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Beta Interferon
4. Mr. Paul Burstow (Sutton and Cheam): If he will make a statement on the provision of beta interferon in the NHS. [77701]
The Minister of State, Department of Health (Mr. John Denham): All health authorities were issued in 1995 with guidance that covered the use of beta interferon for the treatment of multiple sclerosis. It recommended that prescribing should be initiated by hospital specialists where clinically appropriate. The costs of prescribing are expected to be met within health authority allocations, taking account of local priorities.
Mr. Burstow: I am grateful for that reply. May I draw the Minister's attention to two cases in my constituency? Josephine Timms, a mother with a young family, and Adrian Donno, a young man with a promising career ahead of him, were each diagnosed with multiple sclerosis last July. Both were recommended by consultant neurologists for beta interferon prescription, but both are still waiting.
Every time they have a further attack, they become more dependent and more disabled. The longer they wait, the more likely it is that they will not fit the health authority's criteria for prescribing, which require them to demonstrate that they can walk unassisted without stopping for at least 100 yd.
Does the Minister agree that the failure to prescribe treatment that the consultant neurologists say will be beneficial to those patients and to others like them lets those people down and leads to a reduction in their quality of life?
Mr. Denham:
Obviously, I shall take an interest in any individual case raised by an hon. Member. However, we should be clear that there are continuing questions about the clinical effectiveness and cost effectiveness of beta interferon, the level of benefits achieved, which patients will benefit and for how long, and how the benefits compare with those of supporting MS patients through, for example, specialist nursing care. Health authorities and clinicians rightly take those and other factors into account when they set local priorities.
Mr. Gordon Prentice (Pendle):
As the Minister tells us, beta interferon can be prescribed only by a hospital consultant. The problem is, however, that, after initial diagnosis, many people with multiple sclerosis do not see a hospital consultant for years. They therefore do not know whether beta interferon would be the drug to help them. Would it not be sensible to put in place some recall system so that people with MS have the option to see a consultant if they feel that beta interferon or some other drug might help them, or if they are not coping as well as they should with MS?
Mr. Denham:
I shall consider my hon. Friend's suggestion carefully. We must ensure that clinical and cost-effective treatments are spread throughout the
Miss Ann Widdecombe (Maidstone and The Weald):
Is the hon. Gentleman aware of an exchange about rationing in the health service that took place last year between me and the Minister for Public Health, in which I asked a very simple question:
Miss Widdecombe:
Is there or is there not rationing of beta interferon? Is there or is there not rationing of Aricept? Is there or is there not rationing of Ironotecan? Is there or is there not rationing of Taxol? If not, why cannot those patients who are prescribed those drugs obtain them?
Mr. Denham:
The reality is that priority setting is a feature of every health care system in the world. It happens to be the case that the national health service is fairer, more equitable and more efficient than the privatised alternative that the hon. Member for Rutland and Melton (Mr. Duncan) advocated earlier this week. While the Conservatives are giving up on the national health service, new Labour is building a new national health service.
Miss Widdecombe:
Will the hon. Gentleman answer a simple question? If he is denying rationing in the health service, will he explain to the House, and to those concerned people who would like to obtain drugs and operations that are not available, his definition of the difference between rationing and a priority?
Mr. Denham:
Under the health system advocated by the right hon. Lady and her hon. Friends, any access to health care would be rationed by the ability to pay.
5. Mr. Denis Murphy (Wansbeck):
What estimate he has made of the total amount to be spent in the current financial year on improving NHS children's services. [77702]
The Parliamentary Under-Secretary of State for Health (Mr. John Hutton):
Forecast total gross expenditure on the national health service in the United Kingdom for 1998-99 is £48.1 billion. Overall funding does not distinguish between age groups, although there are specific initiatives in our expenditure plans that will
Mr. Murphy:
I thank my hon. Friend for that reply. Northumbria health care trust plans to build phase 2 of Wansbeck general hospital. When will that building commence and will it include the much-needed children's centre?
Mr. Hutton:
I acknowledge the support that my hon. Friend has shown for the new hospital development in his constituency. The child health centre is an integrated part of the Wansbeck phase 2 scheme, which is now under private finance initiative negotiation. It is expected that a full business case will be submitted to the regional office in May 1999. The trust hopes to be in a position to complete negotiations with a PFI partner within the next few weeks and officials from the regional office and the PFI unit are working with the trust on various aspects of the deal.
Mr. Andrew Lansley (South Cambridgeshire):
Is the Minister aware that funding of additional paediatric intensive care beds at Addenbrooke's hospital in my constituency is a priority task for the management in the financial year ahead? Is he further aware that Addenbrooke's hospital is forecasting for the first time ever a revenue deficit of £2.5 million in the year ahead? For a well-managed hospital, that is an exceptional situation. Can the Minister explain why the Government have contributed to that difficulty by imposing costs of £622,000 next year to pay for the implementation of the working time directive?
Mr. Hutton:
The hon. Gentleman takes a regrettably negative tone. He has failed to acknowledge the fact--and it is a fact--that additional money is being made available to provide additional paediatric intensive care beds in the national health service.
Mr. Lansley
indicated dissent.
Mr. Hutton:
It is no good the hon. Gentleman shaking his head, because that is a fact. Some £15 million is being made available to provide additional paediatric intensive care beds. He let that fact slip through his hands.
