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Commons ChamberRead Hansard Text Read Debate Ministerial Extracts
Madam Deputy Speaker (Dawn Primarolo)
Five Members are listed to take part in this debate. There is a time limit on Back-Bench speeches of six minutes. I remind Ministers that this is a Back-Bench debate and that the Backbench Business Committee has recommended that the time available for Ministers should be up to 10 minutes. Each time they go over that, they take time away from Back Benchers.
Tracey Crouch (Chatham and Aylesford) (Con)
It is a pleasure to open the health section of the Christmas Adjournment debate.
Albert Einstein famously said:
“It is strange to be known so universally and yet to be so lonely.”
At a time of extreme population growth, greater connectivity created by technological advances and the ability to sustain friendships around the globe, it is perhaps bizarre to think about the worrying consequences of social isolation, yet it is incumbent on us to do so because increasing levels of loneliness are making elderly people in particular incredibly vulnerable.
More than 1 million people aged over 65 say that they feel socially or emotionally lonely all or most of the time. It is heartbreaking that while many of us will be spending the festive season with our family and friends, 500,000 older people will spend this Christmas day alone. Sadly, that seclusion is not confined to the Christmas season. Chillingly, it is part of the day-to-day life of many older people.
If people more cynical than your good self, Madam Deputy Speaker, are wondering why I am spending valuable parliamentary time talking about a natural human emotion, they do not understand the severe social, health and financial consequences of loneliness. Researchers rate it as a higher health risk than lifelong smoking or obesity. Associated physical and mental health conditions include sleep deprivation, a weakened immune system, higher blood pressure, an increased risk of dementia and intense levels of depression.
By raising the profile of the Campaign to End Loneliness today in this short debate, I hope to increase awareness of the scandalous isolation of older people. That is not just a sad indication of community breakdown but, to be brutally frank, has a long-term cost for our social service and health budgets. It can be halted through better state and voluntary intervention.
No one body can solve the problem. In fact, it is one for everyone in society to tackle, from local and central Government to the voluntary sector, and of course not forgetting us as individuals. However, the state has a significant role to play and is often best placed to act as the main co-ordinator.
At local level, the police, fire services and GPs are considered the most trusted bodies by older people, and therefore they can identify those most in need through their everyday activities. There is a fantastic example of that in Manchester, with police community support officers knocking on the doors of older people with a specific remit of reaching out to those who would otherwise slip under the radar. Likewise, Merseyside fire and rescue service, which comes into contact with people when it fits fire alarms or attends emergencies, has been using those occasions to identify those whom they feel are isolated and to flag them up to the appropriate body.
In my own constituency, Tonbridge and Malling council often finds that housing register applicants state that they want to move because they are lonely and feel isolated. That admission helps to identify those in need, and then the support and befriending services of local voluntary organisations are deployed. One such service is the Beat Project, which is funded by the Snodland Partnership and organises an informal coffee and chat group every week. It specifically seeks to engage people who would not normally join organised groups in the town. Many older people now attend, including a group from a local dementia nursing home. Many report that the event is often their only social contact with the outside world.
Medway council runs similar events through its older people’s partnership and its work with the WRVS. Through statutory, voluntary and community sector partners, it has sought to engage with older people across the local authority area to improve mental and physical well-being, create opportunities for intergenerational involvement and develop social networks to enable older people to lead full and active lives.
The last Government declared in the 2007 concordat for social care, “Putting People First”, that the alleviation of loneliness and isolation should be a major priority. I completely agree with that intention. Encouragingly, the current Government have put a welcome emphasis on improving community connections and well-being, which will help to meet that priority. However, any Government who are serious about enabling well-being must acknowledge the problem of loneliness as one of the targets of their activities. I hope the Minister will indicate today how far the Government intend to go in measuring loneliness as part of the well-being index.
There are many good schemes out there that can combat isolation—too many for me to mention in my remaining time. They all require one more thing, which is the ability to reach to those who remain in isolation. That is where the statutory services should help. Better co-ordination cannot be underestimated as the means of solving the wider problem of loneliness.
In the past I have planned to spend Christmas alone, but acquaintances from a local bar took in this particular waif and stray and have remained friends since. This year, Abbeyfield Kent and Age Concern Kent are opening up their doors and offering Christmas dinner to pensioners who would otherwise spend Christmas alone. I hope that that will create future social networks for those attending.
