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4. Mr. Harry Barnes (North-East Derbyshire): What representations he has received concerning the funding of beta-interferon; and if he will make a statement. [57352]
The Minister of State, Department of Health (Mr. Alan Milburn): In the past 18 months, the Department's records show that we received 177 written representations from Members of Parliament, patients' groups and the public about the prescribing and funding of beta-interferon. I also met representatives of the Multiple Sclerosis Society in May.
Most health authorities now have procedures in place by which patients can receive treatment with beta-interferon. More generally, the Government want greater consistency in the delivery of cost-effective clinical services to patients, wherever they live.
Mr. Barnes:
Is the Minister aware that many MS patients in North Derbyshire have been prescribed beta-interferon, but have been lucky enough to receive it only if they are in the top eight on the list for treatment; have successfully pursued a court case, as one of my constituents has; or have decided to go private until the money runs out, such as Lesley Coombes of Ashover? Reassessments have been made to take off the list between 40 and 50 people who had hoped to receive beta-interferon. Is there not a case for earmarked resources for such authorities as North Derbyshire so that it can handle that massive problem?
Mr. Milburn:
I would be very glad to look into the individual case that my hon. Friend has highlighted, and I hope that North Derbyshire health authority feels in a rather more comfortable financial position as a result of today's extra allocation of resources. The extra £13.9 million that my hon. Friend's health authority will receive next year represents a cash increase of 6.6 per cent.
I know that my hon. Friend has not done so, but it is terribly important that no one raises any false expectations about the ability of beta-interferon or any other drug to combat an extremely debilitating and distressing condition. Beta-interferon is not a cure for multiple sclerosis; there is no cure for it. The evidence seems to suggest that some patients with a particular form of the disease can benefit briefly from the use of beta-interferon. Sadly, the evidence also suggests that those short-term improvements are not always sustained. The Department will be commissioning new research into the appropriate usage of beta-interferon, and we will be issuing new guidelines before too long to ensure greater national consistency in the uptake of the drug.
Mrs. Marion Roe (Broxbourne):
Given the inconsistent availability of beta-interferon, does the right hon. Gentleman continue to believe that there is no such thing as rationing in the national health service?
Mr. Milburn:
Opposition Members are in terrible danger of fermenting a crisis on this issue in the national health service. It is important to remember that for the vast majority of patients, in the vast majority of places, for the vast majority of the time, the vast majority of treatments are available on the national health service. Under this Government they will continue to be available on the NHS.
Mr. Alan Simpson (Nottingham, South):
I know that the Minister is aware of the work on beta-interferon by Professor Blumhardt in Nottingham. I understand that
Mr. Milburn:
I can give my hon. Friend that assurance. The products currently on the market are for a particular form of MS--the relapsing, remitting form--whereas the article in The Lancet is about the more serious, progressive form. The product to which my hon. Friend referred has not yet been licensed through the European procedures, let alone in this country. It is our intention to examine all beta-interferon products to achieve the greater national consistency in prescribing that all right hon. and hon. Members want.
Mr. Alan Duncan (Rutland and Melton):
First, may I welcome the Under-Secretary of State for Health, the hon. Member for Barrow and Furness (Mr. Hutton) to the Dispatch Box for the first time? He has important responsibilities, and I assure him that we have every intention of keeping him as busy as possible.
Many people will question the Minister's answer to his hon. Friend the Member for North-East Derbyshire (Mr. Barnes), and he did not answer the question put to him by my hon. Friend the Member for Broxbourne (Mrs. Roe). Will he admit that there is rationing in the national health service? There always has been, although the Secretary of State persistently refuses to admit that. The inconsistency in the availability of beta-interferon and many other inconsistent availabilities in the national health service prove that. If the Minister is not prepared to admit that there is rationing, there is no way that we can have a grown-up debate about the future of the health service. Will he admit it now?
