Commissioning and Public Expenditure
Lord Lansley Excerpts(13 years, 11 months ago)
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The Secretary of State for Health (Mr Andrew Lansley)
I have today laid before Parliament the Government’s responses (Cm 8007 and Cm 8009) to the House of Commons Health Select Committee reports “Public Expenditure: Second Report of Session 2010-11”, which was published on 14 December 2010 and “Commissioning: Third Report of Session 2010-11”, which was published on 18 January 2011.
We accept the level of challenge presented in our modernisation of health and social care but we are clear that these changes are necessary and that the funding announced during the 2010 spending review, coupled with more efficient delivery systems, will allow the required change to take place across the health and social care sectors. These changes will bring about closer working across the sectors creating services that will be more responsive, more personalised and more preventative with better outcomes for those who use them.
The starting point for the Committee’s inquiry into commissioning has been the previous Committee’s findings on the significant shortcomings of the current arrangements for commissioning in the NHS. We welcome the Committee’s conclusion that more effective commissioning is the key to delivery of efficiency gains. The White Paper, “Liberating the NHS”, sets out a new direction for the future of commissioning, intending to put commissioning decisions in the hands of those who are closest to patients themselves—GPs.
The Health and Social Care Bill introduced into Parliament on 19 January takes forward the changes to the NHS set out in the White Paper and further developed in December’s “Legislative framework and next steps”.
The programme of modernisation we have set out is essential both to drive efficiency in the short-term, and help ensure that the NHS meets the ambition to achieve outcomes for patients that are among the best in the world.
Today’s publications are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office.
Oral Answers to Questions
Lord Lansley Excerpts(13 years, 11 months ago)
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Christopher Pincher (Tamworth) (Con)
11. What recent progress he has made in introducing GP commissioning consortia.
The Secretary of State for Health (Mr Andrew Lansley)
Last week, I announced the second wave of GP-led pathfinder consortia. There are now 141 groups of GP practices piloting the future GP commissioning arrangements. Those groups are made up of more than 4,000 GP practices, with over half the population starting to benefit from services that better meet their needs and improve outcomes for patients. The Health and Social Care Bill, which had its First Reading last week, sets out the legislative framework that supports our reforms.
Mark Lancaster
Consortia in Milton Keynes have been given £1 per patient as a transition fund. That money is most welcome. It will rise to £2 per head next year. The problem, however, is that the fund is proving hard to access because of the bureaucratic nature of the local primary care trust. Will the Secretary of State look into that and ensure that the money is accessible?
Mr Lansley
I entirely understand my hon. Friend’s point. The PCT’s role is to support the development of consortia, not inhibit it. The operating framework that was published last month sets out the range of support that PCTs should be offering emerging consortia. Milton Keynes PCT has confirmed that it will actively support Premier MK, one of two consortia in the area, with its application to become a pathfinder, and that it is actively working with another consortium in the Milton Keynes area.
Stephen Mosley
Pathfinder consortia will play a crucial role in improving the NHS, so it is imperative that any problems are sorted out as quickly as possible. How does my right hon. Friend propose to help any pathfinder consortium that finds itself in the unfortunate position of failing to deliver the results expected of it?
Mr Lansley
My hon. Friend makes an important point. He will recall that before the election, the Select Committee on Health severely criticised the way in which primary care trusts were going about commissioning. We are looking to consortia because they are clinically led and responsive to patients in designing far better clinical services, and they will have considerable support in doing so. Over the next two years, we will enable them to develop support arrangements, whether through existing primary care trust teams, local authorities, the NHS commissioning board, or a range of voluntary and independent sector organisations.
Nick de Bois
Will the Secretary of State outline the role that charities and voluntary organisations will play under GP commissioning to ensure that the needs and views of patients are at the heart of services?
Mr Lansley
To give my hon. Friend one example, last Friday I spoke to the Motor Neurone Disease Association, which has developed a commissioning support organisation with the Multiple Sclerosis Society and Parkinson’s UK. The voluntary sector can therefore be involved directly in helping GP consortia to commission for those critical diseases more effectively. My hon. Friend might have seen what Sir Stephen Bubb, the chief executive of the Association of Chief Executives of Voluntary Organisations, said last week:
“These reforms could herald a new and dynamic relationship between local GPs and charities that both deliver good services and act as a powerful voice for patients.”
Mr Lansley
My hon. Friend might like to speak to general practitioners in Redbridge in London who, as a pathfinder consortium, have been pioneering GP-led commissioning for 18 months. They have redesigned care for patients with diabetes and coronary artery disease, and are shifting care in ophthalmology and dermatology to primary care settings. They are demonstrating how this form of locally and clinically-led commissioning is more responsive to patients and more effective.
Christopher Pincher
As we shift from PCTs commissioning services to GP consortia doing so, can my right hon. Friend confirm that the important work done by pharmacies, such as providing anti-smoking clinics and the supervised consumption of drug substitutes, will not be left out in the cold?
Mr Lansley
My hon. Friend enables me to say that I and my colleagues entirely understand and endorse the stronger role that pharmacies can play, including by assisting with the provision of services such as minor ailments services and medicines use reviews, which will be commissioned through arrangements led by the NHS commissioning board. In addition, the services that he describes, such as stop smoking services, will be commissioned as part of the public health efforts, which will be led by local authorities through their local health improvement plans.
Emma Reynolds (Wolverhampton North East) (Lab)
Will the Secretary of State comment on the apparent conflict between, on the one hand, a general practitioner being an advocate for their patient and taking purely clinical decisions and, on the other hand, GPs having to allocate resources in the new system? Will that conflict not lead to a breakdown of trust in the relationship between the GP and their patients?
Mr Lansley
I am afraid the hon. Lady sees a conflict where, to GPs, there is none. It is their responsibility—[Interruption.] No, their first duty is always to their patients, whose best interests they must secure. When she has an opportunity to look at the Health and Social Care Bill, which we published last week, she will see that it makes very clear the duty to improve quality and continuously to improve standards. We all know that we have to achieve that with finite resources, but we will do that much better when we let clinical leaders influence directly how those resources are used rather than letting a management bureaucracy tell them how to do it.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
Can the Secretary of State explain why, at a time when front-line NHS staff in my constituency and elsewhere across the country are in fear of their jobs, it is proposed that the NHS commissioning board will be able to make bonus payments to a GP consortium if, to quote the Bill,
“it considers that the consortium has performed well”,
and that a GP consortium may
“distribute any payments received by it…among its members”?
Is that not the worst kind of excess? We do not want to see it in our banking system, and we certainly do not want to see it in our NHS.
Mr Lansley
I am glad to have the opportunity to welcome the hon. Lady to the Opposition Benches and wish her well in representing Oldham East and Saddleworth. I am sorry that she did not take the opportunity to welcome in particular the Government’s commitment to the new women and children’s unit at the Royal Oldham hospital.
For years, general practices have been remunerated partly through a quality and outcomes framework. The principle is that if they deliver better outcomes for patients, they should have a corresponding benefit from doing so. In the same way, if the commissioning consortia deliver improving outcomes for patients, that should be recognised in their overall reward.
John Healey (Wentworth and Dearne) (Lab)
The Secretary of State talks a lot about GPs using £80 billion of public money to commission services, but if they are to carry on being family doctors, the planning, negotiating, managing and monitoring of hundreds of commissioning contracts will be done not by GPs but in their name, either by the people who do it now in primary care trusts or by the big health companies that are already hard-selling the service to new GP consortia. Is he not deliberately disguising the true purpose of his changes, which is to open up all parts of the NHS to big private health care companies?
Mr Lansley
On the contrary, the purposes of the Bill are very clear to see—for example, the duty to improve quality and raise standards throughout the health service. I hope that the shadow Secretary of State will acknowledge that putting clinical leadership at the heart of the system is essential. I entirely understand that leadership is not the same thing as management, as do general practitioners. The Prime Minister and I will meet the first wave of pathfinder consortia tomorrow, and we will support them in taking clinical leadership in designing services for patients and bringing to bear the best management support in doing so.
John Healey
Why will the right hon. Gentleman not be straight with the public? I have with me the White Paper—57 pages and only three references to the market, all of them to the social market. He talks about GP commissioning, but not about the hard-line political ideology that underlines these changes. The Bill puts no limit on the use of NHS beds and staff to treat private patients, it puts no limits on big private health care companies undercutting and undermining local hospitals, and it puts at the heart of the new system an economic regulator charged not with improving services but with guaranteeing and enforcing competition. Is this NHS reorganisation not like an iceberg, with the substantial ideological bulk being kept out of the public’s sight?
Mr Lansley
The shadow Secretary of State cannot actually criticise what we put forward in the White Paper or the Bill and is resorting to inventing something else and attacking that. Let me tell him that the one thing we will not do with the private sector is rig the market so that private companies get contracts and guaranteed money whether or not they treat patients. We are not going to give them 11% more money than the NHS would get for doing the same work. We will give NHS organisations a proper chance to deliver services for patients.
Liz Kendall (Leicester West) (Lab)
Whatever the Secretary of State claims about his reorganisation, a King’s Fund survey showed that more than three quarters of doctors do not believe that it will improve patient care, and even his Department’s impact assessment on the Health and Social Care Bill says that the reorganisation risks distracting staff and making them less focused on patient care.
Will the Health Secretary now confirm that the number of patients waiting more than six weeks for their cancer test has already doubled under this Government, and that routine operations are being cancelled? Will he finally listen to the Royal College of Nursing and the British Medical Association, which have told him that his plans are
“extremely risky and potentially disastrous”
for the NHS and patient care?
Mr Lansley
I find it astonishing that the hon. Lady should attack the NHS because some elective operations have been cancelled. We have been through a flu outbreak and very severe weather, and that is what happens as a consequence. She should not try to make a political point out of it.
It is also astonishing that the hon. Lady gets up and says that she does not agree with our policy. On 3 December, she is quoted in GP news as saying that
“it is ‘absolutely right’ that GPs are ‘better involved’ in commissioning services.”
She supported it. The truth is that before the election the Labour Government instituted practice-based commissioning, introduced foundation trusts, started payment by results and said that patient choice was right. The shadow Secretary of State said just last week that
“these plans”—
our plans—
“are consistent, coherent and comprehensive”,
and indeed they are.
