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Incapacity Benefit
19. Mr. Tam Dalyell (Linlithgow): What representations he has received from organisations representing the disabled on the operation of incapacity benefit. [102949]
The Parliamentary Under-Secretary of State for Social Security (Mr. Hugh Bayley): We regularly receive representations about benefits from organisations representing disabled people, including on matters relating to incapacity benefit.
Mr. Dalyell: Albeit that the Government have--rightly or wrongly--got their way on incapacity benefit, do they
recognise that the controversy has not gone away? Problems remain. Would it not be a good idea if, in a year or 15 months, there were a formal review of what was taking place, with formal evidence requested from the disability groups that are still so uncertain as to what is happening?
Mr. Bayley: My hon. Friend knows that the process by which legislation is made by the House is one of debate and amendment, and the Government did indeed listen to voluntary bodies, hon. Members and Members in another place, and changed our proposals on incapacity benefit in several ways. The final amendments raised the disregard for occupational pensions from £50 to £85, and extended from two to three years the period during which people could pay the qualifying national insurance contributions.
When the Government published our strategy to combat poverty last autumn, that was widely welcomed, but we will not achieve our aim of dramatically reducing poverty and, in particular, of eliminating child poverty, unless we make it a priority to give more help to the poorest. That, of course, is what our disability benefit reforms are doing by increasing by up to £26 a week the benefits for people who are born severely disabled or who are so severely disabled early in life that they never have the opportunity to earn and pay national insurance contributions or to contribute to an occupational pension. They are the poorest, and they must be the priority.
Influenza
3.31 pm
The Secretary of State for Health (Mr. Alan Milburn): With permission, Madam Speaker, I would like to make a statement on the outbreak of influenza that is gripping the country and the impact that it is having on NHS services.
As the House will be aware, the past few weeks have seen a particular strain of influenza--Sydney A--affecting thousands of people in all parts of the country. According to the Public Health Laboratory Service, which monitors the incidence of flu, it has been rising in all regions over recent weeks. The worst-affected regions to date have been the north and central. Nationally in early December, the numbers of people consulting their GP for the first time with flu-like symptoms stood at 40 per 100,000 of population. Today, I can tell the House that the latest provisional figure has more than quadrupled to 197 per 100,000.
The chief medical officer, Professor Liam Donaldson, has advised me that the official figures reflect only the people who have consulted their doctor and undoubtedly understate the true size of the outbreak. That is because heavy usage of the new service, NHS Direct, and the number of patients going to the pharmacist mean that many patients will not show up on the conventional GP-based tracking system.
The previous highest levels of influenza since monitoring began were in 1968-69 and 1989-90. The CMO believes that the present epidemic will not reach those levels, but he considers that there are people missing from official statistics, because instead of consulting their GP, they have used alternative routes of advice. That means that unless present levels of influenza activity peak very soon, we could be heading for the worst epidemic in the past decade.
That certainly chimes with most people's experiences. There can hardly be a family in the land that has not been affected by the flu. Everybody knows somebody who has had it. People also know that it is particularly severe in its effects. Professor Brian Duerden, deputy director of the PHLS, says that
The serious flu outbreak has placed additional strain on local health services in many parts of the country. In the past three weeks, the number of people attending hospital accident and emergency departments has risen to more than 600,000. There have been 250,000 calls to ambulance services--an increase of almost one third on
last year--and a similar number of calls to NHS Direct over the past three weeks, many flu-related. According to Professor Mike Pringle, chairman of the Royal College of General Practitioners, over the millennium, GP co-operatives had 50 per cent. more calls than last year, mainly owing to the flu.
Those figures clearly demonstrate that the flu outbreak has put real pressure on NHS services--there is no doubt about that. Equally, the evidence suggests that the NHS is dealing with those pressures. All acute hospitals throughout the country have remained open throughout the winter period. Of course, both GP surgeries and hospitals have been extremely busy.
The highest priority is being given to patients who are the most seriously ill. As is usual, and as had been planned, most hospitals have undertaken little routine elective surgery over the past few weeks so as to be able to concentrate their efforts on emergency cases. The number of emergency admissions remained unusually high last week because of the flu outbreak, and many hospitals that had planned to start surgery today have decided to delay until the immediate emergency pressures subside. Hospital managers and clinicians will judge how best to balance their work load in the light of local experience over the next few weeks.
