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Elderly Care Beds
10. Miss Anne McIntosh (Vale of York) (Con): What the role of primary care trusts is in the allocation of beds for care of the elderly. [274107]
The Minister of State, Department of Health (Phil Hope): Primary care trusts work with local authority partners to commission high-quality care services from appropriate providers to meet local patient needs, with a clear focus on improving health outcomes for the population, including older people. It is the responsibility of each provider—be it the hospital, the residential facility or another provider—to determine the level of service provision, such as bed numbers, to meet expected demand and to provide high-quality care.
Miss McIntosh: I put it to the Minister that it is entirely wrong that primary care trusts that are not clinically qualified should deprive dying patients of beds. I hope that he will remove them from the picture and allow a decision to be taken by clinically qualified practitioners.
Phil Hope: I understand the importance of the issue to the hon. Lady, but it is vital that we have an appropriate process for commissioning high-quality services locally. It is the responsibility of primary care trusts to undertake that function and, in the case of the care of elderly people, to do so, through beds in hospitals, beds in residential care and so on, in partnership with their local authorities. It is their responsibility to ensure that we have high-quality services from those appropriate providers. It is also a responsibility—this is subject to inspections and so on by the Care Quality Commission—to ensure that the relevant provider provides that high-quality care in a way that meets elderly people’s needs.
Miss McIntosh: Owing to that entirely inadequate response, Mr. Speaker, I move for an Adjournment debate to be held on that question.
Mr. Speaker: I hear the hon. Lady, but we must move on.
NHS Dentistry
11. Mr. Andrew Turner (Isle of Wight) (Con): What his latest assessment is of levels of access to NHS dentistry in (a) the Isle of Wight and (b) England. [274108]
The Minister of State, Department of Health (Dawn Primarolo): In the 24 months ending September 2008, 66,250 people saw an NHS dentist on the Isle of Wight. The equivalent figure for England was 27.1 million. We have increased dental funding to more than £2 billion and made it a national priority in the NHS operating framework that primary care trusts commission services to ensure access for anyone who seeks help in finding an NHS dentist. The NHS is planning that all PCTs will deliver this by March 2011.
Mr. Turner: I thank the right hon. Lady very much. There was an improvement in the availability of dentists on the island until the NHS abolished registration. We now have figures that show the number of treatments, rather than the number of individual patients getting treatment. Will she explain why the figures are now taking this form, rather than the old form?
Dawn Primarolo: On the Isle of Wight, the number of people getting access to, and treatment from, NHS dentists increased from 26.2 per cent. to 38.1 per cent. between March 2006 and September 2008. In fact, that is the biggest percentage increase in the country. The Isle of Wight is doing precisely as the Government have advised. It is looking at local need, commissioning the appropriate services and delivering that access. I understand that the hon. Gentleman would like that process to move faster, but the ring-fenced investment and the plans are in place, and the powers are in place for the PCTs. He has seen a marked improvement in his constituency.
Topical Questions
T1. [274124] Kerry McCarthy (Bristol, East) (Lab): If he will make a statement on his departmental responsibilities.
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.
Kerry McCarthy: I am sure that my right hon. Friend shares my concern about the continued inequalities in relation to cardiovascular disease. Will he provide me with an update on what is being done to tackle inequalities not only in the prevalence of the disease but in access to care?
Alan Johnson: My hon. Friend is absolutely right about the importance of this matter. The inequalities relating to cardiovascular disease have narrowed substantially over the past eight years, and we are well on track for a 40 per cent. reduction in the inequalities gap by 2010. The most important measure—among a range that I have too little time to set out—is the introduction of a vascular health check for everyone between the ages of 40 and 74 on a call-and-recall basis every three years. That programme commenced last month and it will be one of the most important contributors to tackling this disease and to focusing the NHS much more on prevention than on diagnosis and cure.
T2. [274125] Bob Spink (Castle Point) (Ind): A number of my constituents have been the victims of contaminated blood. When will the Government respond to the Archer report, and may we have a debate so that we can consider the report and Tainted Blood’s document, “We Accuse”? This is a matter of decency and fair play for those victims.
The Minister of State, Department of Health (Dawn Primarolo): My right hon. Friend the Secretary of State and I have met Lord Archer to discuss his report, and the Government intend to respond to his findings before the House adjourns for the spring bank holiday recess. The question of a debate is a bit beyond my remit, Mr. Speaker, but I am sure that you heard what the hon. Gentleman said.
T4. [274127] Natascha Engel (North-East Derbyshire) (Lab): As my right hon. Friend is aware, the few people with thalidomide-related conditions who have survived are now in their mid-to-late 40s. Many of them experience severe pain and serious physical difficulties. Will her Department look into providing extra funding to support those people?
