Severe Eating Disorders (North-East England)

Mary Glindon Excerpts

Monday 23rd June 2014 Commons Chamber

[Chi Onwurah]

The hon. Gentleman makes an excellent point, and I certainly believe that the decision should and must be reviewed. It is clear that a number of hon. Members have been contacted by concerned constituents. Indeed, the right hon. Member for Berwick-upon-Tweed (Sir Alan Beith), who cannot attend this debate, asked me to say that he also had constituents who are affected.

Given that admissions in the north-east are 30% above the national average, and that the Royal College of Psychiatrists recommends that six beds per million of the population are needed for average admission rates, the north-east’s 2.8 million people need 23 beds. I will return to that figure, but first a word about the threatened unit that hon. Members have already referred to.

The Richardson eating disorder service is operated by Northumberland, Tyne and Wear NHS Foundation Trust. It is in the centre of Newcastle, with excellent transport links. It is acknowledged to be an outstanding unit, rated excellent by the Royal College of Psychiatrists and the Care Quality Commission. It has just won Beat’s clinical team of the year award. A stable, vastly experienced staff has been treating adult in and out-patients since 1997, and it has saved many lives. One sufferer said:

“I have suffered from anorexia nervosa for over 12 years and unfortunately during that time I have required many admissions to medical and eating disorder units”.

She names a number of them before going on to say:

“The admission to the Richardson was by far the most successful. I made such huge strides towards recovery and was the healthiest I have been since this all began.”

[Mrs Mary Glindon (North Tyneside) (Lab)]

In the light of what my hon. Friend says, and the fact that the unit’s model of partial hospitalisation of out-patient services has been so successful, does she not agree that NHS England should look at that model and perhaps reconsider its decision on the specification of specialised services?

[Chi Onwurah]

My hon. Friend makes an excellent point. Indeed, if the criteria on which this decision was made were publicly available, we could perhaps tell which models NHS England considered and what it hoped to achieve. Unfortunately, there is no transparency, which is one of the key issues.

Problems started in 2010, when commissioned adult eating disorder in-patient beds were tendered and the contract was awarded to Tees, Esk and Wear Valleys NHS Foundation Trust, although it did not then operate an in-patient unit. It quickly established a 10-bed unit in Darlington, but on a site with poor transport links to the north. For clarity for those Members who may not be familiar with the north, Newcastle is to the north of Darlington.

The award was a shock to many people, not simply because of the result, but because of the lack of consultation. I should like to ask the Minister a specific question: against what criteria were proposed services considered to be better than award-winning ones already on offer in the Richardson? If he does not know, I hope that he will promise to find out. Was cost the driving factor? What was the evidence basis for the centralising of these critical mental health services?

The National Institute for Health and Care Excellence guidelines specifically state that for severe eating disorders patients should be treated near their homes, with the support of family and friends. These are often young, vulnerable people, who are not yet independent of their family, either financially or emotionally. As one told me,

“Seriously ill anorexics are often cognitively impaired as a result of severe starvation and separation from loving support, together with that the challenge to dangerous and entrenched behavioural traits is often too much to bear.”

Given the lack of consultation, the north-east specialised commissioning group was instructed to strengthen its relationships with stakeholders and report any other substantial changes or developments to the NHS scrutiny committee.

NEEDAG, formed by carers and patients concerned about the threat to the Richardson, hoped that at least five of the beds in the Richardson would continue to be used by those in the north of the region, given overall regional demand. However, in April 2012, the commissioner increased the number of beds at Darlington to 15—again, without any consultation, scrutiny or performance data by which to make judgments. When challenged, I am told that the commissioner said they were not obligated to consult anyone. I hope that the Minister will correct them on this point. It is possible that the top-down reorganisation of the NHS instituted by this Government may have led to them forgetting their obligations under the NHS constitution.

When Darlington was full, commissioners started sending very ill patients out of the area, instead of to the Richardson, saying that every commissioned bed in England, no matter where it was, had to be filled before a patient from Tyneside could be sent to Newcastle. That is how we have arrived at the ridiculous and tragic situation of our national health service sending vulnerable Tyneside patients to Glasgow, Norwich and London when there are empty beds in the Richardson unit in the centre of Newcastle.

