Oral Answers to Questions

Edward Timpson Excerpts

Tuesday 10th March 2020 Commons Chamber

[Sir Desmond Swayne (New Forest West) (Con)]

2. What steps he is taking to reduce waiting times for GP appointments.

[Edward Timpson (Eddisbury) (Con)]

5. What steps his Department is taking to increase the availability of appointments in GP surgeries.

--- Later in debate ---

[Jo Churchill]

Shortly—I thank my right hon. Friend for that. First, I should like just to whip over the statistics. In December, there were nearly 400 more nurses, 200 more doctors and 1,000 more other staff providing patient care in primary care than there were a year earlier. By encouraging recruitment and retention, and minimising unnecessary bureaucracy, we will help primary care to support the patients in the most appropriate way and ensure that everyone has faster access to appointments sooner. If you would indulge me for a second, Mr Speaker, I would like to thank all those in primary care and across the NHS, who are working harder than ever to provide support to patients as our response to coronavirus ramps up. Everyone has a part to play in getting through the next few weeks and months. We are rightly proud of how our NHS has and will continue to support anyone affected, but we need also to support them.

[Edward Timpson]

At a time when the Government are rightly committed to increasing GP provision, my constituents and I are deeply concerned that Sandiway surgery in the north of Eddisbury has been earmarked for closure by its practice group. What can my hon. Friend, or Cheshire clinical commissioning group, do to help the practice to improve its overall standard so that it can continue to treat its 3,700 patients for many years to come?

[Jo Churchill]

The closure of any GP practice stirs up understandably strong emotions in the local community. The Care Quality Commission inspection last May highlighted safety concerns at Sandiway surgery, and significant investment is required to bring the premises up to standard. I believe Danebridge medical centre has consulted on and looked into the difficult decision to close the practice and increase appointments and services at the other two local practices. As ever, I am happy to meet my hon. Friend to discuss how we can ensure that Sandiway residents have access.

Coronavirus

Edward Timpson Excerpts

Monday 9th March 2020 Commons Chamber

[Matt Hancock]

I am very happy to look into that specific example.

[Edward Timpson (Eddisbury) (Con)]

In May and June millions of pupils, including in Eddisbury, will be sitting important public exams. Although I accept that my right hon. Friend is doing the right thing by following the scientific evidence, may I encourage him to do everything possible to ensure that those exams go ahead, and to put in place clear contingency plans in the event that they do not?

[Matt Hancock]

Yes, of course. This is a lead for the Education Secretary, but he and the Schools Minister are working very hard on it.

Health Inequalities

Edward Timpson Excerpts

Wednesday 4th March 2020 Commons Chamber

[Edward Timpson (Eddisbury) (Con)]

When considering how best to improve the nation’s health, including where inequalities exist, I have a natural tendency to want to go back to the very beginning and consider whether the experience of children can lead us to the answers. To that end, I want to raise the—literally—growing problem of childhood obesity. If we look at the overall statistics, we see that a third of children aged two to 15 are overweight or obese, and that 79% of children who are obese in their early teens will remain obese as adults. That puts them at risk of conditions including diabetes, asthma, cardiovascular disease, joint pain and cancer, but it also damages their life chances and can lead to psychological issues that can bear down on and impact their quality of life.

The causes are, as ever, multiple and complex: social, environmental, biological, personal and economic. Looking at the financial position of people, it is true to say that it is cheaper to fill a hungry child with doughnuts than with apples. Of course it is possible to eat healthily for less, but even here we see inequality. Research from University College London and Loughborough University in 2018 found that although childhood obesity had increased in recent decades, its rise had not affected children equally. The report concluded that

“the powerful influence of the obesogenic environment”—

that is, growing up in an environment that encourages or at least facilitates unhealthy eating—

“has disproportionately affected socioeconomically disadvantaged children”.

For example, the obesity figures for four to five-year-olds are at their highest among children from the most deprived areas, where 13.3% are obese, compared with 5.9% in more affluent areas. Although this is a long-running disparity, it is no less concerning, as these figures show. The seeds of a lifelong battle with obesity are sown at an early age, with one in five children already obese or overweight before they have even started school. Understanding the drivers and the most effective interventions is clearly going to be crucial to achieving the change that is needed.

