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Topical Questions

Volume 556: debated on Tuesday 15 January 2013

We want to make 2013 the year we break down the stigma associated with dementia and transform the care and treatment received by the one in three over-65s who will get the condition at some stage. Today, the Alzheimer’s Society published a map showing the totally unacceptable variations in dementia diagnosis across the country, with some areas diagnosing fewer than a third of people who have the condition, thereby denying them the medicine and support that would help them live happily at home for much longer. We are determined to put this right.

Given that next week is designated as cervical cancer prevention week and we know that many women ignore, or do not recognise, the early symptoms of cervical cancer, what action will the Secretary of State take to raise awareness of cervical cancer symptoms?

That is a very important point. Every year we screen about 3.5 million women for cervical cancer and we think we save about 4,500 lives, but we could save many more. Our “Be Clear on Cancer” campaign is highlighting the four clear symptoms people need to watch out for: unexplained bleeding, weight loss, pain, and lumps.

T3. The Minister of State earlier failed to answer the key question on midwife numbers, so I wonder whether the Secretary of State could take it on. Before the last election, the Prime Minister made a firm pledge to increase the number of midwives by 3,000. Will the Secretary of State tell the House whether that pledge will be honoured or discarded along with all the other promises on the NHS? (136859)

The number is up by 800 already, but as the Labour Front-Bench team knows, it takes some time to train midwives. I say to the hon. Gentleman that none of the investment in additional midwives would be possible if we had a real-terms cut in the NHS budget, which is what his Front-Bench team wants.

T2. Many of my constituents in Jaywick have complained about local GP services, saying that there are too many locums and inadequate provision. In order to attract and retain good GPs in an area with a challenging work load, the local commissioning body needs to be able to offer them more favourable terms. Will the Minister ensure that there is sufficient local flexibility so that the commissioning body can do that? (136858)

My hon. Friend makes a very important point, putting his finger on a key issue: the 24-hour availability of GP services. That is going to be crucial as the NHS goes forward. The NHS medical director, Bruce Keogh, is looking at the whole issue of seven-day working in the NHS and will certainly be examining what flexibility needs to be given to local areas to make that possible.

T4. On 30 December, ambulances in north-east London were diverted from the Whipps Cross, Queen’s and Homerton hospitals, with only the accident and emergency units at the Royal London hospital and the King George hospital in Ilford being open. Last week, on 8 January, Queen’s hospital in Romford was again diverting ambulances. Will the new Secretary of State look at the decision of his predecessor, whom I see on the Bench near him, and cancel the insane decision to close the accident and emergency unit at King George hospital? (136860)

The decision has been taken, but we have made it absolutely clear that we will not proceed with implementing it until there is sufficient capacity in the area, particularly at Queen’s hospital in Romford, to cope with any additional pressures caused by it, and that undertaking remains.

T5. The NHS has confirmed that North Yorkshire is the only part of the country that will inherit a £19 million debt, which has to be carried by the new clinical commissioning groups. That was the situation we were promised we would never be in. What is the Secretary of State going to do to urgently address the chronic underfunding of rural areas for the NHS in North Yorkshire? (136861)

My hon. Friend and I have previously discussed this matter, and she is right to highlight that there are particular challenges to address in rural areas, in terms of both distances to travel and an ageing population requiring considerable health care resources. That will of course be a matter for the NHS Commissioning Board to examine when it considers future funding allocations.

T6. As one in three women who get cancer are over the age of 70, can the Minister say when the newly launched Be Clear on Cancer campaign will be rolled out nationally? (136862)

It is our intention to roll it out nationally as soon as possible, and I will make sure that the hon. Lady gets the exact details.

T9. Many of my constituents are concerned by the Care Quality Commission’s recent findings at Milton Keynes hospital, which came despite an increase in nursing staff since 2010. What reassurances can my right hon. Friend give my constituents that the problems are being rectified and that they will be able to enjoy high-quality care? (136865)

First, let me say that substandard care simply will not be tolerated and it has to be taken extremely seriously. I understand that the trust involved is reviewing its staffing levels so that the necessary improvements can be made. It has also started two-hourly checks, during which nursing staff check that patients have everything they need to be both safe and comfortable. There is clearly a big challenge and the trust has to meet it.

