Grahame M. Morris (Easington) (Lab)
2. What progress he has made on the commitment that patients would have access to appropriate radiotherapy wherever they lived.
The Parliamentary Under-Secretary of State for Health (Anna Soubry)
I am pleased to say that from 26 March £22.7 million of the Prime Minister’s fund to improve access to what is called intensity modulated radiotherapy—IMR in short—has already been committed. The money is being used to update machines and ensure that radiographers receive extra training if they need it. We are well on our way, especially as it is now a nationally commissioned service, so there is no reason why anybody should not have the access they need to this treatment.
Grahame M. Morris
I thank the Minister for that response, but is she aware that new guidelines released by NHS England for treating patients using stereotactic ablative radiotherapy—advanced radiotherapy—say that only commissioning for early stage lung cancer will be approved, and that other treatments for all other cancers can be paid for only in clinical trials? As no trials are being commissioned in England, can the Minister explain how the treatment for patients with prostate, liver and spinal cancer, who were receiving SABR treatment last month, will be funded in the future?
Anna Soubry
What I do know, having had a long meeting with my officials only this morning, is that the evidence, as they have explained it to me, is clear: SABR is effective only in a small number of people who have, unfortunately, a certain small tumour in their lungs, and it is not suitable for other treatments of cancers. However, if the hon. Gentleman wants to discuss the matter further, my door is always open.
Mr James Gray (North Wiltshire) (Con)
The trouble with all these things is that medical science moves faster than the targets set by the Government. Does the Minister agree with me that proton beam therapy is now almost as important as radiotherapy? How much have the Government spent on this therapy, and how many patients have been helped by it?
Anna Soubry
We are building two new machines specifically to deliver that treatment. I accept that these things often take a long time, but those machines are planned. In the meantime, NHS England has made it clear that people who need this specific type of treatment can receive it overseas and it will be funded accordingly.
Tessa Munt (Wells) (LD)
Two years ago, the Prime Minister accepted the installation of CyberKnife as the latest in cancer radiosurgery equipment at the world-leading Royal Marsden hospital cancer centre. At the last Health questions, I asked the Secretary of State whether he would accept one of the countless invitations to visit the Royal Marsden. The consultant clinical oncologist has issued and reissued that invitation, but has had no response from the Department. Will the Secretary of State now please visit CyberKnife at the Royal Marsden?
Anna Soubry
I have to tell the hon. Lady that, as she knows, there is some controversy over this treatment, which is backed by a very large and powerful American company. The Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), has visited, and I know that the Secretary of State has an extremely busy and full diary. It is not as simple as a visit; it is all about whether there is any clinical value.
Eric Ollerenshaw (Lancaster and Fleetwood) (Con)
3. What steps his Department is taking to raise awareness of the signs and symptoms of cancer.
Fiona Bruce (Congleton) (Con)
12. What steps his Department is taking to raise awareness of the signs and symptoms of cancer.
The Parliamentary Under-Secretary of State for Health (Anna Soubry)
It would take me a very long time to give all the details of the Department’s work. In short, we have run a number of specific campaigns, both locally and regionally, to deal with a number of cancers. We will now evaluate whether those pilots have been successful. What I can say is that, such is the success of the lung cancer campaign, we will be recommissioning it in July.
Eric Ollerenshaw
I thank the Minister for that reply. May I raise, in particular, the issue of poor outcomes in pancreatic and prostate cancer? The problem we face is how to achieve the earlier diagnosis that is needed by GPs, so that we can achieve better outcomes in terms of international comparisons.
Anna Soubry
It was a great pleasure to meet my hon. Friend and the hon. Member for Scunthorpe (Nic Dakin) to discuss prostate and pancreatic cancer. Those cancers are difficult because often the symptoms are not obvious. The “Know 4 sure” campaign highlights some of the symptoms associated with them. We are evaluating this matter, and if we think that there is benefit in a campaign specifically on those cancers, we will run it.
Steve Brine
The Minister will be aware that the all-party group on breast cancer, which I co-chair, is holding an inquiry into older people and breast cancer, starting this afternoon. We look forward to seeing her there. What plans do the Government have to ensure that everyone affected by breast cancer, regardless of their age, is diagnosed at the earliest possible stage?
Anna Soubry
I pay tribute to the work of my hon. Friend and all those involved with the all-party group—I am indeed looking forward to this afternoon’s session. I particularly commend the group’s work on targeting women over 70. Again, we have run a pilot campaign on that and are evaluating the results, and if there is value in it, it will be rolled out in order to bring huge benefits.
Fiona Bruce
Given the link between smoking and cancer and the fact that 70% of smokers start before they are 18 and 94% before they are 25, what consideration have the Government given to introducing plain packaging in order to drive down the number of young people attracted to smoking in the first place?
Anna Soubry
We are considering what has been a huge consultation, but I must correct my hon. Friend—I am in no way criticising her—because it is not plain packaging, but what we call standardised packaging. If, like me, hon. Members were to see the cigarette packets now issued in Australia, they would realise that they are far from plain. Some would say that they are a counterfeiter’s nightmare, not a charter for counterfeiters.
John Healey (Wentworth and Dearne) (Lab)
People remember the massive improvements in cancer care services under Labour. Now, more and more people are having to wait longer and longer for those crucial diagnostic cancer tests, when they might be worried sick about what they will have to face. Is the Minister happy that more people are waiting longer and what is she doing now to cut those waiting times?
Anna Soubry
We have invested £450 million in improving exactly the matter that the right hon. Gentleman raises, and I do not share his analysis one bit.
Valerie Vaz (Walsall South) (Lab)
As well as raising awareness of cancer, will the Minister clarify whether this new list of 28 prescribed drugs produced by the NHS Commissioning Board will increase access to the cancer drugs fund?
Anna Soubry
What I know is that the cancer drugs fund is delivering in a way that, if I may say so, was not delivered under the last Administration.
Ms Margaret Ritchie (South Down) (SDLP)
What discussions have taken place with Health ministerial colleagues in devolved Administrations on the need to share best practice in diagnosis, analysis of biopsies and future treatments and care for those suffering from different forms and types of cancer?
