North Tees and Hartlepool NHS Foundation Trust

John Bercow Excerpts

Monday 5th July 2010 Commons Chamber

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

I congratulate my hon. Friend the Member for Stockton South— [Interruption.] I am sorry—we will get that one next time. I congratulate my hon. Friend the Member for Stockton North (Alex Cunningham) on securing this debate. People in my constituency and the five others that were to have been served by this new hospital need to know why this project was cancelled when three other schemes elsewhere in the country were approved. The Minister is being coy in his written answers to questions, but we really need answers. The need remains. Issues of health inequality need to be addressed. I want to place it on record that south Easington, which would be served by this new hospital, is one of the most deprived communities in the United Kingdom, as identified by the indices of multiple deprivation. Health inequalities still play a significant role in determining life expectancy and quality of life. Health inequalities remain a big issue: they are inequalities not just in terms of outcomes but in access to health care resources—

[Mr Speaker]

Order. May I say very gently to new Members, whose passion for this subject I respect, that although the hon. Member for Stockton North (Alex Cunningham) is showing great forbearance there is a difference between a speech and a short intervention?

[Alex Cunningham]

Mr Speaker, I agree with the long intervention and the facts laid out by my hon. Friend the Member for Easington (Grahame M. Morris).

In Stockton-on-Tees, just over a quarter of residents live in some of the most deprived areas of England. Early deaths from heart disease and stroke and from cancer are higher than the England average. Inequalities are starkly demonstrated by the fact that a man living in one of the least deprived areas of Stockton can expect to live just over 10 years longer than a man living in one of the most deprived areas.

Since 1997, however, early death rates from heart disease and stroke have fallen markedly and early death rates from cancer have also fallen, albeit more slowly. We have also seen a narrowing in the gap between our area and the rest of the country. Things are improving for my constituents, and my concern is that the coalition’s decision will see a halt to and possibly even a reversal in these positive outcomes. The NHS is too important to be turned into a party political football, however. Those listening to this debate back in the north-east this evening do not want to hear us point scoring. I have heard you say yourself, Mr Speaker, that that is the sort of behaviour that turns people off politics and politicians.

I wholeheartedly welcome the commitment shown by the Prime Minister and his party to the NHS, and I would like to draw the attention of hon. Members to a statement that he made during the election campaign. He said:

“The test of a good society is you look after the elderly, the frail, the vulnerable, the poorest in our society. And that test is even more important in difficult times, when difficult decisions have to be taken, than it is in better times.”

I could not agree more with the Prime Minister’s statement, but I fear that his words are not being followed by his actions. As we all know, it is all too easy to make promises in politics. The real test is whether we stand by our word once the votes have been counted.

During the election campaign, the Conservative party claimed that it was now the party of the NHS. I doubt very much that people who went to the ballot box on 6 May and put a cross next to the name of their Conservative candidate thought that the right hon. Member for Witney (Mr Cameron) would be authorising the cancellation of a long-awaited new hospital just weeks later. We all acknowledge that cuts have to be made to reduce the deficit, but this is a much needed front-line service, and I will not stand by and let this project disappear without a fight.

Of course, 6 May gave us not a Conservative Government but a Liberal Democrat and Conservative coalition, so I urge Members to refer to the document “The Coalition: our programme for government”, which states:

“We are committed to the continuous improvement of the quality of services to patients.”

Again, I warmly welcome that statement, but I fear that when push comes to shove, it will mean very little to my constituents and those in neighbouring areas. This coalition seems intent on cutting spending without fully realising the human cost of the cuts. This decision is a backward step for the communities that would have been served by the new hospital, and it does not tally with the Prime Minister’s claim that the Conservatives are now the party of the NHS or with the coalition’s document.

Since the announcement on 17 June, I and other Labour Members have met the chair and chief executive of North Tees and Hartlepool NHS Foundation Trust. They are understandably extremely disappointed that, after the many years of hard work creating and fine-tuning the plans for the future of health services in our region, those plans have been sent back to the drawing board. It is not only the foundation trust that is unhappy with the decision: on Saturday 26 June, other Members and I attended a rally in Hartlepool to highlight local opposition to the decision, which grows by the day.