T7. The implications of HIV go well beyond health issues alone, yet the Government have so far refused to implement a new, cross-departmental HIV strategy. The Scottish and Welsh Governments have implemented their own such strategies, but 95% of people in the UK living with HIV reside in England. Will the Secretary of State commit to discussing this issue with his Cabinet colleagues, particularly those in the Department for Work and Pensions and the Department for Education? (136863)

I take extremely seriously the point that the hon. Lady makes. It seems to make more sense to be part of a comprehensive, integrated sexual health strategy, which the Government are planning and which will be published very soon. Services tend to be delivered together in the same units, so it makes sense to have a single strategy to deal with all those issues.

T10. In the light of widespread representations from constituents about the proposals for the centralisation of pathology services, will my right hon. Friend the Secretary of State consider the clinical concerns very carefully before any such changes are sanctioned? (136866)

I thank my hon. Friend for that question and he is right to highlight the fact that any decisions about service reconfigurations must be clinically led, as was outlined in the Government’s tests for any service reconfiguration.

T8. Last week, the Secretary of State refused my request to meet a small group of local GPs, hospital doctors and residents who are opposed to the closure of accident and emergency and maternity at Lewisham hospital, yet in his former role he seemed very happy to trade hundreds of texts with Rupert Murdoch’s lobbyists about the purchase of BSkyB by News Corp. Why is it one rule for Rupert Murdoch’s lobbyists and another for doctors in Lewisham? (136864)

I think that the hon. Lady might perhaps read Lord Leveson’s conclusions before she starts hurling about allegations, many of which came from her side of the House, that were later shown to be totally false. With respect to the decision on Lewisham hospital, I thought that we had a very useful meeting last night with the south London MPs who are directly affected. She understands that the process put into law by her party and her Government means that I cannot reopen the entire consultation and start seeing some groups without seeing all groups that are affected. That is why I am limiting the discussions I have with colleagues, but I think that that is the right thing to do.

The evidence is compelling that improved access to talking therapies for children and adults makes a huge difference to their mental health. Will the Minister therefore assure me and the House that the NHS Commissioning Board will have the necessary dedicated teams to ensure that the adult improving access to psychological therapies—IAPT—programme is delivered and that the new children’s programme is, too?

I thank my hon. Friend for that question. The Government take the development of talking therapies extremely seriously and I can confirm that I met Lord Layard yesterday, together with representatives of the NHS Commissioning Board. There will be a central team and we are absolutely determined to keep driving this approach forward, as there is real evidence of results.

Today’s edition of The Daily Telegraph carries an article on dementia, including a quote from a GP who says that it is not useful to give an early diagnosis when there are no drug or care needs. Does the Minister agree that that GP, like many others, fails to realise that for pre-senile dementias in particular, early diagnosis allows planning and allows families to understand the confusion created by altered personalities, behaviour, emotional responses and language skills?

I know that the hon. Lady spoke very movingly in the debate on dementia last week and I wholeheartedly agree with her. The medicines available for people with dementia do not help everyone, but we do not know that until we try them. By diagnosing only 42% of people with dementia, as is currently the case, we are denying nearly two thirds of dementia sufferers the chance to see whether they could benefit from those medicines and, as she rightly says, the chance to plan their care, which could mean that they could live at home for much longer.

The all-party group on cancer is delighted that the one and five-year cancer survival indicators have been included in the CCG outcome indicator set. We have campaigned for that in the belief that it will drive forward earlier diagnosis, as the Secretary of State knows. Can he clarify how CCGs will be held to account through that indicator set? For example, what action will be taken on underperforming CCGs?

I congratulate my hon. Friend on his campaigning on cancer issues through the all-party group. The NHS Commissioning Board is held to account through the mandate, which clearly states that we must make tangible progress towards having the lowest mortality rates in Europe for cancer and a number of other major diseases. I will expect the board to clamp down hard on CCGs who fail to deliver on what needs to happen for them to deliver on that promise.