Loneliness is not just for Christmas, but this seems to me a perfectly good time to highlight in the House and beyond the worthwhile campaign to end loneliness among older people. As Mother Theresa said:
“Loneliness and the feeling of being unwanted is the most terrible poverty.”
Alison Seabeck (Plymouth, Moor View) (Lab)
I am grateful for the opportunity to speak about the accessibility of services and entertainment for people who are deaf or hard of hearing. Several of the issues cut across other Departments, and I hope that the Minister will be tolerant, but I also hope that she will pass on my remarks to the relevant Departments.
Some 10 million people in the UK have some form of hearing loss, which is around 11,500 in every constituency. The hon. Member for Chatham and Aylesford (Tracey Crouch) spoke about loneliness, and those who are deaf or hard of hearing can feel particularly isolated. It is sad that even in 2011 people with hearing loss still face unnecessary barriers to everyday activities, such as banking, shopping and watching television. I wish to highlight some of the positive steps that can be taken by businesses and Government to improve accessibility, and the forward-looking solutions that would guarantee accessible television entertainment for people who are deaf or hard of hearing.
Hearing loss is often referred to as an invisible impairment, and it can present a significant challenge if colleagues or service providers do not know that someone is struggling to hear. I declare an interest as I lost all hearing in one ear at the age of 16 after contracting mumps. My recent change in workplace seating arrangements has caused enormous problems, because the Speaker’s Chair is now on my deaf side, and I run the real risk of not hearing the Speaker’s instructions. Difficulty hearing in a debating chamber is an unusual problem, so I will consider some more common activities.
Imagine someone with hearing loss who begins their day by telephoning their bank. They will be met with a series of pre-recorded voice messages, which are now a familiar feature of all helplines, but present huge problems for people who cannot hear clearly. All the numbers whizz by and people miss hearing what they all mean. People with hearing loss would benefit from a clear, early option to be put through to an operator who has received deaf awareness training, and I urge companies to consider implementing this routinely.
Someone who has been unable to get through to their bank by phone might try to go and speak to them in person. Unfortunately for people with hearing loss, this still does not guarantee that they will be able to communicate successfully. There are 2 million hearing aid users in the UK, and a fully functioning induction loop is often the only way to guarantee somebody effective communication. However, in a recent survey by the excellent organisation Action on Hearing Loss, 86% of services were found to be inaccessible for hearing aid users. Where organisations had a loop system, it was often not working, it was not turned on, or staff were not trained in its use. Worryingly, more than 60% of the 1,500 premises visited did not have a loop system fitted at all.
There are any number of day-to-day examples I could give, but time does not allow, so I will turn to the end of a typical day, when someone might look forward to catching up with their favourite television programme. Surely, in the comfort of their own home, they will not be limited by their hearing loss. Sadly, even in the 21st century, against a backdrop of vast technological developments, it is still very likely that the chosen television programme will not be accompanied by subtitles. This is particularly true of programmes delivered on catch-up services over the internet, where there are currently no quotas for access services. This is despite the fact that in a recent survey three quarters of Action on Hearing Loss members said they used subtitles, with 43% using them all the time.
It would be an effective forward-looking solution if people with sensory loss could benefit from the inclusion of quotas for access services on all television programmes, regardless of the platform through which they are delivered. That would be in line with existing quotas for terrestrial television. New legislation, which I think the Government plan to introduce, should also ensure that technology is future-proofed. Believe it or not, subtitles were not initially available on high-definition TV, for example. That is quite astonishing—and they were only recently introduced on the public broadcasting HD channels. I urge Ministers not to pass up any opportunity to improve the situation through legislation.
I hope that this afternoon’s debate has demonstrated how important accessibility to services and entertainment is for people who are deaf or hard of hearing. As the population ages, the number of people with hearing loss in the UK will continue to rise. I therefore urge Ministers to cut across Departments to ensure that easy access to services and entertainment for people with hearing loss becomes the norm, not the exception.
