(12 years ago)
Commons ChamberI 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.
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.