Tim Farron (Westmorland and Lonsdale) (LD)
Cumbria’s current health commissioners—the PCT—chose to scrap the heart unit at Westmorland general hospital, despite medical, clinical and public opposition. Will the Secretary of State confirm that new GP fundholding arrangements allows the possibility of returning services that are clinically supportable, such as a heart unit at Westmorland general?
Mr Lansley
I know, not least from visiting that hospital, how strongly people in my hon. Friend’s area feel about their access to services locally. I am pleased to say that he will see in the Bill that one of the duties of the NHS commissioning board is to reduce inequalities in access to health services, and GPs can do precisely that.
Mr Stephen Hepburn (Jarrow) (Lab)
The Secretary of State knows fine well that the British public knew nothing at the general election of his plans dramatically to dismantle and privatise the NHS. Will he give them a say now and have a referendum on the issue?
Mr Lansley
Since we have no plan either to dismantle or to privatise the NHS, it is no surprise that people were not told of any such plan. Before the election and in the Conservative manifesto, people were told of our determination to cut bureaucracy and get money to front-line care. They were told of the determination of both parties in the coalition to get decision making close to the front line, to enhance accountability, including democratic accountability, and to give greater responsibility to clinicians to lead the development of services.
Charlie Elphicke (Dover) (Con)
2. What steps he plans to take to increase cancer survival rates.
David Rutley (Macclesfield) (Con)
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 national health service in delivering improved health outcomes in England, to lead a public health service which 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.
David Rutley
Cheshire East council is working closely with local health care partners in my constituency to tackle the growing challenge of alcohol abuse, which not only causes serious illness and injury but costs our local primary care trust £34 million a year. Does my right hon. Friend agree that that is the right way in which to tackle this growing problem, and will a member of his ministerial team meet me, along with representatives of the council, to help secure the best possible outcomes in Macclesfield?
Mr Lansley
Of course we will support the efforts of my hon. Friend and his local council to tackle alcohol abuse. He will have heard what was said earlier by the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton), which I entirely endorse.
Local authorities and their communities should have a greater say in what happens in their areas. We will enable them to do so, through the Health and Social Care Bill, the establishment of local health improvement plans, and—as my hon. Friend the Under-Secretary said—the alcohol strategy that we will introduce following the public health White Paper later in the year.
Ian Lavery (Wansbeck) (Lab)
T3. Does the Secretary of State envisage a time when GP consortia may be purchased by foreign companies, and operated and administered thousands of miles away across the globe?
Mr Lansley
No, I do not. I am glad that the hon. Gentleman has asked that question, because I think that there is a world of difference between the question of the exercising of clinical leadership by general practices as members of a consortium in an area and the question of from whom they derive management support. I believe that many will derive it from existing PCT teams, the voluntary sector and local authorities. Sometimes the independent sector will be involved, but it is a question of the consortium choosing where to go rather than being taken over.
Margot James (Stourbridge) (Con)
T2. Some care homes that have received critical reports from the Care Quality Commission are reopening under the same management but with different names. The CQC’s practice is to remove earlier poor reports from its website, leaving potential customers in the dark about the poor record of those homes. Will the Minister remind the CQC of its responsibility to highlight poor practice in care homes, and request that it change its practice?
Paul Blomfield (Sheffield Central) (Lab)
T5. A year ago, writing in The Sun, the Prime Minister made a firm and passionate pledge to increase the number of midwives by 3,000. Last week, the chief executive of the NHS told the Public Accounts Committee that the NHS is now short by 4,500 midwives. Will the Secretary of State tell the House when he intends to implement plans to honour the Prime Minister’s pledge—or can we take it that it is just another Conservative broken promise on the NHS?
Mr Lansley
Well, I do not wish to embarrass the chief executive of the NHS, but actually, he told me he made an error—he was referring to health visitors, not midwives, when he was talking to the Public Accounts Committee. We are short of health visitors precisely because, through the life of the last Government, the number was continuously going down, and we are going to recruit more. Actually, we share the last Labour Government’s commitment to increase the number of midwives, not least because of the increase in the number of births, and to do so in pace with that. As a consequence, in conversations that the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton), and I have had with the Royal College of Midwives, we have made it clear that we will do all we possibly can. We already have more midwives in training than at any other time in our history.
John Stevenson (Carlisle) (Con)
T4. As Ministers are aware, GPs in north Cumbria are supportive of GP commissioning and are already working hard for its success. However, given the rural nature of the area, what support will be given to the local hospitals to ensure that they can provide secondary health care within the new regime, when they have to accommodate the additional costs of providing health care in a rural environment?
Mr Lansley
Yes, I entirely endorse what my hon. Friend says about GPs in Cumbria. They are indeed very forward-looking and show that, even under the last Government, practice-based commissioning was demonstrating its benefits, and we are building on that. I mentioned earlier the duty in the Health and Social Care Bill on the NHS commissioning board to reduce inequalities in access to health care. That will be important for rural areas. The pricing arrangements, led by the commissioning board and Monitor, must also take into account varying costs associated with the delivery of care in different localities.
Mr Tom Harris (Glasgow South) (Lab)
T8. If the Government will not even trust GPs with the responsibility of ordering flu vaccine, how on earth can they trust them with commissioning the care and treatment of cancer victims?
Mr Lansley
Of course, it was the last Government who agreed the arrangements with GPs. It was the last Government who, in 2007, undertook a flu review when central procurement of flu vaccine was recommended, but did nothing about it. The public health responsibility is distinct from the commissioning responsibility for health care of patients. We will look at, and we have still to make a decision about, how we procure flu vaccine in future years. We may do it through central procurement or through continuing GP procurement; but either way, we will make sure that we improve on the system we inherited.
David T. C. Davies (Monmouth) (Con)
T6. Can the Minister tell us how much money is spent each year on disposable surgical instruments, and whether any thought has been given to greater use of properly sterilised reusable instruments?
Grahame M. Morris (Easington) (Lab)
T9. May I ask the Secretary of State directly about leaked documents seen by The Northern Echo? They show that a £53 million NHS contract to provide health care services to the prison service in the north-east was awarded to a private company, Care UK, even though the NHS provider was marked higher on quality, delivery and risk. Care UK beat the NHS provider only on price. Is this confirmation of the Minister of State’s remarks on Newsnight, that this Bill will create a full market and full competition?
Mr Lansley
The hon. Gentleman is asking about arrangements that we have inherited from his Government; they are from before the election and are nothing to do with the White Paper or the Bill. The contract to which he refers was let by the North East Offender Health Commissioning Unit. This was its procurement decision and it states that a competitive, robust and transparent process was followed. This was not a decision taken or influenced by the Department of Health.
Karen Lumley (Redditch) (Con)
T7. In support of national obesity fortnight, which is currently running, I wish to raise awareness of this serious condition, which causes numerous deaths and other serious health conditions. Redditch has high levels of obesity compared with the average in England. NHS Worcestershire is doing a fantastic job, but what more can the Government do to ensure that the NHS will not be overly burdened with increasing obesity problems?
Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
The Minister of State referred earlier to Labour Members cherry-picking quotes, but I do not believe that Laurence Buckman, chair of the British Medical Association’s GP committee, was mincing his words when today he described the Government’s reorganisation plans as “fatally flawed”, warning that they
“would see the poor, elderly, infirm and terminally ill in large parts of the country losing out”.
Why does the Secretary of State believe that he knows better than Dr Buckman?
Mr Lansley
I do not recall the BMA ever agreeing with the previous Government. Let me provide one quote to the hon. Lady:
“The general aims of reform are sound—greater role for clinicians in commissioning care, more involvement of patients, less bureaucracy and greater priority on improving health outcomes—and are common ground between patients, health professions and political parties.”
The shadow Secretary of State said that last week.
Duncan Hames (Chippenham) (LD)
The NHS Litigation Authority has presented NHS Wiltshire with a bill for more than £3.5 million in clinical negligence scheme payments this year. Nationally, among closed claims, legal fees made up more than a third of costs last year. How does the Minister propose to switch this expenditure away from lawyers and towards front-line health services?
Mr Lansley
I wish, first, to say two things, but there may be further to add. First, my right hon. and learned Friend the Secretary of State for Justice is working on the implementation of the Jackson review. That, in itself, will help considerably in reducing the extent to which these costs are consumed in legal fees, rather than proper compensation for clinical negligence. As we made clear in response to Lord Young’s report, we will also pursue the question of whether we can have a fact-finding phase following up a claim against the national health service, so as to mitigate what is otherwise considerable additional cost on conditional fee arrangements and getting expert witnesses.
Mr Dennis Skinner (Bolsover) (Lab)
Why is it that the Secretary of State does not compliment the Labour Government on providing £110 billion, starting with £33 billion in 1997? Is it not a fact that waiting times have fallen as a result of the nurses, the doctors and that money? Is he frightened to utter the words because in 2001 every single Tory MP marched through the Lobby not to give the money to the national health service?
Mr Lansley
Let me remind the hon. Gentleman that at the general election we just fought we were the party that was committed to increased resources for the national health service. We are the coalition Government who, over this Parliament, will increase resources for the national health service by £10.7 billion, even in the face of the deficit we inherited from Labour. The hon. Gentleman’s party’s response was to tell us that we should cut the NHS, and we are not going to do it.
David Tredinnick (Bosworth) (Con)
Will my right hon. Friend the Secretary of State please explain why it is taking so long for him to come to the House about the regulation of herbal medicine? He has to do that before April to comply with European legislation. What is the hold-up?
Dr William McCrea (South Antrim) (DUP)
Specialists in the field state that the figures that point to a more than 50% rise in young drinkers ending up in hospital are a gross underestimate of the serious problem. What further steps can the Department and the Government take to address this important problem?
Mr Lansley
As the hon. Gentleman will recall from earlier exchanges, it is absolutely right that we must have a series of measures to tackle alcohol abuse. Price is part of it, as is the enforcement of legislation. Community alcohol partnerships have been very promising. We must have better alcohol education, and I spoke at the first annual conference of Drinkaware yesterday, encouraging it in the work that it does. We must understand that we have to change people’s behaviour and that the damage that can be done is intense. As a consequence of chronic alcohol abuse, large numbers of people are coming in and out of intensive care units, presenting an enormous burden to the health service as well as doing great damage to themselves.