In the last few seconds, I want to get an unrelated point on the record. I would really like the Government to look at how the administration process works, following the experience of Plymouth Argyle. There are genuine issues that need to be addressed, either by Ministers or by a Select Committee of this House, such as whether the creditors get the best value and whether the staff involved at the time are also protected.
Finally, Madam Deputy Speaker, I wish you, all Members of this House and all the staff, who support us so fantastically throughout the year, a very happy Christmas.
Pauline Latham (Mid Derbyshire) (Con)
I rise today to talk about the east midlands cancer drugs fund, because I have had many dealings with this organisation, none of them very satisfactory. The last such dealing was today, although I would like to start my story, as it were, with my attempts over some months to get Avastin for a constituent of mine. She has already funded more than £60,000-worth of the drug herself. She has sold her car, used her retirement money and sold her heirlooms, and she now has no money left, yet still the east midlands cancer drugs fund will not give her Avastin, because—it says—there is no proof that it works. However, she is living proof that it works, because she has been taking it for two years. It costs her £1,600 every three weeks, and nobody can afford that sort of money. I also have another affected constituent, whom I saw on Friday, but because she is smaller than the other lady it costs her only £1,300—a real snip.
I am appalled at the way those patients are being treated. The reason why we are talking about a second-line treatment is that the first line failed. However, those patients do not choose the first line, because they rely on the consultants to give them the right drug in the first place. When that drug fails, the consultant puts the patient on a drug that works, but in this case, those in the east midlands are not allowed to have that drug funded by the NHS. However, patients can have it funded in the west midlands, the north-east and East Anglia, along with four other trusts.
I first wrote to the east midlands cancer drugs fund about this case on 28 September. Hon. Members should remember that it is supposed to reply within 10 working days, but in this case it did not. As Avastin is not a priority drug, and as my constituent is not a priority person, the fund will reply at its leisure. I wrote on 28 September, but the first I heard from the fund was on 4 November, when, after pushing the organisation, I received a letter from the medical director of NHS Midlands and East, which said that that body would have the ultimate view on whether the drug could be prescribed. The letter also said:
“I can, however, ask the Clinical Panel to review”
my constituent’s
“case and have asked the Clinical Lead to convene an urgent meeting. This meeting will consider clinical effectiveness evidence in accordance with the principles underpinning the East Midlands Cancer Drugs Fund. I will also ask the Panel to reconsider the evidence in the context that other parts of the country have reached a different conclusion regarding the efficacy of avastin as a second line treatment. The Chair of the Clinical Panel will inform me of the outcome of its deliberations”.
That was on 4 November, after I had written on 28 September. That panel has not met. Why not? Because those responsible cannot get the right people together. They convened a meeting, but they asked the wrong people to come to it, so they decided to abandon that. Eventually, after several e-mails, on 10 and 14 November, they let me know that they were urgently considering a meeting, but had not had one yet, and they still have not. Apparently, the people who make the decisions are informing them by e-mail what they think of this case—everything is being reviewed by e-mail.
It is getting close to Christmas, as we are all aware. On 30 November I was told that I would hear by the end of that week. I have not heard anything. Now I am told that I will hear by the end of this week. This is completely and utterly unacceptable for my two constituents, who could die because of the irresponsible and inefficient way in which the organisation works. Fortunately, they are not doing so; they are getting good treatment, and both of their tumour levels have decreased from 40 to 5 while using that drug. That shows that it works, and I do not understand the reluctance of the east midlands cancer drugs fund to prescribe it.
Jo Swinson (East Dunbartonshire) (LD)
I thank the hon. Lady for giving way, and I apologise for not being here for the beginning of her speech. I was on the telephone to the consultant of one of my constituents who is terminally ill and who would love to get ipilimumab prescribed. Unfortunately, that is not possible. Sadly for constituents in Scotland, there is no cancer drugs fund there because the Scottish Government have different priorities from those of the coalition Government here. I understand the hon. Lady’s frustration with the way in which the fund is being administered in her area, but would she at least agree that the existence of such a fund is a real benefit to people in England? I wish that that could be the case in Scotland.
Pauline Latham
Yes, everyone should have a cancer drugs fund, but those funds should be reactive to what works for people. If I have time, I want to talk about ipilimumab too. It is a difficult name to say, but it is also known as Yervoy. The hon. Lady should talk to the Government in Scotland and ask them to do what we are doing here in this country. They have devolved powers that were voted for by this House—and which I do not agree with—but they have them, and they must make their own decisions.
