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30 Jun 2003 : Column 156W—continued
IT Procurement
Tim Loughton: To ask the Secretary of State for Health how much his Department has provided to the South West IT procurement team for financial advice and expertise from Partnerships UK. [120373]
Mr. Hutton: The Department has not provided funds to the South West IT procurement team for advice from Partnerships UK. Partnerships UK provided general financial advice and expertise, including advice to the Shires on the closure of the procurement. This advice was provided as part of their work on the National Programme for Information Technology in the national health service.
Tim Loughton: To ask the Secretary of State for Health how much his Department has spent on supporting and assessing the Shires Acute and Community Hospital EPR Procurement Programme. [120374]
Mr. Hutton: The Department of Health has supported the Shires Acute and Community Hospital electronic patient record (EPR) procurement programme with a one-off contribution of £350,000.
Local Election Campaigns
Mr. Luff: To ask the Secretary of State for Health what guidance he has given to primary care trusts about the timing of consultations on changes to services during local council election campaigns; and if he will make a statement. [108142]
Mr. Hutton [pursuant to his answer 14 April 2003, Official Report, column 613W]: I regret that my response was incorrect. The response should have read as follows:
- "The Department has not issued any guidance specifically about the timing of consultations on changes to services during local council election campaigns. However, a personal note from the national health service Chief Executive to chief executives in the NHS, local authority chief executives and social services directors issued on 14 March 2003, included a reference to the local election purdah and drew attention to Cabinet Office
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- guidance on the conduct of public servants during election periods. A copy of the relevant extract has been placed in the Library.
- Strategic Health Authorities are expected to ensure that primary care trusts in their areas undertaking consultations have regard to the guidance".
Long-term Care
Mr. Burstow: To ask the Secretary of State for Health pursuant to his answer of 9 June 2003, Official Report, column 688W, on long-term care, what plans he has to issue new continuing care guidance to local authorities. [121652]
Dr. Ladyman: There are no current plans to issue new continuing care guidance.
Lung Patients
Mr. Burns: To ask the Secretary of State for Health (1) if he will make a statement on the provision of pulmonary rehabilitation to lung patients in England; [121765]
- (2) if he will provide secure funding for pulmonary rehabilitation programmes in every hospital. [121766]
Dr. Ladyman [holding answer 26 June 2003]: The National Institute for Clinical Excellence (NICE) is currently developing a guideline on the management of chronic obstructive pulmonary disease (COPD) in primary and secondary care. NICE is due to publish the guideline in 2004. In January 2003, the Respiratory Alliance published their guidance, "Bridging the Gap", which aims to help primary care trusts to commission and deliver high quality allergy and respiratory care. Local British Lung Foundation "Breathe Easy" groups often reinforce pulmonary rehabilitation programmes.
Information is not held centrally regarding the proportion of people with COPD who can access pulmonary rehabilitation. However, a recent survey by the British Lung Foundation and the British Thoracic Society found that 160 out of 266 hospitals across the country provide some form of pulmonary rehabilitation to lung patients. A wide range of patients can benefit from pulmonary rehabilitation. These include those with chronic lung diseases such as emphysema, chronic bronchitis, asthma, bronchiectasis, interstitial lung disease, or lung tumours. Most pulmonary rehabilitation programs include medical management, education, emotional support, exercise, breathing retraining, and nutritional counselling. The objective is to help people gain the highest level of function and independence possible, and to improve overall quality of life.
Substantial new investment in both health and social care services was announced in the 2002 Budget. This amounts to the largest sustained increase in funding of any five-year period in the history of the national health service. Over the years 2003–04 to 2007–08, these plans mean that expenditure on the NHS in England will increase on average by 7.4 per cent. a year over and above inflation—a total increase over the period of 43 per cent. in real terms. This means that over the same five-year period, there will be an increase of £34 billion.
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It is the role of strategic health authorities, in partnership with primary care trusts, to decide what services to provide for their populations including those with respiratory conditions. They are best placed to understand local health needs and commission services to meet them.
