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Tuberculosis

Volume 542: debated on Tuesday 27 March 2012

Provisional numbers of tuberculosis cases in England in 2011 increased by 556 compared with 2010, although the number of cases is lower than in 2009. This may indicate that TB is stabilising, but it is too early to draw firm conclusions. We expect local NHS organisations, in partnership with other agencies, to sustain their efforts to control TB. On 23 March, the National Institute for Health and Clinical Excellence published new guidance to help the NHS manage TB in hard-to-reach groups, including collaborative commissioning.

I thank the Minister for his answer. London has the highest rate of TB of any city in western Europe, with more than 3,000 cases a year. When faced with the same problem in Paris and New York, respective Governments committed to increasing resources and a clear model of care. Given the scale of the problem here, and the growing concern about drug-resistant TB, will the Secretary of State commit to implementing the London model of care for TB services that was developed by TB health professionals and advocacy groups to stop this ever-worsening problem?

I know that the hon. Gentleman takes a close interest in this matter. He is a member of the all-party group on tuberculosis, and I believe he is meeting the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton) to discuss these matters further. He is right that this is a big issue in London as well as a global issue. The Department is working closely with TB Alert, the tuberculosis charity, which is running a series of programmes to raise awareness. It is working with the NHS and the voluntary sector, particularly in communities with higher risk populations, and we are working with the Royal College of General Practitioners to develop an online resource to promote the better detection and treatment of TB in primary care. I hope that he can explore these issues further, but the Government take them very seriously and are working with other agencies to make progress.

It was 50 years ago that my dad moved on from being research secretary at the British Tuberculosis Association at Harefield because, in the 1950s, TB had ceased to be a killer in the UK. It is a tragedy that it has now come back, largely as a consequence of people with infectivity from overseas bringing TB into the country. What more can be done to enhance the screening of travellers from high-infection areas entering the UK so that those infected with TB can be identified and treated before they infect others in the population here?

My hon. Friend makes an important point about one aspect of the better control of TB and its spread. The Home Office has been running a pilot programme for some years. It continues to evaluate the effectiveness of that programme with a view to establishing whether it is more widely applicable. We know that this disease has moved from the general population to specific high-risk groups, which is why the targeted approach I mentioned in my initial answer is the key to controlling it.

The Minister has heard that TB is a particular problem in London—there was an 8% rise last year—and he will be aware that the current difficulties concern delays in detection and referral and the variability of commissioning and service provision. Given that the Health and Social Care Bill will necessarily lead to further fragmentation, separating health protection and public health from commissioning, how will he ensure that the Bill does not make a bad situation, in respect of TB in London, worse?

The Bill will not lead to fragmentation. It actually supports greater integration of health, social care and public health and, at a local level, it allows health and wellbeing boards to become the means by which to co-ordinate all the agencies that have a part to play when it comes to tackling TB, not least in ensuring that the advice of public health officials benefits not just the NHS but wider public services that also have a role to play in raising awareness of the disease and ensuring that it is properly tackled.