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11. Miss Julie Kirkbride (Bromsgrove) (Con): What assessment he has made of the impact of his Departments proposals for polyclinics on the provision of general practitioner services in rural areas; and if he will make a statement. 
The Minister of State, Department of Health (Mr. Ben Bradshaw):
Local primary care trusts are responsible for organising services in their area. They are currently
talking to local people and NHS staff about how the new GP-led health centres can best be provided to meet local needs.
Miss Kirkbride: I have to say that the Ministers answer gives me only very modest reassurance about the intentions of the Department of Health. I implore him not to allow PCTs to have a one-size-fits-all answer, because although polyclinics may be very worth while in some parts of the country, in other more rural parts the local GP servicethe smaller service, which perhaps does not offer all the services that are available at the polyclinicis much more welcome, and much more appreciated by the people who use it, than a polyclinic at much greater distance would be.
Mr. Bradshaw: I entirely agree that there should not be a one-size-fits-all diktat from Whitehall, and that is exactly why we are leaving it up to local primary care trusts to decide, at the local level, what is the best model for them to use in providing the new services to which we are committed. However, a health centre or polyclinic, or whatever people want to call it, opened recently in a rural area in Devon, near my constituency, and it is very popular. It offers complementary medicinethe hon. Member for Bosworth (David Tredinnick) is no longer in the Chamberand a number of other services that patients welcome and benefit from. In some cases, such centres can reduce hugely the number of unnecessary admissions to local acute hospitals, which eases pressure on them.
John Mann (Bassetlaw) (Lab): If the Minister comes up to my large rural constituency, he will be able to see how best to introduce polyclinics. Will he allow us to keep the title health centre rather than polyclinic for both Warsop and Harworth?
Mr. Bradshaw: Yes. We should not get hung up on definitions. One persons health centre is another persons polyclinic is another persons community hospital. I am aware that there is a good one in my hon. Friends constituency. It is not my area, but I am sure that one of my hon. Friends will be delighted to come and visit it.
The Secretary of State for Health (Alan Johnson): The responsibilities of my Department embrace the whole range of NHS, social care, mental health and public health service delivery, all of which are of equal importance.
Ben Chapman: Is my right hon. Friend aware that there is widespread concern in the Wirral that the decentralisation of dermatology services will result in a deterioration in the quality of the treatment provided, a loss of critical mass, a loss of specialism, a loss of resource and a generally poorer service? Does he have plans to review the policy?
Alan Johnson: I do not agree with my hon. Friend, who wrote to me about the matter in June. What has happened in the Wirral is that some dermatology services are moving to local community-based services. That does not detract at all from the specialist dermatology units in hospitals in the Wirral, and I can give him the assurance that that will enhance dermatology services and not detract from them.
T2.  Mr. James Gray (North Wiltshire) (Con): It is only just over a year ago now that the Government produced their consultation paper on community hospitals, giving broad support for hospitals, despite which Kennett and North Wiltshire primary care trust announced deep and damaging cuts in Chippenham hospital in my constituency. It announced that the number of beds in Chippenham hospital would go down from 43 to 30, which we all opposed. Will the Minister explain why the PCT announced today that there would be not even 30 beds but 10, which is not viable from an economic or a medical standpoint?
The Minister of State, Department of Health (Mr. Ben Bradshaw): Our understanding is that the local PCT has decided to reduce the number of medical beds not to 10 but to 20 at Chippenham hospital, because it has cut delayed discharges by half and successfully introduced district nursing teams. The maternity unit at Chippenham is being expanded. The proposals have been backed by the Conservative Wiltshire county council overview and scrutiny committee. As the hon. Gentleman knows, because he has had a good briefing from the local PCT chief executive, the PCT is bidding for capital funding from the Department for a massive expansion of facilities at Chippenham hospital.
T3.  Richard Ottaway (Croydon, South) (Con): Is the Minister aware that there is a problem with prescription drugs being ordered on the internet from overseas and imported into the United Kingdom through the post? That is fuelling a growing trend, particularly in sleeping pill addiction, sometimes with fatal consequences. Will she consider speaking to the Foreign Office and the Home Office to set up a special unit to address this dangerous trade?
The Minister of State, Department of Health (Dawn Primarolo): I am aware of the trends that the hon. Gentleman describes and I have had discussions with the relevant authorities. As he knows, there are strict controls on imported drugs, but we are speaking primarily about internet and mail order for personal use. The Medicines and Healthcare products Regulatory Agency is taking steps to monitor that and working with Her Majestys Revenue and Customs, international authorities, the Association of the British Pharmaceutical Industry and the British Medical Association. I will certainly consider the hon. Gentlemans point about taking that further through co-operation in Europe.
