Care and Support

David Tredinnick Excerpts

Wednesday 11th July 2012 Commons Chamber

[Mr Lansley]

I am sorry, but the hon. Gentleman simply demonstrates his ignorance of what is in the White Paper. Those who work in social care, those who represent care users, care recipients and carers want the changes in legislation and in support to focus on looking after people. That is absolutely our agenda. We know that there are funding needs. That is why, in the spending review, we have provided the sums that I have set out. That will enable local authorities to maintain their eligibility to care. This year, only six authorities have reduced their level of eligibility to care from moderate to substantial.

[David Tredinnick (Bosworth) (Con)]

My right hon. Friend’s statement will be widely welcomed, especially the loans aspect and the emphasis on personal care budgets. Will he confirm that his Department’s trials are showing that personal care budgets are very effective in empowering patients, reducing costs and bringing in a wider range of services and greater patient choice?

[Mr Lansley]

My hon. Friend is absolutely right. A study published in the latter part of last year demonstrated exactly what he has set out. There has been a major increase in access to personal budgets. When we came to office, about 168,000 people had access to a personal budget. The latest figures show that we have reached 432,000 people. We are aiming for everyone who wants it to have access to a personal budget by April 2013. The draft Bill that we have published today would give legal backing to that and to access to direct payments.

Cosmetic Surgery

David Tredinnick Excerpts

Thursday 5th July 2012 Westminster Hall

[David Tredinnick (Bosworth) (Con)]

Thank you, Mr Rosindell, for giving me the opportunity to speak in this debate.

It is a pleasure to follow my hon. Friend the Member for Totnes (Dr Wollaston) and my right hon. Friend the Member for Charnwood (Mr Dorrell), who is not only the Chair of the Health Committee but who was, of course, Secretary of State for Health in the Major Government. I think I can say modestly that I have been in Parliament long enough to remember him as an Under-Secretary in the Department of Health—at that time, of course, he was the MP for Loughborough—although I have not been in Parliament as long as he has.

I do not wish to repeat the remarks that were made earlier by my right hon. Friend and my hon. Friend, other than to say that we are basically dealing with a French company—Poly Implant Prothèse, or PIP— that produced a defective product. It then used false documentation—my recollection is that it did so by registering in Germany; I think that came up in the Health Committee. The company was also using non-compliant silicone. My right hon. Friend also said that there was a period—between March 2010 and July 2011—when there was a lack of action. The Health Committee was certainly concerned about why my hon. Friend the Minister and our right hon. Friend the Secretary of State for Health did not look at the issue earlier.

My right hon. Friend the Member for Charnwood has already given us the background, so I do not want to go into it further, but there are two types of issue to consider: first, the PIP implants, which are the defective products; and secondly, the wider issues.

Both my right hon. Friend the Member for Charnwood and my hon. Friend the Member for Totnes have mentioned the lack of a register, which is a fundamental problem. Without a register, we do not know the size of the problem. I have no doubt that my hon. Friend the Minister will refer to that issue in her response.

The second issue that really exercised me when the Select Committee was considering this topic was what I noted down as “the double jeopardy rule”—it is not quite a double jeopardy rule, but a woman will potentially need two operations if they have this problem. The NHS is looking to offer more patient choice and greater flexibility, and dealing with this issue is a good opportunity to provide greater flexibility. It makes absolutely no sense to have a surgeon remove an implant and then to have another surgeon at another time replace it with something else. First, I think it is clinically unwise; I do not know if my hon. Friend the Member for Totnes wants to comment on that. Secondly, it is certainly bad value. Thirdly, it means that the patient will have a much higher level of stress. I would have thought that statistically the probability of complications must be greater if a patient has two operations rather than one.

The third issue that I want to raise is advertising. The advertising for these products appears to be misleading, to say the least. We have heard that there is a failure to mention the inevitable requirement for removal of the implants. It is not only the surgeons or the promoters of the operation who should make patients aware of that requirement, but the advertising, which should carry a warning at the bottom.

The next point about advertising of these products is that I think a lot of it is targeted at less well-off people—a market in which people might not necessarily apply their minds as extensively as people in some other socio-economic groups might do to the consequences of these implants. A culture, or belief, has grown up around implants that they will enhance careers and make a person more attractive, which may not necessarily be the case.

