Ann Keen: The hon. Gentleman is right. The Department for Children, Schools and Families works closely with the Department of Health. Secretaries of State from both Departments meet regularly to consider the childrens plan and the health plan. It is not only alcohol that causes liver disease and hepatitis, but obesity, too. The obesity plan for young people is currently in place.
The Minister of State, Department of Health (Mr. Ben Bradshaw): In March, we agreed changes with the British Medical Association to reward practices that extend their opening to provide weekend or evening appointments. I am pleased to tell the House that 21 primary care trust areas have already achieved our aim that at least 50 per cent. of surgeries should offer extended hours.
Paddy Tipping: But would not the creation of 152 GP-led surgeries, open from 8 am until 8 pm, seven days a week, provide greater choice and better health opportunities for patients [ Interruption. ]rather than leading to closures in Nottinghamshire, or anywhere else in the country, as the British Medical Association suggests?
Mr. Bradshaw: I agree with my hon. Friend, who makes an important point. I heard some Opposition Members shout, Not in rural areas. Yet Cornwall is one of the counties that has already achieved the 50 per cent. targetindeed, it has exceeded 90 per cent. However, some GPs may not want to open in the evenings or at weekends, so we believe that it is perfectly proper that patients in those areas are not denied the ability to remain registered with their GP, if they wish, and to see a GP in the evening or at weekends. They will value that greatly and not understand the Conservatives promise to reverse the policy.
Sir Nicholas Winterton (Macclesfield) (Con): I strongly support the idea that GPs surgeries should open for longer. In the main, GPs are popular with their patients, are trusted and know the details of the conditions of those on their panel. However, I am reserved about the Governments proposal to open polyclinics, which I believe would be an expensive duplication of GPs services and undermine the position of GP surgeries. Will not the Government reconsider their proposal and perhaps try to work through GPs to extend services, so that the services that people want are available in the evening and at weekends?
The hon. Gentleman is rarely known to be reserved in the House, but I welcome his support for our extended hours drive and invite him to discuss it with his Front Benchers. As I said, they promised to reverse the policy and give the BMA a veto over extended hours. The last time we had an exchange on the subject, the hon. Gentleman highlighted the success and popularity of a GP-led health centre that provides an excellent service in his constituency. We are not imposing anything on any primary care trust, but simply saying that, in every PCT area, there should be a GP-led health centre,
such as the one of which the hon. Gentleman is fond in his constituency, for patients whose surgeries are not open in the evenings or at weekends to give them the choice.
Mr. Ken Purchase (Wolverhampton, North-East) (Lab/Co-op): In the city of Wolverhampton, some GPs have tried extended opening and found little demand, whereas another surgery is opening on Saturday mornings to trial the policy. Is there any quantitative evidence from the west midlandsor, indeed, the city of Wolverhamptonthat might give us a better steer on potential demand from patients for the extended hours service?
Mr. Bradshaw: Every survey that we conduct of what the public think is the most important improvement that we can make to build on the improvements that we have already made in the health service shows that people want to be able to see a GP at a more convenient time to the patientat weekends or in the evenings. My hon. Friends local primary care trust may not yet have hit the 50 per cent. target, but neighbouring Heart of Birmingham PCT has, with 75 per cent. of GP practices already offering extended hours. It is popular, the public tell us that they like it, and the GPs, once they start doing it, also find it popular.
Miss Anne McIntosh (Vale of York) (Con): Does the Minister agree that it is not so much the hours that GPs are available that are important, but the services that each GP practice offers? Is he aware that the White Paper on pharmacy proposed taking away the ability of GP practices in market towns such as Thirsk to dispense? That will reduce the services that they can offer. There is no point in the Minister of State, the right hon. Member for Bristol, South (Dawn Primarolo) shaking her head. I met representatives of GP practices and I also declare an interest as a GPs daughter and a GPs sister. We want to keep dispensing services in rural practices.
Mr. Bradshaw: My right hon. Friend was shaking her head because she wrote the pharmacy White Paper and she knows that it does not do what the hon. Lady suggests. The hon. Lady also knows that we are consulting on all aspects of the White Paper, and I invite her to make a formal representation as part of the consultation.
Charlotte Atkins (Staffordshire, Moorlands) (Lab): Does the Minister know that, in areas such as Leek, which is a market town, GPs already successfully offer an out-of-hours service from 10 am until 2 pm, on Saturdays, Sundays and bank holidays? Is not it time that other GPs followed that good practice and recognised that patients want not only high quality but more accessible services to fit in with their lifestyles?
Mr. Bradshaw: I agree with my hon. Friend, who has given a good example of what happens in an area when one or two GPs start offering the service to patients: other GPs quickly follow suit because they discover that it is popular. It is extraordinary that some hon. Members still believe that, although it is fine for people in some parts of the country to be able to see a GP in the evenings and at weekends, that service should not be available to everybody. Labour Members believe that it should be.