That approach represents a sensible deployment of NHS staff and resources, allowing the health service to cope with the surge in emergency demand that the flu outbreak has brought. Thanks to the staff who run critical care services, they, too, are coping with the demands being placed on them, despite the fact that intensive care is under real pressure. About half the patients being admitted to intensive care have flu or flu-like illnesses, sometimes resulting in pneumonia and--less commonly--in septicaemia, leading to multiple organ failure.
This year, the Government have provided a record number of intensive care and high-dependency beds. We have worked closely with the Intensive Care Society to plan critical care facilities in hospitals. Patients who need acute and critical care are being looked after. There has been an increase of 100 critical care beds this year and, in the face of exceptional demand, staff and facilities are being used flexibly to ensure that patients receive the care that they need. Staff are doing an excellent job in difficult circumstances.
The number of beds available fluctuates by the hour, but I can tell the House that, as of mid-morning today, there were 22 beds available. However, local surges in demand arising as the flu moves around the country will continue to place particular pressures on critical care facilities. Where appropriate, local NHS hospitals have made arrangements with local independent hospitals for critical care. If transfers between intensive care units are required as a last resort, the chief executives of NHS trusts have been asked to ensure that the arrangements run smoothly and that clinical staff are given as much support as possible.
The influenza outbreak has put great pressure on the NHS, but the NHS is coping. As the chairman of the British Medical Association, Dr. Ian Bogle, said earlier today:
Each local group submitted its plans for dealing with winter pressures by the end of September 1999. They were followed by visits from the Department of Health's millennium executive team to ensure the robustness of the plans. We have extended the capacity of local health services to deal with winter pressures. Extra beds have been provided, and over the millennium period, for example, 45 per cent. more ambulance staff than the year before were on duty.
Winter planning has also included a major public information campaign. Its aim has been to encourage the public to use the most appropriate service for their needs--the local pharmacy and NHS Direct or, indeed, self-care--as a complement to GP or hospital services. The campaign was backed by the BMA, the Royal College of Nursing and the Patients Association, among others. All the evidence that we have received to date suggests that the public have responded positively to the campaign by recognising that health services should be used appropriately and responsibly.
The campaign was also supported by a large increase in flu vaccinations made available to the public through family doctors. Flu vaccine can never eradicate flu, but it can help to provide further protection for vulnerable groups. This winter, 8.6 million doses of influenza vaccine were made available: 1 million up on last year. We do not as yet have uptake levels for flu vaccine this year, but we will review them when they become available. In the meantime, I have asked the chief medical officer to consider ways of enhancing uptake in future. Increased use of computerised call-up systems is one possibility.
"it is a more prolonged illness, at 10 to 12 days before people start to feel better rather than four or five."
The epidemic is also having a particular impact on elderly people, some of whom have developed serious complications such as bronchitis and pneumonia. In addition to influenza, other viruses such as respiratory syncytial virus--RSV--are contributing to acute respiratory illness. I am advised that RSV illness is at its peak at present. Emergency admissions to hospital have increased as a result: there have been more than 200,000 such admissions to hospitals in the past three weeks alone, and there has been an increase of almost 30 per cent. in the past two months. The evidence that we are receiving from hospitals is that the patients who are being admitted are more ill than normal and are staying longer than normal.
"all parts of the NHS have been put under pressure but doctors and nurses are coping well from GP services to intensive care. The incidence of new cases of flu is uneven but wherever it is occurring it is a particularly nasty strain. Thanks to the high level of planning across the country we are coping".
10 Jan 2000 : Column 23
Of course the NHS is under severe pressure. Winter is always the busiest time of year for the national health service; in addition, this winter, the NHS and social services have had to deal with the special pressures brought by the extended millennium period.
That is why planning for this winter began earlier than ever. Local winter planning groups were established in April last year in every part of England to co-ordinate the planning and provision of health and social services over the winter and millennium period. Each group includes health authorities, social services, NHS trusts, primary care groups, out-of-hours and deputising services, NHS Direct, police and fire services, community health councils, other local authority departments, and, of course, the voluntary and private sector.
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