Gordon Birtwistle (Burnley) (LD)
The College of Emergency Medicine recently stated that if a hospital A and E unit is to be downgraded to an urgent care centre, the nearest A and E unit should be no more than 12 miles away. Will the Secretary of State revisit the cases of A and E units that were recently downgraded by the previous Government to urgent care centres when the nearest A and E unit is more than 12 miles away?
Mr Lansley
Yes. My hon. Friend makes a very important point. I promise I will discuss with John Heyworth of the College of Emergency Medicine precisely the point that my hon. Friend has raised. The College of Emergency Medicine says that it does not recognise what an urgent care centre is. From its point of view, hospitals should either have an emergency department or an A and E or they should not. If they do not, it is very important to be clear that they do not. I feel that we need to be much clearer about the nature of the service provided in A and E departments and the distinction between that and the service provided in minor injury or minor illness centres.
David Wright (Telford) (Lab)
Do not the reorganisation plans for the NHS, coupled with cuts to local authority budgets, mean that public health projects in this country will effectively be binned?
Mr Lansley
No, they will not. We are making very clear our determination to ring-fence public health budgets so that prevention does not suffer, as it did under the hon. Gentleman’s Government. In 2005-06, the first things to disappear as a consequence of financial pressures were the public health budgets and public health staffing. We will not allow that to happen.
Zac Goldsmith (Richmond Park) (Con)
I welcome the Government’s commitment to ending mixed-sex wards, but does the Secretary of State agree that it is both unnecessary and extreme to extend that policy to children’s wards and to enforce it with the threat of fines?
Mr Lansley
I entirely understand my hon. Friend’s point, and the rules we have set out for the NHS are very clear. We are also clear that we will ensure, through the NHS, that people have access to the privacy and dignity they have a right to expect, contrary to what the hon. Member for Leicester West (Liz Kendall) has said. She said that as long as they get the treatment through the NHS, it does not matter whether they are in mixed-sex accommodation, but that is not our policy. It does matter, and we will enforce it.
Strategy for Cancer
Lord Lansley Excerpts(13 years, 11 months ago)
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The Secretary of State for Health (Mr Andrew Lansley)
Today, I formally launch “Improving Outcomes: A Strategy for Cancer”, which outlines the coalition Government’s plans to deliver health outcomes for cancer patients that are among the best in the world in a reformed national health service. Although significant improvements have been made in recent decades—and we welcome the work of all those involved in driving these improvements—outcomes for patients in England continue to lag behind those in countries of comparable wealth.
The strategy translates the three underpinning principles of the coalition Government’s reforms of the health and care services into the steps we need to take to drive improvements in cancer outcomes. In order to put patients, service users and members of the public at the heart of decisions about their care, this strategy sets out the actions we will take to tackle the preventable causes of cancer, to improve the experience of cancer patients and support the increasing number of cancer survivors; describes the ways in which choice for patients in their cancer care will be extended and implemented; and identifies the gaps in information on health outcomes that are crucial to ensuring patients are empowered.
In order to ensure that health and care services are orientated towards delivering the improvements in outcomes for people with cancer we wish to see, the strategy sets out the work which the public health service will be charged with undertaking to deliver the necessary improvements in prevention, raising awareness of cancer symptoms and achieving earlier diagnosis; outlines the resources the NHS commissioning board will be able to draw on to drive improvements in the quality of NHS cancer commissioning; and identifies ways in which best practice approaches to cancer commissioning can be disseminated for use by pathfinder consortia through the transition and beyond.
In order to empower local organisations and front-line professionals to encourage the delivery of improved cancer care, the strategy provides possible future models for the delivery of advice and support on cancer commissioning at the national level; reports on the review of cancer waiting time standards, recommending that current cancer waiting time standards are retained; and announces plans to harness the innovation and responsiveness of the charitable sector further in cancer care, to build on the important work done to date to promote healthier lifestyles, encourage earlier diagnosis and provide information and support for those living with cancer.
The strategy sets out how—in cancer care—we will bring the approach we have set out for health and care services to bear in order to improve outcomes for all cancer patients and achieve our aim of improving cancer survival rates, at the same time as working more efficiently so that cancer services make a significant contribution to meeting the quality and productivity challenge the NHS has been set in this spending review.
Through the approaches this strategy sets out, we aim to save an additional 5,000 lives every year by 2014-15, aiming to narrow the inequalities gap at the same time. The strategy is backed with more than £750 million investment over this spending review, which includes over £450 million to support earlier diagnosis of cancer.
“Improving Outcomes: A Strategy for Cancer” 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.
Swine Flu
Lord Lansley Excerpts(13 years, 11 months ago)
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John Healey (Wentworth and Dearne) (Lab) (Urgent Question)
Thank you, Mr Speaker, for allowing this urgent question to ask the Secretary of State for Health if he will make a statement on the Government’s preparations for and response to the current flu outbreak.
The Secretary of State for Health (Mr Andrew Lansley)
Every winter, flu causes illness and distress to many people. It causes serious illness in some cases and, unfortunately, some deaths. I know that each death is a tragedy that will cause distress to family and friends.
The NHS is again well prepared to respond to the pressures that winter brings—it has responded excellently this year. I thank in particular general practitioners, who each year work tirelessly to look after the health of their patients—especially this winter when the weather, as well as flu and other viruses, has presented challenges.
The rate of GP consultations for influenza-like illness is currently 98 per 100,000 people, down from 124 per 100,000. Those figures are lower than the numbers recorded during the pandemic in 2009-10 and below epidemic levels, which are defined as 200 per 100,000 people. The most recent data showed that 783 people were in critical care in England with influenza-like illness.
Where necessary, local NHS organisations have increased their critical care capacity, in part by—regrettably—delaying routine operations that require critical care back-up. That is a normal local NHS operational process; critical care capacity is always able to be flexible according to local need. We have also increased the number of extracorporeal membrane oxygenation beds, for patients with the most severe disease, from five to 22. A seasonal flu vaccine is again available this year. Our surveillance data show that the vaccine is a good match to the strains of flu that are circulating.
GPs in England order seasonal flu vaccine direct from the manufacturers, according to their needs. Vaccine supply is determined in the early part of the year, for autumn delivery. We recently became aware of reports of flu vaccine supply shortages in some areas in England. We are working with the NHS locally to ensure available supplies of surplus vaccine are moved to where they are needed. In addition, the H1N1 monovalent vaccine is now available to GPs for patients who are eligible for the seasonal flu vaccine.
The Government continue to take expert advice from the Joint Committee on Vaccination and Immunisation. Last year, the JCVI advised for the first time that, in addition to usual risk groups, healthy pregnant women should be vaccinated with seasonal flu vaccine. It did not recommend that children under the age of five outside the at-risk groups should be vaccinated. On 30 December, the JCVI assured me that this advice remains appropriate.
The number of deaths in the UK this winter from flu, verified by the Health Protection Agency, currently is 50. The number of deaths from seasonal flu varies each year, with over 10,000 deaths from seasonal flu estimated in the winter of 2008-09.
Antiviral medicines can also help clinical at-risk groups who have been exposed to flu-like illness. We notified clinicians that the use of antiviral medicines in these groups was justified and, at their discretion, with other patients. We have given access to the national antiviral stockpile to support that.
We are making publicly available for the first time a range of winter performance information, published on the Winterwatch section of the Department’s website. I wrote to all Members last week to inform them of the NHS response to flu, and updated them further in a written statement published this morning.
John Healey
I thank the Health Secretary for that statement, but the truth is that he has been slow to act at every stage of this outbreak, and that is putting great pressure on the NHS across the country. It is working flat-out in our local hospital in Rotherham. We have had to open extra beds, and since last Tuesday have cancelled all non-urgent surgery. Four of the 50 patients in the UK who have so far died linked to this flu have been in Rotherham, and two were constituents.
The Health Secretary talks about seasonal flu, but we knew this would not be like normal winter flu because we knew swine flu would be dominant, so the central question for the Health Secretary is why he made less preparation for a flu outbreak that was expected to be more serious. Why did he axe the annual autumn advertising campaign to help boost take-up of the flu jab and help the public understand who is at risk and what treatment is available? We know it works, and this was a serious misjudgment.
Why was the Government’s first circular to midwives, urging them to help get pregnant women to take up the flu jab, not sent out until 16 December? Why has there been no move to offer vaccines through antenatal clinics, and why are the Government not publishing details of the numbers of pregnant women who are seriously ill or who have died, as they are with other groups that are most at risk?
With proper planning and preparation, we should not have seen GPs and pharmacies running out of the vaccine in some areas last week, nor should we have seen parents confused about the treatment available for their young children. I hope last week’s figures mean we may be over the worst, but, with 783 people in critical care and a long winter still ahead, what steps will the Health Secretary take if the numbers of ill people continue to rise? Can he now, today, give the House the reassurance he has failed so far to give the public, which is that he really has got a grip on this situation? Finally, when all the bodies he is relying on to sort out this situation will be abolished under his internal organisation, what assurance can he give the public that this will be any better handled in the future?
Mr Lansley
I share the right hon. Gentleman’s deep sadness at the deaths in Rotherham and join him in expressing clearly my condolences to the families of his and other Members’ constituents who have died. Regrettably, there will, I fear, be further deaths from flu—that is in the nature of the winter flu season—but I have to explain to him that we are in the midst of a seasonal flu outbreak that has not reached epidemic levels. Neither is it a pandemic, which is clearly a different situation in which a novel virus, to which there is not acquired immunity, is in circulation.
The right hon. Gentleman asked some specific questions. First, on having to cancel operations, I have made it clear that that is, unfortunately, a consequence: if the NHS’s critical care capacity is under pressure, it cannot admit large numbers of patients for elective operations that might require critical care back-up. The seasonal winter flu outbreak has led to an increase in the number of patients with flu in critical care beds, although they still constitute only about one fifth of the total number of critical care beds, and I pay tribute to hospitals across the country that have increased their critical care capacity, particularly in intensive care, to deal with the situation.
We are also providing assistance to the NHS. I am sorry that the right hon. Gentleman did not refer to my important announcement last Tuesday that, because we made savings in the Department of Health’s central budgets, on things such as management consultancy costs and the IT scheme, we have been able to issue this financial year—in other words, starting now—an additional £162 million to primary care trusts throughout England. They will be able to use that money directly with their local authorities to facilitate the discharge of patients. There are currently about 2,500 patients in hospital who could be discharged if the appropriate arrangements were in place. That will accelerate the relationship with social care that we are looking for.
