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House of Commons

Tuesday 12 January 2010

The House met at half-past Two o'clock


[Mr. Speaker in the Chair]

Oral Answers to Questions


The Secretary of State was asked-

Dentistry (Shropshire)

1. Daniel Kawczynski (Shrewsbury and Atcham) (Con): What plans there are to improve NHS dental provision in Shropshire. [310016]

The Parliamentary Under-Secretary of State for Health (Ann Keen): The Department has invested a record £2 billion in dentistry and set up a national access programme to help the national health service deliver its commitment to providing, by 2011, access for all who seek it. It is, of course, the responsibility of Shropshire County primary care trust to plan and develop appropriate services, including dental services, to meet the needs of its resident population.

Daniel Kawczynski: I thank the Minister for that answer, but I must tell her that my experience of trying to find an NHS dentist in Shrewsbury for myself and my family has been an absolute nightmare. Can she provide me with a list of NHS dentists in Shrewsbury and Atcham that are currently taking on patients, so that I can share that with my constituents?

Ann Keen: I am sorry that the hon. Gentleman and his family were troubled with uncomfortable dental pain at some time, but I know that he accessed the advice line and that he was assisted. I would be happy to talk outside the Chamber about any particular points that he wants to make on that. Of course, access to NHS dentistry has grown in Shropshire. Over the past 12 months the number of people who have seen an NHS dentist has risen by more than 11,000. I am aware that the PCT is tendering three new contracts-in Market Drayton, Oswestry and Bridgnorth-which are due to start in April 2010, and a new contract was tendered in 2006 for Shrewsbury as a high-priority area.

Trafficked Women

2. Mr. Anthony Steen (Totnes) (Con): What recent representations the health taskforce on violence against women and girls has received on the role and response of health services in respect of trafficked people. [310017]

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The Parliamentary Under-Secretary of State for Health (Ann Keen): The taskforce has heard evidence from many groups representing women and children who are victims of all forms of violence, including trafficking. The taskforce on the health aspects of violence against women and girls, chaired by Sir George Alberti, is currently considering the report and the recommendations of the sub-group on harmful traditional practices and trafficking, which it established for that purpose.

Mr. Steen: Is the Minister aware that many trafficked women display multiple problems, both physical and mental, and that when they go to accident and emergency units in hospitals, as well as to general practitioners, they are not readily identified as trafficked women, but viewed as victims of violence? Will she therefore consider whether we could improve training for both GPs and hospital staff, so that when they actually meet battered or mentally disturbed women who have been trafficked, they recognise that, rather than seeing them simply as victims of violence?

Ann Keen: First, I am sure the whole House congratulates the hon. Gentleman on his work with the all-party group. He has been such a force for good, and not only in our own country: he has often visited other European countries to see what is happening.

I know that Devon black and minority ethnic community development workers engage with vulnerable communities, but the taskforce is such an important one and the questions are so relevant. The training that health care workers receive for meeting difficult situations will be covered in Sir George Alberti's report, which we expect to be published in early February. A specific training mandate will, I feel, be put in place from those recommendations.

Alan Simpson (Nottingham, South) (Lab): I doubt whether anyone can match the hon. Member for Totnes (Mr. Steen) for the work he has done on this issue, but my limited experience of it prompts me to ask whether the interface that trafficked women have with health services in the voluntary sector can be assisted by overcoming the linguistic barriers, which are part of the problem. In many cases there is a heavy dependence on people who are themselves part of refugee communities to act as translators. Often, they have real difficulties facing the Home Office when addressing their own problems regarding deportation. Will the Minister ask for a coherent interface between key workers and those within the refugee communities in that process, to ease the problems that those women face?

Ann Keen: My hon. Friend raises some more excellent points. Those areas are covered by the research and the report's findings, and we are working across Government with other Ministers, particularly Home Office Ministers, to address that very point.

NHS Funding

3. Dr. Roberta Blackman-Woods (City of Durham) (Lab): What account is taken of relative levels of deprivation in determining NHS resource allocations. [310018]

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The Secretary of State for Health (Andy Burnham): Deprivation is accounted for in the NHS funding formula, which reflects both deprived and older populations' greater need for health care. An additional health inequalities component in the formula directs funding to the places with the worst health outcomes, targeting health inequalities better than ever before.

Dr. Blackman-Woods: Can the Secretary of State tell the House whether he has any further plans to try to reduce health inequalities by targeting resources further towards the most deprived areas of the country? Does he agree that the Opposition's premium pledge is just a sham, because the policy is already being implemented by the Government?

