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to quote a line from a track on “Sgt. Pepper”. It is getting better in dentistry because the original contract, which the hon. Gentleman seems to want us to reintroduce, was wrong in every respect.

Mike Penning: No, we do not.

Alan Johnson: But we are being asked to withdraw the current contract. It replaced the contract that encouraged drill and fill. It meant that when dentists left the local vicinity, the money went with them. Of course, there was a period when dentists did not sign up to the new contract. Gradually, they are coming back and gradually we are getting to a situation in which dentistry is provided not just on the basis of drill and fill, but on a preventive basis, with a much simpler structure and much better access. The money that we are putting into dentistry this year, next year and the year after has gone up, and primary care trusts are commissioning more dental practices as a result.

T4. [211318] Mrs. Claire Curtis-Thomas (Crosby) (Lab): As my right hon. Friend will know, back in 1997, the construction industry was on the point of collapse. I am proud of the health service’s commitments to new hospitals and clinics, which have revitalised the industry, but I want to ensure that its significant investment leads to training opportunities for young people as part of their apprenticeship programmes. What is my right hon. Friend doing to ensure that those public sector funds are spent on delivering better skills and better-qualified young people?

Alan Johnson: My hon. Friend has been a champion of apprenticeships. I think she will accept that what the Department is doing is exemplary in Whitehall terms. Indeed, I hope she will accept that we are “Top of the Pops” in terms of the number of apprentices we are recruiting.

As for what we are doing in the country more generally, my right hon. Friend the Secretary of State for Innovation, Universities and Skills is running an integrated project to establish how we can use the huge public sector
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investments that we are making in, for instance, hospital-building programmes to ensure that apprenticeships are provided in the construction industry, and also in education, so that we do not waste the valuable opportunity provided by our capital investment to increase the number of apprentices again. It needs to be raised to the level suggested in the Leitch review by 2015.

T3. [211317] Mark Pritchard (The Wrekin) (Con): Would the Minister of State like to have another go at answering my earlier question about HIV/AIDS? Given the increasing number of cases of HIV/AIDS and, indeed, TB in this country, many of them brought in by people from sub-Saharan Africa, will she tell us whether she believes that selective pre-screening of those people before they enter the United Kingdom, not while they are here, is a good idea for Britain?

The Minister of State, Department of Health (Dawn Primarolo): I believe that I have already answered the question, but I will answer it again. No, the Government do not consider pre-screening to be necessary. Our policy is to encourage the highest-risk groups to come forward voluntarily for screening. The group that the hon. Gentleman has identified is not the highest-risk group, but it is one of the groups that we are addressing.

T5. [211319] Mr. Tom Clarke (Coatbridge, Chryston and Bellshill) (Lab): The report “Aiming high for disabled children: better support for families” led to additional resources. Can my hon. Friend the Under-Secretary of State assure me that they are being used to enable the services identified in the report to benefit disabled children and their families, and for no other purpose?

The Parliamentary Under-Secretary of State for Health (Mr. Ivan Lewis): I pay tribute to my right hon. Friend for the work that he did in the House in championing the needs of disabled children and their families, as a result of which we are investing an unprecedented amount to support those families—and so we should.

The money from the Department for Children, Schools and Families is ring-fenced, and amounts to £370 million over three years. In the autumn of this year, the Department of Health will announce the overall sum that we will invest in child health over the next three years. It will include a specific figure to be put into primary care trust baselines to increase support for children with special needs and provide short breaks and support for children with palliative care needs. It is crucial, in all parts of the United Kingdom, for us to prioritise the needs of disabled children and their families, and to ensure that the money allocated for the purpose is spent on improving their quality of life.

Anne Milton (Guildford) (Con): Although the number of people admitted to hospital suffering from under-nutrition has increased by 85 per cent. since 1997, I understand that the Minister is scrapping the Nutrition Action Plan Delivery Board that he established last year. What reassurance can he give us that he takes malnutrition in the elderly seriously?

Mr. Lewis: As I have only just established the board, I am hardly likely to be scrapping it. The hon. Lady’s information is completely untrue.


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The nutrition action plan is overseen by the director general of Age Concern. It has independence, and is being overseen by someone who has passionately championed the importance of nutrition, particularly in relation to older people. What we have said, as the hon. Lady knows full well, is that the board will do its work for 12 months and then we will review where it goes from there. There has been absolutely no suggestion that we intend to scrap it.

T9. [211323] Dr. Phyllis Starkey (Milton Keynes, South-West) (Lab): A constituent of mine with cystitis has received treatment for acute episodes at the nurse-led walk-in centre in Milton Keynes, but she has been unable to get an appointment with her GP in order to be referred to a consultant because she is a shift worker and because of the booking system at the surgery. Will the Minister point out to the British Medical Association and the Opposition that this is exactly the sort of problem that could be addressed by the new seven-day surgery proposed by the PCT in Milton Keynes?