That is why the measures that the Government have taken through the national childhood obesity plan, the Green Paper “Advancing our health: prevention in the 2020s” and the NHS long-term plan are important parts of the solution. We know that the soft drinks industry levy has been effective in reducing sugar content, with about 37.5 billion kilocalories removed from the soft drinks industry every year. We have the school food plan, and health education is now compulsory in our schools. We also have the primary PE and sport premium and the Healthy Start scheme, as well as the healthy child programme that we have heard about. All these measures are helping to tackle childhood obesity, but we know that there is a lot more to do if we are to meet our target of halving childhood obesity by 2030.

Suicide Prevention

Edward Timpson Excerpts

Wednesday 6th February 2013 Commons Chamber

[The Parliamentary Under-Secretary of State for Education (Mr Edward Timpson)]

I have a short 10 minutes to close the debate. I thank all hon. Members who have spoken—they have made well informed, serious contributions to this excellent and deeply insightful debate on this hugely important subject. As the Prime Minister said today at Prime Minister’s questions in commending DUP Members for tabling the motion, we, as a society, do not talk enough about suicide and the impact it has on families. By being up-front about its often complex causes, we can be better at recognising the signs that lead to suicide and at preventing more lives from being taken in future.

As my hon. Friend the Minister of State, Department for Health, said on behalf of the Government, every life taken by suicide is one too many. When that person is a child, the tragedy is merely multiplied. I am speaking as the Minister with responsibility for children and families as well as a co-chair of the UK Council for Child Internet Safety. I shall briefly explain what the Department for Education is doing to help children as part of a cross-government outcomes strategy to prevent suicide, but before I do so I wanted to mention one or two of the contributions to the debate that have been thought-provoking not just for me, but I am sure for many of the people watching and listening.

I acknowledge the brave and touching speech made by the hon. Member for Foyle (Mark Durkan), who said that suicide has deeply affected not only his community, but his family. I know it was a difficult speech for him to make, but those suicides have left a lot of unanswered questions for him and many others. It leads to the conclusion that we must do more. We must acknowledge that we need to place huge importance on ensuring that the support made available to families who are grieving the loss of someone in such circumstances is at the heart of the services and support we offer in our communities.

The hon. Member for South Antrim (Dr McCrea) made a powerful and compassionate speech to open the debate. He said we should not sweep suicide under the carpet—that we cannot run away from it and must face up to it. The situation in Northern Ireland is particularly concerning. He highlighted the fact that 289 people took their own lives in 2011. As he said, it is a personal tragedy for anyone who comes to that decision. We must bear in mind that it can often be triggered by what can seem like a minor or innocuous event. This is a complex issue, and there is very rarely a single factor, although mental health is often a central feature of suicide cases. We need to understand and be better aware of all the different events and pressures on people’s lives that can contribute to them coming to that state of mind.

The hon. Member for Bridgend (Mrs Moon), the chair of the all-party parliamentary group on suicide and self-harm prevention, made, as usual, a highly knowledgeable speech and asked the question we should all ask ourselves: what causes suicide and self-harm to feature in people’s lives in the first place? Her point about raising awareness across agencies—she mentioned the Department for Work and Pensions as one such agency—was absolutely right. I will take it away and ensure that other Departments think carefully about how they train their staff so they understand the signs they need to look for and can point people in the direction of the support that we know is out there.

On the hon. Lady’s point about the coroner’s narrative verdicts, the Ministry of Justice is, as she said, looking into the matter. I understand that the Office for National Statistics and the chief coroner will attend the next meeting of the Government’s national suicide prevention strategy advisory group—narrative verdicts are on the agenda—which is coming up next month. Hopefully, therefore, progress can be made.

She also mentioned the “Help is at Hand” resource for people bereaved by suicide and other sudden traumatic deaths. It is an excellent piece of work that is clear and accessible for those who want support. We are distributing it, and it is on the Department of Health website. I think that approximately 1,000 copies are going out each month, but we need to do better and improve distribution. We are working with coroners’ offices to make sure we achieve that.