The cancer drugs fund in the east midlands is not fit for purpose. It is not working for the benefit of patients. The people involved say that they need the necessary clinical knowledge of these cases, but they already have it. The consultant has written to them, as have I, and they can see that those patients are still alive. They are still failing miserably, however, to help my two constituents, who will die if they do not get the drug. I hope that the Minister will contact those people and ask them to work more efficiently and effectively to help those patients who rely desperately on them to provide the necessary drugs.
I want briefly to talk about Yervoy, which is also known by that other name that I cannot pronounce. It is used to treat malignant melanoma. I have to declare an interest, in that my brother died of malignant melanoma 11 years ago next month, before this drug was discovered. It is the first new treatment for malignant melanoma for 30 years. More people are dying of malignant melanoma than ever before, and it is on the increase. I believe that the National Institute for Health and Clinical Excellence should recommend that people should have that drug. I have heard stories of people in their 30s with young children getting the condition, and there is no hope for their future. As a responsive listening Government, we should be ensuring that those people get the drugs that they require.
Keith Vaz (Leicester East) (Lab)
It is a pleasure to follow the hon. Member for Mid Derbyshire (Pauline Latham). I am sure that the whole House will wish her well in her pursuit of those cases on behalf of her constituents.
I want to talk about diabetes. I discovered that I had type 2 diabetes only a few years ago, when I went to visit my local GP. He had asked me to open a diabetes awareness day. I turned up, and blood was taken from my finger. People like taking blood from politicians. I was told that someone would ring me the next day to tell me whether I had managed to get into the local newspaper. Dr Farooqi rang me. He said that the good news was that I was on the front page of the Leicester Mercury, and that the bad news was that I had type 2 diabetes.
With diabetes, we are facing a health tsunami. There are now 2.8 million people in the UK suffering from the condition. Worldwide, the figure is a staggering 346 million. It is the fifth most common cause of death in the world, and it is undoubtedly a health concern of epidemic proportions. The International Diabetes Federation predicts that if the situation is allowed to continue on its current path, 522 million people worldwide—one in every 10—will have diabetes by 2030.
In recent months the work of diabetes charities has gained a significant momentum. I would like to congratulate the International Diabetes Federation, led by its president Jean-Claude Mbaya, on hosting the World Diabetes Congress in Dubai, which I attended and at which I spoke briefly. We are going to have a British president of the federation in two years’ time—Sir Michael Hirst. I wish him well. I also commend the work of Diabetes UK and its chief executive, Baroness Young, as well as that of a charity in my constituency that I had the honour to help establish, Silver Star. It came here to test MPs for diabetes. It has worked in partnership with organisations, including the Leicester Mercury, and helped to light up its iconic headquarters in blue on world diabetes day, 14 November.
For the purposes of this debate I shall refer to type 2 diabetes, which is the type that 90% of people with diabetes around the world have. Diabetes is currently the leading cause of blindness, amputation, renal disease and cardiovascular disease. On average it reduces life expectancy by 10 years. Each week 100 people with diabetes lose a toe, foot or lower limb due to the condition. In 2010 an estimated 4,200 people lost their sight due to diabetic retinopathy. This figure increases by 1,280 a year. Only last week we were told in a Government-commissioned report that 24,000 people with diabetes are dying avoidably each year because they do not receive the right health care or do not manage their condition properly.
It is estimated that diabetes care accounts for 10% of the NHS annual budget—£9 billion a year, or £1 million an hour. Diabetes prescriptions account for 7% of NHS costs. These staggering costs will only increase unless this illness is prevented and contained.
We are now 12 days from new year’s eve—a time to make new resolutions. I urge the Minister—the hon. Member for Hornchurch and Upminster (Angela Watkinson)—to adopt my five resolutions. The first is to increase the level of education and awareness—including among ourselves: 10% of those sitting in the Chamber today will have diabetes without knowing it. And anyone walking into the Tea Room, as I have just done, will be offered every sweet and chocolate they could possibly want, and drinks loaded with sugar.
