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Cervical Smear Tests
9. Mr. John Heppell (Nottingham, East): How many women in the Trent health region have received cervical smear tests in the last year. [67167]
The Parliamentary Under-Secretary of State for Health (Mr. John Hutton): In the year ending 31 March 1998, 350,617 women in the Trent region were tested, up from 328,014 women in the year to 31 March 1997--an increase of nearly 7 per cent.
Mr. Heppell: I thank my hon. Friend for that response. I congratulate the Government on their recent action in ensuring that quality standards on cervical screening are consistent across the whole country.
Will my hon. Friend confirm that the cervical screening programme has been a success, and has saved the lives of thousands of women, and that a lot of that success is due to the dedication of the staff of the service? The previous Government left the work of the staff unsung; the service was understaffed and the staff were overworked and underpaid. On that last point, will my hon. Friend at least ensure that, in the next pay round, the dedication of the staff is recognised?
Mr. Hutton:
I am grateful to my hon. Friend for drawing attention to the success of the cervical screening programme. About 4 million women are screened each year in England and it has been estimated that the programme prevents up to 3,900 cases of cervical cancer each year. He might also want to know that coverage in Nottinghamshire is among the highest in the country--slightly over 90 per cent., compared with a target of 80 per cent.
Mr. Stephen Dorrell (Charnwood):
I am pleased that the Minister recognises that the cervical smear testing programme constitutes a huge advance in women's health in this country--in the Trent region and elsewhere. Will he also recognise that the programme was introduced--and was given huge stimulation--as a result of the NHS reforms introduced in 1990 by my right hon. and learned Friend the Member for Rushcliffe (Mr. Clarke)? Will the Minister take this opportunity to congratulate the previous Conservative Government on an important public health programme launched by my right hon. and learned Friend?
Mr. Hutton:
I am sorry to have to disappoint the right hon. Gentleman, but I shall not be able to do that. We inherited a situation that was not satisfactory and I should point out to him that one of the consequences of the reforms that he oversaw, and for which he was responsible, was the compromising of the effective monitoring arrangements for the cervical screening tests. He should be ashamed of that.
Mr. Michael Clapham (Barnsley, West and Penistone):
My hon. Friend will be aware that the assessment of the cervical tests varies from area to area, and that causes some concern. What mechanism is he considering to drive best practice through the service?
Mr. Hutton:
I can assure my hon. Friend that the whole thrust of our reforms, right across the board, is to improve the quality of services available to everyone who uses the national health service, including those women who use the cervical test screening programme.
We want to improve the service across the board. That is one of the priorities that we have identified in all our policy documents, and in all that we have said in the House about our policies.
10. Mr. James Gray (North Wiltshire):
If he will make a statement on how he intends to meet his target for nurse recruitment. [67168]
The Secretary of State for Health (Mr. Frank Dobson):
Our target is to have enough nurses and
That is not all. We are also making nursing more attractive by providing more flexible shift patterns. We want to make things better for more experienced nurses by replacing the rigid grading system with arrangements that will help them to develop their careers and reward their additional responsibilities.
Mr. Gray:
I thank the Secretary of State for his answer. He will know, however, that only 15,000 of the 300,000 nurses in the national health service will welcome yesterday's announcement. In that context, is the right hon. Gentleman not concerned about the NHS Direct service, about which he will shortly make a statement? The service was piloted in Wiltshire hospitals--so well run by the Wiltshire NHS trust over the past three years, incidentally, and set up by the Conservative Government. Does the right hon. Gentleman not fear that a nurse-based service such as the NHS trust--thought up by the Conservatives--will be hard to man if experienced nurses leave the service?
Mr. Dobson:
The hon. Gentleman ought to learn to count, or else brief himself before coming into the Chamber. While between 13,000 and 15,000 nurses will receive a 12 per cent. pay increase, another 70,000 will receive an increase of 8.2 per cent. or more, and the remainder will receive 4.7 per cent.
I shall deal with recruitment through NHS Direct in my statement. At this stage, I shall merely say that I have urged NHS management who are involved in the introduction of NHS Direct to try to recruit, in particular, nurses who have had to leave nursing because of industrial injuries. A back injury, for instance, might make it impossible for a nurse to perform the normal nursing task, but that nurse might still be able to deal with telephone callers. Nurses would thus be able to use their skills for the benefit of patients and their own great satisfaction.
Laura Moffatt (Crawley):
Can my right hon. Friend reassure us that the superb nurses' award--about which many of my colleagues will be thrilled--will affect neither recruitment nor the modernisation of our health service? Those who work in the health service are our best-ever asset, and we must ensure that we modernise their pay. Will my right hon. Friend confirm that the money that has been set aside for modernisation will not be affected by the award?