Alan Johnson: We will have the perfect opportunity to do that in about five minutes’ time.

T6. [211320] Mr. Desmond Swayne (New Forest, West) (Con): If GP-led health centres are in the interests of patients, does not the Secretary of State believe that primary care trusts will procure them anyway? Why is he running the show like a command economy and requiring 121 PCTs outside London to procure them?

Alan Johnson: Because, No. 1, we believe that we ought to enhance capacity in primary care; No. 2, we do not believe that PCTs should be paying for extra facilities from money we have already allocated—we will provide that from the centre; No. 3, we think patients such as the constituent of my hon. Friend the Member for Milton Keynes, South-West (Dr. Starkey) should be able to access a GP surgery from 8 am to 8 pm, seven days a week, 365 days a year; and, No. 4, we believe that people who cannot get to their GP because, for example, they work in the centre of town or in another town should be able to access primary care. For all those reasons, it is extraordinary that Opposition Members, including the Parliamentary Private Secretary to the Leader of the Opposition, oppose this extra investment in primary care. They will live to rue the day.

T7. [211321] Tom Brake (Carshalton and Wallington) (LD): I met Dr. Goel at his Carshalton fields surgery a couple of weeks ago and he presented me with a petition with 570 signatures from patients who are very worried about the future of their local family GP practice. Can the Secretary of State confirm that that practice will not be forced to merge with a polytechnic—or a polyclinic, rather—at some point in the future?

Alan Johnson: It certainly will not be forced to merge with a polytechnic; I can give the hon. Gentleman that assurance very firmly. Our proposals are for additional GP-led health centres. The name should give the Opposition a bit of a clue as to who will lead these health centres. They will be GP-led, and there is no intention whatever of removing existing services.


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Mrs. Ann Cryer (Keighley) (Lab): Does my hon. Friend have a view on the Council for Healthcare Regulatory Excellence report on the Nursing and Midwifery Council?

The Minister of State, Department of Health (Mr. Ben Bradshaw): We welcome the report and accept its recommendations. It makes some very serious criticisms of the functioning and leadership of the NMC, saying it has failed to carry out its statutory duties to the standard the public have the right to expect and it has lost the confidence of its stakeholders. It is our view and that of the CHRE, the trade unions and other stakeholders that it would be in the best interests of the NMC and the individuals involved if all three senior figures stepped down from their current positions. We welcome the leadership shown by the president and chief executive today in indicating their intentions to resign.

T8. [211322] Bob Russell (Colchester) (LD): I am sure that the Secretary of State will agree that many of our hospital accident and emergency departments are full of people whose ailments would be better treated elsewhere. On the basis that all of us are in favour of preventive health measures, will the Secretary of State discuss with the Secretary of State for Children, Schools and Families the possibility of introducing first-aid training as part of the school curriculum, in accordance with my excellent ten-minute Bill?

Alan Johnson: I will have another look at the hon. Gentleman’s excellent ten-minute Bill, and will doubtless talk about it in the many meetings I have with the Secretary of State for Children, Schools and Families. The hon. Gentleman makes an important point, and one of the fundamental reasons why the NHS in London is proposing polyclinics in London is the number of people clogging up accident and emergency departments who should really be in primary care.

T10. [211324] James Duddridge (Rochford and Southend, East) (Con): Is the Secretary of State aware that some hospitals have banned people from bringing in flowers for patients on health and safety grounds, and what guidance, if any, does he have for these hospitals?

Alan Johnson: I have a full briefing with me that relates to every issue under the sun, but not this one. I do not think that it is a matter for me; I think it is for the local trusts, and I would be very surprised if they took that decision on any grounds other than patient safety. I believe that health care-acquired infections may well be the reason these flowers have been banned, but I will find out, perhaps, and write to the hon. Gentleman.


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Mr. Graham Stuart (Beverley and Holderness) (Con): Does the Secretary of State share my concern that 1 million people appear to have been treated under NHS dentistry since the new contract came in, and that there also appear to be perverse incentives within the contract so that dentists are encouraged by the financial set-up not to treat those with the greatest oral health need? Could we not have a perverse outcome whereby those with least in our society will be able to tell their social class by the state of their teeth—and under a Labour Government?

Alan Johnson: The hon. Gentleman was probably mistaken in saying that he thinks that there are 1 million more dentist appointments now, because he probably meant the reverse—I do not accept what he says either way. I believe that this is a big issue in relation to heath inequalities, which is why I announced to Parliament our intention to introduce fluoride in more areas. That is the single biggest contribution that we can make to tackling health inequalities. On the dental health of young children in this country, our 12-year-olds have the healthiest teeth in the whole of Europe. That is a great tribute to the dental profession, and I would think that it is not detrimental to the amount of investment that this Government are putting into dental care.

