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Topical Questions

Volume 531: debated on Tuesday 12 July 2011

My responsibility is to lead the national health service 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 that supports and protects vulnerable people.

Having met families and patients who use the children’s heart unit in Leeds, I know the value of that service. Does the Secretary of State agree that asking families to travel across the country, which is the stark reality they face if the unit is closed down, puts at risk the family support that is so important to children during these difficult times, and will he pledge to do all he can to keep the heart unit open?

I am sure that the hon. Lady will have heard the reply from the Minister of State, Department of Health, my right hon. Friend the Member for Chelmsford (Mr Burns), who explained the continuing process that the joint committee of primary care trusts will undertake. In the context of her question, it is important to make it clear that the intention of the review is not to close paediatric cardiac centres. Surgery in some of the centres might cease, depending on the conclusions the committee reaches, but they will continue to provide specialist non-surgical services for local populations. The review intends to ensure that as much non-surgical care is delivered as close to children’s homes as possible through the development of local congenital heart networks.

T2. Under the previous Government, Savernake hospital in my constituency was redeveloped. As a result, taxpayers have got stuck with nearly £1 million a year in private finance initiative unitary charges and local services offered have been cut drastically. Will the Minister undertake to look at all hospitals labouring under uneconomic PFI burdens and meet me to discuss the Savernake hospital situation specifically? (65133)

I am grateful to my hon. Friend, because she has been campaigning on this issue for more than a year, and rightly so. Work is being done on the whole issue of PFI and the NHS to ensure value for money. Given her concerns, I would be more than happy to meet to discuss this particular case.

I want to say to the Health Secretary directly that it is a disgrace how he and his Ministers have ducked responsibility for reassuring more than 30,000 elderly and vulnerable residents whose homes may be at risk because of the financial crisis at Southern Cross. Today’s urgent question is the second time in a month that this House has had to drag Ministers to Parliament to explain what is going on. Southern Cross is set to close down completely by October. Will the Secretary of State give a commitment this afternoon to the residents of Southern Cross, their families and 40,000 staff that Ministers will in future show leadership and make public statements to this House?

I am grateful to the right hon. Gentleman for his question. He will of course know that when the first urgent question was asked, the Government had already provided a written ministerial statement setting out these matters in great detail, and we are happy to answer the questions that hon. Members will want to put in the urgent question later on. We have also said throughout that we do not help the welfare or interests of residents by an ongoing running commentary on these matters.

T6. Despite the Government making available an additional £400 million for primary care trusts to support carers, I understand that my local Princess Royal Trust carers service is finding it very hard to engage with the local PCT in my constituency. Will Ministers remind PCTs to follow guidance and work with local carers’ organisations to develop plans for using the additional Government money that has been provided? (65140)

I share the hon. Gentleman’s concern. The NHS operating framework that the Government published last December makes it abundantly clear that primary care trusts need to work with their local authorities and care organisations to agree a budget and, where possible, to pool it so that it can be provided to individuals to enable them to get respite in the way that suits them best. I will certainly be pursuing this through the Government’s normal assurance processes to ensure that these things happen through the operating framework, but the hon. Gentleman might also want to invite his local overview and scrutiny committee to call to account local commissioners for the way in which they are behaving at the moment.

T3. NHS West Midlands is cutting nurse training next year by a fifth and predicting a reduction of 7.25% over five years in the qualifying work force—not bureaucrats, but nurses—thereby denying youngsters in this country training for a worthwhile profession and career. Is not this a scandal and a shambles, and what is the Minister going to do about it? (65134)

The right hon. Gentleman may not know this, but following representations made directly to me I have looked at this very carefully. The strategic health authority is currently responsible for the number of nursing commissions that it undertakes. It has assessed the number of commissions that it should undertake based on its future work force requirements and has reached the conclusion that it is indeed reducing the number of commissions in the west midlands. That is not true to the same extent in other strategic health authorities across the country. In the listening exercise conducted by the NHS Future Forum, further recommendations were made about how we can reform education and training, and we will be taking those forward to try to ensure that there is greater collective understanding of work force requirements.

Recent figures show that just over 40% of Bradfordians have not visited a dentist in the past two years, and many of my constituents say that that is simply because they cannot get an NHS dentist. Does the Minister agree that it would be extremely difficult for a centralised national commissioning board to deal with this insufficient supply of NHS dentists at a local level?

I am interested in my hon. Friend’s point. As he will have heard in response to an earlier question, we are already increasing access to NHS dentistry, with a 0.75 million increase in the space of a year. In fact, it is probably possible to address more effectively some of these questions of access to dentistry through a consistent national contract that can be responded to locally through the work of the health and well-being boards, which will be able to make their own recommendations through the joint strategic needs assessment.

T4. Given that the UK has the worst one-year and five-year survival rates for lung cancer compared with Australia, Canada, Norway, Sweden and Denmark, as has been highlighted today by the Roy Castle Lung Cancer Foundation report, what measures is the Secretary of State taking to improve the detection of lung cancer symptoms in primary care? (65135)

The hon. Lady will know that we are focusing, as I said in response to an earlier question, on improving survival rates at one and five years for lung cancer, among other cancers. One essential task is to improve public awareness of the symptoms of lung cancer, and we are already piloting means by which we can do that. At the same time, there have been research trials on the effectiveness of X-ray screening for lung cancer, and we will look at the results shortly.

I have been contacted by a constituent who has just graduated in dentistry but has been unable to find a placement for his dental foundation year. What support are we giving such students so that we increase access to NHS dentistry?

I understand that more dentists are currently employed in the UK than ever before. My hon. Friend makes an important point and if she is able to provide further details, I will pursue it, because one objective of deaneries should be to ensure that the major investment that we put into the initial education of dentists is followed through in professional training.