I have also received encouraging support for early-day motion 273, which asks for a review of the coalition’s decision. To date, it has received 42 signatures—regrettably, only from Members on this side of the House. I hope that it will not only be Labour Members arguing this evening that their constituents should not lose out after waiting so long for an agreement on the future of health care in our area.

One of the key questions that I hope the Minister will answer this evening is why this particular project has been scrapped. The Chief Secretary to the Treasury said in his statement to the House that his decision to cut £2 billion of public spending, including on our new hospital, was guided by a principle of fairness. At the moment, we feel as though we have been subject to an arbitrary decision. I have yet to hear any persuasive argument as to why people in the north-east have had their new hospital withdrawn while schemes such as the Royal Liverpool hospital, the Pennine acute hospital and the Epsom and St Helier hospital are going ahead. What advice did the Minister receive from his Department that led to the conclusion that the North Tees and Hartlepool project did not represent value for money, compared with the other projects?

The Chief Secretary to the Treasury told the House on 17 June that our new hospital was

“assessed against a number of other major build projects that were at the same stage of development; those schemes are more urgent.”—[Official Report, 17 June 2010; Vol. 511, c. 1051.]

I would appreciate a little more clarity from the Minister about what was meant by that statement, and I request that he publish the criteria used and the detailed comparisons carried out against the project. The North Tees and Hartlepool project was, according to my right hon. Friend the Member for Leigh (Andy Burnham), the top priority for the NHS. We would like to know why it has slipped down and out of the queue.

In answer to my question on 29 June about the strategy developed by the foundation trust, the Secretary of State for Health did not rule out other ways of making our new hospital happen. I noted that he said it needed to fit his new criteria and that the trust should not ask the Department of Health to meet the whole capital cost of whatever it proposes. Does that mean that some funding could be made available and the balance raised by the trust using its existing powers?

I urge the coalition to work with Members on the Opposition Benches as well as with the foundation trust to look at new and innovative ways of funding the project and ensuring that local people are not left behind. Will the Minister confirm that more time invested in developing a new solution to fund the new hospital will not be a waste of time, and that he and his coalition partners have not set themselves against any new hospital in our part of the country?

If we do not find a solution and build a new hospital, what will happen? The chief executive of the North Tees and Hartlepool NHS Foundation Trust has publicly acknowledged that there is a chance that Hartlepool hospital could close, whether or not a new hospital goes ahead. I know that my hon. Friend the Member for Hartlepool (Mr Wright)is extremely anxious about that. We could end up with one hospital. I want it to be a new one.

There is much more at stake than just health care and a new hospital. The location for the hospital was Wynyard park, a 700 acre high-end mixed-use development accommodating residential and business properties.

Oral Answers to Questions

John Bercow Excerpts

Tuesday 29th June 2010 Commons Chamber

[Mr Burns]

I am extremely grateful to my right hon. Friend, who is absolutely right, and I can give him the categorical assurances he is seeking, but I would also like to add one more: we need information to empower patients, because if patients are going to be at the heart of the NHS they must have the information to take the decisions that are important to their health care.

[Mr Speaker]

Order. May I gently ask the Minister to face the House? I am sure that Opposition Members will want to see his face.

[Andy Burnham (Leigh) (Lab)]

We do, Mr Speaker, very much; we want to see him squirm.

First, let me say that we welcome the Minister back to the Department of Health; he was a Minister in the Department 13 years ago. As I have said before, we trust that he finds the NHS in much better condition than when he left office. Last week we had an independent verdict on those 13 years. The independent and respected Commonwealth Fund said that the NHS was one of the best health care systems in the world, and, indeed, that it was top on efficiency: a ringing endorsement of Labour’s stewardship of the national health service. That verdict reflects the huge progress on waiting times that has been made over those 13 years. So does not the abolition of the 18-week target, which the Minister announced last week, put all that progress at risk? Will he today give us a straight answer to this question: can he guarantee that waiting times will not rise, and that patients will still be treated within 18 weeks?

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[Mr Speaker]

Order. I hope that the hon. Gentleman will apply the ingenuity required to stay within the terms of a question relating to Chesterfield.

[Sir Paul Beresford]

Thank you, Mr Speaker. Given my declared interest, it was too great a temptation not to contribute.

