NHS Future Forum
Lord Lansley Excerpts(12 years, 4 months ago)
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The Secretary of State for Health (Mr Andrew Lansley)
The Department of Health commissioned the independent NHS Future Forum in the summer to conduct a second listening exercise on a series of key issues for health and care. The NHS Future Forum submitted its report to the Department on 20 December and it has been published today. The report contains a series of recommendations for Government and for key bodies in the system in the areas of:
integration;
information;
the NHS’s role in improving the public’s health; and
education and training.
The Department is pleased to be able to accept all the forum’s recommendations for Government and has today published its response to the report.
Also published today is “Liberating the NHS: Developing the Healthcare Workforce, From Design to Delivery”, which sets out the Government’s policy for a new education and training system, and details how the Government are addressing the forum’s recommendations on education and training.
All documents published have been placed in the Library. Copies are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office.
PIP Silicone Gel Breast Implants
Lord Lansley Excerpts(12 years, 4 months ago)
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The Secretary of State for Health (Mr Andrew Lansley)
Approximately 40,000 women in the UK have had implants manufactured by the French manufacturer Poly Implant Prosthèse (PIP). These implants were made of a non-medical grade silicone gel, which was withdrawn from use across Europe on 30 March 2010 following investigations at the PIP plant in France.
The recommendation of the French Government on 23 December that these should be removed has caused understandable worry for women affected. My primary concern is for safety and well-being, which is why I asked the NHS medical director, Sir Bruce Keogh to convene an expert advisory group to review the available data on PIP implants.
My Department published the interim report of the expert advisory group on Friday 6 January 2012. It also published a letter from the NHS chief executive, Sir David Nicholson, to the chief executives of all NHS bodies and from the chief medical officer, Dame Sally Davies, to all general practitioners and other relevant health professionals.
Taken together, these documents provide authoritative advice to women and clinical professionals about the risks associated with PIP implants. The expert advisory group concluded that there is not enough evidence to recommend routine explantation of the implants, although they also recognised this is a worrying time for women with PIP implants. The documents therefore set out the model of care to be provided to NHS patients, and the expectation that the private sector would follow suit.
These documents have been placed in the Library. Copies are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office. I will keep the House updated.
NHS Pension Scheme
Lord Lansley Excerpts(12 years, 4 months ago)
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The Secretary of State for Health (Mr Andrew Lansley)
On 2 November the Chief Secretary to the Treasury made a statement to the House setting out an improved offer on public service pensions to public sector workers (Cm 8214). This offer provided a more generous cost ceiling for scheme-specific discussions to work within, and protected all those within 10 years of their pension age from any further change. This generous offer was conditional on the Government and trade unions reaching agreement by the end of the year, including in the NHS pension scheme, bringing to a conclusion talks that have lasted since February 2011.
Since 2 November I have been engaged in detailed and intensive talks with the health trade unions and employer representatives. I can now report to the House on the heads of agreement on the scheme design for the NHS pension scheme to be reached in 2015, on which talks have concluded. The Government have made it clear this sets out their final position on the main elements of scheme design, which unions have agreed to take to their Executives as the best that can be achieved through negotiations. Further work on the remaining details will take place in the new year, and Executives will consult members as appropriate. This includes a commitment to suspend any further industrial action while the final details are resolved and unions are consulting their members.
The main parameters of the new scheme are set out below:
a. a pension scheme design based on career average ;
b. a provisional accrual rate of l/54th of pensionable earnings each year, subject to further agreement on outstanding issues not covered by this agreement (see annex A);
c. revaluation of active members’ benefits in line with CPI plus 1.5% per annum;
d. a normal pension age equal to the state pension age, which applies both to active members and deferred members (new scheme service only). If a member’s SPA rises, then NPA will do so too for all post 2015 service. Those within 10 years of NPA are excluded and accrued rights will also be related to existing NPA;
e. pensions in payment to increase in line with prices index (currently CPI);
f. benefits to increase in any period of deferment in line with prices index (currently CPI);
g. average member contributions of 9.8%, with tiered contributions. Member contributions in year 1 to increase between 0% and 2.4% in year 1. There will be no increase in year 1 for staff with WTE pensionable pay less than £26,557. There will be further discussions on contribution rates and increases in years 2 and 3;
h. optional lump sum commutation at a rate of £12 of lump sum for every £1 per annum of pension foregone in accordance with HMRC limits and regulations;
i. early/late retirement factors on an actuarially neutral basis;
j. ill-health retirement pensions to be based on the current ill-health retirement arrangements but with enhancement for higher tier awards to be at the rate of 50% of prospective service to normal pension age;
k. spouse and partner pensions to continue to be based on an accrual rate of 1/160th. For deaths in retirement spouse and partner pensions will remain based on pre-commuted pension;
l. an employer contribution cap as detailed in the heads of agreement.
There will be transitional protection:
all accrued rights are protected and those past benefits will be linked to final salary when members leave the scheme;
all active NHS pension scheme members who as of 1 April 2012, have 10 years or less to their current pension age, including MHOs and members of the special classes will see no change in when they can retire, nor any decrease in the amount of pension they receive at their current normal pension age. This will be achieved by allowing such members to remain in their current arrangements until they retire (for 2008 members until they have taken all their 2008 pension benefits);
members who are within a further 3.5 years of their normal pension age, ( i.e. up to 13.5 years from their NPA) will have limited protection with linear tapering so that for every month of age that they are beyond 10 years of their normal pension age, they lose two months of protection. At the end of the protected period, they will be transferred into the new pension arrangements; and
the costs associated with the protection outlined above sit outside the costs of the reference scheme.
On the basis that the scheme design within the heads of agreement is agreed, the Government agree to retain fair deal provision and extend access to public service pension schemes for transferring staff. This means that all staff whose employment is compulsorily transferred from the NHS under TUPE, including subsequent TUPE transfers, will still be able to retain membership of the NHS pension scheme when transferred. These arrangements will replace the current provisions for bulk transfers under fair deal, which will no longer apply. In addition, a partnership review of the implementation of the provisions set out in this paragraph for staff working in “Any Qualified Providers” (AQP) will be carried out.
The Government Actuary’s Department has confirmed that this scheme design does not exceed the cost ceiling set by the Government on 2 November. Copies of the heads of agreement and GAD verification have been placed in the Library.
Public Health System
Lord Lansley Excerpts(12 years, 4 months ago)
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The Secretary of State for Health (Mr Andrew Lansley)
Today I am publishing policy updates on the new public health system, covering local government’s new public health functions and the operating model for Public Health England (PHE). Subject to the passage of the Health and Social Care Bill, PHE will be established in April 2013.
The Government have an ambitious programme to improve public health through strengthening local action, supporting self-esteem and behavioural changes, promoting healthy choices and changing the environment to support healthier lives.
The updates define the Government’s plans, set out in the White Paper “Healthy Lives, Healthy People: Our strategy for public health in England”, in November 2010, to change the way public health is delivered nationally through establishing Public Health England as an executive agency and locally, through moving responsibility and accountability for public health to local government.
These reforms will see local authorities taking the lead for improving health and co-ordinating local efforts to protect the public’s health and well-being, and ensuring health services effectively promote population health. Local political leadership will be central to making this work.
In addition, a new executive agency, Public Health England will:
deliver services: health protection, public health information and intelligence, and services for the public through social marketing and behavioural insight activities;
lead for public health by encouraging transparency and accountability, building the evidence base, building relationships promoting public health; and
support the development of the specialist and wider public health work force by appointing directors of public health with local authorities, supporting excellence in public health practice and bringing together the wider range of public health professionals.
The NHS will continue to play a full role in providing care, tackling inequalities and ensuring every clinical contact counts.
In “Healthy Lives, Health People: update and way forward”, published in July 2011, we included commissioning of termination of pregnancies as one of the areas for which local authorities will be responsible. I have now reflected further on whether it would be appropriate for local authorities to be responsible for commissioning procedures that will involve surgical procedures and the associated need for strong clinical governance arrangements to ensure people receive a safe, legal service. I therefore intend to consult on whether commissioning termination of pregnancies should in the longer term be the responsibility of clinical commissioning groups or local authorities. In the interim, as a practical measure, CCGs will be responsible for commissioning these services for April 2013.
