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House of Commons

Tuesday 24 February 1998

The House met at half-past Two o'clock


[Madam Speaker in the Chair]


Lloyds TSB Bill [Lords]

Order for Second Reading read.

To be read a Second time on Tuesday 3 March.

Oral Answers to Questions


The Secretary of State was asked--


1. Mrs. Butler: What proposals he has to promote the benefits of telemedicine in the NHS. [29313]

The Secretary of State for Health (Mr. Frank Dobson): Telemedicine means harnessing the latest in information technology so as to benefit patients. X-rays and scans can be examined by specialists hundreds of miles away from the patient. Hospitals can send test results to general practitioners and GPs can send patient information to specialists. All this is to provide even higher quality treatment for patients. That is why we are developing telemedicine.

Madam Speaker: Is the Secretary of State taking Question 15 with Question 1?

Mr. Dobson: I understood, Madam Speaker, that Question 15 had been withdrawn.

Madam Speaker: No. The hon. Member for Burnley (Mr. Pike) is in his place. We can take the two questions together.

Mr. Dobson: In that case, with the permission of the House, I should like to take Question 15 with Question 1.

Madam Speaker: My pleasure.

Mr. Pike: To ask the Secretary of State for Health what proposals he has to promote the benefits of telemedicine in the NHS.

Mrs. Butler: Does my right hon. Friend agree that, for a truly modern and dependable health service, we should make better use of information technology? For instance,

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would it not be a good idea for general practitioners to have such technology at their fingertips so that patients could then and there be booked into hospital out-patient appointments? Will my right hon. Friend consider such a scheme?

Mr. Dobson: That is certainly something that we aim for. We think that a great deal of people's frustration with the health service is having to go to their general practitioners and then having to wait for an out-patient's appointment to be made. By using information technology, it should in future be possible for people to have an appointment made there and then at the GP's premises. If people then go to an out-patient department, an in-patient appointment could be made in the same way.

Mr. Pike: I can assure my right hon. Friend that I had no intention of withdrawing Question 15.

I welcome what my right hon. Friend has said. Will not information technology be crucial in the 21st century in giving us a modern and efficient national health service, to which the Government are committed, and that it will play an integral part in developing that process as we go forward?

Mr. Dobson: That is indeed the case. Information technology in the health service is unsatisfactory at present and needs substantially to be improved. I can say from experience within my constituency at the national hospital for neurology and neurosurgery that, if a patient has something wrong with his brain, the authorities flash the scan over to Paris where a professor, who is the world's expert, can examine the scan at the same time as the staff at Queen square, WC1. That is immensely to the benefit of patients, and we want that sort of idea to spread.

Mr. Ian Taylor: Excited as I am by information technology, I am sure that the Secretary of State will recognise that the key feature is not the technology but what it can do. Will the right hon. Gentleman continue to ensure that technology is used to the fullest extent to devolve the health service to small general practitioner practices in rural areas and, ultimately, even to the home, so that people may get a fairly instant reaction to injuries that they have sustained? The beauty of the internet, combined with the NHS network, is that we can obtain access to expert information rapidly. That can transform the rather bureaucratic and centre-driven aspects of the national health service.

Mr. Dobson: The hon. Gentleman has made a good series of points, which I take on board. We are to introduce NHS direct, and we are running pilot schemes from 1 April. We intend to have a scheme covering the entire country. People will be able to ring in to talk about their condition and receive advice from a nurse-organised help line. We believe that that will be effective and popular.

Mr. Ian Bruce: The right hon. Gentleman will know that the year 2000 problems that his Department is tackling will take up virtually the whole of his IT budget. He has set out in the White Paper details of NHS direct and the other schemes about which he has just told the House, which are all desirable and which the Opposition strongly support. However, will he look carefully at the

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resources available for information technology within the NHS and talk urgently to the Treasury about additional funds, which will be necessary to do all the things that he wants to do and the whole House wants him to do?

Mr. Dobson: We hope that, over a period of time, the national health service will get all the resources that it needs to do its job properly, including resources for information technology. The present state of information technology in the NHS is deplorable and it will take a long time and a lot of money to put right.