My hon. Friend the Member for Pudsey (Stuart Andrew) talked about the moving memory he has of someone he lost at school through suicide. He also talked about his work with the hospice movement. We need to ensure we understand that attitudes to suicide sometimes impact more deeply than we realise. Cyber-bullying is a particularly new phenomenon and it is more and more difficult for young people to escape its awful bearing on their own lives. To understand it better, we need to work closely with young people, and to listen to them and their experiences, rather than assuming that we know the answers ourselves.

In the five minutes I have left, I want to touch on what the Department for Education is doing to try to raise awareness and improve our response, particularly with regard to child internet safety. The new suicide prevention strategy for England, which was published last September, has already been referred to. It is right that children and young people have an important place in that strategy. We should all be extremely concerned about the suicide rate among teenagers, even though it is below that of the general population.

To help young people get the support they need and to be able to talk through their problems, we continue to support, to the tune of £11.2 million between 2011 and 2015, the valuable work done by ChildLine in providing children with free and confidential support in conjunction with the National Society for the Prevention of Cruelty to Children helpline.

The strategy recognises—a point raised by a number of hon. Members—that the media have a significant influence on behaviour and attitudes, particularly for teenagers. In 2009—the hon. Member for Bridgend will be acutely aware of this—the Press Complaints Commission highlighted the impact of insensitive and inappropriate reporting of suicides. We all have to take children’s safety extremely seriously, particularly to protect them from any harmful or inappropriate online content. We are clear that we favour a self-regulatory model for the internet industry, but that is as much a pragmatic response as a philosophical response. We have heard today that the law makes it clear that people who intentionally encourage suicide via websites hosted in the UK are at risk of prosecution, and, to be absolutely clear, what is illegal offline is illegal online.

We need to do more, and through the UK Council for Child Internet Safety board we are trying to make sure that all internet service providers step up to the plate and realise their responsibility. They need to ensure that these types of sites are kept away from young people, and that young people’s ability to have direct contact with them is removed altogether—they are truly horrible sites to have anywhere near one’s home.

As the Minister with responsibility for UKCCIS, I am leading the work looking at how ISPs, filtering companies, device manufacturers and public wi-fi, which we find in our local coffee shops and retailers—all the information and communications technology industries—can work together to make sure harmful content is filtered out wherever our children are. With nine out of 10 children having access to the internet in their own home and with children aged between 12 and 15 proportionately more likely to own a smartphone than their parents, this issue is only going to get bigger rather than smaller.

There are good examples of the internet industry working with the charitable sector, and that will be a key element as we go forward. As the hon. Member for South Antrim said, Google searches on the word “suicide” will return details of the Samaritans at the top of the results—a real step forward—and Facebook has teamed up with the Samaritans to make it easier to report concerns about a friend who might be considering self-harm or suicide. We must do more, however. As the hon. Member for Hackney North and Stoke Newington (Ms Abbott) mentioned, yesterday was the 10th safer internet day. I met a group of young people who were discussing the excellent “Have Your Say” survey. Some 24,000 school-aged children contributed to the largest ever survey about what they expect online. The thing they wanted most was to be safe. That is something we need to deliver for young people, because they are the ones exposed to what adults provide for them.

In conclusion, this has been an excellent debate. I am sure that many people will be encouraged that the House takes the issue extremely seriously and can work together to keep people as safe as possible from the ravages that suicide can bring to families.

Question put and agreed to.

Resolved,

That this House recognises that the number of suicides in the UK, particularly amongst young people, represents a major challenge for government and society; acknowledges the work that is taking place to address the issue; calls for even more urgency to be shown in seeking to reduce the rate of suicides; notes the danger posed in particular by websites which promote or give information about harmful behaviours such as suicide; and calls upon the Government to adequately resource and promote child and adolescent digital safety.

