What improvements he proposes to make to the quality and provision of mental health services. [88237]

The Government are determined to raise both the quality and provision of mental health services. We have already set that in motion by investing significant additional resources in this financial year, and for the next two years, amounting to £700 million, and we have made mental health a clear priority for both the national health service and social services. We have initiated a thorough review of the legislation to underpin the provision of care and treatment, and we are about to publish a national service framework to address unacceptable variations in service delivery.

May I thank my hon. Friend for that reply and welcome the additional resources to be made available for mental health? I welcome also yesterday's announcement of the Nye Bevan award for mental health services in Dewsbury. However, as I am sure my hon. Friend is aware, there are excellent mental health services in other parts of the country. In Blackpool, along the Fylde coast, there have been exciting developments in child and adolescent psychiatry. A new day centre has opened and new family support workers have been appointed.

Order. A question, please.

Can my hon. Friend offer me reassurances about the training and recruitment of staff, especially in child psychiatry, which is such an important area?

I can certainly reassure my hon. Friend about that. I remind the House that the Government have committed £90 million over the next three years to improving the provision of child and adolescent mental health services, which have been neglected in the past and which can play an important role in improving mental health services. My hon. Friend is right to draw attention to some of the problems in recruiting staff in a specialist area. She may be reassured to know, for example, that between 1997 and 1998, there has been a nearly 8 per cent. growth in the number of consultants in the psychiatry specialty group. The numbers in general psychiatry are expected to double from about 150 to 300. We are trying to address these problems. It is important that we succeed in doing so because these services are extremely important.

I think that the Minister will know how strongly I believe that additional priority should be given to mental health services. May I ask him again to look at how funding has affected the home counties? In Surrey, there is no money to recruit or employ people and there have been cuts across the board. At a time when policy soundbites are good, it is particularly dispiriting for those who are involved in the service not to have the wherewithal to embark on the necessary improvements.

I can reassure the right hon. Lady. She will know that I am meeting the chief executive of Cruse tomorrow to discuss her concerns and how the Government can better support the provision of bereavement services throughout the country. I remind the right hon. Lady that the £90 million to which I referred represents additional resources for child and adolescent mental health services, which will be distributed fairly throughout the country. I point out again to the right hon. Lady and to other Surrey Members, who raise these issues regularly with me, that both local authority social services and the national health service in Surrey have received real-terms increases in their allocations this year. At some point, the right hon. Lady might begin to acknowledge that fact.

In Bolton, mental health providers are being used to train people who are working for the pilot new deal scheme for the disabled. Jointly with the local authority, specialist helpers have been recruited to help people with mental health problems to get a job. Once they have obtained a job, the helpers are there to support them. Does my hon. Friend agree that joint working of this kind is the way forward for the benefit of our citizens?

I certainly do. My hon. Friend will probably be aware that there are initiatives in the north-west to try to provide better services for people with mental health problems to assist them in getting back into work and in retaining employment. We do not intend to let people with mental health problems slip through the net. We want to provide better services to support them in employment and to help those who fall out of employment.

If he will make a statement on waiting times from GP referral to in-patient admission in the South Staffordshire health authority area. [88238]

The Department has never collected data on patients' total waiting time from general practitioner referral to in-patient admission. However, I am pleased to say that during 1998–99, in-patient waiting lists in South Staffordshire fell by 2,233. Lengthy waits of over nine months fell by 7 per cent.

It is not waiting lists but waiting times that count. I found out in January that patients hoping to go to the Good Hope hospital have to wait twice as long if they live in the South Staffordshire health authority area as people who live in Birmingham, for treatment for exactly the same clinical problem. I wrote to the Department of Health in January, and eventually got a reply in March from Baroness Hayman. She agreed that it was an anomaly and that it was wrong, and she stated that she had therefore asked her officials

"at the West Midlands Regional Office of the NHS Executive to meet with the Health Authorities and Trust to see if there is scope for improving waiting times".

Order. We have had a very bad start to questions. These are really Adjournment debates. Will the hon. Gentleman put his question to the Minister now?

Thank you, Madam Speaker.

