Oral Answers to Questions

Paul Burstow Excerpts

Tuesday 7th September 2010 Commons Chamber

[Emma Reynolds (Wolverhampton North East) (Lab)]

2. What account he took of arrangements for the provision of mental health services in developing his proposals for GP commissioning.

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

GPs play a crucial role in co-ordinating patient care and committing NHS resources through daily clinical decisions. Our new model of commissioning builds on the regular contact that GPs have with patients and their understanding of patients’ wider health care needs. Our proposals will create an effective dialogue across all health and social care, with professionals putting in place the conditions for a more integrated and personalised approach to both physical and mental health.

[Emma Reynolds]

I thank the Minister for his answer. According to a recent survey by the leading mental health charity Rethink, 58% of GPs questioned said that they did not feel they had the level of expertise required to commission mental health services. Given that, what specific measures will the Government take to ensure that GPs have the skills and expertise needed to commission those highly specialised services?

[Mr Burstow]

I do not accept that that is the case, and from the consultation and engagement that the Department and I have already had with GPs and others, it is quite clear that there is huge enthusiasm for the reforms that we propose in the White Paper and a real desire both to see patients put at the heart of the NHS and for GPs to have real control over commissioning again, to ensure that services really meet patients’ needs. When it comes to specialist commissioning, we have said in the White Paper that there will be opportunities for charities, other providers and local authorities to access support to harness those skills.

[Mr Stewart Jackson (Peterborough) (Con)]

Parnwell, in the east of Peterborough, which has specific health needs, faces the loss of its current single general practitioner upon his retirement at the end of October. Can the Minister confirm that there is no necessity to remove single practitioner GP facilities, and that they can be incorporated into the new GP commissioning system as we go forward?

[Mr Burstow]

I am very happy to give that confirmation.

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

It is of great concern that medical charities such as Rethink tell us that most GPs that they have surveyed feel that they lack the expertise needed to commission mental health services, and also that campaigning groups such as the Muscular Dystrophy Campaign feel that GPs have too little knowledge of muscle wasting conditions to commission services for their patients. Given Government plans to hand commissioning over to GPs, to abolish primary care trusts and, according to the White Paper, to reduce the role of the Department of Health in training, can the Minister say more to the House about how the considerable shortfall in expertise in commissioning services will be tackled over the next year or two?

[Mr Burstow]

It is perhaps worth noting that the Select Committee on Health, when there was a Labour majority on it before the election, back in March, identified significant weaknesses in PCT commissioning. In particular, it identified the lack of clinical input. Our White Paper puts that clinical input back into commissioning. When one considers that one in four of all consultations involve mental health problems and that 90% of all mental health care is delivered in primary care settings, one sees that putting the GP right at the centre is critical to better outcomes.

[Dr John Pugh (Southport) (LD)]

On the subject of consultation, what consultations have taken place with the mental health charities, either prior or subsequent to the proposals?

[Mr Burstow]

In July, I and the Secretary of State had a successful and long engagement with all the mental health charities, and we are continuing to have a dialogue with them.

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

3. What estimate he has made of the number of redundancies which would result from the abolition of strategic health authorities and primary care trusts?

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[Keith Vaz (Leicester East) (Lab)]

9. What steps his Department is taking to inform young people about diabetes prevention.

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

I thank the right hon. Gentleman for his question, and for his tireless campaigning to raise awareness of diabetes. We know that being physically active and maintaining a healthy weight can reduce an individual’s risk of developing type 2 diabetes and cardiovascular disease. Our approach is to support families and young people to eat healthily and be physically active.

[Keith Vaz]

I thank the Minister for his comments. I declare an interest as one who has type 2 diabetes. As he knows, we spend £1 million an hour treating diabetes-related illnesses, and more and more people are now being diagnosed at a much younger age. What steps are the Government taking to alert parents and young people to the perils of diabetes?

[Mr Burstow]

The right hon. Gentleman is absolutely right to draw our attention to the rising rate of diabetes in our country. When it comes to diabetes in children, we have to bear in mind that the diagnosis for type 1 diabetes—which affects about 23,000 children in this country—is a genetically predisposed condition that cannot easily be prevented. We need to do more about type 2 diabetes, however, by tackling the obesity problems in this country. We need to deliver physical and healthy eating programmes through schools and other partners, and those things are much better done in the context of the local authorities, which will now have a new responsibility for public health that the last Government never gave them.

[Mr Adrian Sanders (Torbay) (LD)]

Information and education are also important for people with the condition of diabetes, to help them to get the maximum benefit from their prescribed course of treatment. May I urge the Minister to make an assessment of the improvements to health that education and information can contribute?

[Mr Burstow]

My hon. Friend makes a good point about the value of information in empowering patients, and about the value of education. That is why we want to do more with NHS information prescriptions, which is an important tool, and to ensure that the care planning process that delivers tailored care plans also includes structured education. There is no doubt that providing education really does make a difference to the outcomes for people with diabetes.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his response to the question. I also wish to declare an interest as a type 2 diabetic. The junk food culture of the moment is a serious problem, so what steps is the Minister taking to address that in his effort to reduce the number of people being diagnosed as diabetic over the next year?