Rare Disease Strategy

Edward Timpson Excerpts

Monday 30th April 2012 Commons Chamber

[Mr Edward Timpson (Crewe and Nantwich) (Con)]

As ever, I am grateful, and indeed delighted, to have the opportunity to address the House in this timely and much-needed debate. Just eight days ago, along with 37,000 other hardy souls, I stood, full of trepidation and excitement, at the start line for the 2012 London marathon. I was running with my wife, Julia, and am pleased to report that we finished the course together in just under four hours. Far more importantly, our run raised over £6,000 for the national charity CLIMB.

That is all very interesting, you might say, Mr Deputy Speaker, but what has this rare accomplishment for a Member of Parliament got to do with a rare disease strategy for the UK? To explain, CLIMB stands for “children living with inherited metabolic diseases” and is a charity based in Crewe in my constituency. It is one of an important network of rare disease charities that strive to raise awareness of rare diseases, not least through Rare Disease day, which takes place on the last day of February each year. Under the stewardship of Steve Hannigan, CLIMB provides vital advice and support to many children and families affected by one of the around 730 known metabolic diseases. One of those children is my nephew Leo.

Leo was born in 2001 with an inherited metabolic disease known as MCADD. Approximately one in 10,000 babies born in the UK has MCADD, which means that they are missing an enzyme that helps break down the fats that provide energy for the body, particularly after long periods without food. This inability to break down fat leads to the build-up of medium-chain fats that can produce toxic substances and lead to severe symptoms, including seizures and possibly coma and death. As Leo was born before the introduction of routine baby screening for MCADD in 2008, neither medical professionals nor his parents knew that he had the disease.

For Leo, all was well until he was 10 months old, when he contracted pneumonia that was coupled with three days of severe hypoglycaemic episodes. Because the knowledge of rare diseases among medical staff was and, indeed, remains limited, and because he had not been screened for MCADD, no one picked up on this underlying rare condition and the need to treat him accordingly. More by luck than by informed professional judgment, thankfully Leo survived.

When Leo suffered a further hypo episode at 14 months, triggered by nothing more than a routine cold, the doctor on duty, who had some knowledge of MCADD, realised that his low blood sugar was unexplained, and subsequent relevant tests revealed a diagnosis of the metabolic disease.

Leo is now 11 and living a full and active life, but, with the mortality rate of children under the age of one who have undiagnosed MCADD being approximately 25%, the routine screening that CLIMB long campaigned for, and which is soon to be introduced throughout all four nations of the UK, is a vital tool in saving lives.

In the past year alone, more than 80 newborn babies have been diagnosed with MCADD—80 babies whose disease would otherwise have remained undetected and who would have been at significant risk. That is why I wanted this debate: to be able to speak up for all those, like Leo, with a rare disease, to put a proposition to the Minister and to question him about, how we can improve the services, information, treatment and support that those with rare diseases receive in order to ensure that we maximise their quality of life.

We are not talking about a handful of isolated cases. With close to 7,000 distinct rare diseases having been discovered, and with five new diseases described every week in medical literature, rare diseases are collectively far from rare. In the UK it is estimated that 3.5 million people, or one in 17, will be affected by a rare disease at some point in their life, with 30% of patients dying before their fifth birthday.

So what is a rare disease? The European commission on public health defines rare diseases, sometimes known as “orphan diseases”, as

“life-threatening or chronically debilitating diseases which are of such low prevalence”—

affecting fewer than one in 2,000 people—

“that special combined efforts are needed to address them.”

About 80% are genetic in origin, but many are auto-immune, such as Crohn’s disease, and others are infectious in nature.

Motor neurone disease, cystic fibrosis, muscular dystrophy and Huntington’s disease may be some of the more widely known rare diseases, whereas acquired non-histamine induced angiodema and Adair-Dighton syndrome are just two of the many thousands of others that I have come across in my own research.

[Jim Shannon (Strangford) (DUP)]

One rare disease that I am aware of is Prader-Willi syndrome, which affects the muscular build-up, eating habits and sleep patterns of some 2,000 people in the United Kingdom and 50 people in Northern Ireland. Does the hon. Gentleman feel that, if there is to be a strategy for the United Kingdom, it must involve all those regions where health matters are devolved to the Administration? Does he feel also that along with such a strategy and, given all the different areas that there are, we need to have something for respite care, because parents, and the way in which they play their part, are vital?