Andy Burnham: I can say to my hon. Friend that next year County Durham PCT will receive £1,800 per head of population, £200 more than the England average, reflecting the fact that there are higher levels of disease and deprivation in her local community. Obviously that has been a component of the formula since 1999. The Advisory Committee on Resource Allocation in the NHS keeps the matter under review, and it says that the decision is an interim step to give more money to tackle health inequalities. We keep the matter under review, and I can advise my hon. Friend that Professor Marmot will shortly give us his report on further action to tackle health inequalities, which we shall consider in due course.

Philip Davies (Shipley) (Con): Surely the purpose of the NHS is simply to treat individuals, wherever they happen to live around the country, with the treatment that they need to deal with their particular problems. Will the Secretary of State confirm that all health spending will be given on that basis, and that basis alone, rather than basing it on the socio-economic environment in which an individual lives?

Andy Burnham: I am told that there is a general election not too far off. May I respectfully point out to the hon. Gentleman that it might help him to read his party's draft manifesto from last week, which included the commitment to

He is going to be standing on that manifesto in a few months, so he had better read it-and pretty quickly, I would say.

Mr. Kevin Barron (Rother Valley) (Lab): Can my right hon. Friend tell us what the level of resources per head was 10 years ago?

Andy Burnham: I can say to the Chairman of the Select Committee on Health that the England average next year will be £1,600 per head of population. Turning the clock back 10 years, we see that it used to be £426 per head of population. That figure demonstrates the change that this country voted for when it elected a Labour Government. The country was saying, "Our NHS needs to be put back on its feet. We need to invest in it to give people in all parts of the country the best possible health care." In that figure alone we can see the difference that this Labour Government have made.

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Norman Lamb (North Norfolk) (LD): The Secretary of State will be aware that GP practices in deprived communities lose out financially and that there are 18 per cent. fewer GPs working in poorer communities. He will also be aware that the Health Committee heard evidence of the failure of the incentive scheme for payments to GPs to do anything effective about health inequalities. There is evidence supporting the call for radical action to change the way in which the qualities and outcomes framework works. When will the Government take action to change the current completely unacceptable situation, whereby GPs in richer areas are paid better than those in poorer communities?

Andy Burnham: Of course we keep such matters under review at all times. However, the funding formula for general practice contains a minimum practice income guarantee, which protects precisely those practices to which the hon. Gentleman referred. I would also point him towards the respected international Commonwealth Fund, which late last year published a comparison of primary care in the 12 most developed countries around the world. It is a source of huge pride to me and to every Member on the Government Front Bench-indeed, to every Member on the Labour Benches-that primary care under this Labour Government is the envy of the world.

Mr. Parmjit Dhanda (Gloucester) (Lab): Is my right hon. Friend aware that the alternative formula that was put forward in this Chamber three years ago by the hon. Member for South Cambridgeshire (Mr. Lansley) would reduce the funding going to our local NHS in Gloucestershire by £109 for every man, woman and child who lives there? Will my right hon. Friend resist that 9 per cent. cut to our local NHS?

Andy Burnham: What I would say to my hon. Friend is that we have sat in the House over the past five years of this Parliament and heard every member of the shadow health team criticise the Government for allocating more resources to communities with higher health needs and more deprivation. So when we read what the Opposition's policy in their draft manifesto is, I do not know how they have the brass neck to sit there today and look as though it was always their policy: it beggars belief. The Opposition need to spell out which PCTs will win and which will lose under the new policy. I suspect that my hon. Friend's PCT might lose from a policy that gave more money to deprivation, on top of what we give such communities today.

Mr. Andrew Lansley (South Cambridgeshire) (Con): May I just say how much we will miss David Taylor at our Health questions and health debates? He was always here, and always had good insights and real commitment to the national health service. He will be much missed, as he was a good colleague to us all.

Will the Secretary of State confirm that patients should be able to expect equivalent access to treatment from the NHS wherever they are in the country? Will he explain why in his Leigh constituency, the NHS spends over 40 per cent. more on cancer services per cancer patient than it does in my constituency?

Andy Burnham: I would like to begin by echoing the shadow Health Secretary's remarks about David Taylor, who was a regular attender at Health questions and
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health debates; I am sure that his voice will be sorely and genuinely missed by Members on all sides of the House.

The answer to the hon. Gentleman's question is that my constituency has more deprivation and ill health than his does, and that is picked up in the funding formula. I am amazed that the hon. Gentleman is asking this question when his manifesto of last week said in terms that his party will adopt precisely the same policy-so how can he stand at the Dispatch Box and criticise the fact that my constituency of Leigh, a former mining area, receives more for its greater health needs?

