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14 Jan 2003 : Column 539—continued

MRI Scans (Yeovil)

7. Mr. David Laws (Yeovil): What his estimate is of the waiting time for MRI scans in the Yeovil constituency. [90195]

The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): I am advised by Dorset and Somerset strategic health authority that both East Somerset NHS trust and Taunton and Somerset NHS trust are currently meeting the target for urgent referrals for MRI scans as set by the NHS cancer plan. Waiting

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times for non-urgent MRI scans have fallen significantly at East Somerset NHS trust, although waiting times for non-urgent MRI scans at Taunton and Somerset NHS trust have risen in recent months.

Mr. Laws : Is the Minister not aware that waiting times for MRI scans at Yeovil hospital are longer than they were in 1997, and that at Musgrove Park hospital they are now 38 weeks? Are not some of the longest waiting times in the NHS for diagnostic tests and for consultant-to-consultant referrals? Would it not be better for the Government to publish the information nationally so that we do not have a distortion in priorities across the NHS?

Ms Blears: The hon. Gentleman will be aware that waiting times at Yeovil hospital, which serves his constituents, have been coming down recently. It is also due to get a new scanner in May, which will make the process even faster. It may be able to help out with waiting lists at Musgrove Park hospital, which has problems with non-urgent MRI scan waiting times, although it has just appointed two new radiographers and extended the working day from 8 o'clock in the morning to 8 o'clock at night. In addition, people are working on Saturday mornings. The combination of extra investment and reform to working practices is beginning to make a difference on this very important issue.


9. Paul Flynn (Newport, West): What new proposals he has to reduce nicotine deaths. [90197]

The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): Some 120,000 people die every year from smoking. Forthcoming changes that will reduce deaths include banning tobacco advertising, starting with newspapers and billboards from 14 February, new stark warnings on cigarette packets and a major expansion of NHS smoking cessation services.

Paul Flynn : The Government are to be warmly congratulated on their work on this issue, but is it not amazing that over the past 20 years the number of male cancers in Sweden has been cut in half and that smoking among men has gone down from 36 per cent. to 17 per cent.? Last month, the Royal College of Physicians said that using smokeless tobacco is up to 1,000 times less hazardous than using smoking tobacco. Is it not right that the product that has achieved that remarkable health improvement should now be taken off the banned list and become available in some form in countries outside Sweden? Unfortunately, the Government have said that setting up a regulatory authority to consider all those matters is not planned at the moment. When is that likely to be done, enabling us to take a rational look at all forms of smoking?

Ms Blears: I am afraid that I do not agree with my hon. Friend that smokeless tobacco should be encouraged. All tobacco products are addictive, and it is much better to take our approach—helping people to give up smoking entirely, with Zyban and nicotine

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replacement therapy—and to see how that works. I am afraid that we do not have a history of oral tobacco use, as people have in Sweden. The Swedish National Institute of Public Health does not support the use of Snus as a smoking cessation product because it is very concerned indeed that it could become a gateway to tobacco use, particularly for young people, at whom it is specifically marketed. Far from helping people to give up, it could increase the number, especially of young people, who use tobacco. It is a very interesting debate—I am sure that it will continue—but I am afraid that I do not agree with my hon. Friend on this issue.

Mrs. Marion Roe (Broxbourne): Will the Minister join me in congratulating South East Hertfordshire primary care trust, together with local GPs, pharmacists, practice nurses and the Hertfordshire stop smoking groups, on the excellent work that they are doing in my constituency to help my constituents to give up smoking? Although we still have three months to go, the primary care trust has already exceeded its 2002–03 Government target, with more than 200 people having given up smoking. Will the Minister please tell the House what action she is taking to put pressure on Ministers in other Departments to tackle the very serious problem of tobacco and cigarette smuggling, which has a serious impact on the issue that we are trying to address and which, of course, she particularly wishes to solve?

Ms Blears: I am delighted to join the hon. Lady in congratulating all the people in her local area on the magnificent results that they have achieved. Those results are replicated throughout the country. More than 200,000 people are now being helped to give up smoking, and we are aiming for an extra 800,000 over the next three years. We are putting in the money to ensure that that can happen, because it requires extra resources as well.