The update documents have been placed in the Library. Copies are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office. The updates are also available at
http://healthandcare.dh.gov.uk/category/public-health.
Tobacco Control Legislation
Lord Lansley Excerpts(12 years, 4 months ago)
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The Secretary of State for Health (Mr Andrew Lansley)
The Government will publish a consultation on the packaging of tobacco products in spring 2012.
In March 2011 the Government published “Healthy Lives, Healthy People: A Tobacco Control Plan for England” which set out how our comprehensive, evidence-based programme of tobacco control will be delivered within the context of the new public health system over the next five years.
The tobacco control plan included a commitment to explore options to reduce the promotional impact of tobacco packaging and to publish a consultation paper.
The Government take very seriously the need to reduce the number of young people who take up smoking. Each year, in England alone, around 330,000 children under 16 first try smoking and the majority of smokers start smoking regularly before they are 18 years old.
I am pleased to confirm that this consultation will be carried out on a UK-wide basis. Ministers in Scotland, Wales and Northern Ireland are also eager to gain a better understanding of whether the plain packaging of tobacco products could be effective in reducing the number of young people who take up smoking and in supporting adults who want to quit. Participating in this consultation will help them in making decisions about how they wish to take forward this matter in their own Administrations.
It is also important to create a supportive environment for adults who want to quit smoking. Most smokers report that it takes many attempts before they succeed in quitting. Removing sources of temptation that undermine quit attempts can be of great help.
The Government want to make it easier for people to make healthy choices. To do this, we need to understand whether there is evidence to demonstrate that the plain packaging of tobacco products would have an additional health benefit, over and above existing tobacco control initiatives. The Department of Health has, therefore, commissioned an independent academic review of the existing evidence relevant to the effects of tobacco packaging. This systematic evidence review will be peer reviewed and made available alongside the consultation.
Department of Health officials are also working with colleagues across Government to explore the implications and likely impacts of options for tobacco packaging.
This presents a complex series of issues and we will need to take all the relevant factors into account.
In view of these requirements, the consultation will not be available prior to the new year. The consultation will be published in spring 2012 and I would encourage all those with an interest to respond.
Revenue Allocations 2012-13 (Primary Care Trusts)
Lord Lansley Excerpts(12 years, 4 months ago)
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The Secretary of State for Health (Mr Andrew Lansley)
Today I am announcing revenue allocations to primary care trusts (PCTs) for 2012-13.
The PCT revenue allocations in 2012-13 will grow at 2.8%, which represents a real-terms increase, taking account of the Office for Budget Responsibility figure for the GDP deflator in 2012-13. This represents continued positive investment in front-line NHS services.
This means total investment in local NHS services in 2012-13 of £91.6 billion, an increase in excess of £2.5 billion in total allocations assigned in 2011-12. It puts the NHS in a strong position to deliver the Government’s national priorities set out in the 2012-13 operating framework published on 24 November.
To allow the NHS financial stability during a period of transition, the weighted capitation formula, normally used to determine PCTs fair shares of available resources, has not been applied to the allocations. For 2012-13, all PCTs will receive the same percentage uplift in their recurrent allocations.
This will be the last round of allocations made to PCTs as, subject to the passage of the Health and Social Care Bill, the NHS Commissioning Board would be responsible for the allocation of resources and pace of change policy to clinical commissioning groups (CCGs) from 2013-14.
In common with previous practice, I have today written to all hon. Members to inform them of the revenue allocations made to the PCTs covered by their constituencies.
Full details of all local allocations, including details of other, specific allocations (to support primary dental care, pharmaceutical services, general ophthalmic services and joint working between health and social care) have been placed in the Library. Copies are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office. They can also be found at
www.dh.gov.uk/health/2011/12/pct-allocations.
NHS Outcomes Framework 2012-13
Lord Lansley Excerpts(12 years, 5 months ago)
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The Secretary of State for Health (Mr Andrew Lansley)
The White Paper “Equity and Excellence: Liberating the NHS” (Cm 7881) outlined a vision of an NHS that achieves health outcomes that are among the best in the world. It explained that an NHS outcomes framework would be developed to provide national level accountability for the outcomes that the NHS delivers.
I have today published “The NHS Outcomes Framework 2012-13”. This refreshes the first NHS outcomes framework published for England in December 2010 and includes updated definitions for some of the indicators in the framework.
The framework has three main purposes, which remain the same in this updated version:
to provide a national level overview of how the NHS is performing against certain outcome measures;
to act as a mechanism for the Secretary of State to hold the NHS Commissioning Board to account for delivering improvements in outcomes, from April 2013; and
to act as a catalyst for driving improvement and a focus on outcomes throughout the NHS.
A copy of “The NHS Outcomes Framework 2012-13” has been placed in the Library. Copies are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office.
Life Sciences
Lord Lansley Excerpts(12 years, 5 months ago)
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The Secretary of State for Health (Mr Andrew Lansley)
With permission, Mr Speaker, I would like to make a statement about the strategy for UK life sciences that the Prime Minister is launching this afternoon at a leading life sciences conference. The life sciences industry is one of the most promising areas for growth in the UK economy. It has consistently shown stronger growth than the United Kingdom as a whole, and it accounts for 165,000 UK jobs and totals more than £50 billion in turnover. Pharmaceuticals alone account for more than a quarter of our total industrial research and development spend. Global pharmaceutical sales are predicted to grow by up to 6% a year in the coming years, and in emerging economies medical technology is achieving growth rates of more than 12%. A flourishing life sciences sector is essential if we want to build a more outward-looking, export-driven economy. The partnership between industry, the NHS and our outstanding universities is not just essential to economic growth; it will benefit millions of future and current NHS patients, fuelling the more rapid development of cutting-edge treatments and earlier access to those treatments for NHS patients.
Like many industries, the life sciences industry is undergoing rapid change. The old “big pharma” model of having thousands of highly-paid researchers working on a pipeline of blockbuster drugs is declining. A new model has emerged—one that is more about collaboration, the outsourcing of research and early clinical trials on patients. Excessive regulation can mean that the uptake of new treatments and technology is slow. That is a challenge felt acutely by an industry that sometimes feels that the return is not there quickly enough to satisfy investors. It is felt even more acutely by patients, who understandably expect that they should be able to access the latest and most effective treatments, and that new innovations in care should be adopted rapidly by the NHS.
We have a leading science base, four of the world’s top 10 universities and a national health service that is uniquely capable of understanding population health characteristics, but those strengths alone are not enough to keep pace with what is happening. We must radically change the way we innovate and the way we collaborate.
The life sciences strategy we launch today, alongside the NHS chief executive’s review on innovation, health and wealth, sets out how we will support closer collaboration between the NHS, industry and our universities, driving growth in the economy and improvements in the NHS. All the documents have been placed in the Library.
Among other key measures, we will set up a new programme between the Medical Research Council and the Technology Strategy Board to bring medical discoveries closer to commercialisation and use in the NHS. There are many medical products being developed to treat patients and the cost of developing them is high because they take a long time to develop and test. Investors want to see at least some evidence that the products might work in people and robust validation of the quality of the research and development work being undertaken, as well as of the capability of the company to bring the product to market, before they will finance the development of the products. That means that some of the best medical innovations are not making it through to patients. We are already providing investment to address that, but we believe that we can do more to support the development of these products across funding organisations and the successive stages of product development, which will support the development of promising innovations and help to increase the number of treatments made available to patients. We are therefore introducing a £180 million catalyst fund for the most promising medical treatments.
It can take more than 20 years from the first discovery of a drug until patients can be prescribed it by their doctor and we have already taken steps to address that. Through the National Institute for Health Research, we are investing £800 million in new research centres and two major translational research partnerships that will help cut the time between the development of new treatments and their application in the NHS—from the bench to the bedside.
Now, we are going further. As part of a major drive to improve innovation and access to medicines in the NHS, we are announcing proposals on a new early access scheme that could allow thousands of the most seriously ill patients to access new cutting-edge drugs up to a year earlier than they can now. Through the early access scheme, the medicines regulator, the Medicines and Healthcare products Regulatory Agency, would provide a scientific opinion on the emerging benefits and risks of very promising new drugs to treat patients with life-threatening or debilitating conditions for whom there are no satisfactory treatment options. That will mean that seriously ill patients of any age who have no other hope of being treated or having their life extended could benefit from drugs more quickly, around a year before they are licensed.