Taking things a stage further, when teenagers are encouraged to have implants there is an absolute duty of care on those who promote them to explain to those concerned that although they may not be very full in the front at that age, if they have children they will naturally expand and have no need for implants. Furthermore, if they reach that point of having children, they may not want the implants that they received earlier. We need to think particularly about the market involving younger people.

My right hon. Friend the Member for Charnwood and the Committee agreed to the web forum on patient experiences, which was a very good exercise. Select Committees should consider using such an approach regularly in the future. We had responses from 194 women, and there were 279 posts. That widened the base of the pyramid of knowledge that the Committee had to reflect on, provided a greater degree of certainty about where things are going, and gave us understanding.

My hon. Friend the Member for Totnes touched on the long-term consequences of ruptures and the fact that that issue has not been fully recognised in the responses so far. Last week we had a presentation in private by distinguished academics from the university of Leeds. One point that came up was that if the silicone leaks, it can find its way into glands and lymph nodes. I cannot believe that that is a desirable impact for any patient. It defies logic to suggest that if there is a foreign body in a part of someone’s body there will be no complications or implications; and if there are none now, where will we be 30 or 40 years down the road? As a Member who has represented a constituency with a declining coal mining industry, I deal even now—30, 40 or 50 years down the road—with cases of emphysema and other mining-related diseases. What will happen after that length of time with the issue we are discussing now? We simply do not know. We cannot tell.

Dr Hardy and Professor Holliday at Leeds made two recommendations, which I am not going to claim as my own, and which merit serious consideration. The first is that all advertising should carry the risk rate. I am thinking both of advertisements and the agents’ recommendations to the client. There should be an absolute requirement to explain complications, and the fact that implants will have to be replaced at some time. The failure to tell patients that implants must, whether faulty or not, be replaced at some point, came through on many occasions in evidence.

The second point was also an excellent one: the contract that the patient forms should be not with the agency, which could fold, but with the surgeon, who is covered by a form of insurance, and tightly regulated. Any issue in the future would be with the surgeon himself. That would give us a much greater degree of accountability and make the regulation much more simple.

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[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

Sadly, as I only have about five minutes left, I will not be able to answer all the issues that the shadow Minister, the hon. Member for Hackney North and Stoke Newington (Ms Abbott), raised.

[David Tredinnick]

On a point of order, Mr Rosindell. My understanding is that the debate can continue at the discretion of the Chair.

[Andrew Rosindell (in the Chair)]

Yes, indeed that is so. I intend to let the debate run on a bit longer to allow the Minister to respond and Mr Dorrell to have his two minutes towards the end.

--- Later in debate ---

[Anne Milton]

My only hesitation is that there might be constraints that I know nothing about. However, I can see no reason why not if the evidence has been assessed. The evidence will, almost by definition, be in the public domain because it will be in papers that have been peer-reviewed and probably published. There should therefore be no reason why it should not be available to all women.

My right hon. Friend raises an important point: it is not just about what one does, but about what one is seen to do. Any restriction on access to information raises suspicions in people’s minds. All those women have already had a bad experience—they had their surgery and were reassured by surgeons and staff at the organisations they went to—and already feel that they have been deceived. Therefore, it is more important than ever to make sure that they have access to the information that we have access to.

As I said, Sir Bruce’s group has published its final report, which was informed by detailed tests on the silicone used in PIP implants and by large-scale data on the rupture rate of the implants. It draws on what doctors found when they removed some implants. It was painstaking work, and three main conclusions stand out. It is important to reiterate that research—data—should always be under constant review.

First, the evidence supports the fact that impurities in silicone gel do not pose a threat to health. That fits with the conclusions of tests on the gel carried out in the UK and other countries. Secondly, there is clear evidence that the rupture rate for PIP implants is significantly greater than for other silicone gel implants on the UK market. Thirdly, although some ruptures are associated with local clinical reactions, in the great majority of cases, that was already apparent before removal of the implant. So-called silent ruptures detected by scanning, but with no outward signs or symptoms of a possible rupture, are not in general associated with significant clinical reactions when the implants are taken out. The group therefore concluded that PIP implants are clearly substandard—there is no doubt about that—but that if the implants are still whole inside the body, there is no evidence of an increased risk of clinical problems.

