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The Minister of State, Department of Health (Ms Rosie Winterton): Local involvement networks will provide flexible ways for a much larger number of people to engage with their local health, as well as social care, organisations to help to shape services and priorities in ways that best suit communities and the people in them.
Would the Minister be interested to hear about the good work that is taking place between Croydons PPI and the Mayday trust? For example, there was an unannounced visit last week to eight
wards and recommendations were made on both the quality of fare and patient care. Such lay-visiting puts as its first question, Would I like my relative or myself to be in these conditions in the hospital?, but surely that will not be available under the new and more formalised local involvement networks.
Ms Winterton: I am certainly aware of the good PPI work that goes on in the hon. Gentlemans area. However, when we consulted on the future of patient forums and PPI, many of the forums told us that some of their inspection work was duplicated by the Healthcare Commission. We will want LINks to examine the services provided in a specific area by following the patient pathway, in a sense, rather than by being attached to individual buildings and simply inspecting those. I assure the hon. Gentleman that we will expect the Healthcare Commission to involve LINks when it carries out inspections, but we do not want the duplication of inspection activities that exists at the moment.
Patrick Hall (Bedford) (Lab): Given the many changes facing the national health service, does my right hon. Friend agree that we need a stronger and more effective system of patient and public involvement than that which we have had thus far? She will have the opportunity to meet forum members from all over the country at a meeting next Monday in the House, which I am sure will be most productive. Does she acknowledge that the transition from the existing system to LINks must be sensitively handled so that we can maintain the involvement of volunteers and continuity, and deal with all the changes and the comments about them that will be required? Does she accept as well
Ms Winterton: I certainly agree, and I congratulate my hon. Friend on all the work that he does on the all-party group to promote patient and public involvement. Patient forums have done an excellent job and we do not want to lose the expertise that has been built up. I will examine the ways in which we can work with local authorities, which will handle the contracts for the local involvement networks, to ensure that they are able to bring existing members into the new system. However, one advantage of the new system is that LINks will examine not only health services, but social services, so they will be able to consider some of the joint commissioning between the two and work closely with some of the overview and scrutiny committees. Such a system will provide a better overview of access to local services. It will ensure that local services are of a high quality and give people the right to challenge them if they are not.
Dr. Richard Taylor (Wyre Forest) (Ind): Will the Minister explain how the Department of Health can issue a paper entitled Patient and Public Involvement in Commissioning, suggesting that patient petitions be used in primary care trusts, in which there is not a single mention of the local involvement networks that the Government established to provide precisely that sort of communication?
Ms Winterton: We have made connections between local involvement networks and the possibility of petitions. We have said that local involvement networks can, through the overview and scrutiny committees, approach PCTs and ask for a response within 20 days if there are complaints about a service. LINks will be able to work with PCTs, and can ask them why they have made particular priorities in an area, whether they are adequately assessing local health need, and whether they are prioritising spending to effect any changes needed. They will be able to challenge service delivery and involve a much wider group of people than are currently involved in patient forums. As I have said, we are building on the good work that has already been done by patient forums, but are involving more people and giving them greater powers.
Keith Vaz (Leicester, East) (Lab): My right hon. Friend will recall her visit to Leicester, during which she paid tribute to the work of a Leicester PPI forum. She will know that it was through the work of that PPI forum, in partnership with the local health authority, that the incidence of MRSA was discovered. How can we be reassured that the issue raised by the hon. Member for Croydon, Central (Mr. Pelling) will be addressed? I take the Ministers point about duplication, but we need to be reassured that the same rights that were available to the previous forums will be available to her new commission.
Ms Winterton: I certainly pay tribute to the members of the patient forums in the constituency of my right hon. Friend the Member for Leicester, East (Keith Vaz); their enthusiasm was boundless and their dedication and commitment to ensuring good services was plain for all to see. However, I stress again that it is important that there should be no duplication of the work of the Healthcare Commission and the Commission for Social Care Inspection. We want to give LINks the opportunity to consult local people if there have been a lot of complaints to the patient advice and liaison services, or the independent complaints and advocacy service, about local services. If it is believed that there is a particular problem, LINks can refer it to the PCT and, if necessary, onward through the overview and scrutiny committees to the appropriate regulators. We would expect the regulators to involve LINks in their inspection processes but, as I say, we do not want duplication of a process, which is what happens at the moment.
Mr. John Baron (Billericay) (Con): I put it to the Minister that she totally misunderstands the central point made by my hon. Friend the Member for Croydon, Central (Mr. Pelling) and others. We all agree that, at a time of massive change in the NHS, a strong patient voice is required. However, given that LINks will not have the powers that patient forums had to monitor and inspect the NHS and access information, and given that PCTs will be obliged to listen to the recommendations of LINks, but will not necessarily be obliged act on them, is the Minister not at least a little concerned that LINks will turn out to be nothing more than toothless talking shops?
