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Andy Burnham:
If that is the case, it is a major U-turn by the hon. Gentleman-a major U-turn-and it has been forced on him because yesterday his leader ripped up his policies in front of the entire House and the whole country. For the past two years, in every speech, the hon. Gentleman has said, "We oppose the 18-week target. We oppose the two-week target. We oppose four-hour A and E targets." Those targets are in the
handbook he has just mentioned, so I am afraid that his utter isolation and confusion are plain for all to see. It is quite absurd.
The confusion does not end there. Today, in response to a point made by the hon. Member for Wycombe (Mr. Goodman), I heard the hon. Member for South Cambridgeshire say-I wrote it down-that clinicians should make decisions about where services are best provided, yet he goes round the country posing with Tory candidates promising to reverse every clinically led reconfiguration of recent times.
Let us take an example: a "Pendle Matters" leaflet said, "Tory health chief backs call for A&E to return to Burnley". I am sure that that suited the shadow Health Secretary's electioneering purposes, but what does he say to the clinician who had a public meeting in Burnley a couple of weeks ago? My hon. Friend the Member for Burnley (Kitty Ussher) said that at that meeting, the clinician presented independent evidence that about 200 lives had been saved by the A and E reconfiguration in the area. What does the shadow Secretary of State say to that clinician, when he has just told the House that clinicians should be able to decide where services go?
Mr. Lansley: I went to Burnley and met the chief executive of the local NHS trust. I also talked to the chief executive of the ambulance trust. They agreed that it was right to put the medical directors of the ambulance trust and the hospital trust together, to see whether there could be protocols that meant that someone in an ambulance could be taken to Blackburn for blue-light purposes if necessary, and that an A and E department could still be established at Burnley. That is precisely why, shortly after I went to Burnley and made the perfectly reasonable point that the A and E department could be returned, the Secretary of State had a meeting with the hon. Member for Pendle (Mr. Prentice) and instituted an independent review of the decision to close the A and E department at Burnley. [Interruption.]
Andy Burnham: The hon. Gentleman has been found out. I am sorry to disappoint my hon. Friend the Member for Pendle (Mr. Prentice), but I am not proposing what the shadow Health Secretary suggests. I can stand making a tough decision. I can say, "This is saving lives; I will stand by it," but the hon. Gentleman wanders round constituencies with candidates wearing rosettes, promising the earth. He does that not just in Burnley, but in my patch, Greater Manchester, where we have had a difficult review of maternity services. He goes round Greater Manchester promising to reopen everything. Does he remember the leader in the Manchester Evening News that promised that babies' lives would be saved? Does he remember the review? Has he looked at the clinical evidence? Has he heard the views of clinicians about that reconfiguration?
The hon. Gentleman today claimed in the House that clinicians should decide where services are placed, yet he wanders round the country with Conservative candidates, opposing every clinically led decision in the land. That is not a credible position to take. He says that he wants patient choice, but would allow general practitioners to reverse extended opening hours. To cap it all, the Conservatives say that they want a bonfire of the quangos, but then pledge to have an independent board for the
NHS; that would turn it into the biggest quango in the world. It is dangerous for a Labour Minister to quote "The Thick of It", but under the hon. Gentleman, Tory health policy really is turning into an omnishambles.
Mr. Graham Stuart: The big question in my constituency is why the East Riding of Yorkshire, which has an older-than-average population and a higher burden of disease than average, receives one of the lowest health funding settlements in the country. Will the Secretary of State explain why that is, or give my constituents cause to believe that fairer funding would be provided by a future Labour Government, if, improbably, Labour was re-elected?
Andy Burnham: I have heard more than one plea for more funding from Tory Members today. The funding formula follows health need, and we believe that it is right for funding to be targeted in that way. If the hon. Gentleman proposes changes, he will have to justify taking money away from areas where the health need is greater.
We have heard some good contributions and important points in this debate; let me pick up on some of the points made. Colleagues have mentioned reconfiguration decisions. The hon. Member for Bexleyheath and Crayford (Mr. Evennett) talked of the temporary closure of A and E at Queen Mary's hospital, Sidcup. There is an extension of service provision in the urgent care centre; its opening times have been extended to 24 hours a day, seven days a week. The majority of patients will continue to have access to urgent care on the Queen Mary's hospital site.
