House of Commons
Tuesday 13 October 2009
The House met at half-past Two o'clock
Prayers
[Mr. Speaker in the Chair]
Oral Answers to Questions
Health
The Secretary of State was asked-
Prostate Cancer
1. John Robertson (Glasgow, North-West) (Lab): What steps his Department is taking to raise the level of awareness of prostate cancer. [292228]
The Minister of State, Department of Health (Gillian Merron): Through our national awareness and early diagnosis initiative, we are working to improve awareness of the signs and symptoms of cancer, including prostate cancer, among the public and health care professionals in England. As part of this initiative, we are investing in a number of prostate cancer awareness campaigns.
John Robertson: I thank my hon. Friend for her answer. She will be aware that of the 35,000 men who get prostate cancer each year, 10,000 are unlikely to live. Men are seen as being particularly loth to go to hospital or to the doctor with problems relating to intimate parts of the body. What does my hon. Friend intend to do to allay men's fears and get them to go to their GP or to hospital, to ensure that 10,000 more people do not die next year?
Gillian Merron: My hon. Friend raises an important point. We know that men tend to put off going to see their GP, which can result in devastating effects following later diagnosis and treatment. We are investing in schemes such as the Football Foundation's Ahead of the Game campaign, which uses the appeal of football to raise awareness of prostate, lung and bowel cancers in men over 55. We are also working with a number of prostate cancer charities and patients to raise awareness of that cancer and to get the message out: "Don't wait-check it out."
Christopher Fraser (South-West Norfolk) (Con): Research carried out by the Prostate Cancer Charter for Action shows that, in at least 96 of England's 529 constituencies, the death rate from prostate cancer is well above England's average. Does the Minister accept that this reflects inequalities in NHS prostate cancer services? What is being done to remedy this?
Gillian Merron: We have done much to narrow the gap in relation to the inequality of cancer services. The introduction of the two-week maximum wait from GP referral to seeing a specialist and the recent announcement of a diagnostic result one week after being referred will also be extremely welcome. There are differences around the country, and it is difficult to give a definitive answer, but we have ensured that doctors are educated and supported to provide the right kind of understanding. As I have said, we are also working to raise awareness of the signs and symptoms, because the main thing is the need for men to present earlier.
Meg Munn (Sheffield, Heeley) (Lab/Co-op): My hon. Friend will be aware of how successful women have been in coming together to campaign on breast cancer. Indeed, I am wearing pink today to support that campaign. What does she think can be done to get more men to campaign on the important issue of prostate cancer, and to persuade them not to ignore it? She will be aware that my own father went to the doctor too late, and consequently died of the disease. Can we not get men to do more?
Gillian Merron: My hon. Friend has sad and poignant personal experience in this respect, and I thank her for sharing it with the House. Prostate cancer represents a different challenge for all of us, not least because the signs and symptoms are not always as clear as we might want. Research needs to be encouraged and supported to develop effective screening, which we do not have at the moment. We are, however, providing high-quality services tailored to the individual patient, and I am sure that men across the country will have heard my hon. Friend's encouragement and will rally to take action, which I would certainly welcome.
Maternity Services (Rochdale)
2. Paul Rowen (Rochdale) (LD): What his most recent assessment is of the adequacy of maternity service provision in Rochdale constituency. [292229]
The Parliamentary Under-Secretary of State for Health (Ann Keen): The North West strategic health authority reports that work is progressing as planned on the Making it Better reconfiguration, which aims to improve the quality of maternity services across Greater Manchester.
Paul Rowen: Does the Minister accept that in the current economic climate, closing two maternity units-at Rochdale infirmary and Bury Fairfield hospital-that are less than 10 years old and spending £15 million on a brand new unit at the Royal Oldham hospital does not represent best value for money? Does she agree that the money could be better used elsewhere?
Ann Keen: I am sure that the hon. Gentleman is aware that the Manchester proposals are overwhelmingly supported by local clinicians and backed by a clinical and quality-based case for change. Making it Better will provide safer, higher-quality care for the residents of Greater Manchester, and the nearby Royal Oldham site will become a centre of excellence for maternity and neonatal care.
Mr. Andrew Lansley (South Cambridgeshire) (Con): The Minister may recall that I made it clear during Health questions in May that the birth rate in Greater Manchester was rising, contrary to the predictions on which the reconfiguration proposals were based. We now know that something like 5,000 more babies were born in Greater Manchester than had been predicted. If the assumptions on which the plan was based are no longer true, will she act on the evidence and reconsider the plans to shut obstetrics services at the Fairfield hospital in Bury and at Rochdale infirmary? Otherwise, 5,000-plus mothers living north of the M62 simply will not have the choice to access obstetrics services close to home.