Anna Soubry
We are always open to discuss anything that can improve outcomes for anybody suffering from cancer, and certainly we are alert to all new research. As I said, if that involves talking to devolved Administrations, my officials do that in order to improve outcomes for people in England.
David Tredinnick (Bosworth) (Con)
Is my hon. Friend aware that one of the most effective treatments in reducing the impact of prostate cancer is traditional Chinese herbal medicine and acupuncture, and does she agree that it is crucial that we get the regulation of herbal practitioners in place as soon as we can?
Anna Soubry
All these things have to be evidence-based. I am reminded of the evidence that the chief medical officer gave recently on this subject.
Andrew Gwynne (Denton and Reddish) (Lab)
A freedom of information survey by Labour showed that cancer networks saw their funding cut by 26% between 2010 and 2013 and lost 20% of their work force over the same period, losing vital skills and expertise along the way, despite repeated reassurances from the Government that funding for clinical networks would be protected. Even more shockingly, all this is happening at a time when the Department of Health has handed back £2.2 billion to the Chancellor of the Exchequer. How can the Minister justify handing vital NHS funding back to the Treasury when cancer networks are being cut, specialist staff and skills are being lost and thousands of nurses are being axed?
Anna Soubry
I think that that was about four questions in one, but I would certainly dispute all that has been said. Let me make this absolutely clear: we know that there was great success in the cancer networks, which is why we have extended them, so that they now include, for example, dementia and mental health, and far from cutting the overall money going to all the strategic networks, we have increased it by 27%.
Christopher Pincher (Tamworth) (Con)
4. What support his Department has given to local authorities and NHS commissioners to improve cardiovascular disease outcomes.
The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)
On 5 March, we published the cardiovascular disease outcomes strategy, which included 10 key actions for commissioners and providers to ensure patients and carers get the best possible support. As set out in the strategy, we will continue to make data available to local authorities to see where their areas of greatest need are and to shape their own response accordingly.
Christopher Pincher
Will my hon. Friend support the efforts of local clinicians, Tamworth borough council and charities such as Tamworth in the Community, which are working with parents, teachers and children to educate them about the importance of healthy eating and exercise, to deal with the health challenges we have in Tamworth and tackle the rather unfair notoriety that Tamworth gained in the press?
Dr Poulter
I commend the work being done locally in Tamworth to address this issue. As we know, one of the biggest public health challenges facing this country is obesity. The risk factors for cardiovascular disease include diabetes and high cholesterol. If we can tackle obesity and improve lifestyles, we will address both those risk factors directly, so I wish my hon. Friend’s local organisations every success in tackling those challenges.
Keith Vaz (Leicester East) (Lab)
As the Minister has said, those with diabetes are five times more likely than others to develop cardiovascular disease, which currently costs the national health service £9.8 billion a year. Will he commit to a public awareness campaign and issue guidelines for local health and wellbeing boards so that they make this a priority?
Dr Poulter
I commend the right hon. Gentleman’s work in raising the profile of diabetes. A lot of the Government’s work is focused on the importance of improving public health in this country and in particular on obesity, and if we are to tackle that we have to deal with diabetes. As a key part of that, we are now giving 40% of the public health money to local authorities to do exactly what he has just described: to focus money in the right places to tackle cardiovascular disease in those communities that most need it, particularly in inner-city areas.
Greg Mulholland (Leeds North West) (LD)
The role of local authorities in scrutinising NHS decisions is now even more important, yet the joint health overview and scrutiny committee of Yorkshire and Humber councils was consistently denied a number of important documents, which was one reason the High Court ruled that the decision taken in the Safe and Sustainable review was unlawful. This is now in tatters. Will the Minister now confirm whether he will instruct NHS England not to appeal the High Court decision?
Dr Poulter
Surely the validity of evidence is a matter for the court. I am sure my hon. Friend would recognise that there has to be a distinction between what we do here in Parliament and what is done in the courts. If NHS England would like to appeal the decision and if it thinks there are good grounds to do that, it must do that. The decision will then ultimately be made in the courts, on the basis of how valid that appeal is.
Liz Kendall (Leicester West) (Lab)
The best way to improve outcomes for heart disease patients and get the best value for public money is to help people to manage their condition at home. Will the Minister therefore explain the thinking behind the Government’s strategy of cutting one in five district nurses, so that delayed discharges from hospital due specifically to a lack of NHS community services rise by 40%, costing taxpayers £6 million a month as a result?
Dr Poulter
The hon. Lady and Opposition Members are fond of saying that we are cutting the NHS. It is their party that has said it will cut; they think it is irresponsible to increase funding for the NHS. We on the Government Benches have invested £12.5 billion more in the NHS. There are 6,000 more clinical staff working on the ground, focusing specifically on early intervention, early strategies and lifestyle. We now have almost 1,000 more health visitors working in the NHS and we have expanded the family nurse partnership programme. All these things will make a difference. Indeed, there is now a lot more joint commissioning between hospitals and primary care, to ensure that commissioning arrangements are in place better to support the role of community nurses and district nurses in preventive care and better look after people with long-term conditions.
Mark Menzies (Fylde) (Con)
6. What steps his Department plans to take to improve dementia diagnosis rates and to reduce regional variations in such diagnoses.
The Secretary of State for Health (Mr Jeremy Hunt)
Dementia diagnosis rates vary across the country, from 75% in the best areas to a shocking 31% in the worst areas. That is totally unacceptable, given the difference that we know a diagnosis and a good care plan can make to people who have dementia.
Mark Menzies
What steps is my right hon. Friend’s Department taking to ensure that GPs are adequately supported, so that his ambitious targets for dementia diagnosis are met?
Mr Hunt
My hon. Friend makes an important point. There is a misconception among some GPs that a dementia diagnosis is pointless and cannot make a difference, when we know that in fact the correct medicines can help between one in three and one in four of those who have the condition. However, some GPs also have a point when they are concerned that it is difficult to access good services for people who have dementia. The way we will change GPs’ minds is for them to appreciate that something will change if someone gets a dementia diagnosis. That is the big challenge that this ministerial team has set the Department.