We must also ensure that we make better use of our unique NHS data capability. It is often said that the NHS is data-rich but information-poor. As a national health service, it contains more data about health than any other comparable health system in the world, but neither the NHS nor scientists developing new drugs and treatments have always been able consistently to make good use of the data or to use them to drive further scientific breakthroughs.
We have seen how powerful the release of data can be. For example, South London and Maudsley NHS Trust and the Institute of Psychiatry now have access to a database covering 250,000 patients. It includes their brain scans, medical records and notes—a wealth of information, all consented to and all anonymised, that is helping them find new answers in the fight against dementia.
We need powerful data-handling capacity and the skills to write the software to mine them. That is why we are investing in e-infrastructure, which will provide secure data services to researchers. The clinical practice research datalink is being introduced by the MHRA in partnership with the NIHR and will provide a specialised service to the research and life sciences communities. Let me reassure the House that we will take all necessary steps to ensure safeguards for patient confidentiality.
We will also make sure that more UK patients get the opportunity to take part in national and international clinical trials and play a much greater role in the development of cutting-edge treatments. We believe that patients should have the right to access new treatments and be involved in research to develop new medicines.
We have responded to calls from research charities and clinicians for Government to get patients more involved in supporting research. A recent Ipsos MORI poll in June found that 97% of people believed it is important that the NHS should support research into new treatments and, in addition, 72% would like to be offered opportunities to be involved in research trials. We will therefore consult on changing the NHS constitution so that there is an assumption, with the ability to opt out, that data collected during a patient’s care by the NHS may be used for approved research.
That would make it clear that researchers and companies with new and potentially life-saving medicines could access the data of patients and could approach patients whom they feel could benefit in order to discuss their involvement in research studies. This would encourage growth in the life sciences industry as more people and more detailed data would be available for the important trials and research needed to get breakthrough treatments used more widely.
Additionally, we have set out actions to improve incentives for investment in innovation and to reduce regulatory bureaucracy. With the creation of the Health Research Authority, we will streamline regulation and improve the cost-effectiveness of clinical trials. As the NHS chief executive’s review of innovation has shown, the NHS needs to be quicker and smarter in adopting new technologies and approaches to care that can both save more lives and cut costs.
Sometimes, it is a question of evidence. Until recently, we could not say with certainty that telehealth could keep people out of hospital and save lives, and there was understandable reluctance among parts of the NHS and councils to invest in untried technology. However, as early results from the whole system demonstrator pilots show, the potential of telehealth is nothing short of remarkable, with dramatic reductions in mortality, in hospital admissions, in emergency visits and in the number of hospital bed days. To make the most of this, we will support the NHS and work in partnership with industry and councils dramatically to spread the use of telehealth over the next five years. In doing so, we are looking to transform the lives of 3 million people in this country.
We will become a global leader in the management of chronic and long-term conditions, generating massive opportunities for UK companies developing this technology. It will be innovation in practice and we will foster other proven innovations such as fluid management technology techniques that were developed for use in high-risk surgery and critical care to help clinicians administer fluids and drugs safely. In March 2011, the National Institute for Health and Clinical Excellence published guidance recommending that this technology should be used for patients undergoing major or high-risk surgery. Currently, it is used for fewer than 5% of applicable patients despite evidence showing that it could benefit 800,000 patients and save the NHS £400 million. We will launch a national drive to make sure that fluid management technology is used in appropriate settings across the NHS. That is one example of many.
The innovation review sets out how we will address all the barriers to innovation in the NHS, whether they involve culture, leadership, training, use of information or lack of incentives and investment. We will also introduce a NICE compliance regime that will mean that medicines approved by NICE will be available on the NHS much more quickly. The plans set out in today’s strategies will help to drive the development of new technologies to diagnose and treat the most complex diseases in this country for the benefit of NHS patients. This is a strong package of measures that will support economic growth and innovation in the NHS and will drive significant improvements in patient care. I commend this statement to the House.
Andy Burnham (Leigh) (Lab)
May I thank the right hon. Gentleman for his statement and start by setting out two points of common ground with the Government? First, we too have pride in Britain’s life sciences industry and its strength. We agree that the industry needs Government support and focus if its potential to contribute to the country’s industrial future is to be maximised. Secondly, we agree that there are huge potential benefits to British patients from closer collaboration between the NHS and the industry. We all want patients to have the quickest possible access to the latest life-saving and life-enhancing treatments.
It was for those two principal reasons that Labour, when in government, prioritised the life sciences sector and established the Office for Life Sciences. In Lord Drayson, we created a life sciences Minister who was a contact point for the industry—someone of huge experience and with real personal commitment to the industry. One of our criticisms of this Government is that they have allowed the momentum that Labour had established in promoting the industry to fall away. Progress has stalled because of the Government’s failure to understand that economic growth needs a proper partnership between the public and private sector and because of the combined effect of a number of their policies. Such policies include: damaging 15% real-terms cuts to the science budget; the loss of the regional developments agencies, many of which were heavily involved in this area; cuts to regional investment; and the destabilising effect of the unnecessary reorganisation of the NHS, particularly the disintegration of the strategic health authorities, which played a role in promoting research. The unexpected closure of Pfizer earlier this year exposed a Government asleep at the wheel and was a wake-up call, and now we see a Government playing catch-up.
Although we welcome their belated recognition of the importance of the sector, there are sensitive issues involved and Ministers need to tread carefully so as not to undermine public trust. What they are fond of calling red tape are, to others, essential safeguards. Some areas will always need proper regulation and the use of patient data is most certainly one of them. As we have heard from patients groups today, some have been caused real anxiety by this media-briefed statement from the Government and the lack of accompanying detail.
Ministers need to be aware that people with terminal illnesses and long-term conditions will react differently from others to a statement of this kind, so for them we seek direct assurances today from the Secretary of State that he failed to give in his statement. Will all patients have the ability to opt out of the sharing of their data, even in anonymised form? Surely that fundamental principle of consent should form the bedrock of any new system, and that control of data should be possible in today’s information age. If the Secretary of State cannot give that assurance, why not? How can he justify that?
Did patients’ representatives walk away from the Department of Health working group on these important matters and, if so, why? One representative said on the radio this morning that the whole process “stinks”. Does the Secretary of State not accept that he and his Department will need to do better than this to uphold public confidence in the process or risk undermining trust in the whole principle? What safeguards will there be to ensure that patient data are stored securely? Does he not need to articulate a more positive statement of patients’ rights in this important area, rather than the loose opt-out he proposes in the NHS constitution?
Is it the case that the anonymity of data cannot always be guaranteed? If so, what are those circumstances and, again, why not? Even within anonymised datasets, particularly dealing with small numbers of very specific conditions, it is possible to identify individual patients. What steps are being taken to guard against those risks? Will the Secretary of State give a categorical assurance that data cannot be used for purposes other than research—passed on to third parties or used by the same company to target people for other products and services?
Today’s announcement also needs to be considered in the context of the Government’s reorganisation of the NHS. Does not a more market-based health system with a greater number of private providers create much greater challenges for the control of data? I had many dealings with senior figures in the pharmaceutical industry in my time as a Minister. They were clear that it was the national structure of the NHS, and the ability to collaborate and share information across a whole health system, that was a huge attraction to the industry and a competitive strength for this country.
Does not the Secretary of State’s Health and Social Care Bill risk turning the NHS into a competitive market, where collaboration is discouraged in an any-qualified-provider free-for-all? So how can he guarantee that that competitive strength will be there in the future and will continue to be used by the pharmaceutical industry? Although he will not admit it today, were not many of the measures he has announced, particularly the expansion of telecare, made possible by the steps that we took to invest and modernise NHS IT?
More broadly, this announcement raises questions about the Government’s policy on the involvement of the private sector in the NHS. The Government need to set out what, if any, limit they see on the involvement of the private sector in the NHS. The Prime Minister has said that he wants the NHS to be a fantastic business. Let me quote from a recent leaked document on NHS commissioning, “Towards Service Excellence”. It says:
“The NHS sector . . . needs to make the transition from statutory function to freestanding enterprise.”
