There have been two important developments since the previous Health questions. First, in response to pressure on A and E departments, my Department, together with NHS England, has started work on a vulnerable older people’s plan that will act quickly to address the underlying causes of the issues, including services that are not integrated, poor IT systems, confused emergency care offered to the public and poor primary care alternatives.
Secondly, following the tragedy at Mid Staffs, I am delighted to announced that Professor Sir Mike Richards has been appointed as England’s first ever chief inspector of hospitals. He is an inspirational leader who has personally championed huge improvements in cancer survival rates. He will lead the vital work of driving up standards of safety and care throughout NHS hospitals.
My hon. Friend makes an important point. Talk to any A and E department in the country, and they will say that poor alternatives in the primary care sector are one of the things that are driving the pressures on them. It is important that we look at the structures put in place by the 2004 GP contract to see whether they are the right way to provide the care we need to give to older people.
Last week, the Select Committee on Health took expert evidence on the increased pressures in emergency departments and the causes of the worst A and E crisis in a decade. On Wednesday, the Chair of the Committee told this House that the 2004 GP contract
“is not why those pressures exist.”—[Official Report, 5 June 2013; Vol. 563, c. 1605.]
Will the Secretary of State tell us whether the right hon. Member for Charnwood (Mr Dorrell) is wrong?
I advise the hon. Lady to listen more carefully to what the Chair of the Select Committee said. He actually said that he agreed with much of what I said on the GP contract. While the Opposition are defending the status quo of the 2004 contract, independent support for reforming primary care is coming from the College of Emergency Medicine, the Royal College of Physicians, the NHS Alliance, the Family Doctor Association and even the head of the Royal College of General Practitioners.
T2. In my borough of Southwark we have higher than average smoking rates, and the Cabinet member responsible for health has said that hundreds of people are dying early because they smoke. Can Ministers help me to persuade our Labour council that it is inconsistent to say “Don’t smoke” on the one hand and invest £2.6 million of pension funds in British American Tobacco on the other? (158892)
That is a good point, but I have to say that I am not convinced that it is just a Labour-run council that might have chosen to invest their staff pensions in this way; I strongly suspect that all political parties are guilty of this. While this is, of course, a matter for local authorities, it is also the sort of great campaigning work that MPs can do with their local councillors. It is even more important that they do that, given that they now have this great responsibility for public health.
T3. I welcome the leading role that the Department is taking in the formulation of a national strategy for TB. Its importance was reinforced by a recent all-party group report on resistant forms of the disease. One of the key points in the report was the importance of joint working in the development of the strategy, and that it should be public health-led. Does the Minister agree that NHS England also has a crucial role to play in the development of the strategy? Will she ensure that it works closely with Public Health England to develop it? (158893)
T7. Now that public health responsibilities have, as has been discussed, moved to local authorities and Public Health England, can the Government confirm that raising awareness of the signs and symptoms of cancer and early diagnosis, which is of course so important, will be key priorities for those bodies? Will the Minister tell the House how the Government will assess progress? (158897)
Again, that is a very good point. I completely agree with my hon. Friend and pay tribute to the work of his all-party group on breast cancer. Screening is important. This is also a good opportunity to pay tribute to the Secretary of State’s announcement today of the publication on the website of such outcomes, which will not only drive huge improvement in public health, but, most importantly, ensure that we reduce health inequalities. The previous Government failed to do that; this Government are determined that we will improve them.
T4. An enormous number of people—largely women—involved in on-street prostitution are caught in a cycle of drug and alcohol abuse, and are working to feed their habit, but at the same time, beyond managing drug dependency, many drug and alcohol services do not offer any practical pathways out of prostitution or even ask whether the client wishes to exit prostitution. Will Ministers look into this issue, consider issuing guidance and write to me? (158894)
Absolutely yes on all those very important points. The hon. Gentleman makes an extremely important point to which I absolutely subscribe. I have regular meetings on this matter, and I hope that our sexual health strategy addressed exactly those points, but I am more than happy not only to write, but to meet him to discuss the matter further. If I might say, I think that all Members, whatever the party political divide, could do far more both here and locally to reduce the number of women who find themselves working on the streets as prostitutes. I have long taken the view that these are some of the most vulnerable people in our society, and without exception I have never met a prostitute—I used to represent many of them—who has not herself been abused, usually as a child. They are vulnerable people and we should recognise them for that.
T8. More than 5,000 schools across the UK now serve good-quality, sustainable meals with the Food for Life catering mark, but only three hospitals have achieved the same. It is often said that hospitals cannot do so because of the cost implications, but the three that have done so not only have incurred no extra costs, but, in the case of Nottingham hospital, have actually saved significant amounts. May I urge my hon. Friend actively to encourage take-up of the Food for Life catering mark as a model of best practice? (158898)
We will certainly look into the issue that my hon. Friend raises, but he will be aware that there are campaigns throughout the NHS focused on supporting local food producers, which is important in many constituencies, particularly rural ones, and developing best practice and encouraging nutrition. Chefs such as James Martin have been involved in helping to drive up standards of care, particularly in Yorkshire and other parts of the country.