Dawn Primarolo: As my hon. Friend will know, the Department of Health’s long-held policy is not to fund in cases such as these. However, she has raised details about which the whole House will be concerned and on which it will want to see progress. The Secretary of State has offered to have a meeting with officials and the national advisory council of the Thalidomide Trust to pursue these matters, and I agreed during an Adjournment debate on 31 March to meet the all-party group on thalidomide. My hon. Friend the Member for Gower (Mr. Caton), who chairs the group, is going to write to me with details of the points that he wishes to raise with the Department on behalf of the group. That offers us a way of taking this matter forward.
T3. [274126] Andrew Stunell (Hazel Grove) (LD): Stockport NHS Foundation Trust has paid £2,937,000 of interest charges on loans taken out to cover the deficit on its finances. That rate is 10 times the Bank of England base rate and is paid to the NHS bank. Will the Secretary of State arrange for that rate to be brought more into line with the Bank of England rate, reducing those interest charges and allowing more money to be spent in Stockport on NHS health, as it was originally intended?
The Minister of State, Department of Health (Mr. Ben Bradshaw): I will happily look into the case that the hon. Gentleman raises. He will know that foundation trusts come under the remit of Monitor rather than the direct remit of the Department of Health. I would also point out the finances not only of his local hospital but of the NHS in general are in much better shape than they were even just three or four years ago.
Mr. Kevin Barron (Rother Valley) (Lab): May I congratulate my right hon. Friend on the abolition of NHS prescription charges for cancer patients? Will he tell us when the review of long-term conditions that are currently not exempt from such charges will be completed?
Alan Johnson:
My right hon. Friend is right to say that we took the decision on cancer prescriptions as the first step towards looking at other long-term conditions.
The first thing we have to do is to define long-term conditions—some very easily slot into that definition and there is no mystery, but there are some cases around the edges that we need to be absolutely sure about. That is why we asked Professor Ian Gilmore to carry out this report. I understand that his work will be completed in the summer.
T6. [274129] Tom Brake (Carshalton and Wallington) (LD): The Secretary of State will recall our meeting over the future of St. Helier hospital. There has been a further slight delay as a result of some more modelling that needs to be done. Will he take the opportunity to reconfirm that the rebuilding of St. Helier hospital and the development of the local care hospitals, as proposed by “Better Healthcare Closer to Home”, is still exactly the type of project that the Government want to see proceed?
Alan Johnson: I can confirm that. It is the type of project that we want to succeed because it is the type of project that the local NHS feels is absolutely essential. As far as I am aware, nothing has changed from the position that obtained when we met in my office a few months ago.
T5. [274128] Mr. David Anderson (Blaydon) (Lab): The Secretary of State will recall that I raised with him on previous questions the decision of Newcastle laundries. Newcastle hospital pulled out of a laundry contract involving the Queen Elizabeth hospital in Gateshead. I thank my right hon. Friend for the response from his office, but it was based solely on information from the Newcastle side. The Queen Elizabeth side is very concerned because Newcastle is saying that it can save 35 per cent. of the cost and Gateshead is putting the figure at more like 1 per cent. Will the Secretary of State meet me and representatives from the hospital as a matter of urgency to try and work this out?
Alan Johnson: I am grateful to my hon. Friend for writing to me, following the last Health questions. I wrote to him earlier today about this. The local health trust says that giving this contract— [Interruption.] Postmen can deliver very quickly. The gloriously named Sunlight Laundry, which will take over this project, can do everything being done at the moment but at a lower price. I am sure that it does not want its dirty linen to be washed in public, so what I have done in my letter to my hon. Friend is to offer a meeting with the Under-Secretary of State for Health, my hon. Friend the Member for Brentford and Isleworth (Ann Keen). I hope that it can take place shortly.
T8. [274131] Tony Baldry (Banbury) (Con): The King’s Fund advises that the poor state of the public finances means that the NHS must prepare, at best, for very low or zero growth in funding from 2011 onwards. I would like to know what the Secretary of State is doing to advise strategic health authorities that they must now start planning for zero or very low growth within the NHS from 2011 onwards?
Alan Johnson:
What we have done since the allocations last December—it was a two-year allocation of 5.5 per cent. each year and included the ability to draw down £800 million of surplus—is to say that there is a message
here. It comes from the chief executive of the NHS as well, and it is that the NHS has to prepare for a time when we will not have such spectacular increases in growth. We brought the level of investment up to within touching distance of the European average. Now that we are there, at around 9 per cent., it is inconceivable—irrespective, incidentally, of the economic situation—that such large increases will continue. The message from the chief executive of the NHS and from me is that we need to think in a five-year time frame, including not just the next two years, but the three years to follow.
We cannot say at this stage what the expenditure will be in the NHS, but we can say that it will continue to be our absolute priority. As the Prime Minister told the Royal College of Nursing yesterday, we hope very much to ensure that there are real-terms increases over the coming years, although they may not be at the same level as in the past.
