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The Secretary of State for Health (Ms Patricia Hewitt):
The NHS has always used the private sector for many services and will continue to do so where it can help the NHS to give patients even better care and better value for money. By the end of next year, patients
needing elective treatment will be able to choose from any health care providerNHS or independent sectorthat meets NHS standards within the NHS price.
Andrew George: When Ministers held the proverbial gun to the heads of primary care trusts and told them to privatise the easiest elective proceduresor elsewas the Secretary of State aware that under European competition law she was opening a Pandoras box in that if she wished to run the NHS by market rules, she would have to play by those ruleseven to the point that that would perpetually restrict her capacity to intervene to protect the public interest?
Ms Hewitt: I do not accept for one moment the hon. Gentlemans accusation. It is a great pity that he does not recognise the contribution that the independent sector is making at the Bodmin treatment centre, for instance, orin a different part of his regionat the Shepton Mallet independent sector treatment centre. The latter is not only giving the patients whom it receives very good and much faster care, it has also led Yeovil District Hospital NHS Foundation Trust to change the way it organises its services, making it one of the first hospitals that will achieve for most of its patients the 18 weeks targetand a year ahead of the goal that we set.
Dr. Doug Naysmith (Bristol, North-West) (Lab/Co-op): My right hon. Friend will be aware that successive Secretaries of State for Health have assured the Health Select Committee that the policy of developing the use of the private sector is being pursued to address lack of capacity in the NHS. Can she confirm that that remains the major reason for that policy?
Ms Hewitt: My hon. Friend is right. When we began the new compact with the private sector through the NHS plan in 2000, it was precisely to address the problem of additional capacity. However and as we have made clear in several successive documentsincluding the 2005 Labour party manifestowe also use the independent sector where it can help to challenge under-performing parts of the NHS, support patient choice and give patients even better care. The fact is that there has always been private health care in Britain, but the difference is that under a Conservative Government, private hospitals recruited patients on the back of NHS waiting lists and treated only the few who could afford to pay. Today, thanks to our reforms, private hospitals and treatment centres are part of the NHS family. They are helping to cut waiting lists and to treat NHS patientsall of it free at the point of need.
Sir Paul Beresford (Mole Valley) (Con): To continue the theme, the Secretary of State is possibly aware that there is a charitable health trust associated with Epsom hospital. It has put in a bid to the local NHS agencies and authorities to purchase that hospital, and the intention is to run it for NHS, charitable and private patients. It has the backing of the local medical fraternity, and enormous financial backing. Is the Secretary of State willing to meet a very small delegation at or near the end of those discussions, so that it can set out its innovative and expanding programme?
Ms Hewitt: I would certainly be happy to meet the hon. Gentleman to hear about what sounds like an interesting proposal. I will draw it to the attention of the local primary care trust, which willI am surelook at it with interest.
Mr. Eric Illsley (Barnsley, Central) (Lab): The independent sector treatment centre in south Yorkshire has done a good job in helping to reduce waiting times throughout the area. It has been able to do so because it has been guaranteed money over and above the tariff, unproblematic cases and a set number of patients. If those advantages are to continue, eventually the centre will be in conflict with NHS hospitals, which will struggle to survive against that unfair competition. Will my right hon. Friend ensure that that situation does not come about and that the independent centres do not threaten the existence of NHS acute hospitals?
Ms Hewitt: All treatment centres take the simpler casesthat is why they are therewhether they are run by NHS hospitals, as the majority are, or by the independent sector. That is what they do, they do it well, and it speeds up care for hundreds of thousands of patients who need elective treatment. My hon. Friend is right that in the first wave of the independent sector treatment centres a premium was paid, although far less than the premium that the NHS used to pay to the private sector when it needed to use it to reduce waiting times. That was needed in the first wave to bring in new capacity, especially from abroad, when it was desperately needed. As I have indicated, what we are seeking to do is to move to a level playing field so that the independent sector and NHS hospitals will all provide care to the same quality and price, and all free at the point of need.
Dr. Richard Taylor (Wyre Forest) (Ind): To assist integration between private sector treatment centres and the NHS, will the Secretary of State look at the practicalities of letting NHS consultants work in the private sector treatment centres even if they are in, for example, orthopaedics, which is currently defined as a shortage specialty?