It is no wonder that, on the back of these worrying words, the British Medical Association has adopted a position of outright opposition to the Secretary of State’s Bill. Our worry is that, in their desperation to develop a credible industrial strategy, Ministers seem ready to put large chunks of the NHS up for sale.
Patient data are not the Secretary of State’s to give away. The NHS is not his to sell. The truth is that the Government are running huge risks with patient confidentiality and patient safety by opening up the NHS to the private sector and reorganising at a time of financial stress, but we do not yet know the full scale of those risks.
Andy Burnham
It is.
The great irony is this: while Ministers are happy to offer up other people’s data, they continue to withhold the NHS risk register, which shows the risk they are running with our NHS. Is that not why people are increasingly asking what the Secretary of State has to hide?
Mr Lansley
I am afraid that the last sentence was not really worth it, Mr Speaker. The right hon. Gentleman, while talking about things that were completely irrelevant to my statement, asked a number of questions. Will patients be able to opt out? Yes. It is clear that they will be able to opt out, as I have said. Are there risks relating to a small number of patients being identified? No. As he should know, and as has been done in relation to the general practice research database, where there are small populations of patients in which it might be possible to indentify individuals, or where a small number of patients have very specific sub-sets of conditions and there is a risk of identification, it is perfectly possible to ensure that that information cannot be accessed through the database. We have made it clear that data would be not only anonymised—in fact, it would be double anonymised—in order to ensure that it cannot be recreated, but viewed in such a way that will make it impossible to identify from the circumstances of the data where the patient comes from.
The right hon. Gentleman asked whether the database must be used for approved research or could be used for other purposes. It must be used for approved research and cannot be used for other purposes. It is not a database that people, whoever they may be, whether from universities or pharmaceutical research companies, can simply access in order to go mining for information; they must do so only through the MHRA and for approved research purposes.
Finally, the right hon. Gentleman asked—frankly, I think it is irrelevant—about the extent of the private sector’s role. Unlike his predecessor, Patricia Hewitt, who was Secretary of State when he was a Health Minister, and who said that she was aiming for 10% or 15% private sector involvement, we are not looking for a specific level of private sector involvement or creating a free market in the NHS. It will continue to be a national health service with the national characteristics that we would expect, funded through taxation and available to all based on need, not ability to pay, and in this context it will continue to be a national NHS. The simple fact that, among other measures in the life sciences strategy, we are able to show how we can bring data sets together, including the general practice database, the hospital episodes statistics, the cancer registries and so on, in order to show the power of data across the whole NHS to support research for new treatments is a complete vindication of the fact that it will be a national health service—that it will change in that respect and that patients will benefit from both the national health service and the research that comes with it.
Mr David Burrowes (Enfield, Southgate) (Con)
May I be the first warmly to welcome the Secretary of State’s statement and to make a bid for the catalyst fund for regenerative medicine, which not only offers great hope for the future but is providing life-saving treatment through umbilical cord blood? I refer him to the recommendation the UK stem cell strategic forum made last year for collaboration between universities, hospitals and farming industries to make greater use of the application of cord blood now and in future.
Mr Lansley
I am grateful to my hon. Friend and heartily welcome his support for the opportunities in regenerative medicine. I was fortunate enough to meet at the UK Stroke Forum last Thursday, among those exhibiting, a company that is based in England but undertaking trials and research activity in Scotland and is looking precisely at how it can use foetal-derived stem cells for regenerative purposes. The right hon. Member for Leigh (Andy Burnham) talked about Pfizer. In my constituency, it has been one of the companies leading the development of new regenerative medicine techniques. That is clearly one of the areas that this country has tremendous potential in developing. The technology innovation centre for regenerative medicine was announced in the “Plan for Growth” published alongside the Budget earlier this year, and I hope that it will be one of the areas in which we will see those developments.
Mr Kevin Barron (Rother Valley) (Lab)
The Health Committee, in its report on the electronic patient record, published in September 2007, stated that the highly detailed data captured had “outstanding” prospects for new and improved research, but it also asked that the best balance be found between
“the opportunity to improve access for research purposes with the ongoing need to safeguard patient privacy”.
Do the Government believe they can get that right, so that we can go ahead and use the enormous amount of data that we have in this country to improve health care for patients not just here, but throughout the world?
Mr Lansley
I am glad that the right hon. Gentleman is here and able to ask that question, because he was the Chair of the Health Committee in September 2007, when it stated that the secondary use of data in the NHS was “vital” for the development of the NHS, including for research use. I hope that he is one of those who recognise that what we are setting out in the life sciences strategy—in particular, with the clinical practice research datalink—will enable precisely all those secondary uses for research to be developed.
Dr Julian Huppert (Cambridge) (LD)
As the Secretary of State will know well, the Cambridge area is world leading in life sciences, both in academia and in industry. This strategy, and the investment to go with it, is very welcome indeed and will, I am sure, support a lot of activity in Cambridge and in South Cambridgeshire. There is one slightly sour note about private data, however, so I hope that the details will be published of exactly how the steps to which the Secretary of State referred will be taken to protect that, but, on clinical trials and what will happen to regulation, will he implement in full the recommendations of the Academy of Medical Sciences?
Mr Lansley
I am grateful to my hon. Friend. He and I share a vigorous and vibrant life sciences sector, and I hope that the strategy that we have announced today will be taken up rapidly in our constituencies. He asks about the Academy of Medical Sciences. Back in the “Plan for Growth” in the Budget, we responded precisely to that point, and on 1 December, as a consequence of the positive response to what the academy said, I brought into effect the Health Research Authority to ensure that we simplify the process of approval for clinical trials. Through the National Institute for Health Research, as we said earlier in the year, we are seeking to arrive at a point where there is a maximum of 70 days for the first recruitment of patients to clinical trials, and that will get us into an internationally competitive position.
Mr Frank Field (Birkenhead) (Lab)
May I ask the Secretary of State a further question about the rights of people to opt out of the scheme? Will he extend the right of opt-out for those people who refuse to participate in the scheme to include a refusal of the advantages that come from sharing such information, which will be gained by the generosity of spirit of their fellow citizens who participate?
Mr Lansley
I understand the right hon. Gentleman’s point, but the ethical approach is for everyone to have access to the latest and best available treatments through the NHS. That is the principle that we apply, but we should be aware that, although we offer people the right to opt out, we have seen—for example, in relation to the general practice research database, where patients have the equivalent right to opt out, and in two pilots conducted on the proposals that we have announced—that the rate of opt out is 0.1%.
Dr Sarah Wollaston (Totnes) (Con)
I warmly welcome the Secretary of State’s statement, as this strategy will reduce the delay between discovery and dispensing and, undoubtedly, bring great benefits to patients and to our pharmaceutical industry, but in return will he ask the industry to go further and publish negative trial data, as well as positive trial data, as a gesture to improve the quality of research data?
Mr Lansley
I am grateful to my hon. Friend for that point. The industry has done quite a lot in recent years in publishing more data, including data that do not necessarily support the positive case that it is looking for, because all of us, and especially those working in the field, learn a great deal and, sometimes, as much from clinical trials that produce a negative result as we do from those that produce a positive result. So, I will certainly take her point away, explore it with my colleagues and write to her if we can take further steps in that direction.
Hywel Williams (Arfon) (PC)
Are the patient data proposals to be England-only or UK-wide? If so, what is the relationship with projects such as the SAIL—Secure Anonymised Information Linkage—database in Swansea and Biobank? I foresee some ethical problems, as Biobank operates specifically on a voluntary basis with a written, sought-for consent. Does the Secretary of State see that there might be some problems there?
Mr Lansley
I am grateful for that question. What we are setting out is hosted by the Medicines and Healthcare products Regulatory Agency, which will be able to link datasets for which it is responsible, which do, in some cases, have a UK basis rather than an England-alone basis.
John Pugh (Southport) (LD)
I welcome the statement. The Secretary of State mentions telehealth, which is currently making greater progress in Scotland than in England. Has this anything to do with less structural reform or more strategic leadership?
