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Smoking Cessation

5. Mr. Christopher Chope (Christchurch) (Con): If his Department will take steps to promote the health benefits of low-toxicant smokeless tobacco products as aids for smoking cessation. [300143]

The Minister of State, Department of Health (Gillian Merron): There is no evidence that smokeless tobacco can help people to quit smoking. Such products are tobacco, and they release harmful toxins when used. The Department therefore has no plans to promote that form of tobacco, but we will continue to support smokers in quitting using safer means, including licensed nicotine replacement medicines.

Mr. Chope: What an arrogant and irresponsible reply that is. Does the Minister not realise that based on the Swedish experience, if snus were legalised in the United Kingdom it would save up to 30,000 lives a year? Does she not realise that even the World Health Organisation recognises snus as a useful harm reduction product?

Gillian Merron: I am sorry to disappoint the hon. Gentleman, but there are very good reasons for my comments. The Scientific Committee on Emerging and Newly Identified Health Risks, which is both official and independent and provides the European Commission with scientific advice, considered in detail the health
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effects of smokeless tobacco products and concluded that such products were addictive. I have myself looked at the packaging of such items and seen that even the tobacco industry acknowledges that they are not a safe alternative to cigarettes.

Mr. Adrian Bailey (West Bromwich, West) (Lab/Co-op): May I associate myself with my hon. Friend the Minister's remarks? Does she agree that the most effective way to reduce the incidence of smoking is to reduce peer group pressure on young people to take up smoking? What assessment has she made of the role of the ban on smoking in public bars and restaurants in achieving that?

Gillian Merron: My hon. Friend will know that just this year we celebrated the 10th anniversary of the NHS stop smoking services, which have saved more than 70,000 lives. We know that people are four times as likely to quit with support than without it. The important point that he makes is that two thirds of smokers start before they are 18, and that is why smoke-free legislation and other measures in recent health legislation will contribute to reducing the numbers of new recruits to the tobacco industry.

Social Care Reform

7. Mr. Mark Harper (Forest of Dean) (Con): When he plans to publish the Government's response to their consultation on the reform of social care. [300145]

The Secretary of State for Health (Andy Burnham): The consultation closed on 13 November. More than 28,000 responses have been received and 37 events held in all parts of the country. The Government's response to the consultation will be published in the new year.

Mr. Harper: I am grateful for that reply. The Secretary of State will know that all the options being consulted on, except for the one whereby everyone would pay for themselves, assume that the Government would take attendance allowance and disability living allowance from the over-65s and put them into a social care system, which would take away individual control. That move is opposed by every single organisation representing disabled people. When he publishes those consultation responses, will he listen to them and cancel that aspect of his social care plan?

Andy Burnham: The hon. Gentleman either has not read the Green Paper or has misunderstood it. The Minister of State, Department of Health, my hon. Friend the Member for Corby (Phil Hope), who has responsibility for care services, has said that the principle of individual budgets, introduced by this Government, would be the cornerstone of any national care service. That control over purchasing care would be replicated in and be at the heart of any new system.

This is an important debate which is at the forefront of many older and disabled people's minds. The unpleasant campaign that the Conservative party launched last week will frighten vulnerable people about their benefits with misleading claims about what will happen to them. I find it despicable.

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Tony Lloyd (Manchester, Central) (Lab): Does my right hon. Friend agree that when we are talking about people who are disadvantaged and vulnerable, and who have great fears about their future, playing party politics is disgraceful?

Andy Burnham: I entirely agree with my hon. Friend. It is utterly disgraceful. There were claims made last week that benefits would be taken away from elderly and disabled people and that some could lose "up to £60" a week. I do not know how the shadow Health Secretary can justify those claims when he knows them to be untrue. We have said clearly that in any new system people would be offered an equivalent level of support. The whole aim of this reform is to provide more support to vulnerable people, not less. It is because the Conservatives have such a threadbare response to these serious issues that they resort to scaremongering and frankly despicable tactics.

Mr. Andrew Lansley (South Cambridgeshire) (Con): Responding to the Green Paper, Age Concern said:

I agree with Age Concern. The Secretary of State seems to have been thrown into a panic by this subject. Why does he not simply get up now and say that the Government will reject any of the options in the Green Paper that depend on scrapping attendance allowance or disability living allowance for the over-65s?

Andy Burnham: I will get up and say what I have just said-that every person will get an equivalent level of support, and I have made that clear. The hon. Gentleman went to a press conference last week at which he suggested that money would be taken from those people. That destabilises, upsets and causes anxiety in some of the most vulnerable people in society, and for whose purposes? It is for the purposes of the Conservative party's election campaign. I find it beneath contempt, and we would do those people a greater service by having a proper debate on the issues.

