The Vice-Chamberlain of the Household reported to the House, That the Address of 17 December, praying that Her Majesty will appoint Jennifer Watson to the Office of Chairman of the Electoral Commission with effect from 1 January 2009 for the period ending on 31 December 2012, was presented to Her Majesty who was graciously pleased to comply with the request.
1. Mr. David Kidney (Stafford) (Lab): What recent assessment he has made of the contribution that district general hospitals make to improving the health of the public in their local communities. 
The Minister of State, Department of Health (Mr. Ben Bradshaw): District general hospitals provide a vital range of services for local people, and the level and range of their activities have expanded significantly in recent years. At the same time, some treatments that used to be provided in hospitals can now be provided in the community and smaller local hospitals, GP practices or even peoples homes, while some specialisms and acute treatments are best provided in specialist centres, which can offer the necessary round-the-clock professional and technical expertise and capacity.
After last years scare stories from some quarters about mass closures of district general hospitals, I thank the Minister for a reassuring answer. Does he agree that to be truly effective in serving their public in future, those hospitals need very strong links with their
primary health care, social services, housing providers and the third sector, and that that is especially important against the background of an ageing and growing population, if they are to keep to a minimum admissions to hospitals in the first place and re-admissions after discharge into the community?
Mr. Bradshaw: My hon. Friend is right, although a hospitals role is, of course, mainly to help deal with people when they fail to prevent an illness for one reason or another. It is important that hospitals work closely with primary care trusts, social services and others on the public health agenda, and one of the things that the next stage review published by my noble Friend Lord Darzi made clear last year is that we now expect every primary care trust in the country to commission comprehensive well-being and prevention services based on local needs, but including delivery on a number of important issues, such as mental health, obesity, alcohol, smoking and sexual health, which I hope are being provided for in my hon. Friends constituency.
Mr. Simon Burns (West Chelmsford) (Con): Can the Minister please explain to my constituents what positive contribution there can be to improving health care from the Mid-Essex Hospital Services NHS Trust receiving about £1 million a year in car park fees, which many of my constituents regard as a tax on health care?
Mr. Bradshaw: The hon. Gentleman should be aware that the shadow spokesman on health supports the freedom of hospitals in England to levy acceptable charges to help cover the cost of hospitals; if they did not levy those amounts, they would have to take them away from patient care. I often get questions on the subject from hon. Members such as What about Scotland? or What about Wales? In Scotland and Wales, people wait much, much longer for their operation. If the hon. Gentleman has a particular problem with his local hospitals policy, he should take that up with the hospital, which is supposed to offer concessions to people who need to visit regularly. If he is suggesting that everyone at his local hospital should be able to park freely, regardless of what they are doing there, that is a very foolish approach and it would take money away from essential medical need.
Mr. Eric Illsley (Barnsley, Central) (Lab): One of the issues that is affecting district general hospitals such as mine in Barnsley is their inability to attract sufficient numbers of doctors. The postgraduate dean at the Yorkshire and the Humber NHS Deanery has done some work on the issue, which shows that in certain areas of the country, including Yorkshire and Humberside, we are under-provided for in almost every discipline in health. I have written to my right hon. Friend the Secretary of State for a meeting to discuss this, but will my hon. Friend look into the matter to try to determine what we can do to redress the balance between Yorkshire and Humberside and other areas of the country, such as London and the south-east?
We have record numbers of doctors, health care professionals and health services, as my hon. Friend knows. I will certainly look into the concern that he raises about Barnsley and his local area. I would find it surprising, however, if it was even more challenging for Barnsley and the surrounding area to attract good doctors and staff than it is in London, where attracting
them can be a particular challenge, for a number of reasons which most hon. Members understand. I will have a word with the strategic health authority covering Barnsley, which is responsible for ensuring that work-force planning is carried out effectively and that the needs of local hospitals, including his own, are fully appreciated.
Ann Winterton (Congleton) (Con): Does the Minister acknowledge the excellence of our local district general hospital at Macclesfield? It has retained superb maternity and accident and emergency units and is applying for NHS foundation status. Does he recognise that it serves not only the towns of Macclesfield and Congleton, but a huge rural area? Patients come from Derbyshire and Staffordshire as well as Cheshire. Such district general hospitals must be retained for the future health care needs of a very large area.
