Thursday 20th December 2012

(11 years, 10 months ago)

Commons Chamber
Read Full debate Read Hansard Text Read Debate Ministerial Extracts
Jeremy Lefroy Portrait Jeremy Lefroy
- Hansard - - Excerpts

I thank the hon. Gentleman for his intervention. I am not convinced that that is the case at all. I believe Ministers are listening and are considering matters very carefully, but there is a danger, of course, that a template will be inflicted. The hon. Gentleman and I both earnestly trust that that will not be the case.

As I said, I believe that national tariffs are not impartial arbiters. They generally work against acute care, and there is a risk that the constant pressure which they are placing on acute care, particularly in district general hospitals, will make much of the sector unsustainable, yet without it, we do not have an NHS.

Finally, I wish to raise a specific point about Monitor’s review of Mid Staffordshire. Clearly, the population served by the trust is a very important consideration. The trust’s 2011-12 report said that it was around 276,000, yet I have heard reports that the Monitor team considers it to be as low as 220,000 and therefore potentially too small to sustain certain services. The facts that I have clearly support the trust’s figure, not the one that I have heard rumoured.

I have spoken much today about figures, because they are an important part of the Monitor review, but more important is the quality of services, for which Monitor also has a legal responsibility. Early next year, the Secretary of State will bring to the House the report of Robert Francis QC from his public inquiry into Mid Staffordshire. Julie Bailey and the Cure the NHS group, who from their own experiences brought to light the harm that was done, have set out radical and clear ideas for turning the NHS the right way up, with the patient at the top, not the bottom—right first time with zero harm to each and every patient. That is something which caring, hard-working staff in our NHS in Stafford and Cannock—where waiting times and mortality rates are improving, although there is much to be done—and right across the country went into the NHS to provide.

The NHS, as the right hon. Member for Wentworth and Dearne (John Healey) said, and the nursing and medical professions must make it clear that there is no place for anyone for whom quality patient care does not come above all else. The regulations must show that.

The Monitor review is an opportunity for Stafford and Cannock hospitals to become a model of how to provide sustainable high quality emergency, acute and community care to a mid-sized population. If Monitor succeeds in achieving this there and elsewhere, as the hon. Member for Lewisham West and Penge (Jim Dowd) mentioned, it will have done the nation a great service, and I am sure the Minister will be remembered as someone who played a major part in improving our NHS. I urge Monitor to rise to the challenge.

Grahame Morris Portrait Grahame M. Morris (Easington) (Lab)
- Hansard -

I thank the Backbench Business Committee for making this debate possible before the Christmas recess. I shall raise an important issue, access to advanced therapeutic radiotherapy. I have raised this previously and I make no apology for doing so again. I intend to keep raising it until my constituents and those all across the country have proper access to advanced and innovative therapeutic radiotherapy systems.

I remind the House that prior to the Conservative party conference the Prime Minister pledged that from April next year cancer patients who need innovative radiotherapy will get it. That pledge was confirmed to the House by the Secretary of State for Health on 23 October and by the Under-Secretary of State for Health, the hon. Member for Broxtowe (Anna Soubry), who has responsibility for cancer services, in written replies on 30 October.

The Department of Health’s press release on 8 October expanded on the Prime Minister’s statement, indicating that a new £15 million cancer radiotherapy innovation fund was being created, drawn from the underspend of the cancer drugs fund. I bring to the House’s attention the fact that the £200 million cancer drugs fund has been under-spent by an average of £150 million each year since it was established. That was reported to the House on 16 April 2012—column 134W in Hansard.

The Health Minister confirmed on 30 October that the pledge meant three specific things: patients would have access to appropriate radiotherapy wherever they lived; the new national Commissioning Board would be responsible for funding; and intensity-modulated radiation therapy, known as IMRT, stereotactic ablative radiotherapy, know as SABR, and stereotactic radiosurgery would be included.

