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Topical Questions

Volume 561: debated on Tuesday 16 April 2013

In a week when we are remembering the remarkable contribution made by Margaret Thatcher to our national life, we should also mark the extraordinary contribution made by someone else who died last week—Professor Sir Robert Edwards, the Nobel prize-winning doctor who pioneered modern IVF treatment. One in seven couples in this country experience fertility problems and he has given them hope and, in many cases, wonderful happiness. The whole House will want to applaud not just his scientific boldness, but his moral courage in confronting what was considered at the time to be an extremely difficult ethical issue.

In the light of the recent measles outbreak in south Wales, does my right hon. Friend agree that the claims made by Dr Andrew Wakefield about the MMR vaccine are both discredited and completely wrong?

I absolutely agree with my hon. Friend. What Andrew Wakefield said had no scientific basis and caused huge damage and worry to many thousands of parents. It is very important to reiterate that the scientific way to prevent measles, which can be a horrible and even a fatal disease, is to make sure that children have had two doses of MMR. Parents of children of any age who have not had those doses should contact their GP, particularly in the current circumstances.

Accident and emergency departments across England are being closed, even though all are under intense pressure. For 11 weeks running, the NHS has missed the Government’s national A and E target. Last week, in places, one in three patients waited more than four hours in scenes not seen since the bad old days of the mid-1990s. What clearer symbol of the growing crisis in A and E is there than a tent as a makeshift ward in the car park at Norwich? The Secretary of State’s failure to address that cannot continue. Nursing jobs have been lost, ambulances are queuing outside A and E and patients are being treated in car parks. When will he get a grip?

The statistic that the right hon. Gentleman will not give the House is that for the year as a whole, which ended last March, the Government hit our A and E target. Furthermore, he still will not tell the House about the disaster that is happening in Labour-controlled Wales, where the A and E target has not been hit since 2009. He still refuses to condemn what is happening there. There is a lot of pressure on A and E, because 1 million more people are using A and E every year, compared with just two years ago. What are the root causes? They are poor primary care alternatives that date directly to the disastrous GP contract negotiated by his Government, since when more than 4 million additional people have been using A and E every year, social care and hospital sectors that are not joined up—Labour had 13 years to sort that out but did nothing—and problems in recruitment that have been made a great deal worse by his disastrous decision to implement the working time directive. It is time he sorted out his own issues before trying to criticise the Government for sorting them out.

T2. The all-party group on men’s health, of which I am vice-chairman, has assisted in research that seems to show that men’s poor sexual health is often symptomatic of more serious problems, such as type 2 diabetes and cardiovascular disease. Will my hon. Friend assure me that all robust measures are being put in place to ensure that that is not overlooked and that men do not die unnecessarily because that situation is taken for granted? (150789)

I completely agree with everything my hon. Friend has said, and the sexual health document we published in March relates specifically to those matters. Men are not very good at going to see their GP, a nurse or another health professional when they fear that they might need some sort of assistance. It is beholden on all men to follow the lead of women.

T5. Evidence from the all-party muscular dystrophy group’s inquiry into access to high-cost drugs for rare diseases has highlighted the importance in clinical trials of centres of excellence, such as the International Centre for Life, which is based in Newcastle. Will the Minister, with NHS North of England, meet me to discuss changes to specialist neuromuscular care in my area as a result of the new NHS set-up? (150792)

I am tempted to say no, but I would not get away with it—so, yes, of course the hon. Lady can join all the rest and arrange to meet me. I would be very happy to discuss her concerns. While I am at the Dispatch Box, may I pay tribute to the International Centre for Life, which does really important work?

T3. The all-party group on global tuberculosis has just published a report on rising rates of drug-resistant TB. One recommendation is for a national strategy for TB in the UK. Will the Minister comment on that? The officers of the all-party group would also be grateful if he fitted us into his very busy schedule of meetings. (150790)

My hon. Friend the Member for North Norfolk (Norman Lamb) is having a break on that one. The continuing outbreaks of TB cause a lot of concern, especially in certain communities. I have no hesitation in agreeing to meet my hon. Friend to explain what NHS England is doing and the development of a national strategy.

