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The Minister of State, Department of Health (Caroline Flint): The Government have a number of programmes in place to improve the diet and awareness of healthy eating among children and young people. These include the new school meals standards, the healthy schools programme, healthy start, 5 a day, and the school fruit and vegetable scheme.
Dr. Blackman-Woods: I thank the Minister for her response. Does she agree that much could be done to tackle child obesity and health inequalities if she was to work with colleagues in the Department for Education and Skills to build on the excellent initiative of providing free fruit and veg to schools and deliver free, compulsory, nutritious school meals for all children?
Caroline Flint: My hon. Friend makes a good point about tackling inequalities. I was pleased that the 2005 health survey for England showed that the number of children eating fruit and vegetables was increasing, with the number eating at least five a day going up to 17 per cent. from 10 per cent. in 2001. I am also pleased that the Department for Environment, Food and Rural Affairs household expenditure survey, which was published in January, shows that there has been the biggest increase in expenditure on fruit and vegetables for 20 yearsit is up by 7.7 per cent. However, we can do more. This Government have given local authorities the power to decide whether they want to provide free school meals, and that matter is best dealt with locally. I am proud of our joint work with the Department for Education and Skills which has meant that more than 89 per cent. of schools are now taking part in a voluntary programme called healthy schools.
Sir Peter Tapsell (Louth and Horncastle) (Con): Since every woman I have ever known, from my grandmother onwards, has tirelessly tried to persuade their offspringand indeed their husbandsto eat more vegetables, what makes the hon. Lady think that her increasingly Orwellian Department will be more successful?
Caroline Flint: Well, clearly we support families making choices. I am pleased that families are increasingly making healthy choices for their children and themselves. I do not want to get into the hon. Gentlemans family background in relation to this
Caroline Flint: I will leave others to comment on that. However, we must get the balance right when the Government are trying to intervene in areas that are their responsibility. We expect children to attend school; that is part of the law [ Interruption. ] Even grammar schools. Given that we require children to go to school, it is part of our endeavour that when food and drink are provided at school, they should be the healthiest available. We must achieve a step change through which parents are enabled to make the right choices for their children. More and more parents are doing so with our support, rather than any lecturing.
Barbara Keeley (Worsley) (Lab):
On Friday, I am visiting Ellenbrook primary school in my constituency to open its healthy schools vegetable garden. Will my
hon. Friend congratulate the school on not only promoting healthy eating, but teaching children how to grow the herbs, fruit and vegetables that will be used in their school meals every day? Does she think that other schools should follow that example?
Caroline Flint: My hon. Friend cites a really good example of a project that is seeking to achieve on several fronts. It is encouraging an understanding of the need to eat healthily and getting children out there to grow food, thus increasing their understanding of where it comes from. Alongside that, it increases physical activity at school. I am pleased to inform the House that from September, we will start a joint project with DFES and DEFRA: the year of food and farming. We will make links with local producers to find out what we can do to encourage more schools to purchase more locally the fruit and vegetables that can make a difference. Learning about how food is grown and its production to the point at which it ends up on the plate can make a difference to an understanding of a healthy diet.
Tim Loughton (East Worthing and Shoreham) (Con): Why does the Minister think that the recent evaluation of the school fruit and vegetable programme by the National Foundation for Educational Research found that it had no lasting impact on what children were eating, that only 27 per cent. of children achieved the five-a-day target, and that only a third of children were aware of what that target wasno doubt some thought that it referred to cigarettes? In any case, two thirds of the fruit and veg in the programme comes from overseas and half contains more than one type of possibly harmful pesticide. Some £77 million later, is this another costly, headline-grabbing, ill-thought-out Government initiative that has gone pear shaped?
Caroline Flint: The hon. Gentleman raises several questions. I understand that the article that appeared in The Sunday Telegraph a few weeks ago was based on a report that examined figures from about three years ago. We are evaluating the scheme at present and we will publish the figures shortly. However, the indicators show that both the consumption and purchase of fruit and vegetables are going up. The school fruit and vegetable scheme serves 2 million four to six-year-olds. Next time I get letters from Conservative Members asking me to extend the scheme, I will refer them to the hon. Gentleman.
