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Topical Questions

Volume 582: debated on Tuesday 10 June 2014

Almost a year ago, following the Keogh report, we put 11 NHS trusts into special measures, the first time such a large number of trusts have been put into special measures. Yesterday I was pleased to report to the House that the first trust, Basildon, has come out of special measures. I am pleased to tell the House today that across all the trusts in special measures, an additional 1,202 nurses and an additional 118 doctors have been recruited. The programme is making good progress, and the whole House will want to commend the efforts of all the staff in those hospitals on the tremendous efforts they are making.

I join the Secretary of State in commending the management and all the staff of Basildon hospital for their excellent work and a great team effort. The hospital is now no doubt on an upward trajectory. I should like to raise with him the matter of the human papilloma virus vaccination programme for young women. It has been a success, and there is mounting evidence that is should be extended to young men. Will the Government now look into the feasibility of doing that?

My hon. Friend is right, and I am grateful to him for mentioning how proud we are of the HPV vaccination programme for girls and women. It is one of the best in the world, and we are getting an 86% take-up rate among eligible 12 to 13-year-old girls. He is also right to say that we now need to look at whether the programme should be extended to men and boys. A decision was taken at the time that it did not need to be, but we are now reviewing that decision. We will shortly be getting advice from the Joint Committee on Vaccination and Immunisation—which, as he will know, gives us independent advice on these matters—and we will take its advice seriously.

I am sure that, like me, the Secretary of State will have been shocked to the core by the serious case review into the Orchid View care home. It spoke of institutionalised abuse and of residents dying of sheer neglect. This is just the latest case of appalling abuse in care homes, following that of Winterbourne View and the recent “Panorama” programme on Oban House. People are asking how many more times we must see abuse of this kind in our care homes before we take decisive action to stop it. Will the Secretary of State give serious consideration to the central finding of yesterday’s review, which was that the same principles of patient safety that apply in the NHS should now be applied to the care home sector?

I thank the right hon. Gentleman for that question. He is absolutely right to suggest that the lessons of Francis need to be applied to the care home sector, to general practice and to all out-of-hospital care every bit as much as they are applied to NHS hospitals. That is why we have legislated in the Care Act 2014 not only for a chief inspector of general practice but for a chief inspector of adult social care, Andrea Sutcliffe, who has made an excellent start. She is going around all the care homes, and she is bringing back the rigorous Ofsted-style analysis that was unfortunately taken away by the last Government. That will mean that we have proper transparency in standards. Going back to an earlier question from my hon. Friend the Member for Lichfield (Michael Fabricant), we also need to do more to help whistleblowers working in care homes. Because there are so many care homes, we cannot depend solely on the inspectors to get this right. We have also introduced the ability to prosecute offenders, which did not exist before.

T3. The fears of the people of the Ribble valley that the old Clitheroe hospital would be closed and not replaced were allayed when the new hospital was built. It recently opened with 32 in-patient beds, radiology, diagnostics and other facilities. Will the Secretary of State come to Clitheroe to have a look at this brand-spanking-new hospital, which is being welcomed by the local community, and to say thank you to the staff there for all they do? If he does so, I promise to take him for a pint of healthy real ale afterwards in the Campaign for Real Ale pub of the year in Pendleton in the Ribble valley, to celebrate the opening of the new hospital. (904095)

Well, I must say that that sounds like a pretty irresistible offer, and I will give it careful consideration. Local community hospitals have an important role to play in our NHS because of the high standard of compassionate care that they deliver, and because they are easy for relatives to get to. I am delighted to see my hon. Friend campaigning for his local hospital, and delighted that it is doing so well.

T2. A Birmingham trust has recently announced that it will be possible to cut 1,000 beds across the city by setting a maximum stay of seven days for most patients. Not surprisingly, this has caused some alarm. Are Ministers aware of that proposal? What guidance, if any, can they offer in regard to such proposals? (904094)

As the hon. Gentleman will be aware, patients need to be treated according to clinical need, and bed stays should not be determined by anything other than that. So if what he describes is actually the case, it would be very disturbing. If he would like to raise the issue further with me, I would be happy to look into it for him.

