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Waiting Times (Avon)

3. Mr. Brian Cotter (Weston-super-Mare): If he will make a statement on the average out-patient waiting time for an ear, nose and throat consultation in the Avon health authority area in the last 12 months. [142898]

The Parliamentary Under-Secretary of State for Health (Yvette Cooper): The latest figures, for the quarter ending 30 September 2000, show that in Avon health authority the number of ENT out-patients being seen in less than 13 weeks increased from 54 per cent. to 57 per cent., compared with the previous year. On that date, the number of patients in Avon waiting more than 13 weeks was 7.8 per cent. lower than on the same day in 1999. Avon health authority, like others, will benefit from the action in the NHS plan to cut maximum waiting times for out-patients.

Mr. Cotter: We in Weston-super-Mare must be very unlucky. Is the Minister aware that the mother of a five-year-old suffering from a recurrent ear infection has been told that the child must wait a year for an appointment? I am sure that she will agree that that is a long time for a child to suffer discomfort.

Yvette Cooper: I know that the Weston area health NHS trust has shown the greatest improvement in dealing with ENT long-waiters, with 63 per cent. having their out-patient appointment in less than 13 weeks, compared with 43 per cent. the previous year. However, I shall look into the case mentioned by the hon. Gentleman.

Ms Julia Drown (South Swindon): Has the NHS executive for the region covering Avon health authority been charged with ensuring that best practice is spread from one trust to another, so that those in Avon health authority can benefit from best practice elsewhere? My local trust, at Princess Margaret hospital, has reduced the number of people waiting 13 weeks for ENT appointments from 200 to 75 in only three months. We want such progress to be made throughout the country. No one should wait more than 26 weeks. Such best practice should be spread to Avon health authority and elsewhere.

Yvette Cooper: My hon. Friend is absolutely right to say that we need to spread throughout the country the best practice used in many areas. That is what the action on ENT programme is all about. The pilot of the partial booking system in Basildon has already met the three-month wait target for out-patients set in the NHS plan, and we shall introduce that system throughout the country.

Dr. Liam Fox (Woodspring): As one who shares the Avon health authority area with the hon. Member for

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Weston-super-Mare (Mr. Cotter), I can confirm that cases such as the one that he mentioned occur throughout the region. Does the Minister accept that the situation in Avon is mirrored throughout the country? Can she confirm that the waiting list for the waiting list, which is what the hon. Gentleman described, is now 55,000 higher than when the Government came to office; and that consultants throughout the country are now saying that the waiting list initiative itself means that they are spending a disproportionate amount of time in theatre dealing with minor cases, while the sickest patients often wait longer to see a consultant in out-patients? How many patients will have to suffer as a consequence of that policy before it is abandoned?

Yvette Cooper: I am proud that the Government have met our manifesto pledge to cut in-patient waiting lists by more than 100,000. It is absolutely right that we should cut waiting times in in-patients and out-patients, and that is exactly what is set out in the NHS plan. Perhaps the hon. Gentleman would like to explain why he said that patients should wait longer for certain treatments. Will he say which of his constituents in Avon he believes should wait longer as a result of his proposals?


4. Mr. Peter Bradley (The Wrekin): What advice he has received about the medical properties of cannabis. [142899]

The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart): The Government have approved a number of clinical trials into the medicinal use of cannabis. Once the results of the trials have been properly evaluated, we will have an evidence base that will allow us to decide how to proceed.

Mr. Bradley: I thank my hon. Friend for that answer, but it will come as little relief to the thousands of people throughout the country who suffer the torment of multiple sclerosis. They include a courageous but desperate constituent of mine: courageous because she has allowed me to use her name--indeed, she has encouraged me to do so--and desperate because she suffers the pain of MS. Until relatively recently, she was an undercover drugs squad officer with West Midlands police; it was her job to pursue and lock up people who peddle drugs. Now, she is out on the streets trying to secure her only relief from the pain that she suffers. Will my hon. Friend assure me that she and her colleagues will try to persuade the Home Office and the police service that such people are victims, not criminals? They are victims of the torment of MS, and they should not be made victims of injustice.

Ms Stuart: I sympathise with any patient who is suffering and feels that an effective medicine is not available. However, as with any chronic illness, it is important to evaluate the benefits and risks of treatment. It is therefore extremely important that the research that we are undertaking is properly supervised. It involves 660 MS sufferers and there will be a report in 2003. We shall make a decision based on that clinical evidence.

It is important to put it on the record that the possession of cannabis is against the law for good scientific reasons in terms of acute and chronic health effects. However,

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at each stage of the criminal justice system, there is discretion to allow for public interest considerations to be weighed in the balance. It is right that each case should be considered on its merit; to do otherwise would raise issues of constitutional propriety. The important point is that cannabis and any medicine that is used must be properly tested and assessed. Only when it is seen to be safe and effective will it be used in the NHS.