Jim Shannon (Strangford) (DUP)
Does the Minister agree that there is much to be learned from the high rate of dementia diagnosis in Northern Ireland? Is not that an example of how important it is for the devolved powers to share information and tactics for success in their own areas with the other devolved bodies?
Mr Hunt
I agree with the hon. Gentleman. Some of the devolved Administrations, particularly Scotland, actually do better than England in regard to dementia diagnosis, and one thing that we must learn from them is the value of a properly integrated care plan. I am working closely with the Minister of State to ensure that we deliver that in England.
Mr Stephen Dorrell (Charnwood) (Con)
My right hon. Friend said in his answer to my hon. Friend the Member for Fylde (Mark Menzies) that certain aspects of the treatment of dementia patients had to change. Does he agree that that should include the services that are delivered to them becoming more integrated, not only between hospitals and community health care services but between social care services and social housing support, in order to provide a proper joined-up package of care for people who receive such diagnoses?
Mr Hunt
I wholeheartedly agree with my right hon. Friend. I was in the accident and emergency unit at Watford hospital last week when a lady with advanced dementia was admitted. She had bruises all over her face after having had a fall. The shocking reality was that that A and E department knew nothing about that lady. It did not know her medical history, and it did not know whether that was her normal condition. There was no proper joined-up link between the social care system and the NHS. Tackling that issue is probably the single biggest long-term and strategic challenge that we have to address in the NHS.
Steve McCabe (Birmingham, Selly Oak) (Lab)
Was Professor Malcolm Grant, the chairman of NHS England, talking about dementia sufferers when he said today that the NHS would have to charge for particular treatments? If not, will the Secretary of State specifically rule that out?
Patrick Mercer (Newark) (Con)
I should like to thank the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), for his visit to Newark, which was a huge success. However, it has been pointed out that there is a distinct feeling in Newark that dementia patients are not being treated quite so quickly there as they are in other parts of Nottinghamshire. Will the Secretary of State please give that matter his attention?
Mr Hunt
I entirely agree with my hon. Friend the Member for Newark (Patrick Mercer). We must urgently tackle the variation in dementia diagnosis rates. In the end, the litmus test of whether we are able to cope with an ageing population in the NHS will be how we deal with dementia, which now affects one in three people over the age of 65. There is still a lot of misunderstanding about the impact that a good diagnosis and care plan can have, and for the sake of my hon. Friend’s constituents and everyone else, this is an area in which we need to make urgent change.
Mr Graham Allen (Nottingham North) (Lab)
9. If his Department will make early intervention a priority for clinical commissioning groups and public health officers.
The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)
I commend the tremendous amount of work undertaken by the hon. Gentleman on early intervention. Yesterday, he and I attended the Early Intervention Foundation, which he has set up. We are talking a lot about legacies this week, and his legacy and the work that he has done to promote early intervention will certainly stand the test of time. The Government are committed to supporting that work, both through his foundation and through the work that we are doing to expand the family nurse partnership programme and the number of health visitors available to young families.
Mr Allen
I thank the Minister for those remarks, and I would like to thank those on both Front Benches for their support for the Early Intervention Foundation, which is greatly appreciated. Would the Minister accept that, in addition to having police and crime commissioners and councils promoting early intervention, the role of GPs, of directors of public health and of health and wellbeing boards will be absolutely central to getting early intervention plans and programmes to scale across the whole of England?
Dr Poulter
The hon. Gentleman is absolutely right. The health and wellbeing boards in particular will be well placed to bring together and join up what goes on in early interventions and to break down some of the silos that have existed in education, social services and health care. It is through the health and wellbeing boards that a lot of the work being done by health visitors and others to improve the life chances of many children, particularly those in the poorest communities, can be taken forward locally in a much stronger way.
Andrew Bridgen (North West Leicestershire) (Con)
What steps are being taken to encourage and help local authorities to focus on illness prevention and help people to lead healthier lives?
Dr Poulter
My hon. Friend will be aware that local authorities are now receiving 40% of the public health budget. That allows local authorities to have a much more nuanced approach to how and where they direct their budgets. It is of course desirable to focus on the early years to give each and every child the best start in life, to set good and healthy eating patterns and to support the work being done in the health service in expanding the health visitor programme. This also allows local authorities to address other public health challenges in the area by focusing, for example, on areas with high rates of teenage pregnancy, smoking or cardiovascular disease death.
Mr Speaker
I am grateful to the Minister, but we do have quite a lot to get through, so shorter answers would help.
Mr Peter Hain (Neath) (Lab)
What sort of early intervention have the Government ordered to prevent a contagious spread of measles from the outbreak in the Neath and Swansea area of more than 700 serious cases? Thousands of parents across Britain will have been tormented by the choice of whether to vaccinate their children for measles, mumps and rubella because of the scare. Surely the Minister should take serious action to instruct public health officials to combat this issue.
Dr Poulter
We are taking exactly that action to make sure that the vaccine is available and to promote the uptake of it. The right hon. Gentleman will of course be aware that the problems and concerns about the failure of some families to take up the vaccine resulted from some mis-used data in the past. That was a regrettable incident concerning the use of medical data, and is unfortunately causing great problems now. We are committed to making sure that those vaccines are available to the children who need it.
Paul Burstow (Sutton and Cheam) (LD)
When it comes to early intervention with the one in 10 children in this country who have a diagnosable mental health problem, will the Minister confirm that it is the Government’s intention to ensure that those children all have access to talking therapies so that they get the right treatment at the right time, which will make a big difference for them?
Dr Poulter
In his time in office, my right hon. Friend did a tremendous amount to promote the cause of mental health and to get parity of treatment between mental and physical health. That is exactly what we propose to do with the money going into the talking therapies—to get in place those early interventions, not just for adults, but for children, too. We shall be taking that work forward in earnest in the years ahead.
Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)
Does the Minister agree that the most important form of early intervention is for the public to get prompt advice on their symptoms? Does he share my concern that a leaked report on the national performance of the 111 line shows that the service is in crisis with staff shortages, delays, abandoned calls, 11-hour waits for call-backs, staff being wrongly diverted to attend cats with diarrhoea and ambulance crews going without breaks for 12 or more hours? Is this not a trademark Government shambles?
Dr Poulter
The hon. Lady will be aware that it is important not to rush the roll-out of any service. That is why we kept in place the NHS Direct service in areas where rolling out the 111 service has been slower. A lot of good work is going on in early intervention; it focuses on giving local authorities the budget and the powers to make a difference to local communities. The Labour party should get behind that and do much more to support it. It is this Government who are making a difference in early years, and I hope that the Opposition can support us on that.
Dan Jarvis (Barnsley Central) (Lab)
10. When the Government plan to respond to the consultation on standardised packaging for tobacco products; and if he will bring forward legislative proposals on standardised packaging.
The Parliamentary Under-Secretary of State for Health (Anna Soubry)
I am afraid that I cannot give a timetable, and I make no apology for the fact that this Government are taking a careful look at all the evidence that has come out of the consultation.
Dan Jarvis
Figures from Cancer Research UK show that more than 1,100 of the 10 to 14-year-olds in Barnsley are regular smokers. Given that countries such as Australia and New Zealand have now committed to standardised packaging, I ask the Minister again: are the Government planning to legislate to give millions of children one less reason to start smoking?
Anna Soubry
I find it most bizarre that the advice I am given by my officials—and I absolutely accept their advice—is that, as the hon. Gentleman will understand, because of judicial reviews of consultations, I am not allowed to have an opinion, so I do not give any opinion, notwithstanding the fact that many people would say that he advances a number of important arguments. I will say, however, that it is important to look at all the emerging evidence, including that coming out of Australia. As he will no doubt know, Australia continues to face a legal challenge that is yet to be resolved. It is also important to be aware of that.
Dame Angela Watkinson (Hornchurch and Upminster) (Con)
Does the Minister agree that adult smokers have already made a conscious decision to disregard all the health warnings that are so highly publicised, and are therefore unlikely to be influenced by the appearance of a packet of cigarettes? Is not the best way of deterring children from smoking the setting of a good example by responsible parents who know how much money their children are spending without supervision, and what they are spending it on?
Anna Soubry
If only it were as simple as that. Emerging evidence that I have seen suggests that it is the attractiveness of the packets that leads young people to decide to take up smoking. It also suggests—it is important for us to bear this in mind—that standardised packaging is not intended to persuade those who choose to smoke to continue to do so, and will make no difference to their choices. The aim is to protect children and young people.
Mr Kevin Barron (Rother Valley) (Lab)
22. It is a well-known fact that for many decades cigarette packaging has been there to attract the eyes of not just current smokers, but those who are yet to become smokers. Given that 50% of people who smoke die prematurely, it is clear that, over those many decades, the tobacco industry’s intention has been to attract new smokers, including young children. The sooner we get on with standardising packaging, the better.
Anna Soubry
As I have said, I am precluded from giving any personal opinion, but I am sure that we will all take on board what the right hon. Gentleman has said.
Jackie Doyle-Price (Thurrock) (Con)
Recent press reports have revealed that as many as a third of the number of cigarettes sold in the London area are contraband. Will the Minister discuss the matter with those in other Departments, in order to ensure that the objective that we are trying to achieve by standardising packaging will be achieved by that means?
Anna Soubry
I shall be meeting the relevant Home Office Minister today to discuss that very issue, but let me repeat that, far from being a counterfeiter’s dream, the packets produced in Australia would clearly be a nightmare here. A variety of colours, watermarks and holograms, and all manner of other things, can be attached to them, which is why they are described as “standardised” rather than “plain”.
Catherine McKinnell (Newcastle upon Tyne North) (Lab)
20. This decision is taking too long, and those who care about the impact of smoking on children are at a loss to understand why. Given the U-turn on minimum alcohol pricing, the delaying of the sexual health strategy and, now, the stalling on standardised packaging, I must ask whether the Government have simply given up on public health.
Anna Soubry
And it was all going so well. I will take no lectures from Labour Members, who had 13 years in which to resolve this issue, but did not do so because they knew that these were difficult and tricky matters, and that it was important for all the evidence to be considered properly. I do not know what peculiar gestures Opposition Front Benchers are making, but they are clearly not listening and understanding when it comes to stuff that they themselves must have considered when they were in government.
Mark Durkan (Foyle) (SDLP)
11. What steps the Government plan to take to ensure that patients with rare and very rare muscle-wasting conditions have access to high cost drugs when such treatments become available.
The Minister of State, Department of Health (Norman Lamb)
Our priority is to ensure that patients in England, including those with rare and very rare muscle-wasting conditions, have access to new and effective treatments on terms that represent value to the NHS and the taxpayer.
Mark Durkan
The all-party parliamentary group for muscular dystrophy, which has been conducting an inquiry, was told recently that patients who are experiencing muscle-wasting conditions, and their families, are concerned about the possibility that they will be denied access to potential treatment because of regulatory barriers, and/or on cost grounds. Will the Minister meet the all-party group to discuss measures for the removal of any such impediments?
Norman Lamb
I am certainly willing to meet the all-party group, but I think that significant new opportunities are emerging. For example, from this month the National Institute for Health and Clinical Excellence will be responsible for the evaluation of new drugs for the treatment of rare conditions, and I think that that is a very good thing.
Mr Gary Streeter (South West Devon) (Con)
One of my constituents, a seven-year-old boy, has Duchenne muscular dystrophy. His family are pinning their hopes on a new drug called ataluren, which has not yet completed its trials. Can the Minister give me any idea when it might become available?
Norman Lamb
I understand that the manufacturer of ataluren has applied for conditional approval from the regulatory authorities. We await the outcome of that process, but I am afraid that I cannot give a time scale for it.