It is pretty rich for the right hon. Gentleman and the Labour party to say that there should not have been any shortages. The number of vaccines supplied to the United Kingdom was determined before the Government took office. It was determined under the previous Administration, in the early part of last year, not by this Administration. Furthermore, it was equally not just presumptuous but unhelpful for him, during the Christmas period, to talk inaccurately about whether children under the age of five should be vaccinated. He knows perfectly well that like his predecessors we take advice from the Joint Committee on Vaccination and Immunisation. With the chief medical officer, we asked the committee to look at the issue again, and it met on 30 December and reiterated its advice that young children should not be vaccinated. So for him to stimulate press reports suggesting that parents should have their children vaccinated, when the expert advice was not that that should be done, was deeply unhelpful.
The right hon. Gentleman’s final point was about the organisations. It is clear to me that, by abolishing the Health Protection Agency and bringing its responsibilities inside the Department of Health under the new Public Health England, we will have a more integrated and more effective system for responding to seasonal flu in future years.
Nicky Morgan (Loughborough) (Con)
The Secretary of State is right that general practitioners are on the front line, and it is to them that patients will turn. Does he have any thoughts on the case of a constituent of mine who contacted me yesterday to say that he has been trying to get a vaccination, but has been unable to do so because he wants to have one after 4 o’clock in the afternoon, when he can get away from work? He does not want to jeopardise his job and is finding it difficult to access the vaccination before then, but GPs would rather vaccinate in the morning.
Mr Lansley
The arrangements that individual GP surgeries make for ordering and administering doses of the vaccine have been, since October, for them to make. From our point of view, as soon as we were aware that local supply would not necessarily match local demand in the places it should, we took the decision last week to make available the NHS stockpile—there are 12.7 million doses of the H1N1 vaccine—and I can tell my hon. Friend that 20,000 doses began to be distributed this morning. There is no reason why we cannot meet the requirement for vaccinations, whether through GPs’ own doses and local arrangements, through issuing NHS prescriptions that can be fulfilled at local pharmacies or through surgeries ordering the H1N1 vaccine from us.
Sir Gerald Kaufman (Manchester, Gorton) (Lab)
Happy new year, Mr Speaker. Is the right hon. Gentleman aware—he should be because I have written to him about this—of serious concerns in my constituency about the shortage of flu vaccine, including for chronically sick people? Will he tell the House, in the most specific way, what action he is taking to ensure that sufficient flu vaccine is available in the city of Manchester and in Greater Manchester?
Mr Lansley
May I reiterate to the right hon. Gentleman that the amount of vaccine supplied to the United Kingdom is determined by manufacturers on the basis of discussions with not only the Department, but others, and that the vaccines are ordered by individual GP surgeries? The total amount of vaccine was 14.8 million doses, which is comparable to the level in previous years. Although GP surgeries have shortages, because of the preparations made during the pandemic in 2009 and given that the principal strain of flu circulating is the H1N1 strain—it is not the only strain, but it is the most relevant to guard against for many in the at-risk groups under the age of 65—we made it clear that we would back up GPs who had any shortages with access to our stockpile of H1N1 vaccine. Orders have come in and they are being filled.
John Pugh (Southport) (LD)
Governments do not control diseases yet, but in my constituency elective surgery has been cancelled and pharmacies have run out of vaccine. What is the serious long-term alternative to the over-provision of last year and the localised under-provision of this year?
Mr Lansley
I do not think one can say that there was over-provision during the pandemic, because one could not have been at all clear about the nature of the progress of H1N1. However, what that meant is that we have the stockpile of vaccine available to back up the NHS this year. My hon. Friend makes a very good point, because there is clearly an issue to deal with regarding how this is properly managed. Before Labour Members start talking from a sedentary position, they might wish to re-examine the 2007 flu review. It was conducted by the Department of Health under the previous Administration and recommended that there should be central procurement of flu vaccine in England, but the previous Administration did nothing about it.
Mr Kevin Barron (Rother Valley) (Lab)
Can the Secretary of State tell us why the midwives association was not written to until 16 December?
Mr Lansley
We made it very clear that everyone in the at-risk groups was going to be contacted through their GP surgery, and it is the responsibility of GPs to have done that.
Mark Pawsey (Rugby) (Con)
I am grateful to my right hon. Friend for the information that he has provided so far, but I wonder whether he could reassure the parents of a 13-year-old boy. They came to see me on Saturday because their son is egg allergic and also suffers from asthma, and they are concerned about the availability of a flu vaccine this year.
Mr Lansley
I will certainly write to my hon. Friend about this, but I am confident that one of the number of vaccines that are available will be suitable for his constituent.
Hugh Bayley (York Central) (Lab)
Last week, 30 beds at York hospital were occupied by people with suspected or confirmed cases of flu. That is costing the local NHS £7,500 a day—£50,000 a week—and that money could be spent on treating patients with unavoidable conditions. What lessons will the Secretary of State learn from the failure to promote the uptake of the flu vaccine this year to ensure that we do not encounter a similar problem next year?
Mr Lansley
The hon. Gentleman’s question is based on a false premise, because the level of vaccine uptake this year among over-65s is 70% and among under-65s is 45.5%, which is comparable to previous years. He did not refer to this, but because we made savings we provided the NHS with considerable additional resources in the last three months of the year precisely to manage winter pressures and ensure that beds in hospitals are available.
David Tredinnick (Bosworth) (Con)
I congratulate my right hon. Friend on the increase in the critical case capacity and in the number of extra corporeal membrane oxygenation—ECMO—beds from five to 22, which has made a difference. Will he also pay tribute to others who help in these situations, such as the manufacturers of homeopathic medicines and homeopathic chemists? They provide preparations that may be suitable for people, such as the constituent of my hon. Friend the Member for Rugby (Mark Pawsey), who are unable to take flu vaccines and others who choose not to do so.
Mr Lansley
I am grateful to my hon. Friend for that question. His local hospital, the Glenfield in Leicester, leads on specialised ECMO bed services. In this country, we have increased the number of ECMO beds; we have more per head of population than any of the developed health economies, including the United States. As for treatments and vaccinations, I continue to rest upon the scientific and expert advice. Indeed, I hope that patients will consult their clinicians about their treatments.
Valerie Vaz (Walsall South) (Lab)
Will the Secretary of State say whether he took the decision to delay the advertising campaign and, if so, when?
Mr Lansley
I announced just after Christmas the “catch it, bin it, kill it” campaign. I had not—[Interruption.] Let me explain to Opposition Members. In 2009, the campaign took place in November. Why? It was because the spread of flu took place in late October, early November. Therefore, it occurred at the point at which there was a substantial spread of the influenza in the community. That is precisely what we did this year.
Henry Smith (Crawley) (Con)
As an asthma sufferer, I am pleased to report that just this morning I had the benefit of the flu jab and it was professionally and painlessly administered. However, constituents have come to me concerned about, in one case, a child who has had the respiratory syncytial virus, or RSV and, in another case, an adult who has had pneumonia, who have been denied the flu vaccine. Will he examine how the guidance to GP practices can be amended to include such groups?
Mr Lansley
I will of course write to my hon. Friend about the nature of the advice provided by the joint committee, but we follow and have followed at each stage the advice given to us by that independent expert committee, the Joint Committee on Vaccination and Immunisation. I will certainly write to him to explain how it has determined the at-risk groups for these purposes.
Mr John Spellar (Warley) (Lab)
Earlier, the Secretary of State made the astonishing admission that he has done nothing since the Labour Government left office. He rightly drew attention to the work being done for at-risk groups. However, emergency planning requires the sustaining of the emergency services. Why is he not giving priority to those who work for the emergency services—the police, the fire and ambulance services?
Mr Lansley
I have two points for the right hon. Gentleman. First, all NHS staff, including ambulance staff, are eligible for the vaccine. Regrettably, when I last looked, under 20% had availed themselves of that opportunity. I wish that it were higher.
Liz Kendall (Leicester West) (Lab)
“Wish”? Does the Secretary of State think wishing is enough?
Mr Lansley
They are all offered it, so they can all be provided with it. I am not in a position to require people to take a vaccine. We are not providing mandatory vaccination in this country yet, and I do not suppose that we shall.
Secondly, I was not admitting that I had done nothing—on the contrary. What the right hon. Gentleman perhaps does not understand is that one cannot simply order additional large-scale supplies of a vaccine. A long process of manufacture is required, as it is an egg-based culture system. The amount is ordered in the spring for autumn delivery, so the amount was determined in the spring. When I entered office in May, there was not any reason particularly to think that we would need more than in other flu seasons, and we knew that we had the back-up of the H1N1 vaccine if we needed it. In early August, I made it clear that I intended to review further the system of procurement, distribution of flu vaccine and its supply. That review is ongoing and will be published shortly.
Jeremy Lefroy (Stafford) (Con)
Does my right hon. Friend agree that the reason that acute beds are under such pressure at this time of swine flu is that we do not have sufficient step-down or community beds into which people can transfer from acute beds?
Mr Lansley
My hon. Friend makes an important point. Primary care trusts and local authorities working together should now be able to have confidence that the resources are available in this financial year—and £648 million will be available in the next financial year, and more in years beyond—to improve the relationship between health and social care not only through things such as step-down beds, but through operating, for example, hospital at home services, community equipment services and home adaptations to ensure that only those people who need to be in hospital are in hospital.
Ms Gisela Stuart (Birmingham, Edgbaston) (Lab)
There have been several reports about children having to travel extremely long distances to access critical care in children’s hospitals. Is the Secretary of State satisfied that there is sufficient capacity for paediatric intensive care and high dependency care?
Mr Lansley
Yes, I am. The hon. Lady will know that there have always been occasions when paediatric intensive care capacity in a particular hospital is full and when it is necessary for children to be taken a distance. On Christmas eve, I was at the intensive care unit at Alder Hey and I want to pay tribute to the tremendous work done by staff there. They acknowledge that this was not just about H1N1. One reason the committee did not recommend vaccinating all children under the age of five was that children, particularly very young children, were in intensive care because of a combination of H1N1 and/or bronchiolitis and RSV. A range of conditions was impacting at that moment on very young children.
Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
Several chemists and GPs’ surgeries in Merseyside have run out of the flu vaccine, leaving at-risk patients unable to obtain the jab. The Health Protection Agency has highlighted Liverpool as having significantly higher rates of swine flu than the English average. Will Liverpool therefore receive a higher proportion of the £162 million that the Secretary of State has made available to primary care trusts to help those affected?