[Mr Timpson]

I am grateful to the hon. Gentleman for raising a particular issue in his constituency in Northern Ireland. He is absolutely right that we need to ensure that the strategy we develop for rare diseases supports not just those who suffer from the disease, but the families who every day, for every hour, have to cope with it and support them. We need to ensure that that is a central part of the strategy.

Such diseases—especially those, including the one to which the hon. Member for Strangford (Jim Shannon) refers, that are particularly rare—are no less important, however, and therein lies the problem. Most rare diseases are under the medical and public radar—too exceptional to attract the attention, recognition and resources required and, above all, the coherent plan needed to tackle the fragmented, inefficient and often inequitable services on offer.

That is why I welcome the Government’s current consultation on the development of a UK strategy for rare diseases and why this debate is so apt. For too long, rare diseases have been placed in the “too difficult to do” pile, but with the onset of changes to health care commissioning and the refocus on putting patients at the heart of the NHS, there is a real opportunity to do things more effectively and much smarter. That means that the consultation must be ambitious, provide strong leadership, and be unambiguous about how the core vision that it reveals can be successfully implemented practically and realistically on the ground across all four home nations.

I have taken the time to read the consultation document, and although it makes many of the right noises, there is a nagging doubt as to whether it meets all the challenges faced by those with rare diseases. I am told by those working in the field of rare diseases that Lord Howe, the Minister who, together with his colleagues in the devolved nations, is responsible for the document, genuinely appears to understand the importance of getting this right. I trust, therefore, that he and they will listen carefully to the submissions they receive, including mine this evening and those of other hon. Members.

So what needs improving? It is clear from my many conversations and my correspondence with clinicians, patient groups and charities working on and living with rare diseases that the ad-hoc nature in which services have developed has led to the principal problems of delays in diagnosis; misdiagnosis; lack of information, communication and awareness; limited research; scarce and unequal access to orphan medicines; poor commissioning and care co-ordination; and a failure to monitor outcomes.

That is not to say that it is all bad news. There is, as ever, some fantastic best practice already taking place. The TREAT-NMD—Translational Research in Europe: Assessment and Treatment of Neuromuscular Diseases—network for neuromuscular diseases, the European Huntington’s Disease Network’s REGISTRY, and the Tay Sachs walk-in clinic at Guy’s hospital are all good examples of innovative, effective and efficient service delivery on which any strategy should seek to build.

[Margot James (Stourbridge) (Con)]

I congratulate my hon. Friend on this very important debate. Does he agree that some rare diseases at least have a high profile, which is advantageous in garnering research and funding? I should like to draw his and the Minister’s attention to a rare disease that has a very low profile—FOP, or fibrodysplasia ossificans progressiva, which is a tragic condition where bone grows in muscle. The funding and research that are required for this condition are set back due to its low profile. Will my hon. Friend join me in wishing to raise the profile of this rare condition and many others with such a low profile?

[Mr Timpson]

My hon. Friend has done just that. I know that she has recently become patron of the charity FOP Action. I believe that this disease affects only one in 2 million people. I congratulate her on taking up that task and wish her and the charity well in raising awareness and the profile of that disease so that even the very small number of people who are affected by it receive the best possible care and support throughout their lives.

In the short time that this debate allows, it is not possible to dig down into the detailed analysis of where the system is currently failing to meet patients’ needs, but I urge the Minister to concentrate on six specific areas, the first of which is diagnosis and screening. As I have said, diagnosis is a major issue. Rare Disease UK has found that nearly half of all patients wait over a year for an accurate diagnosis following the onset of symptoms, with 20% waiting over five years and 12% over 10 years. Misdiagnosis is also a key problem, with almost half of patients being misdiagnosed and almost a third being so three times or more—an avoidable waste on many levels.