Chi Onwurah (Newcastle upon Tyne Central) (Lab)
Eculizumab is a high-cost drug that makes a profound difference to the lives of people with a rare kidney disorder, yet the Department has rejected the recommendation of the Advisory Group for National Specialised Services to make it available to all patients, instead referring it to the National Institute for Health and Clinical Excellence, which will delay any decision by at least a year. Will the Minister meet me and specialists from my Newcastle constituency to discuss how we can ensure those patients are not adversely affected by this delay?
Norman Lamb
I am certainly happy to have a discussion with the hon. Lady, and to look into the concerns she raises and get back to her on them.
George Freeman (Mid Norfolk) (Con)
As the Minister is aware, the active involvement of patients in biomedical research is one of the areas in which Britain is increasingly leading. Yesterday, I chaired a meeting with my hon. Friend the Member for The Cotswolds (Geoffrey Clifton-Brown) and the Empower: Access to Medicine group and Les Halpin, who is suffering from a terminal disease and is launching a campaign for greater patient involvement in access to rare drugs. Will the Minister meet me and my hon. Friend to take that forward?
Norman Lamb
I seem to be ready to agree to several meetings and I will certainly add that one to my list. I will be delighted to meet my hon. Friend—and I should also pay tribute to him for the work he is doing in this area.
Sir Tony Baldry (Banbury) (Con)
13. What steps he is taking to make the services of hospices more available to NHS patients.
The Minister of State, Department of Health (Norman Lamb)
We are supporting NHS England to develop a fairer and more transparent funding system for hospices, to be in place by 2015. We have made £60 million in capital available to hospices to improve their physical environments, and will continue to provide over £10 million in central funding for children’s hospices.
Sir Tony Baldry
Will my hon. Friend confirm that the new NHS commissioning arrangements should increase the opportunities for hospices in the voluntary sector, such as the excellent Katharine House hospice in my constituency, to provide palliative care and terminal care for NHS patients?
Norman Lamb
I pay tribute to the hospice movement, including Katharine House in my hon. Friend’s constituency. It is crazy that we are spending a lot of public money on caring for people at the end of life in places where they do not want to be. Most people do not want to end their life in hospital, yet about 50% of people still die in hospital. We are looking to create a new funding regime where money will follow the patient, to ensure people’s choice is respected so they can die where they want to, and so that hospices have fair funding.
Barbara Keeley (Worsley and Eccles South) (Lab)
I recently had a case of very poor care of a terminally ill patient in the last few days of her life. She was let down by a GP who refused to prescribe the pain relief she needed and a district nursing service that provided wholly inadequate support. Given what the Minister has just said and that 20% of people want to die at home, what action will be taken to ensure that such cases do not happen and that instead we start to provide much better support for people so they can die peacefully at home?
Norman Lamb
My ambition is that the UK have a global reputation for the best possible care at the end of life. Whether we are talking about the Liverpool care pathway and concerns that have been raised about some care in hospital or care in the community and caring for people at home at the end of life, it is essential that people have a dignified death and the best possible care. Everything we are doing is aimed at achieving that. Where there are specific cases such as the one the hon. Lady raises, the relatives have the right to pursue a complaint, and ought to do so if care has fallen below an acceptable standard.
Mr John Baron (Basildon and Billericay) (Con)
14. How the NHS will be held to account on the experiences of cancer patients using the NHS.
The Parliamentary Under-Secretary of State for Health (Anna Soubry)
The Secretary of State made it very clear to NHS England in his mandate that we expect to see an improvement in patient experience.
Mr Baron
The Francis report recommended that the NHS be held to account on patient experiences. Given that the national cancer patient experience survey is a proven tool in driving up the quality of care, will the Minister endorse calls for the survey to be carried out annually, and support the development of a clinical commissioning group outcomes indicator set indicator based on the results in order to incentivise CCGs to improve cancer patient experience?
Anna Soubry
I am grateful to my hon. Friend for those comments; as he knows, these are now matters for NHS England. I will make sure it is aware of what he has said and his urging it to do both those things for the obvious benefits they would have for a cancer patient’s experience.
Mr Jamie Reed (Copeland) (Lab)
The hon. Member for Basildon and Billericay (Mr Baron) is absolutely right: it is essential that the NHS is held to account for the experiences of cancer patients and patients with other conditions, too. Accountability has undoubtedly been weakened, however, as a result of the NHS reorganisation that came into effect this month. Last week, the outgoing deputy chief executive of the NHS, David Flory, said that the loss of experience in the NHS is greater than he has ever seen and that hospitals have been left struggling as a result. How can a service stripped of so much skill, knowledge and expertise provide the accountability that patients deserve?
Anna Soubry
I am afraid that the hon. Gentleman’s question depicts a situation that I simply do not recognise. As I visit hospitals and other organisations, both in my constituency and across the country, I am told that there has been a huge improvement, especially in commissioning—[Interruption.] No, by front-line clinicians, who talk with enthusiasm about how the commissioning of services has improved because now at last the clinicians—those who know best—are in charge, and not, as has often been the case, faceless bureaucrats and managers.
Kate Green (Stretford and Urmston) (Lab)
15. When he expects to take a decision on the reconfiguration of hospital services in Trafford.
The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)
Following a referral from the joint Manchester and Trafford health overview and scrutiny committee, the Secretary of State requested initial advice from the independent reconfiguration panel. That was received on 27 March 2013. The Secretary of State will consider the advice and make a decision in due course.
Kate Green
This issue is of huge importance to my constituents, who are concerned about access to accident and emergency and acute services and about delays in discharge into the community in the absence of adequate community provision. So far, Ministers have refused to meet me so that I can make representations about my constituents’ concerns. Will the Minister give me an undertaking that no final decision will be taken until that meeting can take place so that local concerns can be properly taken into account?
Dr Poulter
I am sure that we would be happy to meet the hon. Lady; I am certainly happy to do so. A number of the concerns she has outlined in the House and at a local level will be taken into consideration by my right hon. Friend the Secretary of State when he considers the report.
Mr Graham Brady (Altrincham and Sale West) (Con)
I welcome the Minister’s undertaking to meet local Members to discuss these important matters and I endorse the comments made by the hon. Member for Stretford and Urmston (Kate Green) about the importance of a timely resolution. The longer this goes on, the greater the cost will be to local health services.