Mr Lansley
My hon. Friend might like to know that while initial and very positive steps were taken in Scotland —for example, in Lanarkshire—we have now undertaken, through the whole system demonstrator pilots, the world’s largest randomised control trial of telehealth technology, and that gives us a strength from which we can develop telehealth systems that is unparalleled anywhere in the world. In so far as there is a capacity to provide telehealth systems and provide for their use across health care systems, I suspect that we shall shortly see England overtake Scotland in that respect. It is a form of competition that I am perfectly happy to be engaged in—and if the Scots can do better than us, then good luck to them. However, we are showing, through these pilots, how we are ready to go at developing something of great benefit to patients.
Andrew Miller (Ellesmere Port and Neston) (Lab)
It is good to see that the Secretary of State is now on the same side of the debate as me regarding NO2ID and similar issues. Nevertheless, there is an important issue about ensuring the greatest public buy-in to the issue of data sharing, and careful work is needed on that. May I specifically ask him about the catalyst fund? To what extent is this new money? Can he assure the House that money from patient care is not being transferred into the catalyst fund? Will the Technology Strategy Board be able to control its use, or will it be directed by Government?
Mr Lansley
In the first instance, the £180 million to which I referred consists of £90 million from the Medical Research Council, which is new money within its existing budget but not at the expense of any other programmes. The other £90 million is provided by the Treasury to the TSB and is new money. None of this comes out of any NHS resources. The implementation will be led by the Medical Research Council, so to that extent it will not be driven by Government.
Iain Stewart (Milton Keynes South) (Con)
Does my right hon. Friend believe that there is a threat that parts of the UK pharmaceutical industry might relocate overseas if this package of reforms does not proceed?
Mr Lansley
There is always that risk because, as my hon. Friend entirely knows, international competition is intense, particularly in the pharmaceutical sector. Following the measures that were announced alongside the Budget in the plan for growth, not least the availability of the patent box from April 2013, it is clear from discussions that my right hon. Friends and I have had with many of the boards of leading international pharmaceutical companies that the United Kingdom is now becoming a better location for investment in pharmaceutical activity than used to be the case. Those companies look very positively at the steps we have taken on regulatory activity and clinical trials, at the steps we are taking on promoting innovation through the value-based pricing system, and in particular, understandably, at the tax measures that my right hon. Friend the Chancellor announced, especially on the patent box.
Paul Goggins (Wythenshawe and Sale East) (Lab)
The Secretary of State’s statement raises a number of important ethical issues. Will he take a close look at the emerging proposals for a medipark that is close to Wythenshawe hospital and part of Greater Manchester’s airport city enterprise zone? This has tremendous potential to attract investment from global bioscience and pharmaceutical companies, which would make a massive difference in my constituency and way beyond that. Will he look to see what support can be offered?
Mr Lansley
I will gladly do so. As the right hon. Gentleman knows, the designation of an academic health science centre in Manchester has supported many developments. We want to go further. In today’s life sciences strategy, we are making it clear that not only do we want to maintain the academic health science centre designation as a world-class designation for comprehensive research centres, but we want to go further and ensure that such centres are used to diffuse and spread innovation across the NHS more effectively. Next spring, we will set out how we will enable academic health science networks to be designated. That will happen during 2012-13. I will happily look at the circumstances in south Manchester and at how this matter will apply there. I hope that partnerships will be forged between the NHS, universities and the private sector of the kind that he and I know will be successful.
John Howell (Henley) (Con)
Does my right hon. Friend agree that there is a world of difference between streamlining regulation, to use his phrase, and the picture of the indiscriminate abolishment of regulation that the Opposition tried to create? Such streamlining is essential to cut the time from invention to adoption.
Mr Lansley
I am clear, and I know that my hon. Friend agrees, that we must ensure that the regulatory processes are effective and that the medicines that are available in this country are of the necessary quality, safe and effective. However, we must not allow the delays that are inherent in some of these processes to prevent information from being provided on the basis of which clinicians, with the active, informed consent of patients, can access what they regard as potentially effective medicines. In the overall context of patient safety, we do patients a serious disservice if we know that there is a potentially effective medicine available and do not give them the first possible opportunity to access it.
Julie Hilling (Bolton West) (Lab)
The Secretary of State says that his proposals reflect his commitment to the national health service. If GPs will be commissioning treatments, how will he ensure that they commission new and more effective treatments that might be more expensive?
Mr Lansley
As the hon. Lady will know, the Health and Social Care Bill that is being considered in another place will, for the first time, place a direct legal duty to support innovation on clinical commissioning groups. That will be supported by the process of commissioning from the acute sector, in which the quality increments in the tariff will directly drive innovations in best practice.
David Rutley (Macclesfield) (Con)
I welcome the Secretary of State’s statement. These proposals are vital for the competitiveness of life sciences and pharmaceuticals, which are vital for the UK and for the local economy in Macclesfield. Will he tell the House how these steps will reduce the time that is taken to establish clinical trials, which has been a barrier for far too long?
Mr Lansley
The principal impact that we are having relates to the National Institute for Health Research, which, through its contracts with the NHS and other partners, is driving the time to the first recruitment of clinical trials down to 70 days. That will get us to a competitive position. We are also working in partnership with the pharmaceutical industry, for example to look at how some of the new stratified medicines will be available. Today, we are entering into partnership with AstraZeneca, which is close to my hon. Friend’s constituency, to understand what specific compounds are likely to be of benefit to some subsets of the population with cancer through the use of targeted new medicines.
Paul Flynn (Newport West) (Lab)
As the policy rests on the trust in the regulatory body that was tardy in protecting patients against the adverse side effects of Vioxx and Seroxat, is it not time that we had a fully independent MHRA and not one that is funded entirely by the pharmaceutical industry? As big pharma pays the piper, is it not possible that it will call the tune for its own commercial interests?
Mr Lansley
I think that the hon. Gentleman is wrong about that. The MHRA operates, in scientific and expert terms, in an independent fashion. In so far as it is accountable, it is accountable to me as Secretary of State and to this House. It is not accountable to the pharmaceutical industry. If he is proposing a major transfer of costs from the pharmaceutical industry to the taxpayer, I am afraid that I do not agree with him.
Nick de Bois (Enfield North) (Con)
I warmly welcome the commitment to telehealth and the expansion of it over the next five years. Does the Secretary of State agree, however, that that represents a step change for patients? Will it be the responsibility of councils and stakeholders to demonstrate the value and benefits of telehealth to their patients, so that there is full buy-in?
Mr Lansley
I am grateful to my hon. Friend. The figures from the evaluation of the 6,000 or so patients who have participated in the three pilots in Cornwall, Kent and Newham suggest that if telehealth is appropriately and properly provided, there are benefits. There was a total reduction of 45% in mortality, about 21% in accident and emergency visits, about 15% in planned admissions and bed stays in hospital and about 8% in costs. Those are dramatic benefits, but the most important aspect is the empowerment that telehealth gives patients so that they can be at home and be confident about their care, rather than be prey to rapid crises leading to admission to hospital.
Mr Dennis Skinner (Bolsover) (Lab)
Is this whole idea not being driven by the pharmaceutical industry in order to make money? In the real world, when I have been in hospital in these past 10 or 15 years for all sorts of different problems, all of us have relied on the care and attention of the doctors and nurses. There was an increase of about 30,000 doctors and 80,000 nurses, because we put a lot more money in. I did not meet anybody at all who ever said to me, “I’ve just been given some drugs to look after my heart, but I don’t like them and I want something else”. The whole thing is a money-making exercise by the pharmaceutical industry, which has friends in the Tory party. We are supposed to be short of money in this country and in the health service. What we really need is to stop sacking nurses, which will make it a lot better.
Mr Lansley
The hon. Gentleman will have to talk to the right hon. Member for Leigh (Andy Burnham), who claimed to be the friend of the pharmaceutical industry. The truth is that we should all be friends of it and support it. Why? Because it has the capacity to bring in new medicines and new treatments that are to the benefit of patients. From my point of view, it is not about the profitability of the pharmaceutical industry, it is about working with those who have the greatest potential to bring investment to this country for economic benefit and, more importantly, to improve benefits for patients. The hon. Gentleman, who has no doubt been the beneficiary of many therapeutic improvements generated by investment in the pharmaceutical industry, should not decry it.