One of the things that we must tackle is the unacceptable variations in access to treatment and care, which were the legacy that we inherited from the fragmentation and divisiveness of the previous Government. May I say to the hon. Gentleman and his constituent that in drawing a comparison with Birmingham, the hon. Gentleman is drawing a comparison with one of the five best performing health authorities in the country. Birmingham has the shortest waiting times for patient treatment and the shortest lists per head of population. It should be congratulated on that. The median waiting time for in-patient treatment at the Good Hope hospital is just under 12 weeks. For South Staffordshire, it is between two and three weeks longer than that.

When will the Minister produce the figures that matter to patients in South Staffordshire, as my hon. Friend the Member for Lichfield (Mr. Fabricant) mentioned, and publish the waiting times from referral by their GP to their actual treatment?

The reason why this Government have not collected the figures from GP referral to in-patient admission is, I believe, the same reason why the previous Government did not do so: not all GP referrals end up with an in-patient admission, so that would not provide a meaningful statistic about the health service. I remember that under the previous Government, of whom the hon. Gentleman was a member—I should have congratulated him on his new appointment—many, many people waited longer than 18 months for treatment. For nine months in a row, there have been no reports of people in the NHS having to wait for 18 months.

The constituents of my hon. Friend the Member for Lichfield (Mr. Fabricant) will have learned from the Minister what the true position is. The Government will not collect the figures because they know that they are creating waiting lists for waiting lists. When one adds the number of patients waiting to wait to the number of those actually waiting, one gets a much bigger number than the Government's fiddled figures. The Secretary of State promised to give us the figures back in September. The Minister is in charge of a health service in which junior doctors are betrayed, the British Medical Association says that morale is at an all-time low, complaints are up and confidence is down. The truth is that health is getting worse under Labour.

That is simply not true. The hon. Gentleman makes claims about fiddled waiting list figures. He knows that the only change that this Government have made in the collection and publication of waiting list data is that we publish the information far more often than the previous Government did. As waiting lists come down—and they have come down—waiting times are coming down as well.

What progress has been made in reducing waiting times in accident and emergency wards in London hospitals in the past two years. [88239]

More than £15 million is to be invested in A and E schemes across London hospitals for 26 accident and emergency departments. The money will help to ensure that long waits are tackled through the introduction of admission wards, special areas for children, the appointment of more emergency nurse practitioners and new initiatives such as direct links with general practitioner surgeries.

Is the Minister aware of the absolutely critical situation in south-west London, particularly at the West Middlesex and Kingston hospitals, which is manifested in large numbers of overnight stays and longer waits? Although we appreciate the programme of additional works that the Government are contemplating, will he consider an emergency programme designed to increase the number of beds in the hospitals so that the accident and emergency wards do not simply become annexes to the hospitals and chronically overcrowded as a result?

I am sure that the hon. Gentleman would acknowledge that one of the A and E departments covered by the investment to which I have referred is at Kingston hospital, which will receive £2 million for accident and emergency redevelopment. That is, by some way, the largest sum for any London hospital. The way in which the accident and emergency money will be invested across London depends very much on what will make the biggest impact on the quality of service in each hospital. In four cases, X-ray facilities will be improved. In five cases, facilities such as medical assessment units or observation wards will be improved, which will reduce the waiting times for admission. In other cases, there will be additional treatment rooms or cubicles. We are taking the appropriate measures in each of the hospitals concerned to make the biggest possible impact on accident and emergency waiting times.

Does the Minister agree that matters will improve in London's accident and emergency departments only with the support and collaboration of the junior doctors who work in them round the clock? Is it not obvious from the proceedings of the British Medical Association conference this week that the Secretary of State has forfeited the confidence of junior and senior doctors? Would it not be in the best interests of the national health service in London if he were to let someone else rebuild that confidence?

I am pleased to pay tribute to junior doctors and the role that they play in our hospitals; I met them recently and we had constructive discussions. I am as anxious as they are to ensure that improvements continue to be made in their working conditions and working hours, and in the other matters that affect the conditions of their rest periods. That is a promise that we are determined to see through. My right hon. Friend has led on it since he became Secretary of State and we shall continue to honour it.

