The Minister of State, Department of Health (Andy Burnham): Hornsey Central hospital closed in 2000. At the time of its closure the hospital was underutilised and in a poor physical condition. In November 2006, Haringey Teaching primary care trust board endorsed plans for a new community hospital on the Hornsey Central site. The PCT aims to commence building work in the summer.
Lynne Featherstone: I thank the Minister for that statement. He will be aware that the London strategic health authority backs the bid for community hospital funding from the Government, but my understanding is that it is held up by technical accounting difficulties because of its connection to a local improvement finance trust scheme. Will he assure my constituents that they will not be denied this health facility due to those technical accounting difficulties?
Andy Burnham: I have been reading the hon. Ladys blog on this very subject, and I commend it to all hon. Members as an eloquent and persuasive endorsement of Government health policy, calling as it does for an expanded range of services delivered from a modern community hospital setting. She will know that the Department is considering the very bid to which she refers, but I hope that, like me, she will celebrate the fact that her PCT has endorsed this ambitious £12.8 million scheme, which seems likely to succeed. I look forward to reading on her blog about it all being made possible by Labours substantial investment in the NHS.
The Secretary of State for Health (Ms Patricia Hewitt): All primary care trusts are funding photodynamic therapy for age-related macular degeneration in line with National Institute for Health and Clinical Excellence guidance. NICE is appraising Macugen and Lucentis for treating this condition and it expects to publish guidance in October.
Michael Connarty: I am sure that my right hon. Friend is aware that Macugen, an anti-vascular endothelial growth factor drug that can stop macular degeneration occurring in the eyes of elderly people, has already been approved in Scotland. As the increase of diabetes is likely to result in a vast increase in age-related macular degeneration, is it not time that the English authorities were allowed the same funding to give people the drug that is now available in Scotland?
Ms Hewitt: My hon. Friend is right that the Scottish Medicines Consortium has approved Macugen since August, although it has not arrived at any decision on Lucentis. Its view will be superseded by NICE guidance when it is available. The important thing is that decisions on the cost and clinical effectiveness of new drugs should be made by independent clinical authorities, not by politicians, and that is precisely why we established NICE and back it in making its judgments.
Sandra Gidley: The Secretary of State will be aware that 57 people start to lose their sight daily through this condition, and the average annual cost of support is £9,500. Given that these therapies are widely regarded as being very effective, is there not a case for fast-tracking the NICE decision so that fewer people go blind?
Ms Hewitt: No patient should be refused Lucentis or Macugen simply because NICE guidance does not yet exist, but NICE needs to evaluate the new treatments thoroughly and it has decided, I think rightly, to evaluate them together so that the two treatments can be compared with each other as well as with the existing treatment. That means that it is taking a little longer, although it started on the evaluation before Lucentis was licensed, as it was only a couple of weeks ago. The guidance will be ready as fast as possible, consistent with arriving at a good, thorough and fair decision.
Mr. Kevin Barron (Rother Valley) (Lab): My right hon. Friend will know that wet AMD is also being treated at the moment on the NHS in some parts of the country by the use off-licence of a drug called Avastin that is licensed for the treatment of bowel cancer. When or if either of the drugs being appraised by NICE come into the marketplace with NICEs approval, will Avastin still be available on the NHS if both the clinician and the patient believe that it should be?
Ms Hewitt: My right hon. Friend has raised an extremely important point. As he has said, Avastin has not been licensed for use on macular degeneration, although it is being used by some clinicians with the support of the NHS. The problem is that the companies concernedGenentech which manufactures it and Roche which distributes it in Europehave not applied for a licence for its use on macular degeneration, and no clinical trials have been conducted for that purpose. At the moment, if a clinician wants to use Avastin and the patient is willing to have an unlicensed drug used, it is available on the clinicians judgment, which will continue to be the case within the NHS. Although we cannot require the companies concerned to apply for a licence, in view of the very promising results that have been reported by a number of doctors, I urge both companies to initiate clinical trials for the use of Avastin for people with macular degeneration and to consider applying for a licence in the light of those trials.
Mrs. Iris Robinson (Strangford) (DUP): What is the Secretary of State doing to ensure that people have the same opportunity to receive treatment for macular degeneration right across the country? In particular, Northern Ireland seems to be the last part of the United Kingdom to receive access to drugs, while others on the mainland benefit from them based on NICE guidelines.
Ms Hewitt: Health is a devolved matter. At the moment, I understand that the health boards in Northern Ireland are not funding either Macugen or Lucentis. However, I am sure that they will want to take account of the NICE guidance, as soon as it becomes available.
