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PETITIONS
School Funding
6 pm
Mr. David Heath (Somerton and Frome): I wish to present a petition on behalf of schools throughout Somerset that are desperately concerned about not only the funding crisis this year, but the chronic under-funding of Somerset schools. I entirely agree with its sentiments.
The petition has been signed by about 1,300 people and has been collected from 59 different schools in my constituency and across Somerset. It states:
- To the House of Commons, The petition of Anne Stephens, on behalf of the schools of Somerset, Declares that the funds allocated do not meet the needs of schools.
The Petitioners therefore request that the House of Commons consider a fairer settlement for Somerset children.
And the Petitioners remain etc.
Air Quality (South Essex)
6.1 pm
Bob Spink (Castle Point): I raised the issue of air quality in south Essex in the 1990s when I was first a Member of Parliament and I raised it again in the first month that I returned to the House in 2001, yet still no proper action has been taken to provide proper monitoring of the problem in south Essex, hence the nightmare of the past five months in my constituency and surrounding areas. People have suffered health and quality-of-life problems because proper action has not been taken. I congratulate the Yellow Advertiser and my hon. Friend the Member for Billericay (Mr. Baron) on their campaign. I have been pleased to be able to join them in fighting on this issue.
The Yellow Advertiser raised a petition that states:
- To the Honourable Commons of the United Kingdom, Great Britain and Northern Ireland in Parliament assembled.
The Humble Petition of the Yellow Advertiser sheweth.
That there is great anger and fear in South Essex about the pungent smells emanating from Pitsea Tip and blighting our communities, and residents and visitors wish to register their protest against those smells which have also caused serious health concerns and destroyed whole communities' quality of life.
Wherefore your Petitioners pray that your Honourable House shall urge the Government to take action, through the Environment Agency, to curb the smells, to set up proper monitoring, to establish contingency plans to deal with any further smells and therefore to protect our communities.
And your Petitioners, as in duty bound, will ever pray, etc.
Community Pharmacies
6.2 pm
Mr. Martin Salter (Reading, West): In common with many other right hon. Members and hon. Members, I have been petitioned by pharmacists and the customers of community pharmacies with a generic petition entitled "Save our pharmacy services".
- The petition of the residents of Reading
Declares that the proposals to allow unrestricted opening of pharmacies able to dispense NHS prescriptions would undermine the excellent service currently provided by community pharmacists.
The Petitioners therefore request that the House of Commons reject proposals to allow unrestricted opening of pharmacies able to dispense NHS prescriptions.
And the Petitioners remain, etc.
Rheumatoid Arthritis
Motion made, and Question proposed, That this House do now adjourn.—[Charlotte Atkins.]
6.4 pm
Mr. David Amess (Southend, West): I am very grateful to Mr. Speaker for giving me the opportunity to raise the important question of the treatment and care of people who suffer from rheumatoid arthritis. The Under-Secretary of State for Health, the hon. Member for South Thanet (Dr. Ladyman), is fairly new to his post and I certainly do not expect him to be an expert on this subject. This debate is not an opportunity for me and my colleagues to attack the Government's health policy. Given that all Governments must have priorities, I ask him to find out whether he can nudge rheumatoid arthritis up the list because it is a dreadful disease from which many people suffer.
Rheumatoid arthritis is a common auto-immune disease that is painful, disabling and progressive. It affects people of all ages including young children and teenagers—I do not think that that is widely understood. It has a mortality rate similar to that of coronary heart disease, diabetes, Hodgkin's disease and stroke, yet unfortunately, by comparison, its treatment is comparatively poorly resourced. The lack of appropriate funding and resources leads to a lack of adequate disease management, which in turn impacts adversely on patients' quality of life. The loss of earnings suffered when people have to stop work because of rheumatoid arthritis has a detrimental financial impact on patients, their families and the wider community.
Some 42 per cent. of rheumatoid arthritis patients are registered disabled within three years while 80 per cent. become moderately to severely disabled within 20 years of their diagnosis. There were 1.9 million consultations with general practitioners for inflammatory arthritis in 2000, and in 1999–2000, 9.4 million working days were lost in the United Kingdom because of rheumatoid arthritis, which represents £833 million of lost production.
I pay tribute to Mrs. Ailsa Bosworth, who is the president and founder of the National Rheumatoid Arthritis Society—NRAS. There is no doubt that without her determination, rheumatoid arthritis would not have achieved such prominence among the general public. I hope that the Government will respond to that accordingly.
My fellow officers of the all-party group on rheumatoid arthritis and I had the opportunity to visit Guy's hospital and meet Dr. Kirkham and Professor Panayi, who have given great service to people who suffer from rheumatoid arthritis. We saw the hospital's excellent facilities from which rheumatoid arthritis sufferers could benefit. We also had the opportunity to visit Queen Mary's hospital in Sidcup, where we met Dr. Banerjee. He is a wonderful doctor who has given great care to his patients, but unfortunately for them, the hospital's facilities are in no way comparable to those at Guy's.