The impact on vulnerable young people of being separated from their families undoubtedly makes it more difficult to recover—hence the NICE guidelines. The cost of visiting for families is enormous, both financially and emotionally. One parent wrote:

“This will then have an effect on our family’s mental health as we are all struggling to come to terms with the condition and to help M recover. I would refuse to let M be admitted so far away from home and would rather give up my full time job to look after her in the familiar and safe surroundings of home.”

Another parent who fought to win a place for their daughter at the Richardson said:

“We were very angry to have been put in the position of having to fight for a bed for our dangerously ill daughter at a time when all our energy was needed to comfort and support her through a very difficult time. The added pressure and anxiety it caused the whole family was dreadful.”

It has been announced that the unit will be closed down, because it was said—cynically and cruelly—that it was not being used locally. If it was not being used locally, it was because NHS England was sending local people hundreds of miles away. Freedom of information requests submitted by NEEDAG show that Darlington’s 15 beds are full; that there are eight in-patients from the north-east in London, Sheffield, Leeds, Glasgow and Norwich; and that five patients have managed to win beds in the Richardson.

Social Care Budget Changes

Mary Glindon Excerpts

Wednesday 4th December 2013 Ministerial Corrections

The following is the answer given by the Minister of State, Department of Health, the hon. Member for North Norfolk (Norman Lamb), to the hon. Member for North Tyneside (Mrs Glindon) during Health Question Time on 26 November 2013.

[Mrs Glindon]

In the first two years of this Government, there was a frightening 66% increase in the number of people aged 90 and over coming into accident and emergency in a blue-light ambulance. When will the Minister accept that cuts to elderly care have increased pressure on the NHS, and are a major cause of the A and E crisis?

[Norman Lamb]

First, it is worth us all recognising that there is an increase in the number of frail elderly people in our society living with chronic conditions and that that is putting additional pressure on accident and emergency departments. The numbers have increased by over a million a year since 2010. However, the fact that there has been a reduction of 50,000 in the number of delayed discharges demonstrates that the social care system is doing incredibly well, and we should pay tribute to social care workers across the system who are doing so well to ensure that that improvement is taking place.

[Official Report, 26 November 2013, Vol. 571, c. 148.]

Letter of correction from Norman Lamb:

An error has been identified in an oral answer given to the hon. Member for North Tyneside (Mrs Glindon) on 26 November 2013.

The correct answer should have been:

Oral Answers to Questions

Mary Glindon Excerpts

Tuesday 26th November 2013 Commons Chamber

[Mr Hunt]

I do not think I have yet answered a question across the Dispatch Box from the hon. Lady, so I welcome her to her post. I just say that she should be careful what she chooses to turn into a political football, because hypothermia admissions, as Public Health England said in August, are very closely linked to the number of cold days over a winter and the length of that winter. We had a particularly difficult winter last year, but the number of winter deaths was nearly 20% higher under the previous Government, when the right hon. Member for Leigh (Andy Burnham) was Health Secretary.

[Mrs Mary Glindon (North Tyneside) (Lab)]

8. What assessment he has made of the effects of social care budget changes on attendances at accident and emergency departments.

[The Minister of State, Department of Health (Norman Lamb)]

Joining up health and social care is an absolute priority for this Government. The NHS will provide £900 million this year and £1.1 billion next year to support social care services with a health benefit and to promote joint working. In 2015-16, we will introduce a £3.8 billion pooled budget for health and social care. The number of bed days lost because of delays attributable to social care was nearly 50,000 lower in 2012-13 than it was in 2011-12.

[Mrs Glindon]

In the first two years of this Government, there was a frightening 66% increase in the number of people aged 90 and over coming into accident and emergency in a blue-light ambulance. When will the Minister accept that cuts to elderly care have increased pressure on the NHS, and are a major cause of the A and E crisis?

[Norman Lamb]

First, it is worth us all recognising that there is an increase in the number of frail elderly people in our society living with chronic conditions and that that is putting additional pressure on accident and emergency departments. The numbers have increased by over a million a year since 2010. However, the fact that there has been a reduction of 50,000 in the number of delayed discharges demonstrates that the social care system is doing incredibly well, and we should pay tribute to social care workers across the system who are doing so well to ensure that that improvement is taking place.[Official Report, 4 December 2013, Vol. 571, c. 13MC.]