Measles and Mumps Vaccines
Mr. Hunter: To ask the Secretary of State for Health (1) what his policy is in respect of the granting of licences for the distribution of single measles and mumps vaccines; [120235]
- (2) if he will take measures to ensure the wider availability of single measles and mumps vaccines; [120236]
(3) what powers he has to prevent clinics providing single measles and mumps vaccinations; and if he will make a statement. [120239]
Miss Melanie Johnson: The current United Kingdom policy is not to offer single measles and mumps vaccines, because this exposes children to a greater risk of disease due to the longer course of vaccination required. Single vaccines leave children at risk of diseases that have serious complications for no benefit and the Government do not endorse this. There is very considerable evidence for the safety of MMR vaccine. The World Health Organisation (WHO) stated:
"WHO strongly supports the use of MMR vaccine on the grounds of its convincing record of safety and efficacy. The combination vaccine is recommended rather that the monovalent presentation (single vaccines) when available and the disease burden justifies its use".
Medical Accidents/Clinical Negligence
Dr. Palmer: To ask the Secretary of State for Health if he will review the way in which the NHS handles compensation after a medical accident; and when the Chief Medical Officer's report into clinical negligence will be published. [120302]
Ms Rosie Winterton: I am pleased to announce the publication today of a report for consultation by the Government's chief medical officer, Professor Sir Liam Donaldson, outlining proposals for reform of the national health service clinical negligence system.
The report, entitled "Making Amends; a consultation paper setting out proposals for reforming the approach to clinical negligence in the NHS", has been prepared against a background of the rising cost of claims for clinical negligence, which have drawn much media attention. In line with our wider drive to put patients at the heart of the NHS and patient safety at the top of its agenda, Sir Liam proposes that a less adversarial system
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should be available. Injured patients would no longer have to resort to lengthy and costly court action under the tort law. It would allow the NHS to be pro-active in responding to sub-standard care. There would be clear links to NHS quality initiatives to improve the patient's experience of the NHS as well as an incentive to drive up standards and so reduce injuries in the first place.
The chief medical officer proposes a NHS redress scheme which would offer redress for injuries, in all senses of that word. The scheme would provide people who were injured with an explanation of what went wrong, the necessary apologies, treatment for that injury and support for patients and their families, as well as some financial compensation in appropriate cases. It is proposed that families of neurologically impaired babies would also be eligible for the NHS redress scheme if the impairment was birth related and fulfilled other eligibility criteria.
Although a person's right to pursue a formal claim in the court would remain, patients would no longer have to resort to the law as the only way of resolving a dispute with the NHS. Proposed improvements to the legal aid system would mean that use of the NHS scheme would be taken into account if a claimant applied for legal aid after rejecting a fair package of redress under the NHS scheme. At present, over 70 per cent. of clinical negligence cases are legally aided, meaning the taxpayer often foots the bill through the legal aid budget if the NHS wins a case or the NHS budget if it loses.
For too long, we have had a disjointed approach to clinical negligence in the NHS. There are often no clear links between complaints procedures and the systems to deal with clinical negligence claims at a local level. There is little consideration of the wider issues raised by complaints and clinical negligence claims—and settlements—locally and nationally. Finally, there are no reliable systems of ensuring that mistakes made in one organisation are not repeated in another.
The proposed NHS redress scheme would link to the NHS complaints procedure and the new independent inspection structures being taken forward through the Health and Social Care Reform Bill presently before the House.
The report emphasises the importance of building a NHS that is better at addressing injuries resulting from poor quality treatment. As well as the NHS redress scheme, it recommends that the NHS should improve rehabilitation services and that in cases of clinical negligence the costs of future care should be considered on an NHS-provided rather than a privately-provided basis. This is a long-term measure and it will take time to establish the necessary specialist NHS capacity. However, the Department will be exploring taking this forward through the long-term care national service framework, as it makes sense that those injured by the NHS should be able to get the care that they need from the NHS.
Sir Liam's review has been wide-ranging and he proposes radical reform of the present lengthy, complicated and overly adversarial court-based system. The existing system is slow and often does not provide injured patients with the response to their injuries that they seek. The new system will be more responsive to the
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needs of patients for redress, and of the NHS for mechanisms that help it learn from mistakes. I believe it is possible to have a system that responds to patients' needs, that supports clinicians to deliver the very best quality care, and that is a driver for the NHS to learn from mistakes to continue to improve the quality of care it delivers.
There will now be a consultation period until 17 October. Following considerations of the issues raised and of the views of respondents on the specific questions asked, the Department expects to set out the next steps to reform the clinical negligence system in the autumn.
A copy of the report has been placed in the Library.
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