Mr Lansley
The £162 million will be allocated to primary care trusts based on the social care allocation formula, which will be the same for next year. Any GP surgery, or for that matter the primary care trust in Merseyside, is free to come to us to order supplies from the national stockpile of the H1N1 vaccine to ensure that those who require vaccination can receive it.
Kevin Brennan (Cardiff West) (Lab)
In his answer to my hon. Friend the Member for Walsall South (Valerie Vaz), the Secretary of State was clearly giving an after-the-fact justification for his failure to act on the winter awareness campaign earlier in the year. He is fond of telling anyone who ventures to criticise him that they are completely wrong. Will he admit that on this occasion, as far as the awareness campaign is concerned, he was the one who was completely wrong?
Mr Lansley
No, absolutely not. I was simply pointing out to Opposition Members that the principle that applied in 2009, which was that the point at which flu was circulating in the community was the point at which the “catch it, bin it, kill it” campaign was initiated, was precisely the same principle that I applied this year.
May I say in response to the hon. Member for Liverpool, Wavertree (Luciana Berger) that the supplies of vaccine provided to primary care trusts or GPs’ surgeries from the national stockpile of swine flu vaccine will be provided free?
Chris Leslie (Nottingham East) (Lab/Co-op)
To be absolutely clear on that answer, does the Secretary of State have any regrets whatsoever about not proceeding with the flu publicity campaign?
Mr Lansley
No. I have made it perfectly clear that the principle we applied is exactly the same and was based on the medical advice given to me, which was to pursue an awareness campaign on respiratory and hand hygiene at the point at which flu was circulating in the community. That is what I was asked and that is the decision I took.
Tom Greatrex (Rutherglen and Hamilton West) (Lab/Co-op)
Will the Secretary of State comment on the worrying media reports emanating from Scotland that at a time when there were shortages of vaccine the Department of Health was scrabbling around trying to get supplies from other countries when there was a surplus in Scotland, but it never asked the Scottish Government? Is that the case, or is it nationalist mischief making from Edinburgh?
Mr Lansley
All I can tell the hon. Gentleman is the simple truth. In the early part of last week, we asked manufacturers whether they had additional supplies. I believe that some additional seasonal flu vaccine that is licensed for use in this country probably will be made available. In any case, we have the H1N1 vaccine to support the immunisation, where required. Early last week, we did ask Scotland. The amounts that would have been available in the short run were not significant at all, so it was better for them to be retained in Scotland because there might be a continuing need for the vaccine there, rather than here.
Miss Anne McIntosh (Thirsk and Malton) (Con)
Will the Secretary of State explain when in the course of the year the vaccine would normally be ordered?
Paul Flynn (Newport West) (Lab)
H1N1 deaths are especially tragic because they involve people with expectations of a long life. Last year, 65,000 deaths were anticipated but fewer than 500 died with swine flu and 150 died of swine flu. If the priorities of the health service are not to be distorted, should not we approach this problem with a sense of both caution and proportion?
Mr Lansley
I share the hon. Gentleman’s deep regret. H1N1, unlike many previous flu strains, does not particularly impact on the elderly; it impacts on younger people and on younger adults in particular. That is the principal reason why we are seeing a relatively larger number of people occupying critical care beds. The NHS response has been to accelerate the provision of critical care capacity and of ECMO beds in particular.
Ian Paisley (North Antrim) (DUP)
The Secretary of State will be aware that tragically there have been 14 flu-related deaths in Northern Ireland during this winter. Given that that figure is proportionately higher than in other parts of the United Kingdom, what discussions has he had or does he intend to have with his counterpart in Northern Ireland to assess why the proportion is so much higher and whether there is a black spot with regard to that disease?
Mr Lansley
The figure of 50 deaths to which I have referred is the total number of deaths verified by the Health Protection Agency. There have been more deaths than that, but they have not been verified to have been caused by flu. I cannot comment on the relationship between the number that I quoted for the United Kingdom as a whole and that for Northern Ireland, because we are not dealing with comparable figures. My colleagues in the devolved Administrations and I will continue to keep in touch. It is important for us not to be simplistic about this. There are differences in vaccine take-up between Administrations—they are not major, but they exist. There are differences in the prevalence of swine flu, and the prevalence of flu in Northern Ireland is very high compared with England—it is even a great deal higher than that in Scotland. Happily, the number of deaths is only ever a very small proportion of the people who contract flu. To that extent, it is difficult to draw from the number of deaths conclusions about the nature of the response to flu overall, not least because the prevalence is overwhelmingly among people who are not in the at-risk groups, who, I hope, were vaccinated.
Mr Denis MacShane (Rotherham) (Lab)
Mr Speaker, I am not sure whether you have noticed that since the Secretary of State started making his excuses for this problem, Government Front Benchers and Back Benchers have looked more and more unwell. Will the Secretary of State confirm that he has had the flu jab and that he has made sure that his Front-Bench team have had it?
Mr Lansley
I take this issue seriously, even if the right hon. Gentleman does not. As it happens, I fall into one of the at-risk groups, because I had a stroke in 1992, so I have had the flu jab. I would not ask members of my ministerial team who are not in the at-risk groups to have the vaccination, because it is not recommended.
Toby Perkins (Chesterfield) (Lab)
The biggest tragedy is that the Secretary of State has learned no lessons whatsoever from what has happened. As a result, it is likely that the same mistakes will be made in the future. His answers about the advertising campaign are completely unconvincing. Will he explain why he cancelled the advertising campaign, which GPs were demanding at the time, to increase the take-up of vaccinations?
Mr Lansley
I cancelled no campaign; I proceeded only with the awareness campaign on respiratory and hand hygiene. An advertising campaign aimed at the general population would not have been effective, and I was advised that there was no evidence that it would be effective. We knew who the at-risk groups were, and it was possible to reach them directly rather than engaging in wider advertising.
Owen Smith (Pontypridd) (Lab)
Will the Secretary of State tell us what role primary care trusts and strategic health authorities are playing in dealing with the crisis? Will he explain what dismantling the SHAs and PCTs will do in terms of central planning for future crises?
Mr Lansley
The role of SHAs and PCTs is, as in previous years, to manage the NHS response to winter pressures. In future, the commissioning consortiums together with the NHS Commissioning Board, will fulfil similar responsibilities. In future years, there will be a stronger ability to integrate the response of the Department of Health and the Health Protection Agency, working together as one new organisation, Public Health England, which will have a stronger public health infrastructure.
Contaminated Blood
Lord Lansley Excerpts(13 years, 11 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health (Mr Andrew Lansley)
With permission, I would like to make a statement on hepatitis C and HIV-infected blood.
What happened during the 1970s and 1980s, when thousands of patients contracted hepatitis C and HIV from NHS blood and blood products, is one of the great tragedies of modern health care. It is desperately sad to recall that during this period the best efforts of the NHS to restore people to health actually consigned very many to a life of illness and hardship. As the current Health Secretary, and on behalf of Governments extending back to the 1970s, may I begin by saying how sorry I am that this happened and by expressing my deep regret for the pain and misery that many have suffered as a result?
It is now almost two decades since the full extent of the infection was established and two years since the independent inquiry led by Lord Archer of Sandwell reported. The majority of Lord Archer’s recommendations are in place, as are programmes of ex gratia payments, which are administered by the Macfarlane Trust and the Eileen Trust for the HIV-infected and by the Skipton Fund for those with hepatitis C. However, significant anomalies remain and I pay tribute to Lord Archer, to other noble Lords and to hon. Members in this place from all parties for highlighting them.
In October, the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton), announced a review into the current support arrangements —to look at reducing the differences between the hepatitis C and HIV financial support schemes and to explore other issues raised by Members during the recent Back-Bench debate, including prescription charges and wider support for those affected. We also asked clinical experts to advise on the impact of hepatitis C infection on a person’s health and quality of life and to consider whether an increase in financial support was needed. My hon. Friend the Under-Secretary has met representative groups to understand the impact that these infections were having on people’s lives and has also met many Members of both Houses who have been strong advocates on behalf of those affected.
We have now considered the findings of the clinical expert group and we accept that the needs of those with advanced liver disease from hepatitis C merit higher levels of support. At present, the amount of money paid to this group depends on the seriousness of the infection. There are two stages at which the Skipton Fund will make a payment, the first of which is when the person develops chronic hepatitis C infection. At this point, a person is eligible for a stage 1 relief payment—currently a lump sum of £20,000. Some may reach a second stage of developing an advanced liver disease such as cirrhosis or cancer, or of requiring a liver transplant; they then become eligible for a stage 2 payment, which is currently another lump sum of £25,000. Under new arrangements that we will introduce, this second stage payment will increase from £25,000 to £50,000. This will apply retrospectively, so that if a person has already received an initial stage 2 payment of £25,000, they will now get another £25,000 lump sum, bringing the total to £50,000.
In addition, we will also introduce a new, annual payment of £12,800 for those with hepatitis C who reach this second stage. This is the same amount as those who were infected with HIV receive. Those infected with both HIV and hepatitis C from contaminated blood will now receive two annual payments of £12,800 if they meet the stage 2 criteria—one payment for each infection—along with the respective lump sums. All annual payments that are made, both to those so infected with HIV and to those with hepatitis C, will now be uprated annually in line with the consumer prices index to keep pace with living costs.
We know that some of those infected with HIV or hepatitis C from NHS blood and blood products face particular hardship and poverty. Those infected with HIV can already apply for additional discretionary payments from the Eileen Trust and the Macfarlane Trust, but no equivalent arrangements are in place for those infected with hepatitis C, so we will now establish a new charitable trust to make similar payments to those with hepatitis C who are in serious financial need. These payments will be available for those at all stages of their illness, based on individual circumstances. Discretionary payments will also be available to support the dependants of those infected with hepatitis C, including the dependants of those who have since died. Again, this will echo the arrangements in place for those infected with HIV and will enable us to give more to those in the greatest need.
We must also ensure that those infected through NHS blood and blood products get the right medical and psychological support. I can therefore announce two further measures. First, those infected with hepatitis C or HIV will no longer pay for their prescriptions. They will now receive the cost of an annual prescription prepayment certificate if they are currently charged for prescriptions. Secondly, the representative groups raised the issue of counselling support for those infected through blood and blood products. We fully recognise the emotional distress that they have experienced. As a result, we will provide £300,000 over the next three years to allow for around 6,000 hours of counselling to help those groups.
