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Macular Degeneration

8. Mr. Alan Simpson (Nottingham, South): What treatment is available within the NHS for macular degeneration. [488]

The Parliamentary Under-Secretary of State for Health (Yvette Cooper): There are two kinds of age-related macular degeneration. Dry age-related macular degeneration accounts for 90 per cent. of cases

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and has no currently available treatment. Wet age-related macular degeneration can be treated with laser coagulation and photodynamic therapy on the NHS.

Mr. Simpson: I know that the Minister will share my concern about the increasing numbers of older people who suffer from macular degeneration--bleeding at the back of the eye that destroys all central vision and results in near blindness. I know that she is also aware that the Queen's medical centre in my constituency is one of four centres of excellence which are offering treatments in the United Kingdom that had previously been available only in other parts of Europe.

I am sure that the Minister will be delighted to know that those treatments take up no more than half an hour of NHS time, but I am sure that she will share my concern to discover that patients in Nottingham are being told that they cannot have access to such treatment under the NHS unless they can fork out £1,000 a time for it. Will she look into the charging process that makes those treatments available in our own funded programmes, and give the House some assurance about when we shall be able to guarantee that those treatments will be available on the basis of need, not wealth?

Yvette Cooper: I can assure my hon. Friend that I will look into the cases that he describes. I am not aware of the details that he is talking about. I know, however, that we have asked the National Institute for Clinical Excellence to examine one of the proposed treatments, visudyne, which is being trialled in many areas across the NHS, to assess its clinical and cost effectiveness, so that we can follow set recommendations throughout the NHS instead of different recommendations being followed in different areas.

Mr. David Tredinnick (Bosworth): May I correct the Minister and say that macular degeneration can be treated by using homeopathic remedies, by herbal remedies and by using acupuncture? Is not it very regrettable that, since the introduction of primary care groups in the national health service, the number of complementary therapies available in the health service has decreased? Will the Government look into that urgently? Was the Minister aware that last week was homeopathic awareness week, which of course was very important?

Yvette Cooper: I certainly congratulate the hon. Gentleman on finding an opportunity to raise complementary and alternative medicine in Health questions--the clock was ticking and I wondered when he would find the opportunity to do so. He has taken the opportunity to inform the House of the fact that last week was homeopathic awareness week.

I am interested to hear what the hon. Gentleman says about the possible impact of complementary and alternative medicine on treating age-related macular degeneration. He is aware that we have provided extensive information to primary care groups to promote their awareness of the impact that complementary and alternative medicine can have. The choice of treatments is obviously a decision for primary care groups and trusts to take, but we are keen to ensure that they have full information about the benefits of complementary and alternative medicine so that they can take informed decisions in the interests of their patients.

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Basildon Hospital

10. Andrew Mackinlay (Thurrock): If he will make a statement on measures proposed to improve the accident and emergency department at Basildon hospital. [491]

The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): Of the £150 million that has been invested in improving accident and emergency departments across the country, Basildon has received £338,000, which has already helped to fund the refurbishment of the resuscitation room and provision of a children's waiting area.

Andrew Mackinlay: I thank the Minister for that reply. When the Secretary of State had just become a junior health Minister, I introduced an Adjournment debate, which I expect he will recall. In prophetic terms, I explained that the closure of the Orsett hospital A and E department--the decision was made under the Conservative Administration--meant that the Basildon A and E department would not be able to cope. Will she send some of her folk down from the Ministry to have a look? There is massive overcrowding, people have to stay in the A and E department because they cannot go on to the wards and there is bed-blocking, which is largely caused by Essex county council. That needs to be tackled. We are in a crisis in which I can no longer acquiesce by my silence, and I will not do so.

Ms Blears: I am aware of my hon. Friend's consistency on the matter and that he raised it again in his contribution on the Queen's Speech. We have already done better than sending officials down, because, in February, my right hon. Friend the Secretary of State visited with my hon. Friend the Member for Basildon (Angela Smith), who has made similar representations for a long time. As a result of that visit, an extra £7.2 million was awarded to build a third storey on top of new wards. That will provide an extra 108 beds at the hospital, but, to help with emergency pressures in particular, the provision of a 27-bed ward is being brought forward six months. It will open just before Christmas and will be in place when the hospital experiences peak demand--over Christmas and into the new year. Although we hope to achieve a better flow of patients into those new beds, we are acutely conscious of the tremendous problems at Basildon and we shall continue to monitor them.

