House of Commons
Tuesday 18 July 2006
The House met at half-past Two o’clock
Prayers
[Mr. Speaker in the Chair]
Oral Answers to Questions
Health
The Secretary of State was asked—
Hospital Travel Costs
1. Ben Chapman (Wirral, South) (Lab): What assistance is available for cancer patients to help with travel costs to and from hospital. [85839]
The Minister of State, Department of Health (Andy Burnham): The hospital travel costs scheme provides financial assistance to NHS patients, including cancer patients, who do not have a medical need for ambulance transport but who require assistance in meeting the costs of travel to and from care.
Ben Chapman: Does my hon. Friend accept that cancer patients, at a sensitive time in their lives, must travel to hospital an average of 50 times in the course of their no doubt excellent treatment, at places such as Clatterbridge centre for oncology? In doing so, they incur costs of hundreds of pounds in travel and in the lottery of car parking charges. Will the Department move forward with consulting on better awareness of the hospital travel costs scheme and increasing its uptake?
Andy Burnham: My hon. Friend makes an extremely important point; he has a distinguished cancer treatment centre in his constituency. As a fellow north-west MP, I know that my constituents must travel some considerable distance to Christie’s, while others in the Merseyside region travel to his constituency. I therefore accept that people can face extra financial worries at a time of stress and anxiety due to their illness. First, further work is needed to ensure that the scheme’s scope is not too rigid and focused on hospital settings as opposed to primary care, where more could be done. Secondly, and more importantly, we need to get better information to people who may be eligible to benefit from the scheme. Many patients may be able to get significant support for their travel costs.
Steve Webb (Northavon) (LD):
The Minister will be aware that the cumulative cost of car parking, not just for cancer patients but for other regular visitors to
hospital, can be substantial. At this point, the normal ministerial reply is that that is a local issue—but is the Department of Health at all responsible? Does it feel that it has any national role at all in the health service, or will it just allow local trusts to charge what they like?
Andy Burnham: Normally, Liberal Democrats are the first to jump up and cry foul about micro-management and targets coming from the centre. Again, dare I say, they want to have it both ways. As far as I am concerned, car parking is a big issue for the public— [Interruption.] If the hon. Gentleman will hear me out, I shall go on to say that it is perhaps a bigger issue for the public than the managers of some NHS trusts accept. In a world in which patients have more choice, many of them will make an important point of this issue, and many trusts will be required to think harder about it. Essentially, however, it is a local decision depending on the availability of space on trust land and the proximity of the trust to the town centre.
Mr. Kevin Barron (Rother Valley) (Lab): I do not expect my hon. Friend to comment yet on the publication this morning of the Health Committee’s report on NHS charges. However, we are deeply concerned about patients’ knowledge of the hospital travel costs scheme. Can he ensure that that is improved? Can he also consider setting national guidelines for hospital car park charges, especially for patients, as the situation is a bit of a mess at the moment?
Andy Burnham: I woke up this morning to reports of the findings of my right hon. Friend’s Committee, and I detected his forthright Yorkshire tones in some of the language used to describe the situation. He is right to say that more effort needs to be made to ensure that patients, particularly those on low incomes, are given access to information about their eligibility to claim for their transport costs, either in whole or in part. How people receive that money back from hospital trusts, whether after or before their treatment, is also an issue. My right hon. Friend is also right to say that car parking is a big issue for patients. Many trusts are making exceptions for car parking, particularly for cancer patients. Others that are not doing that should look at those who are, and see whether they can provide better support to patients at a difficult time in their lives.
Anne Main (St. Albans) (Con): According to the 19th report of the Public Accounts Committee, more than three quarters of NHS patients were not given information on financial benefits that could be used, for example, to help to pay their car parking fees. As it was stated in evidence to the Committee that progress was hoped for by the end of 2005 on delivery of disability living allowance and attendance allowance to cancer patients, what progress has been made?
Andy Burnham:
The health White Paper published earlier this year made a specific commitment to consult on the hospital travel costs scheme: first, on whether the scope needs to be increased so that patients not under the care of a consultant but another health service practitioner can benefit; and secondly, working with Macmillan, which has done excellent work in this
area, on exactly how patients are given information about whether they are eligible to benefit. It is not as easy as sticking a poster up on a wall; we must see how we can get relevant information to patients who may be able to benefit. That is a fair and legitimate point, and we will take that forward in consultation this autumn.
Abortion
2. Mr. Jim Cunningham (Coventry, South) (Lab): What recent discussions she has had with representatives of the Roman Catholic Church on Government policy on abortion. [85840]
The Secretary of State for Health (Ms Patricia Hewitt): When I met Cardinal Murphy-O’Connor and his colleagues recently, we discussed several issues, including whether the 24-week time limit on abortion should be reduced. The Government have no plans to change the law on abortion.
Mr. Cunningham: Has my right hon. Friend had consultations with any other parties, such as members of the medical profession?