We need to make sure that, particularly in Olympics year, we get people to engage in physical activity. We also need to adopt the “fat tax” adopted in Denmark to try to make manufacturers responsible for what they sell. We must ensure that there is universal screening. Although the Government are currently committed to screening, it is not as widespread as we would like. Between April and June this year only 2.7% of eligible patients received a health check.
I want to ensure that we look carefully for ways to prevent the south Asian community in particular from getting diabetes. They suffer more from contracting it, as they are particularly susceptible to it as a group.
Finally, speaking as someone who has to get a prescription from my GP every month, I believe it absurd that there are 15 separate companies all producing different blood glucose testing strips. I often go to the pharmacy to get my prescription, but they give me the wrong strip for the wrong machine. It is vital that we ensure that there is one common strip.
Diabetes is a worldwide problem. My message is simple: no more declarations, no more fine words, no more summits: if we are to try to save lives, we need action now.
Dr Sarah Wollaston (Totnes) (Con)
It is a pleasure to follow the right hon. Member for Leicester East (Keith Vaz).
I want to speak on behalf of community hospitals, both locally in my own constituency and nationally on behalf of CHANT—Community Hospitals Acting Nationally Together. Before coming to the House, I worked as a GP in rural Dartmoor, covering the smallest hospital in England at Moretonhampstead. I was privileged to see first hand how a personal and compassionate service transformed the care and saved the lives of so many of my former patients.
We know that we need to change the way that health care is delivered. As we all live longer and with multiple complex medical problems, we need to focus on preventing admissions to acute hospitals in the first place. Community hospitals are ideally placed to deliver that care. There are four in my constituency: Totnes, Brixham, South Hams in Kingsbridge, and Dartmouth. I pay tribute to all their staff, and to the volunteers in the leagues of friends.
The leagues of friends are a vital resource in all our constituencies. They raise an incredible amount of money—between £7 million and £8 million has been raised in south Devon alone over the last decade—and are made up entirely of volunteers who co-ordinate fundraising events as well as managing donations and legacies, and then plan how those projects should be managed in the future.
As a direct result of voluntary contributions, patients in South Hams hospital are able to have their chemotherapy locally rather than making the long, arduous journey to Plymouth, and in Brixham, the league of friends has donated £200,000 towards the new hospital ward. There have been numerous projects in Dartmouth and Totnes, all improving dignity, privacy and comfort and raising money for equipment. However, the contributions go way beyond funding. Local residents volunteer their services on the wards for both patients and visitors, and directly improve the quality of care.
I am delighted that the coalition has repeatedly expressed its commitment to community hospitals, and has recognised the vital role that they play in rural areas in particular. However, I should like the Department of Health to respond to a number of concerns and uncertainties so that these much-loved community resources can be put on an even stronger footing. The issues that I wish to raise are the ownership of the community hospital estate and the operation of the current tariff system.
I have heard from some leagues of friends that they are holding back funding of projects as a result of concerns expressed by some of their members about the future ownership of community hospitals. They are afraid that money raised by local communities and invested in local services could end up being lost to those communities should the ownership of the estates pass elsewhere. I know that the ownership of the premises in south Devon will pass to Torbay care trust, but concern is still being expressed at a high level in my local NHS about the possibility that the future ownership arrangements will inadvertently decouple community infrastructures from the communities that they serve. Those communities seek reassurance that if for any reason the provider trust that owns a community hospital relinquishes ownership of a building, selling it without reinvesting in an improved and equally local facility, the funds raised by local communities will be returned to them in full.
Harriett Baldwin (West Worcestershire) (Con)
There are three fine community hospitals in my constituency: Pershore, Tenbury and Malvern. My hon. Friend may wish to invite her constituents to visit the Pershore hospital, which is owned by the district council and operated by the NHS care trust. It is an interesting model.
Dr Wollaston
I thank my hon. Friend for that intervention. There is an understandable fear that many premises in the most stunning locations, which have been bequeathed to their communities by local benefactors, could end up being sold off with communities powerless to intervene. I want to touch on some of the alternative models. Communities are reassured that for the time being there is a clear directive providing that in future only NHS organisations may own the estate, but I agree with my hon. Friend that local models can provide alternatives. NHS ownership may, in some circumstances, create difficulties, and inhibit the development of hospitals’ full potential. For example, the Community Hospitals Association is concerned that in some areas management may pass to mental health organisations with little experience of managing community hospitals. There is also a concern that passing management to predominantly secondary-care-focused trusts could cause the hospitals’ interests to be sidelined.