What steps he plans to take to encourage commissioners of HIV services to agree longer-term contracts with the voluntary sector. [88240]

We fully accept the importance of providing stability for voluntary sector providers of HIV services through longer-term rather than year-on-year contracts. Many authorities, especially in London and other cities, are working with consortiums to place three-year contracts with their voluntary sector providers. We welcome that. I have asked that this issue also be looked at particularly by the HIV-AIDS strategy steering group.

That is all very well, but I am sure that the Minister agrees that voluntary organisations have played a huge part in the containment of HIV in this country. They still have an important part to play, but many of them did not know their financial situation until well into the year and they simply cannot plan. According to the curiously named Home Office document, "Compact on Relations Between Government and the Voluntary Sector", it is

"good practice to give voluntary organisations early and transparent information".

I pay tribute to the voluntary sector in the HIV-AIDS field; it makes a vital contribution to the care and support of people with AIDS and HIV. The HIV strategy document will be issued for consultation next spring, and we are determined to deal with the problems faced by the voluntary sector by replacing annual contracts with longer-term contracts to ensure that its work has the stability that is so important for the people whom it serves.

What the planned level of capital investment in the national health service is over the next three years. [88241]

More than £8 billion of capital investment is planned for the national health service over the next three years. Since we won the election, work has begun on 17 major new hospital projects, and more will be announced shortly.

I thank my right hon. Friend for that reply. The planned investment will go some way towards addressing the chronic lack of capital investment in our precious asset, the national health service. Does the investment to which he referred include the new PFI-funded hospital at Oldchurch Park, Romford, recommended in the Turnberg report? What a wonderful birthday present that would be for my constituents on the 51st anniversary of the national health service.

I do not want to anticipate any announcements that may be made tomorrow, but I think that my hon. Friend's constituency will be getting a birthday present.

Why do the public think that things in the NHS are not getting any better even after the Government have been in office for two years? Many of the staff in the NHS think that things are getting worse. Is it because, for the first two years, there was no more investment than there was under the Tories? Or is it because the Government are going down the PFI route far more enthusiastically than the Tories ever did, selling off assets in the biggest privatisation in the history of the health service? In the words of the editor of this week's British Medical Journal, the Government are at risk of leaving the NHS as a rump service. Could that be the reason?

The editor of the British Medical Journal is talking just as much claptrap as the hon. Gentleman. The hon. Gentleman should be grateful for the amount of capital that the Government have put into the services in his constituency at Guy's and St. Thomas's hospitals, where building works have already started on massive improvements in the services for the people whom he purports to represent. On top of that, we are building a new medical school.

Is my right hon. Friend aware that, later today, representatives of the University Hospital Birmingham NHS trust will be talking to the Birmingham group of Labour MPs about its plans and proposals for a new hospital in the south of Birmingham? Does he agree with me that, although the staff at the Queen Elizabeth and Selly Oak hospitals provide a first-class service, all too often they work in totally unsatisfactory conditions as a result of neglect during 18 years of Tory rule? There is a serious need to improve the condition of our hospital stock in south Birmingham, so it is important that the current consultation reaches a successful conclusion as quickly as possible.

I agree that it is a disgrace that dedicated professionals in many parts of the national health service are expected to work in deplorable conditions with unreliable equipment that no other professional group would tolerate for five minutes. These problems cannot be put right immediately, but since we got in, we have started on 17 major new hospital projects and more will be announced. We are putting billions of pounds into improving existing hospitals. This year, £350 million is already earmarked for improving equipment, because it is a disgrace that staff constantly have to use equipment that goes on the blink or breaks down because it is out of date. I am glad to say that we shall also be using more than £100 million from the national lottery to provide more reliable and up-to-date equipment for cancer diagnosis and treatment.

In assessing the funds available for capital investment in the next three years, what account has the Secretary of State taken of revenues generated under the Road Traffic (NHS) Charges Act 1999? Is it true that not a penny has so far been handed over? If it is not true, how much has been handed over?

