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The history of this countrys approach to access to mental health services in primary care is not a happy one, but I am proud of the fact that we are the first Government since the national health service was created to say that people in every community should have universal access to psychological therapy according to clinical need. The health service must concern itself as much with mental well-being as with physical well-being. Over the next three years, we will be investing an unprecedented amount in access to
psychological services, which is every bit as important as the extension of GP hours and conventional primary care. We can be proud of the fact that we are the first Government since the creation of the health service to ensure that people have access to universal psychological services, recognising that mental well-being is every bit as important as peoples physical health.
11. Mr. Andrew Robathan (Blaby) (Con): What assessment he has made of the contribution of community hospitals in (a) England and (b) Leicestershire. The Minister of State, Department of Health (Mr. Ben Bradshaw): Community hospitals can provide care closer to where people live. The local health service makes decisions about how services are organised, but the Government are providing £750 million over five years for new community hospitals and new community services throughout the country.
Mr. Robathan: The Minister states that the Government want people to be treated closer to home, which I applaud. However, in Leicestershire as elsewhere, the primary care trust is considering closing down or reducing services in community hospitals, especially in Lutterworth in my constituency, and possibly in Ashby. Will the Minister explain to me and to my constituents in the Lutterworth areaand, indeed, to Leicestershire PCThow treatment closer to home is deemed desirable, yet services in Lutterworth are being reduced, which will mean people having to travel to Leicester or Rugby for treatment?
Mr. Bradshaw: It is not the job of Ministers in Whitehall to second-guess the decisions of local primary care trusts, but I am sure that the hon. Gentlemans PCT has listened carefully to his comments. However, my information from the PCT is that there are currently no proposals such as he describes for Lutterworth, and it has decided not to go ahead with any consultation about Lutterworth in the first round of consultation on community hospitals in Leicestershire. Contrary to his suggestion, the PCT is trying to do exactly what I described earlier: moving more services out of the big acute hospitals in Leicester and elsewhere into community hospitals, and from community hospitals into peoples homes, because that is what people want. It may be decided locally that some services are best provided by one community hospital, or by district nurses or others who go into peoples homes. That is a matter for the local PCT. If the hon. Gentleman does not like its proposals, he should speak to its representatives. If the local elected councillors do not like them, they have a democratic forum in the overview and scrutiny committee to refer them to the national independent review panel, which examines any objections to the sort of reorganisation that he describes.
The Minister of State, Department of Health (Mr. Ben Bradshaw): The Government are working to make it easier for people to see their GP in the evening and at weekends. We are also investing £250 million in new GP-led health centres in every health care area of England, open 12 hours a day, seven days a week, and in extra GP surgeries in poorly served areas.
Anne Snelgrove: My constituency has benefited from a great deal of investment, especially at Priory Road health centre in Parks. Does my hon. Friend share the concern of my constituents at the Queens Road medical centre, who are unsure whether they will have a GP surgery in future, as it is considering moving to north Swindon? What hope can he give my constituents that they can see a doctor without having to make a complicated bus journey?
Mr. Bradshaw: I understand that the problem to which my hon. Friend refers concerns two branches of a practice, which it does not believe are adequate to provide the sort of care that their patients expect. However, it is the duty of all primary care trusts to ensure that GPs and primary care services are adequate for an area and that there are no big gaps, especially in areas such as those that my hon. Friend mentioned, which I know quite well. I hope that when the local primary care trust considers the proposals, it will work closely with my hon. Friend, and also with my hon. Friend the Member for North Swindon (Mr. Wills), to ensure that all patients in the city of Swindon are well served by expanding GP services.
Mark Simmonds (Boston and Skegness) (Con): The Opposition believe that the most accessible health care services are those tailored to local needs and priorities, not those that are centrally imposed. In the debate on 23 April about GP services and access, the Secretary of State said that primary care trusts that did not want GP-led health centres would be able to use the resources to provide primary care services more appropriate to their local patients needs. Does the Minister stand by his bosss statement that primary care trusts can say no to GP-led health centres?
Mr. Bradshaw: No, my right hon. Friend did not say that. There is good flexibility in the proposals that we put to primary care trusts. Labour Members are interested in making it easier for people to see their GP. It is astonishing that the Conservative partys policy now is to hand over policy to the doctors union, the BMA, and allow it to decide [Interruption.] Yes, I am sorry, but the Leader of the Opposition said in a speech 10 days ago that the BMA should be able to decide when surgeries could open and where they were located. The Conservatives even launched a website so that doctors could sign their petition.
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.
Joan Walley: May I ask my right hon. Friend why, in connection with the consultation on the framework for the registration of health and adult social care providers, which is due to end shortly, he has decided to exclude non-urgent patient transport services from the services that will come under the remit of the Care Quality Commission? Those servicesincluding taking people who need dialysis to hospital, for exampleare a seamless part of the health and social services that we provide, so it seems perverse that they should not be included. Would the Secretary of State consider, at this late stage, including those services within the remit of the proper standards of care regulation?