Dr Poulter
My hon. Friend is absolutely right, and it is important that a timely conclusion is reached. It is also right, as the hon. Member for Stretford and Urmston (Kate Green) said, that the need to improve community services and preventive care and to provide better support for people with long-term conditions in the Trafford area should be considered.
Paul Goggins (Wythenshawe and Sale East) (Lab)
I also welcome the Minister’s agreement to meetings. Will he and the Secretary of State carefully consider the likely impact of downgrading accident and emergency facilities at Trafford general and the implications for nearby Wythenshawe hospital? Does the Minister agree that a failure to provide proper facilities at Wythenshawe for the anticipated additional 4,500 accident and emergency patients, the additional admissions stemming from that and the extra beds required could lead to long delays and a diminution in the service?
Dr Poulter
My right hon. Friend the Secretary of State has visited Wythenshawe hospital and can pay testament to the high-quality care available there. All the points that the right hon. Gentleman has raised will, of course, be taken into account when a decision is made.
Mrs Linda Riordan (Halifax) (Lab/Co-op)
16. What steps the Government plans to take to improve public awareness of the signs and symptoms of early rheumatoid arthritis.
The Minister of State, Department of Health (Norman Lamb)
We have made earlier diagnosis a clear objective in our mandate to the NHS. It is for NHS England and local commissioners to undertake appropriate awareness campaigns on arthritis. We very much welcome the appointment of Professor Peter Kay as the first national clinical director of musculoskeletal disease to advise on specific initiatives.
Mrs Riordan
I thank the Minister for his reply. May I ask him for another meeting to discuss this very important matter and take forward further action on it?
Norman Lamb
The meetings are stacking up, but I would love to meet the hon. Lady. She should just get in touch with my office and we will get it arranged.
Miss Anne McIntosh (Thirsk and Malton) (Con)
I will spare my hon. Friend a meeting, but will he tell me what evidence there is to suggest that there was more awareness and earlier diagnosis when spa towns such as Harrogate and Bath provided spa facilities for those most badly affected by rheumatism and arthritis?
Norman Lamb
My hon. Friend makes an extremely interesting point. Although I have not agreed to meet her, I would be happy to have an informal discussion with her at some later stage.
David Morris (Morecambe and Lunesdale) (Con)
17. Whether there are plans to close the accident and emergency department at the Royal Lancaster Infirmary.
The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)
I would like to reassure my hon. Friend that there are no plans and never have been any plans to close the accident and emergency department at Royal Lancaster Infirmary.
David Morris
I thank my hon. Friend for that robust answer. Does he agree that the local Labour party fabricated the scare story that the A and E department was going to close? It was never going to close, as he has just stated. Will he assist me in taking the local Labour party’s bogus petition offline?
Dr Poulter
My hon. Friend is right to highlight the fact that it is wrong of any political party—in this case, the Labour party—to focus on scaremongering when there is no basis in truth. At no point have there been plans to close Royal Lancaster Infirmary.
Mr Philip Hollobone (Kettering) (Con)
18. What assessment he has made of (a) the pressures faced by Kettering general hospital’s accident and emergency department and (b) what can be done by Kettering general hospital to achieve national accident and emergency transition time targets.
The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)
Local health care commissioners have worked with the trust, Monitor and NHS England’s Hertfordshire and South Midlands local area team to ensure that robust plans are in place to improve the trust’s performance against accident and emergency waiting time performance indicators.
Mr Hollobone
The greatest difficulty for Kettering is that it has the sixth fastest household growth rate in the country, and A and E admissions are up 12% year on year. Will the Minister ensure that the NHS Commissioning Board makes sure that population estimates are put into its funding formula?
Dr Poulter
My hon. Friend makes a very good point. I will take up the matter further with the NHS Commissioning Board because it is important that when we are commissioning services we take into account future population growth.
Andy Sawford (Corby) (Lab/Co-op)
Along with the hon. Members for Kettering (Mr Hollobone) and for Wellingborough (Mr Bone), I shall meet the chief executive and chair of Kettering general hospital this Friday to discuss the latest steps in the Healthier Together review. Does the Minister agree that it is important that we urge on Kettering general hospital and all the other decision makers that we must maintain our proper accident and emergency and other vital services at Kettering general hospital?
Dr Poulter
It certainly sounds as though there is a need for an accident and emergency department in Kettering. These are matters for the local commissioning boards to take forward, but it would be wrong for the hon. Gentleman or anyone else to say that as part of the Healthier Together programme there are any site-specific proposals that would in any way threaten Kettering accident and emergency department.
David Rutley (Macclesfield) (Con)
T1. If he will make a statement on his departmental responsibilities.
The Secretary of State for Health (Mr Jeremy Hunt)
In a week when we are remembering the remarkable contribution made by Margaret Thatcher to our national life, we should also mark the extraordinary contribution made by someone else who died last week—Professor Sir Robert Edwards, the Nobel prize-winning doctor who pioneered modern IVF treatment. One in seven couples in this country experience fertility problems and he has given them hope and, in many cases, wonderful happiness. The whole House will want to applaud not just his scientific boldness, but his moral courage in confronting what was considered at the time to be an extremely difficult ethical issue.
David Rutley
In the light of the recent measles outbreak in south Wales, does my right hon. Friend agree that the claims made by Dr Andrew Wakefield about the MMR vaccine are both discredited and completely wrong?
Mr Hunt
I absolutely agree with my hon. Friend. What Andrew Wakefield said had no scientific basis and caused huge damage and worry to many thousands of parents. It is very important to reiterate that the scientific way to prevent measles, which can be a horrible and even a fatal disease, is to make sure that children have had two doses of MMR. Parents of children of any age who have not had those doses should contact their GP, particularly in the current circumstances.