Dr. Brian Iddon (Bolton, South-East) (Lab): On the basis that prevention is better than cure, will my right hon. Friend congratulate Simon Kellys team at the Royal Bolton hospital, which has established a firm link between AMD and smoking? Does she agree that we should get the message across to all smokers in the land to try to avoid incidences of that difficult condition?
Ms Hewitt: My hon. Friend is absolutely right, and I readily congratulate that team on its excellent research. The introduction of smoke-free legislation later this year will be an important step forward in public health generally, and specifically in reducing the risk of other people acquiring that appalling condition in future. We will, of course, redouble our efforts to get across the message about the huge dangers involved in smoking for people of any age.
Anne Milton (Guildford) (Con): Does the Secretary of State agree that the cost of the drugs that can have a successful effect on people with conditions such as AMD are insignificant compared with the social costs of failing to treat such diseases?
The hon. Lady is right, because one has to look at the consequences for an individual and for social care and health services of a patient losing their sight. However, it really is not good enough for Conservative Members constantly to demand additional funding for
new drugs, new treatments and additional services, when they have been wholly unwilling to support additional investment in the NHSinvestment that we made and they voted against.
Sarah McCarthy-Fry (Portsmouth, North) (Lab/Co-op): I think that the frightening thing is the speed with which the degeneration occursone of my constituents recently wrote to me about it. What are the Government doing to further research into vision and particularly into AMD? I welcome the Secretary of States statement on Lucentis today.
Ms Hewitt: My hon. Friend has raised an extremely important point. Research on vision and on many medical conditions is the responsibility of the Medical Research Council, the funding for which we have significantly increased. I draw my hon. Friends attention to the review that we recently published of eye-care services, which emphasises the need to ensure that local primary care trusts get the best possible local eye-care services, with an emphasis on early diagnosis and better treatment in the community.
Mr. John Baron (Billericay) (Con): As we have heard, despite Macugen being approved by the Scottish Medicines Consortium, and Lucentis receiving its European licence, neither drug will be appraised by NICE until later this year. Given the real concern felt by manyin particular, the Royal National Institute of the Blind and people such as Alice Mahonthat cash-strapped PCTs are withholding funding, and given the fact that the Government are not assessing what proportion of patients recommended for such treatments are being turned away, which is something that my PCT is struggling to answer, what concrete assurances can the Secretary of State give that PCTs are following her instruction that funding should not be withheld purely on the grounds that NICE has not yet issued its guidance?
Ms Hewitt: Just before Christmas, we reiterated guidance to the NHS that no patient should be refused Lucentis or Macugen, or indeed other treatments, simply because NICE guidance does not yet exist. Until NICE issues its guidance, as it will later this year, it is up to each primary care trust, whose professional executive is chaired by a clinician, to consider each case on an individual basis. The hon. Gentleman has to decide whether he supports NICE, which is widely regarded as a model around the world, or wants to go on undermining the outstanding and important work that it does.
4. Mr. Iain Wright (Hartlepool) (Lab): If she will make a statement on the recommendations made by the independent reconfiguration panel on maternity and paediatric services in Hartlepool and Teesside. 
The Minister of State, Department of Health (Ms Rosie Winterton):
My right hon. Friend the Secretary of State agreed the recommendations of the independent
reconfiguration panel as regards building a new hospital accessible to the people of Hartlepool, Stockton, Easington and Sedgefield and improving local community services.
There is no question of the hospital closing or services being run down. John Reid is saying it wont close, Im saying it wont close, I dont know what the next authority is you go to.
Given that, as my right hon. Friend said, the Secretary of State has accepted recommendations from the independent reconfiguration panel that will result in the closure of the hospital, can she advise me as to what authority I go to next?
Ms Winterton: I should remind my hon. Friend that in terms of the independent reconfiguration panel recommendations, we are talking about opening a new hospital. I recognise that changing the way in which health services operate is a very emotive issue, as he has indicated. However, it is also important to say that the panel looked at the best way of ensuring that maternity and paediatric provision met high-quality care and safety standards and concluded that centralising consultant-led maternity and paediatrics on one site would make the best use of staff and ensure patient safety.
Sir Nicholas Winterton (Macclesfield) (Con): May I support the hon. Member for Hartlepool (Mr. Wright) in the concern that he expressed? I declare an interest as an honorary vice-president of the Royal College of Midwives. Midwives are deeply concerned about the reduction in paediatric and maternity services that will occur throughout the country if the Governments proposals are carried forward. Will she listen to the RCM, which represents mothers, babies and mothers-to-be? Its views are important, and it believes that the local provision of paediatric and maternity services is essential for the safety and well-being of mothers and children.