Mr Skinner
Yes, but in a free health service, not a privatised health service, which it will be—
Mike Crockart (Edinburgh West) (LD)
Key to the strategy announced today is the ability to translate primary research into early adoption and commercial outcomes. Does the Secretary of State agree that Edinburgh’s BioQuarter is uniquely placed to do that, as it already shares a campus with the state-of-the-art royal infirmary of Edinburgh and is hopefully soon to be joined by the excellent sick children’s hospital, providing a base for the commercialisation of the innovative work being carried out by Edinburgh’s universities?
Mr Lansley
My hon. Friend makes a very good point, and far be it from me to comment further. He explained very well the benefits associated with investment and developments in Edinburgh and how the universities, the pharmaceutical industry and the NHS are working together there. That is also happening in locations in England, and across the United Kingdom we are providing real opportunities for international investment in biosciences.
Stuart Andrew (Pudsey) (Con)
During my time working within the hospice movement, it was my privilege to meet many patients and families. They naturally wanted everything at their disposal that would extend patients’ lives or at the very least make them more comfortable. At times, they would feel frustrated that patients in other countries benefited from drugs before they could, even though they were invented here. What is the Secretary of State doing to try to rectify that problem?
Mr Lansley
My hon. Friend makes a very good point from his personal experience. It is precisely because we recognised that patients in Britain were not getting access to the latest cancer medicines as quickly as patients in other countries that we were clear at the election that we would introduce a cancer drugs fund. Since the introduction of the fund in October 2010, more than 7,500 patients have accessed new cancer medicines through it. The early access scheme that I have described will go even a step further in anticipating the successful, efficacious introduction of new medicines in a way that allows patients and clinicians sometimes to access medicines even before the point at which they are licensed.
Andrew Bridgen (North West Leicestershire) (Con)
As a graduate in biological sciences, I welcome the Secretary of State’s commitment to life sciences in this country. In my opinion, there has been too much of a disconnect between vital research at universities and in the private sector and the NHS. How will the Secretary of State ensure that the biggest beneficiaries of the release of these valuable data are UK patients and universities, and UK-based companies?
Mr Lansley
I would instance two things in that respect, the first of which is the developing collaborations that were started under the academic health science centres and that will be continued through the networks that we want to extend. Those partnerships are specifically designed—£800 million was allocated in August, based on a competition—to enable the translation of discovery into new medicines in this country.
Secondly, the £180 million catalyst fund, which the MRC and Technology Strategy Board will implement, is specifically designed to take those ideas—the MRC says that it has some 360 such potential developments in medicines and treatments—through to the point at which they can be developed. Of course, that will be in this country.
Mr Philip Hollobone (Kettering) (Con)
Given that Northamptonshire has one of the most rapidly growing populations of patients in older age of anywhere in the country, I am sure my constituents will welcome the Secretary of State’s commitment that this country will become the global leader in the management of chronic and long-term conditions. We want to realise that praiseworthy ambition, but how far behind the curve are we at the moment?
Mr Lansley
The answer to that question varies depending on which conditions one is talking about. When one looks at the OECD “Health at a Glance” data that was published on 23 November, one sees how relatively poor are our mortality outcomes in relation to respiratory and chronic obstructive pulmonary diseases. By contrast, we are slightly better than average in relation to diabetes. However, I have seen for myself how well patients with COPD can manage their conditions at home. For example, they can see their blood oxygen levels day-by-day and have supplies of medicines at home, including steroids. They can therefore anticipate and deal with any exacerbations of their condition so that they do not end up in an ambulance going to hospital late at night.
Duncan Hames (Chippenham) (LD)
From earlier access to potentially life-saving medicines through to releasing the power of information in the NHS, there is much to welcome in this statement. Given the importance of techniques such as pseudonymisation, how satisfied is the Secretary of State with the priority afforded to developing the informatics capability of NHS staff?
Mr Lansley
My hon. Friend makes an important point, to which I fear I do not have time to respond fully. One thing that I hope we can do as a consequence of abandoning the previous Government’s failed NHS IT structure is empower many individual hospital trusts and general practices once more to develop their own informatics expertise, which will stretch beyond IT infrastructure to the positive uses of data and information for the benefit of patients.
Oral Answers to Questions
Lord Lansley Excerpts(12 years, 5 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Sarah Newton (Truro and Falmouth) (Con)
4. What steps he is taking to reduce the burden of debt for NHS hospitals.
The Secretary of State for Health (Mr Andrew Lansley)
Although the overall financial position remains healthy, we will continue to focus on the small number of organisations in the NHS that are struggling to manage their finances. We are working to help all NHS trusts to be sustainable providers of high-quality health care and move forward to foundation trust status. That will include, where appropriate, agreeing solutions to resolve the regrettable legacy of debt from the previous Government.
Sarah Newton
Despite the fact that the staff of the Royal Cornwall Hospitals NHS Trust have made big strides forward in improving patient care while delivering efficiency savings, the trust is saddled with historic debt, largely as a result of Labour accountancy measures. Does my right hon. Friend agree that that is grossly unfair and will he meet me to find ways of writing off the remaining Labour debt so that my constituents can stop worrying about the future of the only acute hospital in Cornwall?
Mr Lansley
I am grateful to my hon. Friend and completely concur. I have had the privilege of visiting Treliske hospital and seeing the good work that is being done there. In the course of the last financial year, the trust returned a surplus and it is projecting a surplus this year. As she knows, it has a legacy of debt that is being financed by a working capital loan. As with other NHS trusts, we are looking to ensure that through the process of becoming a foundation trust it will move from having legacy debts from the previous Government’s regime to being financially sustainable year-on-year while meeting the viability and balance sheet criteria for foundation trust status.
Mr Dave Watts (St Helens North) (Lab)
When will the Secretary of State get a grip and sort out the problems of PFI long-term funding—[Laughter]—given the fact that Ministers promised to do that six months ago and that we are no nearer a resolution than we were before?
Mr Lansley
I do not know whether Hansard will record it, but the mirth with which that remark was met is an indication from Members that they know perfectly well, as the hon. Gentleman ought to know, that the previous Labour Government left a terrible legacy of unaffordable PFI projects that were poor value for money when they were introduced. He knows perfectly well the position his local trust has been put in. We are working through that, and out of the work that has been done to resolve that poor legacy, we identified 22 NHS trusts which said that their PFI was an impediment. We are working with all of them to resolve that.
Emma Reynolds (Wolverhampton North East) (Lab)
5. What plans he has to allocate resources to local authorities when they assume responsibility for public health.
Nick de Bois (Enfield North) (Con)
6. What steps he is taking to raise the standards of care provided by health care workers and care assistants.
The Secretary of State for Health (Mr Andrew Lansley)
I have commissioned Skills for Health and Skills for Care in partnership with employers, unions, regulators, educators and others to develop a code of conduct and minimum training standards for health care support workers and adult social care workers in England. This will give employers and patients confidence in the employment and standards of staffing at all levels. I expect the final report and recommendations by September 2012.
Nick de Bois
The Secretary of State knows that I believe in less, not more, regulation, but given the increasing role and responsibilities of health care assistants, particularly with the elderly, does he agree that the time has come both to recognise their increased responsibilities and to provide safeguards at a national level by requiring them to be on a national register?
Mr Lansley
My hon. Friend will know that health care and social care support workers do responsible jobs and that the responsibility for them lies principally with their employers and the staff who supervise them. We made provision in the White Paper we published last December for a process of assured voluntary registration. What I announced and referred to a moment ago will give a code of conduct and standards that will form a basis for an assured voluntary registration scheme in future.
Andrew Gwynne (Denton and Reddish) (Lab)
One key care standard is the time that people have to wait for their treatment. Labour got waiting times down to an historic low, and we warned the Secretary of State what would happen if he relaxed the 18-week standard. Figures show that the number of patients waiting longer than 18 weeks is up by 43% and, despite the U-turn that the Government have made on the use of targets, is not the problem that they have been so fixated on their top-down reorganisation that they lost control of waiting lists? Surely it is time for them to drop the Health and Social Care Bill and focus on the things that really matter to the people using and working in the NHS.