I stress that that is not what the Government say; it is what an expert group says. I am happy to send anybody who wants it the list of who made up that expert group. It is important and it is about confidence in what we are doing. Ministers are not scientists. It is important that we rely on and get the best possible scientific advice, and that we remain vigilant in scrutinising that advice.

[Mr Joe Benton in the Chair]

[David Tredinnick]

My hon. Friend might be about to move on to this, but did the expert group consider the points made about two operations for people having problems with implants? She will probably deal with that in a moment, but she will forgive me for nudging her.

[Anne Milton]

I need no nudging, but I take my hon. Friend’s intervention in the friendly manner in which it was intended. I will move on to that.

The group reiterated the earlier advice that women with evidence of ruptured implants should be offered removal, and women with no sign of rupture should talk to their specialists, discuss the pros and cons of removal and decide with their doctor the best way forward.

In January 2012, in line with the interim advice, we published the NHS offer: women who originally received implants from the NHS are entitled to a consultation and a scan if appropriate. Then if the woman and her doctor so decide, the NHS will offer to remove and replace the implants. From the start, we made it clear that we expected private providers to match that offer. Many have done so. In fairness and for balance, I point out that some have been very responsible. I hesitate to mention some, as the list will not be conclusive, but BMI Healthcare, Linea Cosmetic Surgery, Nuffield Health, Ramsay Health Care, Spire Healthcare, The Hospital Group and Transform have been responsible and stepped up to the plate. It would be a shame if this debate cast negative views on all those involved in the plastic surgery industry, but I will come to some of the other points raised before I finish.

Where a private provider has gone out of business or fails to meet its moral and legal obligations, the NHS will provide a consultation, a scan if appropriate and removal, but not normally replacement, of the implants. That policy remains in place today. My hon. Friend the Member for Bosworth (David Tredinnick) wanted me to go on to the question whether the policy should be varied. As has been reiterated today, the Select Committee on Health suggested that women should be able to pay a fee for new implants to be put in place by the NHS during the same operation in which the old ones are taken out. I completely understand why, and I have discussed the issue at length.

There are several points. Allowing a mixture of NHS and privately funded care within a single operation risks undermining a founding principle of the NHS that care is free. I take the point made by my hon. Friend the Member for Totnes (Dr Wollaston) about co-payments in the NHS for dentistry, glasses and so on—I could go on. I believe that Bevan resigned within two or three years of the formation of the NHS, on that very point. The issue of co-payments goes back a long time. However, I feel that this situation, although complicated, is different. If the NHS were to carry out replacement breast augmentation, it would become responsible for all the aftercare, including possible future replacements. As my hon. Friend the Member for Totnes and my right hon. Friend the Member for Charnwood mentioned, the rupture rate is significant anyway. Breast implants do not last a lifetime; it is unlikely that they will.

NHS Annual Report and Care Objectives

David Tredinnick Excerpts

Wednesday 4th July 2012 Commons Chamber

[Mr Lansley]

At no point did the shadow Secretary of State express any appreciation for what the staff of the NHS have achieved in the past year. A party political rant populated with most of his misconceptions and poorly based arguments does not get him anywhere.

The right hon. Gentleman went around the country trying to drum up something he could throw at us about things that he believed were going wrong in the NHS. Do you know what he ended up with, Mr Speaker? He ended up by saying the NHS was rationing care. What was the basis for that? That parts of the NHS have restrictions on weight-loss surgery, because people have to be obese before they have access to it. That is meaningless. I wrote to the shadow Secretary of State this morning, and went through his so-called health check. There is no such ban on surgery as he claims. Time and again, he says, “Oh, they are rationing.” They are not, because last year, the co-operation and competition panel produced a report that showed where there had been blanket bans on NHS services under a Labour Government. We introduced measures to ensure that that would not happen in future across the service. Not only is he not giving the NHS credit for the achievements that I listed in detail in my statement but he is now pretending that the NHS is somehow in chaos or financial trouble. It is complete nonsense. Across the NHS, only three primary care trusts out of 154 were in deficit at the end of the year. The cumulative surplus across all the PCTs and strategic health authorities is £1.6 billion carried forward into this financial year.