Ms Hewitt: Members of the medical profession, particularly the Royal College of Obstetricians and Gynaecologists and the British Medical Association, have recently made clear that they do not believe the evidence supports any need to change the time limits specified in the present law on abortion.
Richard Ottaway (Croydon, South) (Con): Does the Secretary of State accept that if a decision is to be made, it must be made on the basis of the best advice and evidence available to Members? Will she seriously consider Cardinal Murphy-O’Connor’s suggestion that a Joint Committee of the two Houses be set up to hear the evidence so that a rational and sensible decision can be made?
Ms Hewitt: That is, of course, a matter for individual Select Committees and for the House, not for the Government. However, I stress that when the law was revised in the late 1980s, the medical profession believed that the age at which a foetus was considered viable should be reduced from 28 weeks’ gestation to 24. There was a clear medical consensus on that, based on evidence. There is no such consensus or similar evidence today.
Chris McCafferty (Calder Valley) (Lab): Does my right hon. Friend agree that safe and legal abortion is crucial to the mental and physical well-being of women in this country, given that no contraceptive method is 100 per cent. safe? Does she acknowledge that fewer than 0.1 per cent. of late terminations take place at 24 weeks, and that the reason for those terminations is usually concern for the health and welfare of the mother and child or the death or divorce of a partner in marriage?
Ms Hewitt:
I agree with my hon. Friend. Many Members on both sides of the House fought to ensure that the law would allow women to choose a safe and legal abortion should they need to do so. Speaking for myself, I believe that that is right, and that it would be
a tragedy for many women if it were reversed. My hon. Friend is also right about late abortions: according to the most recent figures that we have, 137 abortions in the last year took place at 24 weeks’ gestation or above.
Sandra Gidley (Romsey) (LD): I am sure the Secretary of State agrees that improved education and access to contraception would help to reduce the abortion rate. Why are many primary care trusts cutting the number of community clinics as part of their strategy to reduce deficits? Will the Secretary of State ensure that clinics do not close, so that a vital service remains available and doctors and nurses can retain their skills?
Ms Hewitt: The hon. Lady is absolutely right: of course it is better for women not to find themselves with unwanted pregnancies. That is why we have substantially increased investment not just in contraception services but in targeted measures to reduce the number of teenage pregnancies. I know the hon. Lady will welcome the fact that the number of pregnancies among those under 18 has been falling, and is now at its lowest since the mid-1980s. However, as was recently announced by the Minister of State, Department of Health, my hon. Friend the Member for Don Valley (Caroline Flint), primary care trusts are considering how to redesign their sexual health services, including contraception services, to ensure that they are as effective and available as possible.
Audiology
3. Helen Goodman (Bishop Auckland) (Lab): What the current average waiting time is for a hearing aid within the NHS. [85841]
4. Mr. Desmond Swayne (New Forest, West) (Con): What targets she has set for audiology waiting times. [85842]
6. Dr. Vincent Cable (Twickenham) (LD): If she will make a statement on audiology services in the NHS. [85844]
9. Lorely Burt (Solihull) (LD): When her Department expects to take steps to reduce waiting times for audiology services. [85847]
The Parliamentary Under-Secretary of State for Health (Mr. Ivan Lewis): The Department does not collect waiting times for hearing aid fittings. We aim to deliver audiology diagnostic tests within 13 weeks by March 2007, and within six weeks by December 2008.
Helen Goodman: I am sure that the Minister has spoken to many people who now have digital hearing aids, who will have told him how tremendously their quality of life and that of their families has improved. Why are hearing aids not subject to the waiting time targets that apply to other health care provision?
Mr. Lewis:
We want to maintain a situation in which most patients are referred directly by GPs to audiology departments, not consultants, and we do not want to create a position that would distort that practice. However, there are genuine challenges and problems
with waiting times in certain parts of the country, which is why the Department will be working with stakeholders such as the Royal National Institute for Deaf People to produce an action plan to improve waiting times across the country, rather than have the unacceptable standards that apply in some parts of the country.
Mr. Swayne: This happens all the time. One tables a perfectly straightforward question, and the Minister answers another. Is not the answer to my question, as it appears on the Order Paper, “None”?
Mr. Lewis: May I suggest that if the hon. Gentleman forwarded his questions by e-mail he might get a more satisfactory response? He should note that the £125 million invested in the programme for modernising hearing aid services has been warmly welcomed by people who have benefited tremendously from digital hearing aids, as my hon. Friend the Member for Bishop Auckland (Helen Goodman) said. I also have to say that Conservative Members did not vote for that £125 million expenditure on the modernisation programme.
Dr. Cable: Does the Minister acknowledge that, in addition to the long waiting lists for fitting—more than a year in my primary care trust area—and additional waits for diagnostic tests, there is a large legacy problem of analogue hearing aids that need to be replaced by digital aids in the course of time? What would be a realistic time frame for clearing the large backlog of commitments, which in so many cases are long awaited?