First, I welcome the hon. Gentleman to his new job. He is the fourth shadow Secretary of State for Health that I have faced. Hereinafter we shall refer to him as Liam IV.

If he will make a statement on the number of dental patients treated under the national health service each month. [88242]

About 3 million people in England complete a course of dental treatment in the general dental service each month. That means that more than 3 million visit NHS dentists each month, because many will visit more than once during the month.

Is my hon. Friend aware that dental practices in some areas—such as Stocksbridge, quite a large town in my constituency—have withdrawn the facility for adults to receive NHS dental treatment, and have told them to use a private contributory scheme? A filling costs £25, and an extraction £30. People are left with the choice between doing that and paying the £3 bus fare to Sheffield to obtain NHS treatment.

Although the number of NHS dentists has risen, as has the number of treatments carried out under the NHS, access to NHS dentistry is unsatisfactory in some parts of the country. I am aware of the problem in Stocksbridge. The Government have introduced two measures designed to enable health authorities to cope with the difficulties. The investing in dentistry scheme, which ran until April this year, will enable an extra 650,000 patients to register for NHS dental treatment, and the personal dental services schemes—of which there are many throughout the country—provide a more flexible way of allowing access to NHS dentistry. It is important for health authorities to take full advantage of those initiatives. Sheffield made no proposals under either scheme; I do not know why, but I urge my hon. Friend to encourage her health authority to make the best possible use of the Government's mechanisms to support NHS dentistry.

Our experience in North Wiltshire is very similar to that of the hon. Member for Sheffield, Hillsborough (Helen Jackson). We had three NHS dentists when the Labour party came to power; all three have since gone out of business, and Chippenham, a prosperous town with a population of 30,000, has no NHS dentists at all.

The investing in dentistry scheme closed to new applications on 23 April, but a number of applications—including, I believe, that of the hon. Gentleman's constituent—are still being considered under that procedure. We are looking for the best ways to continue our support for NHS dentistry, and will publish an NHS dentistry strategy later this year.

What progress he has made in implementing the action plan agreed at the cancer summit meeting in May. [88243]

Work is under way to implement the action plan agreed at the Prime Minister's cancer summit in May. The Medical Research Council is bringing together major funders of cancer research to consider how research can be better co-ordinated. National standards and performance indicators are still being developed as part of the implementation of the Calman-Hine approach introduced by the previous Government. A director of the cancer action team will take up a post in July. We hope that, as a result of those measures, we shall ensure that the standards of diagnosis and treatment of cancer that currently apply in the best units apply in every part of the country.

The cancer summit at Downing street clearly threw down the gauntlet in regard to tackling and improving our dreadful cancer statistics. The all-party group on cancer has issued five policy pledges, which I have here. Will my hon. Friend congratulate the Cancer Research Campaign, which today launched an anti-tobacco research and surveillance unit to chase and harry the tobacco giants as they try to flout the advertising laws? Will he ensure that no doctor has to stand in front of a patient ever again and say, "I cannot give you the drugs to cure and treat your cancer because the health authority refuses to pay for them"?

I generally welcome the actions of the Cancer Research Campaign—even, occasionally, when it asks for more money. I certainly welcome what it is doing in relation to tobacco. Every year, the tobacco industry has to recruit 120,000 people to make up for the 120,000 who are killed by following the makers' instructions on the packets in which the tobacco companies sell the cigarettes. They usually target that effort at children because most people start smoking when they are children. Anything that we can do to counter what they have been doing is to be welcomed. There is clear evidence that, almost 20 years ago, they were looking at ways of countering the possibility that tobacco advertising might be banned.

Is the Secretary of State's pledge to introduce a maximum two-week waiting time for breast cancer treatment due to be met on schedule? What representations has he received regarding the clinical necessity of such a policy?

I do not yet have the reports, but, so far as I know, we expect the target to be met in most places; I hope that it will be met in all places. Some clinicians have doubts about the target, but others have welcomed it. We believe that it is right and proper to set those targets, particularly because women are naturally extremely perturbed if they are referred by their general practitioner for urgent examination and diagnosis by a cancer specialist when it is suspected that they may have breast cancer. We were advised by the then chief medical officer that a two-week target was reasonable.

