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I had the pleasure of visiting my hon. Friends constituency a few weeks ago. Newham was in fact a national demonstrator site for the development of new psychological therapies and a whole range of new services, and I was extremely impressed by what I saw. I congratulate her on the work that she does in her constituency to support the development of those services. In Newham, 16 staff are part of an early intervention team that helps young people between the ages of 14 and 35 with assessment and care. In particular, it tries to prevent those young people from being admitted to hospital at the first onset of psychosis or some other form of mental illness. Those new early intervention teamsa major investmentare matched by other teams that handle crisis resolution in homes, and outreach in the community. I hope that when she goes back to her constituents in Newham, she will congratulate them on the pathfinding work that they are doing, and assure
them that the NHS in her area is seeking to work with other providers to meet the needs of young people and others in the community.
Anne Milton (Guildford) (Con): The picture around the rest of the country may not be not quite so rosy. Figures show that the number of people admitted to hospital for intentional self-harm has increased by a third in the past five years, from 74,000 to 97,000. More than 4,000 of those admissions were of children under the age of 14. One in eight women admitted to self-harm in 2007, an 80 per cent. increase since 2000. Figures released by the National Society for the Prevention of Cruelty to Children yesterday show that the number of suicidal children ringing the helpline ChildLine has tripled in the past five years. Is the Minister not ashamed of these appalling figures and the Governments failure to turn the tide on the countrys deteriorating mental health?
Phil Hope: I understand the hon. Ladys concerns; it just surprises me sometimes when Opposition Front-Bench spokespersons reel off a list of statistics without asking questions and, more importantly, without acknowledging the substantial extra investment that this Labour Government have put in place and which her party voted against in every Budget since 1997. The issues that she highlights are serious and need to be addressed. I am pleased that the suicide rate in England continues to fall. It is now at its lowest since records began in 1861, and is among the lowest in Europe. I am also pleased that the World Health Organisation said:
The ambition and pace of change in England has been remarkable over the last 10 years, and mental health services here are increasingly being seen across Europe as a model to follow.
Dr. Doug Naysmith (Bristol, North-West) (Lab/Co-op): In his reply to my hon. Friend the Member for West Ham (Lyn Brown), my hon. Friend the Minister said that there had been a 70 per cent. increase in clinical psychologyI think the figure was 70 per cent.but he will know, as I do, that that was from a pretty low base. Can he assure me that he will redouble his efforts to ensure increased numbers of clinical psychologists? Too often people who have been prescribed clinical psychology have to wait for it.
Phil Hope: My hon. Friend is right to say that we inherited a pretty poor show from the Conservatives after they were in power for 18 years. We are endeavouring to increase the quality of mental health services. This year is the last year of the national service framework for mental health, and it is the year in which we intend to look forward to establishing a new strategy for mental health services. Building on the success that we have had so far, we will be launching our New Horizons project to go out to consultation to enable us to hear throughout the country what more we can do to embed success in our mental health services, and to go further to ensure that we have mentally healthy communities more widely so that the public health system, as well as specialist services, reach the quality of care that we wish every individual to be able to receive across the country.
The Parliamentary Under-Secretary of State for Health (Ann Keen): I was assured by NHS South West and Gloucestershire primary care trust this morning that the PCT is in the process of inviting tenders for dental services with a total value of £6 million over the next two yearsthat is, £3 million in 2009-10 and £3 million in 2010-11. This investment will be used for building purpose-built practices as well as refurbishing community hospital sites to enable them to provide dental services, focusing on areas of most need in Gloucestershire. This investment has the potential to offer access to a dentist to approximately 95,000 people.
Mr. Robertson: It is difficult to calculate how many people are registered with an NHS dentist since the new contract was established. Perhaps the Minister could give us some idea of how many people are registered in Gloucestershire and nationally. Registration is patchy. In my Tewkesbury constituency a relatively small number of people are registered with NHS dentists, even when compared to other constituencies in Gloucestershire and especially when the national figure is taken into account. What can the Minister do to help the local PCT to increase that number?
Ann Keen: We have just announced the money, which will give access to an extra 95,000 people. I am sure that the hon. Gentleman would like to welcome that and congratulate the strategic health authority and primary care trust on the great leadership that they have shown on dental practice. I have been advised by the South West strategic health authority that Gloucestershire commissioned three new dental practices, all of which became operational in October 2008in Forest of Dean, Cirencester and Tewksbury. The SHA has advised that in 2009-10 the tender is expected to be let for schemes in the areas of Gloucester city, Cheltenham and Stroud. The plan is for them to be fully operational by 2010-11.
