Oral Answers to Questions Debate
Full Debate: Read Full DebatePaul Burstow
Main Page: Paul Burstow (Liberal Democrat - Sutton and Cheam)Department Debates - View all Paul Burstow's debates with the Department of Health and Social Care
(13 years, 10 months ago)
Commons ChamberWe published “Improving Outcomes: A Strategy for Cancer” on 12 January, which sets out a range of actions to improve cancer outcomes, including diagnosing cancer earlier, helping people to live healthier lives to reduce preventable cancers, screening more people, introducing new screening programmes, and ensuring that all patients have access to the best possible treatment, care and support. Through those approaches, we aim to save at least an additional 5,000 lives every year by 2014-15.
May I raise the case of my constituent, Suzanne Lloyd, who was diagnosed with breast cancer a decade ago? She was told that she had two years to live, but has successfully battled cancer for the last decade. The problem is that she has also been battling health chiefs to give her the drugs that she needs to extend her life. Will the Minister tell the House about measures to increase longevity through greater drug access?
Just last year the national clinical director published a report on the extent and causes of international variations in drug usage, which revealed that the UK tends to lag behind other countries in its use of newer cancer drugs. That is one reason why we have introduced the interim cancer drugs fund of £50 million in this current year and will introduce the full fund of £200 million from this April. That will help my hon. Friend’s constituent.
What steps is my hon. Friend taking to ensure that all GP consortia will have access to the expertise they need to commission cancer services effectively?
The national cancer director will work with pathfinder GP consortia on commissioning cancer services, and that work will be fed into a cancer commissioning support pack that will be developed to support GP commissioners in discharging their functions effectively. Cancer networks will also be well placed to support GP consortia in that activity.
We all agree that properly evaluated, appropriately prescribed drugs make a big difference to survival, which is why patients welcome what was described as the additional special fund, of which Ministers made mention this afternoon, of £200 million for the coming two years. Why is it, therefore, that the budget for Sheffield has been top-sliced for next year to the tune of £1.5 million to pay towards this £200 million, which was supposed to be additional—to add to and not subtract from—what was available through GP commissioning?
The NHS has real-terms increases in its resources, and those resources are going into the programme that we outlined in our outcome strategy. Three quarters of a billion pounds will be going into that programme to deliver improvements in cancer services and the £200 million, being extra, will go into improving cancer services. That is the commitment that the Government have made and that is the investment that we will make.
Is the Minister listening when Macmillan warns that the proposed changes to the NHS risk us losing expertise in the cancer networks? If that happens, Macmillan says that
“cancer treatment will get worse…some treatments could even collapse in parts of the country…more patients could die earlier”.
As the Minister in charge of cancer services, should not he be on the side of cancer patients, not backing his boss’s reckless reforms?
The last comment was pretty cheap, and no Government Member has suggested that the future of the cancer networks is in doubt. Indeed, in the coming financial year, the funding is secure. As we move to the new arrangements, it will be for the NHS commissioning board to decide the appropriate arrangements for commissioning in the future. We are clear that the expertise of those groups could, should and will continue to be used to support commissioning in the future.
4. What steps he is taking to improve co-ordination of social care and health care for the benefit of patients.
We have set out in the White Paper “Equity and Excellence: Liberating the NHS” and the Health and Social Care Bill how we will deliver the coalition programme for Government commitment to promote greater integrated working. This includes local authorities taking the lead role in the future in joining up local NHS services, social care and health improvement via council-led health and well-being boards.
Can my hon. Friend assure me that there will be a joined-up approach when addressing patients’ interests and complaints when they straddle social care? Perhaps a single point of contact for a complaint would be a good step forward from what we have now.
My hon. Friend is right to draw attention to the need to integrate not only the way in which we deliver and plan services, but the way in which we manage complaints. That is why the Government have included in the Bill our proposals for the establishment of local healthwatch and healthwatch England. Local healthwatch will have the ability to deal with complaints and also have the capacity to refer concerns about services to the Care Quality Commission so that it can take the necessary steps to investigate. In that way, we will deliver a more integrated system for dealing with such complaints.
Is the Minister aware that most of us are in favour of much better co-ordination of these services, but we worry about the backdrop of the reforms? In Yorkshire, some doctors are saying, “Come on, guys, this is a bonanza and we will all be California-style millionaires under these reforms.” What sort of a backdrop is that for health care reforms and better co-ordination of services?
The backdrop that the hon. Gentleman has just painted is a rather thin one. In fact, it does not exist at all. The Government set out in the Bill we published last week that there will be clear responsibilities on GP commissioning consortia, working in partnership with their colleagues in local government, to commission services in ways that will improve quality of life for people in his constituency, my constituency and the constituencies of all hon. Members.