On cross-government action to reduce smuggling, we are in constant contact with Treasury Ministers to ensure that we bear down on the problem. We have a cross-government action plan to tackle not just smoking but all the damaging effects of tobacco on our community. We have a whole range of policies in the Treasury, the Department of Health and, particularly, the Department for Education and Skills, and we are doing a great deal of work to alert young people in schools to the dangers of tobacco and, indeed, of other drugs.

Dr. Howard Stoate (Dartford): I congratulate my hon. Friend on her work on tobacco, particularly in relation to tobacco advertising. The next huge timebomb that we face in health is obesity in children. Is she prepared to consider as part of a strategy limiting the advertising to young people of products high in fat, sugar and salt, which cause such huge damage to our young population?

Ms Blears: My hon. Friend highlights an extremely important issue, which is almost a timebomb waiting to hit us in years to come. He will know that the Government have a huge range of policies to improve people's diet and nutrition: the national school fruit scheme, the five-a-day projects and a range of plans to

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encourage people to have access to a healthier diet. He raises the important issue of advertising to young people. The Food Standards Agency is conducting a research project to examine the effects of advertising foods high in sugar and salt to young children. I shall read its report with great interest to see what action we can take to improve the diets of young people in this country.

GP Appointments

10. Mr. John Bercow (Buckingham): What estimate he has made of the number and proportion of missed appointments with general practitioners in each of the last five years. [90198]

The Minister of State, Department of Health (Mr. John Hutton): Information is not available for each of the last five years. Surveys conducted over the past two years by the Doctor Patient Partnership and the Institute of Healthcare Management, with funding from the Department of Health, have shown a reduction in the number of missed appointments of more than 8 per cent. during that period.

Mr. Bercow: I am grateful for that answer. Given that people who miss their general practitioner appointments without good reason cause unnecessary cost to public funds, waste doctors' time and selfishly inconvenience other patients, does the Minister agree that, although people should always be free to use their GP, they should certainly not be free to abuse their GP?

Mr. Hutton: I agree with the hon. Gentleman's latter point, and I also agree with his views on the Conservative party, which we have all enjoyed reading. He raises a serious point, so he is entitled to a serious answer. He is right that the waste of resources caused by people who do not bother to turn up for appointments is a huge drain on the NHS; we are trying to find the best way to make sure that we minimise the incidence of the problem. As he will be aware, a number of GP practices in Buckinghamshire are taking part in the work of the primary care collaborative, including some, I think, in his constituency. We have found that improving the appointments system that practices operate can have a beneficial effect on the number of missed appointments. I am glad to say that, so far, the introduction of better appointments systems through the primary care collaborative has seen the national average of missed appointments fall by 50 per cent. That is the right way to proceed.

Caroline Flint (Don Valley): Everyone would agree that missing an appointment with a doctor or at a hospital requires good reasons. I urge my hon. Friend, however, to do further work to examine why people do not attend appointments. Too often, statistics are produced showing that X per cent. of people have not attended appointments, but we do not go on to ask why. We need to spread good practice in terms of having an efficient appointments system, but we must understand that people may not attend appointments for many

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good reasons. They may be fearful of seeing their doctor, or they may have got better, which is also worth knowing. We need more research in this area.

Mr. Hutton: I agree with my hon. Friend. We are committed to working with the Doctor Patient Partnership to examine some of the issues that she raises. We know, for example, that the incidence of missed appointments tends to be higher in mental health trusts than in other NHS organisations, probably for obvious reasons. We certainly need to examine the background, including access, transport and convenience issues. I say to my hon. Friend what I said to the hon. Member for Buckingham (Mr. Bercow): it is important that we work with the primary care sector, GPs and practice managers to improve the convenience and accessibility of the appointments system. If people are given a genuine choice not only over the time at which they are seen but where they are seen, all the evidence confirms that they are more likely to attend their appointment than if they are given little choice.

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