The newly formed all-party group on rheumatoid arthritis, of which I am chairman, has worked closely with the NRAS since last October, with the specific aim
of bringing the needs of rheumatoid arthritis patients and the resources required for rheumatology, as a specialist health area, to the Government's attention. Addressing the issues that relate directly to rheumatoid arthritis would benefit the wider patient community who suffer from osteoarthritis and other forms of arthritis, as well as people with musculo-skeletal conditions who are also treated by consultant rheumatologists and multidisciplinary teams that operate in the rheumatology field. I am pleased to say that a summary of the issues will be the subject of a NRAS consensus report that will be published at the end of the month. It will include contributions from patients, leading rheumatologists, primary care physicians and specialist rheumatology nurses from the Royal College of Nursing rheumatology nursing forum.I ask the Government to do whatever they can to give access to quality treatment. Early diagnosis and treatment is essential to minimise disease progression, joint damage and pain. The NRAS patient survey that was conducted earlier this year showed that it is unfortunately not uncommon for a patient to wait longer than a year to be referred into secondary care to see a specialist—of course, that is not acceptable. Early referral to a multidisciplinary team involving specialist nurses, physiotherapists, occupational therapists and podiatrists is recommended for best care. There are simply not enough of those teams. The recommended provision for consultant rheumatologists is one per 85,000 people. Sadly, that is not met anywhere in the United Kingdom. The latest figures suggest that the speciality is more than 40 per cent. under strength, with an average of one consultant rheumatologist for every 150,000 people.
I am also concerned about professional training and standards of care generally. Training in musculo-skeletal disease does not have sufficient priority in primary and secondary care. Current training is inadequate. There are also barriers to adequate rheumatoid arthritis services. The NHS has not paid enough attention to that over the decades. That is not in any sense a jibe at the Government. No Government have given it sufficient priority. The distortion of care in national priorities has to be addressed. It is no longer acceptable that guidelines have been produced for optimal care in Scotland and that a strategy for arthritis in Wales is being developed by the Welsh Assembly, but nothing has been developed in England. No doubt the Minister will tell me that that is on the agenda.
There is no national service framework for rheumatoid arthritis, other forms of arthritis and musculo-skeletal conditions. There is only a brief mention of the disease in the new GP contract. There is no drive that I am aware of—again, the Minister may tell me otherwise—to improve the quality of services in general. Too few primary care organisations or health authorities have the background to commission relevant services.
In March 2002, the National Institute for Clinical Excellence approved use of anti-TNF therapy for people with severe rheumatoid arthritis on whom existing treatments had failed. Since the debate was publicised, any number of organisations and interested parties have advised me on what I should raise, but I cannot cover all the issues in 15 minutes. More than 12
months on from NICE approving its use, the key finding is that postcode prescribing of anti-TNF therapy remains a significant problem in the UK.More than a third of the rheumatologists in the survey reported that they are still unable to prescribe anti-TNF therapy to every patient they identify in accordance with NICE guidance. In at least one area, the local primary care trust has decided not to commission any anti-TNF therapy on the ground of a major shortfall in cash. In the majority of cases in which rheumatologists could not prescribe anti-TNF therapy to all the patients they identified, insufficient funding was reported as the main barrier. That is obviously worrying. The survey took place between February and May 2003. Of 184 UK consultant rheumatologists surveyed, 152 participated, which is a pretty good response, representing 82.6 per cent. of respondents, the majority of whom were from England and Wales.
I have three questions for the Minister. If he does not have time to reply, perhaps he could write to me. Does he agree that the loss of quality of life to rheumatoid arthritis patients, the burden of care put on families, which leads to a high level of separation and divorce, the loss of £833 million-worth of production to employers, the loss of revenue to the Government and the cost of benefits paid to disabled rheumatoid arthritis patients, is a serious issue and must be addressed?
The main point is that I would like to know from the Government what importance and what priority they attach to treating inflammatory arthritis.
The second point is whether the Minister agrees that general practitioners, primary care trusts and special health authorities will put their resources foremost into meeting Government targets and priorities, and that unless rheumatoid arthritis and arthritis generally are made higher priorities by the Government, rheumatoid arthritis patients will miss out.
Finally, will the Minister welcome the work that is being done by patient groups and health professionals under the standards of care project that is currently under way, which is being co-ordinated and sponsored by the Arthritis and Musculo-skeletal Alliance? Perhaps the Minister might agree to an all-party meeting where we might have more time to go into greater depth on this important issue.
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