Alan Johnson: This matter is out to consultation, and the consultation finishes on 7 June. Our view is that it is in the interests of good regulation that we should split away the high-dependency patient transport service from the non-urgent, as my hon. Friend the Member for Stoke-on-Trent, North (Joan Walley) rightly says. There is an issue about the balance of regulation, and we thought that that was the best idea. The issue is out to consultation. My hon. Friend will obviously make her views known, as will others, and we will consider them at the end of the consultation period.
T3.  Sir Nicholas Winterton (Macclesfield) (Con): I declare an interest as honorary vice-president of the Royal College of Midwives. What steps have the Government taken to ensure that there are sufficient places for student midwives and midwifery educators in England to meet the Departments target of 4,000 more NHS midwives by 2012? It is a simple question; I hope that I can get a good, positive answer.
Alan Johnson: The hon. Gentleman is a hero of the Royal College of Midwives, let alone a patron. He raises an important point. We wish to recruit 4,000 new midwives. Some of them will return to practice, but a large group will require extra training places. We are working on that, and I believe that there might be an announcement around the time of the annual conference of the Royal College of Midwives.
T6.  Mr. Graham Allen (Nottingham, North) (Lab): Will the Secretary of State tell us what impact health can have on reducing crime and on ensuring that youngsters get good qualifications and do not spend a lifetime on benefits? Does he agree that early intervention by the health service, particularly through the nurse-family partnership, sets young people on the way forward, andto ensure the topicality of this questionmay I also ask him whether he welcomes those initiatives being applied to Nottingham?
Alan Johnson: The nurse-family partnership is undergoing a £30 million expansion, which includes Nottingham. The most important point in what my hon. Friend said about the link between crime and health relates to mental health. I believe that the recruitment of 3,600 psychological therapists, based on the pilot in east London and Doncaster, will have a startling effect on the mental health problems that have previously consigned many youngsters to less fulfilling lives than those of those fortunate enough not to suffer from such problems.
We consider that, more than any other factor, it is the failure to implement the existing guidelines described in the 1994 report that has contributed to the recent rise.
Alan Johnson: No, of course I cannot cover the course of 11 years in this answer. What I would say is that there was a period at the end of the 1990s when, if the problem had been tackled, we could have seen the elimination of MRSA before it took root, as happened in many other European countries. However, there has been a 30 per cent. reduction in MRSA since this time last year and a 23 per cent. reduction in clostridium difficile. The important elements are hand washing, isolation with cohort nursing, and the responsible prescription of antibiotics. We are acting on all three.
Mr. Lansley: The complacency of the Secretary of States answer explains exactly why there is a wreckage of the Labour party across the country following last Thursdays election results. Perhaps he can explain why, 11 years into a Labour Government, the report says that half the hospitals in England have C. difficile infection rates 10 times those reported in other countries. People know that the experience of Labour government has been of a top-down, target-led, bureaucracy-obsessed culture that is preventing the NHS from delivering high-quality care, and which has led directly to an inability to focus on patient safety. Will the Secretary of State explain that?
Alan Johnson: The hon. Gentlemans problem is that people have long memories. They remember waiting lists such that people waiting for fairly routine operations wrote to ask whether their place in the queue could be bequeathed in their will to their children or their nephews, because the queues sometimes lasted four or five years. They remember the lack of capital investment in hospitals and equipment, they remember that there were too few doctors and nurses, and they remember that the health service was on its knees when we came to power in 1997.
Clive Efford (Eltham) (Lab): May I commend my right hon. Friends decision to move services into the local community? I want to draw his attention to a consultation that I held about my local primary care trusts proposal to open a cottage hospital in Eltham, to which the response rate was more than 10 per cent. More than 1,400 people responded, virtually 100 per cent. of whom were in favour of having a cottage hospital in the middle of our community, bringing services into the heart of Eltham. I commend the Secretary of States approach, and I commend my PCTs proposal to him.
I am happy to be commended on that proposal. I believe that the consultation taking place in London about what kind of health service people want is revealing that the majority of people see the sense in the review conducted by NHS London. They see cottage hospitals and polyclinicsI see, today, that the
public in London have overwhelmingly said that polyclinics are a good thingas a sign that we are going in the right direction.
T4.  Mr. David Heathcoat-Amory (Wells) (Con): Will the Secretary of State tackle more vigorously the waste of medicines in the NHS, which is enormous and scandalous? Will he look specifically into the issue of repeat prescriptions going uncollected by patients in pharmacies? That problem needs ministerial intervention, and could be tackled by better liaison between prescribing doctors and pharmacists. The current situation is completely unacceptable and an enormous waste of public money, and it needs his attention urgently.
