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The Minister of State, Department of Health (Ms Rosie Winterton):
I congratulate my hon. Friend the Member for Ochil and South Perthshire (Gordon Banks) on securing this debate. I have to say that this is one of the best attended end-of-sitting debates that I have responded to. I am also pleased to have heard the contributions of the hon. Member for Daventry (Mr. Boswell) and from my hon. Friends the Members for Pudsey (Mr. Truswell), for North Durham (Mr. Jones) and for Loughborough (Mr. Reed). They have demonstrated the extent of the concern that exists in the House about this matter, and also the success of
the all-party group, which is vital for raising public awareness of the issues that affect those who live with coeliac disease.
It would be nice to have another hour to debate the points that have been made in all those contributions, but I will try to address as many of them as possible in the remaining time. It is good news that this matter is also being debated in the Scottish Parliament, and that the devolved Administrations are looking at the issue. I would like to pay tribute to Coeliac UK, and particularly to Sarah Sleet. They play such an important role in improving the lives of people with coeliac disease through support, campaigning and research at national level and, importantly, at local level. I might say more about that when I go on to talk about prescribing.
My hon. Friend the Member for Ochil and South Perthshire graphically and movingly described the problems that people face if they are not diagnosed early. It is vital that GPs should be able to recognise the early symptoms of the condition, although we need to face the fact that it can sometimes be difficult to recognise it, as its symptoms can be similar to those of other conditions. Raising the profile of coeliac disease with the medical profession, and particularly with GPs, is therefore vital, and the work that Coeliac UK and the all-party group are doing can help to achieve that.
That is also why the Department of Health set up Prodigy, an online, up-to-date and interactive decision support system. It is a source of clinical knowledge that can help health care professionals and patients to manage the common conditions generally seen in primary and first-contact care. The sections of Prodigy devoted to the diagnosis, treatment and management of coeliac disease expressly recommend Coeliac UK as a source of information and support.
The Primary Care Society for Gastroenterology last year revised and issued guidelines on the recognition, diagnosis and management of coeliac disease. They are designed to assist the NHS in achieving earlier diagnosis, and they include the latest information on the clinical features, diagnosis and management of the disease. My hon. Friend and others made a point about the Biocard testing kits. While we of course welcome any new tools that can help to get more people diagnosed, it must be recognised that self-testing kits should not replace a medical diagnosis, and that anyone experiencing symptoms of coeliac disease should seek the advice of their doctor. It is important to get that point across.
In relation to raising awareness among the general public, NHS Direct, NHS Direct Online and NHS Direct Interactive have been established to provide advice and information on health and self-care. We can therefore ensure that people have access to information on conditions and illnesses such as coeliac disease. I am glad that my hon. Friend the Member for Ochil and South Perthshire has had a meeting with my hon. Friend the Minister with responsibility for disabled people to examine ways in which awareness can be raised in different Departments.
The type of principles set out by the Department of Health in its national service framework on long-term conditions would apply to people with coeliac disease. I
am aware, however, that medication is not always relevant to the condition, and that a gluten-free diet is often the answer.
Correct diet is essential to control of the condition and, as has been pointed out, such a diet can be much more expensive than an ordinary diet. Gluten-free products are now available on prescription to ensure that people with the disease can obtain staple foods. We fully expect GPs who prescribe gluten-free products to assess the dietary requirements of individual patients, taking into account not only their nutritional requirements but their lifestyle and needs. It is true that the survey conducted by Coeliac UK in 2002 found that more than 90 per cent. of people with the disease obtained some gluten-free food on prescription.
However, I appreciate the concerns raised by Members that changes to local prescribing policies mean that some PCTs may not be fully meeting the dietary needs of their patients. I know that the position in Northampton is being reviewed in April, and that Coeliac UK has done a lot of work with PCTs in others areas to highlight some of the problems. That has had an effect on local decisions. We certainly expect the provision of food items to be based on individual need, not on a preconceived idea of what someone ought to receive.
The Advisory Committee on Borderline Substances was set up in 1971 to advise GPs on the prescription of products such as foodstuffs. It has now become the NHS Purchasing and Supply Agency. Later in the year, a review will be carried out of the remit, membership and functioning of the body to make sure that it meets some of the NHS’s changing needs, and this area may be one of those considered.
With regard to food labelling and prescribing of foods, obviously, prescribed foods will represent a small proportion of an individual’s diet. As my hon. Friend the Member for Ochil and South Perthshire said, coeliac disease sufferers buy most of their food from high street shops, like everyone else. It is therefore important that food labelling be comprehensive and reliable. I think that it has got better in recent years.
Again, Coeliac UK provides quarterly updates on products, which is extremely helpful for sufferers. The Food Standards Agency has strengthened food labelling rules to help people to avoid certain ingredients, but I know that with coeliac disease, there can be issues around, for example, the production process if flour is used. That is important. I will talk to the Minister of State, Department of Health, my hon. Friend the Member for Don Valley (Caroline Flint), about some of the issues that have been raised with regard to labelling.
I thank my hon. Friend the Member for Ochil and South Perthshire for the invitation to the reception, which I certainly hope to attend. I hope to reflect the support that the Government give to the work of the all-party group and to Coeliac UK, and to help to continue to raise awareness of the issue in the House and outside.
The motion having been made after Seven o'clock, and the debate having continued for half an hour, Mr. Deputy Speaker adjourned the House without Question put, pursuant to the Standing Order.
Adjourned at fifteen minutes to Eight o'clock.
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