Ms Hewitt: That is an important issue and one that we keep regularly under review. We have discussed it over the past year or two, especially with the Royal College of Surgeons, and as a result have made some changes to both the shortage and the additionality rules in order to ensure that NHS surgeons and other consultants make their time available to their NHS employer first and foremost. If they have additional time that is not needed by that employer, they may make it available to those parts of the independent sector that are also treating NHS patients within the NHS family.
8. Mrs. Siân C. James (Swansea, East) (Lab): If she will assess the merits of placing advertisements in magazines and media aimed at teenagers about the (a) potential dangers of sunbed use and (b) availability of fake tanning products. 
The Minister of State, Department of Health (Caroline Flint): The SunSmart skin cancer prevention campaign will, we understand, include in its next phase the dangers of sunbed use, especially by those under 18. SunSmart is an integrated public health campaign that includes a high profile, intensive press and PR programme, supported by targeted distribution of public information resources.
Mrs. James: I thank my hon. Friend for that answer. I wish to draw to her attention some research on children under 15 that has been sent to me by two doctors at Singleton hospital. They found that 32 per cent. of girls and 9 per cent. of boys said that they had used sunbeds. I have also had information sent to me by the Killing Cancer charity, which found that 75 per cent. of girls under 15 said that they had used sunbeds. There are many doubting Thomases who say that there is no problem
Caroline Flint: My hon. Friend has been constructively engaging with me and the Department to share her knowledge, especially her work on the worrying use of coin-operated sunbed parlours. As I have said, SunSmart will consider the next phase of the campaign, and especially how to approach and raise the awareness of those under 18. I have heard what my hon. Friend has said and I ask her to come into the Department to share her information with us so that we can think about how it can be incorporated into the next phase of the campaign. I very much welcome her interest and that of other hon. Members.
9. Mr. David Heath (Somerton and Frome) (LD): What percentage of NHS trusts have (a) deferred operations, (b) made redundancies and (c) restricted provision of treatments in 2006-07 on grounds of reducing costs; and what percentage plan to do so in 2007-08. 
The Secretary of State for Health (Ms Patricia Hewitt): As set out in the most recent financial report, it is now clear that the NHS will achieve the three financial targets set for this year while maintaining key service standards. Achieving financial balance this year means that the NHS will be in a far stronger position in the new financial year and, in particular, will be able to make substantial progress towards achieving the target of 18 weeks maximum from GP referral to hospital operation.
That was just typical: I asked three specific questions and received not a single reply from the Secretary of State. I thought that she would at least quote the results of the Health Service Journal survey of chief executives of trusts across the country, which revealed that 50 per cent. of primary care trusts are delaying operations; that 47 per cent. of all trusts may, have made or intend to make redundancies; and that 73 per cent. of PCTs are restricting access to treatment. Is not the conundrum thisthat at a time when there is
record cash going into the NHS and welcome investment in capital projects, we nevertheless have cuts in treatment? How can that be?
Ms Hewitt: At least the hon. Gentleman and his party voted for those extra resources. I am surprised, however, that he did not refer to the fact that the NHS in Somerset will get additional funding of almost £120 million over the current year and next year. That is being reflected in the improvements taking place in Minehead hospital, the new cancer centre in Taunton and Somerset and the new community hospital at Frome. We believe that what we need is fair funding for the NHSrecord funding for the NHSand the best care for patients within the budget available. I know that the Liberal party has never been very keen on sound public finances or value for money, but the Government will continue to ensure that patients get the best possible value from the record investment that we have made.
Charlotte Atkins (Staffordshire, Moorlands) (Lab): Is my hospital trust typical? The university hospital of North Staffordshire announced 1,000 redundancies as a result of its deficit, but ultimately only 150 redundancies resulted, two thirds of which were voluntary. Clearly, any redundancy is a matter of regret, particularly in an area such as north Staffordshire, but where does that leave the Oppositions claims of 20,000 redundancies nationwide?
Ms Hewitt: My hon. Friend makes an extremely important point. In striking contrast to the scaremongering that we get from the Conservative party about 20,000 redundancies, over the current financial year there have been just over 1,400 redundancies, the great majority in management and administrative jobs. Although it is of course difficult for the individuals concernedwe are ensuring that the NHS supports them in these difficult timesit is very different from what the Conservative party and some of the media have been telling people.
Tim Loughton (East Worthing and Shoreham) (Con): What the hon. Member for Somerton and Frome (Mr. Heath) failed to mention was that the Health Service Journal survey also revealed that seven out of 10 PCT chief executives agreed that patient care would suffer because of restricting access to treatments. Does the Secretary of State think that they should be applauded as good financial planners, encouraged by her Department to fudge the books and please the accountants, or is it a false economy that forces consultants to twiddle their thumbs for several months while sick patients are denied the treatments they need?