In many parts of the country, social enterprises have been formed to provide community services, but currently they cannot own and invest in premises, and nor can GPs acting as commissioners. May I ask the Minister to look into how ownership arrangements could be made more flexible in order to provide local solutions, while at the same time guaranteeing to local people that the value of their assets will be safeguarded for their communities? I hope that all our leagues of friends will then feel confident enough to continue to invest for the future.
Let me briefly raise the issue of the system of tariff payments. As the Minister will know, currently the tariff is not fairly distributed, which means that community hospitals are often not funded for the provision of step-down care. The acute hospital receives all the funding irrespective of how long the patient remains in its care, although community hospitals are ideally placed to provide safe step-down services. I therefore hope that the Minister will give an update on how and when the tariff will be reformed to assist community hospitals to offer the full range of services they wish to provide.
The main focus should be on avoiding the need for acute hospital admissions in the first place. Community hospitals have a key role to play in providing many services, not just in-patient and palliative care. I join the Community Hospitals Association in calling for more investment in research and evaluation of their role and contribution to high-quality care and the wider social care economy.
Finally, I wish all Members and staff of the House a very happy Christmas.
The Lord Commissioner of Her Majesty's Treasury (Angela Watkinson)
May I start by saying that I appreciate the waiving of my customary Whiply silence, albeit temporarily, to enable me to participate in this debate?
I thank my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) for raising the important issue of the loneliness and isolation that can affect older people. I welcome the good work done by Independent Age, Age UK Oxfordshire, Counsel and Care, and the WRVS on the campaign to end loneliness. We are living longer, healthier lives. We should celebrate that, and seek to unlock the rich potential of our older population, as well as promoting their well-being.
We recognise the terrible impact that isolation and loneliness can have on people’s health and well-being. We know that multi-professional collaboration from a health and social care perspective on the needs of older people—including recognising isolation and those at risk from it—will make a huge contribution to keeping older people well and independent in their own homes, and to helping to maintain a decent quality of life for them. Of course, combating loneliness and isolation cannot be the job of health and care services alone. A range of services must be involved, including transport, housing and leisure.
We recently concluded the caring for our future engagement exercise, and we will produce a White Paper and a progress report on funding. That is planned for spring 2012. The engagement exercise considered six areas: quality and work force; personalisation and choice; shaping local care services; prevention and early intervention: integration; and the role of financial services. Throughout this engagement exercise we heard from a wide range of organisations, carers and people who use services, and the issue of loneliness and isolation among older people was raised.
Under the provisions of the Health and Social Care Bill currently before Parliament, local health and wellbeing boards will take responsibility for producing the joint strategic needs assessment and a local health and well-being strategy. I pay tribute to the London borough of Havering; it has shown great commitment in setting up its health and wellbeing board and it has already made significant arrangements for taking on this important new role. I also applaud the good work done by Age Action Alliance, an independent alliance of organisations working together to improve the lives of older people. It is aiming to prevent deprivation in later life, as well as challenging age discrimination and seeking to make older people feel valued and able to contribute to their local communities and the wider society. We look forward to the ideas that will emerge from that alliance.
We are doing everything we can, and we also support the efforts of others, to ensure that older people have access to all the help they need to reduce social isolation. I hope that that reassures my hon. Friend.
The hon. Member for Plymouth, Moor View (Alison Seabeck) made a thoughtful contribution about the understanding, patience and sympathy people with hearing loss need but do not always receive. She described the limitations on everyday activities such as using the telephone, and the absence of subtitles on television, which greatly disadvantage those with hearing loss. I shall refer those matters to the relevant Minister. We hope to improve the quality of life of people with hearing loss.
My hon. Friend the Member for Mid Derbyshire (Pauline Latham) raised concerns about two constituents who were unable to receive specific cancer drugs under their NHS treatment from the East Midlands strategic health authority. She has made her feelings very clear. The health authority will have heard her and will wish to respond with some urgency; and the Secretary of State will, I am sure, expect that to happen.