That means that the NHS begins 2012-13 in a stronger financial place than anyone had any right to expect, because it is delivering better services more effectively, with GP referrals reduced, and reduced growth in the number of patients attending emergency departments. The right hon. Gentleman asked, “What about patients who leave A and E without being seen?” Under the Labour Government, no one ever measured whether patients left A and E without being seen. For the first time, we are measuring that, and we publish the results in the A and E quality indicators. There was a variation between about 0.5% and 11% of patients leaving without being seen when we first published that, but since then the variation has reduced. The average number has gone down, and it is now at 3%, so he ought to know his facts before he stands up at the Dispatch Box and begins to make accusations. We published those facts for the first time.

I will not reiterate the A and E target, because I mentioned it in the statement, but 96% of patients are seen within four hours in A and E. The right hon. Gentleman should withdraw all those absurd propositions that the NHS is not delivering. He should get up when next he can and express appreciation to the NHS for what it is achieving. Patients do so: last year, 92% of in-patients and 95% of out-patients thought that they had good or excellent care from the NHS, which is as high as in any previous year. That is what patients feel. Staff should be proud of what they achieve in the NHS, and the Labour party should be ashamed of itself.

[David Tredinnick (Bosworth) (Con)]

My right hon. Friend’s statement, which is very positive, will be widely welcomed, particularly what he said about low waiting times. He said that patients in future will be more in control. Is he referring to the personal health budgets in the Health and Social Care Act 2012, and does he expect a greater range of treatments to be available on the health service in future?

[Mr Lansley]

I am grateful to my hon. Friend. There are many ways in which we can improve the control that patients can exercise, including greater opportunities for patients to exercise choice. In my announcement today, that includes the opportunity for patients to choose alternative providers of NHS care if, for example, the standard of 18 weeks that the constitution sets is not met. I might say that, at the last election, 209,000 patients were waiting for treatment beyond 18 weeks. That number has been brought down to 160,000.

My hon. Friend makes an important point about the exercise of control on the part of patients, who have an opportunity to access clinically appropriate care through the NHS. We will make sure that that is available and, as he knows, in relation to homeopathic treatments, for example, we have maintained clinicians’ ability across the service to make such treatments available through the NHS when they think that it is appropriate to do so.

Oral Answers to Questions

David Tredinnick Excerpts

Tuesday 27th March 2012 Commons Chamber

[Mr Burns]

If I could explain this to the hon. Gentleman, the £500 million that he is talking about was part of the savings made through renegotiating the IT contract. It is a perfectly normal procedure, because as the right hon. Member for Leigh (Andy Burnham) will know, the average figure for previous years was £850 million, and one year when he was a Minister at the Department of Health, it was £2.3 billion.

[David Tredinnick (Bosworth) (Con)]

As part of the reorganisation, my right hon. Friend the Secretary of State has decided—rightly in my view—that the Health Professions Council will regulate Chinese medical practitioners, but there is widespread concern in the community that these practitioners will not have protection of title. Will he please ensure that they do when he finishes his consultation?

[Mr Burns]

I am extremely grateful to my hon. Friend and, as his question suggested, there is a consultation process. I can give him an assurance that the point that he has made will be fully considered as part of that consultation process.

Health and Social Care Bill

David Tredinnick Excerpts

Tuesday 28th February 2012 Commons Chamber

[Mr Lansley]

I refer the hon. Lady to pages 46 and 47 of the Conservative party manifesto and, to understand the Bill fully, to the Liberal Democrat manifesto.

[David Tredinnick (Bosworth) (Con)]

I encourage my right hon. Friend to read the minutes of the Hinckley and Bosworth health and wellbeing partnership meeting. He will see that clinical commissioning groups are in place and that there is a priority on early intervention. There is support for the health and wellbeing board and its priorities. Does that not go completely against what we are hearing from Opposition Members?

