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The Minister of State, Department of Health (Mr. Mike O'Brien): As my right hon. Friend the Secretary of State has said, deprivation is a key feature of the NHS funding formula, which reflects both deprived and older people's needs in health care. We are clear that we want to ensure that that remains part of the formula.
Ms Keeble: I am grateful to my right hon. and learned Friend for that answer. I wanted to ask him further about the deprivation experienced by pensioners in the community in view of the very tragic deaths of two of my constituents, Derek and Jean Randall, in quite appalling circumstances. In view of my lack of confidence in some of our local arrangements, will he ensure that his Department has very careful national oversight of the local review of the case that is going to take place? Will he ensure that any lessons that can be learned that apply nationally are rolled out and applied nationally to ensure that no one else has to endure something like this? It is completely inappropriate in 21st century Britain that pensioners should experience such ordeals and should die such very tragic deaths.
Mr. O'Brien: My hon. Friend is right. The case of Derek and Jean Randall is deeply tragic and we need to ensure that it is fully and properly investigated. I understand that a local multi-agency safeguarding board is undertaking a serious case review. I cannot comment until all the details are available-I have only read the front page of the Daily Mail today, and it certainly seems a very worrying case. I want to ensure that this is fully investigated and that the results of the investigation are open. We will take a keen interest in the outcome and we want to ensure that any lessons that need to be learned are learned and that this sort of thing does not happen in the future.
Sir Nicholas Winterton (Macclesfield) (Con): Will the Minister tell the House whether the level of deprivation featured in the decision of the Department of Health to end the reciprocal health agreement with the Government of the Isle of Man? That agreement, which has been in place since 1948, is to be ended on 1 April this year. This is a very serious matter. May I have an answer?
Mr. O'Brien: My right hon. Friend the Secretary of State will be meeting the Manx Minister in due course. We are not minded to change our policy on this. We take the view that our approach is the right one, and we will see what the outcomes are of the discussions with the Isle of Man.
The Minister of State, Department of Health (Gillian Merron): Independent pharmacies play an important and valuable role in providing pharmaceutical services. The NHS pharmaceutical services regulations treat all providers equally and there are no plans to change this.
Mr. Allen: After a powerful campaign by the local community in my constituency, we were able to keep open Mr. Mistry's pharmacy, a local community pharmacy in my constituency, and Tesco withdrew its application to have an in-house pharmacy nearby. That is a good outcome for everyone in the community, but will the Department pull together some of the big supermarkets and the representatives of the pharmacy associations to discuss a sensible way forward so that such battles do not take place and local communities keep effective pharmacy services?
Gillian Merron: Pharmacists such as Mr. Mistry and many others up and down the country provide an excellent service to their local community, and my hon. Friend is quite right to campaign for a vibrant and diverse range of pharmacies. The truth is that the public value and use a range of provisions from supermarkets through to local pharmacies. Perhaps we can look to the provisions of the Health Act 2009, which will mean that the local NHS will be able to assess local needs and to meet them.
Hywel Williams (Caernarfon) (PC): Does the Minister accept that there is a particular problem in rural areas, where the predatory practices of supermarkets might lead to the closure of pharmacies, depriving large geographical areas that are thinly populated? Will she take some steps specifically in that case?
Gillian Merron: The provisions of the Health Act will mean that the local NHS will be able to assess local needs, to fill the gaps and to monitor quality better. This is all about being driven more by the needs of the patient, whether they are in rural or urban areas, than by those of the provider of the services, as is the case at present. It is important to say that the supermarket sector provides some 5 per cent. of the market, whereas the larger contractors-such as Boots, the Co-op and Lloyds pharmacy-provide something like one third. There is no evidence that supermarkets are driving the smaller operator out of business.
The Minister of State, Department of Health (Mr. Mike O'Brien): Information on ambulance turnaround times is not collected by the Department, so in a sense we do not have that information. There is quite a wide range of data in relation to how long people get for lunchtimes and so on. We do, of course, keep response times and that sort of data.
Does the Minister agree with Unison that the new eight-minute target for ambulance response times could put patient lives at risk by forcing ambulance
crews to go from two to one? Would it not be better to find a bottom-up solution and force ambulance trusts to publish their data on websites so that the public could see individual ambulance response times?