Mitochondrial Disease

Mary Glindon Excerpts

Tuesday 25th June 2013 Westminster Hall

[Chi Onwurah (Newcastle upon Tyne Central) (Lab)]

It is a great pleasure to serve under your chairmanship, Mr Davies. I am pleased to be able to lead a debate on this most important subject. I shall speak about mitochondrial disease, the devastation it causes and the new techniques developed by Newcastle university to prevent it. I declare an interest in that my father studied medicine at Newcastle, so I am a natural champion of that great university’s medical research and innovation. I am here primarily to champion not Newcastle university however, but the interests of my constituents struck down by mitochondrial disease, and indeed all those who suffer from it.

The subject is technical and I will attempt to be as clear as possible in setting out the arguments. Mitochondria are found in every cell in the human body, except red blood cells. They are the batteries generating energy for the cell. Mitochondria convert the energy of food molecules into the energy that powers the cell’s functions. About 200 children are born every year with a mitochondrial disease. Such diseases are passed from mothers to their children and are caused by faulty mitochondria. Like all DNA, the DNA in mitochondria can mutate and mothers can pass those mutations on to their children. Faulty mitochondria mean that the cells are unable to function normally and the diseases caused by them can have a devastating effect on families. The diseases tend to affect parts of the body that use a lot of energy, such as the brain, muscles, nerves, liver, kidney and heart, and vary widely in severity, from life-threatening to having few or no obvious symptoms. Symptoms vary, but can include poor growth, muscle weakness, tiredness, poor co-ordination, and sensory, respiratory or cognitive problems.

There are no effective treatments available for serious mitochondrial disease. When the cells go wrong, it can result in serious conditions, including blindness, fatal heart failure, liver failure, learning disabilities and diabetes, and can lead to death in early infancy. Prevention is the only realistic option. In 2010, Newcastle university scientists, with funding from the Wellcome Trust, pioneered research into variations of in vitro fertilisation procedures that could prevent the transmission of the genetic mutations that cause these devastating disorders. The techniques use part of an egg donated by a healthy individual, to replace the faulty mitochondria of the affected mother. The intention is to give affected families a chance to have healthy children that are genetically related to them, but born free of mitochondrial disorders. Such techniques are not currently permitted in the UK, but legislation allows the Government to introduce secondary legislation that would allow the treatments to be used.

Mitochondrial disease can blight families for generations, because, as I said, it is passed from the mother to child during pregnancy. The techniques could put a stop to it, by preventing the faulty mitochondria from being passed to the embryo. Mitochondrial disease affects about 6,000 adults in the UK. In my constituency, four families—Bumstead, Cass, Bland and Mahmood—suffer from mitochondrial disease. Although every effort is being made to help them, there is no cure. For example, Lily Cass, who is in her 70s now, has five brothers and three sisters, and one brother who died at 56. They are all affected in different ways by mitochondrial diseases, and some more severely than others. Some days, Lily can hardly move due to lack of energy caused by her faulty mitochondria, which takes all her strength away. She has four children, including a daughter, who is likely to pass the disease on to her children. She worries about that all the time.

For those women and their families, the most important help we can offer is potential treatments, to prevent the next generation of patients from being affected. The opportunity to have their own children free of disease is something that the patients understandably want.

As with all such advances, it is right that the ethics are properly considered before techniques are adopted, and the Minister will be aware that concerns have been raised. There are those who argue that the techniques create children with three parents, but the embryo would carry only a small number of genes from the donor—just 13 out of 23,000, or 0.056% of the genetic material. How much of a parent is that? The function of the 13 genes is restricted to powering the mitochondria; they do not affect personal characteristics such as eye or hair colour, or behaviour.

Last June, the Nuffield Council on Bioethics produced a report that found that the technique would be an ethical treatment option for affected families, as long as research showed that treatment was likely to be safe and effective, and families were offered full information and support. The council’s report found that no strong cultural or social emphasis is generally placed on mitochondrial inheritance as a specific element of personal identity. Many of the social and biological aspects that typically imply a “parent”, and may be relevant in egg donation for reproduction, do not apply to mitochondrial donation. The council therefore suggested that if the treatments were made available, mitochondrial donors should not have the same status in regulation as reproductive egg donors.

[Mrs Mary Glindon (North Tyneside) (Lab)]

My hon. Friend makes a good case about the serious effects that the diseases resulting from the condition have on families. If we think forward to any children who are fortunate enough to be born without disease because of the treatment, would there be any possibility that they might consider themselves to have three parents, whether or not they had any traits from the third one? Has thought been given to how that would be considered if it should happen?