Andy Burnham (Leigh) (Lab)
Accident and emergency departments across England are being closed, even though all are under intense pressure. For 11 weeks running, the NHS has missed the Government’s national A and E target. Last week, in places, one in three patients waited more than four hours in scenes not seen since the bad old days of the mid-1990s. What clearer symbol of the growing crisis in A and E is there than a tent as a makeshift ward in the car park at Norwich? The Secretary of State’s failure to address that cannot continue. Nursing jobs have been lost, ambulances are queuing outside A and E and patients are being treated in car parks. When will he get a grip?
Mr Hunt
The statistic that the right hon. Gentleman will not give the House is that for the year as a whole, which ended last March, the Government hit our A and E target. Furthermore, he still will not tell the House about the disaster that is happening in Labour-controlled Wales, where the A and E target has not been hit since 2009. He still refuses to condemn what is happening there. There is a lot of pressure on A and E, because 1 million more people are using A and E every year, compared with just two years ago. What are the root causes? They are poor primary care alternatives that date directly to the disastrous GP contract negotiated by his Government, since when more than 4 million additional people have been using A and E every year, social care and hospital sectors that are not joined up—Labour had 13 years to sort that out but did nothing—and problems in recruitment that have been made a great deal worse by his disastrous decision to implement the working time directive. It is time he sorted out his own issues before trying to criticise the Government for sorting them out.
Paul Uppal (Wolverhampton South West) (Con)
T2. The all-party group on men’s health, of which I am vice-chairman, has assisted in research that seems to show that men’s poor sexual health is often symptomatic of more serious problems, such as type 2 diabetes and cardiovascular disease. Will my hon. Friend assure me that all robust measures are being put in place to ensure that that is not overlooked and that men do not die unnecessarily because that situation is taken for granted?
The Parliamentary Under-Secretary of State for Health (Anna Soubry)
I completely agree with everything my hon. Friend has said, and the sexual health document we published in March relates specifically to those matters. Men are not very good at going to see their GP, a nurse or another health professional when they fear that they might need some sort of assistance. It is beholden on all men to follow the lead of women.
Mrs Mary Glindon (North Tyneside) (Lab)
T5. Evidence from the all-party muscular dystrophy group’s inquiry into access to high-cost drugs for rare diseases has highlighted the importance in clinical trials of centres of excellence, such as the International Centre for Life, which is based in Newcastle. Will the Minister, with NHS North of England, meet me to discuss changes to specialist neuromuscular care in my area as a result of the new NHS set-up?
The Minister of State, Department of Health (Norman Lamb)
I am tempted to say no, but I would not get away with it—so, yes, of course the hon. Lady can join all the rest and arrange to meet me. I would be very happy to discuss her concerns. While I am at the Dispatch Box, may I pay tribute to the International Centre for Life, which does really important work?
Mr Speaker
The Minister can report to his family just how popular a fellow he is.
Annette Brooke (Mid Dorset and North Poole) (LD)
T3. The all-party group on global tuberculosis has just published a report on rising rates of drug-resistant TB. One recommendation is for a national strategy for TB in the UK. Will the Minister comment on that? The officers of the all-party group would also be grateful if he fitted us into his very busy schedule of meetings.
Anna Soubry
My hon. Friend the Member for North Norfolk (Norman Lamb) is having a break on that one. The continuing outbreaks of TB cause a lot of concern, especially in certain communities. I have no hesitation in agreeing to meet my hon. Friend to explain what NHS England is doing and the development of a national strategy.
Andy Burnham (Leigh) (Lab)
Here comes another request for a meeting with the very obliging Minister. Last month he promised the House that he would rewrite the section 75 regulations to rule out enforced competitive tendering in the NHS. However, before Easter the respected House of Lords Secondary Legislation Scrutiny Committee said this of his redraft:
“The substitute Regulations are substantially the same as the original Regulations.”
It is no surprise that it seems to many that the Government are intent on privatisation by the back door, putting large parts of the NHS up for sale. With a crunch vote in the Lords next week, it is turning into another shambles. I make this offer to the Minister: will he again agree to withdraw the regulations and to sit down with us and the professions this week and come up with wording that is acceptable to all?
Norman Lamb
This really is the most outrageous scaremongering from the Labour party. In March 2010, the Labour Government issued guidance on European procurement law that described the limited circumstances in which one could avoid going out to tender. The wording used in these regulations is exactly the same as that used by Labour in March 2010, yet Labour Members will not admit that. There are also added safeguards in the redrafted regulations to ensure that there is a clear incentive for integrating and co-ordinating services for the benefit of patients.
Priti Patel (Witham) (Con)
T4. The Secretary of State is aware of the widespread management failures of East of England ambulance trust, and last month we saw the belated resignation of its chair. Will he ensure that the trust makes patient care the No. 1 priority, and will he join me in calling for its remaining non-executive directors, who presided over these management failings, to reflect on their own positions?
Mr Jeremy Hunt
I congratulate my hon. Friend on her campaigning on this. There must be full accountability for what went wrong in that ambulance trust. It is absolutely a top priority for me and my Ministers, two of whom represent Norfolk and Suffolk, to sort out what is happening in the trust, and that is why very decisive action has been taken.
Catherine McKinnell (Newcastle upon Tyne North) (Lab)
T7. Further to the question from my hon. Friend the Member for Newcastle upon Tyne Central (Chi Onwurah), several of my constituents with desperately ill relatives are very angry about the Government referring to NICE a decision on the use of eculizumab. The continuing delay is risking lives and also means that people have several invasive treatments that could well cost more. To save space in the Minister’s diary, may I add a request to join the meeting with my hon. Friend to talk about how this dangerous delay is causing very great distress to many constituents?
Norman Lamb
The hon. Lady raises a very important point, and I would be delighted for her to join the meeting rather than my having another one.
Mr Philip Hollobone (Kettering) (Con)
T8. Kettering general hospital’s new £30 million foundation wing has a new 16-bed intensive care unit, 28-bed cardiac unit and 32-bed children’s unit, and it opens to patients for the first time this coming Saturday. Will my right hon. Friend the Secretary of State take this opportunity to congratulate all those at Kettering general hospital who have brought this project to fruition?
