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Coronary Heart Disease
8. Ms Sally Keeble (Northampton, North): What progress is being made in improving services which will cut the incidence of coronary heart disease. [151956]
The Minister for Public Health (Yvette Cooper): Two of the biggest causes of heart disease are smoking and lack of access to fruit and vegetables. That is why the action to cut the incidence of heart disease includes comprehensive support for smokers who want to give up, and rolling out free fruit in infants schools.
Ms Keeble: I thank my hon. Friend for that response. Is she aware that this Friday, a new chest pain clinic is opening at Northampton general hospital, and does she agree that such measures will not only help to cure heart disease but will help people to monitor their own condition and get it under control?
Yvette Cooper: I agree with my hon. Friend, and I certainly welcome the arrival of the new rapid-access chest pain clinic in Northampton. In the national service framework we have set out plans for rapid-access chest pain clinics throughout the country. Those are being opened as we speak, and are starting to provide services throughout the country, because it is important that when people are suspected of suffering from heart disease they can be seen very swiftly and properly diagnosed.
Dr. Jenny Tonge (Richmond Park): Is the Minister not concerned about the lack of fitness among our young people, and does she not consider that that is due to a lack of sporting facilities and sports education in our schools? We may accept that that is largely due to the selling of school playing fields and the requirements of the national curriculum, but what talks is the Minister having with her counterparts in the Department for Education and Employment to ensure that sport is made compulsory in our schools?
Yvette Cooper: We have had considerable discussions with the DFEE and the Department for Culture, Media and Sport about promoting sport in schools. The hon. Lady will be aware that considerable work has been done to promote sport in schools, and to create school sports co-ordinators to increase access to exercise among young people. However, this issue is not just about sports; it is about exercise and access to exercise across the board.
The creation of safe routes to school for many of our young people is another important way of increasing their access to exercise.
Mr. Dennis Turner (Wolverhampton, South-East): I am not sure whether Ministers, particularly my right hon. Friend himself, are aware of the deep affection in which the Secretary of State is held by my constituents, following his recent announcement of a state-of-the-art £44 million coronary care unit for Wolverhampton and the black country. My right hon. Friend is aware, as all our Ministers are, that we have the highest incidence of heart disease in the whole west midlands region, but the lowest access to such important life-saving facilities. Thank you very much, Ministers.
Yvette Cooper: I join my hon. Friend in welcoming the new state-of-the-art cardiac surgery centre in Wolverhampton, and pay tribute to his very persistent lobbying on behalf of his constituents for the cardiac centre these past many months. He is right that it is important to increase access to heart operations and to increase the number of heart operations taking place in this country. He is also right that it is important to target those services exactly where we need them, in order to tackle the health inequalities as well, because the blunt fact is that a person on a low income is three times more likely to suffer from heart disease than a person on a high income. That health inequality is morally wrong.
Consultants Contracts
9. Mr. David Amess (Southend, West): What representations he has received on the negotiations for new consultants contracts. [151957]
13. Dr. Julian Lewis (New Forest, East): If he will make a statement on the recruitment and retention of consultants. [151961]
The Secretary of State for Health (Mr. Alan Milburn): The Government's proposals for a new consultants contract were published last month. We are now in negotiation with the British Medical Association on our proposals and its own. In the meantime, the number of consultants in the NHS has increased by almost 3,000 since 1997. We are committed to further significant increases as part of the NHS plan. By 2004, there will be 7,500 more consultants working in the NHS.
Mr. Amess: I take all that with a pinch of salt. Surely the Secretary of State realises that, even by the standards of this deeply sinister, incompetent--[Hon. Members: "Rotten Government"]--rotten Government, his policy on consultants contracts is wrong. Will he now undertake to look carefully at the evidence given to the Select Committee on Health, which showed that morale in our health service will plummet as a result of that policy? Will he undertake to stop his wicked attack on our hard-working consultants and realise that although we need more hospital consultants, we certainly do not need a Labour Secretary of State for Health?
Mr. Milburn: I know that the hon. Gentleman is parliamentary adviser to the Caravan Club--which probably explains why he is undertaking his political tour
of Essex constituencies at the moment--but not everyone has the luxury of having two jobs at once. It is right that we correct this historic anomaly, and our proposals are designed to do something very simple indeed. The consultants contract has remained unreformed since 1948; it is about time it was changed. I want to put the NHS in a better position to compete for consultants valuable time, expertise and skills, for the benefit of NHS patients.
Dr. Lewis: Does the Secretary of State's policy not show that he thinks he knows a lot better than the founding fathers of the NHS, who recognised the problems that would be caused if consultants were forced into the NHS and not allowed to engage in private practice? What makes him think that he has a better solution to the problem, which is fundamentally the same now as it was when Aneurin Bevan and other Labour Ministers, who knew what they were doing, decided that the course that he proposes to adopt was totally wrong, counter-productive and would result in consultants being lost from the NHS?