[Chi Onwurah]

My hon. Friend is right. There has been some debate about the status not only of the donors but, most importantly, of the children. The Nuffield Council on Bioethics says that families must be offered full information and support, and that must also apply to the children, so that they understand the scientific nature of the very limited gene inheritance from the donation.

If mitochondrial donors were not given the same status as reproductive egg donors, it would be not legally required for them to be identifiable to people born from their donations. The council concluded that the proposed treatments would be a form of gene therapy that would permanently cure the disease in future generations. Changes resulting from the replacement of mitochondrial DNA would be passed on not only to the resulting children, but to the descendants of any girls born from the techniques, via their eggs.

Dr Geoff Watts, who chaired the inquiry, said:

“We understand that some people concerned about the idea of germline therapies may fear that if such treatments for mitochondrial gene disorders were approved, a ‘slippery slope’ would be created towards comparable alterations to the nuclear genome.”

That is an understandable fear, but he went on to make a very important point:

“However, we are only talking about the use of these techniques in the clearly-defined situation of otherwise incurable mitochondrial disorders, under strict regulation.”

In 2012, the Human Fertilisation and Embryology Authority—HFEA—launched a public consultation on mitochondria replacement. It interviewed almost 1,000 people, and a further 1,800 completed questionnaires. It also organised public workshops around the UK and spoke to individuals affected by the diseases, to gauge their views. It published the results in March of this year, and found broad public support for the use of the technique.

The HFEA asked four main questions about attitudes to the gene treatment of mitochondrial diseases. When asked about attitudes to the selection of embryos based on testing, 65% of those questioned were positive or very positive, with only 8% negative. When asked about altering the genetic make-up of an egg or an embryo, 56% were positive or very positive and only 10% were negative. Attitudes to the use of genetic material from a third person showed that 44% were positive or very positive, with only 15% negative. The HFEA therefore advised the Government that there was broad support for mitochondrial replacement being made available to families at risk of passing on a serious mitochondrial disease. It also advised that if treatment were to be authorised by Parliament, it should be under certain conditions, such as its being available only in licensed clinics.

The HFEA recommendations have been widely welcomed by campaigners. For example, Dr Marita Pohlschmidt, director of research at the Muscular Dystrophy Campaign, said:

“We welcome this outcome. There is currently no effective treatment available for mitochondrial diseases, and at this time, prevention remains our strongest option. By taking forward research into pro nuclear IVF, we move towards giving women living with these devastating and unpredictable conditions the choice to bear their own unaffected children. This technique does involve a step into new scientific territory. But it is a calculated, specific step with the sole aim of preventing a potential fatal condition from being passed down to the next generation, where possible.”

We are now waiting for a decision from the Government about whether secondary legislation that will allow the techniques to be licensed for use in patients will be introduced in this parliamentary Session. It has taken years to get to this stage, and it is important that progress does not stall because families are waiting for this. Introducing regulations now will ensure there is no avoidable delay in the treatments reaching affected families once research is completed and the HFEA considers there to be sufficient evidence that the techniques are safe and effective.

I called this debate to hear an update from the Minister on the progress that she has made, and to ask when we can expect a decision, and when we can expect to see legislation.

Children’s Heart Surgery

Mary Glindon Excerpts

Wednesday 12th June 2013 Commons Chamber

[Mr Hunt]

I can confirm that a thorough process of learning the lessons will happen. As I said earlier, we must learn big lessons about the time it takes to make very important service changes in the NHS, not just in children’s heart surgery but in many other areas. We need to learn those lessons. The person who was responsible for the JCPCT, Sir Neil McKay, is no longer responsible and has retired from the NHS. We need to look at everyone who was involved in the process and see where the right calls were and were not made. If we do not, we will never be able to make important changes in the NHS—and we have a big responsibility to make those changes.

[Mrs Mary Glindon (North Tyneside) (Lab)]

The proposed reconfiguration of children’s heart surgery has gone on for years. Meanwhile, children are suffering and even dying. Why cannot the Secretary of State have a more rigorous timetable based on the lessons learned from the review so far?