[Mr Burstow]

The best way of responding to the hon. Gentleman’s very appropriate question is to say that we are taking a four-pronged approach to diabetes. First, we need to tackle the causes of the condition through a renewed impetus on public health. We shall announce more of our plans in our White Paper later this autumn. Secondly, we need earlier identification and diagnosis so that we can help people to manage their condition at an earlier stage so that it does not progress. Thirdly, we need effective management and self-directed care. Finally, we need world-class research so that we can better understand the condition and deliver better treatments.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

10. What steps he is taking to ensure the adequacy of resources allocated to hospital accident and emergency departments.

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[Mr John Baron (Basildon and Billericay) (Con)]

13. What recent representations he has received on the proposed one-year cancer survival measure.

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

I have received many helpful representations on the proposed one-year survival measure, including his own when I met him along with a number of leading cancer charities in July. We have launched a full public consultation to shape the first ever outcomes framework for the NHS, and I urge all interested parties to contribute. The consultation document has put forward a range of possible outcome measures, including a one-year cancer survival rate that could be included in the framework. A full response to the consultation will be provided when it closes on 11 October.

[Mr Baron]

The one-year cancer survival measure is welcome, because it will encourage earlier diagnosis. As the Minister will know, however, under-treatment of the elderly in the NHS remains a pressing problem, which was highlighted in a recent report on cancer inequalities by the all-party parliamentary group on cancer. Can he assure us that the over-75s will not be excluded from the one-year or the five-year cancer survival measures once they are constructed?

[Mr Burstow]

The hon. Gentleman makes an important point. It is essential for us to ensure that the NHS delivers treatments that are both based on evidence and age-appropriate, which means ensuring that older people receive treatments that will enable them to survive cancers. His representations will need to be taken fully into account as we consider the results of the consultation on the outcomes framework.

[Chris Leslie (Nottingham East) (Lab/Co-op)]

Has the Minister seen today’s report from Cancer Research UK? It suggests that many primary care trusts and hospitals focus on drug therapy, and that radiotherapy—particularly targeted and image-guided radiotherapy—is often not given enough priority. Can the Minister assure us that, when considering cancer drugs expenditure, he will give equal priority to radiotherapy treatment?

[Mr Burstow]

The hon. Gentleman’s question is also relevant to surgery, but Cancer Research UK was right to produce this snapshot of the lamentable record of the last Government on access to radiotherapy. Spending on the NHS has now reached European levels, but we have not seen an equivalent achievement in terms of outcomes. That is why the present Government have been consulting on outcomes, and why we have asked Mike Richards, clinical director for cancer services, to examine these very issues in his review of the cancer reform strategy.

[Gordon Birtwistle (Burnley) (LD)]

14. What steps his Department takes to ensure that local NHS trusts observe its guidelines on reconfigurations involving transfer of facilities from one hospital to another.

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[Anna Soubry (Broxtowe) (Con)]

15. What mechanisms are in place to assess the effectiveness of assertive outreach teams in providing support for people with severe mental illness; and if he will make a statement.

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

The Department of Health has issued guidance on the key components of an effective assertive outreach team. It is for each local trust to put in place robust quality assurance arrangements to ensure that it delivers the high-quality and effective service that the public expect. That is further underpinned by the work of the Care Quality Commission.

[Anna Soubry]

I am grateful to the Minister for his response. One of my constituents, William Barnard, who was profoundly mentally ill, went on to kill his grandfather as a result of the poor system that was operating in relation to his care. What progress has been made in ensuring that other teams do not suffer from the same failings in their systems?

[Mr Burstow]

The hon. Lady and I debated this issue in the Chamber back in July. One of the most concerning aspects of the case of William Barnard was a singular failure to listen to the concerns expressed by family members and carers on the part of those who could have taken the necessary action to improve matters. I continue to take a close interest in the investigations being undertaken by the local NHS. We want to ensure that when lessons can be learned nationally, they are reflected in the Government’s forthcoming mental health policies.

[Miss Anne Begg (Aberdeen South) (Lab)]

Have the Minister or others in his Department had any discussions with the Department for Work and Pensions, because in the coming months a large number of people with mental health problems will be called in for interview to be reassessed from incapacity benefit on to employment and support allowance? This is already causing a great deal of anxiety among my constituents because Aberdeen is one of the trial areas. I wonder whether any of the mental health professionals have been informed and are ready for the influx that might result from that change in policy.

[Mr Burstow]

There are several parts to that question. First, we have already made commitments to invest in talking therapies, which are improving hugely the quality of lives of many people with mental health conditions. Secondly, I and departmental officials have had meetings with colleagues in the DWP, and I will have further meetings shortly, particularly to discuss the DWP input into a cross-Government mental health strategy.

[Andrea Leadsom (South Northamptonshire) (Con)]

16. What recent representations he has received on requirements for doctors to record the primary cause of death on a death certificate.