Mr Lansley
I am sorry, but that was all completely synthetic anger on the hon. Gentleman’s part. The average time that patients have been waiting in the NHS for treatment continues to be between eight and nine weeks. It has been so ever since the last election. The operational standard under the previous Government and now for the 18-week waiting time is that at least 90% of patients who are admitted for treatment should be admitted and treated within 18 weeks, and 95% of outpatients. Both of those operational standards continue to be met. Last week I made it clear that whereas the previous Government abandoned people who went beyond 18 weeks—and there were 250,000 of them who went beyond 18 weeks—we will not abandon those forgotten patients. We will make sure that they, too, are brought into treatment as soon as possible.
Mr David Evennett (Bexleyheath and Crayford) (Con)
12. What steps his Department plans to take to assist hospitals with the cost of PFI payments.
The Secretary of State for Health (Mr Andrew Lansley)
A Treasury review identified savings opportunities of up to 5% on annual payments in NHS PFI schemes. The lessons learned from the PFI savings pilot will be applied to all schemes in the PFI pipeline. The previous Government left a £50 billion post-dated cheque to pay for their hospital building programme. Much of it was unaffordable and poor value for money. We are dealing with that unfortunate legacy, including the 22 NHS trusts that identified this as a constraint on their future sustainability.
Mr Jones
I thank my right hon. Friend for his response. PFI schemes have undoubtedly undermined the financial stability of many local health economies, as is the case in Coventry and Warwickshire. Can my right hon. Friend assure my constituents that any solution to assist PFI schemes, such as at the University Hospitals Coventry and Warwickshire NHS Trust, will not be to the detriment of my constituents who use the George Eliot hospital in Nuneaton?
Mr Lansley
Yes, I believe I can give my hon. Friend that assurance. Through the process of working with NHS trusts to see what is necessary for them to become foundation trusts—for example, we are working with University Hospitals Coventry and Warwickshire NHS Trust—it is clear that action taken locally with support can deliver viability and sustainability for the future. I hope the same will be true for the George Eliot hospital, but as a separate trust it will not be as a direct consequence of the steps that are taken at Walsgrave.
Mr Evennett
I welcome my right hon. Friend’s response to the original question. Poorly negotiated PFI deals for hospitals in the South London Healthcare NHS Trust are causing real financial problems and have led to the downgrading of Queen Mary’s hospital in my borough of Bexley. Does he share my concerns about this injustice, and will he ensure that my constituents get the first-class health care that they need and deserve and look again at this PFI situation?
Mr Lansley
Yes, of course. My hon. Friend understands very well indeed how difficult are the circumstances of his trust, which includes two PFI hospitals, and Queen Mary’s at Sidcup has suffered from the consequences of those PFIs. I am looking forward to the proposals on the future provision of health services on the Queen Mary’s Sidcup site. South London Healthcare is clearly an extremely challenged trust and we inherited very substantial problems there. We are looking to resolve them with it, but it will need additional national support.
Claire Perry (Devizes) (Con)
In addition to struggling hospital trusts, many, many community hospitals throughout the country, such as Savernake hospital near Marlborough, are also labouring under the burden of an enormous PFI contract and having the indignity of vital local services hollowed out under that lot’s leadership on the Labour Benches. Will the Secretary of State please tell me what he will do to help those smaller hospitals with vital local services?
Mr Lansley
As my hon. Friend knows from her conversations with the Minister of State, Department of Health, my right hon. Friend the Member for Chelmsford (Mr Burns), we are very sympathetic to her concerns. By devolving commissioning responsibilities to clinical commissioning groups, I expect the local clinical leadership, understanding fully the contribution that community hospitals can make, to be supportive of that in their commissioning intentions in her constituency and others.
Dr Julian Huppert (Cambridge) (LD)
14. What plans he has to ensure balanced political and geographical representation on health and wellbeing boards.
Guy Opperman (Hexham) (Con)
15. What plans he has to ensure that the NHS is prepared for winter pressures.
The Secretary of State for Health (Mr Andrew Lansley)
The NHS and social care systems are well prepared for winter. Our Winterwatch summary was first published last Thursday. It showed higher flu vaccination uptake, and I announced additional extracorporeal membrane oxygenation—ECMO—capacity, which will be in place by December. There is always more pressure on the NHS during winter. This year will be no different, but the preparations are in place.
Guy Opperman
Given the director of immunisation’s recent report on the take-up by medical staff of the flu jab and the local efforts of Dr Alastair Blair, the chair of the Northumberland clinical commissioning group, will the Minister expand on the need for patient protection in the form of flu jabs in hospitals and surgeries around the country?
Mr Lansley
I would like to take this opportunity not least to commend the work that the chief medical officer has done this year in encouraging health care workers to have their seasonal flu jab. The latest figures are that 29% have done so, compared with 11% at the same point last year. We heard earlier from my hon. Friend the Member for Kettering (Mr Hollobone) how well Kettering has done, and there are hospitals that are demonstrating that a higher level is entirely achievable. I urge staff across the NHS to have their flu vaccination. It is the ethical thing to do, not least to provide protection to their patients.
John Healey (Wentworth and Dearne) (Lab)
One of the things that makes the problem of winter pressures much greater is the NHS coping with the biggest reorganisation ever. The public have a right to know the risks that the Government’s policies are placing on our NHS. The Information Commissioner agrees and has judged that the Secretary of State must now release the risk assessments and register for his NHS reorganisation. Will he now obey the law and end his 12-month cover-up?
Mr Lansley
I have been very clear and published all the cost-benefit and risk information relating to the modernisation of the NHS, and the impact assessment was published when the legislation was presented to the House of Lords.
David Morris (Morecambe and Lunesdale) (Con)
The Care Quality Commission and Monitor are looking into the affairs of the University Hospitals of Morecambe Bay NHS Foundation Trust. Will my right hon. Friend assure my constituents that whatever the findings, the Government will act upon them quickly?
Mr Lansley
I entirely understand my hon. Friend’s point. I of course will not prejudice whatever might be said in relation to that, but I will look at the report very carefully when it is presented.
Liz Kendall (Leicester West) (Lab)
Social care is vital for reducing winter pressures on the NHS by helping to keep older people out of hospital, but the Government are cutting funding for older people’s social care by £1.3 billion. Delayed discharges from hospitals are already up 11% from this time last year. The Minister responsible for care said in Westminster Hall on 10 November:
“cuts to front-line adult social care services are really beginning to bite.”—[Official Report, 10 November 2011; Vol. 535, c. 178WH.]
Does the Secretary of State agree?
Mr Lansley
I have to say to the hon. Lady that it was this Government who, through the spending review, gave priority to social care. More than £7 billion was added to the social care budget as a consequence of the steps taken by my right hon. Friend the Secretary of State for Communities and Local Government and by the NHS. This year the NHS is providing an additional £648 million specifically to support adult social care. In addition, I have announced our Warm Homes Healthy People funding for this winter, which will provide additional support for those most urgently in need.
John Mann (Bassetlaw) (Lab)
16. How many accident and emergency departments have reduced their on-site service provision in the last 12 months.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
18. What steps he is taking to improve the training of nurses and doctors.
The Secretary of State for Health (Mr Andrew Lansley)
Our reforms aim for excellence in education and training and for a better patient experience by ensuring greater accountability for employers in planning and developing their work force while being professionally informed and underpinned by strong academic links. I have always been clear that I want to see greater professional ownership of the standards of education and training, and greater employer engagement in getting work force planning right. We will publish more details on that when the NHS Future Forum reports shortly.
Mr Sheerman
Does the Secretary of State share the concerns that I have picked up in my constituency? First, although we have very good nurses in Huddersfield, national stories about a lack of care for elderly people make all of us worried about the quality of training of some nurses in some institutions. Secondly, will he remember that, with his demolition of the health service, we are moving to a system in which no management training is given to any doctor or GP? Is that not a recipe for chaos?
Mr Lansley
On the latter point, I have been talking to those in training, and part of their education increasingly includes leadership. That is what we are looking for—clinical leadership, not to turn clinicians into managers. They will work with managers, but they will provide leadership.