May I congratulate my right hon. Friend again on his wisdom and intelligence in selecting the breast cancer service that is based at Royal Lancaster infirmary to be a national health service beacon? May I assure him that his judgment is sound? It is an excellent service. It will go from strength to strength, given the confidence that he and his Department have shown in it.

I always welcome the odd compliment, as we get so much abuse—although, on reflection, I have concluded that we get far more abuse in the newspapers than we ever do in the House of Commons. As my hon. Friend knows, I was pleased to be at the new unit in Lancaster, where there was a good partnership between the clinicians, other people from the NHS, social services and the Macmillan organisation to provide a better service, which backs up the extended service that is available nearby in Preston.

As vice-chairman of the all-party group on cancer, may I reassure the Secretary of State that none of the five sensible pledges for the comprehensive cancer strategy is described as an early pledge so Liberal Democrats hope that they be may implemented. But how can the Secretary of State implement any strategy on cancer without considering staffing? Is he aware that any expansion in the breast screening programme may be held up by a shortage of qualified radiologists, who are terrified to enter a sector where they are liable to be condemned by Ministers for errors in the service? Up to half of cytology screening units have lost their quality accreditation and his Department is still sending out redundancy notices to qualified, ready-to-be-consultant gynaecologists, when women are dying as a result of inadequate gynaecological cancer services.

I know that the hon. Gentleman is a doctor, but I noticed a quick shift in his question from radiology to obstetrics and gynaecology. Certainly I am very well aware that we do not have sufficient radiologists to do the work that we should all like to be done. [Interruption.] I cannot imagine why any Tory Member is yakking about that. When they were in office, not enough radiologists were taken on, trained and subsequently made consultants. We want not only to try to make maximum use of the radiologists available but to recruit and train more radiologists as soon as possible. As I said, in some cases, we want to use lottery money—in other cases, just plain NHS money—to improve diagnostic equipment and make it more reliable. That would be good for patients and staff.

The gimmickry of the Prime Minister's cancer summit brings no comfort to cancer sufferers denied access to modern cancer drugs such as Taxol and Tamoxifen. Will the right hon. Gentleman ensure that, as a result of the work of the National Institute for Clinical Excellence, further rationing of those drugs is prevented?

I welcome the hon. Lady to her job. If she had asked anyone who attended the Prime Minister's cancer summit, she would know that none of them thought that it was a gimmick, and that, afterwards, they all praised it. I would rather take my cue from them than from the Tory party. I confirm that Taxol is likely to be one of the highest-priority drugs for consideration by NICE. If the institute advises that it should be rolled out across the country, rolled out it will be.

If he will make a statement on the level of teenage conception and pregnancy in the South Humber health authority area. [88244]

In 1997, the conception rate for under-20s in South Humber health authority area was 81 per 1,000, compared with an average for England of 61.9 per 1,000. South Humber has already identified prevention of teenage pregnancy as a local priority.

I thank my right hon. Friend for that reply, and warmly welcome the Government's recent initiatives on tackling teenage pregnancy. However, does she acknowledge that emergency contraception plays a vital role in tackling unwanted pregnancy and in reducing abortion rates among young women? To that end, will she seriously consider making emergency contraception more widely available—as has been called for by Cosmopolitan magazine and the British Pregnancy Advisory Service? The harsh reality is that, for young women who have unprotected sex on a Friday or Saturday night, it is nigh on impossible to get to their doctor within 72 hours to get that prescription.

I thank my hon. Friend for her question, and her praise of the social exclusion unit's action plan to tackle teenage pregnancy. For a combination of reasons—such as low expectations, ignorance and the mixed messages on sex sent to our young people—the United Kingdom has Europe's highest teenage pregnancy rate. My hon. Friend is absolutely right that one reason why our teenage pregnancy rate is so high is the low rate of contraception use compared with that in other European countries. About 50 per cent. of young people use contraception the first time that they have sex. One of the intentions of the social exclusion unit action plan will be to ensure better access to contraception and to counselling about contraception, including emergency contraception.