Dental Services (Shropshire)

2. Mr. Paterson: If he will make a statement on dental services in Shropshire. [29314]

The Minister of State, Department of Health (Mr. Alan Milburn): Shropshire is an area where we have inherited local difficulties of access to national health service dentistry. Shropshire health authority has submitted eight proposals under the investing in dentistry scheme. One has already been approved at a cost of £45,000.

Mr. Paterson: NHS dentistry is not available to any new patients in Oswestry and, although the new schemes are welcome, they are many miles away. What action will the Minister take this afternoon for the 10,000 to 20,000 people who are estimated by the local heath authority to be on lists for NHS dentistry treatment?

Mr. Milburn: The one thing that I did not bring with me today was my cheque book. I assure the hon. Gentleman that all the proposals received from his area are being considered seriously. In some ways, he wins the award for bare-faced cheek, as it was his Government who ran down NHS dentistry in the first place, not just in Shropshire but throughout the country. This Government will build it up again.

Tobacco Advertising

3. Ms Stuart: If he will make a statement on progress towards implementing the EC directive on tobacco advertising. [29315]

The Minister for Public Health (Ms Tessa Jowell): A common position was agreed on 4 December at the Health Council and was formally adopted on 12 February at the Research Council. The text will now be considered by the European Parliament and the Government will continue to work hard to achieve final adoption of that important and long-awaited legislation.

Ms Stuart: Is it not the case that that historic agreement would not have been achieved without the British vote? Will my hon. Friend join me in congratulating Birmingham health authority on its public health policy of a smoke-free city, particularly its half a million annual expenditure programme targeting both young and adult smokers? Will she also congratulate Birmingham on achieving a 50 per cent. increase in the number of calls to the national quit smoking line this year alone?

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Ms Jowell: I am happy to congratulate Birmingham on its efforts to reduce smoking. Birmingham sets a clear example and the Government will build on the experience of such cities in taking action across a range of areas to combat smoking. We shall publish our plans in a White Paper later this year. Birmingham is a smoke-free city; it is an extremely good model for combating the harm done by smoking in public places. However, it is clear that a ban on tobacco advertising must be central to all our efforts to protect children from the pernicious effects of tobacco manufacturers' efforts to recruit them to smoking and to get them to take up an addictive habit that will only do them harm.

Mrs. Lait: Is not the high cost of tobacco one of the most effective deterrents to smoking? What discussions has the Minister had with her fellow Ministers in the Health Council about raising the excise duty on tobacco in other European countries so that bootleggers and smugglers can no longer undercut our high taxation policy by selling cheap tobacco to youngsters?

Ms Jowell: I agree with the hon. Lady that maintaining the high cost of tobacco is an important part of combating consumption, particularly among children. My right hon. Friend the Chancellor is aware of that and has raised the matter with other European Finance Ministers. He has also taken a lead in setting up tough action to combat fraud and smuggling.

Mr. Stevenson: While my hon. Friend's statement about a ban on tobacco advertising in Europe is welcome, is it not a serious contradiction, given that the European Union spends some 1 billion European currency units on subsidising tobacco that cannot be sold elsewhere because it is of such a low quality? Will my hon. Friend make every effort in the European Council to end that serious situation? On the one hand, we are trying to reduce smoking but, on the other, taxpayers' money is subsidising tobacco production.

Ms Jowell: Yes, that is a contradiction. I shall raise the matter with other European Health Ministers, just as my right hon. Friend the Minister of Agriculture, Fisheries and Food has expressed the Government's concern in the Agriculture Council.

Mr. Ieuan Wyn Jones: Is the Minister aware of the considerable disparity between the revenue raised by the Chancellor through tobacco sales and the low priority given to resources for health promotion? The two figures do not bear comparison. As well as driving forward the agenda to secure an EEC directive, does she recognise the need to promote health among young people? They should not start smoking, but, if they have, they should be encouraged to stop.

Ms Jowell: My right hon. Friend the Chancellor shares with my right hon. Friend the Secretary of State and Ministers across Government a determination to reduce both the rate at which children take up smoking and tobacco consumption. Smoking costs the national health service £1.4 billion every year. We are determined to reduce that figure by cutting consumption. I remind the House of the previous Government's legacy to the children of this country: in 1992, one in four 15-year-old girls smoked; in 1997, the figure was one in three.

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