Mr Jeremy Hunt
I would be absolutely delighted to do that. I had an excellent visit to Kettering hospital that was hosted by my hon. Friend, and I saw at first hand just how hard people are working in tough circumstances, with big increases in A and E admissions causing a great deal of pressure throughout the hospital. One had a sense at the hospital that there was a mission to turn things around and make things better, and a management team who were totally committed to doing that. I congratulate them and all the front-line staff who are doing such an important job for the people of Kettering.
Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)
A year ago, GPs in Hackney bid to run the out-of-hours services. Earlier this year, they were told that it had to be tendered because the board was fearful of legal challenge from private health companies. Who is running the NHS—the Secretary of State or the private health company lawyers?
The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)
That is an absolutely extraordinary question given that it was the previous Labour Government’s decision to contract out out-of-hours services in the first place, which has led to the massive pressure on so many A and Es. The regulations in place for many of these arrangements were laid by the previous Labour Government.
John Pugh (Southport) (LD)
T9. What is the Department doing to deal with the difficulties presented by poor data sharing between health and social care agencies and the threat to integration that that presents?
Mr Jeremy Hunt
My hon. Friend makes a very good point, and I pay tribute to him for raising this issue frequently. We will not have properly integrated, joined-up health and care services unless we crack the issue of data sharing. There need to be protections for people so that they can prevent their data from being shared if they do not want that, but by the same merit we have to make sure that there is better availability. For example, delayed discharges from hospitals, which are causing pressure on A and Es, would be directly helped if we cracked this. That is why we have called for a paperless NHS by 2018.
Meg Munn (Sheffield, Heeley) (Lab/Co-op)
Under the previous Government, my constituents could get an appointment with their GP within 48 hours. I recently heard of a wait for a routine appointment taking three weeks. Is not this one of the reasons there is such pressure on A and Es, and will the Secretary of State reintroduce the 48-hour appointment?
Mr Hunt
The reason there is so much pressure on A and Es is the disastrous GP contract negotiated by the hon. Lady’s party in government, since when—I do not know whether she was listening to what I said earlier—an additional 4 million people every year are going to our A and Es. That is what is causing the huge pressure, and that is what we are determined to put right.
Steve Brine (Winchester) (Con)
T10. The Secretary of State will know that the number of people donating organs after their death has risen by 50% in the past five years. Does he credit the network of specialist nurses who support bereaved families in hospital for that increase and, if so, what lessons does he take from that?
Mr Hunt
This is an example of a programme that has been a huge success and I pay tribute to the work done by the previous Government as well as this Government in making sure that we can tackle this very serious problem. All I would say to my hon. Friend is that three people still die every day, I believe, because we are not able to get the organ donations we need. We should not think that, despite the success, we have solved this problem. There is much work to do and I personally think that it is something that everyone should think about doing. It can be a source of personal pride to put oneself on the organ donation list and we should all encourage our constituents to think about it as well.
Jenny Chapman (Darlington) (Lab)
I have listened very carefully to what the Secretary of State has said on A and E, but he has not addressed the fact that under the previous Government waiting times reduced and under his Government they are growing and are now at their longest for more than a decade, so what is he going to do?
Mr Hunt
As I said to the right hon. Member for Leigh (Andy Burnham) earlier, we actually hit our A and E waiting time target last year. If the hon. Lady is talking about waiting times in general, the number of people waiting for more than a year for an operation was 18,000 under the previous Government, and the figure has fallen to just 800 under this Government.
Andrew George (St Ives) (LD)
If there is a smidgeon of space in any of the Ministers’ diaries, is there a chance that they could meet me and representatives of the nursing profession to address not the issue that I think the Government are saying they are opposed to—mandatory nurse to patient ratios on wards—but that of adequate registered nurse levels on hospital wards?
Dr Poulter
Of course, I would be very happy to meet my hon. Friend to discuss this matter further. He can be reassured that I have regular discussions on these matters with representatives from the nursing profession, both in my clinical work and, more specifically, in my ministerial roles.
John Cryer (Leyton and Wanstead) (Lab)
The Secretary of State said earlier that 1 million extra people are attending A and Es annually, but a few minutes later he said that the figure was 4 million. Which one is it?
Dr Sarah Wollaston (Totnes) (Con)
In Brixham in my constituency, 94% of five-year-olds are protected against measles. Just up the road in Totnes the figure is only 70%. There are many reasons for the variation, but does the Secretary of State share my concern that if parents believe they are protected by, for example, homeopathy products, they might be less likely to use an evidence-based treatment? Will he make an unequivocal statement that such products will not give any protection?
Mr Hunt
I am happy to do so and thank my hon. Friend for bringing up the issue. There is no scientific evidence whatsoever that homeopathic products can provide protection against measles. The right thing to do is to get two doses of the MMR jab. As I said earlier, anyone whose children, whatever their age, have not had those two doses should contact their GP.
Lucy Powell (Manchester Central) (Lab/Co-op)
As we have heard, A and E waiting times are at their worst level for a decade, yet we hear of proposed A and E reconfigurations based on tackling so-called inappropriate presentations. Does the Secretary of State agree that that approach is the wrong way around and that he would be better off tackling why people are going to A and E first, before he embarks on any reconfigurations?
Mr Hunt
That is exactly what we are doing. We are looking at the root causes of the fact that admissions to A and E are going up so fast—namely, that there is such poor primary care provision; that, as we discussed earlier, changes to the GP contract led to a big decline in the availability of out-of-hour services; and, that health and social care services are so badly joined up. That is how we are going to tackle this issue with A and E, and that is what we are doing.
Mr Stewart Jackson (Peterborough) (Con)
I am delighted to learn that there will shortly be a new national clinical director for neurological conditions, focusing in particular on conditions such as Tourette’s syndrome. Will the Secretary of State reassure us that that appointment, which is so long overdue, will be expedited at the earliest opportunity?
Norman Lamb
I agree with the hon. Gentleman about the real value of this appointment and I think that the clinical director’s work will emphasise the importance of addressing conditions such as that to which he referred. I am delighted that the hon. Gentleman is showing such clear support for this initiative.