, PCT managers in London are being brought together into PCT groupings. I do not understand the survey. They have a responsibility both to improve clinical commissioning by supporting their GP groups, which are coming together across London to do this, and to ensure strong financial control.

How can the Secretary of State ensure that HIV and sexual health services receive sufficient local political attention?

Local attention, through the public health responsibilities that currently lie with PCTs, but which in future will lie with local authorities, is a means by which we can improve health and the health of some of the groups most at risk of HIV. We have a number of pilot schemes that my hon. Friend might know about and that we are currently assessing, which have looked at opportunistic HIV screening for the many people who are currently undiagnosed with HIV. That is encouraging, and we might well be able to follow up on it.

T10. Given that the chief medical officer does not have a background in public health, and despite the existence of Public Health England, should the Secretary of State not ensure that there is a public health expert on the national commissioning board, because that is where all the power lies? (44510)

I am surprised, because the hon. Lady is on the Select Committee on Health and should know that responsibility for public health will lie both with Public Health England, inside the Department of Health, and with local authorities. The NHS commissioning board will have a responsibility for prevention, but the population health responsibility will lie with Public Health England, and I have absolute confidence that Dame Sally Davies, the newly appointed chief medical officer, will be a leader in public health delivery, through Public Health England.

I represent a constituency with a young and highly mobile population. Younger women are very much over-represented among those who do not respond to routine invitations to screenings. Will Ministers promote the increasing use of mobile communications in inviting women to routine screening services?

That is certainly one way in which we can improve access, and it is one of many that we outlined in the improving cancer outcomes strategy that we published in January.

Given that the Prime Minister has ordered his new communications director to order a shake-up of the health team because he is worried that they are losing the argument on the Government’s health upheaval, would it not save us all a lot of trouble if the Secretary of State admitted, not least to the Prime Minister, that it is not the public relations that is the problem, but the policy?

The cancer drugs fund is available only for pharmaceutical drugs, but can it be used for wider support services, such as healers, aromatherapists, those using therapeutic touch and other such practitioners?

We are finalising the design of the future cancer drugs fund from April, and we will publish shortly. The interim cancer drugs fund is designed to support new effective medicines, based on clinical panels’ assessments of the needs of individual patients.

Today is international women’s day, so let me pass on the good wishes of the women of Darlington to the Secretary of State.

Indeed. However, what does the Secretary of State have to say to those women when they are angry and concerned at the proposal from the County Durham and Darlington foundation trust to move their maternity services from Darlington to Durham, 20 miles away?

I would be grateful if the hon. Lady conveyed my very best wishes to the women of Darlington on international women’s day and said to them that I know from my visits to the north-east that a general practice-led commissioning pathfinder consortium has come together in their area. It is with that consortium and their local authority that they should look at which services they think should be provided in their area, and they will have the power to make that happen.

What plans does my right hon. Friend have to increase the number of single rooms in the NHS? Increasing their number will help to tackle mixed-sex accommodation, and increase privacy and dignity in end-of-life care.

I thank my hon. Friend for that question. As was said earlier, privacy and dignity are central to all the care that we provide in the health service. Mixed-sex accommodation was not tackled by the previous Government; we are determined to tackle it now, and providing single rooms is part of that. Privacy and dignity must be maintained at all times.