Mr. Milburn:
I am not sure that grown-up debates and the hon. Gentleman are always as compatible as they should be. The real reason why the Opposition are seeking to foment a debate about rationing is not beta-interferon, but the Conservative party's failure to match our record levels of investment in the national health service. It is about time the Opposition came clean. If they are not prepared to match pound for pound the extra investment in the hon. Gentleman's health authority and others, they should list item by item, procedure by procedure and treatment by treatment, those patients who will lose out and will not now be treated on the NHS, and will be forced to go private. The difference between the hon. Gentleman's party and the Labour party is that we believe in treatment being available according to clinical need and not ability to pay.
5. Mr. Jim Cunningham (Coventry, South):
If he will make a statement on the investment he is making to reduce NHS waiting lists over the next three years. [57353]
6. Mr. Nick St. Aubyn (Guildford):
If he will estimate the total cost of his planned reduction in waiting lists; when he expects to achieve that reduction; and if he will make a statement. [57354]
12. Mr. Tom Cox (Tooting):
If he will make a statement on his Department's funding for reductions in NHS waiting lists over the next three years. [57361]
The Secretary of State for Health (Mr. Frank Dobson):
Waiting lists have fallen by more than 98,000 since April. The Government are investing an extra £21 billion in the national health service over the next three years, and I announced today the main allocation of next year's funds to health authorities, amounting to a total of £31 billion. That includes £320 million specifically for reducing waiting lists, to help us to deliver our promise to reduce them to a total 100,000 lower than the total that we inherited.
The extra allocation announced today for Coventry--which covers the constituency of my hon. Friend the Member for Coventry, South (Mr. Cunningham)--is £13.7 million. The extra allocation for West Surrey, which covers the constituency of the hon. Member for Guildford (Mr. St. Aubyn), is £19 million. As for the two health authorities that serve the constituency of my hon. Friend the Member for Tooting (Mr. Cox), Lambeth, Southwark and Lewisham will receive an extra £38 million, while Merton, Sutton and Wandsworth will receive an extra £25 million. All that is in addition to what the Tories planned to provide.
Mr. Cunningham:
I am sure that many people, not only in Coventry but throughout the country, will welcome my right hon. Friend's statement. Is he aware that the shadow Chancellor has said that our investment in the national health service is reckless, and that the shadow Secretary of State for Health has said that it is a waste of time spending money on waiting lists? What is more appropriate--the investment of money in reducing waiting lists or the recklessness of the Tories in not investing any money at all?
Mr. Dobson:
I fully expect all honest Tory Members to say now that, as the shadow Chancellor says that our health spending is reckless, they do not want the money to be spent in their constituencies.
Mr. St. Aubyn:
I congratulate the Secretary of State on attempting to match the previous Government's record of real increases in health spending. May I point out, however, that the number of patients waiting for more than 12 months has risen by more than 30,000? Will the right hon. Gentleman now admit that the only reason for the general decline in waiting lists is that simple, quick operations are being performed before longer, more complex ones?
Mr. Dobson:
No--and the number of people waiting for more than 12 months for treatment has fallen by 9,000 since June this year.
Mr. Cox:
I thank my right hon. Friend for his statement. It is very different from the statements that I heard under the last Administration: in those days we repeatedly sought meetings with Secretaries of State, only to be told, "No money is available for your area".
Are not the facts that there is extra money, that more people are being treated and that waiting lists are being reduced a clear indication of this Government's commitment? I hope that my right hon. Friend will announce those facts not just in the House but throughout the country, because it is not just areas such as mine that are benefiting from the Government's policy: the whole country is benefiting.
Mr. Dobson:
I have to agree with my hon. Friend. The two health authorities that serve his constituency will receive more than £62 million extra to serve the people next year, which will bring spending in those two areas--many parts of which are very deprived--to nearly £8 billion. That is hugely in excess of the funds that the previous Government made available in the past, or intended to make available in the future. I am glad that we are doing this; I am proud that we are keeping our promises; and I am confident that the excellent 1 million staff in the health service will be able to deliver the better, quicker, more efficient top-quality health service that we all want.