T7. [274130] John Robertson (Glasgow, North-West) (Lab): My right hon. Friend will share my concern about what are labelled “legal high” drugs, which are appearing not only on the internet but in shops. That label hides the real nature of the drugs. What is my right hon. Friend doing to assess the position, to try to stop the drugs appearing—especially in shops—and to protect children who have access to them?
Dawn Primarolo: My hon. Friend has raised a very important point, which will concern all Members, about the drugs that are apparently being made available, particularly those containing benzylpiperazine. The Medicines and Healthcare products Regulatory Agency is pursuing the matter, and is trying to establish whether the drugs need to be defined as medicines when they are sold either on the internet or over the counter. In addition, the Advisory Council on the Misuse of Drugs is considering the whole issue and, in particular, whether certain products should now be banned. When we receive its recommendations, I shall be more than happy to inform my hon. Friend of them, because the present position is resulting in deadly drugs being available when they should not be.
Mr. Mark Harper (Forest of Dean) (Con): The Minister of State will know from our recent Adjournment debate how important it is for thousands of my constituents to be guaranteed access to GPs registered in England so that they, residents of England, can be treated under the rules of the English NHS rather than those of the Welsh health service. Is he able to update me following his recent visit to my constituency and his meeting with the chief executive of my local primary care trust?
Mr. Bradshaw:
I am well aware of the issue, because the hon. Gentleman has raised it with me on a number of occasions. I am not sure that anyone could say with any confidence that thousands of people may be in this position, but there is no doubt that a number of them may be. Having discussed the matter with the chief executive of NHS Gloucestershire during my visit to the hon. Gentleman’s constituency last week, I can inform him that the primary care trust will seek to resolve the case that he raised with it, involving a particular couple. It also intends to survey all Gloucestershire residents registered with GPs in Wales
to establish how many of them might wish to register with GPs in England, with a view to providing more GPs in the part of the hon. Gentleman’s constituency where a problem exists.
Charlotte Atkins (Staffordshire, Moorlands) (Lab): Why are NHS children-only dental contracts still operating with private dentists? Is that not an unacceptable legacy of practice in the past, when parents were persuaded to take up private treatment on the basis that their children would continue to receive NHS treatment?
Alan Johnson: My hon. Friend is a member of the Select Committee on Health, which produced a very good report on dentistry, and that is one of the points that it raised. I have asked Professor Jimmy Steele to examine all the issues, including registration and children’s services, and to report back very quickly. I hope that at the same time we can produce a response to the Committee’s report, because I think that it made an important contribution to the debate about the future of dentistry.
Jo Swinson (East Dunbartonshire) (LD): One in five people in the United Kingdom suffers from hay fever, especially at this time of year, and one in three people will develop an allergy at some point in their lives. What are the Government doing to raise awareness among GPs of immunotherapy as a treatment that can tackle causes, not just symptoms, and bring lasting relief to many allergy sufferers?
Alan Johnson: I have absolutely no idea, but, as a hay fever sufferer myself, I intend to find out.
Mr. Lindsay Hoyle (Chorley) (Lab): I thank my right hon. Friend for his visit to Chorley hospital, but may I draw his attention to an issue that affects the whole of Lancashire and, indeed, the whole country? I refer to the funding of mental health services. We all know that mental health care is a poor relation. What can my right hon. Friend do to help pensioners who suffer from mental illness? Can he secure extra funds and support, and ensure that provision is seamless between social services, primary care trusts and hospitals themselves?
Alan Johnson: I very much enjoyed my visit to my hon. Friend’s constituency; I saw some very good things going on there. On mental health, last year’s OECD report said that Britain is in the lead on mental health services—in the lead on the number of psychiatrists and psychiatric nurses per head of population, and in the lead in having the lowest suicide rates since records began. We want to do more, however. The roll-out of psychological therapies is crucial to people of all age groups, but especially pensioners, and 3,600 psychological therapists are being trained up in what Lord Layard describes as the biggest single improvement to mental health since the NHS began.
Mr. Graham Brady (Altrincham and Sale, West) (Con): In the interests of value for money in the NHS, may I ask Ministers to look into the prescription of what are known as “specials” by GPs? A local pharmacist has written to me giving an example of a product consisting of 50 g of Betnovate cream, which costs £2.86, and 450 g of E45, costing £5.39; the total cost of the mixed cream was £347.88. Clearly, there is money being wasted here; will Ministers please look into this?
Dawn Primarolo: Yes, we certainly will.
Points of Order
3.31 pm
John Mann (Bassetlaw) (Lab): On a point of order, Mr. Speaker. It is stated on page 370 of the 22nd edition of “Erskine May” that
“parliamentary government requires the majority to abide by a decision regularly come to, however unexpected”,
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