Mike Penning (Hemel Hempstead) (Con): The 90,000 extra places for patients that the Minister has just announced will go part of the way to addressing the issue of the 1.1 million people who would like an NHS dentist. Professor Steele is currently doing his review. Will his report be published in full, and will the Government accept all his recommendations?
Ann Keen: No, it will be published in full; all of us on this side of the House are humble enough to say when we have made an error. I only wish that the hon. Gentleman would be as honest when Conservative Members do. Like any sensible Government, we will look at the review when it is published.
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.
Tony Baldry: I suspect that neither the Secretary of State nor the Government will want any surprises in early August. So will the right hon. Gentleman ask all the chief executives of hospital NHS trusts to report to him personally by the end of May on their ability and preparedness fully to implement the European working time directive? I suspect that such reports will demonstrate the need for some more middle-grade doctors if we are to continue with existing services.
Alan Johnson: We debated that issue during an Opposition day a few weeks ago. Everyone is aware of the need to comply with the European working time directive by 1 August; I trust that Opposition Front Benchers are now aware that every individual has the benefit of the opt-out.
T5.  Mr. David Kidney (Stafford) (Lab): I called for a public inquiry into Stafford hospital. As that matter has been given a full airing already, may I ask whether the Secretary of State read the comments that I made in the House yesterday about Professor Albertis review? Can he confirm that there will be no no-go areas at Stafford hospital for the Alberti review?
Alan Johnson: Yes, I can. I saw my hon. Friends comments; obviously, I am particularly sensitive to how he, as the local MP, feels this inquiry is going. George Alberti has not only national but international renown on accident and emergency. As the Healthcare Commission report points out, accident and emergency is where the problem is in Stafford hospital. I assure my hon. Friend that there will be no no-go areas for Professor Alberti as he conducts his inquiry.
T2.  Tom Brake (Carshalton and Wallington) (LD): Yesterday, I had a meeting with Mr. Longhurst, a constituent of mine whose three-year-old daughter suffers from epilepsy. He is very worried that services are going to be concentrated at St. Georges and moved away from St. Helier, our local hospital. Will the Secretary of State agree to meet parents, my hon. Friend the Member for Sutton and Cheam (Mr. Burstow) and me to discuss parents concerns? Furthermore, will he encourage the local trust to provide a speaker at a public meeting to discuss the issue? Finally, will he confirm that should services go to St. Georges
Unless my memory is fading, I met the hon. Gentleman and the hon. Member for Sutton and Cheam (Mr. Burstow) very recently. But let me say this: services locally in their area have to be determined on the basis of what is best for patient care. I will become
involved in the issue only if local politicians on the overview and scrutiny committee refer it to me. That is the right way for those issues to be resolved.
T3.  Sir Nicholas Winterton (Macclesfield) (Con): What assessment have the Government made of the future impact of cardiovascular and kidney disease and diabetes on NHS resources, and what plans are being put in place to deal with what will clearly be an additional burden on the NHS?
Alan Johnson: There are a number of bits of analysis on this. The one that struck home more than any other was the Foresight report conducted by some of the worlds most eminent scientists and epidemiologists about the effect of obesity, which is a major driving factor in type 2 diabetes, cardiovascular disease and, indeed, cancer. They said that if we do nothing about this, by 2050 not only will there be an enormous burden in terms of disease but enormous coststhey estimate the cost will be around £50 billion to the NHS and to society more generally. That is why we are introducing the abdominal aortic aneurysm ultrasound check from this year, the vascular check for every adult between 40 and 73, call and recall, and many other initiatives to deal with prevention. The hon. Gentleman raises a crucial point about what we have to do now to prevent this disease burden in future.
Mr. John Heppell (Nottingham, East) (Lab): Last week, I attended a celebration of the Ear Foundation, which is a charity that was set up to fund the first cochlear implant procedure in the city of Nottingham. Now that the National Institute for Health and Clinical Excellence has decided that it is a good idea for profoundly deaf children to have implants for both ears, can the Secretary of State tell me what he is doing to ensure that primary care trusts listen to that advice?
The Minister of State, Department of Health (Dawn Primarolo): The recommendations from NICE with regard to implants must be complied with within three months of the guidance being issued, which was 28 January. PCTs are required to do two things. First, they must make available the funds for clinical decisions to be taken on the patients who should receive that treatment. Secondly, where there are patients who have already been treated but would now benefit from the NICE recommendations, they must ensure that a proper assessment is made of whether they should have that treatment provided to them.
T4.  Christopher Fraser (South-West Norfolk) (Con): A particular area of concern for GPs in my constituency is the provision of psychiatric services. They say that those services are extremely thinly spread and greatly needed in all localities. Given that that need is expected to rise during the recession, does the Secretary of State accept that this is a problem in large rural areas such as Norfolk?