Mr. Dafydd Wigley (Caernarfon): Does the Minister accept that there has for a long time been evidence of the benefit of cannabis to MS sufferers? Is it not time that the Government made more rapid progress to relieve those people of worries about potential law-breaking, or that they might be unable to get the cannabis that they need for their treatment? Will the hon. Lady give an undertaking that, if necessary, legislation will be introduced when she has enough evidence to make that decision?

Ms Stuart: That is precisely what we are doing. That is why the trials were set up in 1999 and why £950,000 has been put into them. They will be properly conducted and the results properly assessed. When those involved report back with their evidence, we shall take appropriate action. However, that action will be based on reliable scientific evidence and not on anecdotal evidence, which is what we have had so far.

Mr. Paul Flynn (Newport, West): Cannabis has been trialled and tested for 5,000 years in every continent by millions of people, and it has not had any serious side effect throughout that period. One hundred Members of Parliament, the majority of the British Medical Association and the House of Lords Select Committee on Science and Technology all agree that natural cannabis should now be used medicinally. Is it not ironic that Clare Hodges, who has gone to the Belgium Parliament and convinced it to change its law in the past three months to allow medicinal cannabis to be prescribed, has to go on the streets of this country to get her own cannabis? She is an MS sufferer. Another MS sufferer was dragged through the courts six months ago. The policy is stupid and cruel.

Ms Stuart: We need to draw a clear distinction between a drug that is illegal--that is, cannabis--and a medicine that is used within the NHS. The medicine will be used only when it has been properly trialled and tested under clinical conditions. That is what is happening in respect of the medicinal use of cannabis, and it is the right and proper way to proceed.

Over-prescribing (Alzheimer's Disease)

5. Rev. Martin Smyth (Belfast, South): What assessment he has made of injurious impact of over-prescribing of drugs for patients with Alzheimer's disease. [142900]

The Minister of State, Department of Health (Mr. John Hutton): All prescribing for older people, including those with Alzheimer's disease, should be undertaken and monitored carefully by the doctor responsible. The Department published advice in 1998 on prescribing in residential and nursing homes, which covered the use of neuroleptic drugs. The national service

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framework for older people will also contribute to improving the care of older people with dementia by setting new national standards for health and social care services.

Rev. Martin Smyth: I welcome that response and the standard that has been set. I also welcome the improved care for those with Alzheimer's disease and look forward to more discoveries that will help them and cure them. Having said that, does the Minister share my concern that, although some of us thought that the liquid cosh was a thing of the past, there seem to be more reports of people being drugged so that they are subdued and do not cause trouble to their carers?

Mr. Hutton: I am grateful to the hon. Gentleman for his opening comments. There is little doubt that dealing with Alzheimer's disease and other forms of dementia is one of the greatest health and social care challenges that our society faces. Currently, 600,000 people suffer from Alzheimer's disease, and it is estimated that the number will increase substantially in the years ahead as the number of people in our society aged over 80 increases significantly.

I am aware of the concerns that the hon. Gentleman and many other hon. Members have expressed about the use of neuroleptic drugs in care homes. Almost two years ago, Age Concern produced some helpful advice, which included the recommendation that there should be regular reviews of the prescription of neuroleptic drugs. The hon. Gentleman and I share a common interest. We shall make sure that the use of such drugs is kept under proper review.

Mr. Denis MacShane (Rotherham): Is my hon. Friend aware that some doctors in this country--I have in mind a constituency case--are urging dementia patients to take drugs that are banned in America by the Food and Drug Administration? We need a lot more information. Anybody who suffers from or has an elderly relative who suffers from one of the 200 dementing illnesses faces huge personal and social pressure, and it is wrong for doctors casually to say, "This drug will do the trick for you", when it may be banned in other countries. We are working through the National Institute for Clinical Excellence to achieve an even balance throughout the country, but we need more publicity, openness and information. I hope that his Department can help to provide that.

Mr. Hutton: I am grateful to my hon. Friend for his comments. Of course, he is absolutely right. NICE is reviewing a range of available drug treatments for those who have been afflicted with Alzheimer's disease, and I understand that the final appraisal advice will be available shortly.

Mrs. Caroline Spelman (Meriden): With respect to the hon. Member for Belfast, South (Rev. Martin Smyth), Alzheimer's sufferers would say that the problem is under-prescribing of the drugs that they need. In the west midlands, Aricept is not available on the NHS unless the patient is prepared to take part in a trial, which is unnecessary and merely aggravates the problem of

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postcode prescribing to which the Government have failed to deliver a solution. The Secretary of State said:

What went wrong?

Mr. Hutton: I am afraid that that confirms that the modern Conservative party is the stupid party of British politics. The hon. Lady complains about the postcode lottery of care, but she might remind the House of the solution proposed by her party and the Conservative Government: they created the lottery of care and their NHS reforms made it impossible to deal with those problems. She is aware, as I hope the whole House is, that NICE is reviewing the evidence surrounding the use of such drugs and will shortly publish its final advice.

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