Mark Simmonds (Boston and Skegness) (Con): It seems extraordinary that the Minister is claiming credit for the Government reinstating a service that they removed three or four years ago. I want to press him further on the point that my hon. Friend the Member for Vale of York (Miss McIntosh) made. She was absolutely right to say that access to GPs and primary care is about more than just opening hours. Will the Minister acknowledge that the proposals in the pharmacy White Paper that potentially remove the right of GP practices to dispense are causing immense concern both to service providers and, more importantly, to their patients? In consultation with the Minister responsiblethe right hon. Member for Bristol, South (Dawn Primarolo), who is whispering in his earwill he confirm that there will be no changes to the control of entry regime without a full, published, comprehensive and genuine consultation that takes into account the needs of communities that use GP dispensing services and pays particular regard to the proposed changes in the White Paper to the imposed distance criteria?
Mr. Bradshaw: The hon. Gentleman is doing the same thing as a lot of his hon. Friendsconfusing out-of-hours services with extended hours. I am pleased if he is reversing the Conservatives policy and saying that they will not reverse the provision for extended hours, because I suspect that he will find shortly that extended hours will be very popular with the public when they begin to access to them. I suspect that the policy is not one that the Conservatives will abandon as quickly as they have most of their other policies.
On the pharmacy White Paper, I have already said in answer to the hon. Member for Vale of York (Miss McIntosh) that there will be a consultation. Our view is that the hon. Gentleman is wrong in his interpretation of the White Papers impact, but he is welcome to make his views felt during the consultation.
The Minister of State, Department of Health (Mr. Ben Bradshaw): The national health service locally in my hon. Friends constituency is continuing to consider the future of the Standish hospital site and is exploring the potential to develop services that would benefit the people of Gloucestershire. We expect the decision to be made shortly.
Mr. Drew: I thank my hon. Friend for that and commend him on visiting the site. He knows what a beautiful site it is and what potential it has. It would be good to hear that progress is being made. Indeed, I gather from what is happening that this innovative scheme between the learning and disabilities trust, the primary care trust and the voluntary sector will become a reality, so anything that he can do to help it along will be gratefully welcomed in the area.
I am grateful to my hon. Friend for that and for the invitation to visit his constituency, which I recall I did on an extremely wet spring day. My
understanding is that the main obstacle to progress is the listing of part of a building on the site. May I suggest to my hon. Friend that he make representations to my right hon. Friend the Minister of State, Department for Culture, Media and Sport, if he has not already done so, to ensure that she is well aware of his views on the merits or otherwise of listing that building?
The Minister of State, Department of Health (Dawn Primarolo): Two main issues are currently being addressed. First, the Government conducted a survey of in vitro fertilisation provision in all primary care trusts. A copy of that survey has been placed in the Library today. That is part of the Departments regular monitoring of IVF provision and tracking of progress towards the National Institute for Health and Clinical Excellences recommendations. Secondly, the Infertility Network UK, which is funded by the Department for that activity, is identifying and establishing standard access criteria to fertility treatment.
Ms Keeble: I very much welcome that statement. As my right hon. Friend knows, next month is the 30th anniversary of the birth of the first test-tube baby. Will she consider marking that by ensuring an end to the postcode lottery that still exists in access to treatment and by increasing entitlement to three rounds of treatment on the NHS, as recommended by NICE?
Dawn Primarolo: As my hon. Friend is well awareshe has campaigned extensively in her constituency and in the Housethe local NHS takes decisions about the treatment that it provides for its local communities and identifies priorities. In my view, we will reach the NICE recommendations when the local NHS acknowledges the fact that one in seven adults experiences difficulties with fertility, and makes the provision of fertility treatment services a higher priority. Members of Parliament have an important role in discussions with their PCTs, which do a difficult job in trying to reflect local criteria and priorities.
Mr. Peter Bone (Wellingborough) (Con): The Minister will know that IVF treatment was suspended in Northamptonshire because of lack of money. Northamptonshire is the worst funded primary care trust in the whole country in respect of the national capitation formula, so the suggestion that it is up to local PCTs to decide on IVF treatment is a little unfair when the problem is the lack of Government money going to Northamptonshire.
That is simply not true. I know that the hon. Gentleman has made representations and that he is very clear in making them for his constituents, but he will also know that his PCT is within the 3.5 band in terms of funding. I have to tell him, in view of the different number of cycles offered, that one of the big debates that remains to be concluded across the country is whether the provision of IVF treatment is a priority for local health services that is equal to other priorities.
