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Topical Questions

Volume 542: debated on Tuesday 27 March 2012

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.

An estimated 50,000 people, mostly men, are misusing anabolic steroids to build muscle, which can result in liver cancer, depression, a damaged immune system, kidney problems and cardiovascular disease. Will the Secretary of State examine the public health implications of the 56% rise in steroid misuse over five years? Will he work to address its causes, such as body image anxiety, as well as just treating the problem?

I am grateful to my hon. Friend for making a good and important point. My right hon. Friend the Home Secretary will be subjecting these drugs to greater control under the Misuse of Drugs Act 1971, restricting their illegal import into this country. Controlling supply is one part of the effort. Prevention is also important; people need to be fully aware of the risks to their health. The FRANK service, which provides advice to young people and parents about drugs misuse, will make it clear that the misuse of steroids is dangerous. I would encourage local areas to work with local businesses, such as gyms and fitness centres, to publicise those risks.

T2. The Department’s latest estimate shows that alcohol misuse costs the NHS £3.5 billion every year. Will the Secretary of State now champion a 50p minimum unit price? That would save more than 3,000 lives a year, rather than 1,000 a year, which is what his public health responsibility deal is expected to secure. (101898)

The hon. Gentleman should have welcomed the alcohol strategy that my right hon. Friend the Home Secretary published last Friday. Not only did we see the Government’s intention to introduce a unit price, but on that day 35 business organisations across the country collectively, under the responsibility deal, pledged themselves to take 1 billion units of alcohol out of the UK market in the course of a year.

T7. Many hospitals, including the Norfolk and Norwich university hospital, have reported a dramatic increase in alcohol-related admissions over the past 10 years, so I welcome the latest alcohol strategy. But what steps is the Secretary of State taking to support the expansion of treatment and early interventions for dependent and harmful drinkers in Norfolk and elsewhere? (101905)

I am grateful to my hon. Friend for his question, and he is absolutely right to identify the priority that this Government are now placing on dealing with the harm caused by alcohol, not least because of the 1.2 million alcohol-related hospital admissions. The strategy outlined by the Home Secretary last week is about education and raising awareness; enforcement; and treatment—making sure that the treatment services are more widely spread. It is also about recognising that this is a cross-government responsibility, not the responsibility of any one Department. That is why the proposals to use a national minimum unit pricing policy will tackle cheap booze and the binge culture.

T3. We now know that the Conservatives have received more than £8 million in donations from private health care companies since 2001. This goes beyond simply cash for access to a much more sinister issue of cash for policy influence. Ministers have said that they do not expect any increase in private sector provision in the NHS, but how will this be measured in years to come? (101899)

Nobody buys influence over the policy of the Conservative party or the coalition Government. That is in complete contrast to the situation with the right hon. Member for Leigh (Andy Burnham) and his friends on the Opposition Front Bench, who are the wholly owned subsidiaries of the trade unions.

T8. Could my right hon. Friend indicate how he proposes to use his welcome new duty to reduce health inequalities under the Health and Social Care Bill? (101906)

I am extremely grateful to my hon. Friend for that question. As he will be aware from his time on the Bill Committee this Government have for the first time in the 64 years of the NHS put into legislation a duty to reduce health inequalities. That will be done through the NHS Commissioning Board and clinical commissioning groups, each being under a duty to have regard to the need to reduce inequalities in access to and the outcomes of health care. The Secretary of State will also have a wider duty to have regard to the need to reduce inequalities relating to the health service. That will include his duties for both the NHS and public health. It is a great step forward and I am surprised that the previous Government did not think of doing it during their 13 years.

T4. At a time of major upheaval in the national health service, the people of west Lancashire and other areas of Lancashire are being failed by the chief executive of the Lancashire primary care trust cluster. Living in Yorkshire and working from Lancaster, Janet Soo-Chung has failed to meet with me or other colleagues, including my hon. Friend the Member for Chorley (Mr Hoyle). Can the Secretary of State assure me that the necessary time and development is being invested in health services in west Lancashire to ensure that authorisation takes place in a timely way without conditions and that the health services provided to my constituents are good? (101900)

I will, of course, ask Janet if she will meet the hon. Lady and her colleagues, but I think the hon. Lady might have noted that the NHS is performing magnificently. The quarter document published just this morning gives details of 14 performance measures across the NHS, in five of which performance has been maintained and in nine of which there has been improvement, so there has been no deterioration in performance. When the hon. Lady gets to her feet she should say to the NHS, “Well done for improving performance.”

Currently, there is a review into paediatric cardiac services going on. I recognise that that is independent of Government, but we now have the independent analysis of patient flows, which says exactly what we have been saying—that patients in south and west Yorkshire will not go to Newcastle. Does my right hon. Friend agree that this is an important development and that the options should reflect that because this is a serious problem for heart services in the north of England?

I congratulate my hon. Friend on his persistent championing of his constituents, but sadly I cannot be drawn into a discussion about evidence, facts and figures that might come up around this issue, because as he will appreciate it is an independent review which is divorced from Ministers.

T5. Mindfulness-based meditation techniques have been deemed by the National Institute for Health and Clinical Excellence to be more effective than drug-based therapy in the treatment of recurring depression in many circumstances. Will the Minister tell the House his views on mindfulness-based techniques and say what other conditions and diseases he thinks would benefit from such therapy? (101902)

The Government are committed to extending the range of NICE approved therapies when it comes to access to talking therapies. Certainly, we will look very carefully at how we extend it in the area he has suggested. I will write to him in further detail about this.

What reassurance can the Secretary of State give to Members of Parliament representing areas that have received an allocation from the formula which has been significantly below their target, given the change in arrangements to clinical commissioning groups in future?