[Mr Lansley]

I had the pleasure—before Christmas, I think—of meeting the local authority, the director of public health and the three clinical commissioning groups from across Leicestershire, who are all enthusiastic about the opportunities presented by the modernisation of the NHS legislation.

Oral Answers to Questions

David Tredinnick Excerpts

Tuesday 10th January 2012 Commons Chamber

[Mr Lansley]

I should be grateful if the hon. Lady wrote to me about that case and gave me the opportunity to look at it, which I would be pleased to do. From my point of view, we do not countenance such requirements, through charging, denying patients access to any NHS treatment.

[David Tredinnick (Bosworth) (Con)]

In addition to approving drugs, NICE has also approved acupuncture for lower back pain. Should this not be widely available on the health service now?

[Mr Lansley]

Of course, my hon. Friend will know very well that choice of treatment is a shared decision between patients and their clinicians. NICE appraisals are about whether treatments are available in the NHS and giving information to clinicians about their relative clinical and cost-effectiveness, not prescribing that treatments should be available in specific circumstances.

Oral Answers to Questions

David Tredinnick Excerpts

Tuesday 22nd November 2011 Commons Chamber

[Mr Burns]

I heard what the hon. Gentleman said, and I was disappointed that we did not reach his question on the Order Paper earlier, because he has been extremely concerned about the A and E in his own area in Hartlepool. That decision was taken on safety grounds. Emergency care has been provided at the One Life centre. The decision was taken with the support of the local overview and scrutiny committee, which he will appreciate has democratic accountability. That was the right decision. Where there are clinical reasons for taking such decisions, they should be taken.

[David Tredinnick (Bosworth) (Con)]

Has my right hon. Friend the Secretary of State or any of his ministerial colleagues been able to visit the People’s Republic of China to consider traditional Chinese medicine?

[Anne Milton]

I thank my hon. Friend for that question. He must be psychic, because I recently visited China, and it was fascinating to meet Ministers there. He will also be very pleased to hear, as I am sure the whole House will, that I visited a hospital and community centre that combines western medicine and traditional Chinese medicine.

Oral Answers to Questions

David Tredinnick Excerpts

Tuesday 18th October 2011 Commons Chamber

[Paul Burstow]

The hon. Lady is spreading yet more myths and misconceptions about the reforms that this Government are making. If she had researched the matter more thoroughly, she would know that there is a code of conduct for the promotion of NHS-funded services, which makes it clear that providers of primary medical services cannot directly or indirectly seek or accept from any of their patients payment or other remuneration for any treatment. As a result, the PCT is questioning that clinic about how it has used patient information and will continue to pursue the matter.

[David Tredinnick (Bosworth) (Con)]

Does my hon. Friend agree that many patients look to NHS Choices for accurate and unbiased information? Is he aware that its site on homeopathy is both biased and inaccurate? As the Department has had a long-standing review that has not reported, will he—

[Mr Speaker]

Order. I call the Minister.

Health and Social Care (Re-committed) Bill

David Tredinnick Excerpts

Wednesday 7th September 2011 Commons Chamber

[Owen Smith]

I accept that there are obviously different needs and that there is a good case for a needs-based assessment model being used by PCTs in the current situation or by CCGs. Indeed, one of the amendments tabled by Liberal Democrat Members on a needs-based assessment is excellent and I wish that we had tabled it. However, the crucial difference, which I alluded to earlier, is that previously the Secretary of State has had a direct duty under section 3 of the National Health Service Act 2006 to provide and secure a whole range of relevant and necessary pieces of the health ecosystem, such as hospitals, within a given area. Under the Bill, that duty will pass to clinical commissioning groups. That is a further crucial removal of responsibility and accountability from the Secretary of State and transference of them to CCGs.

Under the aegis of the Bill, many CCGs may well plan well for their local population, and perhaps better than primary care trusts, but what if they do not? What if they get it wrong and determine for clinical reasons—or, dare I say it, because in this new world they are sitting cheek by jowl in the boardroom with commercial players who have a stake and a skin in the game financially—that they no longer feel it is “reasonable”, as the Bill puts it, to provide certain services? I think that is perfectly foreseeable.

