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Infant and Perinatal Mortality
6. Sir Sydney Chapman: To ask the Secretary of State for Health if he will make a statement about the change in (a) infant and (b) perinatal mortality rates in the last 15 years. [2177]
Mr. Dorrell: Infant and perinatal mortality rates are at their lowest levels ever. Deaths of children aged under one year--the infant mortality rate--fell by half between 1979 and 1994. Stillbirths and deaths of babies less than a week old--the perinatal rate--fell by nearly 40 per cent. over the same period.
Sir Sydney Chapman: I warmly welcome my right hon. Friend's reply, which reveals a staggering reduction
in the number of fatalities. Does he agree that that is due principally to three factors; first, the great advances in medical technology; secondly, the increasing skill of our doctors and nurses; and, thirdly, the vastly increased amounts of taxpayers' money put into the national health service? Does my right hon. Friend agree that those figures underline the increased quality of infant health care, like so many other NHS services, for the benefit of the whole nation?
Mr. Dorrell: My hon. Friend is precisely right on every count. Those indicators are interesting, because they are some of the relatively few health outcome indicators that are directly comparable with those in different countries. Such indicators tell heavily in favour of the good value and efficient health service delivered by the NHS, which has been consistently supported by the Government and which we shall continue to support.
Mr. Simon Hughes: Has the Secretary of State had a chance to look at the King's Fund's recent publication, "Tackling Inequalities in Health", which confirms--as is to be expected--that over the past 10 years there has been a widening gap between the rich and the poor, and that that gap is reflected by widening differentials in mortality rates for adults and infants? If that is so, what is the Department of Health doing to ensure improvements in health nationwide by increasing equality in wealth and income for all citizens?
Mr. Dorrell: I talked yesterday about some of the things that we are doing to ensure that we deliver, nation wide, the objectives of the national health service. The establishment of proper purchasing arrangements for the health services within the reformed management is designed precisely to target resources on health need. The Government's commitment to weighted capitation-- I announced a further step towards its delivery yesterday--is also intended to eliminate variations. That commitment is precisely directed to answer the hon. Gentleman's concerns.
Dame Jill Knight: Does my right hon. Friend agree that it would be welcome, fair and right if the media sometimes concentrated on the remarkable advance that has been made in this part of the health service as in others, and that tiny babies are saved today who would not have had a hope of life even 10 or 12 years ago?
Mr. Dorrell: My hon. Friend is entirely right. It is a dry statistic that tells a very human story of which anyone interested in the NHS should be proud. It is a comparison between health care in Britain and health care in virtually every other developed country and it tells in favour of both our national health service and the Government's support for it.
Mr. Milburn: Although the overall fall in death rates is clearly welcome, will the Secretary of State explain why last year both the South Tyneside and the Sandwell health care NHS trusts had a perinatal mortality rate of 13.7 per 1,000 live births, while in Kingston and Richmond the rate was just 3.4 per 1,000 live births? Will he also confirm that, if all infants and children enjoyed the same survival rates as those in social classes I and II, up to 3,000 deaths a year might be prevented? Does that latter figure not show that the price of widening social and economic inequality under the Government is being paid for in the health of poorer people?
Mr. Dorrell: What the hon. Gentleman does not cover is two facts: first, that health outcomes are improving for all social classes in Britain; and, secondly, that the Government have put in place reformed management of the health service, precisely to ensure that health resources are targeted at health need. It is precisely for that reason that we changed the management of the health service. Since the hon. Gentleman raises the subject, I assume that he would now like to welcome that.
Huddersfield Health Care Services NHS Trust
7. Mr. Riddick: To ask the Secretary of State for Health if he will make a statement about the development package recently announced by the Huddersfield national health service trust. [2178]
Mr. Malone: I very much welcome this £10 million development programme. It will provide improved health care facilities for the people of Huddersfield, in the context of a modern health service.
Mr. Riddick: Does my hon. Friend agree that this £10 million development programme, across a range of health facilities in my local hospital, represents a remarkable investment in improved health care for the people in and around Huddersfield and is the sort of good news about which we never hear from Opposition Members? Is he aware that I get far fewer complaints about my local hospitals than, for example, about my local Labour council?
Mr. Malone: I am not surprised to learn of the content of my hon. Friend's postbag, because he does indeed have an excellent local hospital. May I, in the words of the trust chief executive, point out that
- "Never before have we had so many new developments planned on this scale . . . together, they form a major step forward for patient care"?
That is a great improvement, in the context of that particular hospital. What the Labour party always fails to acknowledge is that such things are happening throughout the country. Perhaps when it happens in the areas of Opposition Members, they might table the sort of question that my hon. Friend tabled today.
Mr. Malone: Yet again, we have the hon. Lady complaining about investment in the health service which will benefit the whole range of the population that this hospital trust serves. Of course we understand that it is up to local health authorities to decide where they purchase their health care; now they will be able to do so on behalf of my hon. Friend's constituents and those of the hon. Lady. Those people can be served by this hospital through updated facilities in which £10 million is being invested. I would have thought that the hon. Lady might welcome that.
Haemophiliacs
8. Mr. John Marshall: To ask the Secretary of State for Health what representations he has received about making an ex gratia payment to haemophiliacs infected with hepatitis C. [2179]
Mr. Horam: Representations include seven earlier parliamentary questions, and five early-day motions. There was also an Adjournment debate initiated by my hon. Friend on 11 July and a short debate in another place. Ministers have received 291 letters.
Mr. Marshall: I congratulate my hon. Friend on his promotion to the Department of Health. Since his promotion, has he had a chance to read the impact study produced by the Haemophilia Society, which has been made available to his Department, which demonstrates the physical, financial and emotional hardship suffered by haemophiliacs? As the cause of that hardship, infected blood products, is the same as that which passed on the HIV virus to haemophiliacs, should not the Government's reaction be the same?
Mr. Horam: First, I congratulate the Haemophilia Society on its sensible review and my hon. Friend on his relentless questioning over many years, which has already achieved quite staggering results. I have not yet read the full review, but I shall do so as a matter of priority and I shall obviously take its conclusions most carefully into account.
Mr. Mudie: Does the Minister realise the stress caused to the families of individuals, such as a 13-year-old youngster in my constituency, who not only have to cope with haemophilia but have now been totally devastated by having to cope with the effects of hepatitis C? Please may we have an early and sympathetic decision to bring some hope to those families?
Mr. Horam: I assure the hon. Gentleman that the problem will always receive sympathy from me.
Residential Care
9. Mr. Thurnham: To ask the Secretary of State for Health if he will clarify the criteria used to assess voluntary groups providing high standards of care in residential settings for those with challenging behaviour, in respect of the application of necessary minimum levels of proper discipline and restraint. [2181]
Mr. Bowis: Regulations require that the owners and managers of homes should both safeguard and promote the welfare of residents. We expect statutory authorities to ensure that service providers should have clear, written policies on the management of people who may cause harm to themselves or others.
Mr. Thurnham: Does my hon. Friend agree that it is not an easy job to look after the severely mentally handicapped, and that common-sense disciplines should prevail over fashionable, impractical social services' ideologies which are certainly not in the best interests of the residents themselves?
Mr. Bowis: My hon. Friend is entirely right. When we are talking about difficult to manage individuals, we must ensure that the restraint and control used are sufficient to prevent a person from hurting himself or herself, other people or property. That is common sense, which must always take precedence over political correctness.
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