The hon. Member for Ilford, North (Mr. Scott), raised issues to do with the potential reconfiguration of services in north-east London. Those issues are currently the subject of analysis by NHS London. Obviously, there would have to be a robust option appraisal process before any proposals were sent out to consultation, but I am sure that NHS London will have heard the views expressed today.
I greatly respect the hon. Member for Ribble Valley (Mr. Evans) on health service matters. I know that he speaks with sincerity, and he raised the question about the decision on liver cancer treatments by the National Institute for Health and Clinical Excellence. As the shadow Health Secretary rightly said, that decision is provisional and subject to appeal, and, although I am sure that the comments of the hon. Member for Ribble Valley will have been heard today, I encourage him to make his views known to NICE, following its decision.
The hon. Member for Worthing, West (Peter Bottomley) talked about public involvement in the NHS and complained about the abolition of community health councils. However, local involvement networks-LINks-are beginning to work well throughout the country, and he should speak to the hon. Member for Wyre Forest (Dr. Taylor), who takes a keen interest in those matters. There is growing evidence that LINks are beginning to provide a strong voice locally for patients, but I accept the point made by the hon. Member for Worthing, West that they could do better, and in some parts of the country we need to do more to lift their profile. I am working with the hon. Gentleman on that issue, but I heard what he said to the House today.
My hon. Friend the Member for Huddersfield (Mr. Sheerman) raised questions about obesity in the context of product placement. I was Culture Secretary, so my views are well known and, perhaps, would not help me if I were to rehearse them today. I do have concerns about product placement- [Interruption.] They were very well publicised, I can tell the hon. Member for Surrey Heath (Michael Gove). I was not the strongest proponent of product placement, and I was not in the majority on that question. However, I will keep a close eye on the issue to ensure that placement does not allow, through the back door, any products that may damage health, and in particular children's health. I give my hon. Friend that promise.
The Government have done a huge amount to tackle teenage pregnancy. It is a responsibility that my right hon. Friend the Secretary of State for Children, Schools and Families and I take very seriously, and we need to work on it jointly. The legislative proposals on the statutory basis for personal, social and health education guidance will make a significant contribution, but I take the point that we cannot be at all complacent about that issue.
Peter Bottomley: I am not trying to make a party point about the three organisations with acronyms, given that LINks did not follow CHCs, because something else came in between. However, the LINks decision has not worked. We recognise that the hon. Member for Wyre Forest has done very well, but in most places one cannot get ordinary people to make the LINks system work as well as the CHCs did. Will the Secretary of State explain how we can avoid the process errors that led both to the chaos of the MMC programme and the MTAS, and to the lack of benefit from the cost of the NHS IT system? Those are genuine points; I am not trying to knock the Secretary of State.
Andy Burnham: I take the hon. Gentleman's point on LINks-that we probably have more to do to give them a higher profile, and that we have to work harder to make them more effective. However, I urge him to work through the all-party group that the hon. Member for Wyre Forest chairs to see whether we can make progress in that regard.
There is growing evidence that NHS IT is making a genuine difference to patient safety, with more responsive services throughout the country. Again, I am not complacent, because I am sure that we can make further improvements, but the Opposition use an easy stick when they say that it is all a waste. In fact, it is not: it is producing real patient benefit, and I am pleased with the progress that we are making.
The hon. Member for Mid-Dorset and North Poole (Annette Brooke) raised the question of maternity services, as did the hon. Member for Poole (Mr. Syms). I shall look at the matter, and I acknowledge the strength of feeling about it. The matter was voiced by two hon. Members in the area, so I shall consider it. If I am not mistaken, however, the hon. Lady recognised the improvements that have been made in the NHS in the past 10 years, and I am grateful for that.
The hon. Member for Colchester (Bob Russell) made many points about Building Schools for the Future and his frustrations with the process, and I am sure that my hon. Friend the Minister for Schools and Learners
heard them. The hon. Gentleman also questioned the funding of school sixth forms and complained that they are not the same, so I should tell him that my brother is a vice-principal of a sixth-form college and regularly lobbies me on the matter. I should probably say no more than that.