Ann Keen: It is for local commissioners to keep that always under review. As the hon. Gentleman said, the birth rate has risen, but local commissioners are in touch with their clinicians. During the consultation, which was extended over four months, the matter was examined in detail and it was decided that it was safe practice to reconfigure services as has been done.
Norman Lamb (North Norfolk) (LD): The Minister will be aware that one of the biggest challenges facing maternity services in Rochdale and elsewhere is the enormous shortage of midwives. All the signs are that the Government will miss their target of recruiting 3,400 more midwives by 2012, so will the Minister support the Lib Dem plan to scrap the health and maternity grant, which is completely untargeted, and invest the money instead in recruiting 3,000 more midwives and health visitors to give every woman the support she needs during pregnancy?
Ann Keen: I am saddened that the hon. Gentleman raised the issue in that particular way, because we are on target. We have checked with the strategic health authorities- [Interruption.] I must contradict the hon. Gentleman. After checking with the strategic health authorities in England, we know that the target for 4,000 extra midwives by 2012 will be met. We are working closely with the Royal College of Midwives and very positively with the Royal College of Obstetricians and Gynaecologists: the target will be met. As for the comment about the grant, I am sad that the hon. Gentleman feels that way, because I believe every woman is entitled to be healthy through pregnancy, and to have a safe pregnancy.
Small Pharmacies
3. Mr. Graham Allen (Nottingham, North) (Lab): If he will take steps to protect small pharmacies from the effects of the operation of in-house pharmacies established in supermarkets. [292230]
The Minister of State, Department of Health (Mr. Mike O'Brien): Independent pharmacies play an enormously important part in providing pharmaceutical services to the UK. However, the NHS (Pharmaceutical Services) Regulations treat all providers equally, and we do not intend to change that to discriminate against a particular sector.
Mr. Allen: The Minister will be aware from the representations of colleagues throughout the House that small pharmacists are an invaluable part of the local community. They are often the cement that keeps a local parade of shops going, for example, in deprived communities such as mine in Nottingham, North. The giant supermarkets are usually most welcome in communities, but does the Minister accept that they also have a tendency to suck in other services, particularly pharmacies, and not to provide the sort of intimate and local service that reaches out into the community? Will he take every possible step to ensure that local pharmacies are encouraged to survive and thrive?
Mr. O'Brien: We certainly want local pharmacies both to survive and to thrive. Indeed, the Health Bill, which was before the House yesterday, introduces pharmaceutical needs assessments, which will encourage primary care trusts to ensure that they consider the needs in their area. We know that different parts of the community have different needs. Young mothers who live at home with their children, and older people, sometimes like small locally based pharmacies, while younger men sometimes prefer the less intimate surroundings of a supermarket. There are all sorts of diverse needs to provide for. What we want is a broad range of services and pharmacies, ranging from small traders to multinationals.
Mr. Nigel Evans (Ribble Valley) (Con): I have a number of independent pharmacies in towns and villages in my constituency where there are no supermarkets, but supermarkets are not too far away. If those supermarkets suck in some of the customers of the independent pharmacies, we shall see death by a thousand cuts. Some of the ageing population will not be able to get into the major towns, so they will lose an essential place where they can get their medicines. If we do not want to see pharmacies going the same way as the post offices have gone over the past five years, the Government will have to take action now. What action is the Minister prepared to take?
Mr. Speaker: Order. I am not saying that the questions and answers are quite of "War and Peace" proportions, but in several cases they have been a bit on the long side, and we need to hasten progress.
Mr. O'Brien: I have just said that the Bill before the House yesterday provides action in the form of pharmaceutical needs assessments, so that primary care trusts are able to assess local needs and ensure that they respond to precisely the sort of circumstances that the hon. Gentleman raised.
Dr. Brian Iddon (Bolton, South-East) (Lab): First, I thank the Medicines and Healthcare products Regulatory Agency for publishing its new guidelines on the sale of codeine-containing products recently. However, will my right hon. and learned Friend admit that the person paying for codeine-containing products at the checkout would not get the same advice in a supermarket containing a pharmacy as they would in the sort of small pharmacy that my hon. Friend the Member for Nottingham, North (Mr. Allen) described?