Here comes another request for a meeting with the very obliging Minister. Last month he promised the House that he would rewrite the section 75 regulations to rule out enforced competitive tendering in the NHS. However, before Easter the respected House of Lords Secondary Legislation Scrutiny Committee said this of his redraft:

“The substitute Regulations are substantially the same as the original Regulations.”

It is no surprise that it seems to many that the Government are intent on privatisation by the back door, putting large parts of the NHS up for sale. With a crunch vote in the Lords next week, it is turning into another shambles. I make this offer to the Minister: will he again agree to withdraw the regulations and to sit down with us and the professions this week and come up with wording that is acceptable to all?

This really is the most outrageous scaremongering from the Labour party. In March 2010, the Labour Government issued guidance on European procurement law that described the limited circumstances in which one could avoid going out to tender. The wording used in these regulations is exactly the same as that used by Labour in March 2010, yet Labour Members will not admit that. There are also added safeguards in the redrafted regulations to ensure that there is a clear incentive for integrating and co-ordinating services for the benefit of patients.

T4. The Secretary of State is aware of the widespread management failures of East of England ambulance trust, and last month we saw the belated resignation of its chair. Will he ensure that the trust makes patient care the No. 1 priority, and will he join me in calling for its remaining non-executive directors, who presided over these management failings, to reflect on their own positions? (150791)

I congratulate my hon. Friend on her campaigning on this. There must be full accountability for what went wrong in that ambulance trust. It is absolutely a top priority for me and my Ministers, two of whom represent Norfolk and Suffolk, to sort out what is happening in the trust, and that is why very decisive action has been taken.

T7. Further to the question from my hon. Friend the Member for Newcastle upon Tyne Central (Chi Onwurah), several of my constituents with desperately ill relatives are very angry about the Government referring to NICE a decision on the use of eculizumab. The continuing delay is risking lives and also means that people have several invasive treatments that could well cost more. To save space in the Minister’s diary, may I add a request to join the meeting with my hon. Friend to talk about how this dangerous delay is causing very great distress to many constituents? (150794)

The hon. Lady raises a very important point, and I would be delighted for her to join the meeting rather than my having another one.

T8. Kettering general hospital’s new £30 million foundation wing has a new 16-bed intensive care unit, 28-bed cardiac unit and 32-bed children’s unit, and it opens to patients for the first time this coming Saturday. Will my right hon. Friend the Secretary of State take this opportunity to congratulate all those at Kettering general hospital who have brought this project to fruition? (150795)

I would be absolutely delighted to do that. I had an excellent visit to Kettering hospital that was hosted by my hon. Friend, and I saw at first hand just how hard people are working in tough circumstances, with big increases in A and E admissions causing a great deal of pressure throughout the hospital. One had a sense at the hospital that there was a mission to turn things around and make things better, and a management team who were totally committed to doing that. I congratulate them and all the front-line staff who are doing such an important job for the people of Kettering.

A year ago, GPs in Hackney bid to run the out-of-hours services. Earlier this year, they were told that it had to be tendered because the board was fearful of legal challenge from private health companies. Who is running the NHS—the Secretary of State or the private health company lawyers?

That is an absolutely extraordinary question given that it was the previous Labour Government’s decision to contract out out-of-hours services in the first place, which has led to the massive pressure on so many A and Es. The regulations in place for many of these arrangements were laid by the previous Labour Government.

T9. What is the Department doing to deal with the difficulties presented by poor data sharing between health and social care agencies and the threat to integration that that presents? (150796)

My hon. Friend makes a very good point, and I pay tribute to him for raising this issue frequently. We will not have properly integrated, joined-up health and care services unless we crack the issue of data sharing. There need to be protections for people so that they can prevent their data from being shared if they do not want that, but by the same merit we have to make sure that there is better availability. For example, delayed discharges from hospitals, which are causing pressure on A and Es, would be directly helped if we cracked this. That is why we have called for a paperless NHS by 2018.