Mr. Lansley: The Secretary of State just doesn't get it. I was quoting the figures on the amount spent by the NHS in each of those areas per cancer patient-not the overall allocation between the areas, but the amounts spent per cancer patient. Let me give him another example. Perhaps he can explain why, although higher NHS allocations go to more deprived areas, the money is spent on responding to the consequences of ill health rather than on preventing disease, which is the reason why it is allocated. Why is there one hospital bed for every 245 people in the north-east of England, but one bed for every 408 people in South Central?

Andy Burnham: I am genuinely confused, because for five years, from his side of the Dispatch Box, the hon. Gentleman has accused us of spending too much money in constituencies such as mine. The reason why my area can spend more on cancer is that, historically, smoking has been higher in the constituency. It was the hon. Gentleman's manifesto of last week that said that the Conservatives would weight public health funding so that more went to deprived areas. So he would give my constituency more money than it gets today-yet every one of the Conservative Front-Bench team has criticised our funding plans. The hon. Gentleman should either accept the situation today and tell us which primary care trusts will get more and which will get less, or realise that his policy will have no credibility whatever.

Mr. Lansley: He still doesn't get it, does he? Will he explain why the local PCT in his constituency presently spends £39 a head on its management costs but just £31 a head on its healthy individuals programme, which is preventive spend. That is the point; this is about prevention. What is needed is higher public health budgets for the areas with the poorest health: less bureaucracy, more prevention-that is our health premium. Will he not just accept that we need real help to reduce health inequalities through preventive health care-because we can't go on like this?

Andy Burnham: It is our policy to allow local PCTs to decide where they spend the money on the areas that they think will have the most impact, whether that be prevention or cancer. For the last five years the hon. Gentleman has accused me of giving too much money to those areas, and now he has completely abandoned that pledge. It would appear that it is not him but his party leader who is now writing his shadow health policy. Let me tell the hon. Gentleman, who sits there and gives out the orders, that he has had his policy on single rooms dropped, and he has had his policy on health resources dropped, so why does he not book himself-

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Mr. Speaker: Order. I am extremely grateful to the Secretary of State, and I know that he wants to say something about other parties' policies, but he must now focus exclusively upon his own.

Ms Dari Taylor (Stockton, South) (Lab): My right hon. Friend will know that my constituency has had significantly increased funds. None the less, we have very high death rates from heart problems and cancer in low-income wards. How can we manage that situation? What education and community programmes are there to help people in low-income families understand the serious dangers from smoking and poor nutrition?

Andy Burnham: My hon. Friend is right. We need to give the resources to areas such as hers so that they can spend them on smoking cessation programmes and improving access to primary care. Research has shown that communities of that kind benefit greatly from improved primary care, and also that national targets have played an important role in improving health outcomes in the most deprived communities. I assure my hon. Friend that that will remain a central tenet of this Government's health policy.

Mental Health

4. Dr. Julian Lewis (New Forest, East) (Con): What recent assessment he has made of the effectiveness of psychiatric intensive care units in the provision of mental health care. [310019]I note that the Minister of State is to answer this question, which will give the Secretary of State a chance to calm down.

The Minister of State, Department of Health (Phil Hope): Acute care services, including psychiatric intensive care units, remain an essential component of the Government's drive to improve and modernise our mental health services. Moreover, as a result of nine consecutive years of increased mental health spending, more people with acute mental health problems are being treated in the community than ever before.

Dr. Lewis: I give the Government full credit for the creation of the psychiatric intensive care unit at Woodhaven hospital in my constituency. That is why I am so concerned about the fact that it has been "temporarily" closed for the last three months. Six patients from the New Forest who are in desperate need of its assistance have been farmed out to Havant and Basingstoke. May I appeal once more to the Minister to intervene to ensure that Ellingham ward at Woodhaven is reopened as soon as possible?

Phil Hope: The hon. Gentleman has raised this matter with me before, both at Question Time and during debates in Westminster Hall. Since our debate last October, Hampshire Partnership NHS Foundation Trust and Hampshire primary care trust have established an independent review panel to examine their proposals to change services provided by the psychiatric intensive care unit. An updated report will be sent to the Hampshire health overview and scrutiny committee on 26 January, and the full report will be completed within a month. The independent review will be conducted by a panel of experts, including an independent consultant psychiatrist and an independent director of nursing.

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I hope that that reassures the hon. Gentleman that his concerns are being heard, that action is being taken and that an independent review will ensure that we secure the best possible outcome for patients, based on a clinical assessment of their needs.

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