[Mr Hunt]

That is what I absolutely want to do. One huge frustration for those on both sides of the House has been how the process has dragged on. If I could have come to the House today with a detailed timetable, I would have. Although we had internal access to the report before today while I considered its findings and reached a judgment, we believed that it was necessary for external stakeholders to see the report and give their view of how the timetable should proceed. That is why I have given NHS England until the end of July to come back with that timetable.

Oral Answers to Questions

Mary Glindon Excerpts

Tuesday 16th April 2013 Commons Chamber

[Mrs Mary Glindon (North Tyneside) (Lab)]

T5. Evidence from the all-party muscular dystrophy group’s inquiry into access to high-cost drugs for rare diseases has highlighted the importance in clinical trials of centres of excellence, such as the International Centre for Life, which is based in Newcastle. Will the Minister, with NHS North of England, meet me to discuss changes to specialist neuromuscular care in my area as a result of the new NHS set-up?

[The Minister of State, Department of Health (Norman Lamb)]

I am tempted to say no, but I would not get away with it—so, yes, of course the hon. Lady can join all the rest and arrange to meet me. I would be very happy to discuss her concerns. While I am at the Dispatch Box, may I pay tribute to the International Centre for Life, which does really important work?

Backbench business

Mary Glindon Excerpts

Thursday 14th February 2013 Westminster Hall

[Mrs Mary Glindon (North Tyneside) (Lab)]

It is a pleasure to speak in this debate under your chairmanship, Mrs Osborne. I, too, thank the Backbench Business Committee for allowing the debate. However, I particularly thank the hon. Member for Romsey and Southampton North (Caroline Nokes) for securing the debate. She and I are members of the all-party group on body image and, in calling for the debate, she has shown the commitment to, and concern about, the issue that demonstrate why she is deservedly the chair of our group.

Before I had decided to speak in the debate and while I was pondering whether I would be able to spare the time before returning to my constituency, I received a number of e-mails from people across the country, as I am sure other hon. Members did. One was from a young constituent of mine who is just 17 years old. This is why she asked me to attend the debate:

“Recently I have been having problems with my eating and raising awareness would mean people like me can get the help we need and feel less ashamed or judged. This issue is incredibly important to me and you showing your support on Thursday would really help…This serious mental illness is affecting someone you know right now in your constituency.”

What could be more compelling than that?

Today, I would like to be quite parochial and speak about services in the north-east. When looking on the internet to find out where these services were, I was quite concerned to find out how limited they are, but, fortunately, in the north-east we have a unique service; it is the only specialist provision outside hospital services in the north-east. The Northern Initiative on Women and Eating has worked in the area for 24 years; it is referred to as NIWE. Last year, according to its annual report, it helped 1,344 people with eating disorders. For the rest of my speech, I shall refer to them as people with eating distress, as NIWE feels that it is a more appropriate way to describe how people suffer when they have problems with eating. It has also helped 141 carers and supporters of people with eating distress and 636 professions have called on its expertise.

As has been said, 1.6 million people in the UK have eating distress, more than 90% of whom are women, and an increasing number of men are now affected. The figures include only those who are in-patients in NHS treatment, and therefore leave out people who have not come forward or have not been diagnosed and those who are receiving private treatment or being treated as out-patients or in the community. Eating distress is a general term with which people are more comfortable. It covers those diagnosed with conditions such as bulimia, anorexia, eating disorders not otherwise specified and binge eating. Problematic eating habits seriously interfere with people’s lives, as hon. Members have pointed out.

Some people have not even shared their disorders with others. The high levels of stigma have already been pointed out. When people have eating disorders, it often goes unreported to GPs or other medical services, owing to shame and the fear that people’s futures could be jeopardised if anything were recorded in health records. That fear needs to be removed. Sometimes people have lived with eating issues for many years, managing in secret and suffering in silence.

Under-reporting is exacerbated because many eating issues are due to a fundamental lack of self-esteem, which can be brought on by bullying or abuse. They are difficult to diagnose medically and not all GPs have enough specialist knowledge, as we have learnt this afternoon. I do not apologise for repeating some things that have already been said; I do not think we can say enough about what the issues are and how they affect the lives of sufferers.

Eating distress carries the highest mortality rate of any mental illness. During the past two years, hospital admissions in the north-east for eating distress have risen by 16%, compared with 8% for all other admissions. Unfortunately, the figures also show that the highest rates are in the north-east. Overeating is increasing, and the serious long-term health risks of obesity are being highlighted.