One lady who contacted me was Kay Parkinson. Kay set up Alstrom Syndrome UK, a support group for people affected by the same rare genetic disorder that so tragically took the lives of her two children, Charlotte and Matthew. Their desperate story of misdiagnosis, unnecessary and delayed medical interventions and ultimately the most terrible heartache lays bare the consequences of a failure to diagnose early and to diagnose accurately. Through Kay’s dedication, Alstrom Syndrome UK has set up multidisciplinary clinics, funded by the NHS national specialised commissioning group, to help inform patients and professionals of the specialised clinical services available. Its frustration is that it is still unable to find out who and where diagnoses of Alstrom syndrome are made so that it can link them to the specialised NHS services available.

To improve diagnosis, there needs to be: an increase in health care professionals’ knowledge and awareness of rare diseases through initial and ongoing training, particularly for paediatricians; improved links between specialist centres and local services to help with that education, and consideration of the inclusion of appropriate rare diseases in newborn screening, which has proved so successful in the case of MCADD.

The criteria that the National Screening Committee uses should be reviewed to ensure that rare diseases are not being treated unfairly. It is disappointing that the UK lags well behind many other countries in the number of rare diseases for which it screens. For example, in India, the figure is 39; in Poland and China, it is 25; and in the UK, it is just five. Improved access to diagnostic and carrier tests is necessary for even provision across the UK.

Secondly, we need better information. I have spent time between late night votes productively, you will be pleased to hear, Mr Deputy Speaker, in navigating my way around Orphanet in the Library. Orphanet is the European portal for rare diseases and orphan drugs. It provides pretty comprehensive information for patients, professionals, the public and the industry, but is not widely known. Lack of reliable, up-to-date information that helps rather than hinders the prospects of diagnosis remains a significant barrier.

The development of a UK-wide, trusted single portal of information, which has listed against each condition a named clinician who can act as a source of advice and information, would be a major step forward. It would be further enhanced by implementing the international classification of diseases—ICD-11—in 2015. That will bring about the capture of data on the incidence and natural history of rare diseases that are currently poorly understood. The Government should be preparing for such implementation as we speak. I hope that the Minister can give me and other hon. Members assurances that that is the case.

Thirdly, we need research. According to Sir John Burn, professor of clinical genetics at Newcastle university, who was kind enough to contact me, the 80% of rare diseases that have a genetic basis can now be solved using the latest DNA techniques. However, until the 23 regional genetics centres are honed into a single approval structure, huge barriers to research will continue.

Without clinical research networks, the problems of duplication and the perceived lack of impact of research will remain. The knock-on effects are continuing poor relative funding levels and holding back the development of diagnostic tests and treatments.

To ensure that clinical research networks are effective, disease registries need to be established that bring together all clinical information from all patients with a particular condition or type of condition. That will help to deliver more robust research as well as providing more co-ordinated planning and service delivery for the patient.

Fourthly, we need co-ordination of commissioning and care. I have already alluded to the disconnect between the pockets of expertise at regional level and the lack of any real cadre of experts in commissioning locally. That leaves many patients being bounced around the system, with no tangible results or benefits.

Developing a hub-and-spoke model between centres of excellence will help bridge that gap and create meaningful clinical networks. However, ultimately, the new national commissioning board provides a perfect vehicle for ironing out disparities in provision throughout the country. I therefore ask the Minister to explain exactly how the national commissioning board will help create models for cluster-type service delivery for rare diseases.

To ensure that that objective is reached, a national champion for rare diseases, with the necessary clinical clout, is essential in the form of a national clinical director. Bearing in mind that that was a recommendation by the former chief medical officer in his 2009 annual report, I ask the Minister to set out as far as he can the Government’s thinking on that.

The consultation also talks about each patient having a designated care co-ordinator in the same way as cancer patients have now. That is eminently sensible as it fulfils the objective of delivering patient-centred care, and I would be amazed if the Minister felt unable to agree to it in principle.

Fifthly, on access to orphan medicines, the evaluation and appraisal of orphan medicines is different from that of most others. Decisions on whether or not to fund treatments are often made on an individual basis and are very much dependent on which home nation, or indeed which primary care trust, the patient is from. To improve equality of access to orphan medicines requires a proper and consistent appraisal based on the issues specific to them. At the moment, that is lacking, and it follows that a reassessment of the criteria for access is necessary.

