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House of Commons

Tuesday 28 November 2006

The House met at half-past Two o’clock


[Mr. Speaker in the Chair]

Oral Answers to Questions


The Secretary of State was asked—

Healthy Start Scheme

1. Helen Goodman (Bishop Auckland) (Lab): What steps she is taking to encourage healthy eating by pregnant women. [103766]

The Minister of State, Department of Health (Caroline Flint): The new healthy start scheme, which was launched nationwide yesterday, promotes good nutrition for certain low-income pregnant women and all pregnant under-18-year-olds by providing vouchers to spend on a range of healthy foods. All Members of Parliament were sent details of the scheme last week.

Helen Goodman: I am most grateful to the Minister for her response. In October, I spent a week trying to live on income support and to eat a healthy diet fit for a pregnant mother. I could not afford to eat five portions of fruit and vegetables every day, so I know that this announcement will be very welcome. For it to be really effective, it has to be available throughout the country. How many retailers have signed up to the scheme, and what is my hon. Friend doing to ensure that it is available in all communities?

Caroline Flint: My hon. Friend is right. The scheme widens the range of choice beyond the traditional milk offered under the welfare food scheme to include fruit and vegetables. Retailers large and small will be given the opportunity to back the scheme. We are working on a recruitment target of 35,000 retailers with more than 40,000 outlets, which will double the amount in England by about 30,000. The pilot in Devon and Cornwall has enabled small retailers to think about how they can get on board with the scheme—that is welcome.

Mrs. Nadine Dorries (Mid-Bedfordshire) (Con): Advice to pregnant women is lacking in many respects, not only on healthy eating. Thankfully, when a pregnant woman seeks an abortion she is seen and counselled by two professional doctors—

Mr. Speaker: Order. That is slightly wide of the question.

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Sir Patrick Cormack (South Staffordshire) (Con) rose—

Mr. Speaker: I shall try Patrick Cormack—perhaps he will stick to the question.

Sir Patrick Cormack: I will do my very best, Mr. Speaker.

While I entirely applaud the Minister’s sentiments, does she accept that for many of us this is a step too far? It is not the job of Government to tell people what to eat and how to conduct their lives. This is elevating the Secretary of State to the nanny of the state, and we do not want that.

Caroline Flint: Healthy start is a revamp of the welfare food scheme, which has been around for about 60 years, so the hon. Gentleman and his party had the opportunity to get rid of it or revamp it during their 18 years in power. The scheme is not only about providing the vouchers and the extension to fruit and vegetables—parents said they wanted that flexibility—but about giving midwives and health visitors the opportunity to play an important part in supporting families, particularly in the early days of babies arriving, by giving them the best advice, which they can choose whether to take, on the best possible healthy and nutritional start for their children. Importantly, the scheme is also about pregnant mums and the benefits that they derive from a good diet.

Meg Hillier (Hackney, South and Shoreditch) (Lab/Co-op): How will women in my constituency and elsewhere find out about the scheme, and how can we, as Members, encourage them to access it?

Caroline Flint: All families who are currently part of the welfare food scheme will be transferred automatically on to the healthy start scheme. For pregnant women, that should be discussed when they check in for their ante-natal care with their midwives. We are providing a pack to every health professional, health visitor and midwife throughout the country; we are doing work with Sure Start; and we are providing my right hon. and hon. Friends, and hon. Members across Parliament, with information so that you, too, can spread the word across communities —[Interruption.] I meant colleagues, not you, Mr. Speaker, although you could do so as well. We will monitor take-up because we want get the widest possible reach into as many communities as possible, particularly for those on low incomes.

NHS Trusts (Budgets)

2. Simon Hughes (North Southwark and Bermondsey) (LD): What changes in the budgets for 2006-07 for NHS trusts serving Lambeth and Southwark have been agreed since her meeting with me, the right hon. and learned Member for Camberwell and Peckham (Ms Harman), the right hon. Members for Dulwich and West Norwood (Tessa Jowell) and for Streatham (Keith Hill), and the hon. Member for Vauxhall (Kate Hoey). [103768]

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The Secretary of State for Health (Ms Patricia Hewitt): Following the meeting to which the hon. Gentleman refers, I asked NHS London to look again at budgets in Lambeth and Southwark. It has confirmed that after other factors have been taken into account, Lambeth and Southwark primary care trusts were asked to contribute less to the London-wide risk reserves for this year than most other London PCTs.