Cancer Research UK has expressed deep concern about the fragmentation of cancer services and the climate of uncertainty that makes it harder to improve them due to the Government’s NHS reorganisation. I appreciate that that is not the fault of the Secretary of State, but he has the power to do something about it. Will he listen to Cancer Research UK and stop the fragmentation of cancer services?

Of course, I understand the concerns of Cancer Research, and I know that the hon. Gentleman understands the personal tragedy that cancer can cause. The change in the clinical networks is happening because we want them to cover dementia, which we were talking about earlier, mental health services and maternity and paediatric services. It is right that they should do so, but I want to make absolutely sure that as we go through the restructuring the benefits of the cancer clinical networks remain as strong as ever.

Will my right hon. Friend look at the east midlands cancer drugs fund? While I welcome the cancer drugs fund enormously, the east midlands will yet again underspend, leaving some of my constituents paying for their own treatment because they have been refused funding. Will my right hon. Friend please get his Department to investigate why?

My hon. Friend has mentioned the issue to me before, and I am happy to look into it in detail for her.

It will be very easy to look at the number of lives saved. We will be able to see the impact of the fund, because it only started in 2010.

Kettering has the sixth fastest household growth rate in England, and accident and emergency admissions to Kettering general hospital are now at 12% year on year. Will the Secretary of State ensure that the NHS funding formula reflects the very latest population estimates?

NHS funds are independently decided by the NHS Commissioning Board, and I know that is a key concern of the board. I visited Kettering hospital, so I know that it is a very busy hospital coping well in difficult circumstances.

Penalties on readmission rates were introduced to improve clinical practice, but patients suffering from sickle cell and thalassaemia in my constituency and elsewhere cause hospitals to be fined for readmission, even though it is often in the patient’s best clinical interest. Will the Minister once again reconsider exempting sickle cell and thalassaemia from the penalty?

The hon. Lady is right to raise concerns about specific groups. The direction of travel in reducing readmission rates has to be the right thing; far too many patients were bouncing back to hospital when they would have been better looked after in the community. The longer term answer for some conditions, such as heart disease and possibly sickle cell and thalassaemia, may be year-of-care tariffs, which we are looking at very closely, as is the NHS Commissioning Board.

The Secretary of State just referred to the new strategic clinical networks. As the cancer networks are merged with them, what safeguards are there to stem the loss of expertise in cancer and what specialist support will be available to CCGs trying to achieve the targets we have heard about?

The biggest safeguard is the fact that the Government have made it one of our key priorities to improve mortality rates for cancer to the best in Europe. That means we are putting in a huge amount; for example, we are investing £450 million in early diagnosis. There are many other measures, which shows how seriously we take it.

My 92-year-old constituent, Ron Lewin, was referred for minor oral surgery. He was eventually written to by the specialist, who said that waiting lists were very long and that assessment appointments were available in 18 weeks, but that they did offer an independent service if he wished to be seen earlier. Independent obviously means paying to jump the queue. Is that how the Government propose to cut waiting lists?

It is a decision for front-line medical professionals to outline when treatment should or should not be given. Treatment must always be given on the basis of clinical need, so I am sure the hon. Lady will be feeding that message back to local commissioners. There is an opportunity for people to appeal against decisions when they are not made on the basis of clinical need, as that is clearly not the right thing and not in the interests of patients.

Will my right hon. Friend’s Department make an assessment of the effects on local air quality and public health of a potential third runway at Heathrow, and will he submit those findings to the Davies commission on airport capacity?

I am very happy to look into whether that is an area where my Department should take responsibility.

My constituent, Elaine Catterick, has had a serious operation at the James Cook hospital on Teesside cancelled twice in three months—once with just a few hours’ notice. She has also learned that there are twice-daily meetings at the hospital to decide whose operation should be cancelled next, as staff struggle to cope with spending cuts. I hope that is not what the Secretary of State wanted from his reforms, so what is he going to do about it?

All cancelled operations are a concern. The number of cancelled operations was about 50% higher as a proportion of all operations under the previous Government, but no operation should be cancelled, and we will continue to do what we can to bring down the numbers.

Order. My apologies to colleagues whom I could not accommodate but, as usual with Health questions, demand massively outstrips supply.