Mr. O'Brien: We certainly take the view that improving the response times of ambulances is very important. That is why the new response times have been put in-to take away the period of time for the call, which was one of the issues causing delays. In the past, the clock did not start ticking until after the call was put through, whereas we now include the time from the point at which the call is made. That is a better reflection of the standard of service that patients get. As for publishing every ambulance time, I think that might be somewhat bureaucratic, but information can now be provided in general terms about average ambulance times.
The Secretary of State for Health (Andy Burnham): Today, Sir Michael Parkinson has published his report on his year as the national dignity ambassador. I thank him on behalf of the Government for the time that he has given to raising awareness of the issues that affect us all and for the personal insight that he has brought to considering how we can improve care for older people. The fact that there are now 12,000 dignity champions working at a local level illustrates the difference that Sir Michael has made, and we will look to build on that.
As the cold weather continues, staff across the NHS, particularly ambulance services and accident and emergency staff, have been working extremely hard to minimise the impact on patients. Although it is under greater pressure, I can tell the House that the NHS in all parts of the country is coping well. I am sure that Members on both sides of the House will want to join me in thanking health and social care staff for their efforts to help to protect vulnerable people at this time.
Mr. Robertson: I certainly endorse the last part of the Secretary of State's comments. May I bring to his attention the rather long waiting list that people who suffer from acute back pain have to go through before they see a consultant? As a long-standing and regular sufferer myself, I know that it is no laughing matter. The waiting time is such that if the problem is serious, it can progress a great deal in that time. If it is a less serious problem, it will no doubt have corrected itself in that time. Whichever situation applies, the waiting time is far too long. Can the Government do anything about that?
The Parliamentary Under-Secretary of State for Health (Ann Keen): The hon. Gentleman is right to say that back pain creates many problems, not just for the people involved but for the economy in general. That is why we now have a system of self-referral to a physiotherapist. I believe that all patients should have that right. We will also be looking at the development in the chief medical officer's recent report on pain clinics and how chronic pain is managed, including how chronic and acute back problems can be managed.
T4.  Hugh Bayley (City of York) (Lab): In 1997, there were 284,000 people waiting more than six months for NHS treatment. What is the figure today, and what are the Government doing to prevent the situation from sliding back to the bad old days when the Conservatives were in power?
The Minister of State, Department of Health (Mr. Mike O'Brien): My hon. Friend is quite right: we must prevent a drift back to the bad old days. In his area, Yorkshire and Humberside, in 1997, there were 26,719 people waiting more than 26 weeks. In November-these are the latest figures I have-the number was zero, so nobody was waiting. Whereas we will lock in that achievement as a right, the Conservative party would remove the guarantee. The Conservatives will have to explain to the public why they would do that.
T2.  Dr. Evan Harris (Oxford, West and Abingdon) (LD): This morning, I faxed to the Public Health Minister's office some documents provided to me by the investigative journalist Jane Symons. Those documents show that the Human Fertilisation and Embryology Authority has not only spent millions of pounds pursuing, ultimately failingly, an individual clinician, but that the new chief executive who was brought in to sort out the problem had argued for an externally led inquiry last year. Why has that inquiry not happened? Does the Minister have any proposals to ensure that we know why millions of pounds of taxpayers' money was wasted in that way?
The Minister of State, Department of Health (Gillian Merron): I am grateful to the hon. Gentleman for his courtesy in forwarding the documents, but I remain of the view that it would not be in the public interest to pursue an inquiry. There have been a number of significant changes at the authority since the time of the incidents covered in the memo, which I would be happy to write to him about. However, the interim chief executive has acknowledged that the authority is not free from criticism, and there is to be an internal governance review to consider all these issues.
T5.  Mr. Brian Jenkins (Tamworth) (Lab): Given the very harsh winter that we are suffering at present, I have no doubt that my right hon. and learned Friend the Minister of State will recall the annual winter crises that we used to have more than a decade ago. People-mainly elderly people-were lying on trolleys in our hospitals for days before they died, after which their bodies were stuffed in refrigerated vans outside. What can he do to assure me that those crises will never return to this country, and how do we manage to cure that problem?
Mr. Mike O'Brien: Elderly people are of course now able to benefit from flu jabs, winter fuel payments, pension credits and, when it gets very cold, cold weather payments. In 1997, the NHS spent £426 per person on health, but today it spends £1,612. Whereas the Tories were frozen in the ice of their own indifference to older people, this Government actually care.