That matter can be settled locally when it is made clear that the provision of IVF services is important. The hon. Gentlemans PCT provides other services that it also believes are important, so we need to ensure that equal priority is given.
The Minister of State, Department of Health (Dawn Primarolo): There is already a national cord blood programme in place. The NHS cord blood bank, supported by NHS Blood and Transplant and funded by the Department of Health, collects cord blood from four centres. All the cord blood units stored in the NHS cord blood bank are available to NHS patients across the country.
Ann Winterton: Is the Minister aware that the Anthony Nolan Trust estimates that tens of thousands of pints of cord blood, which could be used for transplantation and research purposes, are discarded every year in the UK? Will the Minister support the charitys proposed national cord blood bank to ensure that units donated altruistically by mothers are used to drive forward medical research rather than be discarded, thereby totally wasting this valuable resource?
Dawn Primarolo: I had a meeting with representatives of the Anthony Nolan Trust recently and I should say to the hon. Lady that the NHS has access through the international bone marrow registry and others to about 10 million samples, and that 72 per cent. of the matches in cord blood in the UK are provided internationally. There are two separate issues here: the first is treatment now and the second is research. The Anthony Nolan Trust is looking particularly into the issue of treatment now. The NHS cord blood bank is currently undertaking a review, which will report to me later this year about how to ensure a greater percentage of matches. We have already put in extra money, particularly for collection in respect of black, minority and ethnic communities. Over and above that, the Anthony Nolan Trust is looking into the development of its services, and I have said that it is crucial that developments at both the NHS blood bank and the Anthony Nolan Trust take place in partnership to ensure that we maximise the benefits for UK patients. That is what we intend to do.
The Parliamentary Under-Secretary of State for Health (Mr. Ivan Lewis):
The cardio-vascular safety of Vioxx was intensively monitored and investigated by the Medicines and Healthcare products Regulatory Agency with regular, independent advice from the Committee on Safety of Medicines. That happened since a possible increased cardio-vascular risk was noted in the VIGOR study in 2000, shortly after Vioxx was marketed. The first definitive
evidence of increased cardio-vascular risk arose in a long-term placebo-controlled clinical trial, the APPROVe study, in September 2004, at which time the manufacturer withdrew Vioxx from the market.
Andrew Stunell: May I remind the Minister that many hundreds of NHS patients, such as my constituent, Mr. Lowe, who were prescribed Vioxx have subsequently suffered serious side-effectsin Mr. Lowes case, a heart attack? What steps will the Minister take to get the manufacturer of VioxxMerck Ltd. from the United Statesto face up to its liabilities to patients here in the UK in the way that it has been forced to do in the United States of America?
Mr. Lewis: The hon. Gentleman raises an important point. A number of patients within the NHS feel that their lives have been adversely affected very seriously as a consequence of taking the drug. He is right to say that compensation is being paid by the manufacturer in the United States of America. We need to look at the pressure we can apply to that manufacturer in terms of its responsibilities to people in the United Kingdom who have been affected.
Norman Lamb (North Norfolk) (LD): May I reinforce the intense sense of anger and injustice felt by the victims of Vioxx in the UK, many of whom attended a lobby of Parliament today? They are in exactly the same position as people in the United States who have benefited from a $4.8 billion settlement. Does the Minister agree that it is an outrage that this drug company is discriminating against UK victims? Will he join me in calling on it to rethink its position and meet an all-party delegation of MPs to see what further pressure, as he says, should be put on the company?
Mr. Lewis: Again, I agree with the hon. Gentleman. I think that I can commit to two things. First, of course I will meet an all-party group of MPs to focus on this particular issue and consider what we might do. Secondly, I will certainly be making sure that the Department contacts the manufacturer to ensure that it fulfils its responsibilities to people who have been affected in the UK in the same way as it is now compensating people in the United States.
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.
Lynne Jones: My supplementary question is on mental health advocacy. What measures is my right hon. Friend putting in place to ensure that there will be adequate resources in April 2009 when measures in the Mental Health Act 2007 on independent advocacy are implemented? How will he ensure that non-statutory services will be safeguarded and improved?
Alan Johnson: Negotiations on the comprehensive spending review included the introduction of those services in April 2009. The funding is already available for that. Non-statutory fundingassistance of the voluntary sector and so onis crucial to the success of this project. I give my hon. Friend the assurances that I believe she is seeking.
Access to NHS dentistry is getting better all the time.[ Official Report, 5 February 2008; Vol. 471, c. 772.]
I do not think my constituents, constituents around the country or dentists are quite certain what figures the Secretary of State was referring to. Recent figures since his contribution in 2008 show that nearly 1 million British members of the public no longer have access to NHS dentistry. Will he now retract his comments and scrap this ludicrous contract?