T6.  Mrs. Claire Curtis-Thomas (Crosby) (Lab): Will my right hon. Friend describe what he is doing to ensure that there are opportunities for young people, and particularly for older women eager to start work after having children, to take up apprenticeships in his Department and the wider health service?
Alan Johnson: I can tell my hon. Friend, who is a great champion of apprenticeships, that 5,000 apprentices are registered with the Learning and Skills Council in health-related apprenticeships, for example in dental nursing or as pharmacy assistants. We plan to treble that to 15,000 by 2010. I will look into the possibility of designing apprenticeships so that more women who wish to return to work can do an apprenticeship in the national health service.
Norman Lamb (North Norfolk) (LD): May I draw the Secretary of States attention to a document obtained by Remedy UK? It is a survey of hospital trusts around the country, and it shows massive problems in recruitmentparticularly at senior house officer level. It also shows a national shortage of doctors able to do locums. All that appears to be putting patient safety at risk: in Surrey, an NHS trust says:
we had to run the service on several occasions without the required number of doctors.
On top of all the problems last year, is that not more evidence of a failure of work force management and planning? What will the Government do about it, particularly given the risks to patient safety and patient care?
Alan Johnson: We are aware of the issue; the problem has been circulating anecdotally for some time. We do take it seriously; that is why at the beginning of February we asked the strategic health authorities to help us understand its extent and nature. It is worth bearing in mind the fact that we employ 120,000 doctors in England, and although some trusts have reported such issues, many have not.
There have always been problems in staffing some rotas in shortage specialties. The issue for us has been whether the nature and scale of the problem are different this year. The survey has given us a clearer idea of how to tackle the issue. On the point made by Remedy UK, I should say that this year we will move to three different starting points for junior doctors, rather than the single system that may well have had an effect on the figures cited by the hon. Gentleman.
T7.  Tony Lloyd (Manchester, Central) (Lab): One of the undoubted successes of the past 10 years has been the flow of money into areas such as mine, where medical need is higher than in other parts of the country. However, do my right hon. and hon. Friends on the Front Bench accept that we still have some way to go to make sure that patient need is what determines fundingnot simply historical patterns, particularly those imposed for grossly partisan political reasons by a previous Conservative Government?
Alan Johnson: My hon. Friend will know that the funding for his primary care trust, which covers some deprived areas in Manchester, has increased by 25 per cent. in the past few years. Our aim is to ensure that that process continues without taking away money from areas without those levels of deprivation. All areas must receive an increase in funding; those with specific health needsthey are usually in the areas of greatest deprivationshould receive more.
We have made an across-the-board allocation of 5.5 per cent. this year, because the Advisory Committee on Resource Allocation, the organisation that does the
statistics for us, requested an extension before it could give us its new formula. We have made an across-the-board increase this year; next year, however, we will return to ensuring that issues such as deprivation are fully taken into account.
Mr. Andrew Lansley (South Cambridgeshire) (Con): Does the Secretary of State agree with me that it would be unacceptable if a junior doctor who had been working in the national health service for several years post-registration could not complete their specialty training simply because of the lack of training places?
Alan Johnson: I would like to know the specific details. We would like all doctors in training to have a job at the end of that training. There is no absolute certainty that people training for any professionto be architects, lawyers or even postal workerswill have a job at the end of their training. However, we want to ensure that people do have a job at the end of their training, which is why we try to get the statistics and figures right. If the hon. Gentleman has a particular concern about a specific doctor, I shall be happy to look into the matter.
Mr. Lansley: As we have the Secretary of State here, may I ask him about the Budget? Last week in his Budget statement, the Chancellor did not say anything about the national health service, but according to the Red Book the future provision for NHS expenditure over the next three years was cut by £3.2 billionthat is, there will be £3.2 billion less in provision for the NHS in the next three years. Can the Secretary of State explain why?
Alan Johnson: The Chancellor was able to report record levels of investment in the national health service, rising to £110 billion at the end of this comprehensive spending review period. I am fascinated to learn that the hon. Gentleman is going to put another £28 billion into the NHS, as well as make the £10 billion in tax cuts to which his party is already committed.