Several hon. Members mentioned home education, including the hon. Members for Yeovil (Mr. Laws) and for Beverley and Holderness (Mr. Stuart). I agree with the hon. Member for Beverley and Holderness in saying that home education is a well-established and important part of our education system. He asked us to recognise the contribution of people who give lots of their time and effort in raising the standards of home education. A constituent who recently came to see me-Caroline Shevalan-made the same point, and I am happy to endorse it. It is important that there is certainty, with good processes and standards in place. Registration and monitoring of home education will not be onerous-home educators are doing a good job-but it will give local authorities the tools that they need to tackle the small number of cases where the education provider is not good enough. I hope that we can get the balance right, and I am sure that my right hon. Friend the Children's Secretary is working to ensure that that is the case.
The hon. Member for Surrey Heath asked about NEETs and the September guarantee. I am told that through the September guarantee we are offering a suitable place in education and training to all 16 and 17-year-olds. In Budget 2009, we announced an additional £655 million over the next two years to secure additional learning places to help to meet the guarantee. I hope that that gives him some reassurance.
The shadow Health Secretary raised several points about swine flu. Today there has been the significant announcement that the Government intend to extend the vaccination programme beyond the priority groups that were initially recommended by the Joint Committee on Vaccination and Immunisation. As he said, we are proposing to extend the offer of vaccination to parents of children aged between six months and five years. That particular group of young people has been chosen because there is evidence of higher levels of hospitalisation among them. There are reports today of further deaths from swine flu, which is of course sad news, but there has been a drop in cases.
In extending the programme in this managed and phased way, we want to ensure that we keep a sense of order and discipline about the vaccination process. I was recently in Washington-I think that the shadow Health Secretary was too-and there were chaotic scenes in relation to swine flu vaccine. I think that he would agree-we have had a good measure of agreement on these matters-that we do not want to see such scenes in this country. We want the vaccine to be made available through GPs in an orderly way, and that is what we will continue to do. He asked whether we would take the campaign even further. We will keep all these matters under review, as he requested.
Obviously, it is too early to say whether this week's drop in cases does in fact amount to an end of the second wave or whether it is the effect of half-term holidays. We must be vigilant about that; we do not know how the virus will develop over the coming months. However, I can assure the hon. Gentleman that we will continue to involve and consult him at all stages and
that we will keep open the question of further vaccination for further groups as well as carers, to whom, as we indicated today, we would want to offer the vaccine. We will keep that under review.
Having had a few partisan exchanges with the hon. Gentleman, his comments about the take-up of vaccine, particularly among pregnant women, were very welcome. He was correct to say that this is a proven technology. The clear advice from the chief medical officer is that pregnant women are at risk of greater complications, and the best way that they can protect themselves is to have the vaccine.
My hon. Friend the Member for Bolsover (Mr. Skinner) made some powerful points about cancer services under this Government which are a much better answer to the question asked by the hon. Member for Billericay (Mr. Baron) than the one that I gave a few moments ago. My hon. Friend also raised the important issue of pleural plaques. His constituency and mine share many similarities in that many people worked in industries exposed to asbestos. There is a legacy of people suffering from mesothelioma in certain parts of the north, as well as other parts of the country. In summer, the Justice Secretary announced the elements of a package involving an industry-funded tracing office to help to identify insurance companies and an exploration of ways of speeding up the process of compensation for people with mesothelioma, with more funding for asbestos-related diseases; that aspect is led by my Department. He said that we were taking forward those planks of a package and that a further announcement would be made in due course. In addition, we have agreed to the CMO's recommendation that we should commission more information on pleural plaques for patients, and we are working on that with the British Thoracic Society and the British Lung Foundation. I know of his great interest in the subject. Of course we will do justice to the people concerned by taking forward proposals, and I am grateful to him for raising the matter today.
I shall conclude by speaking for a few moments about our Bill to provide support for people with the highest needs in our society and the provision of free care to help them. We have done a great deal to improve the NHS, but as I have said quite clearly, we must now tackle reform of our social care system. If we fail to do so, we will let down a generation of older people. The hon. Member for South Cambridgeshire is right that we should work to find a national consensus.