While we focus on those still living with infections, we must also recognise the bereaved families of those who have died. At present, no payment can be made to those infected with hepatitis C who passed away before the Skipton Fund was established. That is a source of understandable distress to those who survive them, and that is something that we now want to put right. I can therefore announce that, until the end of March 2011, there will be a window of opportunity in which a posthumous claim of up to £70,000 can be made on behalf of those infected with hepatitis C who died before 29 August 2003. A single payment of £20,000 will be payable if the individual had reached the first stage of chronic infection. Another single payment of £50,000 will be made if their condition had deteriorated to the second stage, in which they suffered serious liver disease or required a liver transplant. We will work with the Skipton Fund and various patient groups to publicise this new payment to those who may benefit. Those new payments, which will go to the individual’s estate, should help more families to get the support that they deserve.
Taken together, these announcements represent a significant rise in the support available to those affected by this tragedy. Putting an exact figure on the package is difficult, as there is some uncertainty about how many people will be eligible, and how their illnesses may progress. However, we believe that the new arrangements could provide £100 million to £130 million-worth of additional support over the course of this Parliament. All payments will be disregarded for calculating income tax and eligibility for other state benefits, including social care. Although the changes apply only to those infected in England, I will be speaking to the devolved Administrations to see whether we can extend the measures across the United Kingdom.
Today’s announcements cannot remove the pain and distress that individuals and families have suffered over the years, but I hope that the measures can at least bring some comfort, some consolation, and perhaps even some closure to those affected. I commend the statement to the House.
Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)
The Opposition welcome the review and today’s statement, and we note that Labour Health Ministers had agreed the review in principle before they left office. We are glad that the statement was made on the very first day back after the Christmas break, because we are aware that the statement was promised before Christmas. We appreciate it being made as soon as it could be made.
Does the Secretary of State agree that the House owes a tremendous debt of gratitude to the patient groups that have campaigned for more than 25 years on the issue? They include the Haemophilia Society, the Hepatitis C Trust, the Taintedblood group, the Manor House Group, and individuals such as Haydn Lewis, who unfortunately passed away before he could see this resolution. Without the campaigning of those groups and individuals over two decades, the issue would have been one of private misery and private suffering. It is because they campaigned and kept the issue before the public and before the eyes of politicians that we are able to move decisively towards a proper resolution today.
Many of the measures in the statement will be welcomed, particularly the help with prescription charges and the £300,000 for counselling—I have seen with my own eyes the awful mental effect of this tragedy on people—as well as the payments for dependants, the provision for posthumous claims, and above all, the move towards parity in the cases of HIV and hepatitis C. All that will be welcomed, but there will still be campaigners who will regret that we have not been able to achieve parity with the compensation that was offered and handed out in the Republic of Ireland. It would be silly to pretend that there will not be many people still saying today, “Why could we not achieve what was done in the Republic of Ireland?”.
Finally, when we remember that more than 4,500 completely innocent and trusting patients contracted HIV, hepatitis C or both as a consequence of tainted blood, and that more than 1,900 of those people have died, leaving thousands of dependants behind, should we not, as a House, resolve that it should never again take 25 years for perfectly innocent victims of errors and mistakes to have proper justice and recompense?
Mr Lansley
I am grateful to the hon. Lady and I entirely endorse her opening and closing remarks paying tribute to all the patient groups. My hon. Friend the Under-Secretary of State for Health has met many of those groups and individuals, and I know that she would heartily endorse what the hon. Lady said about how they have brought these issues time and again to the forefront of attention in the House and the other place. I do not want to underestimate the many in the House and the other place who responded to that and did so very well by bringing these cases forward. I hope that they will see in today’s statement a proper response.
We do not know whether there will ever be a similar case. I hope we can avoid it—it would be much better to avoid it—but if we were ever in a situation where such a consequence flowed from the NHS seeking to do its best to treat patients but such harm nevertheless occurred, I hope we would recognise that, be able to identify it and not allow decades to pass before proper recognition took place.
That brings me to the hon. Lady’s substantive point, which is the relationship between what we are doing and the compensation provided in the Republic of Ireland. As we explained in October, we do not regard these as comparable cases. In the Republic of Ireland, mistakes were made by the Irish Blood Transfusion Service which led to a recognition of liability, leading to a determination of compensation. In this country we are not providing compensation. We are recognising the harm that occurred, notwithstanding the fact that the NHS at the time sought to provide the treatment that it thought was in the best interests of patients.
That harm occurred. As an ex gratia payment and in recognition of the harm that occurred and the distress that followed, we have sought to ensure that there is proper support, financial and otherwise, for the victims and their families. I hope that by getting rid of the anomalies and recognising—in particular, through the work of the clinical expert group—the impact on those with hepatitis C, we are giving the support that those who were damaged should expect.
Jonathan Evans (Cardiff North) (Con)
Although I welcome my right hon. Friend’s statement, I should point out that Lord Archer recommended that there should be compensation along the Irish lines. That is a little of the context of what has taken place.
I take the opportunity of congratulating the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton) on all the work that she has done on the matter, which I know has been welcomed across the House.
May I ask my right hon. Friend about the position in Wales? I was a little taken aback by the fact that he said that he intends to speak to fellow Ministers in Wales. I have a statement from the Welsh Minister indicating that as far as she is concerned, these issues come next to be considered by her in 2014, which was the previous agreement with the Department of Health. Many of my constituents will want to know what discussions have so far taken place and whether the arrangements will be replicated in the Principality.
Mr Lansley
The Under-Secretary will have heard what my hon. Friend said. I am grateful for it, too.
I am speaking on behalf of England in this respect. As the Department of Health, we administer the payments system. We had to reach the decisions and we have done so. We always intended to do so as rapidly as we could for England, but as I explained in my statement, these decisions have yet to be made by the devolved Administrations. It is reasonable for them to see the review report that I am publishing today, not least the clinical expert review that goes with it, in order for them to make their own decisions. Those are decisions that they must make, but if they wished us to continue to administer the system on the same basis across the United Kingdom, we would be happy to do so.
Diana Johnson (Kingston upon Hull North) (Lab)
In the debate on the subject in the autumn, the Under-Secretary of State agreed to speak to her colleagues in the Department for Work and Pensions about the changes to benefits and how those would affect people who had received contaminated blood products. Can the Secretary of State give any guarantee about passporting people affected by the changes in benefits so that they do not lose out and have to go through a further set of medicals?
Mr Lansley
I am grateful for that. This is not a response to precisely the question that the hon. Lady asks, but Lord Archer made a point about whether payments should be made through the Department for Work and Pensions. We do not see that any tangible benefit would flow from that.
Mr Lansley
No, I acknowledged that. I will of course respond to the hon. Lady, but I think it better for us to administer all the payments through the system that I have set out. As I say, they will be disregarded for the purposes of calculation of benefits, so to that extent they will not impact adversely on current benefits.
Jason McCartney (Colne Valley) (Con)
Having spoken in the debate in October and having asked a question in Prime Minister’s questions in November, I very much welcome a number of elements in the Secretary of State’s statement, particularly those on free prescriptions and counselling help. Will he, however, promise to meet the Taintedblood campaigners and perhaps even to look at the overall level of compensation?
Mr Lansley
May I say two things to my hon. Friend? My hon. Friend the Under-Secretary has met those groups and will continue to meet them, because we want to ensure not least that those who are now eligible for enhanced payments and so on make proper applications. We have looked very carefully with the clinical expert group at the support that we ought to give. It is not compensation as such; it is an ex gratia form of support. We have made judgments, and if we were to go further, there would be significant additional costs. My hon. Friend the Under-Secretary and I have made it clear to the House in the past that to provide payments on the scale of the Republic of Ireland might involve up to, or perhaps even in excess of, £3.5 billion a year, so I am not in a position to say to my hon. Friend the Member for Colne Valley (Jason McCartney) that I expect to go beyond the support that I have set out today.
Mr Andy Slaughter (Hammersmith) (Lab)
It is to be regretted that the review’s terms of reference were so narrow, as it did not consider overall levels of compensation or HIV. If the Secretary of State believes that the Republic of Ireland case is simply too expensive, will he please say so and not rely, as the Department has, on either the idea that the Taintedblood campaigners and others are asking him to look at that and tying us to the Irish system, or the idea that they are asking us effectively to look at those levels of compensation because negligence was involved? That was not the case in Ireland. Is not the result likely to be more litigation? The levels of remuneration are still far too low.
Mr Lansley
With respect to the hon. Gentleman, in response to previous questions I made it very clear that the question was not simply about the amount of money. The situation in the Republic of Ireland is unique in respect of its determination of liability because of mistakes made by the Irish Blood Transfusion Service. To that extent, we are making ex gratia payments. The nature of our payments stands comparison to other countries, particularly now, in respect of hepatitis C and my announcements this afternoon.
Jenny Willott (Cardiff Central) (LD)
I really welcome today’s statement and, in particular, the apology, which will go a long way to ease some of the pain that some of the victims have suffered. Proper support for those infected with hepatitis C is also long overdue. Gareth Lewis, who was a leading Taintedblood campaigner—I believe he met the Under Secretary—tragically died just before Christmas, only a few months after his brother, Haydn, whom the hon. Member for Hackney North and Stoke Newington (Ms Abbott) mentioned. That highlights the urgency of my question. Governments are not known for moving quickly, particularly when it involves handing out money, so will the Secretary of State reassure us that everything that can be done will be done to ensure that the payments announced today are made as soon as is humanly possible?
Mr Lansley
May I pay tribute to my hon. Friend, who has on many occasions spoken up on behalf of her constituents and others who were affected by the tainted blood and blood products? The answer to her question is yes—absolutely we will. When we came into office, we were determined to implement the review. As she said, we sought to complete the review before Christmas—technically speaking, we did, but we were not in a position to announce it before Christmas. We are doing this at the first available moment, and we will do everything that we possibly can to ensure that potential beneficiaries are notified and reached as quickly as possible so that the payments are in place as soon as possible.