Does the Minister consider that the best treatment for the condition to which the hon. Member for Cleethorpes (Shona McIsaac) has drawn attention is education and self-discipline, or does she consider that it might be treated by adding something to the water in south Humber? If she favours the former, why does her Department retain a fondness for adding something to the water to treat other conditions?

The hon. Gentleman's comments explain why the rate of teenage pregnancy under the Conservatives remained high—they believed that it had something to do with the water.

What investment his Department is making in services to combat bowel cancer. [88245]

To help prevent bowel cancer, £750,000 has been made available this year for pilot studies relating to diet and colorectal cancer and £1.5 million per annum over three years is funding colorectal cancer screening pilots. Since 1998, an additional £20 million has been invested in additional work force, equipment and audit processes to speed access to diagnosis and treatment of colorectal cancer and to reduce waiting times.

May I draw my right hon. Friend's attention to the Bristol beating bowel cancer campaign, launched earlier this year? It has two main aims: first, to raise £1.5 million for research into bowel cancer, some of which will be spent at the world-class laboratories at Bristol university headed by Professor Chris Paraskeva; and secondly, and perhaps more important, to raise the awareness of bowel cancer among the general population.

I welcome the activities of the BBBC campaign in Bristol, which is obviously doing good work and is exactly the sort of thing that we want to encourage. It sounds to me that it makes better use of its money than the BBC. The statement I shall make a little later today will emphasise the extent to which we want cancer to be combated by early identification and early treatment, particularly those cancers where early treatment means that people can recover entirely. That is very much to be welcomed, and I will do my best to sustain such initiatives.

Does the right hon. Gentleman agree that irritable bowel syndrome in children is a serious problem? What resources are the Government devoting to that? Does he agree that one method of combating bowel complaints is a restrictive diet? Are the Government looking at ways in which such diets can be employed to reduce the incidence of conditions such as irritable bowel syndrome?

I try to be honest, and I do not know the answer to the hon. Gentleman's question about what the Government are doing about irritable bowel syndrome in children. I shall write to him as soon as I find out. Diet has a major impact on that complaint and on all sorts of bowel conditions, including cancer.

What steps he is taking to achieve greater geographic evenness of clinical treatment in the health service. [88246]

We have introduced a number of measures to avoid the problem of the postcode providing unequal access to treatment in the NHS, which we inherited from the previous Government. One major development is the establishment of the National Institute for Clinical Excellence, which seemed to be endorsed for the first time by those on the Tory Front Bench today. It is there to provide guidance to doctors in every part of the country on the latest drugs and treatments.

I am sure that the Secretary of State would allow a measure of autonomy to local health authorities and primary care groups in setting their local strategies and that it would be most inappropriate if he, as a politician, were to tell doctors what to do or what to prescribe. Would he nevertheless concede that, especially in relation to complex or expensive treatments, such as the prescription of beta interferon for multiple sclerosis, we really cannot accept for a moment longer than is necessary the continuing tyranny of prescription by postcode, and that people expect not merely more words about that but some effective action, whether from NICE or from himself, to ensure that it is ended as soon as possible?

We will shortly hold consultations about the use of beta interferon, which will ultimately be considered by NICE, but, in fairness even to the previous Government, there are disputes in some parts of the country between clinicians about the appropriateness of the use of beta interferon and I do not want to poke my nose in if I can possibly avoid it.

I am sure that my right hon. Friend is aware that one of the most effective ways of ensuring the even geographic spread of services is to ensure that resources are spread equally around the country. Is he aware that Leicestershire health authority is still below its weighted capitation fee, and will he ensure that, over the coming years, as the new money feeds into the national health service, Leicestershire makes up the gap between the 97 per cent. that it currently receives and the 100 per cent. that we believe it deserves?

It is our intention to move all authorities near to their established norm, and that will certainly apply in Leicestershire as well as everywhere else.

The Secretary of State is to be congratulated on the moves to spread excellence around, but does he agree that treatment cannot be given if there is still ambiguity about diagnosis? Is it not time to concentrate more on the treatment of ME or chronic fatigue syndrome, which medical people in some parts of the country deny is a disease?