Ms Hewitt: I very much regret the fact that the hon. Gentleman completely fails to give credit to the NHS managers and staff who, in a very difficult year, have got a grip on NHS finances and will achieve financial balance at the end of this month, putting the NHS in a far stronger position. May I suggest that he has a word with his hon. Friend the Member for South Cambridgeshire (Mr. Lansley), just two seats along, who told the House only yesterday that it was the statutory responsibility of
The Minister of State, Department of Health (Andy Burnham): The new strategic health authorities provide leadership and support to ensure that trusts operate effectively and deliver improved performance. The NHS Institute for Innovation and Improvement, as its name suggests, helps trusts to introduce best practice and radical new ideas to deliver health care.
Dr. Iddon: Will my hon. Friend congratulate all the staff at the Royal Bolton hospital for saving lives, increasing efficiency and cutting waste by adopting the lean style of management? What can his Department do to spread such best practice throughout the national health service?
Andy Burnham: Staff in the health service are rightly suspicious of politicians or NHS managers who appear to have swallowed a management consultancy textbook. However, I went to the Royal Bolton hospital with my hon. Friend and, like him, I was incredibly impressed by what I saw. The key principle of the lean management process is that staff lead the change. They are empowered to make changes and drive through the programme on the wards. My hon. Friends hospital trust has seen a 30 per cent. reduction in length of stay for trauma, a 37 per cent. reduction in post-operative mortality and a cut in the processing time for blood samples from five hours to 30 minutes. Those are the huge benefits resulting from staff leading change in the hospital.
Mr. Andrew Lansley (South Cambridgeshire) (Con): The Minister must know that thousands of doctors across the hospital sector are deeply angry at the disgraceful mismanagement of the modernising medical careers system. Three months ago, his predecessor said:
Doctors in training in England should...be pretty confident about securing a training post.
Andy Burnham: The hon. Gentleman will know that, on learning of the problems, we immediately set up an independent review led by Professor Neil Douglas, the vice-president of the Academy of Medical Royal Colleges. The findings emerging from the review are already being implemented. We are not seeking to minimise the problems, or saying that they are not causing uncertainty for doctors in training. We accept that, which is why we have taken this swift action and why measures are now in hand to improve the situation. I point out to the hon. Gentleman, however, that these changes were, in origin, agreed with the royal colleges.
For a start, the Minister should apologise to junior doctors for the disgraceful shambles that they have been landed in. He has issued a ministerial statement today about the review, but it does not answer this question: if there are insufficient training postsand if the assurance that junior doctors should be confident
about securing a training post cannot be fulfilledwill the review recommend that additional trust grade posts be converted into training posts in order to address the problem?
We will see what the review tells us. Significant changes have been made to improve selection in the second round. People want to see immediate
changes so that the situation will improve. We are trying to work our way through the situation to give people more certainty. More broadly, we have to get work force planning right in the national health service to ensure that there are sufficient people in training. If the hon. Gentleman is suggesting that there are simple answers, and asking us to commit to new spending on extra posts, he is sorely mistaken.
Mr. Charles Walker (Broxbourne) (Con): On a point of order, Mr. Speaker. Could you advise me on how best I can politely educate Ministers about the fact that Chase Farm hospital in Enfield, London, serves more than 100,000 people living in Hertfordshire? Many of my constituents, some of whom vote Labour, would be amazed at Ministers ignorance on this matter.
Sir Nicholas Winterton (Macclesfield) (Con): On a point of order, Mr. Speaker. I genuinely seek your advice and help. According to todays Order Paper, a written ministerial statement is to be made today by the Secretary of State for Environment, Food and Rural Affairs on the draft climate change Bill. Could you advise me on whether this matter should be the subject of a statement here on the Floor of the House, given the importance of the issue and the controversy surrounding the pros and cons of the matter?
Mr. Speaker: That shows you how things have changed. Usually the hon. Gentleman gives me advice; now he is asking me to give him advice. These are matters for Ministers to make a judgment on, and I cannot be drawn into whether a statement should be written or [ Interruption. ] Someone has a mobile phone, and it is not me. I cannot be drawn into whether it should be a written or an oral statement. That is up to the judgment of Ministers. Of course, if hon. Members feel that that judgment is not correct, they can seek an urgent question.
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