Chris Bryant (Rhondda) (Lab)
It would be one of the greatest catastrophes if what happened were able to happen again. That is why it is so vital that the Government constantly keep under review the policy on donating blood. As the Secretary of State will know, men who have had sex with men are one of the categories of people who are not able to give blood at the moment, and that seems intrinsically unfair and prejudiced. I urge the Secretary of State to look only at the scientific evidence in the ongoing review; that, and not any other political consideration, is the basis on which the decision should be made.
Andrea Leadsom (South Northamptonshire) (Con)
I have to say that I am a bit disappointed; I am not sure whether today’s announcement will give closure to many people. A constituent of mine told me about a very good friend of his who died in Spain over Christmas. Sadly, his family could not afford to bring the body home, so he had to be cremated in Spain. Under the circumstances, it is very important that the ex gratia payments, available through the new charity to be set up, take into account the tragic and particular problems of individual sufferers.
Mr Lansley
Yes, indeed. I know that they will; that is one of the reasons why, in addition to the lump sum payments and annual payments that I have announced, we wanted to ensure that there was scope for discretionary payments based on individuals’ needs.
Mr Elfyn Llwyd (Dwyfor Meirionnydd) (PC)
May I take the Secretary of State back to the point raised by the hon. Member for Cardiff North (Jonathan Evans)? It is rather surprising that there has not hitherto been any discussion with the devolved Administrations. If such payments are to be made in Scotland and Wales, is it anticipated that they will be made out of existing budgets? How will the matter be handled?
Mr Lansley
What I have announced today will, of course, be funded from the Department of Health’s budget in England and the matter would be a responsibility for the devolved Administrations in relation to their budgets —from within the budgets set through the spending review.
David Tredinnick (Bosworth) (Con)
I, too, congratulate my right hon. Friend. I also congratulate the Under-Secretary of State for Health on all the work that she has done. The statement deals with what Lord Archer called the worst treatment disaster in the history of the national health service. It has to be said that the last Labour Government could have dealt with this, but they did not.
Following the comprehensive package that he has announced, will my right hon. Friend assure us that he will take active steps to contact the families of the bereaved and that no stone will be left unturned in making sure that all those who should have payments receive them?
Mr Lansley
I give my hon. Friend that assurance. We will take all the steps that we possibly can, not least on behalf of the bereaved families of those who died before 29 August 2003. That anomaly, among others, ought to have been rectified long ago.
Owen Smith (Pontypridd) (Lab)
I, too, welcome the statement—in particular the serious and commendable way in which the Under-Secretary of State has dealt with this important issue. However, the people who really need to be congratulated today are the campaigners such as the family of my constituent Leigh Sugar.
I take the Secretary of State back to his comment that the measure will apply to England only. Will he explain the rationale for that? The previous schemes applied to England and Wales, although they predated devolution. Is he saying that no additional funds will be available for Welsh patients, under the Barnett consequentials, to provide similar funding in Wales?
Mr Lansley
I share the view of the hon. Gentleman. Today the people who should feel that we are expressing our support are those who have been harmed and their families. Those are the people whom we are really supporting today. I hope that they will feel that although not everything that they have hoped for is being provided, we are at least making very substantial progress and doing a great deal to show recognition of the harm that occurred to them.
At this Dispatch Box, I speak on health matters for England; I do not speak for Wales and I am not in a position to say what the decisions of the devolved Administrations are. I have set out what we are going to do in England. We are funding the measure from within allocated budgets, so no Barnett consequentials flow from it. These matters will be determined within each of the other Administrations in respect of whether they wish to share in the arrangements that I have described.
Mr Adrian Sanders (Torbay) (LD)
There cannot be a Member of this House who does not have at least one constituent who is affected or who knows someone who is affected by this. I am sure that every hon. Member would like to congratulate the Government on the statement. Will the Secretary of State give an assurance that the bureaucracy needed to process matters forward has been looked at, so that it is kept to a minimum?
Mr Lansley
Yes, we have done that. My hon. Friend is absolutely right: hon. Members will have met constituents or the families of constituents who have been harmed, or the families of those who died. I hope that hon. Members will take the opportunity to bring the terms of today’s statement to their attention, so that people can access the additional support at the earliest possible opportunity. We will seek to do what my hon. Friend mentions. What I am describing builds as far as possible on existing mechanisms and, with the exception of the new discretionary trust, will not create any additional bureaucracy.
Mr Lansley
My hon. Friend will know from the response that my hon. Friend the Under-Secretary gave to October’s Back-Bench debate that we intended to place a note in the Library. We have done so. She has had further occasions to discuss these arrangements with colleagues in the House. The discussions between my officials and officials in the Republic of Ireland have confirmed that a figure of about £750,000 is not inappropriate as an estimate of the level of compensation per individual paid in the Republic of Ireland. That would support the view that we took in the House that the cost of providing compensation, if one were to do so, on the scale required in the Republic of Ireland would be in excess of £3 billion. As I said to the hon. Member for Hammersmith (Mr Slaughter), it is not on the basis of cost alone that we have reached that view; it is on the basis that the circumstances in the Republic of Ireland are unique and do not apply in this country. Therefore, we have assessed the case for support on the basis of the circumstances here and on an ex gratia basis, not on the basis of liability and consequent compensation.
Stephen Barclay (North East Cambridgeshire) (Con)
I also thank the Minister for the welcome measures announced in the statement and for the progress that has been made after so long. May I return to the average figure of £750,000, because there is a concern that that figure could be confusing the average and the mean? If we take a figure between 500 and a million and say that it is the average, it does not provide an average figure. Such an approach is akin to saying that the price of a car ranges from £10,000 to £1 million and therefore the average price of a car is £500,000. In relation to the discussions that the Minister has had with officials in Ireland, will he confirm that the total paid in Ireland—the total payment in terms of Irish settlements on this matter—is less than £1 billion?
Mr Lansley
As I have said in response to previous questions, I pay tribute to the work that my hon. Friends have done in support of their constituents and others. It is not simply a question of trying to calculate what the level of compensation is in Ireland; that is not the issue. We are not making a comparison with Ireland; we are making a judgment. In this case, we have especially done so in relation to hepatitis C, on the basis of the report of the clinical expert group, to try to assess the level of harm and the consequences that have flowed from the transfusions that took place, albeit that in this country the NHS acted on the basis of its best efforts to provide the best possible care for patients. The Republic of Ireland is a unique, and quite distinct, case in that because of mistakes made, a finding of liability was arrived at which leads to compensation. In our case, we are not in that position. We are in the position of recognising the harm and distress that has occurred and, through an ex gratia scheme, providing support to those who have been harmed and their families.
Duncan Hames (Chippenham) (LD)
I thank the Secretary of State for bringing the Government’s deliberations on the issue to this conclusion. Will he reassure the House that those experiencing the symptoms of advanced liver disease who received contaminated blood will not in all cases be required to have a liver biopsy in order to demonstrate and establish their eligibility for these payments?
Mr Lansley
No, they will not. From our point of view, eligibility will simply be based on a diagnosis of their condition.
David Mowat (Warrington South) (Con)
I, too, welcome the statement, particularly the attempt to get better parity between HIV and hepatitis C. However, I remain slightly concerned about the definition of stage 2. What proportion of hepatitis C complainants does the Minister expect to progress to stage 2? He must have estimated that number in order to put a financial amount on the settlement.
Mr Lansley
I regret that I cannot give such an estimate to my hon. Friend. The estimate that I have given is a range that extends from £100 million to £130 million during the life of this Parliament. If one were to go beyond that period, the parameters of the range would widen, not least because we do not, and cannot, know to what extent this infection is likely to progress to the second stage of these diseases.
Charlotte Leslie (Bristol North West) (Con)
I very much welcome much of what has been said in the statement, particularly the fact that the decision has been made to force closure on an issue that has been going on for so long. One of the things that has upset so many of the sufferers is not only that such a scandal happened but the subsequent failings, as they would see it, not of Government but of the Department of Health in being clear and transparent during those years in providing information on exactly what happened. Will the Secretary of State give an assurance that he will have to provide information to help those people who are still affected when they ask questions, perhaps through freedom of information requests, about what occurred in the past?
Mr Lansley
May I once more express my thanks to my hon. Friend for having been a forceful advocate in these matters? The answer to her question is yes, not least because my hon. Friend the Under-Secretary has been very open and willing to talk to everybody concerned, and she will continue to be so, because we are determined to give people confidence that we have not only exercised what we believe to be a responsible and reasonable judgment in these matters but are doing so in an open and transparent fashion.
NHS South West
Lord Lansley Excerpts(13 years, 11 months ago)
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The Secretary of State for Health (Mr Andrew Lansley)
On 17 June 2010, I asked Sir David Nicholson, chief executive of the NHS in England, to initiate a review into the approach and behaviour of the NHS South West (the strategic health authority) in relation to Royal Cornwall Hospitals Trust (RCHT), in particular, to the dismissal of John Watkinson and, by association, the trust’s position in relation to the provision of upper gastro-intestinal services in Cornwall.
Verita, a specialist company that conducts independent investigations, reviews and inquiries, carried out the review. The report was published on the Department of Health website on Tuesday 4 January 2011.
In the written ministerial statement of 17 June 2010, Official Report, column 57WS, I committed to updating the House on the findings of the report and my response. The key findings of the report were:
the strategic health authority put appropriate pressure on the RCHT board to suspend John Watkinson but was not involved in the decision to dismiss him;
the strategic health authority was justifiably concerned about many aspects of RCHT’s performance in the period leading up to the RCHT board’s dismissal of John Watkinson;
the RCHT chair and non-executive directors were relatively inexperienced within the NHS and it was good practice for them to take advice from the more experienced strategic health authority before making their own decision what to do; and
NHS South West is considered to have acted appropriately given its performance management responsibilities for NHS organisations in the south west and the fact that RCHT was not a foundation trust.
The report 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.
Seasonal Influenza Update
Lord Lansley Excerpts(13 years, 11 months ago)
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The Secretary of State for Health (Mr Andrew Lansley)
Seasonal flu virus circulates each year and this year is no exception. This statement is to update Parliament following developments during recess.
Seasonal flu is different from the outbreak of pandemic flu in 2009, when a new flu virus emerged (H1N1, or “swine flu”) against which humans (particularly those aged under 65) had little or no natural immunity. When the pandemic flu virus emerged in 2009, our pandemic preparedness plans were triggered. These plans entailed the mass distribution of “antiviral” drugs, the launch of the “National Flu Line”, and a “Catch it. Bin it, Kill it” advertising campaign designed to help members of the public understand how they could limit the spread of flu.