NHS Governance

8. Mr. Graham Allen (Nottingham, North) (Lab): If he will bring forward proposals to involve more elected representatives in NHS governance structures at local and regional level. [300146]

The Minister of State, Department of Health (Phil Hope): There are many ways in which elected representatives can be involved in the NHS locally. These include opportunities for elected representatives to seek membership of primary care trusts and strategic health authority boards as non-voting members or non-executive directors. There is joint working by elected representatives, local authorities and primary care trusts in local strategic partnerships and, of course, there is the use of overview and scrutiny powers by local government.

Mr. Allen: When I want to discuss health matters with a directly elected person in this country, I cannot do it at either the local or regional level. The first person I come across who is directly elected is my hon. Friend, along with his capable colleagues on the Front Bench. Does he not think that that is going a bit too high up the
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pay grade? Can we not have people who are directly elected and capable at the local council and regional levels?

Phil Hope: I know that my hon. Friend plays a huge role in chairing his local strategic partnership, where he has locally elected representatives and members of the primary care trust sitting round the table talking about local needs and issues. However, I might also draw his attention to the new Regional Select Committees, which can hold regional health authorities to account for specific aspects of their performance. [ Interruption . ] And as you can hear from the noise, Mr. Speaker, the Opposition voted against those regional forms of accountability.

Lembit Öpik (Montgomeryshire) (LD): The hon. Member for Shrewsbury and Atcham (Daniel Kawczynski) and I have worked as locally elected representatives on his energetic campaign to prevent the movement of the accident and emergency unit from Shrewsbury hospital. We have now received assurances from the authorities at the hospital that the service will not be moved, but I do not understand what formal mechanism we would have under the current arrangements to object, especially bearing in mind that this is a cross-party issue. How would the Minister advise us to ensure that our constituents' concerns about any such move are formally registered, given the system that he has been outlining?

Phil Hope: I am not familiar with the hon. Gentleman's specific concern, but in general terms, decisions about reconfiguration, which is what I suspect he is talking about, are clinically led decisions, made by leading local clinicians determining what is in the best interests of patients and services in his constituency and those of his neighbours. I would hope that he, his constituents and other local bodies would make their representations in the normal way, but be guided by the clinicians, who I think probably know what is best for patients in their area.

Mr. Gordon Prentice (Pendle) (Lab): But are patients' voices being heard in the NHS, and what about these local involvement networks? What assessment has the Minister made of their effectiveness?

Phil Hope: The creation of LINks is an important additional form of accountability in the NHS locally, not only to local Members of Parliament and locally elected councillors but directly to service users and patients, who will have an opportunity through LINks to influence the pattern of service, including procurement, provision and quality.

Capital Funding (Hospital Trusts)

9. Mr. Peter Bone (Wellingborough) (Con): What mechanism is used to determine the allocation of capital funding to hospital trusts. [300147]

The Minister of State, Department of Health (Mr. Mike O'Brien): Capital allocations to hospital trusts are determined by local need and subject to local and national affordability.

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Mr. Bone: Wellingborough is a fast-expanding constituency, with thousands of new homes being built. It has no hospital, and now this discredited Government are closing the hospital out-patient facility. In the neighbouring, highly marginal Labour constituency of Corby, a new hospital and a new out-patient facility are being built. Are this Labour Government buying votes?

Mr. O'Brien: I thought the hon. Gentleman's party was fully in favour of foundation trusts. Kettering general hospital foundation trust wants to build a new unit at Irthlingborough, which is 2.7 miles from the current Rushden clinic that he is talking about. Through its overview and scrutiny committee, Conservative-controlled Northamptonshire county council decided that the move did not need consultation, because it was not a substantial change.

Mr. Geoffrey Robinson (Coventry, North-West) (Lab): Given the terrific importance of abolishing car parking charges, about which the Secretary of State made such important announcements a couple of years ago, will my right hon. and learned Friend look into the possibility of appropriating those car parks into the capital structure and capital allowances of hospitals, thereby not imposing that revenue drain on them?

Mr. O'Brien: I shall of course look into the point that my hon. Friend makes, but I have to say this. We want to ensure, as far as finances allow, that patients and those who visit them can get a permit for free car parking in due course. I will look into the point he makes, but our policy is to move towards patients getting that free car parking in due course.