Does my hon. Friend not agree that for dentists, the biggest disincentive to providing an NHS service in Chesterfield—and, in fact, in the rest of England too—is the contract that she just mentioned, with its targets, its “units of dental activity”, its clawbacks and so on? Will she ensure that any new system that she introduces enables and encourages dentists to offer a choice between national health and private dentistry, thus encouraging those who have opted out to opt back in again?

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[Several hon. Members]

rose—

[Mr Speaker]

Order. I have just had Members complaining that they cannot hear. The Minister must face the House. It is a very simple point; I have made it to others and they have understood it.

[Jim Shannon (Strangford) (DUP)]

One of the concerns of a great many of us recently has been the availability of cancer care drugs. [Interruption.] Right across—right across, Mr Speaker, the whole United Kingdom, and Northern Ireland in particular, a great many people have not been able to access cancer care drugs and have had to endure sickness and illness without them. Can the Secretary of State assure the House today that cancer care drugs will be made available and that those who are ill and suffering from cancer can rest easy?

Wheelchair Services

John Bercow Excerpts

Monday 28th June 2010 Commons Chamber

Motion made, and Question proposed, That this House do now adjourn.—(Mr Dunne.)

[Mr Speaker]

Before Mr Anderson starts his speech, may I appeal to right hon. and hon. Members who are leaving the Chamber to do so quickly and quietly, so that he can make his speech and be heard?

Mid Staffordshire NHS Foundation Trust

John Bercow Excerpts

Wednesday 9th June 2010 Commons Chamber

[Mr William Cash (Stone) (Con)]

I thank the Secretary of State for his statement, which was well overdue because the previous Government declined to do what he has agreed to do. I also thank the Prime Minister—a former candidate for Stafford—who took a very active part in this extremely important decision, for which both my constituents and those in Stafford will be deeply grateful. The Secretary of State has rightly dealt with the question of oaths and of compulsion of witnesses. Will he also indicate that expenses relating to the provision of legal representation for witnesses will also be made available? In addition to dealing with issues relating to whistleblowers and targets, will the whole question of self-assessment by hospitals and hospital trusts be considered? Will the inquiry examine those matters? A similar inquiry in 1984 led to a great improvement in the national circumstances relating to hospitals. The same hospital was involved in the legionnaires disease inquiry that Baroness Thatcher incorporated. I again thank the Secretary of State for making this decision, which will be greatly welcomed in my constituency.

[Mr Speaker]

Although we heard about four questions there, I am sure that the Secretary of State will content himself with one reply.

[Mr Lansley]

If I may, Mr Speaker, I shall content myself with saying that my hon. Friend made it clear from the outset that an Inquiries Act inquiry was the right idea. He said that more than a year ago, and had we gone down that route then, we would have been much further towards getting to the whole truth now. Matters relating to the Inquiries Act and the panel membership are ones that will now be determined by Robert Francis. I have published the terms of reference to which he will be working, and under the Inquiries Act issues such as legal representation and its funding are determined under those.

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[Siobhain McDonagh (Mitcham and Morden) (Lab)]

Will the Secretary of State give way?

[Mr Speaker]

There is no giving way involved; this is a statement.

[Heather Wheeler (South Derbyshire) (Con)]

I welcome my right hon. Friend’s statement. Only yesterday, I wrote to him regarding a constituent in South Derbyshire who had gone through a four-hour wait and was then admitted, to make sure that the four-hour rule was not broken, and had to stay in a ward for six hours and see even more people when he could have been on a bus going home much earlier. There are lessons to be learned across the whole country, and I look forward to the report coming through.

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[Mr Lansley]

I am grateful to my hon. Friend. The answer is yes.

[Mr Speaker]

I am grateful to Members for their co-operation. We have got to everybody.

Integrated Health Care

John Bercow Excerpts

Wednesday 2nd June 2010 Commons Chamber

[David Tredinnick (Bosworth) (Con)]

I count myself lucky to have secured this debate on the day that we have debated health matters in the Queen’s Speech, and to discuss integrated health care for the first time in this Parliament. I am fortunate to be—[Interruption.]

[Mr Speaker]

Order. I apologise for interrupting the hon. Gentleman. This has been a stimulating and, for many, a rewarding day, but if Members who are leaving the Chamber could please do so quickly and quietly, the House will benefit from the words of the hon. Gentleman.