Under the previous Government, my constituents could get an appointment with their GP within 48 hours. I recently heard of a wait for a routine appointment taking three weeks. Is not this one of the reasons there is such pressure on A and Es, and will the Secretary of State reintroduce the 48-hour appointment?

The reason there is so much pressure on A and Es is the disastrous GP contract negotiated by the hon. Lady’s party in government, since when—I do not know whether she was listening to what I said earlier—an additional 4 million people every year are going to our A and Es. That is what is causing the huge pressure, and that is what we are determined to put right.

T10. The Secretary of State will know that the number of people donating organs after their death has risen by 50% in the past five years. Does he credit the network of specialist nurses who support bereaved families in hospital for that increase and, if so, what lessons does he take from that? (150797)

This is an example of a programme that has been a huge success and I pay tribute to the work done by the previous Government as well as this Government in making sure that we can tackle this very serious problem. All I would say to my hon. Friend is that three people still die every day, I believe, because we are not able to get the organ donations we need. We should not think that, despite the success, we have solved this problem. There is much work to do and I personally think that it is something that everyone should think about doing. It can be a source of personal pride to put oneself on the organ donation list and we should all encourage our constituents to think about it as well.

I have listened very carefully to what the Secretary of State has said on A and E, but he has not addressed the fact that under the previous Government waiting times reduced and under his Government they are growing and are now at their longest for more than a decade, so what is he going to do?

As I said to the right hon. Member for Leigh (Andy Burnham) earlier, we actually hit our A and E waiting time target last year. If the hon. Lady is talking about waiting times in general, the number of people waiting for more than a year for an operation was 18,000 under the previous Government, and the figure has fallen to just 800 under this Government.

If there is a smidgeon of space in any of the Ministers’ diaries, is there a chance that they could meet me and representatives of the nursing profession to address not the issue that I think the Government are saying they are opposed to—mandatory nurse to patient ratios on wards—but that of adequate registered nurse levels on hospital wards?

Of course, I would be very happy to meet my hon. Friend to discuss this matter further. He can be reassured that I have regular discussions on these matters with representatives from the nursing profession, both in my clinical work and, more specifically, in my ministerial roles.

The Secretary of State said earlier that 1 million extra people are attending A and Es annually, but a few minutes later he said that the figure was 4 million. Which one is it?

It is an additional 4 million since the disastrous changes to the GP contract and an additional 1 million since the last election.

In Brixham in my constituency, 94% of five-year-olds are protected against measles. Just up the road in Totnes the figure is only 70%. There are many reasons for the variation, but does the Secretary of State share my concern that if parents believe they are protected by, for example, homeopathy products, they might be less likely to use an evidence-based treatment? Will he make an unequivocal statement that such products will not give any protection?

I am happy to do so and thank my hon. Friend for bringing up the issue. There is no scientific evidence whatsoever that homeopathic products can provide protection against measles. The right thing to do is to get two doses of the MMR jab. As I said earlier, anyone whose children, whatever their age, have not had those two doses should contact their GP.

As we have heard, A and E waiting times are at their worst level for a decade, yet we hear of proposed A and E reconfigurations based on tackling so-called inappropriate presentations. Does the Secretary of State agree that that approach is the wrong way around and that he would be better off tackling why people are going to A and E first, before he embarks on any reconfigurations?

That is exactly what we are doing. We are looking at the root causes of the fact that admissions to A and E are going up so fast—namely, that there is such poor primary care provision; that, as we discussed earlier, changes to the GP contract led to a big decline in the availability of out-of-hour services; and, that health and social care services are so badly joined up. That is how we are going to tackle this issue with A and E, and that is what we are doing.

I am delighted to learn that there will shortly be a new national clinical director for neurological conditions, focusing in particular on conditions such as Tourette’s syndrome. Will the Secretary of State reassure us that that appointment, which is so long overdue, will be expedited at the earliest opportunity?

I agree with the hon. Gentleman about the real value of this appointment and I think that the clinical director’s work will emphasise the importance of addressing conditions such as that to which he referred. I am delighted that the hon. Gentleman is showing such clear support for this initiative.