I thank the right hon. Member for Leicester East (Keith Vaz) for his question and his continued support for diabetes prevention and improving outcomes for people with diabetes. We pay particular tribute to his work through Silver Star, a charity he founded in Leicestershire that is invaluable in tackling diabetes within south Asian communities. As president of the Havering branch of Diabetes UK, I should like to take this opportunity to pay tribute to the late Sue Braeger, who sadly died recently. As chairman of the Havering branch, Sue was a formidable campaigner on diabetes issues, especially the management of diabetes medication for pupils in schools. She will be a hard act to follow.
We have learned this year—in the last few months, in fact—that nearly 3 million people in the United Kingdom have diabetes, a number that grows year on year. Worse, 24,000 people each year die unnecessarily from the disease—deaths that could have been prevented with better management and care. Much progress has been made in diabetes care since the publication of the national service framework in 2001, but prevention and early diagnosis remain a Government priority.
Next year, the National Audit Office and the NHS leadership team will be reviewing progress and considering whether there is need for further work, co-ordinated at a national level. Any such work would of course seek to reinforce and support activity led by clinicians at local level to improve outcomes for people living with diabetes.
We will also depend on the NHS health check programme, which has the potential to prevent many cases of type 2 diabetes and identify thousands more cases earlier. We will be continuing the change for life campaign, which raises awareness of the importance of maintaining a healthy weight and being physically active. As type 2 diabetes is linked to both obesity and inactivity, these public health initiatives are crucial.
For people diagnosed with diabetes, our priorities for treatment and care are to improve quality of life and reduce complications, and as a result to reduce cost. People with diabetes account for 15% of in-patient hospital beds in England. Their hospital treatment costs £600 million a year more than that for patients admitted without diabetes. Poor management of diabetes and insulin leads to emergency admissions and readmissions, and increased lengths of hospital stay. Poor care can also lead to deaths and permanent disability, with an estimated 80% of the 73 lower-limb amputations suffered each week by people with diabetes considered preventable.
The NAO will be reporting next summer on its study of the management of diabetes services. We expect it to provide robust recommendations on improving services and outcomes for patients and the public, and we look forward to seeing the results.
My hon. Friend the Member for Totnes (Dr Wollaston) raised the important issue of the role of community hospitals and leagues of friends. I should like to assure her that the Government are committed to helping the NHS work better by extending best practice on improving discharge from acute hospitals, and increasing access to care and treatment in the community. Community hospitals can be an important part of delivering this, especially in rural areas, providing both planned and unplanned acute care and diagnostic services closer to home. Community hospitals support best practice in admission avoidance and provide a range of services, from treating minor injuries to intensive rehabilitation. Subject to the passage of the Health and Social Care Bill through Parliament, clinical commissioning groups will be responsible for securing the best health care and health outcomes for their patients and locality.
The Department announced on 4 August that NHS trusts and NHS foundation trusts will also be given the chance to acquire estate from primary care trusts, including the community hospital estate. PCTs have reviewed and provisionally agreed lists of property for transfer to NHS bodies, and those will shortly be approved by the Department of Health. It is expected that the actual transfers of estate will commence in 2012. I know that this is a concern of my hon. Friend, but it is not expected that these changes will affect the role or function of local league of friends’ volunteers, who provide such valuable and important services in community hospitals around the country
The Government are also committed to increasing the scope of a more transparent rules-based funding system, where money follows the patient. Since its introduction, the payment by results national tariff has been mainly restricted to treatments provided in acute hospitals. We want to change that, but in a way that supports the delivery of high-quality services. That will not be easy, as there are significant challenges for us to overcome, such as making sure that activity that takes place in community settings is recorded and reported, as this is essential to plan services and drive payments, but we are making good progress. From April 2012, we will introduce the first ever tariffs for post-discharge care, with transparent prices to give more certainty about funding. I hope that that sets my hon. Friend’s mind at rest.
Finally, may I take this opportunity, Mr Deputy Speaker, to wish everybody the season’s greetings?
Mr Deputy Speaker (Mr Lindsay Hoyle)
Absolutely, and I am sure that it is warmly welcomed with Christmas and the new year upon us.
May I say that we have reduced the time limit to five minutes as we come to the general debate?