Mr. Milburn: The hon. Gentleman is the oddest looking Bevanite that I have ever seen in my life; poor old Nye would be turning in his grave at the prospect of the hon. Gentleman supporting him. The contract has remained unreformed since 1948. It has remained as it was then for the past 53 years, and it has to change. The whole assumption behind the consultant contract has been that the best way for NHS consultants to get on is by opting out of NHS work. We must turn that on its head. There is a fair deal on offer for NHS consultants. We will pay them more for doing more NHS work, in exchange for which we expect them to do less private practice. We have proposed the deal, and we shall negotiate it.
Mr. David Hinchliffe (Wakefield): The Health Committee's inquiry into consultants contracts was mentioned a moment or two ago. Does my right hon. Friend remember that during that inquiry, we received evidence that, in certain parts of the country, NHS waiting lists were being artificially lengthened to stimulate a demand for private consultations and private treatment? In the negotiations with the consultants, has that matter been considered?
Mr. Milburn: I understand that there are concerns about precisely those issues. Many patients find being confronted with such potential conflicts of interest extremely uncomfortable, but that is not the primary purpose of what we seek to do. Given that we have a limited number of NHS consultants--we shall have more in future--our primary purpose is to ensure that we get the maximum amount of NHS time from them. That seems reasonable; it is not a something-for-nothing deal.
We are seeking to pay NHS consultants more for doing more NHS work. They will receive an average of £10,000 a year extra when they start out as NHS consultants. They will have extra access to discretionary points and extra access to £20,000 worth of extra rewards in exchange for doing less private practice. That is the deal that we have proposed. It makes a fundamental break from what has
gone before, but I believe that in the end, it will be welcomed not only by NHS consultants, but, most importantly, by NHS patients.
Mr. Dennis Skinner (Bolsover): I wish my right hon. Friend well in his endeavours. Do we not all know that, contrary to what Tory Members have said, Nye Bevan wanted to do exactly what my right hon. Friend is attempting to do today? The money was not there then, but we have now got an economy that enables us to achieve what we could not do in the 1940s. My right hon. Friend should not worry when the Tories talk about doctors and consultants with more than one job, because nearly every Tory MP moonlights as well.
Mr. Milburn: My hon. Friend, as always, makes a very good point. I will not take much notice of what the Conservatives say, but of course we shall listen to what the consultants say. There will be a negotiation, and we have set out our position very clearly indeed. We shall negotiate on it, and I fully expect us to make progress.
Mr. Peter Lilley (Hitchin and Harpenden): Although I accept that it is normally desirable to retain experienced and dedicated consultants in the NHS, will the Secretary of State set up an inquiry into why Mr. Lennox Kane, a consultant gynaecologist at Hemel Hempstead who had been diagnosed with Parkinson's disease, was allowed to continue operating? Will the inquiry investigate the complaints of 27 of his women patients about the treatment that they received? Will the right hon. Gentleman use his good offices to ensure that the chief executive and chairman of the health authority and the trust agree to meet the members of the action group that was set up to represent those patients before such an inquiry, not after, which is all that they have agreed to at present?
Mr. Milburn: The circumstances that the right hon. Gentleman describes are extremely disturbing. As I understand it, the trust is already reviewing the way in which the complaints were or were not acted upon. I promise him that I shall look into precisely the matters that he has raised with me.
Mr. Desmond Swayne (New Forest, West): On 11 June last year, the Secretary of State told BBC television:
- "In most walks of life employees have got a choice haven't they about whether they work part-time or whether they work full-time . . . We are not going to deny that to consultants. Surely, why should we? It would be a pretty odd state of affairs if we said to highly trained consultants, some of the most expert people, professionals that we have in the Health Service, you are going to be denied a set of rights that everybody in the NHS has."
Mr. Milburn: Welcome to Health questions. The hon. Gentleman should read the Government's proposals.
Mr. Graham Brady (Altrincham and Sale, West): Answer the question.
Mr. Milburn: If the hon. Gentleman will stop hollering, I will try to answer the question. If he calms down and keeps taking the pills, he will be fine.
If the hon. Member for New Forest, West (Mr. Swayne) reads the Government's proposals, he will see that there is perfect consistency between what was said then and what is being said now. We have made it perfectly clear that, in exchange for extra rewards, we will expect newly qualified consultants not to work in private practice for up to seven years. Following that seven-year ban, it will be perfectly permissible for consultants to undertake a limited amount of private practice. That seems to me to be the right thing to do. It is right for consultants, because it gets them extra rewards, and it gets NHS patients the extra skills, the extra commitment and the extra expertise that they need.
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