LINks certainly will not be toothless talking shops. When we carried out our consultation, it was clear that some people felt that there was duplication,
and that their inspections were not taken that seriously. We want to empower LINks to gather peoples views about local services and to hold to account primary care trusts and local authorities for the way in which they assess local need and commission services. I know that the Opposition would reinstate a top-down approach
The Parliamentary Under-Secretary of State for Health (Mr. Ivan Lewis): The average waiting time for the 15 key diagnostic tests on which we collect monthly data was five and a half weeks for patients waiting at the end of Augustdown from seven weeks in January, when the NHS first started collecting diagnostic data.
Mr. Kidney: I thank my hon. Friend for that answer. Everyone connected with Staffordshire general hospital has performed magnificently in the past couple of years to reduce long waits for diagnostic tests such as MRI scans. However, managers have told me that there is still an enormous challenge if they are to meet the Governments ambitious target for 2008 of a maximum wait of 18 weeks from GP surgery to operating theatre. Will my hon. Friend tell meand, through me, those managersabout the support available over the next 12 months to make sure that waits for diagnostic tests are not the weak point in that very ambitious target?
Mr. Lewis: I agree entirely with my hon. Friend. I, too, pay tribute to the staff of Staffordshire hospital, who have worked to make the health service the high-quality service that the people of Stafford have the right to expect. As for the specific question of imaging scans, from April 2006, people who do not receive an appointment within 20 weeks are offered the choice of a scan from another provider within that period. We are driving the system to ensure that there is a guaranteed minimum standard. The great prize for the national health service is the historic 18-week target from the door of the GP surgery to the door of the operating theatre. The achievement of that target would be the greatest manifestation of a modern health service, and it would effectively mean the ending of waiting lists in the NHS. We will ensure that our staff receive all the necessary support to enable us to deliver that historic goal.
Tony Baldry (Banbury) (Con): Is the Minister concerned that the independent orthopaedic treatment centre in my constituency is not conducting diagnostic tests or, indeed, any tests on people who live on their own or do not have a telephone? That is clear discrimination against the single elderly and the poor, and it is a double whammy because, instead of being treated in Banbury, as in the past, the single elderly and people without telephones, who tend to be poorer members of the community, have to go to Oxford. That is disgraceful cherry-picking by those independent treatment centres, and the Minister and the Government should be ashamed.
Mr. Lewis: If the health service was entirely independent I would not be able to intervene. However, that is not the case, so I shall certainly look into the concerns that the hon. Gentleman has raised, speak to the relevant health managers and strategic health authority, and write to him with a response.
The Secretary of State for Health (Ms Patricia Hewitt): In 2003, following a review by the independent advisory committee, we introduced a fairer funding formula to ensure that primary care trusts can commission similar levels of health services for populations in similar need. As a result, Burnley, Pendle and Rossendale PCT has benefited from an increase in funding of £60 million or about 20 per cent. over 2006-07 and 2007-08.
Kitty Ussher: I welcome that answer, precisely because that extra money will be used to help to improve mortality rates in my Burnley constituency, which, regrettably, are worse than the national average across the board. Can my right hon. Friend guarantee that the allocation of funding will always be based on health need?
Ms Hewitt: I can certainly give my hon. Friend an assurance that we will continue to use a fair funding formula that takes into account the fact that different populations in different parts of the country have different health needs, whether that results from a higher proportion of elderly people or from a concentration of communities with a much higher risk of cancer, heart disease, circulatory and other diseases as, indeed, is the case in her constituency, where the average life expectancy is about two and a half years less than the English average, and about five years less than, to take a random example, the average for South Cambridgeshire.
Paul Rowen (Rochdale) (LD): What estimate has the Minister made of the increased costs of the reconfiguration that resulted in the downgrading of Burnley general hospital and Rochdale infirmary, and what is the impact on funding formulae? One of my constituents suffered an accident in Whitworth on Saturday night and was collected by an ambulance that came from Preston. How many extra ambulances are needed to serve those communities?
Ms Hewitt: These matters must be taken into account by the primary care trust and by the hospitals. As the hon. Gentleman indicates, there has been a review of emergency and acute services in east Lancashire, which I believe is under debate by the overview and scrutiny committee. He will understand that I believe that such decisions, about which my hon. Friend the Member for Burnley (Kitty Ussher) has been to see me with some of her constituents, should ideally be made locally. But the overview and scrutiny committee has an important role to play in that, and it would be inappropriate for me to comment further at this stage.