Since the Prime Minister’s pledge, the Department of Health has contacted all cancer centres to inform them that the cancer radiotherapy innovation fund is a revenue fund only and that its use is to be focused on getting as many centres up to the standard of delivering 24% access to IMRT by April next year. In a letter to all cancer centre chief executives on 17 October, the cancer tsar, Sir Mike Richards, stated that only four of the 50 centres were reaching the 24% requirement set by the national radiotherapy implementation group.

In a letter to all radiotherapy service managers on 25 October, the national cancer action team stated that the cancer radiotherapy innovation fund was to be used effectively so that the Prime Minister’s pledge could be honoured and that if they are not delivering IMRT at the required 24% they were to submit an action plan by the end of November indicating how they would achieve that.

The letter also stated that the radiotherapy service managers could access initial funding of up to £150,000 to help them reach the target. However, the Health Minister, when questioned about funding for the pledge on 30 October, told the House that there would be no extra or ongoing funding similar to the cancer drug fund for commissioners to draw on and that any capital funding requirements would have to be met from the current £300 million bulk purchase fund announced earlier this year. In other words, there was no extra money. It seems to me that the pledge cannot be met, in terms of both revenue and capital.

Over the past two years adequate revenue funding has never been available to local commissioners to fund all the radiotherapy patients who have needed it. I know that full well from cases in my constituency. There is no indication that the new national Commissioning Board is to receive any additional funding. Without extra money, how will it fund care for the new 8,000 to 10,000 cancer patients the Prime Minister claims his pledge will help?

I would like to consider capital for a moment. I received an e-mail last night from the charity Breast Cancer Campaign, which indicated that, given the current age profile of the linear accelerators in England, an additional 147 new LINACs will be needed by 2016, at an average cost of £1.5 million. I want to ask the Minister how those will be funded. There are simply not enough advanced radiotherapy systems in the NHS to deliver the pledge. The Department of Health has admitted that only four of the 50 cancer centres are able to deliver IMRT to the required standard. At full capacity they could treat between 1,200 and 1,500 patients a year.

There are only four systems in the NHS delivering SABR up to the required standard, as the Minister has confirmed in written answers, and I have been to see one of the machines in St Bartholomew’s. At full capacity they could treat 1,000 patients a year. There is only one Gamma Knife in the NHS delivering stereotactic radiosurgery—in Sheffield—and at full capacity it could treat around 300 patients a year. With no extra capital available to fund new machines, it will be impossible for patients in most of England, including my region, to be treated by the NHS. There are some machines in the private sector, but the treatment is very expensive.

I am asking not for more money for cancer care, but for a more equal distribution of resources. The Department of Health is telling commissioners that radiotherapy, in conjunction with surgery, is very effective, curing 70% of all cancers. I have come here neither to lambast the Minister, nor to condemn him with faint praise; I have come bearing gifts, as it is Christmas, in the form of a potential solution. If the total underspend from the cancer drugs fund was transferred to radiotherapy in each of England’s regions, the systems could be upgraded with the most advanced radiotherapy equipment by 2015, which would enable constituents in my region and across the country to access life-saving therapies and allow the Prime Minister to fulfil his pledge.

Keith Vaz Portrait Keith Vaz (Leicester East) (Lab)
- Hansard - - Excerpts

It is a pleasure to follow my hon. Friend the Member for Easington (Grahame M. Morris). I share the concerns of all right hon. and hon. Members who have spoken so far about the importance of our national health service and our concerns about its current state. I think that the Minister—I have said this to him privately—is one of the most effective of the junior Ministers who have appeared at the Dispatch Box since the reshuffle. Because he is a doctor, I hope that he will take the concerns that I raise today on diabetes extremely seriously.