However, again on the theme of confusing and conflicting statements, the hon. Gentleman said today that he supports a national care service, but I think I could furnish him with a quote from the day that the Green Paper was launched-we made an oral statement in the House-when he said precisely the opposite. He shakes his head, but I think the record will show that I am right. I think we will leave it there.
The Bill will help to provide help in people's own homes to those most in need. It will guarantee free personal care for the 280,000 people with the highest needs, including those with serious dementia or Parkinson's disease, and help an additional 130,000 people who need home care for the first time to regain their independence. It is the first significant step towards addressing one of the great remaining unfairnesses of modern times, which is that people with the greatest care needs can still face the highest cost, and that those who suffer the most can pay out the most.
I heard the attack today by Members of another place, but they are missing the very important point that the Bill will deal directly with 400,000 of the most vulnerable people in our society, many of whom will already have paid out of their own pockets large amounts for a number of years to fund the cost of their care. Take the example of somebody who needs 17 hours of personal care a week, which is about average for someone who requires intimate personal care. For the essential care that they need, which could include all aspects of their daily lives-eating, drinking, washing, toileting, dressing and so on-they would currently pay around £13,000. Under the Bill, that care will be free.
I am not saying that the Bill is the whole answer, but I am saying that it is a bridge to a national care service. By taking this step, we are making the social care system of this country fairer, right now, for the most vulnerable. They will benefit in the long term from the measures that we are proposing.
It must be right that we make this new system as preventive as possible, and that people are assisted at home and able to regain their independence. That is exactly what we should do. The hon. Member for South Cambridgeshire is right that some people will always need care in a care home setting-I agree with him on that-but it must be our intention to help people to stop them deteriorating and going downhill, and to invest early so that they can regain confidence and independence. That is the whole thrust of our policy.
I must say that the hon. Gentleman's claims today at his press conference were the stuff of the gutter. To say that we are proposing to cut benefits for the most vulnerable people in our society, and to raise anxiety in the way that he has among those people, is scaremongering-nothing more, nothing less. We have said quite clearly that people will be guaranteed an equivalent level of support, so to go out there and say that they would lose thousands of pounds every year is low politics, and it crosses a line over which people should not go. It puts misleading thoughts in people's minds, and he knows that that is not the Government's intention.
Mr. Lansley: Will the Secretary of State therefore explain why page 15 of his Green Paper says that most of the Government's options, apart from the pay-it-all-yourself option, involve "integrating disability benefits" into his proposed national care service? The effect of that is to take away cash benefits that people could have spent how they wished and put it into a service where they get what they are given.
Andy Burnham: The whole aim of the reform is to improve the level of care and support for the most vulnerable people in our society. The hon. Gentleman called a press conference today and said that I wanted to cut benefits and support for vulnerable and older people. [ Interruption. ] He is saying that again and, although I generally do not take offence at much, I do take offence at that.
We have said explicitly that people will be guaranteed an equivalent level of support. We have also said that the proposed national care service would have to be a fundamental reform of the system, and that aspects of
the benefits system, including attendance allowance, would need to be considered alongside the support that the Government put into social care through grants to local councils. However, it is quite a different thing to say that that is about cutting support to vulnerable people.
I have not said that-indeed, I have said quite the opposite. The Opposition are indulging in low politics, which should have no place in our national debate. They appear to be getting very desperate in the way that they are campaigning.
Mr. Graham Stuart: Opposition Members are having difficulty in believing the Secretary of State because exactly the same argument was made when the 10p tax proposal was first brought to the House. The Government were letting down the most vulnerable people then, and I fear that he is doing precisely the same today.
Andy Burnham: I encourage the hon. Gentleman to read the Green Paper, which is about providing more support to vulnerable people. It is this Labour Government who proposed direct payments to older people in need of care so that they had the cash in their hands that would enable them to buy the services and support that they need. He suggests that reforming a benefit equals a cut, but I think that he is more intelligent than that. I find that the Opposition are taking part in gutter politics.
The proposals that we published yesterday have received widespread support. The president of the Association of Directors of Adult Social Services called the Bill
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