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House of Commons

Tuesday 8 June 1999

The House met at half-past Two o'clock


[Madam Speaker in the Chair]

Oral Answers to Questions


The Secretary of State was asked--

Royal Surrey Hospital

1. Mr. Nick St. Aubyn (Guildford): If he will make a statement on the quality of service at the Royal Surrey hospital. [84996]

The Minister of State, Department of Health (Mr. John Denham): It is the responsibility of management and doctors to ensure the quality of services provided locally.

Patients and general practitioners have a right to know that their local health service hospital is performing well. As a first step, we will be publishing hospital-based indicators shortly. On 28 May, it was announced that the Royal Surrey hospital would receive £276,000 from the accident and emergency modernisation fund to enable it to open up a medical admissions unit. The unit will reduce the need for patients to stay overnight in the accident and emergency department.

Mr. St. Aubyn: That contribution is welcome, but waiting lists at the Royal Surrey hospital are still higher than two years ago; the turnover of nursing staff has reached 28 per cent; and 20 per cent. of nursing staff places are currently unfilled. Since the abolition of the internal market, there has been a recurring deficit at the Royal Surrey of £1.4 million a year, which led to the closure last Saturday of one of the clinical wards. In the circumstances, when will the Government give the funding that the Royal Surrey needs to maintain the high standards that it has achieved in the past?

Mr. Denham: The truth is that the health authority has received 2.9 per cent. in real growth this year, and more than £800,000 extra will be available from the modernisation fund to tackle waiting lists. The Royal Surrey hospital has met and will meet its waiting list targets, and it will treat more patients than ever next year.

Miss Ann Widdecombe (Maidstone and The Weald): Is the hon. Gentleman aware that 58 per cent. of junior doctors at the Royal Surrey hospital are working more hours than are specified under the new deal?

Mr. Denham: The Government have made progress in implementing the new deal by improving the conditions for rest periods. We will continue to make progress, working with the junior doctors.

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Miss Widdecombe: How does the hon. Gentleman match that statement with the national figures, which show that whereas only 16 per cent. of junior doctors were working beyond the 56-hour limit when we left office, some 28 per cent. are now working beyond that limit?

Mr. Denham: Because, as the right hon. Lady knows, the figures would show continued progress by the Government if they were seen on a comparable basis. We agreed with the junior doctors that there should be more stringent criteria for their rest periods, as that was in their interests and those of patients. Everyone accepted that bringing in the changes in December would produce a rise in the headline figures for non-compliance with the new deal. However, all the evidence suggests that the actual number of hours worked by junior doctors has not increased.

Miss Widdecombe: The figures for the Royal Surrey hospital fly in the face of what the hon. Gentleman has just said. At 31 March 1998, all 128 posts at the Royal Surrey hospital were declared to be compliant. By 30 September 1998--before the new monitoring criteria were imposed--12 per cent. of posts were not compliant with the hours in the new deal. That shows that the trend of increasing non-compliance started before the hon. Gentleman and the Secretary of State changed the criteria. When will we see the national figures which, mysteriously, are available, but have not been published?

Mr. Denham: The answer is the one that I have already given. The reason for the increase in the headline figure for non-compliance is the change in the definitions in the new deal. However, progress continues to be made, and there is no evidence that junior doctors are working longer hours. So far as any individual hospital is concerned, it is clearly the responsibility of the hospital management to work towards compliance with the new deal. One of the reasons why we are continuing to fund the regional task forces is to work with that minority of hospitals which have a minority of junior doctor places that are not compliant with the new deal.

Mrs. Virginia Bottomley (South-West Surrey): In my 15 years as a local Member of Parliament, there has not been a more severe situation at the Royal Surrey hospital. I would like to help the hon. Gentleman to help the hospital to make difficult decisions, but the options that it is now considering are not fair to patients. The area has one of the highest costs of living, high expectations and massive demand. The combination of the hon. Gentleman's decisions on health funding--among the lowest in the country--and the vindictive social services settlement means that the hospital cannot maintain the quality of service that is necessary. Will he personally look at the health and social services figures together?

Mr. Denham: It is an inescapable fact that the health service in the area has to deal with the deficit of about £18 million built up over two years under the previous Administration. Viewed nationally, the hospital is not typical. There has been considerable progress since we came to office in reducing the number of NHS trusts in serious financial difficulties.