Ms Rosie Winterton: Midwives are always deeply concerned to ensure that the services offered are safe and of high quality. I refer the hon. Gentleman to the report that has been published today, which my hon. Friend the Under-Secretary has put together with input from the Royal College of Midwives. It talks about the importance of those services but also recognises that things sometimes have to change as regards the way in which they are delivered, particularly when demographic changes and changes in medical technology and staffing patterns mean that there needs to be a bringing together of services if they are to be safe and of high quality. That is the best thing for patients and for midwives as well.
Frank Cook (Stockton, North) (Lab): Will my right hon. Friend assure the hon. Member for Macclesfield (Sir Nicholas Winterton) that there is no threat to maternity services in Hartlepool and never has been? The residents of HartlepoolI am a Hartlepudlian by birth and upbringingare worried about reports in the press that the hospital at Hartlepool will be demolished. That cannot be so. As the new hospital is established and begins to function, it will provide specialist services, but Hartlepool General hospital will remain as a secondary form of medical provisionhard-nosed clinical provision for the community.
Ms Winterton: My hon. Friend is quite right to say that and to point out that there is a consultation process on how to put together a package to examine existing facilities, improve services in the community and prepare for a new hospital with high standards of safety and care.
Mr. Graham Stuart (Beverley and Holderness) (Con): Will the Minister consider favourably requests to refer cuts in community hospitals to the independent reconfiguration panel? My constituents refuse to believe that the closure of every NHS bed in our community hospitals will serve their needs and they hope that the panel will intervene. I look forward to an answer from the Minister.
Ms Winterton: I am sure that the hon. Gentleman knows about the process that has been established to make referrals to the independent reconfiguration panel. Consultation is undertaken with the local community; overview and scrutiny committees can examine that and refer the results to the Secretary of State, who decides whether to take them to the independent reconfiguration panel.
Ms Dari Taylor (Stockton, South) (Lab): Will my right hon. Friend confirm that the consultants of North Tees and Hartlepool NHS Trust made a statement to the independent reconfiguration panel that the maternity and paediatric services are not safe enough or of sufficiently high quality? Will she explain why a new hospital would ensure that we have safe services that are of sufficient quality for the constituents whom we represent?
Ms Winterton: My hon. Friend is right to say that the clinicians showed strong support for the independent reconfiguration panels conclusions. A consultation is taking place on them, but she can be assured that the outcome will be high quality, safe services, which are best for her constituents.
Mr. Andrew Lansley (South Cambridgeshire) (Con): As the Minister knows, the independent reconfiguration panels conclusions in December 2006 are similar to those of the Tees service review, which reported in December 2003. Will she therefore tell the House why, in August 2004, the Department instructed the strategic health authority to conduct its own review to revisit the Tees service review?
Ms Winterton: The future of maternity and paediatric services in the area has been controversial for many years. Opinions have differed. Emerging standards were set when we considered the way in which paediatric services should be delivered. The Darzi review was undertaken, but when the Secretary of State examined the issues that the joint overview and scrutiny committees raised, it was decidedstraightforwardlyto refer the matter to the independent reconfiguration panel.
I wish that the Minister would be honest and say that, in July 2004, Peter Mandelson said that he was off to Europe to be a Commissioner and a by-election was held. The Department held a review with the intention of maintaining the fullest range of services at Hartlepool hospital so that the Secretary of
State and the Prime Minister could promise the people of Hartlepool that their hospital would be maintained. That is now all over. How can the Minister justify the fact that three years have passed, during which money was spent and people in Hartlepool and north Tees did not know what would happen to them, only to arrive at the same position? How can she and her ministerial friends have the effrontery to accuse us of standing in the way of change when, during the by-election, her right hon. Friends, including the Prime Minister, objected to change?
Ms Winterton: The hon. Gentleman has to make up his mind whether he is interested in a future for patients and people who work in the health service or whether he wants to go around nit-picking about every decision that is made. The process has been clear and decisions have been taken in the best interests of patients in the area. It is about time that the hon. Gentleman got behind the decision-making process and the improvements that we are making to the NHS in the local area.
Ian Stewart (Eccles) (Lab): I empathise with my hon. Friend the Member for Hartlepool (Mr. Wright). Will the Minister and the Secretary of State deal with an issue that I raised last monthwhether the decision of the Greater Manchester PCT should be referred to the independent reconfiguration panel?
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