Janet Anderson (Rossendale and Darwen) (Lab): May I tell my right hon. Friend that a recent consultation in my constituency in Rossendale showed a clear demand for the retention of community health provision in the Rossendale valley, and that before the end of the year the East Lancashire Hospitals NHS Trust, the PCT and Rossendale borough council will be submitting a bid for funding to establish a health campus in the Rossendale valley? I hope that, when that arrives on her desk, she will give it serious consideration.
Ms Hewitt: My hon. Friend refers to an extremely exciting proposal for a health campus. As she knows, the funding that has been made available by my right hon. Friend the Chancellor is now almost entirely devolved to primary care trusts, following the much fairer funding formula. It will therefore be for the local primary care trust and the strategic health authority in the north-west to decide whether, as she hopes, that project should be a priority for further funding.
The Minister of State, Department of Health (Ms Rosie Winterton): The Government are committed to ensuring that there is a strong voice for the people who use the NHS, as well as for those who work in it. That is why patients and the public, as well as all other stakeholders, are involved in and consulted on changes to the health service.
Mr. Evans: I am grateful for that response, and I am grateful to Lord Warner for meeting two Longridge GPs and Councillor David Smith from Longridge last night, who was speaking up on behalf of the people of Longridge. During the changeovers with the primary care trusts, Longridge was moved from Preston into East Lancashire. Anybody who knows the area knows that Longridge people look towards Preston for all their services. That is where all the bus routes go. Already patients are being told that for diabetes care they need to travel many miles out of their way into east Lancashire. Lord Warner said that he would investigate and I look forward to that, but may we re-examine the processes in the consultation so that local people are listened to effectively?
Ms Winterton: I am aware of the meeting that took place. I gather that it was quite constructive, and that in the course of it there was even an exchange of Lancashire cheese. The issues that the hon. Gentleman mentions can be difficult. One reason for changing the boundaries to that of the local authority was to make them coterminous with the health service to ensure that some of the shared services between local government and health services could be delivered more effectively. For public health purposes, there can also be good reasons for coterminosity. However, I understand that there are some issues in relation to referrals and that Lord Warner has agreed to consider those and discuss them with the strategic health authority.
Alistair Burt (North-East Bedfordshire) (Con): If consultations in Bedfordshire reveal anger and a rejection of the likely downgrading of Bedford hospital, annoyance at the unequal funding of rural and semi-rural areas, and an immediate demand to have fitted in the hospital an MRI scanner, which has been bought and paid for but which is gathering dust in a warehouse, will anyone on the Front Bench be listening?
Ms Winterton: May I reassure the hon. Gentleman that not only has there been extra funding in his area, but there have been increases in staff numbers and equipment? When there are changes to services, a clear pattern must be followed. There is local consultation and the matter can be referred to the overview and scrutiny committee, so that if there are issues about inadequate consultation or detriment to services, those can be referred to the Secretary of State. I hope that the hon. Gentleman will encourage his constituents to participate in consultation processes.
The Minister of State, Department of Health (Caroline Flint): Food retailers have a vital role to play in tackling obesity, and I think that they are beginning to make a difference through reducing the amount of fat and sugar in processed food, providing clear front-of-pack labelling and supporting their customers to make healthy choices. We are seeing more evidence that where retailers take a proactive approach to healthy eating, it can actually improve their profit margins. I suggest that that is a win-win situation.
I recently presented IT equipment to schools in my constituency as part of the Tesco computers for schools initiative, and it occurred to me that much of the money that families spend to obtain the vouchers goes on crisps, sweets and chocolate, which make children obese. I suggested to Tesco that it
should amend its scheme by excluding such products from the eligible spend for the vouchers or by giving double points for fruit and vegetables. Will my hon. Friend support that idea? Does she agree that it is a great opportunity for Tesco, Britains leading food retailer, to send a powerful message and to lead the way in the fight against childhood obesity?
Caroline Flint: It is a good idea for retailers, both Tesco and others, to reward healthy purchasing. There are many ways in which retailers can work to support their customers. I am happy to raise the matter with the retailers, whom I meet regularly. I congratulate my hon. Friend on his initiative.
The Parliamentary Under-Secretary of State for Health (Mr. Ivan Lewis): The Department does not collect information from NHS organisations that would allow an analysis of the cost of management consultants.
Mr. Anderson: Perhaps I can help. Advice was given at the Mesothelioma UK patients and carers conference in Manchester on 5 October that £179 million was spent on management consultants. How can I explain that to my constituents who are waiting for Alimta, which will cost £5 million a year?
Mr. Lewis: I am sure that my hon. Friend agrees that there is a role for management consultants, when they add value to the decisions and issues that managers in the national health service must address. We hope and expect managers to exercise proper judgment in deciding when to use management consultants. If management consultants add value and lead to an improvement in patient care, Government and Opposition Members would say that they have an important role to play. However, we also accept that good judgment must be exercised when consultants are used.
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