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Mr. Milburn: Yes.

Mr. John Townend (East Yorkshire): In view of what the Secretary of State said about the need for immunisation, what would he say to Mrs. Wheddon, of Watton, in my constituency, who rang me this afternoon and said that, today, on the media, she had heard a health service spokesman say that people should go to be vaccinated? She rang up her local surgery and was told that--although she suffers from emphysema--no vaccine was available, and that they thought that there was a shortage of it across the country.

Subsequently, I rang my general practitioner, in Yorkshire, and asked whether--as the Secretary of State recommends--I could have a flu vaccination, but was told that he had no flu vaccine. I pointed out that the other surgery had said that there was a national shortage of flu vaccine, and asked whether that was the case. I was told, "We are going to get some more, but only a very limited quantity, and we will put you on a waiting list."

Does the Secretary of State agree that the current situation demonstrates that the Government were completely unprepared for a flu epidemic, and that spin will not solve Mrs. Wheddon's problem?

Mr. Milburn: Tediously predictable, as usual.

Mr. John Bercow (Buckingham): Could anyone be tediously predictable as not usual?

Mr. Milburn: That is a very good point. It is good to see that the hon. Gentlemen has--perhaps; we shall see--recovered from his Christmas break.

I should be very glad to investigate local problems with the availability of flu vaccination. As far as I am aware, however, there is no local shortage of vaccine. Indeed, although the accusation made by Opposition spokesmen has been that we have not made flu vaccine available, we have in fact been providing it to family doctors. I see the hon. Member for East Yorkshire (Mr. Townend) nodding.

I remind the hon. Gentleman that, last year, the current Government became the first one to make available flu vaccination to all members of vulnerable groups, such as over-75s. We reversed the previous position, as that was the sensible course of action to take. We shall, of course, learn from this year, and we shall improve on it. However, it is simply not the case that people generally have not been receiving a flu vaccination if they need one.

Fiona Mactaggart (Slough): My local hospital, Wexham Park, like that of other hon. Members, is admitting twice as many people as it usually does. It is coping because doctors and nurses are working very hard indeed, for which I pay tribute to them.

Two issues arise. First, many hospital registrars are facing examinations, on which they are working very hard, and hospital management will have to provide them with study time to cope with that pressure. Is any action being taken centrally to help local hospital trusts address that issue?

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Secondly, some of the cancelled elective surgery was cancer surgery. Some local people are scared because we are not meeting the swift times that we have introduced for cancer surgery. As the crisis diminishes, will my right hon. Friend encourage hospital trusts to make those operations a high priority? Some people who have had to have their time changed for inevitable managerial reasons will need to be dealt with urgently when it becomes possible.

Mr. Milburn: I shall give my hon. Friend and her constituents that assurance. We have continually reiterated that treatment on the national health service should be according to clinical urgency as well as clinical need. That has always been the position. Of course hospitals are hard pressed at the moment. Some are having to cancel routine elective surgery. As the pressures diminish, I expect the national health service and local hospitals to get back on track and start to treat patients according to the urgency of their conditions. That is the appropriate thing to do, and it is what the national health service has been doing.

Dr. Evan Harris (Oxford, West and Abingdon): Does the Secretary of State accept that, to justify his assertion that the figures of the Royal College of General Practitioners for a flu epidemic--which show a typical year, not an atypical year--are wrong, the Government need to publish data from NHS Direct or elsewhere? If not, he runs the danger of the chief medical officer appearing to be a political football--a subject just referred to by the hon. Member for Cannock Chase (Dr. Wright).

I worked in my local casualty department over the millennium. Does the Secretary of State accept that NHS staff want more money for the health service? They recognise that the disease afflicting the NHS is a contagious one caught by the Government from the Tories. It involves their spending pre-election war chests on tax bribes rather than on NHS services. Does he accept that to blame a microbe for the problems of the NHS, when the real problem is years of underfunding which the Government have continued, does a disservice to the people working in the health service?

Mr. Milburn: No, I do not accept that. The Government are giving the NHS a record cash injection. I should have thought that the hon. Gentleman would welcome that. As the economy grows, the national health service can grow. I am determined to ensure sustained and sustainable increases in funding for the NHS, not just this year, next year and the following year, but in the years after.

The hon. Gentleman's first point was a decent and substantive one. We are into a new ball game. The chief medical officer is looking again at the advice that we have received from the PHLS, because we have listened carefully to clinicians and managers, who have told us over the past three or four weeks that the official figures dramatically understated the range of demand in hospital accident and emergency departments and in GP surgeries. The evidence on the number of people who have been to the pharmacist and bought cold and flu remedies from major outlets such as Boots the Chemist, as well as those phoning NHS Direct, shows that many people have

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heeded the chief medical officer's sensible advice that the best way to deal with the flu is to take care and stay at home.

Dr. Howard Stoate (Dartford): I spent part of my millennium break helping to treat the flu epidemic and vaccinate those at risk. My local health trust in Dartford and Gravesham has coped very well. It has increased the number of intensive care beds by 50 per cent. to cope with the difficulty. One of the trust's main problems has been a shortage of highly trained specialist nurses to manage those beds. When does my right hon. Friend predict that the Government's new nurse recruitment and training programme will start to roll out such highly qualified and dedicated nurses into our wards and intensive care units, so that we no longer encounter critical problems every year caused by a lack of nurses?

Mr. Milburn: As my hon. Friend knows, we aim to recruit up to an extra 15,000 nurses to the national health service over the next few years. We are making good progress on that. So far, around 4,000 nurses have returned to the national health service or returned to training as a result of the recruitment campaign initiated by my predecessor, my right hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson). That is beginning to take effect.

More optimistically for the longer term, I can tell my hon. Friend that the number of applications this year for nurse training courses in colleges is double the previous year's. That is a good sign. We know that there are problems with particular specialties which have come about as a direct consequence of the fact that the previous Government cut not only the number of nurses, but--even more short-sightedly--the number of nurses in training. We are beginning to make up that lost ground. It will take time, but we are seeing nurses come back to the NHS.

Mr. David Prior (North Norfolk): Does the Secretary of State have the honesty and the courage to admit that, compared with other developed countries, the resources in this country made available to the health service, private and public, are massively underfunded?

Mr. Milburn: As I told the hon. Member for Oxford, West and Abingdon (Dr. Harris), I want to see sustained increases in investment in the NHS--this year, next year and in the years that follow. By the end of this Parliament, for the first time ever, spending on the NHS will have risen to more than 6 per cent. of gross domestic product.

Mrs. Eileen Gordon (Romford): I am a great supporter of NHS Direct--I could be accused of using it as a political football--which was introduced by the Labour Government. Is my right hon. Friend as pleased as I am by the valuable contribution that it has made during the influenza outbreak? Will he issue statistics on how many calls to NHS Direct concern flu-related symptoms? Is there any way of estimating how many of those people chose NHS Direct rather than presenting themselves to GPs or accident and emergency departments, which would have added to the stresses and strains?

Mr. Milburn: My hon. Friend is right. NHS Direct, described by the Tory party as a gimmick, has proved its worth and its mettle over the millennium period. It has

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taken almost 250,000 calls, many of which have been related directly to flu. Early evidence suggests that NHS Direct is referring about one third of those who ring up to more appropriate and less intensive forms of care than they envisaged when they made the phone call. In other words, people who might have expected to turn up at their GP's surgery, to call the family doctor out of hours, or to turn up at the local casualty department are instead looking after themselves and their families at home where that is the safe thing to do. NHS Direct is a real success story, not least because it is helping patients to get the most appropriate level of care and treatment that they need.

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