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NHS Direct

8. Kali Mountford (Colne Valley): What was each monthly total for calls to NHS Direct since its establishment. [102269]

The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart): In October 1999, NHS Direct handled 109,000 calls. This is the first time that more than 100,000 calls have been handled in one month. By the end of October, NHS Direct had handled more than 700,000 calls. A list of the monthly total of calls since its establishment will be placed in the Library.

Kali Mountford: That is an impressive number by anybody's calculation. I understand that 65,000 callers called NHS Direct in west Yorkshire. However, numbers alone are not the most important issue--the appropriateness of advice is extremely important. One of my constituents--a very close friend--rang NHS Direct when she was feeling queasy and did not want to trouble her GP. She was advised to go to hospital immediately, where she was found to be having a heart attack. I am pleased to say that she is now very well. Is it not the case that NHS Direct is an additional service that allows for the range of NHS services to be used appropriately and effectively?

Ms Stuart: I am grateful to my hon. Friend for that example of how NHS Direct is an additional service that improves health care delivery. In September alone, some 2,000 callers to NHS Direct were directed to call 999 for an ambulance.

NHS Direct is part of a £100 million accident and emergency modernisation package. People who are directed to A and E receive the appropriate urgent treatment and NHS Direct facilitates that, not only in the Colne valley but across the country.

Mr. Ian Bruce (South Dorset): I am sure that the Minister will acknowledge the trials for NHS Direct that were set up by the previous Government. We certainly welcome its success. Is the Minister willing to tackle a difficult question? Will putting more money into walk-in centres and NHS Direct, and correctly reducing the load on GPs and casualty departments, mean a change in the funding of GPs in particular when that load is taken off them?

Ms Stuart: I am delighted that the Conservative party is beginning to see the light. Not too long ago, a Conservative Secretary of State called NHS Direct peripheral and irrelevant. It is neither. As for funding, it is a prime example that shows that modernising the NHS means producing facilities that allow patients access to an appropriate level of medical care, whether that is offered by the GP, the hospital or through self-care. The funding formula will respond to the service needs, and NHS Direct is additional to that.

Breast Screening

10. Ms Linda Perham (Ilford, North): What plans he has to ensure all women over 65 years old are informed of their right to self-refer for breast screening. [102271]

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The Parliamentary Under-Secretary of State for Health (Yvette Cooper): The availability of screening for older women is widely publicised. In particular, the NHS breast screening programme is working with Age Concern to encourage older women to request screening. It has produced a leaflet, "65 or over: You are still entitled to breast screening", which is widely available from general practitioners' surgeries, clinics, some post offices and some shops.

Ms Perham: I am grateful for that answer, and I welcome the Government's co-operation with Age Concern to publicise the right to self-referral for women aged over 65, who form the group at highest risk. If take-up by older women increases--my local unit in Epping has reported 500 more women from that age group referring themselves over the past four years--will my hon. Friend address the problem of resources available for breast screening services? Of course, I welcome the extra funding that the Government have put into those services.

Yvette Cooper: I congratulate my hon. Friend on her work on raising awareness of breast cancer screening and the rights of older women to self-refer. She is right that the number of older women requesting screening is increasing--from 39,000 in 1994-95 to nearly 75,000 in 1997-98. It is precisely to deal with such issues that the Government have set up working groups to examine work force issues and ensure that we maintain the quality of the screening programme for older women and for those covered by the automated recall programme.

Mr. David Tredinnick (Bosworth): Does the Minister accept that those who are screened and who are unfortunate enough to be found positive may often find relief through changes in diet or complementary techniques, such as traditional Chinese medicine or homeopathy? Will she assure me that those treatments will not be forgotten when she addresses the issue?

Yvette Cooper: The hon. Gentleman is quite right to say that many people, particularly those with severe cancer, seek and can find relief from alternative therapies. The Government certainly take complementary therapies seriously.

Elderly Care (NHS)

11. Mr. Nigel Waterson (Eastbourne): If he will make a statement about the standards of NHS care available to elderly patients. [102272]

The Minister of State, Department of Health (Mr. John Hutton): The Government are committed to ensuring high standards of care in the national health service for all patients. Our forthcoming national health service framework for older people will set out for the first time new national standards for the treatment and care of older patients. It will be published next year. In the meantime, we have taken action across a number of areas to improve the care of older people. For example, we have extended the annual immunisation programme for influenza to ensure that everyone aged over 75 can

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have the flu vaccine free of charge. From 1 April, everyone over 60 has been eligible again for free eye tests, regardless of their income or health status.

Mr. Waterson: Does the Minister accept that Age Concern has concluded that, contrary to existing guidelines, one in 20 older people are denied treatment because of their age? The Daily Telegraph has also found that significant numbers of elderly patients are literally being starved to death. Does the Minister accept those findings, and what is he doing about them?

Mr. Hutton: We do not accept the accusation that nurses and doctors are routinely killing patients in the national health service. That ludicrous and absurd allegation strikes directly at the integrity and professionalism of nurses and doctors, and we reject it absolutely. We take criticisms about discrimination on the basis of age in the NHS very seriously. As part of our work on the national health service framework, we are developing new standards on fair access to NHS treatment and care for older patients.

We take the allegations of discrimination seriously, and I am sure that the hon. Gentleman will be aware of the steps that we have taken to establish, for example, the new Commission for Health Improvement, which will have a specific role on the implementation of the new framework for older people. Discrimination of any kind is fundamentally unacceptable as it strikes at the principles and ethos on which the NHS was established. Labour established the NHS, and we shall defend those principles.

Mr. Bill O'Brien (Normanton): I welcome my hon. Friend's statement on future provision for the care of the elderly. However, I have received a significant number of complaints from my constituents and from people throughout the Wakefield area on the problems being encountered at the Pinderfields and Pontefract hospitals NHS trust. Will the Minister say something about guidelines to the trust? May I welcome the 6.9 per cent. increase in resources for Wakefield health authority, which will help to address the problems of many constituents who have respiratory diseases? A great number of elderly asthma sufferers live in my area, and the increase will help them considerably. Will the Minister issue instructions to hospital trusts on the future care of the elderly?

Mr. Hutton: I certainly want to reassure my hon. Friend about his concerns. We have taken the step of developing new national standards, which will be introduced next year, on the treatment and care of older people in the NHS to allay such anxieties. I also remind him, although I am sure that he needs no reminding of it, that, as part of our work on health action zones in his part of Yorkshire, a particular strand of work is devoted to improving the treatment and care of older people.

We take all those concerns and criticisms very seriously. We want the NHS to provide the highest possible standards of care for older people and to ensure that those with complaints are properly heard and their problems addressed. I reassure my hon. Friend and the House that the Government are determined to ensure the best possible standards of treatment and care for older people, who make up the largest age group that uses the

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NHS. They represent 16 per cent. of the population, but 40 per cent. of the NHS's resources are devoted to their care.

Mr. Julian Brazier (Canterbury): Is the Minister aware of the concern among my constituents at the way in which East Kent health authority's new blueprint for our hospital service has marginalised care for the elderly? Is he further aware that the excellent Nunnery Fields hospital, which cares for elderly stroke patients, is mentioned directly only once in the document--when an estimate is given of how much money could be realised by selling it?

Mr. Hutton: I am not aware of the particular concerns that the hon. Gentleman has raised. I will look into them on his behalf, but, again, I point out that, as part of our work this year on developing the new national service framework for older people, a specific group is looking particularly at stroke care and treatment. We are doing that important work in consultation with the Stroke Association. We are looking seriously and actively at improving stroke care throughout the country, but I will look into the specific matters that he raised about East Kent health authority.

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