Alan Simpson (Nottingham, South) (Lab): One under-recognised aspect of the role that district hospitals can play is nutritional standards and food procurement policies. In that context, will the Minister add his own congratulations to those given to the Nottingham University Hospitals NHS Trust on the award that it is to receive from the Soil Association on 20 February in relation to the Food for Life programme? The trust has won the award because it threw out the external food contractors and sourced its food supply from local farms, generating 300 jobs in the local food supply industry. Will the Minister also inquire into how he could assist the hospitals in making the next step to developing a sustainable community kitchen that would put £6 million of investment into raising nutritional standards and supporting the local food infrastructure?
Mr. Bradshaw: My hon. Friend raises an important point, and I congratulate Nottingham on the work that it has done. Such work is replicated in a number of other hospitals around the country, including the Royal Brompton hospital and including in Cornwall. In those hospitals, good local food procurement policies have not only saved money butthe evidence gives this impressionhelped to improve recovery rates and general patient satisfaction. We are working actively in the Department and the NHS to see whether that good practice can be spread. We are also consulting on the registration requirements for NHS providers, including hospitals. It is likely that those requirements will include good performance on nutrition.
Dan Rogerson (North Cornwall) (LD): Further to the Ministers initial answer, will he give a little more detail on what is being done to encourage primary care trusts and district general hospitals to work together to provide more services closer to where people live? He will be aware that in my very rural constituency, people live some distance from a district general hospital. What is being done to ensure that people can be treated closer to home?
Rather than reel off a long list, I shall give the hon. Gentleman a concrete example from my own area. Until recently, people in the area needing renal dialysis had to come to the Royal Devon and Exeter hospital in Exeter to have it done. The service
has now been devolved out to the community hospitals, including one in Honiton. People who used to have to travel into Exeter no longer have to travel such distances. That is just one example of a range of services, including in Cornwall. People in Cornwall used to have to access such services by going to Plymouth or Torbay; now they can stay in Cornwall and get them. That is the direction of travel in the health service, and it is absolutely right that it should be. Where possible, people should be treated in their home or community, but when a specialist or acute need can best be met in the safety of a specialist and centralised environment, that is where it should happen.
The Secretary of State for Health (Alan Johnson): The Government strategy document Healthy Weight, Healthy Lives sets out the steps that we are taking to tackle obesity. In addition, tomorrow the Government will publish a new national plan for the delivery of physical activity alongside sport for the period leading up to the London 2012 Olympic and Paralympic games, and beyond. The plan is part of the wider cross-Government strategy, including the flagship Change4Life campaign, to increase participation in physical activity and to reduce obesity.
Mr. Reed: I congratulate the Secretary of State on the strategy to be launched tomorrow. It is vital that there should be a co-ordinated approach to the issue locally. As he knows, and as the National Institute for Health and Clinical Excellence clearly explains, physical activity is the best way to tackle obesity in the long term and one of the most cost-effective ways of doing so. There is a great deal of experience in county sports partnerships. Will he ensure that there is a co-ordinated approach with primary care trusts and CSPs locally, so that there is no duplication? Over time, will he ensure that there is an increase in funding from the Department of Health to cross-match what is coming through sport and other physical activity through local government as well?
Alan Johnson: My hon. Friend is an expert in this area, and he will be delighted to learn that one of the aspects of the plan to be launched tomorrow is energising the existing regional and local delivery structure. He knows about this because he is chair of Leicestershire county sports partnership. He will be pleased to hear that the plan recognises the important role that CSPs can play in local delivery, and that we are investing new money to enable them to continue the seamless co-ordination of physical activity and sport at a local level. To complete his afternoon of happiness, he will also be delighted to hear that crucially, for the first time, we are setting out the financial costs to local authorities of inactivity. That is an important driver in getting the few recalcitrant local authoritiesand perhaps, in some rare cases, NHS truststo work together to tackle these issues.
Nadine Dorries (Mid-Bedfordshire) (Con):
I am sure that the Minister agrees that the main way to increase levels of physical activity is to foster and garner a love of sport in the young. Unfortunately, many teachers in
my constituency tell me that owing to the number of Government-led educational targets they have to meet, the first subject to give way to allow them to do so is sport and physical activity. Should not the Minister be cross-referencing with the Department for Children, Schools and Families to guarantee that children from a very young age get the love of sport that we, at our age, had in our schools?
Alan Johnson: I do not know whether we did have it in our schools. The amount of time, money and effort going into school sports is in a different dimension from when we came into government in 1997; we are not just getting to four hours a week of sport and physical activity in every school, but moving towards getting six hours by 2010-12. Another myth that arises concerns school playing fields. Ten thousand school playing fields were sold off between 1979 and 1997. [ Interruption . ] Still selling them off, says an Opposition Member. That compares with 192 sold off since 1997. Ninety-one of those schools had closed, and every one of the rest had to invest the money in better sports and educational facilities. I am very pleased to set the record straight.