There is no flu pandemic this year, so these plans have not been triggered. Although the H1N1 virus is circulating, it is now one of the seasonal flu strains. This is because when it circulated in 2009-10, it helped to establish a residual level of immunity in people exposed to it, which means that H1N1 now circulates like other seasonal flu viruses.
In the United Kingdom, the H1N1 and influenza B viruses are the strains of flu that are circulating widely. H1N1 is the predominant virus, and is behaving—as expected—as it did in 2009-10. This means that H1N1 is likely to infect younger people—particularly those with underlying disease—and pregnant women.
A seasonal flu vaccine is available this year, as in previous years. This vaccine protects against all three strains of flu which the World Health Organisation identified would be most likely to circulate this year. Surveillance data show that these strains are circulating and that the vaccine is a good match.
General practitioners (GPs) order seasonal flu vaccine direct from the manufacturers according to their needs. This system is different from the childhood vaccination programme where the Department procures vaccine centrally and distributes it free of charge to the NHS.
We are aware of some reports of flu vaccine supply issues in some areas in England. We are working with NHS at the local level to ensure available supplies of surplus vaccine are moved to where they are needed. If efforts to source seasonal flu vaccine locally are not successful, the H1N1 monovalent vaccine (Pandemrix) is now available to GPs, for patients who are eligible for the seasonal flu vaccine.
I have already agreed for a review of procurement options of the seasonal flu vaccine to be undertaken, including central procurement, although no decisions have yet been made.
As in previous years, and on the basis of procedures which have existed for decades, the Government take expert advice from the Joint Committee on Vaccination and Immunisation (JCVI). This year, as last year, the JCVI advised that those aged 65 and over, and those in clinical at-risk groups, should be vaccinated. Because of the specific characteristic of the H1N1 virus, the JCVI also advised for the first time that healthy, pregnant women should be vaccinated with seasonal flu vaccine. The JCVI has recently assured me that this advice is appropriate for this year’s flu season.
As in previous years, only certain groups are being targeted for vaccination. We have therefore focused our efforts on ensuring that these groups are vaccinated. Current information for vaccinations given up to 2 January 2011 shows that 70.0% of over 65s have been vaccinated and 45.4% of those in clinical at-risk groups have been vaccinated, which is broadly in line with previous years.
The latest data indicate that the rate of GP consultations for influenza-like illness (ILI) is currently 98 per 100,000 people but we need to be cautious about interpreting the data due to the holiday period. The highest recorded level this year was 124 per 100,000, which is lower than that recorded during the pandemic in 2009-10 and below the epidemic level of 200 per 100,000 people. Nevertheless, given that they reached these levels I have taken the decision to reinstate the “Catch it, Bin it. Kill it” campaign.
Data indicate that this year’s flu has resulted in greater than usual numbers of patients requiring critical care. These patients have largely been infected with H1N1, and the pattern is consistent with H1N1’s characteristics last year. As a result, where necessary, local NHS organisations have increased their critical care capacity, in part by delaying routine operations requiring critical care back-up. This is a normal operational process which is initiated by NHS organisations at the local level; critical care capacity is not “fixed” but is always able to flex in this way according to local need.
In addition, over the last month we have increased the number of so-called “ECMO” beds—for patients with the most severe disease—from 5 to 22.
The number of deaths this winter from flu verified by the Health Protection Agency currently is 50, with 45 of these being associated with the H1N1 infection. The number of deaths from seasonal flu varies each year, with over 10,000 deaths from seasonal flu estimated in the winter of 2008-09.
Some have queried why statistics for the number of deaths in pregnant women are not available. The only reason the Health Protection Agency has not published the breakdown is to protect those individuals from being personally identifiable, the number of such cases being small.
When influenza is circulating, antiviral medicines can also help clinical at-risk groups who have either been exposed to or have contracted a flu-like illness. This season we notified clinicians that the use of antiviral medicines in these groups was justified, but also, as a higher than normal number of patients outside the clinical at-risk groups were becoming seriously ill with flu, general practitioners (and other prescribers) were recommended to exercise their clinical discretion so that any patient who they feel is at serious risk of developing complications from influenza may receive antiviral treatments on the NHS. In response, demand for these medicines continued to rise.
We have taken prompt action to ensure that all patients have access to appropriate antiviral medicines when they need them, and there is no shortage of antiviral medicines in the country.
There is always more pressure on the NHS during the winter, but the NHS is well-prepared and is coping well. In summary, we are taking the following action:
the first line of defence against flu is vaccination, and we want to see vaccination rates increase still further. That is why we are currently working with the BMA and RCGP to ensure everyone in an at-risk group who has not been vaccinated contacts their GP and books an appointment;
the second line of defence is to practice good respiratory and hand hygiene. That is why we reinstated the Catch it, Bin it, Kill it campaign. In addition, and in advance of the new school term, we are encouraging parents to educate their children to use good hand and respiratory hygiene; and
the third line of defence is a well-prepared NHS with the ability to treat those who do need help. That is why we are working with local NHS organisation to help them escalate critical care capacity where necessary, and have increased the number of ECMO beds available for patients.
We are making available a range of winter performance information publicly available. This is published on the Winterwatch section of the Department’s website at: http://winterwatch.dh.gov.uk/.
Funding and Commissioning Routes for Public Health
Lord Lansley Excerpts(14 years ago)
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The Secretary of State for Health (Mr Andrew Lansley)
Today I am publishing a consultation document, “Healthy Lives, Healthy People: Consultation on the funding and commissioning routes for public health”, seeking views on proposals that were initially outlined in the White Paper “Healthy Lives, Healthy People: Our Strategy for public health in England” (Cm7985).
We are consulting on proposals for the commissioning and funding arrangements for delivery of public health services in the future. The consultation also asks questions about how the Department should implement some of our proposals.
The White Paper described a new era for public health, with a higher priority and dedicated resources. There will be ring-fenced public health funding from within the overall NHS budget. Local authorities will have a new role in improving the health and well-being of their population as part of a new system with localism at its heart and devolved responsibilities, freedoms and funding.
Directors of Public Health will be the strategic leaders for public health and reducing health inequalities in local communities, working in partnership with the local NHS and across the public, private and voluntary sectors. There will also be a new, dedicated, professional public health service—Public Health England—that will be part of the Department of Health.
This consultation is an opportunity to collect the views of public health professionals, NHS commissioners, local authorities, service providers—particularly the voluntary and independent sector—and all other interested parties.
The consultation will close at the end of March 2011.
The document 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.
Transparency in Outcomes
Lord Lansley Excerpts(14 years ago)
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The Secretary of State for Health (Mr Andrew Lansley)
Today marks the beginning of an important shift in focus for the NHS and public health, away from focusing on politically motivated process targets, and towards what matters most: improving quality and delivering health outcomes that are among the best in the world.
I am publishing the first NHS outcomes framework, “The NHS Outcomes Framework 2011-12”, which will serve three purposes:
provide a national level overview of how well the NHS is progressing, so far as possible with international comparisons;
provide an accountability mechanism between the Secretary of State for Health and the NHS Commissioning Board: and
act as a catalyst for driving quality improvement and outcome measurement throughout the NHS by encouraging a change in culture and behaviour, including a renewed focus on tackling inequalities in outcomes.
This framework has been developed building on the proposals set out for consultation in “Transparency in outcomes—a framework for the NHS”, published in July, and the nearly 800 responses to the consultation.
This first NHS outcomes framework looks only to set the direction of travel for the NHS, and will not be used in this coming year for accountability purposes. No levels of ambition are attached to the indicators. For 2011-12, the business, finance and performance rules are set out in “The NHS Operating Framework for England 2011-12”. The NHS outcomes framework will be refined annually, and the next iteration, for 2012-13 will be published in 2011, and will be used to hold the proposed NHS Commissioning Board to account once it takes its statutory place (subject to parliamentary approval).
Alongside the NHS outcomes framework, I am publishing a formal Government response to the consultation “Transparency in outcomes—a framework for the NHS”, an impact assessment and equality impact assessment for the first framework and technical detail on the indicators presented in the framework.
Today I am also publishing “Healthy Lives, Healthy People: Transparency in Outcomes—Proposals for a Public Health Outcomes Framework”, which seeks views on a new strategic outcomes framework for public health at national and local levels. This document was proposed in the recent public health White Paper.
This consultation is an opportunity to collect the views of public health professionals, NHS commissioners, local authorities, service providers, particularly the voluntary and independent sector, and all other interested parties. The consultation will close at the end of March 2011.
Both outcomes frameworks have been designed so that where joint working and alignment is essential to improving outcomes, the NHS and Public Health England are held to account for working together.
All 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.
Work Force Education and Training Consultations
Lord Lansley Excerpts(14 years ago)
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The Secretary of State for Health (Mr Andrew Lansley)
Today I am publishing a consultation document seeking views on proposals set out in the White Paper, “Equity and Excellence: Liberating the NHS” (Cm7881). We are consulting on proposals to create a new framework for education and training of the health care work force. Under these proposals, health care providers will be given responsibility for planning and developing the work force, while the quality of education and training will remain under the stewardship of the health care professions.
“Liberating the NHS: Developing the Healthcare Workforce” has been placed in the Library. Copies are available to hon. Members in the Vote Office and to noble Lords from the Printed Paper Office. The consultation is also available at www.dh.gov.uk/en/Consultations/Liveconsultations/DH_122590.
“Liberating the NHS: Developing the Healthcare Workforce” further develops the education and training commitments in the White Paper that:
Health care employers and their staff will agree plans and funding for work force development and training;
education and commissioning will be led locally and nationally by the health care professions; working with employers;
the professions will have a leading role in deciding the structure and content of training and quality standards;
all providers of health care services will pay to meet the costs of education and training with transparent funding flows supporting the level playing field between providers;
the NHS Commissioning Board will provide national patient and public oversight of health care providers’ funding plans for training and education, checking that these reflect its strategic commissioning intentions. GP consortia will provide this oversight at local level; and
the Centre for Workforce Intelligence will act as a consistent source of information and analysis, informing and informed by all levels of the system.
This consultation is an opportunity to seek the views of health care providers, health care professionals and the wider public to inform the development of a new framework for education and training and developing the health care work force.
The consultation period will close on 31 March 2011.