Oral Answers to Questions

Lord Lansley Excerpts

Tuesday 27th March 2012 Commons Chamber

[Andrew Bridgen (North West Leicestershire) (Con)]

1. What plans he has to improve individual choice and standards for end-of-life care.

[The Secretary of State for Health (Mr Andrew Lansley)]

We are developing a new patient funding system for all providers of palliative care. It will be fair and transparent and deliver better outcomes for patients and better value for the NHS. Just last week, I announced that we are investing £1.8 million in eight pilot sites to help us in that work. Marie Curie Cancer Care is also providing £2.5 million of funding to support those pilots. The new system will be in place by 2015.

[Andrew Bridgen]

I thank the Secretary of State. Does he agree that current state funding for end-of-life and palliative care provision is at best patchy across the country and needs to be improved? Will he outline the role that he sees for voluntary and charitable organisations in the delivery of improved palliative and end-of-life care in future?

[Mr Lansley]

My hon. Friend will know very well of the vital role that the voluntary sector already plays, whether through the hospice movement or through Marie Curie and other voluntary organisations. As he implies, we not only want to secure more consistent, high-quality end-of-life care, to which effect we are already implementing the end-of-life care strategy and the National Institute for Health and Clinical Excellence quality standard for end-of-life care, but through the implementation of the palliative care funding review pilot schemes we want to ensure that the voluntary sector and other providers are equally able to provide the services that patients and their families desire.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

For both end-of-life care and social care more generally, the Budget was a real missed opportunity, in that the Government did not signal what they were going to do about the future funding of social care. Will the Secretary of State now update us on the discussions that he has had with the Treasury about what will be done about the gap in the future funding of social care?

[Mr Lansley]

On the contrary, the Chancellor set out very clearly his intention that a White Paper on the reform of social care would be published in the spring. The hon. Lady may wish to know that we are in direct discussions with the Opposition to seek consensus about the long-term reform of social care funding.

[Mr David Crausby (Bolton North East) (Lab)]

2. What his most recent estimate is of the cost of NHS reorganisation.

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[Ian Lucas (Wrexham) (Lab)]

4. What discussions he has had with Ministers in the Welsh Government on the treatment by the NHS of patients with defective breast implants.

[The Secretary of State for Health (Mr Andrew Lansley)]

My officials have kept colleagues in the Welsh Government closely informed about the advice of Sir Bruce Keogh’s expert group and about our plans for the NHS treatment of patients with PIP breast implants.

[Ian Lucas]

The Secretary of State has said that private providers have a moral duty to replace faulty implants for free. Will he tell the House how many private providers have carried out that moral duty?

[Mr Lansley]

I will write to the hon. Gentleman with the latest figures and place a copy of the letter in the Library. Overall, however, I am aware of 5,232 referrals to private providers, as a result of which 2,704 scans have been conducted. Consequently, the decision to explant breast implants has been taken in 298 cases. Some 75 such operations have been completed.

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[Guy Opperman (Hexham) (Con)]

8. What his policy is on the rationalisation of PFI deals in the north-east for the purposes of making savings on long-standing PFI hospitals; and if he will make a statement. [R]

[The Secretary of State for Health (Mr Andrew Lansley)]

Any plan to rationalise a PFI contract, such as that being considered by Northumbria Healthcare NHS Foundation Trust, would be a local decision. Any trust will need to satisfy itself of the value for money of any proposal. Northumbria Healthcare is a foundation trust, so Monitor is also considering its plans.

[Guy Opperman]

Many hospitals around the country are struggling under PFI debt. What plans does the Secretary of State have to ensure that other types of organisations, aside from Northumbria NHS Foundation Trust, will benefit from the new deal, just as my constituents in Hexham are?

[Mr Lansley]

I am grateful to my hon. Friend. We have recently made it clear that where there is unsustainable PFI debt—as is the case for seven PFI contracts—we stand ready to support those trusts in meeting some of those costs, which we inherited from the last Government. Beyond that, working with the Treasury, we have undertaken a pilot project that has demonstrated how 5%, on average, can be taken out of the cost of PFI contracts through the better management of them. I hope that will be applied across the country. I welcome, as I know my hon. Friend does, the way in which Northumbria Healthcare, with its local authorities, is looking at resolving its PFI debts, and if that represents value for money, I am sure that others across the country will benefit from the experience.