On nursing training, the Care Quality Commission’s recent inspection reports, in particular, illustrated the sheer variability of care—sometimes even between wards in the same hospital. On that basis, we should not in any sense damn the quality of nurse training; we need to focus on the quality of nurse leadership—ward by ward, and hospital by hospital.
Mr Peter Bone (Wellingborough) (Con)
The new Government’s strategy on human trafficking requires the NHS to ensure that victims of human trafficking are recognised in hospitals and reported. One way of doing that is to improve training for nurses. I have just returned from Moldova, where nurses have a course on human trafficking as part of their training, so that they can recognise victims and help them. Is that something that we could incorporate here?
Mr Lansley
I am interested to hear my hon. Friend’s experience. I certainly look forward to hearing more from him about it, and to taking it on board in considering how we respond to those obviously tragic victims.
Kerry McCarthy (Bristol East) (Lab)
19. What assessment he has made of the effects of publishing his Department’s strategic risk register on his restructuring of the NHS.
Helen Jones (Warrington North) (Lab)
T1. If he will make a statement on his departmental responsibilities.
The Secretary of State for Health (Mr Andrew Lansley)
My responsibility is to lead the NHS in delivering improved health outcomes in England, to lead a public health service that improves the health of the nation and reduces health inequalities, and to lead the reform of adult social care, which supports and protects vulnerable people.
Helen Jones
Is the Secretary of State aware that plans to remove vascular services from Warrington hospital will threaten services such as diabetes care, renal cancer care and the co-operation on stroke that has been built up with Whiston hospital? What will he do to protect those services, or is this part of the plan he discussed in February with NHS North West to reduce the number of acute beds and increase competition?
Mr Lansley
I am glad that on Monday the hon. Lady will have an opportunity for an Adjournment debate where this subject can be—
Mr Lansley
I will of course answer the question. The answer is that this is entirely driven by clinical issues in a local context. I can tell the hon. Lady that it is very much about trying to improve vascular services, and the judgments being made are local and clinical.
Iain Stewart (Milton Keynes South) (Con)
T2. What leadership role do the Government expect the new health and wellbeing boards to play in determining significant NHS service changes in each local area?
Mr Lansley
The health and wellbeing boards will have a role not only in leading improvements in public health and social care but, through the joint strategic needs assessment and the strategy derived from that, in establishing how services should respond to the needs of the local population. The clinical commissioning group should respond directly to that, and any specific service configuration changes should form part of the commissioning plan. In addition, the local authority, through its scrutiny role, will have a continuing ability to refer those plans for review.
Mrs Mary Glindon (North Tyneside) (Lab)
T4. Will the Secretary of State agree to meet me, and families living with muscle disease, to discuss the urgent problem of primary care trusts refusing to fund vital cough assist machines, which help to prevent serious and very costly winter respiratory infections for those who are unable to use their lung muscles to cough?
Mr Lansley
Of course I, or one of my colleagues, will be glad to meet the hon. Lady to discuss that. I might also say that it was important to have announced, as I did last week, the expansion of ECMO—extracorporeal membrane oxygenation—facilities across England. Those facilities present a life-saving opportunity for people with the severest respiratory disease.
Sajid Javid (Bromsgrove) (Con)
T3. My apologies, Mr Speaker, for having missed my question on the Order Paper earlier.Every five minutes someone in the UK suffers from a stroke, and over 1 million people are living with the effects of stroke. That is why I welcome the establishment of the first “life after stroke” centre—a £2 million investment in my constituency. Will my right hon. Friend join me in welcoming this excellent initiative by the Stroke Association?
Mr Lansley
Yes, of course I will join my hon. Friend in paying tribute to all the work that I know personally that the Stroke Association has done over a number of years in raising public awareness of the importance of developing stroke services, which has had an impact inside the NHS. We have improving figures in terms of reducing stroke mortality, and I now want to go further in ensuring that we enable people not only to survive stroke but to recover as many as possible of their abilities afterwards.
Paul Goggins (Wythenshawe and Sale East) (Lab)
T5. Will the Minister with responsibility for public health update the House on her plans to review the criteria whereby people with haemophilia who have been infected with hepatitis C can claim stage 2 payments from the Skipton fund? Specifically, will she tell us how she intends to involve patients and carers in that review?
Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
What is the Secretary of State’s estimation of the number of NHS doctors and nurses who, in an astoundingly demoralising way, are having their pay grades downgraded?
Mr Lansley
I do not have a figure for that. If the hon. Lady and others want to discuss it, I would be glad to see evidence of it—and so should NHS employers, because as part of the implementation of “Agenda for Change”, staff should be banded in grades according to independent criteria.
Mr David Amess (Southend West) (Con)
T9. Last year in Westminster Hall, the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton) rightly praised the work of midwives and the Royal College of Midwives. Does she share my concern that locally, there could be a downgrading of community midwives, leading to an overall reduction in the number of midwives in our area?
Phil Wilson (Sedgefield) (Lab)
The coalition agreement states that public sector employees, including health care employees, will be given a new right to set up employee-led co-operatives to run services. Can the Minister detail how many NHS co-operatives have been established and how many employees are involved in them?
Mr Lansley
I will gladly write to the hon. Gentleman if my recollection is wrong, but I think that something in the order of 25,000 staff have been transferred into social enterprises since the election. That represents something like £900 million-worth of NHS activity across England.
Tracey Crouch (Chatham and Aylesford) (Con)
Pension reform is important to those of my constituents who work in the public sector—and, indeed, to the taxpayers who do not. With that in mind, does the Secretary of State agree that the heath service unions should work constructively with the Government on public sector pension reform rather than go on strike next week, potentially putting patients’ lives at risk?
Mr Lansley
Yes, I am grateful to my hon. Friend. It is very important to me that NHS staff, and other public servants, are valued in their remuneration, including the pensions that they receive. That is precisely why I have myself engaged in discussion with the NHS trade unions and staff side and continue to be engaged directly in negotiations with them about that, on the basis of the conditional offer that the Chief Secretary to the Treasury announced to the House recently, which I think would be fair to NHS staff and to taxpayers. On that basis, I think it is completely irresponsible and unacceptable for some unions in the NHS—not the Royal College of Nursing or the British Medical Association—to intend to go on strike next week.
Mr Speaker
We are immensely grateful to the Secretary of State. He is testing the knee muscles of colleagues very considerably, and we are grateful to him for that, I am sure.
Tessa Munt (Wells) (LD)
There are 3,000 cases each year of early stage inoperable lung cancer, but as yet no national stereotactic body radiotherapy treatment for lung cancer. What number of patients does the Secretary of State consider to be the appropriate threshold at which he will instruct his Department to establish a national lung cancer tariff?
Mr Lansley
I am grateful to my hon. Friend for that question. I do not think I am in a position to say what figure is appropriate, but the national clinical director for cancer has already indicated to the NHS that he wishes us to develop a national tariff for stereotactic radiotherapy. A quarter of centres across the country already provide it, and our intention is to ensure that that is supported by a national tariff as soon as possible.
Huw Irranca-Davies (Ogmore) (Lab)
Regrettably, there are still many thousands of attacks by dangerous dogs every year that end up with people in A and E, and occasional fatalities. Has the Secretary of State carried out any assessment of the cost to the NHS of treatment for attacks by dangerous dogs? If not, may I ask him to instruct his officials to do so?
Mr Lansley
I do not have those figures to hand, but I will gladly see whether we have them available, and I will write to the hon. Gentleman.
UK Influenza Pandemic Preparedness Strategy
Lord Lansley Excerpts(12 years, 6 months ago)
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The Secretary of State for Health (Mr Andrew Lansley)
I am today announcing the publication of the “UK Influenza Pandemic Preparedness Strategy 2011” and the Government response to the consultation launched on 22 March 2011.
The majority of comments on both policy and operational detail were in strong agreement with the overall approach set out in the strategy. All comments have been considered when finalising the updated strategy.
Each of the UK Governments will produce separate health and social care facing documents, which will address the operational detail.
We plan to publish the English health and social care document in the next few months and it will be subject to the agreement of the new health system in England.
This strategy and Government response have been placed in the Library. Copies are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office. The strategy can also be found at:
www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_130903.
The consultation response also can be found at:
www.dh.gov.uk/en/Consultations/Responsestoconsultations/DH_130901.