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Cancer Fund Distribution
3. Dr. Ian Gibson (Norwich, North): What plans he has to continue the exceptional tracking exercise carried out recently for cancer fund distribution. [122418]
The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson): This was an exceptional tracking exercise. The NHS is receiving £12.7 billion extra from 2003–04 to 2005–06. It is for primary care trusts in partnership with strategic health authorities and other local stakeholders to determine how best to use their funds to meet national priorities, including cancer targets.
Dr. Gibson : I thank the Under-Secretary for her reply. I welcome the openness and transparency represented by that exercise to find where the cancer money went. Will we ensure in future that all the money—not only 60 per cent., which some authorities spend—will be spent on cancer, as should happen?
Miss Johnson: I know that my hon. Friend is aware that, apart from some central funding, the money is principally routed through the primary care trusts. The research and the report that the national cancer director published on 22 May show that, after some initial
problems, there has been additional major spending on new cancer drugs and significant investment in other important aspects, such as expanding the cancer work force and extending services such as radiotherapy and screening. There is clear evidence that the money is getting through and making a difference, but it is up to local decision making.
Mr. David Tredinnick (Bosworth): Is it not a fact that many cancer patients need nutritional supplements? Given that the Lords rejected the food supplements regulations last night and that 300 nutrients are about to be taken off the shelves, does that not mean that the Government have failed to bat for Britain in Europe? The Minister claims that in the light of the so-called dossier, those nutrients can go back on the market, but is it not true that only 15 supplements have been put forward for that dossier, and that 280 odd will therefore not be put forward? What does the Minister have to say about that?
Miss Johnson: I am not entirely clear as to the direct relevance of those questions, but as you are allowing them, Mr. Speaker, I shall do my best to respond. The point is that we have negotiated the best possible deal with other European member states, and we have a long lead-in for some of the changes. Many issues have yet to be decided, and I think that we all agree that the only reason to ban any supplements is, effectively, that they are unsafe—[Hon. Members: "No."] Well, that is the Government's ground for taking action, and on the basis of evidence. I trust that we can work with the industry to secure the best possible outcome for UK consumers. That is our main objective, and I believe that our best interests are served by working together.
Laura Moffatt (Crawley): My hon. Friend is right to say that the tracking exercise has been incredibly useful. I have seen its effect on my network, allowing those concerned and me, as a Member of Parliament, to understand where the money is going. Visiting the United States also made clear just how well we are doing in terms of cancer treatment. Does she agree that this exercise is one way in which central Government can keep an eye on the money spent and ensure that local teams are spending it where they should? It also allows Members of Parliament to have confidence in the process.
Miss Johnson: I agree with my hon. Friend that it has been a useful exercise. Some differences in experience have clearly been encountered throughout the country, in terms of the money going to where we hoped it would go. But I hope that she and other Members will understand that it is quite difficult permanently to track in detail the money going into cancer services. Much of the money may go to specialisms, in which case only some of the money relates to cancer treatment. Given the ongoing bureaucracy, form filling and returns required to get a detailed picture, such a process is not sensible. However, we have overall targets and we are doing well on all of them, which is evidence that the
money is getting to where it needs to be. I trust that Members will continue to take a lively interest in this issue.
Mr. Julian Brazier (Canterbury): Does the Minister accept that, ultimately, all cancer services in the community and in hospital outstations are underpinned by the regional cancer centres? When will the Government publish the independent review panel report on the future of acute health services in east Kent and, in particular, of the joint cancer centre at the Kent and Canterbury hospital? In practice, will we see a vital and excellent cancer centre eroded and ultimately closed by stealth?
Miss Johnson: We are looking at all of these issues carefully in the light of the panel's recommendations, but I can assure the hon. Gentleman that the report will be published shortly. He will have to wait to see what is in it, but the Government are of course totally committed to having a very high standard of care in excellent centres throughout the country. I am sure that he will join me in working towards that objective.
NHS Patients (Wales)
4. Ian Lucas (Wrexham): What the Government's policy is towards the treatment of NHS patients from Wales in England. [122420]
The Minister of State, Department of Health (Mr. John Hutton): It is the responsibility of local commissioning bodies to ensure proper access to NHS services for their local populations. NHS trusts in England will continue to provide a range of services to patients from Wales in accordance with these arrangements.
Ian Lucas : I am grateful to my right hon. Friend for that reply. Is he aware that many of my constituents and others in north-east Wales currently receive much of their medical treatment from hospitals in England, such as those in Chester, Gobowen, Liverpool and Manchester? My concern is that the Health and Social Care (Community Health and Standards) Bill does not place an obligation on foundation hospitals to continue to treat patients from Wales. Will my right hon. Friend therefore consider an amendment to ensure that hospitals in England continue to have an obligation to treat patients from Wales?
Mr. Hutton: I do not think that we will be considering an amendment to do what my hon. Friend suggests. However, there was some argument in the Standing Committee about the Bill's provision in connection with the treatment of patients from Wales by NHS foundation trusts in England. It was always argued that NHS foundation trusts in England were fully able, and legally empowered, to treat patients from Wales. We have tabled some further amendments in Committee to make that perfectly clear. To put the matter beyond doubt for my hon. Friend, I assure him that there is nothing in the Bill, if it is approved by this House, to
prevent NHS foundation trusts, once they are established, to treat patients from his constituency. I think that that is the right way to deal with this matter.
Chris Grayling (Epsom and Ewell): Will the Minister confirm that the Bill means that English hospitals that treat Welsh patients will be subject to two separate inspection regimes by two sets of inspectors in the same year?
Mr. Hutton: We have made it clear that we want the new audit and inspection arrangements to be as minimally invasive and bureaucratic as possible. It is perfectly possible for the National Assembly for Wales and the commission for health care audit and inspection to co-ordinate and co-operate to determine how the investigations and monitoring arrangements work in practice. That is the sensible way to proceed, but the fundamental problem for Opposition Members is that they do not accept the devolution settlement. They do not accept that it is perfectly possible for the National Assembly for Wales to exercise those functions in a devolved way. Yes, there will be two inspection bodies, but that is no reason to argue that there cannot be proper co-ordination between them. That is the right way to proceed. It reflects the constitutional settlement agreed by this House, which is working well in the interests of the people of Wales and England.
Mr. Jon Owen Jones (Cardiff, Central): My hon. Friend the Minister uncharacteristically misunderstands the question asked by my hon. Friend the Member for Wrexham (Ian Lucas). The point is not that English foundation hospitals will not have the ability to treat Welsh patients but that, although the Bill as constructed gives them a legal responsibility to treat English patients, it does not give them a similar responsibility to treat Welsh patients. Will the Minister carefully consider whether the Bill could be amended so that patients in Wales and in England enjoy equal rights?
Mr. Hutton: With the very greatest respect to my hon. Friend, I must tell him that he is wrong on that point. The Bill makes it evident beyond any reasonable doubt that NHS foundation trusts in England will be perfectly able, legally, to treat NHS patients from Wales. The point that my hon. Friend has not understood is that whether an English hospital treats patients from Wales is a matter for the commissioning bodies and the trust to negotiate. Once the agreements are in place, there is nothing in the Bill to make it impossible for an NHS foundation trust—or any other NHS acute service provider in England—to provide services to patients from Wales.
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