Mr. Khalid Mahmood (Birmingham, Perry Barr) (Lab): Will my right hon. Friend join me in congratulating the Heart of Birmingham primary care trust on building a brand new primary care health centre in my constituency? Will he find time to come to the opening in the near future?
Alan Johnson: I would very much like to come to see my hon. Friends new health centre. [Interruption.] It may well be a polyclinic. The Conservative party spelled polyclinic pollyclinic in a recent press release. We are not building health centres for parrots, and my advice to the Opposition is that they should not criticise a policy they cannot spell.
Sir Nicholas Winterton (Macclesfield) (Con):
Do the Government accept that people in rural areas already have to travel considerable distances to a GP practice, and the cost of getting there will increase in the near future? Does the Secretary of State accept that rural GP practices are particularly important and that the Government should place special emphasis on their
survival? The role that they play in rural areas is important and we must not deprive those areas of facilities any further.
Alan Johnson: The hon. Gentleman is right about the importance of GP services in rural areas, not least because, if we expand the services available in GP practices in rural areas, patients would not have to travel long distances to hospital. I am meeting the Governments rural adviser shortly to discuss GP services in rural areas.
T8. Lorely Burt (Solihull) (LD): Last September, the Prime Minister announced that all hospitals would receive a deep clean to help to tackle the scourge of superbugs such as MRSA. My hospital trustthe Heart of England NHS Foundation Trusthas estimated that it will cost between £600,000 and £700,000 to deliver the deep clean. Why is the cost having to be met from front-line services when the Government asserted that that should be done with new money?
Alan Johnson: The hon. Lady has been misinformed. We have provided the funding to each strategic health authority to meet the cost of the deep clean. They are not expected to divert money from other resources to it. We provided the money from the centre.
T4.  Mr. Philip Hollobone (Kettering) (Con): Three out of 10 pregnant women carry the group B streptococcal bacterium, which is the most common form of life-threatening condition in new-born babies. Will the Minister with responsibility for public health agree to meet me and Group B Strep Support, which campaigns for routine screening for that condition?
Mrs. Joan Humble (Blackpool, North and Fleetwood) (Lab): Is my right hon. Friend the Secretary of State aware that the all-party social care group recently completed an inquiry into the challenges that face the social care work force? Will he ensure that, when social care staff work in multidisciplinary teams, they are accorded due status and that the voice of social work is heard on behalf of their clients?
The Parliamentary Under-Secretary of State for Health (Mr. Ivan Lewis): My hon. Friend is right to make that point. If we consider that more and more people stay in their homes, that we are moving care out of hospital and closer to home, and that we are keeping people out of institutionalised care, the contribution of social care is increasingly essential and every bit as important as that of the NHS. The professionals who work in those different agencies should be afforded the same value and respect. We need to start blurring some of the professional titles and focus on the needs of individual patients and families.
Greg Clark (Tunbridge Wells) (Con):
The Secretary of State knows that everyone in my constituency anxiously awaits his decision to approve the new PFI
hospital at Pembury. Will he reassure me that we will have that decision, as planned, by the end of the month?
Mr. Bradshaw: Yes. My right hon. Friend the Secretary of State has today given final approval for the scheme to reach financial close. He expects the formal contract for the new hospital to be signed shortly. Construction of the new facilities is due to begin in late March and the first patients are scheduled to be admitted in early 2011, with the project completed by 2012.
Mrs. Madeleine Moon (Bridgend) (Lab):
Self-harm is a key indicator that someone may go on to take their
own life. What steps are the Government taking to provide counselling and support for self-harmers?
Mr. Lewis: My hon. Friend raises an important point. As she is aware, we have a national suicide strategy in this country that has been effective in reducing suicides. We have made significant progress. She is absolutely right to raise the particular problem in her constituency and to demand action to deal with it. The number of young people who have died in a relatively short period of time in her constituency is frightening. It is very important that the relevant authorities in that area respond in a positive and collaborative way. We certainly have to take self-harm far more seriously than perhaps we have in the past.
Mr. Andrew Mackay (Bracknell) (Con): On a point of order, Mr. Speaker. This morning you will have noticed news coverage of the Secretary of State for Defence trying to gag coroners by taking legal action. Have you had a request from the Secretary of State to come to the Dispatch Box and make a statement on this important matter?
Tony Baldry (Banbury) (Con): On a point of order, Mr. Speaker. In fairness to you and the House, I simply observe that my office was told by the independent reconfiguration panel that it is publishing its report on Thursday rather than today at the behest of the office of the Secretary of State for Health.
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