This is one of those difficult matters on which there are almost savage disagreements between medical professionals not only about the possible treatment of the condition but about whether it even exists. Once again, that is best resolved by the people who at least in theory know what they are talking about, although if there are two diametrically opposed sides, one of them must be wrong. It is better for them to try to thrash these things out than for me to try to lay down the law. Secretaries of State should keep their powder dry and interfere over the availability of particular drugs only in extreme circumstances.

What measures he is taking to encourage men to examine themselves to assist early diagnosis of testicular cancer; and if he will make a statement. [88248]

The Government are committed to improving cancer services and we fund a number of publications emphasising the importance of a healthy life style, and giving advice on recognition of symptoms of illness, including testicular cancer. The NHS home health care guide, published in 1998, encourages men to be aware of any unusual changes and to discuss them with their doctors at an early stage. From 2000, all those with suspected cancer will be able to see a specialist within two weeks of their GP requesting an urgent appointment. Referral guidelines to help GPs to identify early symptoms of cancer are being developed to assist in the early diagnosis of all cancers.

Does my hon. Friend agree that the lives of many women have been saved by their having been encouraged over the years to do breast self-examination and that, because the lives of men with testicular cancer—the incidence of which is doubling every 20 years—can also be saved if the diagnosis is early, men should be encouraged to examine themselves without embarrassment?

I strongly agree. My hon. Friend will probably be aware that many of our leaflets have been focused on younger men and that testicular cancer is the commonest cancer in men aged between 20 and 34, with about 1,000 new cases being registered each year. I am sure that she will agree that the consensus is that promoting testicular awareness is the most effective way of tackling the problem.

What initiatives his Department is pursuing to increase the availability of NHS dentistry. [88250]

We have already taken action to improve the availability of NHS dentistry through the investing in dentistry and the personal dental services initiatives. We are currently considering options about how best to use available resources in the future to improve the availability of NHS dentistry further. As I said earlier, we shall publish a dental strategy later this year.

Is my hon. Friend aware that, when the Labour Government came to power, no NHS dentist in my constituency was accepting new NHS patients? Since then, new NHS dental practices have opened in Leek and Werrington, but more must be done if we are to safeguard the dental health of our population. I welcome the initiative on an NHS dental strategy, but will my hon. Friend assure me that new and innovative ways will be studied to spread access to NHS dentistry not only to inner-city areas but to rural constituencies such as mine?

My hon. Friend is right. In north Staffordshire, eight investing in dentistry bids have been approved since the Government came to power, of which my hon. Friend mentioned two. They should give a further 23,000 patients in the area the opportunity to access NHS dental care.

I am sure that the Minister will know that there has been a large drop in the number of people registered with NHS dentists since the Government came to power. A dental strategy must be based on people having regular check-ups, which people are not having because they are not registered with NHS dentists. What is the Minister going to do about that?

There was a drop in the number of registrations because the registration period was shortened. The people who did not re-register were those who did not visit their dentists regularly in that period. As I said earlier, the number of NHS dentists is greater than two years ago, as is the number of treatments carried out under NHS dentistry. However, we are not complacent: as I have acknowledged several times this afternoon, access to NHS dentistry is unacceptably difficult in some parts of the country. We have taken many more measures to tackle that problem than the previous Government, but I am sure that we shall need to do more.

What plans he has to review the funding arrangements for GPs; and if he will make a statement. [88251]

We have established the equity in primary care working group, whose membership includes representatives from the general practices committee of the British Medical Association, health authorities, the medical practices committee and the NHS executive. Its task is to consider the equitable distribution of work force and resources in general practice. I expect to receive its recommendations shortly.

In so far as I understand the funding arrangements for GPs, they are ring-fenced and cannot be used to employ GPs on a salaried basis, for example. One effect of that is that places such as Sunderland—which has difficulty attracting its full quota of GPs—effectively subsidise places such as Buckinghamshire. Does my hon. Friend consider that to be satisfactory? If not, will something be done about it?