Alternative Medicine (Regulation)

10. David Tredinnick (Bosworth) (Con): What progress has been made on the regulation of herbal medicine, acupuncture and traditional Chinese medicine; and if he will make a statement. [300148]

The Minister of State, Department of Health (Gillian Merron): The consultation on whether-and if so, how-to regulate practitioners of acupuncture, herbal medicine and traditional Chinese medicine closed on 16 November 2009. We are considering our response to the consultation, and it will be published next year.

David Tredinnick: Is the Minister aware that the qualified practitioners at the Hydes Herbal Clinic on London road in Leicester-the oldest and largest such clinic operating in this country-want statutory regulation to interface with European legislation as quickly as possible? Will she guarantee that the clinic will still be able to treat, and to prescribe and prepare its own herbs?

Gillian Merron: I thank the hon. Gentleman for making that point. We have had some 5,000 responses to the consultation, which I welcome. We will move as quickly as possible, and, when taking our decision, we will balance public safety with the risks involved, and look at the principles of better regulation in deciding whether any action would be transparent, accountable, proportionate, consistent and targeted only where action was needed.

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Mental Health Services

11. Paul Holmes (Chesterfield) (LD): What steps his Department is taking to improve the level of access to mental health services. [300149]

The Minister of State, Department of Health (Phil Hope): As a result of nine consecutive years of increased spending, access to mental health services has never been higher. Many more staff, more community mental health services and increased access to psychological therapies have transformed services since 1997. Our vision for the future of mental health services and wider public mental well-being, which we are calling New Horizons, will be published shortly and will build on these remarkable achievements.

Paul Holmes: Lord Layard's report recently revealed that there are more mentally ill people on incapacity benefit than there are unemployed people on all benefits put together. One in four people will have a mental illness at some stage during their life. However, the 18-week waiting time target applies only to physical ailments, not to mental illness. Why do the Government treat mental health problems as a Cinderella subject, especially when the new NHS constitution states:

Phil Hope: I am pleased to be able to tell the hon. Gentleman that Cinderella has come to the ball. We have increased investment in mental health services by 50 per cent.-£2 billion-since 2001. We have more consultant psychiatrists, more clinical psychologists and more mental health nurses. That investment in the extra services means that individuals will be able to access the mental health services that they need, not least the psychological therapies that we are rolling out across the country, investment in which will rise to a total of £173 million by 2010-11.

Dr. Brian Iddon (Bolton, South-East) (Lab): During the passage of the Mental Health Act 2007, there were many discussions about providing places of safety, other than police stations, to which seriously mentally ill people could be taken. Has any progress been made on that, please?

Phil Hope: Providing such places of safety for people outside police custody has been an important part of developing mental health services for the future, and we continue to drive forward progress in that area. If my hon. Friend has a particular issue in his constituency, I ask him please to write to me and I will be happy to take the matter forward with him.

Anne Milton (Guildford) (Con): The Government predicted that the number of community treatment orders needed in the first year of the Mental Health Act 2007 would be 600 to 800, yet in the past year there have been 4,000. That was therefore a gross under-prediction. Will the Minister investigate the impact of this massive under-prediction on the thousands of vulnerable people without sufficient safeguards in place and without sufficient support in the community?

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Phil Hope: I do not recognise the hon. Lady's description of those services. It is true to say that there has been use of community treatment orders, but those orders can be made only when a clinician has made a decision that that is the safe and right thing to do, that there is support in the community, and that the individual can be recalled if necessary. That has happened on a number of occasions. I believe that the Mental Health Act has been a success, and that these new orders have provided new opportunities to treat people safely in the community and to keep the community safe.

Independent Sector Treatment Centres

12. Greg Mulholland (Leeds, North-West) (LD): What assessment he has made of the use made by the NHS of services commissioned from independent sector treatment centres. [300150]

The Minister of State, Department of Health (Mr. Mike O'Brien): Independent sector treatment centres have treated more than 2 million NHS patients and helped to reduce waiting times and improve patient choice.

Greg Mulholland: The Care Quality Commission carried out a report on the Eccleshill treatment centre in Bradford at the request of the coroner after the death of my constituent, John Hubley, in 2007. A freedom of information request has shown that in January this year, the centre still did not have adequate risk-management procedures or responses to emergency surgical situations. When can we finally have a debate about NHS use of such facilities? Is it right to send patients there when safety procedures are not adequate?

Mr. O'Brien: Debates are a matter for the usual channels. We of course extend our condolences to the family of Dr. John Hubley. The coroner stated that he was satisfied that there was no ongoing system failure at the Eccleshill treatment centre. The Care Quality Commission has looked into this and will continue to monitor it to ensure that quality standards are met, but 96 per cent. of patients who use ISTCs have recorded either excellent or very good quality services.

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