[Stephen Barclay (North East Cambridgeshire) (Con)]

9. What steps his Department is taking to develop more effective performance management of GPs.

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[Miss Anne McIntosh (Thirsk and Malton) (Con)]

11. What recent representations he has received on the 111 pilot telephone service; and if he will make a statement.

[The Secretary of State for Health (Mr Andrew Lansley)]

I have received representations from the British Medical Association and the NHS Alliance, both of which support the NHS 111 model, requesting an extension of the roll-out deadline of April 2013. I am actively considering that, and will be discussing it with the clinical commissioning groups who are leading the development of NHS 111 in their areas.

[Miss McIntosh]

Will the Secretary of State accept representations from me? I have used the 111 service on behalf of a family member, and I know that it is not working as well as it might, which is quite distressing. The call time and the script do not allow a person receiving a particular type of care to be fast-tracked to a clinician. I believe that there is a case for delaying its roll-out, and that the service would be infinitely better if the Secretary of State took my representations on board.

[Mr Lansley]

I will of course accept representations from my hon. Friend and, indeed, from anyone else. Pilot schemes are under way in County Durham and Darlington and in Nottingham, Lincolnshire and Luton. The system is also live in Derbyshire, the Isle of Wight, Cumbria, parts of Lancashire and parts of London. An evaluation will be published shortly by the university of Sheffield, but an interim evaluation suggested that 93% of patients were pleased with the service that they had received, and, most important, 84% felt that it had delivered them to the right place first time.

[John Healey (Wentworth and Dearne) (Lab)]

Will the Secretary of State confirm the provision in regulation, reinforced by his new guidance, that no GPs should use 0844 numbers for their surgeries? Some patients are having to pay over the odds to contact their GPs.

[Mr Lansley]

We have made it very clear that GPs should not be using 0844 numbers for that purpose and charging patients for them. One of the benefits of NHS 111 is that it will be a free service for patients, and will give them an opportunity to gain access to integrated urgent care wherever they are in the country. That is why we want to roll it out as soon as we can.

[John Pugh (Southport) (LD)]

Given the importance of 111 contracts, should we not delay assigning them until the clinical commissioning groups are properly in place?

[Mr Lansley]

My hon. Friend will recall from my first answer that I am looking to discuss the timing of the roll-out with clinical commissioning groups. I do not want that to be unduly delayed, because there are clear benefits to patients in the 111 system in that it gives them a more integrated single point of access to the NHS.

[Mr Jim Cunningham (Coventry South) (Lab)]

12. If he will introduce proposals to require a minimum ratio of nurses to patients in hospitals.

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[Greg Mulholland (Leeds North West) (LD)]

14. What recent progress he has made on the review of adult congenital cardiac services.

[The Secretary of State for Health (Mr Andrew Lansley)]

The review of adult congenital heart services is a clinically-led NHS review, independent of Government. I understand that an expert advisory group has been established and its first task will be to develop designation standards and a model of care that commissioners can use to help determine the future pattern of services.

[Greg Mulholland]

I thank the Secretary of State for that answer, but adult cardiac patients in Yorkshire are both disfranchised and extremely worried because of the review of the children’s heart unit, as if it is closed, they, too, would lose access to surgeons. Does the Secretary of State agree that it does not make sense to have two separate reviews, and that they should instead be brought together?

[Mr Lansley]

My hon. Friend will know that no decision has yet been taken on the location of children’s or adult congenital heart surgery centres in England. Neither the draft adult clinical standards nor the proposed standards for children’s services require services for children and adults to be collocated.

[Nic Dakin (Scunthorpe) (Lab)]

Will the Secretary of State ensure that the relationship between adult and children’s cardiac services is properly considered as part of the review?

[Mr Lansley]

On both children’s and adult congenital heart services, all relevant clinical factors should be taken into account in the review, but I reiterate the point that I made to my hon. Friend the Member for Leeds North West (Greg Mulholland): the standards for those services do not require children’s and adult services to be collocated.

[Neil Carmichael (Stroud) (Con)]

15. What assessment he has made of the provision of vision screening for children.

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[Jo Swinson (East Dunbartonshire) (LD)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health (Mr Andrew Lansley)]

My responsibility is to lead the NHS in delivering improved health outcomes in England; to lead a public health service that improves the health of the nation and reduces health inequalities; and to lead the reform of adult social care, which supports and protects vulnerable people.

