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The Parliamentary Under-Secretary of State for Health (Mr. Liam Byrne): Patients with asbestos-related diseases have access to a number of treatments, including surgery, radiotherapy, chemotherapy and palliative care. Primary care trusts have responsibility for ensuring that they commission services sufficient to meet local need.
Mr. Hepburn: The Minister will be aware of the representations that I have made to him in the past about the availability of the cancer drug Alimta on the NHS in Tyne and Wear, and I thank him and his Department for the work that has been done in getting that drug prescribed. In practical terms, when can mesothelioma sufferers such as my constituent Bob McClaren expect to receive the drug?
Mr. Byrne: I congratulate my hon. Friend on his persistent work to champion the need for better treatment for sufferers from mesothelioma. As he said, Alimta is subject to an appraisal by the National Institute for Health and Clinical Excellence, and we expect guidance in October 2006. In the meantime, doctors can prescribe it on a named-patient basis, and as the Secretary of State has made clear, PCTs cannot refuse to fund such drugs on grounds of cost alone. I am glad to say that on 9 December the northern cancer network decided that all PCTs in its strategic health authority area will fund Alimta for mesothelioma, and that decision is in no small part down to my hon. Friend's persistent work over the past few months.
Is my Friend aware that people in Pendle and in Burnley are outraged at the suggestion that the accident and emergency department at Burnley general may be downgraded and blue light facilities concentrated at Blackburn? The matter has gone out to public consultation, but what weight will be given to the views of the public? Do people have a veto over the proposals?
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Caroline Flint: I am pleased that the people of my hon. Friend's constituency and from further afield are benefiting from the new private finance initiative in Blackburn, where £110 million will create a new hospital, and where £30 million will go to support Burnley general hospital. A pre-consultation process is happening at the moment, and I understand that there is a commitment that there will be acute services at both hospitals. I also understand that formal consultation will start in February, when, of course, everybody will be entitled to have a say. The local authority's overview and scrutiny committee will have its say, too. It is important that services be looked at, and I am pleased that the £140 million going into the two hospitals is a sign of investment in health services in my hon. Friend's area and others.
Dr. Richard Taylor (Wyre Forest) (Ind): Does the Minister agree that when an A and E department is downgraded, a minor injuries unit led by nurseshowever good it may beis not an alternative acceptable to people? Will she promote urgent care centres, like those in Hexham and Bishop Auckland, which appear to be a reasonably acceptable halfway house between a minor injuries unit and a full A and E department, and which retain local accessibility for most emergencies?
Caroline Flint: Acute services with full back-up, resuscitation support and 24-hour consulting services are important, but so are minor injuries units. Sometimes it is quite helpful to have the services separated. More than 25 per cent. of A and E attendees now go to walk-in centres, of which we have 68, with 21 more being developed. That is a way of managing A and E services better for patient safety and access. As a doctor, the hon. Gentleman will know that a number of people who attend acute A and E services could be better served by attending a minor injuries unit or other services that we have been able to provide only because of the resources and investment put in by the Government.
Mr. Tim Boswell (Daventry) (Con): In view of local concern, including that of some of my constituents who live at least 25 miles from an alternative, may I have the Minister's assurance that the accident and emergency department at Horton general hospital in Banbury is safe in her hands?
Caroline Flint: No change will be made without full consultation. I am sure that the hon. Gentleman agrees that we have to consider the patient needs of the 21st century for both accident and emergency and other services. We need to see how best to provide for those in acute need and those who need advice and support for a minor injury. All that is about addressing the needs of local communities, which is one of the first and foremost tasks of PCTs and those who work in them.
Chris Grayling (Epsom and Ewell)
(Con): Yesterday the Secretary of State intervened to overrule my local NHS trust, instructing it to build its proposed new hospital at St. Helier in Carshalton. As a result, more than 150,000 of my constituents and other patients in mid-Surrey will lose local access to accident and
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emergency services. What is the logic of instructing NHS trusts to build a new hospital within three miles of three other major acute centres, in a public park and children's playground and in a location that is poorly accessible by public transport? Does it have something to do with shoring up the defences for the local elections in May?
Caroline Flint: I understand from my right hon. Friend the Secretary of State that the arguments on both sides were finely balanced. The two sites are only two miles apart. In her deliberations, she took into account the issue of health inequalities and the needs in St. Helier outweighed those in the other area. Health inequalities are an important issue to address, but everybody will benefit from the new services that will be provided.
The Minister of State, Department of Health (Jane Kennedy): Provision of clinical advice on poisonings is the responsibility of the Health Protection Agency, which commissions the National Poisons Information Service from a number of trusts in the UK. Guy's and St Thomas' is currently in discussion with the HPA over its role as part of this service.
Simon Hughes: Given that the poisons unit at Guy's hospital at London Bridge is the most well known and respected, the longest established, the busiest and the most used poisons unit in the countryand the only one recognised internationallywill the Minister intervene to ensure that the Health Protection Agency is told that it has to resume discussions with the unit and bring it back into the National Poisons Information Service, and not exclude the key player from the relevant league in the health service? Will she tell the HPA what to do, because at the moment it does not deserve its name?
Jane Kennedy: It is certainly a poisonous time for the Liberal Democrats. However, the hon. Gentleman raises a serious point. Following ministerial agreement on the outcome of the Department of Health review in 1997, the London centre based at Guy's was to have been part of a cohesive, sustainable National Poisons Information Service. I regret that it is not part of the NPIS, but we have limited powers of direction over the Health Protection Agency. As I have said, discussions are ongoing.
It is worth noting that as a result of the establishment of the NPIS, part of the response to the Buncefield explosion involved the on-call consultant toxicologist speaking with the accident and emergency consultants at Hemel Hempstead and St. Albans by 10 am on the Sunday to brief them and give them direct access to NPIS if further advice was needed. There is proven evidence of the worth of the work of the NPIS and I hope that the discussions will bear fruit because, as the hon. Gentleman says, Guy's plays an important role in the issue.
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Kate Hoey (Vauxhall) (Lab): My hon. Friend will be aware that this is an important issue, especially for Londoners at present as they live under the threat of dreadful things such as chemical explosions. Will she look again at this issue? She says that she has no responsibility for the HPA, but surely she is the Minister with responsibility for it. It does seem as if there has been a tiff between the HPA and the poisons unit because the former did not listen to some of the advice provided by the latter.
Jane Kennedy: We have limited powers of direction over the HPA, as I have said. It appears that Guy's and St. Thomas' had established an independent poisons unit while the HPA considered that joint negotiations were still ongoing. Neither the HPA nor the Department has any remit or funding to support a service that runs in parallel with the NPIS and it is regrettable that Guy's appears to have chosen to support such a service. However, as I have said, the discussions are ongoing. I will follow them with interest and report back to my hon. Friend and the hon. Member for North Southwark and Bermondsey (Simon Hughes) on the outcome.
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