Miss Ann Widdecombe (Maidstone and The Weald):
Will the right hon. Gentleman confirm that, when he said yesterday in the House that patients waiting for the removal of internal fixations have never been included in official waiting list statistics, he was utterly incorrect?
Miss Widdecombe:
Then can the right hon. Gentleman explain why a very clear memorandum issued by Bradford hospitals trust makes it clear that before June, when these convenient falls began to happen, such patients were included in its monthly statistics, whereas after that they were not?
Mr. Dobson:
As for the practices in Bradford, I have no control over what that trust has been doing directly, but, as I explained to the right hon. Lady yesterday, the rules that were introduced by her Government, whether they are being complied with in Bradford or not, stated that, if someone with a broken arm had a metal plate inserted and was told by his doctor, "You need it in for 18 months, so you do not come back to have it removed for a further 18 months," that person did not count as someone who was waiting for an operation for 18 months. The previous Government were daft in a lot of respects, but they were perfectly sensible when they said that such people should not be included on the waiting lists.
Miss Widdecombe:
We may have been perfectly sensible in suggesting that such operations should not be included in the monthly returns, but the fact is that they continued to be so in some authorities, including Bradford. They have now been taken out of the monthly returns, so part of the fall in waiting lists announced by the right hon. Gentleman can be accounted for by patients who have not actually received their treatment.
Will the right hon. Gentleman now do three things? First, will he admit that his statement yesterday was incorrect? Secondly, will he apologise to the nation for making it and, thirdly, will he admit that an awful lot of those drops in waiting lists up and down the country represent numbers being fiddled and patients being diddled?
Mr. Dobson:
Up and down the country, in the first six months of this year, 250,000 more people were treated by the national health service than were being treated in the equivalent half of last year, and the year before that. The right hon. Lady apparently wants us to include in waiting lists people whose doctors have said that they should not have an operation for six, 12 or 18 months. To repeat
Mr. Bruce Grocott (Telford):
I warmly welcome the 3.92 per cent. increase in real expenditure that my right hon. Friend has made available to Shropshire health authority. I ask him to remember, as the House will remember, that each month that the waiting lists increased was met by vociferous criticism from the Opposition. I ask him therefore to place in the Library all the letters of congratulation that he will receive from Opposition Members now that waiting lists are falling.
Mr. Dobson:
I can assure my hon. Friend that the Commons Librarian will not need to set aside much shelf space for that purpose, but I am sure that, in common with their elected representative, people in Shropshire will be glad to know that they will benefit from an extra £15 million towards their health care next year. That, of course, is merely the first round of the available extra money.
Mr. James Paice (South-East Cambridgeshire):
Does the Secretary of State recognise that, however hard the NHS works, it has to have a throughput on beds? How on earth could the NHS in Cambridgeshire expect to fulfil its obligations when the right hon. Gentleman granted the local social services £1 million less in cash terms in their standard spending assessment? We now have serious problems, particularly with elderly people who remain in hospital beds long after they should simply because social services have no money to fund their care outside?
Mr. Dobson:
I hope that the hon. Gentleman will therefore welcome the extra £250 million that the Chancellor announced next week--
Mr. Philip Hammond (Runnymede and Weybridge):
Next week?
Mr. Dobson:
I meant last week. I must not give the game away. I hope that the hon. Member for South-East Cambridgeshire (Mr. Paice) will therefore welcome that £250 million extra, which will help local social service departments, hospitals and the rest of the national health service. That money will ensure that people, particularly frail, elderly people who should not be in hospital if they could be properly looked after at home will receive such care at home, and that those in hospital who could be discharged if there was someone to look after them at home will also be properly cared for in their own home. That is what that £250 million is for.
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