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Medical Engineers

2. Dr. Richard Taylor (Wyre Forest) (Ind): If he will make a statement on the provision of training for medical engineers for the national health service. [155719]

The Minister of State, Department of Health (Mr. John Hutton): The Government are increasing the number of scientists and technicians, including medical engineers, employed in the national health service and the number of those people who are entering training. Last year, an additional 1,350 scientists and technicians entered training compared with 1999, an increase of 93 per cent. Over the same period, the number of qualified scientific and technical staff employed in the NHS increased by more than 8,500, an increase of 16 per cent.

Dr. Taylor: I thank the Minister for that reply. Does he recognise the good work that the Capital medical training centre is doing on the Kidderminster hospital site, in providing vocational training courses for NHS and Ministry of Defence medical engineers? If the Minister who has kindly agreed to visit Kidderminster next week has time, will he meet the manager of the centre so that he can hear more about this extremely successful unit? Will he also encourage local managers to allow this training centre to take over more of a block that might otherwise be demolished? If that block were used, it could produce useful income for the Worcestershire Acute Hospitals NHS Trust, which is labouring under a large debt at the moment.

Mr. Hutton: I shall certainly recommend to the Under-Secretary of State for Health, my hon. Friend the Member for South Thanet (Dr. Ladyman) that, if he has time when he visits Kidderminster, he should visit the service to which the hon. Gentleman has referred. In general terms, we are interested in exploring all opportunities for further increasing the range of training opportunities available to this critically important work force. Obviously, however, such decisions are a matter for the local national health service.

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Ophthalmic Conditions

4. Angela Watkinson (Upminster) (Con): What his Department's strategy is to improve access to treatment for ophthalmic conditions. [155721]

The Secretary of State for Health (Dr. John Reid): Our strategy began with reintroducing free eye tests for the over-60s, which had been abolished under the previous Conservative Government. We are building on that by increasing capacity, for example through new treatment centres, and by developing more efficient ways of treating cataracts and chronic eye diseases, thus providing more local and convenient services for patients and delivering greater choice, shorter waits and more consistent quality.

Angela Watkinson : Does the Secretary of State agree that the role of optometrists in the NHS could be significantly expanded, in relation to the provision of clinical eye examinations, as opposed to general eye tests to determine whether people need glasses? In that regard, the early detection of ocular pathologies such as glaucoma is particularly important.

Dr. Reid: The hon. Lady makes a good point. To complement the investment in the NHS, we are trying to carry forward a series of reforms that will allow people a far greater degree of flexibility involving working in partnership, and which will break down previously defined artificial demarcations. I can assure the hon. Lady that we are considering how people can contribute in that way to the maximum extent of their abilities and skills, and one of the areas involved would be the one that she has mentioned.

Jonathan Shaw (Chatham and Aylesford) (Lab): One of the great concerns in my constituency has been the waiting times for people in need of cataract operations. I thank my right hon. Friend for coming to Kent to open a new mobile treatment centre that will enable the number of such operations to rise from 8,000 to 13,000 a year by November. Due to the £4.4 million investment involved, no one will have to wait longer than three months for their cataract operation. Is not this the kind of thing that people want to see from their NHS?

Dr. Reid: Indeed, it was a great pleasure for me to visit the mobile unit in Maidstone on 9 February, where 300 of the extra procedures that my hon. Friend mentioned will take place. As a result of those procedures, the maximum waiting time for cataract operations in Kent will be reduced next month to six months, and to three months by December this year. I am glad to say that this is taking place four years ahead of schedule, due to the investment and reforms that have been put in place by the NHS staff themselves. At a time when every single thing that could go wrong in the NHS is being highlighted, we should mark our respect for the efforts of the NHS staff involved in a huge success such as this—which is resulting in so much pain being relieved—and for the alacrity with which treatment has been made available to so many people who previously had to wait up to two years.

Mr. John Baron (Billericay) (Con): The Secretary of State will be aware that, last September, he extended the

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normal three-month implementation period for National Institute for Clinical Excellence guidance to nine months when photodynamic therapy to those suffering from wet age-related macular degeneration was involved. The Royal National Institute for the Blind estimates that, as a result, a further 2,800 people will go blind unnecessarily. Given that the institute also confirms that at least 50 centres across the country could provide extra photodynamic treatment from today, will the Secretary of State now scrap the July 2004 target for implementing this treatment and allow the NHS to deliver this important sight-saving service as a matter of urgency? If this is purely an issue of cost, I would remind him that the cost of blindness far exceeds the cost of treatment.

Dr. Reid: On the latter point, we are well aware of the costs of blindness, pain and death, which is why we are investing so much in the national health service and doing it over such a sustained period. With regard to the hon. Gentleman's specific points, the timelines and flexibility that we sought on implementing the NICE guidelines were in full accord with the recommendations and advice from NICE. On implementation, it is not cost that prevents it—more money than ever before is going into the treatment of a range of eye diseases—but lack of trained personnel. We have made huge advances in that area, but the truth is that we cannot just conjure up trained personnel without forward planning and investment for their provision—[Interruption.] The hon. Member interrupts me from a sedentary position, but no Government who bring in 80,000 additional cataract operations, as we are doing, can be accused of not taking eye conditions seriously. I assure him that we take this matter seriously, and that as soon as we can get the trained personnel, we will expand the provision. That is a continuing process and it will not be achieved overnight, but development and expansion of the NHS will continue in this area, as in every other area, over the next five years.