T5. Like other rural communities, Herefordshire has long suffered from chronic underfunding in health care. Does the Secretary of State share my view that setting clinical commissioning group allocations should be an evidence-based process that takes into account factors including sparsity and old age? Also, will he ignore the calls from the shadow Health Secretary, who was seeking to cut the previous NHS allocations in areas such as Herefordshire? (904097)

I agree with my hon. Friend that it has to be done on the basis of evidence. Part of that is an important change that the Government have made, which the Labour party criticised a great deal. We have depoliticised the process by giving it to NHS England, where it is decided at arm’s length from Ministers on the basis of need. It is challenging to do it fairly. There are some historical imbalances, and we have to do what we can to address them, but we have to do it in a way that is fair and is not tarnished by party politics.

T4. Health inequality on Teesside is a major issue, but the Government axed plans for our new hospital four years ago. I am told that Ministers now accept that a new hospital to replace the two hospitals at North Tees and Hartlepool is the right way forward. When will they remove the barriers to the project and give the support that is needed? (904096)

T6. The new specialist emergency hospital is nearly 60 miles from Berwick. Given the serious delays in ambulance attendance in recent cases in Northumbria, how can we be sure that serious cases will get paramedic attendance and delivery to the hospital within the critical hour? (904098)

My right hon. Friend is right to raise concern. The North East ambulance service has traditionally been a good performer, but any deterioration that has been identified needs to be addressed very speedily. I urge him to monitor this closely, and if he wants to talk about it further with me, I will be happy to do so.

T10. Last October the Secretary of State said that Hammersmith accident and emergency would be closed when it was safe to do so. Imperial proposes to close it on 10 September, when on its own admission there is insufficient capacity at St Mary’s and it is not safe to do so. Will he keep his promise and ensure that Hammersmith A and E does not close, especially when there is not sufficient capacity in the system? (904102)

I keep my promises, but may I point out to the hon. Gentleman that the way in which he has campaigned on those issues has been totally irresponsible? He put out leaflets in the local election campaign saying that Charing Cross hospital would be demolished. He failed to mention that it was going to be rebuilt as a brand-new hospital with an A and E department. I hope that he will not be invited to it when it is reopened unless he apologises to his constituents for the way he has presented this issue.

T7. The Government can be rightly proud that there are fewer managers and more doctors in the NHS than in 2010. However, recent research by the TaxPayers Alliance shows that in the Greater East Midlands commissioning support unit more than £1 million a year is being spent on 26 administrative jobs of dubious value such as communications managers, communications officers, three communications and engagement leads, and two equality and diversity managers. The list goes on, Mr Speaker, but I will not. What further steps can my right hon. Friend take to ensure that the NHS budget is spent on front-line medical services? (904099)

My hon. Friend is right to highlight the fact that as much money as possible always needs to be put into front-line patient care. Under the previous Government, spending on managers and administrators more than doubled from £3 billion to £7 billion, and we have seen the number of administrators fall by 20,000. There is clearly work to do in his area, because as much money needs to go on front-line patient care as possible, and I hope that local commissioners will be looking to share back-office services as much as possible with other commissioning groups to reduce costs and put money into front-line patient care.

Earlier the Secretary of State and his Minister said that the minimum practice income guarantee was unfair. What is unfair is that so many practices in Hackney and east London are set to close, in an area where there is great deprivation. What are they going to do to make sure that patients still have practices to go to?

We have had this discussion. A payments system that is almost 20 years out of date and is not funding patients according to clinical need or is not per head of population will not deliver good care. The payments system needs to be changed and NHS England is working with practices that are facing challenges to address those challenges and ensure that high-quality patient care can still be delivered locally.

T8. Following the recent speech by the new NHS England chief executive Simon Stevens about the important role of local hospitals, can my right hon. Friend confirm that district general hospitals such as Macclesfield will continue to play a vital role in delivering local health services in the years to come? (904100)

I can confirm that. What my hon. Friend said was profoundly important. There is not an automatic link between size and quality. We know that for certain types of treatment, there is huge benefit in centralising services, as has happened for stroke services in London, but other services can be delivered extremely well at smaller units, and we will continue to support those.

The Minister has just talked rather piously about spending NHS money on front-line services, but the NHS is spending £300,000 on a university secondment for a staff member who has left. How does he justify that sort of abuse?

I just point out to the hon. Lady that in the Queen’s Speech we made it clear that we are cracking down on inappropriate payments to people who leave the NHS, many of which are the result of contracts set up by her Government.