Miss Melanie Johnson (Welwyn Hatfield):
Does my hon. Friend agree that one of the most unpleasant experiences for parents and children in the NHS is being rushed to accident and emergency departments with no separate facilities for children? My right hon. Friend the Secretary of State had the pleasure of visiting the separate, specialist facilities in my constituency at the Queen Elizabeth II hospital, which provides an excellent service for children admitted to A and E. Can my hon. Friend comment on monitoring the expenditure of the welcome new money going into A and E provision and how it will improve services for children where there is no separate provision for them?
Mr. Hutton:
I am grateful to my hon. Friend for raising that point. She is dealing with the reality, which is that the Government are spending significant extra money modernising accident and emergency departments across
6. Mr. Andrew George (St. Ives):
What assessment he has made of the level of nursing shortages; and if he will make a statement. [77704]
The Secretary of State for Health (Mr. Frank Dobson):
From the various figures and sources available, I estimate that there are around 9,000 nursing vacancies in the national health service that have existed for three months or more. As the hon. Gentleman knows, on 1 February we launched a major recruitment campaign. Since then, more than 52,000 people have contacted the national response line. Around 5,000 of them were qualified nurses asking about returning to nursing. Nurses who have to go on refresher courses and return to the NHS will have their fees paid by the NHS; those who have already done so will have their fees reimbursed, including his constituents.
Mr. George:
I am grateful to the Secretary of State for that clarification. The Royal College of Nursing estimates that there are between 12,000 and 13,000 nurse vacancies and believes that nurse shortages rather than flu epidemics created the winter crisis. What steps will he take to encourage experienced nurses--the backbone of the NHS--to remain in nursing and not leave the NHS at the present rate?
Mr. Dobson:
The RCN certainly produced estimates different from those of officials of the NHS and my Department. When I last appeared before the Health Committee, I said that I would authorise my officials to get together with people with other estimates so that we can agree how many vacancies there are and not have futile discussion about numbers rather than doing something about it. We are trying to recruit extra nurses. It looks as though the campaign is successful. We are also trying to introduce family friendly policies so that services are available for nurses who want to be able to take their children to school in the morning, take them home in the evening or need a creche so that they can take younger children to the hospital or community service with them. We are determined to bring that about. That applies not only to nurses, but to everyone who works in the NHS because it must provide a top-class service for patients while allowing its hard-working staff to reconcile their jobs with their family responsibilities.
Laura Moffatt (Crawley):
Will my right hon. Friend join me in congratulating the Surrey and Sussex Healthcare NHS trust, which held open evenings at the Crawley and East Surrey hospital sites attended by 165 people? Ten at Crawley signed up for the back-to-nursing course. They are delighted. There is clearly a new view about nursing and people feel invigorated that they are getting back into the profession that they love.
Mr. Dobson:
My hon. Friend, speaking from her experience as a qualified nurse, offers me
Mrs. Virginia Bottomley (South-West Surrey):
The NHS cannot afford to lose any competent and qualified nurses. I certainly applaud the steps that have been taken to follow up the Opportunity 2000 initiatives. The NHS was the first public sector body to join Opportunity 2000. We had a debate yesterday on the Macpherson report. In 1993, the NHS set a target for the number of black and ethnic minority G grade nurses. What further steps are being taken to ensure that we do not lose the skills of public sector workers in the NHS from the black and ethnic minority communities?
Mr. Dobson:
I agree with the right hon. Lady that it is bad if we lose trained nurses from the health service. When we got in there were 140,000 qualified ex-nurses no longer working in the NHS, the odd one or two of whom, I have reason to believe, left when the right hon. Lady was Secretary of State for Health.
We are doing a lot more than any previous Government about the recruitment and retention of black and Asian staff. One of the biggest problems is that, when one says to Afro-Caribbean young people, "Will you think of taking a job as a nurse in the health service?" they say, "Not if they're going to treat me like they treated my mum." We have to deal with that. We are setting examples in so far as we can. The only appointments that I make in the NHS are of non-executive directors. I am proud to say that since we got in we have raised the number of women on the boards to 50 per cent. and the number of black and Asian people to 10 per cent.
Mrs. Gwyneth Dunwoody (Crewe and Nantwich):
Is my right hon. Friend aware that anyone with an ounce of common sense is highly delighted not only with the recruitment campaign that he has mounted, but with his serious acknowledgement that there is a problem with nurses and nurse retention? Will my right hon. Friend assure me that he will abandon any idea of introducing schemes for discretionary payments for nurses? We know that within the NHS such a scheme for doctors is unfair, inequitable and expensive.
Mr. Dobson:
I am not entirely clear what my hon. Friend is referring to. We have certainly set our faces against the idea of performance-related pay in the NHS. We want to relate pay mainly to responsibility. With-- I think--the likely agreement of the profession, we intend to get rid of the rigid grading system that is holding back the professional development of nurses and holding down their pay.
"Is there rationing or is there not?"
The answer I got was very simple:
"No".--[Official Report, 15 December 1998; Vol. 322, c. 746.]
In view of the evidence put to the House by the hon. Member for Sutton and Cheam (Mr. Burstow), does the Minister now wish to revise that answer?
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