The Secretary of State for Health (Ms Patricia Hewitt): Next month we shall be launching a new online information service, NHS Choices, that will give patients easy access to information about conditions, treatments and hospitals. It will help the public to make informed choices about their own health, including when and where they receive treatment.
Sarah McCarthy-Fry: I thank my right hon. Friend for her answer, but I hope that we have made improvements and alleviated some of the teething problems that were experienced last year. A constituent came to see me over choose and book. She was referred to a dermatology department, and when she rang to make the appointment she was asked which hospital she wanted. When she asked for her local hospital, she was told that the waiting list was too long and was referred to one 20 miles away. When she said that she would prefer to wait a bit longer, she was told that that was not possible. The matter was eventually sorted through the patient advice and liaison service, but surely choice means that patients, if they wish, should be able to choose to wait a little bit longer to go to their local hospital.
Ms Hewitt: My hon. Friend is absolutely right, and I hope that we have now made that crystal clear to NHS hospitals. A local hospital is obliged to treat all patients who choose to be treated there if that is clinically appropriate, and if a patient wants to wait longer than, for instance, the current six-month maximum target for in-patient treatment, of course they are free to choose to do soprovided they are told that when they make their booking. The way that we are extending choice for patients is in accordance with what patients themselves have said they want, and we know from experience over several years that it is a way of ensuring that hospitals respond by giving patients faster and better care.
Dr. Andrew Murrison (Westbury) (Con): Patient choice means being treated with dignity, so what confidence can we have in a Government who may parrot choice, but whose claim to have delivered it to patients wishing to avoid mixed-sex wards is strongly contradicted by experience and by data published by the Healthcare Commission?
Ms Hewitt: As I think the hon. Gentleman knows, the commitment that we made to ensure that everyone had single-sex sleeping accommodation, bathrooms and toilets did not extendbecause it could notto accident and emergency, and to medical admission units. That is one reason why there is a real difference between the reports that we have had from the hospital trusts and the reports of patient experience. Neverthelessthe chief nursing officer recently published press guidance on thiswe have identified those hospital trusts that are really struggling to meet the commitment that patients are entitled to expect, that in, as it were, normal wards, they should have single-sex sleeping accommodation, bathrooms and toilets, and we are giving the NHS extra support, and indeed holding it accountable for delivering that. But I regret that the hon. Gentleman did not mention that the same Healthcare Commission survey found that even more hospital patients are satisfied or very satisfied with the care that they have had from the NHS in the last year.
Ms Winterton: Great. From our public consultation, we know that many people want to have a greater say over their health and social care services. The establishment of local involvement networksLINKswill give people far more opportunities to have a stronger voice over their local services.
Jeremy Wright: I thank the Minister for that answer, and the enthusiasm with which she gave it, but she will have been told, as I have, that one of the tools that members of patient and public involvement forums value most is the ability to inspect hospitals or other health care facilities, including, where they think it necessary, without notice. Given that those powers and that ability will be circumscribed for local involvement networks, and in the case of inspections without notice, removed altogether, does she not think that it is inevitable that the public will have less confidence in LINKs to protect their interests than they did in PPI forums?
Ms Winterton: No, I do not think that they will, because I think that LINKs will actually be very powerful bodies in terms of their ability to get responses from primary care trusts when they raise particular issues, and their ability to look at social care institutions. We wanted to avoid confusion between the inspection roles of the statutory regulators and the powers of LINKs to go into trusts to view the services. That is why we have made a change, to enable them to do that. However, it is important to recognise that when LINKs go into, for example, day care centres under social services, notice needs to be given to people who go to such centres for, in a sense, respite care. We want to make sure that that work does not disturb either staff or patients. However, LINKs will be able to make reports after they have entered premises and to demand replies from PCTs and others.
Mr. Bob Blizzard (Waveney) (Lab): In my area we have a group of very dedicated people who were involved in community health councils, who then became involved in the various patient and public involvement organisations and who want to be involved in the LINKs. However, they are conscious that we are not reaching out to a wider electorate of people who want to get involved in such work. How can we spread the word and get new people involved in these organisations?
Ms Winterton: That is the challenge. We know from consultation that people want to have a greater say. Through some of the draft guidance that we have issued we have looked at how to involve more people. We also have some early adopter sites, which are considering in particular how to widen the range of people who are involved to include voluntary sector and other patient groups.