Of those on NIWE’s waiting list for support and help, 10% are from my constituency and the wider North Tyneside borough. I would like to thank it for helping people from north Tyneside, who, over the past two years, made up 25% of its attendees. Of the people with whom NIWE works, 61% are under 30. NIWE was keen to stress, as was my constituent, that there is a greater chance of recovery with early intervention. Sadly, NIWE also tells us that 70 people are on its waiting list for group therapy. Waiting times are too long, but it simply lacks the capacity to address the issue further, and every day it receives new names.

There is particular concern in the north-east from NIWE and public health leaders over the growing numbers of young people in the north-east, due to the student groups, who are at risk. We have a number of universities. Although NIWE is supported by North Tyneside, Newcastle and Gateshead primary care trusts and Newcastle council, and receives funding from charities, such as the Northern Rock Foundation, it operates on a shoestring.

Many treatments target core eating disorder pathology, primarily weight restoration, but there is a need to look at efficacy and effectiveness in minimising harm and reducing the personal and social costs of chronic illness. NIWE has therapy groups, which are proving successful, that address the underlying determinants of eating distress, but I have to keep returning to the fact that it is underfunded. NIWE has found that people from across the area who are recovering from an eating disorder want recovery groups to be set up, because they help them to progress and maintain their recovery, which must be the ultimate aim of anyone who comes forward to address a problem. The Stay Well group helps such people, but NIWE is, again, trying to raise more funds to support that vital service. It tells me that, as I think we all know, such services need more provision and we need more to be spent on recovery, because, sadly, there is a high relapse rate and many people go through a revolving door. It makes sense to invest in support for people in recovery, because bed rates for those with eating distress are between £450 and £750 a day. In terms of economics, the Government should look at supporting people in recovery.

Support for families and friends who are carers and supporters is important. There are effective family-based interventions. NIWE offers an initial listening and signposting service to under-18s and their families, but it wants to do more. I know that I am pleading for NIWE, but I am sure that those here today know of many other organisations in a similar situation, with the ability, but simply not the capacity, to help. People call NIWE wanting an appointment or asking for other services, but it finds that need far outstrips capacity.

I mentioned that eating distress is becoming more common among the male population and minority groups, including the transgender community. NIWE has been able to introduce some support for young men and others who come to it, but a lot more work needs to be done. Before I make a plea to the Minister on what needs to be done, I shall pay tribute to NIWE’s work by quoting some users of its service. One person said:

“NIWE has saved my life and is trying to help me make sense of it.”

Others said:

“I think this is an unbelievably amazing service. The counsellors in the session were brilliant. I just wish there were more of you out there for all the people still struggling.”

“A relaxed and non-critical atmosphere which enabled me to speak…without feeling isolated.”

There are more quotes, but those demonstrate how organisations such as this are critical and why they need full recognition and support in the health service.

Raising awareness of serious mental health issues and the profile of services is always crucial. With so much pressure on clinical commissioning groups in their new role, specialist non-acute services are in danger of flying under the radar and losing out in commissioning plans. Mental health services are often poor relations when it comes to health funding pots. Acute eating disorder services will be funded through specialised commissioning frameworks, and will often be large regional services remote from many of their users. Small local services, especially ones focusing on early intervention, are therefore vital, but there is a great risk that such services will not be commissioned.

As has already been mentioned, we need a comprehensive awareness-raising programme in schools and youth services. Organisations such as NIWE try to provide that, but much more is needed—more training for professionals and, above all, more money for services, such as NIWE, and more support and acknowledgment. I make a plea to the Government that, following this debate, they will help groups, such as NIWE, that are doing so fantastic and fundamental a job for our communities.

Oral Answers to Questions

Mary Glindon Excerpts

Tuesday 15th January 2013 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

My hon. Friend and I have previously discussed this matter, and she is right to highlight that there are particular challenges to address in rural areas, in terms of both distances to travel and an ageing population requiring considerable health care resources. That will of course be a matter for the NHS Commissioning Board to examine when it considers future funding allocations.

[Mrs Mary Glindon (North Tyneside) (Lab)]

T6. As one in three women who get cancer are over the age of 70, can the Minister say when the newly launched Be Clear on Cancer campaign will be rolled out nationally?

[Mr Hunt]

It is our intention to roll it out nationally as soon as possible, and I will make sure that the hon. Lady gets the exact details.