Simon Hughes: Does the Secretary of State accept that although Lambeth and Southwark are among the two most deprived boroughs in the country and have the most health service needs, that although we have cuts totalling an estimated £23 million to the Guys and St. Thomas’, King’s College Hospital and South London and Maudsley Trusts, that although there was no dispute that that will affect community services, mental health services, preventive health services and others, and that although she agreed at our meeting that it was unfair, there has been no change—there will be just the same cuts, and this year the two local communities will suffer exactly the same reduction in their services as before the meeting, which we left thinking that she was likely to be able to influence the result and produce a fairer outcome?

Ms Hewitt: As I explained to the hon. Gentleman when we met, the NHS in London and in other regions was asked to take into account the impact of the technical adjustment that was made through what is called the purchaser parity adjustment. It has done that, and it is because of that that Southwark and Lambeth have been asked to contribute less to the London-wide reserve than most other PCTs. Of course this is difficult, particularly in Southwark and Lambeth, which are very deprived communities, but the speed with which they will get back the money that they have contributed this year will depend on the speed with which other, overspending organisations in London get themselves back on track and cease to rely on organisations that are in balance to compensate for their overspending.

Kate Hoey (Vauxhall) (Lab): As one of the other Members at that meeting, I share the concerns expressed by the hon. Member for North Southwark and Bermondsey (Simon Hughes), because we left the meeting thinking that there would be some changes. The new planning framework shows a further 3.6 per cent. cut next year in Lambeth and Southwark. These are the most deprived areas in London, and the cuts will affect projects such as the healthy living centre in Stockwell, which will have to close, and all sorts of provisions that affect ordinary people in their daily lives. Why is the Secretary of State not considering the poorer PCTs that have stayed in budget yet have to suffer because of the overspending of others?

Ms Hewitt: It is precisely for that reason that we are insisting that overspending organisations, of which there are far too many in London, get their finances back under control so that we do not have to go on asking the communities in areas such as Lambeth and Southwark, which have been in balance, to make these difficult decisions. As I explained in the letter that I sent to my hon. Friends and other hon. Members after the meeting, it is simply not possible for the NHS in
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London to reopen the allocations, and the decisions that were made with all the London PCTs, to deal with the situation this year. We will continue to ensure, through the allocations formula, that the areas with the biggest needs get the biggest growth. That will be fair to Southwark and Lambeth. It is, of course, opposed by the Conservatives.

Patient Satisfaction

3. Paddy Tipping (Sherwood) (Lab): What research she has recently commissioned into patient satisfaction with the NHS. [103769]

Hon. Members: Answer the question.

Mr. Speaker: Order. Ministers must be on the ball. Who is taking Question 3?

The Secretary of State for Health (Ms Patricia Hewitt): Forgive me, Mr. Speaker. I thought that another hon. Member was seeking to ask a supplementary on Question 2.

Yesterday, we announced our plans to survey 5 million patients to measure how easy it is for them to see their general practitioner. This the first time that the Government have asked patients directly about their experience of the GP appointments system.

Paddy Tipping: I am very grateful for that answer. Has my right hon. Friend seen the recent survey by the Healthcare Commission, which shows that 92 per cent. of patients rate their experience of the NHS “good” to “excellent”? In the light of that, what can she do about closing the gap in perception between those who use the NHS and those who merely read about it?

Ms Hewitt: That was a supplementary question well worth waiting for. My hon. Friend is absolutely right about what patients say about their experience of the NHS, and I am sure that all of us would want to pay a real tribute to NHS staff. There is a big gap between patients’ experience and public perception, however. I hope that Conservative Members and the media all around the country will continue to pay at least as much attention to all the improvements taking place in the NHS as they pay to the sometimes difficult decisions that have to be made in some areas.

Mr. Nigel Waterson (Eastbourne) (Con): Will the Secretary of State also assess the impact on public satisfaction with the NHS reconfiguration process of, for example, the announcement last week by the hospitals trust in my constituency that it will definitely close one of the maternity units in the trust, despite the fact that the public consultation on that option is not due to start until the middle of January?

Ms Hewitt: No decisions are made on significant changes to services of the sort that the hon. Gentleman describes without full public consultation and the involvement of local councillors through the overview and scrutiny committee. I very much regret that, on occasions, when local primary care trusts and hospitals are considering changes—which are generally driven by the need to keep up with changes in medicine and
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clinical practice and to give patients even better care—people leap to the conclusion that there are to be cuts or reductions in services and protest before any decision has been made.