PFI Projects

11. Dr. Julian Lewis (New Forest, East): How many PFI projects are awaiting his approval. [492]

The Minister of State, Department of Health (Mr. John Hutton): Since May 1997, 64 major hospital schemes worth more than £7.4 billion have been given the go-ahead to proceed under PFI, representing the biggest hospital-building programme in the history of the national health service. For major schemes, Ministers approve the final PFI proposal in the full business case. No FBCs are currently awaiting approval by Ministers.

Dr. Lewis: Does the Minister recall that, last year, the NHS executive pulled the plug on two proposed PFI community hospitals, one in Sheppey and one at

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Lymington? Since then, the Sheppey project has been built as a publicly funded hospital, but nothing has happened with regard to the hospital at Lymington, which is desperately needed to serve the New Forest area. Could the difference in treatment be explained by the fact that the hospital in Sheppey was in a Labour marginal seat and the one in the New Forest area was not?

Mr. Hutton: Labour Members used to be accused of being conspiracy theorists--clearly, that infection has spread to the ranks of Conservative Members. There were problems at Lymington of which the hon. Gentleman, to be fair to him, will be aware and the new primary care trust is trying to find a way forward as quickly as possible to resolve the outstanding issues that need to be addressed. We shall give our support to finding the speediest way possible to resolve the problems at Lymington.

Mr. Derek Foster (Bishop Auckland): Through the Minister, may I thank the Secretary of State for a PFI project, which he has signed? The beautiful building rising in the centre of Bishop Auckland will be a superb example of the concept of public-private partnership, but may I tell them that an instruction to deliver is not a mandate to privatise? Will my hon. Friend ensure that the NHS is saved from an unnecessary and counter- productive battle and that we get on with the job, which he is doing so splendidly, of delivering?

Mr. Hutton: I am grateful to my right hon. Friend for his remarks about the Bishop Auckland scheme and I remind the House that it is a good example of what the PFI can do. The public sector capital route would have required a 10-year rebuilding programme over three separate phases. Under the PFI, we were able to achieve that in one go over three years. He is absolutely right--it shows the benefits of private finance and public partnerships.

Let me say to my right hon. Friend, all my hon. Friends and Opposition Members that the Government have no plans to privatise the NHS. We have made that absolutely clear. We need and require a modern and effective relationship with the private sector and we shall achieve that, but we are not privatising the NHS. The NHS is not for sale.

Beta Interferon

12. Mr. John Bercow (Buckingham): When the decision by NICE on the availability of beta interferon to multiple sclerosis sufferers will be made. [493]

The Minister of State, Department of Health (Mr. John Hutton): The National Institute for Clinical Excellence is now consulting on the draft economic model and data on the cost effectiveness of beta interferon and glatiramer acetate. NICE anticipates that its appraisal committee will reconsider the evidence next month and, subject to any further appeals, we expect it to issue its final guidance by November this year.

Mr. Bercow: I am grateful to the Minister of State for that informative reply. Will he confirm that beta interferon for multiple sclerosis sufferers is effective only when it is used early in the course of the disease? Does he accept the estimate of the Multiple Sclerosis Society that hundreds of

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people will be irrevocably disabled if they are denied access to the drug during the extension of the NICE appraisal? If he does, how can he guarantee that his Department's proper exhortation to continue prescribing the drug will be heeded at the local level?

Mr. Hutton: We do not issue guidance simply to amuse ourselves; its purpose is to deal with the situation that the hon. Gentleman describes. The wider issues about the benefits, or otherwise, of beta interferon are matters for the national institute to address. That is why we established it, and we await its guidance with interest.

Hugh Bayley (City of York): Does my hon. Friend accept that beta interferon is not the only treatment for multiple sclerosis? It is effective for some patients, but not for others. Does he agree that it is important that other treatments, such as specialist nursing, are made available? Will he assure me that NICE will also consider the effectiveness and cost-effectiveness of other treatments for multiple sclerosis so that patients get the best possible treatment?

Mr. Hutton: I confirm to my hon. Friend that NICE is examining the widest possible range of treatments for people who suffer from multiple sclerosis. It is important that it has the opportunity to do that properly, on the basis of all the available evidence, and we have asked it to do precisely what he describes.

Sir Patrick Cormack (South Staffordshire): Does the Minister accept that the time that NICE is taking to determine the issue makes its acronym increasingly inappropriate? Will he confirm that beta interferon is significantly cheaper to buy in other countries, such as Australia?

Mr. Hutton: I do not know the price of beta interferon in Australia, but it is desperately important that NICE takes the time that it needs to get the judgment right. It thought that it needed more evidence before it could reach a properly balanced conclusion and we should give it the time to do that.

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