[Jo Swinson]

An estimated 50,000 people, mostly men, are misusing anabolic steroids to build muscle, which can result in liver cancer, depression, a damaged immune system, kidney problems and cardiovascular disease. Will the Secretary of State examine the public health implications of the 56% rise in steroid misuse over five years? Will he work to address its causes, such as body image anxiety, as well as just treating the problem?

[Mr Lansley]

I am grateful to my hon. Friend for making a good and important point. My right hon. Friend the Home Secretary will be subjecting these drugs to greater control under the Misuse of Drugs Act 1971, restricting their illegal import into this country. Controlling supply is one part of the effort. Prevention is also important; people need to be fully aware of the risks to their health. The FRANK service, which provides advice to young people and parents about drugs misuse, will make it clear that the misuse of steroids is dangerous. I would encourage local areas to work with local businesses, such as gyms and fitness centres, to publicise those risks.

[Nick Smith (Blaenau Gwent) (Lab)]

T2. The Department’s latest estimate shows that alcohol misuse costs the NHS £3.5 billion every year. Will the Secretary of State now champion a 50p minimum unit price? That would save more than 3,000 lives a year, rather than 1,000 a year, which is what his public health responsibility deal is expected to secure.

[Mr Lansley]

The hon. Gentleman should have welcomed the alcohol strategy that my right hon. Friend the Home Secretary published last Friday. Not only did we see the Government’s intention to introduce a unit price, but on that day 35 business organisations across the country collectively, under the responsibility deal, pledged themselves to take 1 billion units of alcohol out of the UK market in the course of a year.

[Simon Wright (Norwich South) (LD)]

T7. Many hospitals, including the Norfolk and Norwich university hospital, have reported a dramatic increase in alcohol-related admissions over the past 10 years, so I welcome the latest alcohol strategy. But what steps is the Secretary of State taking to support the expansion of treatment and early interventions for dependent and harmful drinkers in Norfolk and elsewhere?

[Grahame M. Morris (Easington) (Lab)]

T3. We now know that the Conservatives have received more than £8 million in donations from private health care companies since 2001. This goes beyond simply cash for access to a much more sinister issue of cash for policy influence. Ministers have said that they do not expect any increase in private sector provision in the NHS, but how will this be measured in years to come?

[Mr Lansley]

Nobody buys influence over the policy of the Conservative party or the coalition Government. That is in complete contrast to the situation with the right hon. Member for Leigh (Andy Burnham) and his friends on the Opposition Front Bench, who are the wholly owned subsidiaries of the trade unions.

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[Rosie Cooper (West Lancashire) (Lab)]

T4. At a time of major upheaval in the national health service, the people of west Lancashire and other areas of Lancashire are being failed by the chief executive of the Lancashire primary care trust cluster. Living in Yorkshire and working from Lancaster, Janet Soo-Chung has failed to meet with me or other colleagues, including my hon. Friend the Member for Chorley (Mr Hoyle). Can the Secretary of State assure me that the necessary time and development is being invested in health services in west Lancashire to ensure that authorisation takes place in a timely way without conditions and that the health services provided to my constituents are good?

[Mr Lansley]

I will, of course, ask Janet if she will meet the hon. Lady and her colleagues, but I think the hon. Lady might have noted that the NHS is performing magnificently. The quarter document published just this morning gives details of 14 performance measures across the NHS, in five of which performance has been maintained and in nine of which there has been improvement, so there has been no deterioration in performance. When the hon. Lady gets to her feet she should say to the NHS, “Well done for improving performance.”

[Stuart Andrew (Pudsey) (Con)]

Currently, there is a review into paediatric cardiac services going on. I recognise that that is independent of Government, but we now have the independent analysis of patient flows, which says exactly what we have been saying—that patients in south and west Yorkshire will not go to Newcastle. Does my right hon. Friend agree that this is an important development and that the options should reflect that because this is a serious problem for heart services in the north of England?

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[Andrew George (St Ives) (LD)]

What reassurance can the Secretary of State give to Members of Parliament representing areas that have received an allocation from the formula which has been significantly below their target, given the change in arrangements to clinical commissioning groups in future?

[Mr Lansley]

My hon. Friend will be aware that the distance from target on the existing formula for Cornwall in particular has narrowed and is only just over 2%. For the future, I hope that he and all hon. Members will take considerable reassurance from the fact that not only will the formula continue to be the subject of independent advice, but new statutory provisions will set out that it should be intended to reflect the prospective burden of disease in each area, so it should be matched as closely as possible to the need for services in each area.