Alan Johnson: I would be very willing to look at the situation in the hon. Gentlemans own area. The roll-out of the IAPTimproving access to psychological therapiesinitiative, described by Professor Layard as the most important reform in mental health since the NHS was created, will affect the hon. Gentlemans area as well as others. With 3,600 psychological therapists, on the back of a very successful trial in Newham and Doncaster, and the announcement made last Monday for the very reasons that he mentionedthe health problems associated with the global economic recessionwe are bringing forward to this year the money, and recruitment, that was to be spent in 2010-11. That will make an enormous difference to the availability of psychiatric services.
Rob Marris (Wolverhampton, South-West) (Lab): In the private sector and in the public sector, those at senior levels who fail are too often allowed to walk away with money, not fired. Can the Minister tell me how many NHS chief executives and trust board members have been fired since 1997?
Alan Johnson: No, we do not keep those figures centrally. We know how many non-executive directors have been firedseven since 2001, when the Appointments Commission took over the role and kept statistics. Executive directors are the responsibility of each employer and each trust, and we do not hold those figures centrally.
T6.  Mr. Stewart Jackson (Peterborough) (Con): We know that the increase in the number of live births has outstripped the increase in the number of midwives by a ratio of 3:1 in the period since 2001. The impact of that is particularly acute in areas of high population growth, such as my constituency. The Royal College of Midwives states that 3,600 new midwives are needed in such areas. Two weeks ago, six expectant mothers were turned away by the maternity unit at Peterborough district hospital and forced to travel 35 miles to Kings Lynn. What is the Minister going to do about that?
The Parliamentary Under-Secretary of State for Health (Ann Keen): We are actively recruiting midwives, and working very closely with the Royal College of Midwives. If an expectant mother were turned away from a unit it would be for reasons of safetyfor the mother and the birthbecause there was not enough capacity. We have an escalating birth rate and an active recruitment programme of midwives. We are also encouraging return to practise. I am sure that the hon. Gentleman would agree that the safety of the mother, and the circumstances of the birth, is paramount and it is better for a mother to travel elsewhere than for her to be admitted and made unsafe. It is unfortunate when a woman has to travel further to give birth, but it is a matter of safe practice.
Dr. Richard Taylor (Wyre Forest) (Ind): What can the Secretary of State do to encourage NHS chief executives to listen to and take note of staff whistleblowers so that they do not feel that they are putting their jobs and careers in jeopardy?
The hon. Gentleman raises an important point. Some of the evidence from Staffordand we do not have it all yetshows that staff were raising complaints,
but they were never reported to the board. Indeed, the board, when it discussed such issues, met in private, and all the indications are that it did not consider individual cases. It dealt with high-level issues.
The hon. Gentleman will accept that the NHS constitution, which has a substantial section on staff responsibilities, and the Public Interest Disclosure Act 1998, which was introduced by this Government, ensure that if there are whistles available, someone to blow them and something to be blown about, that should happen, and we should know about it. One of the great abiding mysteries of Stafford is that no such whistle was blown.
Mr. David Anderson (Blaydon) (Lab): Will the Secretary of State look into the situation where Newcastle hospitals have withdrawn from the joint partnership on laundry services with the Queen Elizabeth hospital in Gateshead in my constituency? They are now transporting laundry to Leicester364 miles there and back. That is a ridiculous thing to do when the cost of the contract is exactly the same.
T7.  Mr. Andrew Mackay (Bracknell) (Con): While Sir Liam Donaldsons comments about tackling alcohol abuse might have been well meaning, does the Secretary of State accept that for many of my constituentsperfectly ordinary people struggling in this recessionthe idea of a huge tax increase on relatively cheap bottles of wine is quite unreasonable?
Alan Johnson: I share the right hon. Gentlemans view on that. For 150 years, the chief medical officer has been producing such reportsnot the same person, of coursethat have made a huge contribution to public health in this country, sometimes years after a report has been published. I respect the integrity of the chief medical officer, as I am sure the right hon. Gentleman does, but I just happen to disagree with that solution.
Jeff Ennis (Barnsley, East and Mexborough) (Lab): Incidents of methicillin-resistant Staphylococcus aureus in my three local hospitals have drastically reduced in the last few months, but will the Secretary of State look at the methodology currently used for determining incidents of MRSA in hospitals? In Barnsley, we had an incident where a patient had an infection after his pacemaker had been fitted in an independent treatment centre. Because it took some time to discover how he had been infected in the hospital, the infection was counted as three separate incidents of MRSA for that same patient. That seems a bit unfair to me, so will my right hon. Friend look into that?
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