We already know that because of the cost pressures that PCTs are under, they are having to make difficult decisions about which services they will provide and which they will not. They have always had to do that. It is just possible that CCGs will make duff decisions with which local residents disagree. As we heard earlier from my hon. Friends on the Back Benches, they will not be able to be held to account in the way that the Secretary of State, and eventually PCTs through the Secretary of State, can currently be. Those changes are critical, and I suggest that the Minister reflects on them.

Another crucial change to the Bill that we would like to be brought about is in respect of the costs of bureaucracy. We are changing from 150 PCTs to more than 250 clinical commissioning groups and counting. The latter are smaller and less strategic, and certainly less experienced in commissioning, than PCTs or strategic health authorities, and they are arguably too small to compete equitably with very large and financially powerful foundation trusts. That is a real risk. Crucially, they will also increase transaction costs, bureaucracy and administration costs.

That is why, in new clause 11, we have decided to ask the Government to put their money where their mouth is. The Minister asked earlier why we had chosen an “arbitrary” figure of 45% for a cap on the volume of expenditure on administration by CCGs. The answer is simple: it was the number that the Secretary of State came up with. He said that that was how many percentage points he was going to trim off the administration and bureaucracy costs of the NHS. He boasted that he could deliver 45% savings, so we are calling on him today to put his money where his mouth is and legislate for that. Let us measure him against that, because there is not going to be much else that we can hold him accountable for.

We have tabled new clause 10, on waiting times, because targets and standards absolutely matter in the NHS. No matter what the Government keep telling the public, we still believe in clinical targets, including some that the Government would denigrate as “bureaucratic” or “administrative” targets. In new clause 10, we ask the Government to take the power to set transparent regulations relating to waiting times. Waiting times are going up under this Government. There have been 400,000 people with long waits since the Tories came to power. The trajectory and the sense of history repeating itself are depressingly clear to me and my hon. Friends.

[David Tredinnick (Bosworth) (Con)]

I think the hon. Gentleman might inadvertently have misled the House. He said that waiting lists were going up in the NHS. My recollection is that they are going up in Wales. He is shadow Wales Minister, I think.

[Owen Smith]

I was waiting for that intervention and looking forward to it. I was slightly concerned, when the hon. Member for Central Suffolk and North Ipswich intervened and failed to mention the fair and beautiful country of Wales, that I was not going to get the opportunity to put the record straight. I hate to tell the hon. Member for Bosworth (David Tredinnick) this, but he is wrong. Waiting lists in Wales are coming down. We have been hitting 95% of our target week in, week out, month in, month out since September 2009.

--- Later in debate ---

[David Tredinnick]

I am most grateful for being called to speak and for the opportunity to follow my colleague on the Health Committee, the hon. Member for Walsall South (Valerie Vaz), and my hon. Friend the Member for Hexham (Guy Opperman), and to say how pleased I am to see my hon. Friend in his place. I know from experience—not personal experience—just how tough that operation can be, so many congratulations to him on his recovery.

I want to make a short speech on just one issue—patient choice, which is one of the most important, if not the most important, aspects of the Bill—and to challenge my right hon. Friend the Secretary of State on one or two points. Chapter A1 13H sets out the duty that the board has, in the exercise of its functions, to

“promote the involvement of patients, and their carers and representatives…in decisions about the provision of health services to…patients.”

That patient choice depends on clinical commissioning, the subject of the amendments before us, and that in itself hangs on the “any qualified provider” policy, modified recently from “any willing provider”. There I have some concerns.

The TUC brief summed up “any qualified provider” very well:

“Under AQP, patients will be able to choose which provider to use for their treatment, from a list of approved providers (private, public or voluntary sector) who perform the service in exchange for a locally or nationally set tariff.”

Where I have a slight problem is that although the categories of treatment that can be employed, certainly in the transitional year 2012-13, have been set out in the operational guidance, I think there is a strong case for the guidance to be in the Bill itself.