[David Tredinnick]

I am flattered to have the Secretary of State for Health on the Front Bench, the shadow Secretary of State for Health on the Opposition Front Bench and, to my left, a former Secretary of State for Health, my right hon. Friend the Member for Charnwood (Mr Dorrell). It is perhaps pertinent that it was him—then the Member for Loughborough—who, as an Under-Secretary, first made it possible for GPs to refer patients to practitioners who were regarded as complementary and alternative, if they took clinical responsibility. That was the Conservative policy that he instituted way back in 1990.

This debate fits so well with my right hon. Friend the Secretary of State’s determination that, in the words of Queen’s Speech,

“The voice of patients and the role of doctors will be strengthened”.—[Official Report, 25 May 2010; Vol. 510, c. 31.]

This evening I would like principally to address three related issues: the situation regarding homeopathy and homeopathic hospitals; the regulation of herbal medicine and acupuncture; and the consideration of other available models, particularly in Australia and the United States.

Let me start by welcoming my hon. Friend the Under-Secretary to her place. In a sense, this was an integrated health care general election, because the arch-opponent of anything to do with non-orthodox medicine, the former Member for Oxford West and Abingdon, was defeated and the gentleman who stood against me on an anti-alternative medicine ticket lost his deposit. That was because people are increasingly in favour of having alternatives in the health service. Indeed, 50% of the population have at some stage tried one form of integrated health care or another—acupuncture, herbal medicine or homeopathy—or a back treatment.

The Secretary of State’s proposal for an independent national health service board to allocate resources, provide commissioning guidance and allow GPs to commission services on behalf of patients is the ideal vehicle to give guidance. The first point that I would like to make to my hon. Friend the Under-Secretary is that the new board, when instituted, should offer guidance, through the primary care trusts, on what is available in the health service and stress why integrated health care is so important, for which I would suggest there are three principal reasons. First, people often turn to the alternatives when mainstream medicine has not succeeded. Secondly, conditions often fall into what is known as the effectiveness gap—that is, a category that conventional treatment is unable to help. Thirdly, people might not have benefited from conventional treatments or they might have experienced adverse effects owing to drug reactions.

Another important point, which fits the new coalition Government’s proposal for cost-effectiveness, is that the alternative disciplines—herbal medicine, aromatherapy, homeopathy, osteopathy, chiropractic—are very cost-effective. They are often cheaper than other treatments and, if used in conjunction with mainstream medicine, can be very effective in reducing the effects of heart disease, asthma, back pain and stress, for example. An integrated approach will offer my hon. Friend the Minister and my right hon. Friend the Secretary of State new weapons in the armoury of health care.

In the past few years, there has been a concerted attack on the homeopathic hospitals in this country, which go back to the formation of the health service, and on homeopathic treatments generally, on the ground that the science is weak and does not demonstrate that they are effective. This has manifested itself in bogus Department of Health circulars, in the fact that the British Medical Association’s conferences have tabled motions on the subject, and in the Science and Technology Committee’s recent highly controversial report claiming that homeopathy was a placebo.

The effect of that has been to reduce the number of referrals from primary care trusts in London, particularly to the Royal London Homeopathic hospital. The hon. Member for Hampstead and Kilburn (Glenda Jackson) took up that matter. In other parts of the country, pressure has been put on training. I encourage my hon. Friend the Minister to make a statement tonight that the Government are supportive of the homeopathic discipline, as they said they were before the general election.

The problem with the report that the Science and Technology Committee produced was that it did not take evidence from primary care trusts or from the Society of Homeopaths, and it ignored completely the evidence from abroad, which shows a greatly increased use of homeopathic treatments. For example, in France, homeopathy is taught in seven medical schools and practised by 25,000 doctors. In India, it is part of the health service. There are 180 colleges teaching homeopathy there, and more than 300,000 practitioners. Whatever the merits of the scientific research, the fact is that there are 500 doctors in Britain who choose to use homeopathic treatments as part of their work. Whatever the science says—whether it is proven or not—those people believe that homeopathy works, and that is important.