NHS Accountability

5. Mr. David Chaytor (Bury, North) (Lab): What plans he has to increase local democratic accountability within the NHS. [155722]

The Minister of State, Department of Health (Ms Rosie Winterton): The Government are increasing democratic accountability in the NHS by giving elected councillors powers to review and scrutinise health services and establishing the direct elections of governors by local people, patients and staff in NHS foundation trusts.

Mr. Chaytor : May I tell my hon. Friend about the excellent work done by the local authority in my constituency through its health scrutiny committee, which is now regularly interviewing senior management of the acute trust and primary care trust? Does she accept that scrutiny committees have a major role to play and that there is scope to increase their powers as time goes by? Does she further accept, however, that the effectiveness of those committees is variable in different parts of the country? Does she think that there is a case to review formally the functioning of scrutiny

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committees after a suitable period of time—perhaps 24 or 36 months—with a view to improving further the democratic accountability of the NHS in the next Parliament?

Ms Winterton: I am well aware of the work being carried out by the committee in my hon. Friend's constituency. I know that it has taken a particular interest, for example, in mental health services. The overview and scrutiny committees have real powers to require information from the NHS and to require attendance by senior officers at their meetings. What is important is that we make sure that the type of activity that is going on in his constituency is replicated elsewhere. That is why I announced recently something like £2.5 million for the Centre for Public Scrutiny, so that it can look at bringing together local councillors on the committees to examine how the activities that his committee may be undertaking can be used as examples elsewhere. In some areas, those Committees have not been as strong as perhaps they are in his area. We are therefore looking at how we can spread that power to make sure that all are able to take advantage of the new powers given to them.

Mr. Nigel Evans (Ribble Valley) (Con): When will taxpayers in my constituency have a greater say over the level of services that they receive in their area? To give one perfect example, someone who has just moved back into my constituency after six years and has tried to register with an NHS dentist has been told that there are no NHS dentists in the Ribble Valley area and that he would have to do a round trip of more than 70 miles with his family to get one. What accountability will there be on behalf of those who provide such services to ensure that people who pay large, increasing sums of money for the NHS, including the 1 per cent. increase in national insurance contributions, get the level of service for which they are paying?

Ms Winterton: Overview and scrutiny committees can look into the provision of dentistry at local level. Moreover, from next year we shall commission dentistry at local level, which means a radical overhaul of the current system. That will ensure that decisions on local priorities and local expenditure can be made by local people. All trusts will of course be overseen by patients forums.

Roger Casale (Wimbledon) (Lab): Along with investment and reform, will not increasing the power of patients and the public and strengthening their voice in the reshaping of health services become one of the strongest drivers of sustained improvements in the NHS? Will my hon. Friend join me in thanking community groups, members of the public and Sutton and Merton primary care trust in my constituency? They have joined forces in an innovative way to reshape plans for the new Nelson hospital in the constituency. Will my hon. Friend confirm that that is the kind of work that she wants to see taking place throughout the country?

Ms Winterton: I am extremely impressed by the work that my hon. Friend has helped to lead in his constituency, to bring about patient and public involvement. There is indeed an increasing demand

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from local people for more information about why decisions are made at local level, and what priority is given to different funding streams. We are enabling that to become a reality for the first time, and we want what is happening in my hon. Friend's constituency to be replicated elsewhere.

Mr. Patrick McLoughlin (West Derbyshire) (Con): What is the estimated cost of elections to foundation hospitals?

Ms Winterton: That will depend on the number of people who sign up for the nomination process. In some areas at least 9,000, or 10,000, are signing up for the wider elections to each foundation hospital trust. The elections to the board of governors will then take place. It will be up to each area to decide how the elections should be conducted, and the proposals will be put to the independent regulator to ensure that the procedure is adequate and that enough funds are available.

Helen Jones (Warrington, North) (Lab): Does my hon. Friend agree that proper democratic accountability must rest on the provision of accurate information? Will she give serious attention to the refusal of my local strategic health authority to release a document concerning the management of the Mersey regional ambulance service? How can we improve services if the NHS continues to rest on a culture of secrecy, and will not release documents concerning public bodies paid for with public money?

Ms Winterton: My hon. Friend is right: information should be released whenever possible. That is important not only in terms of accountability to patients, but in terms of transparency when it comes to the way in which public money is spent. I understand that my hon. Friend will shortly be meeting the Under-Secretary of State for Health, my hon. Friend the Member for Welwyn Hatfield (Miss Johnson). Perhaps she will raise the matter then.

Mr. Andrew Lansley (South Cambridgeshire) (Con): The Minister will recall that during the progress of the Health and Social Care (Community Health and Standards) Bill, Conservative Members pressed for local accountability to be vested in primary care trusts. That is the obvious place to start in determining local priorities in response to local people. The Secretary of State has told us that 75 per cent of NHS funds are allocated to PCTs. When will the Minister and her colleagues, having previously resisted local ownership and accountability for PCTs, do a U-turn on that as well, and offer such accountability?

Ms Winterton: We have already introduced one of the biggest shake-ups in terms of patient involvement in the NHS. Not only do we have the appropriate systems in the foundation trusts, but every PCT now has a patients forum. It is important to give them time to take root and work properly. We have also introduced patient advice and liaison systems, and an independent complaints system. This is not the time to shake all that up. We want to ensure that it beds down and that the patients forums work effectively, as they have already begun to do. We can then consider any further changes that may be necessary in the future.

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