I personally have nothing at all against Buckinghamshire, but my hon. Friend raises an important point. It is not possible simply to take money notionally allocated to pay a GP under the general medical services budget and reallocate it to a different use. However, health authorities can use the personal medical pilot scheme to create positions for salaried doctors, as well as to vary, by agreement, the contractual arrangements with GPs. I know that Sunderland is keen to use that mechanism to deal with the shortage of GPs.

Might not the Minister also have referred to low rates of recruitment into general practice from among medical students? Is he satisfied with the number who go on to train as GPs, and if he is not, what will he do about it?

I am pleased that the latest national GP recruitment figures are encouraging. A 7.7 per cent. increase in GP registrars shows that many medical students see general practice as an important and fulfilling career. We shall train more medical students, and we announced nearly 800 additional places last week. I am confident that many students will go into general practice as they see our reforms putting GPs and nurses in the driving seat in the new NHS.

What plans he has to introduce new regulations covering private health care. [88252]

On 15 June we published a consultation document, "Regulating Private and Voluntary Healthcare", in which we have proposed a new body with tough powers to regulate private hospitals and to replace the archaic system that currently treats private hospitals as nursing homes.

I welcome my right hon. Friend's reply and the consultation, which builds on work done by people such as my constituent Caroline Buckley, who lost her mother tragically under private health care, and the many bereaved and troubled relatives concerned by the state of the private health care industry. Who does my right hon. Friend believe should foot the bill for the regulation of private health care? Should it be the NHS, as the Opposition believe, or should the industry foot the bill itself?

We propose that the private health care industry should pay the costs of its regulation, and I can safely say that we have the Treasury's wholehearted support.

Will the Secretary of State consider my eight-year-old constituent, Laura Giddings, who lost her leg in the Planet Hollywood explosion and who, as I have said before, has been forced to turn to the private sector to obtain a suitable artificial limb? In drawing up new regulations for the private sector, will he consider applying to artificial limbs the criteria applied to wheelchairs so that someone who has to go to the private sector for a suitable appliance will receive the money that would have been spent on a less suitable appliance by the NHS?

I express sympathy for the little girl and her family. The family have met my right hon. Friend the Minister for Public Health, and I am prepared to consider any arrangement that would facilitate the little girl's being able to get about as well as humanity can manage now that inhumanity has deprived her of her leg.

Has my right hon. Friend been able to study the work of Dr. John Yates at Birmingham university, which proves that areas of the country with the highest number of private beds also seem to have the longest NHS waiting lists? Has he had a chance to consider that matter, and if so, what action are the Government taking?

Yes, I have and the Select Committee on Health, which is chaired by my hon. Friend, is studying that and other matters related to the regulation of the private sector. I look forward to receiving its report and considering it along with the other representations that we receive in response to our consultation document.

What assessment he has made of the impact of the closure of Burford hospital on the treatment of Alzheimer's disease in west Oxfordshire. [88253]

My right hon. Friend the Secretary of State instructed officials at the south-east regional office of the NHS executive to facilitate further discussions about the proposals to reconfigure community services in Oxfordshire. While no decisions have yet been taken, should the Secretary of State decide to support the health authority's decision on the reconfiguration, the authority is committed to consider the relocation of the specialist Alzheimer's disease service that is provided at Burford community hospital.

The Minister will be aware that this is national Alzheimer's awareness week. He will also be aware that the Secretary of State has now had nearly an entire year to consider the future of Burford community hospital. The Royal College of Nursing report on Alzheimer's found that the Burford unit was top of 75 units throughout the country in the pioneering work that it did. The report went on to say that if we are to take Alzheimer's work seriously,

"it is vital that the parent service continues at its present location."

I reassure the hon. Gentleman that we certainly take Alzheimer's disease seriously. In fact, as he will be aware, the publication of the national carers' strategy, which will help significantly the carers of people with the disease, has been widely welcomed. He will also probably be aware that, next year, the new national service framework for the NHS will be for older people. We are looking within the context of that framework to define new service models and national standards for the treatment of Alzheimer's disease. I am sure that he will welcome that.