The costs involved are absolutely minimal. The cost per year to the national health service of homeopathic medicines is £152,000, out of a budget of £11 billion. Over the three years from 2005 to 2008, the hospitals themselves cost the nation £12 million—£4 million a year. These are very small costs, and we really need to take that on board. We must also recognise that there are new approvals coming on stream. At Sao Paolo university in Brazil, homeopathic treatments have been found to be effective in treating depression, instead of Prozac, and the university of Texas has shown the positive effect of homeopathic treatments in killing cancer cells while maintaining good cells. There is a lot to look at there, and the message should be that doctors who wish to use these therapies should do so and should be free to refer. If we can get that simple message across, we will have performed a great service. I am of course speaking to my hon. Friend on the Front Bench.

The regulation of herbal medicine and acupuncture is a crucial area. The previous Government spent for ever debating the matter and calling various professors to look into it. They asked for more and more information, and the final recommendations, produced by Professor Pitillo and Lord Chan, were that these areas should be regulated by the Health Professions Council so that there could be an interface with European legislation next year. However, the recommendation of the outgoing Government was that these matters should be regulated by the Complementary and Natural Healthcare Council instead. I think that that would be a mistake; I believe that we should go for stricter regulation. All the other disciplines could join the 3,000 now registered on the CNHC register. That would be the way forward. Certainly, all the organisations in the field—including the Association of Traditional Chinese Medicine and the European herbal medicine and acupuncture societies—want statutory regulation.

Finally, I turn to deal with what is happening in the rest of the world. I have already referred to the fact that we should take note of the widespread and increasing use of homeopathy in France—I did not mention Germany —and India, while we should also look at what is happening in Australia, which has been a leader. In Australia, according to Government reports, 50% of the population are now using herbal or complementary medicines. There are a number of colleges where these disciplines can be studied and a Complementary Medicine Evaluation committee has been set up; the Australians also have a Therapeutic Goods Administration committee. Herbal medicines are considered by the TGA of Australia to be

“reasonably safe with less adverse reactions than conventional pharmaceutical treatment”—

this is the big hint that we should look seriously at these treatments—and Sydney university has established the herbal medicines research and education centre

“to promote high-quality scholarship and research excellence in herbal medicines through teaching, research and international linkages.”

In fairness to the former Secretary of State, the right hon. Member for Leigh (Andy Burnham), who has just left the Chamber, I should say that he introduced a number of surveys, through the National Institute for Health and Clinical Excellence, which was a welcome development. I think, however, that my hon. Friend the Minister could do more, and I hope that she will. The Australian institutions were given a lot of money. I am not suggesting that there is a lot of money around at the moment, but if Australia can provide $4 million to start up and get going its National Institute of Complementary Medicine, it is something that we should also consider doing.

The other country way ahead of us is the United States of America, which now has a National Centre for Complementary and Alternative Medicine, the federal Government’s lead agency for scientific research on complementary and alternative medicine. It is one of 27 institutes that make up the National Institute of Health in the US and it is statutorily regulated. The mission is to explore

“complementary and alternative healing practices in the context of rigorous science… train complementary and alternative medicine researchers and… disseminate authoritative information to the public and professionals.”

It conducts research using scientific methods and advanced technologies to study CAM. I believe that we should follow that model.

During my time in the House, I have had the honour to chair and be an officer of the parliamentary group for integrated and complementary healthcare and the old parliamentary group for alternative and complementary medicine. Over a period of more than 20 years, we have seen these disciplines come in from out of the cold to complement and augment the wonderful work of our national health service. With our very liberal approach to empowering doctors and to giving patients greater choices in what they want, we have a great opportunity to draw on the wonderful resources we now have vested in our homeopathic hospitals, which offer many other treatments besides homeopathy, and in our 20,000 to 30,000 practitioners out there in the field who can offer herbal medicine and acupuncture.

The Minister now has a great opportunity to grasp the nettle and complete the great work that was started when my right hon. Friend the Member for Charnwood—originally the Member for Loughborough—agreed that doctors taking clinical responsibility could refer to these practitioners. We need to move 20 years ahead, and complete this process with statutory regulation for herbalists and acupuncturists, proper referrals and an acceptance that our 500 homeopathic doctors can refer patients if they want to do so. If we do that, my hon. Friend the Minister will be well remembered in years to come.