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Sexual Health (Women)

2. Fiona Mactaggart (Slough): What action he is taking to improve the sexual health of young women in Britain. [84997]

The Parliamentary Under-Secretary of State for Health (Mr. John Hutton): My right hon. Friend the Minister for Public Health announced on 23 March that the Department of Health will, over the coming year, develop a comprehensive strategy on sexual health. We expect to be in a position to announce in the very near future the membership of an expert group to steer the work.

Fiona Mactaggart: Does my hon. Friend share my concern about sexual ill-health among young women and the rate of chlamydia--a non-symptomatic sexually transmitted infection, most common among women between 16 and 19--with 630 cases per 100,000 women? Is he aware that research suggests that an integrated specialist service can ensure that young women are more likely to be tested for such infections, to be diagnosed and to avoid problems such as infertility and ectopic pregnancy in later life? Will he do more to ensure that specialist services not only focus on reproductive health but deal with sexually transmitted infections in an integrated way?

Mr. Hutton: My hon. Friend is certainly right to draw attention to the risks posed by chlamydia. The rate of infection rose significantly in the last year for which we have figures, with an increase of nearly 21 per cent. Nearly 22,500 young women were diagnosed with chlamydia infection. That is why the Department is trying to promote better awareness. We mounted two public awareness campaigns, targeted primarily at younger women. A booklet was issued through 19 magazine in March and distributed through further education colleges. We are expecting two pilot schemes--one in the Wirral and one in Portsmouth--to begin operating a chlamydia screening service for young women in the summer. The Government are taking action and I certainly recognise the strength of my hon. Friend's argument.

Mr. John Bercow (Buckingham): I accept that constructive sex education in schools can safeguard and even improve the sexual health of young women, but does the Minister agree that the recent suggestion from the hon. Member for Oxford, West and Abingdon (Dr. Harris) that sex education should be available in schools to children of seven is wrong and will rightly be viewed with alarm by millions of people throughout the country?

Mr. Hutton: I appreciate the hon. Gentleman's constructive comments about the importance of good health and sex education in schools. It is compulsory in secondary schools, and has been since 1994; at present, it is at the discretion of school governors in primary schools. I do not want to get involved in that argument today. It is important to recognise what good sex education can contribute. Of course it has to be appropriate to make a good contribution to promoting the sexual health of our young people. The Government are committed to that and we are taking the action that I have already outlined.

Ms Beverley Hughes (Stretford and Urmston): Is my hon. Friend aware of recent research reported in the

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British Medical Journal, concluding that teenage sexual health in Britain is not only bad but getting worse, with increases in terminations among the under-19s and in birth rates? In the context of a fall in cases of sexually transmitted diseases generally, we have had an increase in cases not only of chlamydia but of gonorrhoea among the young. Does he agree that, although sex education and contraception are essential parts of the strategy, they are by no means sufficient by themselves and we must tackle issues of social exclusion, education, parental involvement and indeed poverty?

Mr. Hutton: I agree strongly. My hon. Friend made several sensible and useful points. It is very much the Government's intention to approach these issues in a joined-up way, considering all the services that are available to young women. It is extremely important to improve the sexual health of our young people. We have the highest rate of teenage pregnancy in western Europe and very high rates of sexual infection among young people. That is not acceptable. The Government will address the issues and we are determined to improve the sexual health of our young people.

Dr. Evan Harris (Oxford, West and Abingdon): In view of that answer, does the Minister accept the need for urgency and does he understand the concerns of the British Medical Association, the Royal College of Nursing and the Sex Education Forum about the initiative that he announced a minute ago? We are halfway through this Parliament and we are still awaiting the joint report from the Department of Health and the Department for Education and Employment on personal health and sex education and the report of the social exclusion unit on teenage pregnancy. I urge the Minister to consider becoming involved in the debate on sex education so that we can have a system, such as those in Scandinavia and Holland, of early, clear sex education which has delivered the lowest rates of teenage abortion and under-16 conception in Europe, instead of the highest, which we have.

Mr. Hutton: I welcome the hon. Gentleman's interest and concern, but I shall not take any lectures from him about the speed of the Government's response. We have responded quickly and are putting together a comprehensive strategy to address such issues in the near future. It is a clear priority for the Government to tackle them as quickly as we can, but that must be done in the right way. We have the elements of the strategy in place and that will make a significant contribution to improving the sexual health of young people in this country, which is what we want to do.

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