T9. My constituent, Beth Charlton, recently lost her father to pancreatic cancer and notes that patients have only a 3% chance of surviving five years. That is much lower than the survival rates for other cancers and has not improved in 40 years. Will the Minister invest more in early detection and diagnosis of this silent killer? (904101)

Spending on health care research, including cancer research, has considerably increased under this Government, and much of that funding is allocated independently. It is important to note that pancreatic cancer is, as the hon. Gentleman says, a silent killer, because presentation is often very late in the disease process. Patients can present suddenly with painless jaundice and are often only three months away from death. It is therefore important that we look at the causes of pancreatic cancer and focus on primary prevention and on helping people to develop a healthy attitude to alcohol.

In the last hour I have heard the Secretary of State and his Ministers complain about the problems with A and Es; I have heard them talk about the problems with GPs; now we hear that they have lost control of care of the elderly. Instead of continuing to blame the last Labour Government of four years ago, why does the right hon. Gentleman not admit that the NHS is not safe in his hands? Let us have an election and get a Labour Government.

Because we are making the NHS safe. We are taking action to deal with the issues that the hon. Gentleman’s Government swept under the carpet. The NHS is getting safer and more compassionate. It is delivering more care to more people than ever happened under the Labour Government. We are proud of our record on the NHS, and we will not make the NHS better by pretending that problems do not exist when they do.

Stockport Mind reports that it takes on average 12 months to receive the first appointment for cognitive behavioural therapy after diagnosis. What action can be taken to improve that standard in Greater Manchester?

I mentioned earlier that when the last Labour Government introduced the 18-week waiting time standard they left out mental health. That is at the heart of the problem. We are committed to changing that and to introducing access standards in mental health, and we plan to start next year.

The Stitch project in Bristol has contacted me with concerns about the number of overdoses by people on prescription medication and suggested that allowing medication to be dispensed in instalments would be a better way of handling those vulnerable patients. I was disappointed in the response that I got from the Department, and I urge the Minister to think again on this issue.

I am very happy to meet the hon. Lady to discuss this further and see what we can do because it is important that the vulnerable patient groups she highlighted are looked after in the right way.

As he heralds an era of transparency, can the Secretary of State update us on what steps he has taken to ensure that private providers in the NHS are every bit as transparent and accountable as public ones?

I think they absolutely should be, and the changes that we introduced in the Care Act 2014 relating to the transparency of the inspection regimes apply to private providers supplying services to the NHS just as they do to NHS providers. Let us be absolutely clear: poor care is poor, whether it happens in the public sector or the private sector, and we must clamp down on it wherever it happens.

The Minister said that he was dealing with the chronic shortage of staff who help vulnerable children and young people, who cannot get access to mental health services. Will he tell us when there will be enough staff delivering those services to that important group?

I mentioned that NHS England will very soon publish a report following its analysis of existing facilities across the country, so the hon. Gentleman will get the answer in the next few weeks.

When will the public health Minister publish the regulations for the plain packaging of tobacco products, on which she proposes to consult?

As my hon. Friend knows, Parliament has already granted us the regulation-making powers in the Children and Families Act 2014 and we have said that we are minded to proceed with those. We are still committed to consult. The regulations are being drafted. I had hoped to publish them before the end of April. We were caught by the pre-election purdah period, but I hope to publish them soon.

Order. We are very pressed for time, but I want to accommodate a couple of remaining colleagues.

I am grateful, Mr Speaker. In Brent we have the highest incidence of TB and of type 2 diabetes in the country. We have just received a cut of £450 million in the money allocated to the CCG. The Secretary of State says that this is fair, but my constituents want to know whether it is in accordance with need.

The hon. Gentleman is right to draw attention to the problem of TB in London. As a London Member myself, I know what he is talking about. I encourage him to participate in the current consultation on Public Health England’s comprehensive TB strategy. It is a very important document which marks a step change in the way we confront the problem. That will help us to allocate resources to need and to address serious problems.

Will the Minister give us an update on the proposed licensing of e-cigarettes by the Medicines and Healthcare Products Regulatory Agency? Does her Department believe that e-cigarettes could be used in smoking cessation programmes?

When I brought the regulations before Parliament, we were clear that those e-cigarettes for which a medicinal claim is made must be subjected to medicinal licensing arrangements. Once they are licensed as medicine, they can be prescribed as part of NHS smoking cessation services.