T3.  Mr. Andrew Pelling (Croydon, Central) (Ind):
Will the Minister match the very helpful answer that I had from the Minister of State at the Department for Transport on Thursday about how that Department
and the Department of Health have been working closely together to provide the preventive medicine of road gritting, so that hospitals receive fewer people with fractures? In Croydon's Mayday hospital, fractures are currently up 40 per cent., but at the beginning of the crisis they were up 316 per cent.
Mr. O'Brien: It is certainly the case that we need to ensure that the NHS works with local authorities to make sure that ambulances can get through, that ambulance crews can get to their ambulances, and also that the service is geared up to deal with the various problems arising from the recent very bad weather. We need to make sure that the various bodies work together, and the information that we have so far suggests that they are doing so.
T9.  Tom Levitt (High Peak) (Lab): The Autism Act 2009 was a great success for Back Benchers across the House, in co-operation with a caring and receptive Government. It calls for the autism strategy for helping adults with autism and Asperger's syndrome to be published. Will my hon. Friend the Minister of State make sure that it is published before we are diverted by other matters a little later in the year?
The Minister of State, Department of Health (Phil Hope): I am grateful to my hon. Friend for his comments. The 2009 Act was a landmark piece of legislation, which was passed on a cross-party basis. I can reassure him that the autism strategy is due to be published before 1 April this year. Discussions on the strategy are going on as we speak. Indeed, the external reference group that has been advising us on it-and which involves service users, family carers, voluntary organisations, professionals and so on-met only today to consider its contents. The strategy will be backed up by a clear delivery plan, and further guidance for health and social care providers later this year. So yes, the Government are going to deliver on autism.
Andy Burnham: I recognise that the public mood is changing when it comes to alcohol-not just binge drinking, but the general intake of alcohol by the wider population. There is rising public concern, as reflected in last week's report from the Health Committee. The hon. Gentleman will remember the report on obesity that was published when I used to serve on the Committee with him. That report changed the nature of the debate, and it is possible that last week's report will come to do the same. We are looking at the next steps on tackling alcohol, and considering the consultation on the mandatory code and the measures to combat the irresponsible promotion of alcohol. We are also considering going further on labelling, but of course I remain open to further discussions with him and the Committee on how we may go even further.
Andrew Mackinlay (Thurrock) (Lab): I thank the Secretary of State for agreeing to meet the Chief Minister of the Isle of Man about the future of the reciprocal health agreement. Will he get his officials to look particularly at the impact that that decision could have on his and my constituents who are TT enthusiasts-motorcyclists-and the impact that it would have on NHS North West if the Isle of Man took its elective surgery purchases away from there to Edinburgh, Belfast or Dublin?
Andy Burnham: As the Minister of State, my right hon. and learned Friend the Member for North Warwickshire (Mr. O'Brien), mentioned a moment ago, I have agreed to meet the Manx Health Minister to discuss these issues. As a north-west MP, I know that the island has a long-standing relationship with the north-west of England and its health service, and I will commission the work that my hon. Friend mentions on the potential effect of purchasing being switched. I am not minded at present to change our position but I will, of course, listen to what the Minister has to say.
T7.  Tom Brake (Carshalton and Wallington) (LD): I thank the Minister of State, the right hon. and learned Member for North Warwickshire (Mr. O'Brien), for his support for the Better Healthcare Closer to Home project so far. Is the Department on track to complete the review of the project by the end of this month, and is the Treasury ready to pick up the baton immediately afterwards?
Mr. Mike O'Brien: We want to move the project on as fast as we reasonably can, and we hope to be able to get things sorted through by the end of the month. Let us remember that there are some local decisions to be made over which we do not have entire control, but the objective is to get the project moving.
Alison Seabeck (Plymouth, Devonport) (Lab): Has my right hon. and learned Friend received any recent requests from the Ministry of Justice for up-to-date estimates of the increase in the number of secondary pleural plaques in order to enable it to come to a decision on a compensation package?
Mr. O'Brien: My hon. Friend has indicated that she wants to ensure that we are working with the Ministry of Justice on the matter. I assure her that we will be in regular contact in future with the Ministry of Justice to develop the Government's strategy as a whole in relation to pleural plaques.
T8.  Mr. Paul Burstow (Sutton and Cheam) (LD): I strongly endorse the question asked by my hon. Friend the Member for Carshalton and Wallington (Tom Brake), but may I ask the Minister about another matter, which is related to autism, which has been raised already? Eight out of 10 GPs confirm that they feel they need more training so that they can better understand autism and care for the condition better. What will the Government do to ensure that there are sufficient resources, will and determination to deliver that extra training?
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