Mr. Lewis: I entirely agree that that issue must be taken seriously. It must form an inherent part of the action plan that we take forward, which will include a number of issues as well as that one. Other issues are increasing demand, inadequate capacity, work force skills and competencies, and the fact that we do not yet have sufficient focus on modern technology. Our action plan will address the remaining obstacles and ensure that people all over the country have access to the quality treatment that they deserve.
Lorely Burt: In my constituency, residents are waiting 15 months after their tests before they receive their hearing aids. Given that there is an 18-week target, that is clearly unacceptable. I wonder whether it would be possible to seek a reciprocal agreement with European countries. I am told that in Denmark hearing aids are cheaper and arrive more quickly. Some people are going over there to get their hearing aids, to avoid the waiting lists here. In Luxembourg, too, it is possible to—
Mr. Speaker: Order. I think that the Minister has already got the point that it is better abroad.
Mr. Lewis:
Thank you, Mr. Speaker. At one point I thought that we were having a discussion on the Eurovision song contest—[Hon. Members: “No!”]—not that anyone in the House is going to admit to watching that. The hon. Lady raises a serious issue, and if, as we develop the action plan, I can learn from international best practice, particularly where there are
successes and achievements of better waiting times, I shall attempt to do so and incorporate it into this country’s approach to the problem.
David Taylor (North-West Leicestershire) (Lab/Co-op): Like me, 10 per cent. of British adults—5 million people—suffer from chronic tinnitus, and 1 per cent.—500,000 people—suffer so badly that it impacts severely on their quality of life. Will the Minister confirm whether audiology services for tinnitus, which are not necessarily linked with digital hearing aids, but often provide advice about therapeutic treatment to tackle the problem, are adequately catered for by the NHS? Many advances have been made in other areas of audiology, but this remains somewhat of a Cinderella service.
Mr. Lewis: I would be delighted to give my hon. Friend an assurance that part of the action plan will be to look into the problem of tinnitus. I know that it can be a horrendous condition that adversely affects people’s quality of life and undermines their daily functioning. We should take it extremely seriously, and I confirm my commitment to my hon. Friend that as part of our action plan, we will look specifically into the advice and support that tinnitus sufferers receive.
Angela Watkinson (Upminster) (Con): What advice can the Minister give to my constituent, Mr. Sapsford, who has been waiting for five months for an audiology test? He has been told that he is not a priority because he is not over 90 years old, he is not receiving a war pension and he is not blind. My local trust cannot cope with the level of demand with the current level of staff. If the Secretary of State would consider allowing our trust to recover its budget deficit over the next two or three years, instead of in the current year, it might not have to make those cuts in essential services to patients.
Mr. Lewis: During my responses today, I have frankly acknowledged the difficulties and challenges in certain parts of the country, including the hon. Lady’s constituency, but I hope that she will be equally honest with her constituents and tell them that time and again when we have debated the amount of resources that we should invest in the NHS, the party that she represents in this House has voted against that investment—so the situation could be considerably worse.
Angus Robertson (Moray) (SNP): This is an important issue for people throughout the UK. What is the Minister doing to establish best practice between the UK Government and devolved Administrations? Does he agree that it is strange to hear oppositionist tones from the Liberal Democrats on this subject when in Scotland, they are in government?
Mr. Lewis: Frankly, I am not surprised to hear that the Liberal Democrats are saying one thing in Scotland and something entirely different in England. In my experience in my constituency, they say one thing in one ward and something else in a neighbouring ward.
Mr. John Baron (Billericay) (Con):
The Minister’s admission that there are difficulties in this area is to be welcomed, because many—including the 33,000 patients who have to wait longer than a year for an
audiology test—would otherwise have considered his written statement today on audiology services complacent. Does he accept that the Government’s decision to exclude direct referrals from the 18-week time target, while including referrals made through ear, nose and throat consultants, raises the spectre of a two-tier NHS, in which the articulate and better-off will be able to ask to be referred through an ENT consultant in order to receive a hearing aid within 18 weeks, while those who do not know how the system works will have to wait far longer for their hearing aid? Does the Minister believe that that represents equitable access for all, including the 56 per cent. of patients in his local strategic health authority who have to wait longer than 26 weeks?
Mr. Lewis: The whole purpose of the action plan is to ensure that we have equitable access and that the best practice in some areas—for example, the Pennine Acute Hospitals NHS Trust, my local trust, which has zero waiting time for such services—is replicated all over the country. We need to ensure that we do not have a two-tier system. However, including direct referrals in the 18-week target would have led to a perverse incentive that we do not want to encourage. We want to continue the situation in which the vast majority of people go directly from their GP to audiology departments. Anyway, we want to see more such treatment provided in the community rather than in hospital in the future. Acknowledging the existence of challenges and issues and committing ourselves to producing an action plan is a responsible way to tackle that serious issue.
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