Finally and sixthly, on implementation and outcomes, ultimately any strategy is not worth the paper it is written on if it does not deliver significantly improved outcomes for patients. In the case of rare diseases, that could not be more relevant. Processes are important, but the outcome for the patient is the lasting legacy. Effective implementation of the strategy and the monitoring of outcomes flowing from it are crucial. Clear lines of responsibility for delivering the UK plan must exist and the national commissioning board has a big role to play. Without that accountability, we may never truly know whether this has all been worth our effort.

My greatest personal challenge so far this year has been to haul my body round 26 miles, but it is small beer compared with the challenges faced by the 3.5 million people in the UK who continue their battle with a rare disease. However, perhaps the greatest challenge is to our NHS, which over the years has had no choice but to adapt to the changing health needs of, and treatments available to, its patients. For people with rare diseases, the NHS needs to adapt once more. It can do it, and I hope this strategy will ensure that it does.

Oral Answers to Questions

Edward Timpson Excerpts

Tuesday 25th January 2011 Commons Chamber

[Mr Burns]

Yes, and let me reassure my hon. Friend—because last summer I had the pleasure of joining him to visit what is an excellent hospital for the people of Newark—that under our reforms, given the commissioning powers of the GP consortia in the area, they will be able to help strengthen and tailor the health care that the hospital delivers, ensuring that it meets the needs of the people of Newark.

[Mr Edward Timpson (Crewe and Nantwich) (Con)]

How does my hon. Friend envisage the commissioning of ambulance services under the new GP commissioning regime?

[Mr Burns]

Ambulance services will be commissioned through the GP consortia at the local level. What I envisage—this is not prescriptive from the Department of Health, but what I think will develop—is that, just as ambulance services are currently commissioned for geographical areas in England through one PCT, the consortia will appoint lead consortia to commission the services for that area.

Public Health White Paper

Edward Timpson Excerpts

Tuesday 30th November 2010 Commons Chamber

[Mr Lansley]

I think that I have already answered that question. The hon. Gentleman at least among Opposition Members seems to have understood what it is to be in opposition: the point is simply to oppose and that is all he is doing. This is a positive statement and he should address it in that light.

[Mr Edward Timpson (Crewe and Nantwich) (Con)]

Does the Secretary of State agree with local GPs in my constituency that one way to help reduce health inequalities and spend money in the NHS better is to review reporting mechanisms in the NHS and how they impact on referral decisions, particularly in-house referrals?

[Mr Lansley]

Yes. I know that the GPs in Cheshire are a very go-ahead group and I am looking forward to seeing how they take on these responsibilities. I have seen GPs recently make presentations showing that they can really take a grip on referral patterns. They can see referrals not just in terms of trying to interpret patterns and numbers, but on the basis of clinical judgment. The combination of clinical judgment and understanding and knowledge of commissioning and contracting leverage is the basis from which we can improve overall the commissioning of activity for patients.

Oral Answers to Questions

Edward Timpson Excerpts

Tuesday 29th June 2010 Commons Chamber

[Mr Lansley]

The right hon. Lady knows that we will meet to discuss the issue. However, as I said when I was in Greater Manchester, it is not for me to reconsider the application of the new criteria from 21 May. That is for local people to reconsider. It is for GPs, the public, local authorities and, indeed, PCTs in Salford and district to start thinking about what they consider to be viable and successful future services for mothers-to-be.

[Mr Edward Timpson (Crewe and Nantwich) (Con)]

In helping local people to become more involved in NHS decision making, will my right hon. Friend agree to consider my Ambulance Response Times (Local Reporting) Bill, which received its Second Reading during the last Parliament? The Bill requires all ambulance trusts to publish local as well as regional response times and patient outcomes so that—as is already the case in Crewe and Nantwich—they have access to those details and can deliver better response times, with the help of local initiatives such as Community First Responders.

[Mr Lansley]

Yes, we will consider that.