I suffer from type 2 diabetes—I declare my interest—having discovered it only five years ago after a routine test. I thought I had it under control, because I was taking my medication and doing a little exercise every day, walking from Norman Shaw North to the Palace of Westminster, until I read the national diabetes audit report published on 10 December. It states that people with diabetes are 48% more likely to suffer a heart attack, 65% more likely to have heart failure, 144% more likely to need kidney dialysis, 210% more likely to have leg amputations, 331% more likely to have part of a foot removed and 25% more likely to suffer a stroke. Overall, those with diabetes are, on average, 40% more likely to die each year than those without it. Members will understand my concern, as we approach Christmas, after reading statistics of that kind.

I know that other hon. Members have subsequently discovered that they, too, have diabetes. My hon. Friend the Member for Sedgefield (Phil Wilson), who is in the Chamber, discovered he had it only after being tested here in Parliament by the Silver Star charity. He went to see his GP and then knew that he had been diagnosed.

We are facing a diabetes epidemic, and I ask the Government to take more note of what is happening as far as diabetes is concerned. Generally, people with diabetes look fairly normal—I do not know whether you think I look normal, Mr Deputy Speaker—and do not make a virtue of telling people we have diabetes, except in debates of this kind. That normality lulls us into a false sense of security. We need a national campaign on diabetes in the same way as for other illnesses. Because people are getting treatment and are able to go and get their Metformin or other medication on a regular basis, they feel that everything is going to be all right.

This issue will not only not go away but will get worse. At the moment, 3.7 million people have diabetes, and that figure will rise by another 700,000 in a few years. Some 80% of amputations are preventable with proper care and management. I say to Ministers that this is something we can help the population with now. If we do so, we can save the 10% of the budget that is currently spent on diabetes care and the £1 million an hour that is spent on medication and care in our hospitals. These issues are very much in our hands.

I welcome the new Minister with responsibility for diabetes, the Under-Secretary of State for Health, the hon. Member for Broxtowe (Anna Soubry), who has made an excellent start. The first thing she did was to hold a summit for those with an interest in diabetes. It included Diabetes UK, which does some fantastic work on the subject, Silver Star, a charity of which I am privileged to be the patron, and others, including clinicians. She said what very few Ministers have said in my career in this House—“I want you to tell me what I should do about this subject”—and she was given a lot of good advice and ideas about how to take these matters further.

One thing that we could do immediately is to send out the message to GPs, even in the current climate of ongoing changes within the NHS, that it takes only a minute to offer each patient who comes to see them a diabetes test. I know that we are having screening for those of a certain age and disposition, but people go to see GPs for all kinds of reasons. Campaigning organisations such as Silver Star and Diabetes UK are able to go out to communities and conduct these tests. Indeed, anyone can conduct them. I have my kit with me, and although I am obviously not medically qualified, I can still conduct the test on people and am happy to do so. It is very easy to do. We should say to GPs, “Don’t wait for the screening process—begin now by testing anyone who comes to your surgery.”

We need to send out through the Department of Health a message about what we eat. You have changed physically, Mr Deputy Speaker, in all the years I have known you. I know of your great interest in rugby. You used to be a very beefy character when you were first elected to this House, but you have slimmed down, perhaps since you have been an occupant of the Chair. If people look after their lifestyles better by taking exercise and being careful about what they eat, that could help them. Every time anyone drinks a glass of Coke, eight teaspoons of sugar go straight into their system. When I went over to Atlanta and met the chief executive of Coca-Cola, I asked him what he was doing about it, and he said that Coke Zero is the answer, but it is only part of the answer. The kids in our schools are offered drinks in vending machines which have a huge amount of sugar, and then they get addicted to it for the rest of their lives. This is about things that we can do ourselves and things that parents can do to bring down the bill for the NHS.

When I finish this speech, and after I have listened to the Minister, I will be going to the Tea Room. When we get to the very helpful people there, we find that we have chocolates and mince pies on offer to us. If we turn to the left, we see a lot of food that is totally unfit for diabetics. Of course, I continue to eat this food because we do not have a choice, but it would be possible, through labelling of the drinks and food that we consume, as for people with a nut allergy, to add the words “Suitable for diabetics” or “Unsuitable for diabetics”.