T5. Some 3,500 residents at 98 Southern Cross care homes, including 48 residents at Arcadia Gardens in my constituency, are facing an uncertain future. The Scottish Government have today said that they will work on the presumption that those people will still be in their homes after this crisis. What discussions has the Secretary of State had with Scottish Ministers about finding new operators and a solution that does not show complacency, but delivers continuity of care for the residents? (65136)

That is exactly what the Government are doing. We have had those discussions with the devolved Administrations, and officials are engaged with the landlords and lenders to ensure that they are doing just that. I look forward to answering the urgent question shortly.

It is acknowledged that the rising rates of norovirus are worse where there is a shortage of acute hospital beds. How does the Secretary of State square the understandable desire to get on top of hospital-acquired infections with his zeal to reduce acute hospital beds?

I am grateful to the hon. Gentleman. He will understand that each hospital trust or acute trust must be responsible for ensuring that there is not an excessive length of stay for patients and that it has the ability to isolate patients if necessary. Norovirus is one circumstance in which trusts often have to open additional capacity. In my experience of hospitals, that is precisely what is generally done. There is an ability to open new capacity if necessary when norovirus strikes.

Consulting on changes to health services is not an easy thing to get right. I think that the Secretary of State would agree with that. Will he undertake to look at the consultation taking place in County Durham and Darlington on acute stroke services, because I and the local council believe it to be misleading?

I will, of course, look at that consultation, with which I am not directly familiar. The four tests that I set out shortly after the election—understanding patients’ current and prospective choice; understanding what is demanded by clinical safety and evidence; understanding the view of the public, as represented through the local authority; and understanding the intentions of commissioners, particularly the clinical commissioning groups that are being established—give a much stronger basis for understanding future configuration decisions.

I am sure that my right hon. Friend is aware of the campaign group Transplant 2013, which aims to increase the number of people on the organ donor register by 60% by 2013. Will he join me in encouraging people not only to sign up to the register, but to discuss that action with their families, so that when the time comes their whole family is aware of their wishes?

Yes, I join my hon. Friend in that. I have signed up to the organ donor register and have discussed that with my wife so that she knows my wishes. I encourage others to do the same. In the last few days, I have been to the retirement event of John Wallwork, who was the first surgeon to undertake a successful heart and lung transplant in this country. He has led the charitable activities on transplant over recent years. I know that he would share our desire for more organs to be available for this vital activity.

Has the Secretary of State had an opportunity to pause, reflect and listen to the NHS foundation trusts, particularly North Tees and Hartlepool NHS Trust, which serves part of my area, given the uncertainties created by the Health and Social Care Bill and the difficulties that they are encountering in raising capital for new build and modernisation? In particular, will he indicate what consideration he has given to detailed safeguards?

I appreciate that question, because I understand how important the issue is to the hon. Gentleman. We have had considerable discussions on this matter, which is currently being further discussed by the Department of Health and the Treasury. We hope to reach some decisions shortly, and he will be one of the first to know.

How can a consultation process on children’s heart units that includes the best unit in the country outside London, at Southampton general hospital, in only one out of four options and disregards the population of the Isle of Wight completely be anything other than fundamentally flawed?

As my hon. Friend will know from the debate that we had in the House a few weeks ago, it would be inappropriate for me to comment, because I must in no way be seen to be prejudging the issue. The inquiry and consultation is independent. However, I can say to him that the inquiry is not fixed on determining only four sites if the results of its consultation suggest that there should be more. The decision rests with the inquiry.

The Secretary of State will be aware that there has been a tripling of prescriptions for drugs such as Ritalin, or to give it its generic name methylphenidate hydrochloride, in the past decade. He will also know that National Institute for Health and Clinical Excellence guidelines state that those drugs should not be prescribed to children under the age of six. Why cannot his Department give a breakdown showing how many of those prescriptions are going to children under the age of six? Will he heed the call from the Association of Educational Psychologists for a review of the growth of the prescription of those powerful psycho-stimulants to very young children?

The right hon. Gentleman raises a very important point. We need to ensure that we have the right data to understand prescribing practice properly, so that we can both challenge bad practice and ensure that the NICE guidance is properly followed. I would like to look more closely at his points and then write to him in detail.

Will my right hon. Friend join me in congratulating advisers working for Bexley stop smoking service, who helped more than 1,600 people stop smoking last year? Does the Minister agree that helping people stop smoking should remain an important public health priority?

I am happy to join my hon. Friend in congratulating those who are making efforts locally. As he will be aware, public health services will move to local authorities, and I am sure those efforts will continue. Some 80,000 people a year die of smoking-related disease, and 320,000 young people are taking up smoking each year. We must not only help those who are smoking to stop but prevent young people from taking it up.

The number of patients waiting more than four hours in A and E went up by 76% in the past year, which is an extra 200,000 people. I think we all know what a hellish experience waiting in A and E can be. Does the Secretary of State agree that that is a backward step, and that he ought to take steps to rectify it?

Shortly after the election we took clinical and expert advice that made it very clear that the expectation that 98% of patients should be seen within four hours was not clinically appropriate in some cases, so we relaxed the 98% limit to 95%. As it happens, I believe that according to the latest data, between 97% and 97.5% of patients are being seen in under four hours.

Hospital admissions for food allergy went up by 500% between 1990 and 2006, and there are 15 million hay fever sufferers, which has a real impact on productivity, so we urgently need better allergy services. When will the Government report on the pilot in the north-west of England of a new model of allergy services?

I fear that I do not know when that will be available, but I will certainly write to the hon. Lady. I have visited the allergy unit at Addenbrooke’s hospital in my constituency, and I know how effective, and indeed cost-effective, such work can be in treating allergies.