The Minister of State, Department of Health (Ms Rosie Winterton): The Department collects data on occupied bed days, not on the number of individuals that that represents. In 2006-07, there were 19,988 hospital occupied bed days on adult psychiatric wards of patients aged 16 or 17, and a further 201 hospital occupied bed days on adult psychiatric wards of patients aged under 16.
Annette Brooke: I thank the Minister for that answer. What plans do the Government have to protect centres of excellence for the treatment of adolescents with severe mental health conditions, such as the one that is being closed at Cassel hospital, Richmond. I understand that it is being closed because PCTs across the country are not prepared to pay for out-of-area placements.
Ms Winterton: In providing that more specialised care, we want PCTs to consider the requirements in perhaps a wider area than the PCT area, because sometimes quite small numbers of children require that type of intensive specialist care. However, I feel that often children are sent too far away from home. Some out-of-area provision is necessary, but we want to make sure that such provision is commissioned more effectively and can deal better with the situation that affects small numbers of children. We want to make sure that they can have treatment closer to home than is sometimes the case now.
Andrew Gwynne (Denton and Reddish) (Lab): I thank the Minister for the reassurances on that very issue that she gave during Committee stage of the Mental Health Bill. What discussions will she have with the new coalition on mental health services, which supports the modernisation agenda, so that we can make the positive changes that she wants?
Ms Winterton: My hon. Friend refers, I believe, to the fact that approximately 85 per cent. of those who work in mental health services have now withdrawn from the Mental Health Alliance and are realigning themselves to make sure that some of the steps that we want to take to modernise mental health legislation can go forward. I thank him for his contributions in Committee, where we had a lot of discussions about what we want to do to improve those services and, in particular, about age-appropriate accommodation.
The Secretary of State for Health (Ms Patricia Hewitt): The strongest safeguard is the professionalism of NHS staff themselves, but the modernisation of NHS IT also provides the opportunity to deploy state-of-the-art security safeguards, particularly for confidential patient information. In the rare cases where NHS staff do breach patient confidentiality, they are subject both to disciplinary measures and to the legal penalties provided under the Data Protection Act 1998; professional staff also risk losing their licence to practise.
Mr. Heathcoat-Amory: Three weeks ago the Department of Health made an unauthorised disclosure of the personal details of junior doctors, which was a disgrace. More recently, the Public Accounts Committee severely criticised the main health IT system, which is already running two years late. Apart from the usual bland assurances that we get from the Secretary of State, what guarantees can she give us that patients personal medical records will not be disclosed, and as her Department is clearly incapable of running or commissioning anything properly, will she take independent advice on the matter?
Ms Hewitt: The electronic patient records and other aspects of connecting for health have nothing whatever to do with MTAS; they have all been organised with the highest level of security safeguards, and that has been independently verified. The right hon. Gentleman is simply scaremongering, and instead of doing so [Interruption.] The Conservative party already opposes identity cards. Is the right hon. Gentleman telling us that he will now oppose electronic patient records?
The Parliamentary Under-Secretary of State for Health (Mr. Ivan Lewis): It is for individual national health service hospitals and trusts in England to determine the practicalities of promoting the use of reusable and disposable nappies in their maternity units. For the rest of the United Kingdom, that would be a matter for the devolved Administrations.
Jessica Morden: I thank the Under-Secretary for his response. Having just become a new mum, I am keenly aware of the special access that manufacturers of disposable nappies have to new mums when they are in hospital. Given nappies contribution to landfill, will he look at ways to level the playing field, and will he at least encourage samples of biodegradable and reusable nappies to be made available in hospitals? Once people start using a product, they are more likely to continue using it.
Mr. Lewis: We have to be careful not to encourage too much of a nappy state. We give first-time mothers a pregnancy book and a birth to five book, both of which discuss in some detail the case for and against each kind of nappy. It has to be said that a report by the Department for Environment, Food and Rural Affairs found that, in the end, in terms of overall environmental consequences, there was very little difference between disposable and reusable nappies. I understand that the Minister of State, Department of Health, my hon. Friend the Member for Leigh (Andy Burnham), is happy to host a meeting with the Nappy Alliance to discuss the matter further.
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