Alan Johnson: I will look into this issue personally. There is evidence that there is a great deal of waste involving medicines and prescription, but I would not say that it is as bad as in some other European Union countries: France is one example. Nevertheless, any waste needs to be addressed. We have a target, over this comprehensive spending review period, of making 3 per cent. year-on-year efficiency savings. One part of achieving that should be tackling the waste of medicines.
Dr. Brian Iddon (Bolton, South-East) (Lab): The hepatitis C action plan for England was published four years ago, but a report that has just been published by the all-party group on hepatology shows that there are still big gaps between the diagnosis and treatment of hepatitis C. Will my right hon. Friend look at the report and do what he can to improve, in particular, the treatment of carriers who have been diagnosed with hepatitis C?
Alan Johnson: I will, but it says herein my briefthat the results of the audit are encouraging and show marked improvement since 2006. The results indicate that progress made in implementing the action plan has been sustained. Nevertheless, I accept my hon. Friends point, and we will look to see how much we can improve the situation.
T5.  Mark Pritchard (The Wrekin) (Con): With abortion at near industrial levelsthere were nearly 200,000 in England and Wales last yeardoes the Secretary of State accept that although the original Act, as amended by the Human Fertilisation and Embryology Act 1990, set out a range of medical reasons for abortion, it is increasingly, and in far too many cases, being used for social reasons? Does he agree that that has to stop?
Alan Johnson: I struggle to understand the definition of industrial in this context. This is a matter for all Members of Parliament to address individually. I personally, as an individual, believe that that legislation has stood the test of time, and I would not want to see any change to it.
Alan Johnson: We are likely to publish in the summera period that I accept can, in political terms, stretch from April to December. However, I expect publication to take place in what could be called the summer by most reasonable peoples definition.
T7.  Mr. Philip Hollobone (Kettering) (Con): Having had the worst hospital-acquired infection rates in the whole country in 2006, Kettering general hospital has now halved its rates of infection for C. difficile and MRSA, and met all its major NHS targets this year. In congratulating all those who work at the hospital on this tremendous achievement, will the Secretary of State encourage the strategic health authority to look favourably on Kettering general hospitals application for foundation trust status, which is due to be submitted shortly?
Alan Johnson: I think that the hon. Members for Kettering (Mr. Hollobone) and for Wellingborough (Mr. Bone) should go and have a cup of tea together and compare notes, because we are getting a different picture of what is happening in the health service in their area from each of them. The hon. Member for Kettering has raised an important point, and we should congratulate all the health service workers in his hospital on such a fantastic result. The issues are clear: they involve good hand-washing policy, good isolation facilities with cohort nursing, and the responsible prescription of antibiotics. There are a lot of other things that I could talk about, but those are the three most important messages, and they have obviously been hammered home in the hospital in the hon. Gentlemans constituency.
Paul Rowen (Rochdale) (LD): Can the Secretary of State explain why existing GP practices are being excluded from the new GP posts being established in areas that are under-doctored? Is this another attempt to privatise the NHS?
After a battle to get to the Dispatch Box, may I say to the hon. Gentleman that existing practices are not being excluded? He is absolutely wrong on that point. I did have a representation from a social enterprise to say that it was being excluded. The first contract went to a social enterprise, and I have no doubt that the majority of the contracts will go to
existing GP practices. Those practices are not being excluded. They are, however, being asked to go through a rigorous process, because if we are spending £250 million of taxpayers money in under-doctored areassome of the poorest areas in the countrywe want to ensure that patients and the public in those areas get the service to which they are entitled.
Alan Johnson: The hon. Gentleman has raised a point that I have raised myself in response to questions that I have been asked while going around the country. We should be looking at the situation across the country, because I hear that some places deal with such issues brilliantly, while other places could learn from those centres of excellence. Whether we turn that into a national strategy, with all that that entails, or whether we simply seek to spread the best practice, the hon. Gentleman is right to raise this issue; indeed, I have raised it myself.
Bob Russell (Colchester) (LD): Audiologists have expressed concern about the potential hearing impairment brought about by young people wearing personal music centres plugged into their ears. Does the Secretary of State agree that there is a serious likelihood of hearing impairment affecting those young people at a much earlier stage of their lives, and that there should be an inquiry into what action can be taken to prevent the danger of hearing impairment being brought about by those items of social fashion?
Alan Johnson: The hon. Gentleman has an interest in this subject. I believe that he was the chair of the all-party group on noise [Interruption] of which he has made quite a bit in this Chamber over the years. I do not think that this issue can be near the top of our agenda, but it does need to be looked at. I increasingly find that people, not just young people, have developed problemssometimes mental health problemsbecause they live in an environment of constant noise. In the workplace, for example, noise levels can be huge. Some people think that playing a radio station featuring the inane chatter of a disc jockey all day is good for calming the nerves, whereas actually it does the opposite [ Interruption. ] The hon. Gentleman has started me offbut yes, I do think that we should look into that issue.
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