T5. I listened carefully to the Public Health Minister’s answer just three questions ago, but the Government have disproportionately cut funding to the most deprived local authorities, including Liverpool, and these local authorities have today been shown to have higher mortality rates. How does the Secretary of State expect to close, rather than widen, health inequalities? (158895)
We actually gave a real-terms increase to all areas, including Liverpool, and followed the independent advice. If funding for public health in Liverpool is lower than it should be, that is because the last Government set the baseline way lower than it should have been.
T9. For the last decade, in the face of constant threats of closure to Heatherwood and Wexham Park, I have campaigned alongside local councillors, activists and residents to try to get the right balance of services across my constituency. The people I work with are very reasonable, as is the Secretary of State, so will he meet me and a small delegation from Windsor to discuss their options? (158899)
T6. Three Health Ministers have indicated their support, and one even voted for it, so will the Secretary of State either introduce his own legislation or back new clause 17 to the Children and Families Bill to ban smoking in cars with children present? (158896)
Well, it is a very good point, and the hon. Gentleman knows my own feelings. [Laughter.] No; it is important that we always get the balance right between good public health measures and not getting the accusation from both sides of being a nanny state. [Interruption.] No, no; it is all right his getting agitated, but he knows my view, and I am happy to give him any assistance I can—my door is always open.
Does the Secretary of State agree that any criminal investigation into the 200 to 300 deaths at Mid Staffs should extend not only to front-line staff, who risk getting scapegoated, but to all managerial levels, Department of Health officials and the heart of Government, so that we get answers about who knew what and when, and what action they took or—more importantly—did not take that could have prevented this tragic scandal?
I congratulate my hon. Friend on her determined campaigning on this issue. She will agree that we must allow the law to follow its course. The police are looking at the five reports on hospital safety that were undertaken, the inquests and the lists of patients who appear to have been treated badly, and they are talking to the relatives of those patients. We must allow them to do their work, but no one is above the law, and particularly in this case it is important that justice be done.
T10. With the Department of Health having awarded Cleveland fire brigade £198,000 from its social enterprise investment fund, will the Minister confirm, pursuant to concerns raised by the Fire Industry Association, that his Department undertook an assessment as to the compliance with the European state aid regulations of the state’s funding of community interest companies that compete to take business away from the private sector? (158900)
This is cervical screening awareness week. What plans does the Minister have further to encourage women aged 60 to 64 to attend cervical screening, given the declining levels of screening uptake and the increasing levels of incidence in this age group?
Screening is one of the most important aspects of the work of Public Health England and we are keen to make sure that it is addressed both nationally and locally. Great work can be done by local authorities in making sure that women have this vital screening.
Is the Secretary of State aware of the alcohol treatment centre in the middle of Cardiff, which treats people who are drunk on Friday and Saturday nights and therefore takes pressure off A and E, ambulance services and the police? Will he look at this model, as we are in Swansea, and pilot it elsewhere?
Will my right hon. Friend clarify the position regarding NHS spending, in light of the recent comments from the shadow Health Secretary? My understanding is that spending increased from £99.7 billion in 2009-10 to £106 billion in 2012-13; an increase of £600 million, or 14,000 nurses or 6,000 doctors. Does not this show that the shadow Health Secretary’s reference to cuts is just irresponsible scaremongering?
My hon. Friend is right. There has been a £600 million real- terms increase in spending, something that the right hon. Member for Leigh (Andy Burnham) said was irresponsible. He will have to do a U-turn on this, and it will be an embarrassing one. He has talked about cuts in every single debate in the House and it turns out that those cuts never happened.
Life expectancy in Liverpool is 10 and a half years less than it is in Kensington and Chelsea. Does the Secretary of State think that he has any responsibility to address that?
Yes I do, which is why we have published a website today that gives much more detail than there ever has been before about health inequalities. it is why, nationally, the Government have been responsible for a huge amount of initiatives to boost public health, including calorie labelling in restaurants, action on point of sale display tobacco advertising, alcohol unit labelling and a range of other things. We will play our part.
In April, the BBC’s “Casualty” programme highlighted the vital role that health professionals have in spotting young girls at risk of being taken abroad or of having female genital mutilation carried out on them in this country. We are approaching the most difficult time of the year over the long summer holidays, when girls are most at risk. Will Ministers do all they can to draw the attention of health professionals to the vital role that they have in these critical next two months?
Absolutely, and I pay tribute to my hon. Friend and to other hon. Members on both sides of the Chamber for the great work that they have done on FGM. I am really proud that the Government have produced the FGM passport, which is available to many young women. It does—I hope that it will continue to do so—protect women, especially younger women who are going abroad for this appalling abuse to be carried out upon them. We have done great work already with health professionals who increasingly realise, first, that they must be aware of it; secondly, that they must report it; and thirdly, that they must take action to prevent this appalling abuse of women, especially young women.
I listened to the answer to Question 7 earlier, but surely the best way to improve accountability in the NHS would be much greater consumer choice and competition when it comes to GP services, for which there are virtually no comparative data at the moment. With modern IT, why can patients not choose to have their own medical records and then ring round to find a GP who will treat them when they want to and not when their own GP deigns to see them?