Greg Mulholland (Leeds, North-West) (LD): I welcome the fact that the Government are finally talking about reform of our system of care for the elderly. Given the urgency of the crisis—Help the Aged describes our system as being in crisis, Age Concern calls it a disgrace and the Local Government Association yesterday said that it is coming apart at the seams—will the reform, and the legislation to enable it, be brought before the House before the next general election?

Mr. Lewis: May I say to my good friend that as well as the long-term review, we have, from April, been introducing a transformation programme in every local authority area, supported by £500 million of reform money over three years? We will soon be publishing the first ever national dementia strategy and end-of-life strategy; we have announced the extension of our “Dignity in Care” campaign; the Secretary of State has announced a new package of preventive health measures specifically to support older people; we are extending the Human Rights Act 1998 to publicly funded residents of private care homes; and we have announced a new 10-year strategy to support carers. I am not sure that the hon. Gentleman’s party has anything else to offer on this issue.


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Points of Order

3.32 pm

Ms Sally Keeble (Northampton, North) (Lab): In response to my question, the Minister of State, my right hon. Friend the Member for Bristol, South (Dawn Primarolo), said that she would arrange for a paper to be placed in the House of Commons Library. I checked, and it has not been placed there. I wonder whether it could be placed there today, because it contains important information that answers questions in which hon. Members would be interested.

The Minister of State, Department of Health (Dawn Primarolo) indicated assent.

Mr. Speaker: The point has been answered.

Mr. Jim Devine (Livingston) (Lab): Reference has just been made to the report on the Nursing and Midwifery Council that was published yesterday, which highlighted the fact that that body was not fit for purpose and had a bullying culture. That vindicated claims made by many on both sides of this House and, in particular, by my constituent, Moi Ali, who is the whistleblower in this matter. She is a black lady who has a claim for racism against the NMC. She has used the internal systems and approached people, including her MP, externally to raise the matter. Because of Buggin’s turn, she is the vice-president at the moment and, sadly, she is being pressured to resign from her job. I wonder whether, through your good offices, Mr. Speaker, the Minister with responsibility could come to the House to make a statement on that report?

Mr. Speaker: I am not going to be drawn into that matter.


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Local Authorities (Social Equality Audits)

3.33 pm

Ms Karen Buck (Regent's Park and Kensington, North) (Lab): I beg to move,

The debate about social inequality is beset by stereotypes and simplification. Sometimes stereotypes give us an indication of the truth, but they frequently conceal more than they reveal. So, we hear a lot about the north-south divide, and unemployment and incapacity benefit figures are frequently portrayed exclusively in terms of decayed former industrial communities in the north or in the Welsh valleys. Sometimes Tower Hamlets is contrasted with the Royal Borough of Kensington and Chelsea in what is frequently described as a tale of two cities, revealing the stark divide in average incomes, house prices and life expectancy.

Such attention is broadly welcome because it highlights the continuing extent—and in some ways the worsening or intensification—of the toxin of inequality. It is even more corrosive than poverty, in its own insidious way, as has been so well documented by academics such as Richard Wilkinson. Inequality damages health, undermines community cohesion and is now understood to be more closely correlated with crime than poverty itself.

Inequality is poorly understood. Last year’s report for the Joseph Rowntree Foundation confirmed that people’s knowledge about inequality is limited, and attitudes are complex, ambiguous and apparently contradictory. In turn, policy makers know little about how the perceptions people have are formed, or changed. We could simply choose to ignore the ramifications of inequality, precisely because public attitudes are complex and contradictory. But by doing so, we would be turning our backs on a very real problem. Over the past 20 years a consistently large majority of people have considered the gap between rich and poor to be too large, and only a small minority of people feel that the Government are doing too much to address the problem.

My Bill is intended to make a small contribution to increasing awareness and understanding of social inequality. I seek broadly to mirror the important work done by primary care trusts in their annual public health reports, which have come into their own in recent years as an essential source of data about health inequalities. By requiring all local authorities to produce an annual audit, based on a core basket of indicators, I would hope to achieve three things. First, I would like to get beyond stereotypes, whether of the north-south divide kind, or the Tower Hamlets versus Kensington and Chelsea variety. The reality is far more complex than such stereotypes would have us believe and generalisations limit understanding, not deepen it.

Secondly, I hope that the process of producing and publishing annual audits would generate interest and debate among local policy makers, the media and others, precisely because the information would be local. Of course, there are no guarantees that such interest would sharpen the focus on deprivation and inequality, but it would certainly offer communities a set of tools to hold policy makers to account. That is certainly the experience of PCTs and public health reports in recent years.


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