Charlotte Atkins (Staffordshire, Moorlands) (Lab): In the context of patient satisfaction, is my right hon. Friend aware of the deep vein thrombosis diagnostic service at Leek Moorlands hospital, which last month won the Community Hospitals Association award for innovation in clinical practice? Not only have almost 200 patients been saved a difficult journey to the acute hospital, but emergency capacity has been freed up, saving the local PCT £100,000 a year. The service will now be rolled out across the boundaries of the new reconfigured primary care trusts. Will she congratulate the team on their excellent work in that area?

Ms Hewitt: I am aware of that service, which is absolutely excellent— [Interruption.] Unlike Conservative Members, I want to congratulate all the staff involved in providing an excellent service, which shows how the modern NHS can both improve care for patients and save money, especially on services previously provided in an acute hospital, thus freeing up resources to spend, for instance, on new drugs and other service improvements that patients also need.

Mr. Michael Fallon (Sevenoaks) (Con): Is the Secretary of State aware that 83 per cent. of patients surveyed in a recent breast cancer forum were unaware of the hospital travel costs scheme? Will she consider again whether trusts can be persuaded better to advertise that scheme and to make claiming under it easier?

Ms Hewitt: Of course I will consider the issue raised by the hon. Gentleman. As he indicates, however, it is very much the responsibility of local hospitals to ensure that patients, particularly those such as cancer patients who must have repeated treatment, are aware of the help with travel costs that is available.

Jane Kennedy (Liverpool, Wavertree) (Lab): Research confirms the high level of public and patient satisfaction with Alder Hey, the Royal Liverpool children’s hospital in my constituency. Will my right hon. Friend ensure that the national burns review takes into account the high level of public satisfaction with the burns treatment available at Alder Hey and at Whiston? Will she also ensure that, alongside other options, the national review seriously considers encouraging burns centres across the north of England to network together to improve burns treatments and therefore support even higher levels of public satisfaction?

Ms Hewitt: My right hon. Friend is absolutely right about the high levels of public satisfaction, which reflect in part that waiting times, for instance, are shorter than ever before. We will consider carefully the review of specialist burns units and its recommendations, but she is right that a network of specialist centres is needed to ensure that those patients with the most serious burns receive the necessary specialist attention, which only a limited number of specialist centres can provide.

Steve Webb (Northavon) (LD): A Healthcare Commission survey of patients this year found that more than one in five had had to stay in a mixed-sex
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room or bay. Given that the 1997 Labour manifesto said that the Government would work towards getting rid of mixed-sex wards, the 2001 manifesto said that they would abolish them, and the 2005 manifesto did not mention the subject at all, when will the promise be kept?

Ms Hewitt: The Healthcare Commission survey to which the hon. Gentleman refers includes patients who had recently been cared for in accident and emergency or medical admissions units. When we set the target for single-sex sleeping accommodation, we asked trusts to report on the wards used for regular admissions, not A and E or medical admissions units, which, as Sir George Alberti, the national clinical director for emergency care, has pointed out, cannot always provide single-sex accommodation, because to do so would mean turning away patients who were critically ill and needed short-term observation. We have achieved 95 per cent., which was the target that we set back in 2004, and 99 per cent. of hospital trusts say that they now provide single-sex accommodation in their general wards along with single-sex bathrooms and toilets.

Mr. Sadiq Khan (Tooting) (Lab): A couple of the consequences of the massive talking-down of the NHS by the Opposition are massive demoralisation among staff and patients being scared to receive treatment. Will my right hon. Friend please ensure that some of the research and surveys that she has mentioned are widely disseminated to bust the urban myths put out by the Opposition?

Ms Hewitt: I entirely agree with my hon. Friend. We try all the time to put across the good news about what NHS staff are now achieving, backed by record investment that the Conservatives oppose. With waiting times at their shortest and cancer treatment in particular having been transformed over the past 12 months, there are many reasons for patients and the public to be enormously proud of what the NHS is achieving, although there is still more to be done.

Mr. Andrew Lansley (South Cambridgeshire) (Con): In her first answer, the Secretary of State referred to the survey assessing satisfaction with GPs’ services. The Department of Health has added two more questions, about the opening hours of general practices.

It is the Government’s own GP contract that has led to the closure of practices on Saturday mornings. Does the Secretary of State seriously intend to ask patients whether they want surgeries to be open on Saturday mornings—although their surgeries are not commissioned to be open— and subsequently withhold payments from GPs?

Ms Hewitt: The hon. Gentleman must decide whether patients should be asked whether they are satisfied with the arrangements that their local GPs are making. He must also decide whether he thinks GPs should have been given the choice—which we gave them—of whether to provide out-of-hours services. [Interruption.] That was the choice that we gave them in the survey.

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