Mr. Dobson:
I can confirm precisely that to my hon. Friend, who is one of two former nurses in the House. We are financing the nurses' pay increase with money that we put into the NHS budget for next year. We made the decisions in July last year, and, not unreasonably, we anticipated that the review bodies would make a recommendation well in excess of the rate of inflation, which they have. We therefore set aside, within the modernisation fund, certain sums to help to pay the increase if it reached the level that it has reached. That is a proper use of money to modernise the health service. I think that many people, especially nurses, detest the
Dr. Peter Brand (Isle of Wight):
I am sure that the Secretary of State will agree that nurse recruitment needs good schools of nursing. Will he use his good offices to sort out the unseemly dispute between the universities of Portsmouth and Southampton following the transfer of the contract for nurse training? A number of nurse tutors have been left in limbo, because those two public bodies will not agree on which is responsible for redundancy payments.
Mr. Dobson:
As the hon. Gentleman knows, I want to improve the arrangements for nurse training, not overthrow them because there have been some good developments. I want to change them, so that there is considerably greater national health service influence over who goes into nurse training and what sort of training there is. The aim is to redevelop the links between the NHS and nurses in training. As the NHS has had so little to do with nurse training in recent years, many of those in management have lost interest in nurse training and not given it enough attention.
11. Mr. Bill Michie (Sheffield, Heeley):
What new legal duties on partnership and quality of care he expects to introduce during 1999. [67169]
15. Ms Chris McCafferty (Calder Valley):
What new legal duties on partnership and quality of care he expects to introduce during 1999. [67173]
The Parliamentary Under-Secretary of State for Health (Mr. John Hutton):
We have set out new duties of quality and partnership in the Health Bill that was introduced in another place on 28 January 1999.
Mr. Michie:
I thank my hon. Friend for his answer. I welcome the new initiative, which I believe to be the first on policing legal duties of partnership. Does it include social care?
Mr. Hutton:
Yes. If we are to improve services across the board--that is our primary objective--it is important that we find a way of getting the national health service and social services to work much more effectively together. We know from the result of the consultation on "Partnership in Action", which we published last year, that that is overwhelmingly what people want us to do. The Health Bill will, for the first time, remove the legal obstacles that currently prevent the NHS and social services from working effectively together.
Ms McCafferty:
Can my hon. Friend confirm that, through the Bill, for the first time, a legal duty will be placed on the quality of care, unlike before, when the only duty placed on trust chairs was to balance the books?
Mr. Hutton:
Yes, I can confirm that. Together, the changes that we have published in the Health Bill mark a decisive break from the NHS internal market and its
Mr. Edward Garnier (Harborough):
The Minister will accept that new legal duties will suggest new litigation. By how much will the NHS budget have to increase to take into account the litigation that will flow from the Access to Justice Bill?
Mr. Hutton:
I think that that is a typical lawyer's perspective. [Interruption.] I will answer the hon. and learned Gentleman's question because it is a serious one. The whole purpose and thrust of our new clinical governance and duty-of-care arrangements will be to improve the quality of care. That, I hope, will make it less likely that people will litigate.
Mr. Howard Flight (Arundel and South Downs):
Will the Minister clarify the Government's policy with regard to primary care centres and, in addition, beacon of excellence awards--proposed targets for practices? In my constituency, the leading general practitioner practice was well lined up to develop such a centre and has qualified for a beacon of excellence award, but, for the past few months, the NHS executive has been completely silent on how the scheme is going forward. Yesterday, the Secretary of State for Health was quoted in a leading paper as saying that he supported such centres, pulling together a wider package of optician services, prescriptions and other health care services, but it seems that the Government policy in that area is somewhat in limbo at present.
Mr. Hutton:
With great respect to the hon. Gentleman, the Government's policy is not in limbo. The Health Bill, which I invite him to study, will clearly apply to primary care, but the quality duty that we intend to legislate on is not about individuals; it is about institutions. The principle of clinical governance needs to apply obviously and clearly in the area of primary care, as well as secondary care, and it will.
Mr. Tom Clarke (Coatbridge and Chryston):
Given that elderly patients represent around 50 per cent. of those in hospital, and consistent with the Griffiths report, "Agenda for Action", and Lady Walner's report, "Residential care: options for choice", may I invite my hon. Friend to agree that it is extremely important, as it was when those documents were published about a decade ago, that organisations of elderly people, individual elderly people and elderly people locally should be consulted on services that are vital to their particular needs?
Mr. Hutton:
The answer to my right hon. Friend's question is yes. I also draw his attention specifically to two of our current initiatives. The first is the establishment of the new national service framework for older people, which will make a very positive contribution in defining new service models and in setting national standards across the national health service for the care of older people. Secondly, as I said earlier, we are currently embarked on a new regulatory framework and standard-setting exercise for treatment in registered
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