Does my hon. Friend agree that improved co-ordination between health and social care is fundamental to the delivery of the efficiency challenge faced by the health service and social services? Does he further agree that the £1 billion provided by the health service to reinforce that relationship is an important step taken by the Government to reinforce that interface? Can he assure the House that, as we move into the new world, the existing arrangements for good practice across that interface will be preserved?
Order. I know that three questions will attract one answer from the Minister.
The answer to all those questions is yes. The right hon. Gentleman is right to draw attention to the additional money going into social care via the NHS. It is intended to kick-start the collaborative working that was often so absent under the previous Administration.
The care that someone gets can be defined as either “social care” or “health care”, and that can determine the benefits to which an individual is entitled. With that in mind, what conversations has the Minister had with the Minister with responsibility for disabled people about the Government’s proposal to withdraw mobility disability living allowance from those staying in residential care?
I and the Minister responsible for disability issues in the Department for Work and Pensions meet regularly. In fact, a further meeting on this and other matters is coming up shortly.
5. What recent steps he has taken to reduce levels of alcohol misuse among young people.
9. What assessment he has made of the effectiveness of video link medical consultations in prisons.
The Department has made no assessment. PCTs and prison partnerships may consider using telemedicine as an alternative to hospital appointments for offenders, after considering any security issues and the benefits for improved health care. Decisions about treatments for offenders, including video link consultations, are made by local commissioners.
Red Embedded Design, an SME technology company in my constituency, is working in partnership with Airedale NHS Foundation Trust to enable video link medical consultations to take place in prisons. May I suggest that the Minister look closely at this scheme, which has been rolled out in a number of prisons? He will see the cost benefits and the lack of risk of absconding involved. Will he encourage other PCTs around the country to introduce the system in their prisons?
As part of a wider programme, a demonstrator project looking at telemedicine and telecare, we are looking at a possible roll-out of such approaches. In regard to the specific case of the Airedale NHS Foundation Trust, I would be only too happy to look further at the details and the benefits that have arisen.
Telemedicine is obviously a help, but nothing beats talking to a real human being about our medical problems. Would the ministerial team consider copying the Conservative-Liberal Government in Sweden, who have banned from all public agencies, including health agencies, automatic answering machines—the kind that tell us to “Press 1”, “Press 2” or “Press 3”? Instead, people calling those agencies have to speak to a real live Swede in Sweden. Would not that be a good step forward for our health service?
The right hon. Gentleman has found a cunning way of getting in a point that does not directly relate to the question. He makes a very fair point, however. It is important that people should feel confident that, when they pick up the phone and make a call, they can speak to a person. Telemedicine can provide that route as well, through allowing people to get a diagnosis and treatment, as well as access to the appropriate support at the right time.
12. If he will take steps to increase the availability of the BCG vaccine for children.
T2. Some care homes that have received critical reports from the Care Quality Commission are reopening under the same management but with different names. The CQC’s practice is to remove earlier poor reports from its website, leaving potential customers in the dark about the poor record of those homes. Will the Minister remind the CQC of its responsibility to highlight poor practice in care homes, and request that it change its practice?
I will certainly ensure that the CQC understands that that is a matter of concern. When it discharges home owners and deregisters them, after receiving an application for a fresh registration, it conducts a thorough appraisal and assessment of their fitness to provide the service. The new owner of a home may well have done a great deal of work in improving the quality of training given to staff, but I agree that it ought to be possible for people to look at the CQC’s website and see reports on the quality of the previous provider so that they can assess that as well.
T5. A year ago, writing in The Sun, the Prime Minister made a firm and passionate pledge to increase the number of midwives by 3,000. Last week, the chief executive of the NHS told the Public Accounts Committee that the NHS is now short by 4,500 midwives. Will the Secretary of State tell the House when he intends to implement plans to honour the Prime Minister’s pledge—or can we take it that it is just another Conservative broken promise on the NHS?
T10. What does the Minister think is the likelihood of the pathfinder consortia examining commissioning arrangements for neurological conditions? This is particularly important, because conditions such as Parkinson’s are not familiar to many general practitioners, and commissioning arrangements for these complex conditions are tricky, so they need specialist knowledge. They need to be getting expert support and advice, including from patients and third sector groups.
The hon. Gentleman makes some important points about how the new system provides the opportunity to access a range of new resources to develop the way in which commissioning is provided for people with neurological conditions. Not the least of these are the way in which the Neurological Alliance is working to provide a new structure for its way of operating at the local level to offer commissioning support and, from the Department, how the neurological commissioning support group will be able to work with early implementers of the health and well-being boards and pathfinder GP consortia to provide them with the necessary support to develop their capability in this area.
The Minister of State referred earlier to Labour Members cherry-picking quotes, but I do not believe that Laurence Buckman, chair of the British Medical Association’s GP committee, was mincing his words when today he described the Government’s reorganisation plans as “fatally flawed”, warning that they
“would see the poor, elderly, infirm and terminally ill in large parts of the country losing out”.
Why does the Secretary of State believe that he knows better than Dr Buckman?