However, I am very pleased to see at the top of the list musculoskeletal services for back and neck pain, and I presume, although it is not set out, that that means greater use of osteopathy and chiropractic, both regulated by Acts of Parliament, in 1993 and 1994. I had the honour to serve on the Committees considering those Bills. As the public are to have greater choice, we must look at providing that choice, and they will be asking for those services. They will also want acupuncture for musculoskeletal problems. Acupuncture has been approved by NICE and there are now NICE guidelines supporting acupuncture for use in these services. I would like my right hon. Friend the Secretary of State to consider at some point making a more positive, more specific commitment to the use of those services in the provision for patient choice.

There is a strong case for the “any qualified provider” policy to be set out in the Bill too, although it is set out in the operational guidance. The problem that may occur is in the qualification process. I have no problem with its asking for safe, good-quality care or with the governing principle of qualification being that practitioners be registered with the Care Quality Commission and Monitor, but what about those therapies that do not have those badges in their passport? What about traditional Chinese medicine, which is about to be regulated by the Health Professions Council? May we have a specific assurance that its practitioners can be part of this patient system? Traditional Chinese medicine and acupuncture have increased in popularity dramatically—Chinese practitioners may now be found in any town in the country.

I suggest to my right hon. Friend the Secretary of State that other therapies should be included in the list. He has produced a second list of services to be introduced in 2013-14, which includes community chemotherapy and home chemotherapy. If we are to offer patients choice on those chemotherapy services, we really ought to consider those who can support people who are exhausted after chemotherapy and radiotherapy. I am thinking of not only those who practise traditional Chinese herbal medicine and acupuncture, but the healing fraternity and those who use therapeutic touch, many of whom now work in NHS hospitals to great effect.

I should also like to refer to homeopathic medicine, which I have discussed when you have been in the Chair before, Madam Deputy Speaker. I think I am right in saying that your constituency is not far from the Bristol homeopathic hospital, so perhaps you will not call me to order on this, especially as I am trying to stay in order. Many people use homeopathy every day to cure simple ailments, because it is cheap, easy to understand and very effective. Even if there are not umpteen double-blind placebo-controlled trials, there is a wealth of evidence that it works. I would draw my right hon. Friend’s attention to the fact that the Royal London hospital for integrated medicine, which used to be called the Royal London homeopathic hospital, has the highest patient satisfaction rating of all hospitals in the United Kingdom.

There is a case for including in the Bill clearer direction about the services that will become available. I ask my right hon. Friend to smile on those other disciplines that do not have statutory regulation but perhaps have robust non-statutory, voluntary regulation, such as acupuncture, and ensure that when patients go to their doctors and say, “Doctor, this is what we’ve used; this is what we really want,” they will not be turned away.

[Joan Walley (Stoke-on-Trent North) (Lab)]

Following the hon. Member for Bosworth (David Tredinnick) illustrates the problems that we have with the Bill: even at this stage, specific details need to be discussed and have a case made for them, so that the future of NHS provision can be fully taken on board. At the same time, because of how the Bill has been handled—we have had a re-committal—we have a political debate.

The debate on this specific group of amendments is taking place on two levels. I certainly want to ensure that the true principles of the NHS and its founding fathers, such as Nye Bevan, are followed in future provision. We need that political debate to ensure that the NHS is politically accountable. We have almost lost that opportunity, because we are in this mess, with all this uncertainty and not knowing how the Bill will shape up and go forward. We risk losing the whole of the NHS altogether.

Many people who are part of the medical profession and others who are concerned about their own future health care have contacted me, because they want the Government to be in control and the Secretary of State to have a duty to procure and provide services. This is a political debate, as much as anything else, but it is difficult to have that political debate within the confines of the amendments, although they are central to that debate.

Oral Answers to Questions

David Tredinnick Excerpts

Tuesday 7th June 2011 Commons Chamber

[David Tredinnick (Bosworth) (Con)]

Will commissioners be able to approach specialist integrated cancer services, such as the Penny Brohn cancer clinic in Bristol, and will that clinic and others be represented on health and wellbeing boards in future?

[Paul Burstow]

The membership of health and wellbeing boards will be a matter for the local authorities that will set them up. The Bill provides de minimis provisions for involving local councillors, representatives from commissioning consortia, public health directors, social services and children’s services, but I am sure that many of the pilots that are currently going on across the country are looking at innovative ways of involving others as well.