[Stella Creasy (Walthamstow) (Lab/Co-op)]

T6. The Government say that clinicians understand patients best, but there are doctors in Walthamstow who will not provide contraceptives to local women, and we now have one of the highest rates of teen pregnancy and repeat abortions in the country. Will the Ministers agree to meet women from my constituency and help them understand who, under the new system and the new layers of bureaucracy, they can hold to account for these problems—yes or no?

[Mr Lansley]

The hon. Lady should first have expressed a welcome for the fact that there has been a further reduction overall in the numbers of teenage pregnancies. As she knows, in her constituency there are doctors who, as she says, do not provide contraceptives, but there are also many other practices that do—17 out 18 GP practices in Walthamstow provide contraceptive services. There was a 60% increase in a decade in the number of managers in her area and the result seems to be that she does not understand how services were managed in Walthamstow. Under local authorities and the clinical commissioning groups in the future, there will be a clearer system.

[Mr Speaker]

No one could accuse the Secretary of State of being other than comprehensive. We are grateful to him.

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[Bill Esterson (Sefton Central) (Lab)]

One NHS consultant told me that

“NHS reorganisation could mean that you are forced to spend around 10% of your income on private health care insurance.”

Does the Secretary of State accept that the doctor is right to say that people will either wait longer for care or they will have to pay for it?

[Mr Lansley]

That is complete rubbish. The legislation is absolutely clear that it does not lead to privatisation, it does not promote privatisation, it does not permit privatisation and it does not allow any increase in charges in the NHS. It simply creates a level playing field so that NHS providers will not be disadvantaged compared to the private sector, as they were under a Labour Government.

[Steve Baker (Wycombe) (Con)]

The present Wycombe hospital consultation has proceeded with a number of hiccups, not least because of the false sense of local accountability engendered by Labour’s top-down system of health management. Will the Secretary of State meet me and a small delegation of my constituents to discuss how things will improve under his reforms?

[Mr Lansley]

Of course. I will be glad to meet my hon. Friend and his constituents. I recall how he has been an advocate on their behalf in the past and a vocal advocate of services in Wycombe. I emphasise to my hon. Friend that we are looking towards not only the clinical commissioning groups, but the local authorities injecting further democratic accountability so that in his constituency and those across the country we see much greater local ownership and accountability for the design of services.

[Mark Durkan (Foyle) (SDLP)]

The Chancellor’s evidence to the independent pay review body chairs last week contained curious if not dubious references to nursing pay and non-nursing pay, and possible outcome linkages of those. Does the Secretary of State understand those and can he explain them?

[Mr Lansley]

The hon. Gentleman will know that we have asked the pay review bodies to look at the aspects of pay related to market conditions, and I do not want to prejudice that. They will come back with their advice on that.

[Mark Menzies (Fylde) (Con)]

I welcome the Prime Minister’s announcement yesterday on dementia care. What assurances can the Secretary of State give me that this will be an aggressive strategy, looking at matters such as new access to drugs, early diagnosis and support for carers of those with dementia?

[Mr Lansley]

Not only were there the announcements made yesterday, but as part of that there was the establishment of three sets of champions, including Angela Rippon and Jeremy Hughes from the Alzheimer’s Society, working together as champions to raise awareness and understanding, Ian Carruthers and Sarah Pickup as champions on improving treatment and care, and Dame Sally Davies, the chief medical officer, and Mark Walport from the Wellcome Trust, as champions for research. Their objective is specifically, as the Prime Minister told them, to hold our feet to the fire, not only for the ambitions we set out yesterday, but for going further and faster.

[Simon Danczuk (Rochdale) (Lab)]

On 24 February, my constituent, Audrey Kay, died after a litany of poor treatment. Will the Minister meet her son and me to hear Audrey’s treatment story?

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[Valerie Vaz (Walsall South) (Lab)]

One year on, are the pledges under the responsibility deal working?

[Mr Lansley]

One year on in the responsibility deal we are seeing successes, including the elimination of artificial trans fats, further reductions in salt in manufactured foods, and over 8,000 high street outlets sharing and showing calorie information. The monitoring and evaluation of the deal is vital. We are committed to this and we are making up to £1 million available to fund an independent evaluation.

[Several hon. Members]

rose—