My hon. Friend will be aware that the distance from target on the existing formula for Cornwall in particular has narrowed and is only just over 2%. For the future, I hope that he and all hon. Members will take considerable reassurance from the fact that not only will the formula continue to be the subject of independent advice, but new statutory provisions will set out that it should be intended to reflect the prospective burden of disease in each area, so it should be matched as closely as possible to the need for services in each area.

T6. The Government say that clinicians understand patients best, but there are doctors in Walthamstow who will not provide contraceptives to local women, and we now have one of the highest rates of teen pregnancy and repeat abortions in the country. Will the Ministers agree to meet women from my constituency and help them understand who, under the new system and the new layers of bureaucracy, they can hold to account for these problems—yes or no? (101904)

The hon. Lady should first have expressed a welcome for the fact that there has been a further reduction overall in the numbers of teenage pregnancies. As she knows, in her constituency there are doctors who, as she says, do not provide contraceptives, but there are also many other practices that do—17 out 18 GP practices in Walthamstow provide contraceptive services. There was a 60% increase in a decade in the number of managers in her area and the result seems to be that she does not understand how services were managed in Walthamstow. Under local authorities and the clinical commissioning groups in the future, there will be a clearer system.

No one could accuse the Secretary of State of being other than comprehensive. We are grateful to him.

The Secretary of State will be aware that under the allocation formula a number of PCTs have built up historic deficits, which have required us in Warrington, for example, to reduce our in vitro fertilisation services. Can the Minister confirm that with the transfer to GP commissioning, those historic deficits will be written off, which will in effect inject large amounts of money into local health economies such as Warrington’s?

I hope I can reassure my hon. Friend. PCTs carrying legacy debt into 2012-13 must clear it. Clinical commissioning groups will not be responsible for resolving primary care trust legacy debt that arose prior to 2011-12. It is expected that aspirant CCGs will continue to work closely with primary care trusts and primary care trust clusters in 2012-13 to ensure that no PCT ends 2012-13 in a deficit position.

One NHS consultant told me that

“NHS reorganisation could mean that you are forced to spend around 10% of your income on private health care insurance.”

Does the Secretary of State accept that the doctor is right to say that people will either wait longer for care or they will have to pay for it?

That is complete rubbish. The legislation is absolutely clear that it does not lead to privatisation, it does not promote privatisation, it does not permit privatisation and it does not allow any increase in charges in the NHS. It simply creates a level playing field so that NHS providers will not be disadvantaged compared to the private sector, as they were under a Labour Government.

The present Wycombe hospital consultation has proceeded with a number of hiccups, not least because of the false sense of local accountability engendered by Labour’s top-down system of health management. Will the Secretary of State meet me and a small delegation of my constituents to discuss how things will improve under his reforms?

Of course. I will be glad to meet my hon. Friend and his constituents. I recall how he has been an advocate on their behalf in the past and a vocal advocate of services in Wycombe. I emphasise to my hon. Friend that we are looking towards not only the clinical commissioning groups, but the local authorities injecting further democratic accountability so that in his constituency and those across the country we see much greater local ownership and accountability for the design of services.

The Chancellor’s evidence to the independent pay review body chairs last week contained curious if not dubious references to nursing pay and non-nursing pay, and possible outcome linkages of those. Does the Secretary of State understand those and can he explain them?

The hon. Gentleman will know that we have asked the pay review bodies to look at the aspects of pay related to market conditions, and I do not want to prejudice that. They will come back with their advice on that.

I welcome the Prime Minister’s announcement yesterday on dementia care. What assurances can the Secretary of State give me that this will be an aggressive strategy, looking at matters such as new access to drugs, early diagnosis and support for carers of those with dementia?

Not only were there the announcements made yesterday, but as part of that there was the establishment of three sets of champions, including Angela Rippon and Jeremy Hughes from the Alzheimer’s Society, working together as champions to raise awareness and understanding, Ian Carruthers and Sarah Pickup as champions on improving treatment and care, and Dame Sally Davies, the chief medical officer, and Mark Walport from the Wellcome Trust, as champions for research. Their objective is specifically, as the Prime Minister told them, to hold our feet to the fire, not only for the ambitions we set out yesterday, but for going further and faster.

On 24 February, my constituent, Audrey Kay, died after a litany of poor treatment. Will the Minister meet her son and me to hear Audrey’s treatment story?

Is the Minister aware of the publication today of the industrial action review by the London ambulance service, which details that on 30 November, the day of the public service strikes, in the afternoon and the evening, requests for front-line staff to return to front-line ambulances were made by the London ambulance service. However, of the three unions to strike, only Unison responded to say that it would not ask staff to return to work. Three hours later, after three repeated requests for help, a patient who had been unable to get an ambulance had died. The report has called—

Order. The hon. Gentleman should resume his seat. I do not wish to be unkind, but topical questions are about short questions, and that was not. I am very sorry. The Minister may give a brief reply if he wishes.

The industrial action to which my hon. Friend refers showed both the best and the worst sides of industrial relations in this country. On the one hand, it showed the worst excesses of union militancy and intransigence in failing to put effective contingency plans in place ahead of strike day, and then in refusing to call off the strike. On the other hand, it showed the best traditions of public services when the Metropolitan police, St John Ambulance and many out-of-hour providers came to the aid of the London ambulance service. Were it not for their help, the situation could have been even more serious.

The Minister’s power to anticipate what will be said to him is extremely impressive, and I congratulate him immensely warmly.

One year on in the responsibility deal we are seeing successes, including the elimination of artificial trans fats, further reductions in salt in manufactured foods, and over 8,000 high street outlets sharing and showing calorie information. The monitoring and evaluation of the deal is vital. We are committed to this and we are making up to £1 million available to fund an independent evaluation.

Order. I thank colleagues for their co-operation. I am sorry to disappoint those who were waiting, but we must move on.