Oral Answers to Questions

Mary Glindon Excerpts

Tuesday 23rd October 2012 Commons Chamber

[Mr Hunt]

I agree with my hon. Friend that the purpose of the changes that the coalition Government have brought to the NHS is to tap into local innovation, ideas and ambitions to transform services, and it is important that no changes undermine that. He should take comfort from the fact that my predecessor introduced clear tests for any major reconfigurations, including that they should be strongly supported by local doctors, that the public should be involved in any consultation, that the changes should improve patient choice and that there should be clear evidence of benefits to patients. I hope that that gives him and his constituents some reassurance.

[Mrs Mary Glindon (North Tyneside) (Lab)]

3. What his policy is on upholding national pay arrangements in the NHS.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

NHS trusts and foundation trusts have the freedom to determine the terms and conditions of the staff they employ. As the hon. Lady will be aware, the “Agenda for Change” was negotiated and brought in during 2004 by the then Secretary of State, John Reid, to agree a national framework for pay in the NHS. In general, most trusts support the agreed pay framework and the “Agenda for Change”, and they are likely to continue to use national terms, provided they remain affordable and fit for purpose.

[Mrs Glindon]

In fairness, a truly national health service demands a national pay scheme, and the British Medical Association has warned that the move to regional pay undermines the ethos of “national” in our national health service. How does the Minister intend to act on that warning?

[Dr Poulter]

I remind the hon. Lady that it was the previous Government who set up the current national pay framework in 2004, and that framework has been amended 20 times to support employers over that period. The previous Government gave foundation trusts the freedom to amend those pay terms and conditions. Regional pay does exist in the NHS. On the basis of what she has said, does the hon. Lady wish to remove the London weighting for those workers who live in London? I am sure she would not want to do that because we recognise that it is more expensive to live in certain parts of the country, and workers should be rewarded for that.

Oral Answers to Questions

Mary Glindon Excerpts

Tuesday 17th July 2012 Commons Chamber

[Mr Lansley]

It is staggering, isn’t it? In 2010-11, the NHS budget was set by the right hon. Gentleman, not by us. The final accounts for 2011-12 will not be published until the autumn. I wish he would just get up at the Dispatch Box and admit that over the course of this Parliament the coalition Government will increase the NHS budget in England by 1.8% in real terms, which is £12.5 billion in cash, whereas the Wales Audit Office has said that a Labour Government in Wales will cut the NHS budget over the same period by 10% in real terms.

[Mrs Mary Glindon (North Tyneside) (Lab)]

2. What steps he is taking to bring forward legislative proposals on the funding of social care.

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

15. What steps he is taking to bring forward legislative proposals on the funding of social care.

[The Minister of State, Department of Health (Paul Burstow)]

The draft Care and Support Bill contains clauses that support our commitment to introduce a universal deferred payments scheme and a national eligibility threshold. We have set out our intention to base a new funding model on the principles of the Dilnot commission model and we will take a decision in the next spending review.

[Mrs Glindon]

Last week the Secretary of State dismissed the concerns of Labour MPs about councils being hard pressed to find funds to implement any of the proposals. The Local Government Association stated that there was no money. Will the Minister now commit to legislation in this Parliament to sort out the funding of social care at local level?

[Paul Burstow]

It does not need legislation to sort out the amount of money that goes into social services; it does need legislation, however, to put in place a universal deferred payments scheme. We have made it clear that we will fully fund the commitment that we have already announced and we will work with the Local Government Association and others on its detailed design and implementation.

--- Later in debate ---

[The Minister of State, Department of Health (Mr Simon Burns)]

I am grateful to the right hon. Gentleman for that question. As he knows, any proposals for service changes will be subject to the Secretary of State’s four tests and a full three-month public consultation across south-west London, which I am sure the right hon. Gentleman and his constituents will take part in. My right hon. Friend the Secretary of State will be more than happy to meet him to discuss the matter further.

[Mrs Mary Glindon (North Tyneside) (Lab)]

T8. In the north-east region, there is one neuromuscular care adviser providing dedicated specialist care and support for more than 3,000 people with muscular dystrophy and associated conditions. Will the Minister give assurances that care advisers will continue to be funded and commissioned at specialist NHS Commissioning Board level so that they can carry on supporting community teams across the country?

[Mr Burns]

I give the hon. Lady that assurance. Specialised commissioning will be carried out through the NHS Commissioning Board.