Keith Vaz (Leicester, East) (Lab): The Secretary of State will know that 58 per cent. of type 2 diabetes cases come from obesity. He took a diabetes test when he came to Leicester, and the Minister of State, Department of Health, my hon. Friend the Member for Exeter (Mr. Bradshaw), will take one at 3.30 pm today. Does my right hon. Friend agree that one way of dealing with this issue is to have preventive work, not just exerciseon Sunday, he suggested that people should start dancing moreand that people should have these tests so that they can deal with the issue of diabetes and take the necessary medication?
Alan Johnson: I pay tribute to my right hon. Friend for the work that he has done in Leicester. I did indeed have the test at the splendid centre in the middle of Leicester. I was fine, by the way; for the record, I scored five. My right hon. Friend did the work to get that centre built in his constituency and to have a mobile testing centre that goes out to workplaces; indeed, it came down to the House of Commons a few months ago, and it is here today. He is absolutely right to talk about the importance of these tests. As he knows, they are part of a concerted effort, backed by Diabetes UK, to ensure that physical activity, proper diagnosis and early treatment are regarded as essential; they should be of the quality that they are in Leicester everywhere else in the country.
Sir George Young (North-West Hampshire) (Con): With the imminent arrival of Lent and the associated resolutions to lose weight, is this not a good time to have a gentle campaign to encourage people to walk or cycle to work?
I completely agree with the right hon. Gentleman. The Change4Life campaign is encouraging people to take small stepsnot necessarily to seek to be Olympic athletes or champion dancers, but to build activity into their lives. It is helping them to make those small steps, such as walking to work or, if they have to get the bus, getting off a stop earlier. He will have seen the London underground map that Change4Life has refocused to say how long it will take someone to get to their destination if they get off the tube a stop earlier.
Those small ways of ensuring that people can change their lives include cycling, dancing, of coursemy hon. Friend the Member for Loughborough (Mr. Reed) did ask me what steps we were takingand all aspects of physical activity, with a recognition that according to the statistics, if more people engaged in physical activity, we could reduce the number of premature deaths by about one in 10.
Mary Creagh (Wakefield) (Lab): Wakefield PCT has allocated more than £1 million to local and voluntary sector community groups to help them participate in the Change4Life campaign to help people to change their lives. May I press my right hon. Friend on when we can expect the announcement of a final decision on food labelling, which is essential for parents and consumers if they are to make clear decisions in making the choices that they face in supermarkets? May I also press him on the point that, as part of Change4Life, we should educate parents about the dangers of sweet, sugary drinks and the hundreds of calories that they contain, with zero vitamins or benefits for children?
Alan Johnson: My hon. Friend has done sterling work in this field. I cannot give her a date on which we will make a final statement on food labelling, because the Food Standards Agency has been asked to carry out that work for us, and until it is complete, we cannot make a statement. I will say, however, that this country is well ahead of other countries in the world because retailers have voluntarily adopted food labelling systems. We would like one system, because that would be less baffling and less complex for consumers, but we admire the work that has taken place in this country to put voluntary food labelling at the forefront of these campaigns.
Mr. Andrew Lansley (South Cambridgeshire) (Con): I must say to the Secretary of State that after getting slapped down by Lord Mandelson the week before, it was good to see him get one up on Lord Mandelson this Sunday by having his own Strictly Come Dancing. No doubt he will invite the noble Lord Mandelson to be a participant in that.
I welcome the announcement of the Active England strategy, but it has taken a year to get there. I am afraid that the Secretary of State has got it wrong about school sports. The Government are not meeting their commitment to ensure that all pupils get two hours of sport a week in schools. In the school sport survey last October, the number of 11 to 16-year-olds getting two hours of exercise had gone down from 88 per cent. to 83 per cent. in a year. Will the Secretary of State, with his colleagues at the Department for Children, Schools and Families, ensure that the commitment to a minimum of two hours of exercise in schools is achieved, and will he tell us when will it be achieved?
Alan Johnson: From memory, the proportion of young children getting two hours of exercise in schools was about 24 per cent. when we came into government, so a drop [ Interruption. ] Incidentally, I am not sure about the statistics that the hon. Gentleman just quoted. If there has been a slight drop, it should be seen in that context. Sport in our schools is essential to the sort of message that we seek to deliver, which is why we have pledged not just effort and time, but a huge amount of finance to meet those targets. And we will meet the target in 2010, just as I am absolutely sure we will move on to meet the extended target in 2012.
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