Mr. O'Brien: I certainly agree that local pharmacies are enormously important. That is why we want to support them, and that is why we have introduced the Health Bill, which the House debated yesterday and which provides for pharmaceutical needs assessments for each area. We must ensure that there is diversity of supply so that precisely the sort of needs identified by my hon. Friend are met, and we must recognise that other parts of our community want that diversity as well.
Mark Simmonds (Boston and Skegness) (Con): Along with many others, we value the role of community pharmacists, but recognise that the most important challenge for small and single-handed pharmacies is presented by the Medicines (Pharmacies) (Responsible Pharmacist) Regulations 2008, which came into force last week. Can the Minister deal with the significant confusion and real concern among pharmacists regarding the regulations? Will he, for instance, clarify whether a small pharmacy that is open for the minimum 40 hours per week would be in breach of its NHS terms of service were a responsible pharmacist to be absent for two hours, and whether a responsible pharmacist failing to sign off and taken a rest break would be in breach both of professional requirements and of the European working time directive?
Mr. O'Brien: We certainly do not want a local pharmacist to be in breach of either the regulations or the working time directive. We want and intend to ensure that the regulations are applied flexibly so that we can continue to provide effective and good local services in the community.
Cancer Services
4. David Tredinnick (Bosworth) (Con): What is his most recent assessment of the level of provision of cancer services in England; and if he will make a statement. [292231]
The Secretary of State for Health (Andy Burnham): The first annual report on the Cancer Reform Strategy, published in December 2008, is the most recent assessment of cancer service provision in England. The report showed that good progress is being made against the objectives of the strategy to improve cancer services further across England by 2012.
David Tredinnick: When considering that report, did the Minister examine the research conducted by Professor Karol Sikora at the university of Buckingham medical school? It shows that in NHS centres where complementary services are offered, 70 per cent. of women and 40 per cent. of men take them up, and that they are of great help with chemotherapy. However, there is a real problem. There is not enough knowledge about which therapies are working when they are used together. If I wrote to the Minister, would he please consider funding a little extra research?
Andy Burnham:
I look forward to receiving the hon. Gentleman's correspondence. I do not think that any Member has done more to champion the cause of complementary and alternative medicine across the national health service. As he will know, as a result of his efforts
and those of others, the National Institute for Health and Clinical Excellence has included the role of complementary and alternative medicine in its service configuration guidance on supportive and palliative care for cancer patients-which is due to be implemented fully by December this year. Of course I would welcome a further letter from him, particularly one containing the views of such an eminent clinician as Karol Sikora.
Ms Dari Taylor (Stockton, South) (Lab): In September, I had a breast cancer scare. Within five working days I was in the hospital and being screened-and everything was fine. I want the House to know that that was not because I am a Member of Parliament: when the staff contacted me by phone, they called me Mr. Taylor. I had to correct that quickly!
I raise the matter here today because I received excellent service from the University Hospital of North Tees; the breast cancer unit was excellent. My question to the Secretary of State is quite clear. When is it expected that all cancer services will be resourced to the same extent, so that it will be possible for everyone, within five working days, either to have their minds put at rest or to begin their treatment?
Andy Burnham: I thank my hon. Friend very much for her question, and I will relay what she has said to the NHS so that it will get her name right in future. It is important that she has shared her experience with the House, because it illustrates how far the NHS has travelled. It is a sad fact that breast cancer is the most common form of cancer in England. Some 38,000 new cases were diagnosed in 2006. I have seen the devastating effects of breast cancer in my own family, and I know only too well how quickly it can spread if it is not picked up early.
As my hon. Friend knows, we are extending the two-week guarantee to all suspected cases of breast cancer. She will have heard recently that we also want to extend GPs' access to tests, so that although not every case may qualify for the urgent referral pathway, cases that do not can nevertheless be checked out by GPs. She is absolutely right: there can be no complacency. We will go still further to ensure that we give everyone in the country the best possible chance of surviving breast cancer.
Mr. Andrew Lansley (South Cambridgeshire) (Con): The Secretary of State will recall that the Cancer Reform Strategy says:
"Sufficient finance will be made available to the NHS as part of their general capital allocations to fund investment in new cancer equipment."
That was two years ago. Two weeks ago, the Prime Minister said that hospital building projects should have their resources taken away to fund new cancer equipment. Clearly that has not happened-or can the Secretary of State explain what additional diagnostic equipment is going to be paid for?
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