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14. Vernon Coaker (Gedling) (Lab): What his policy is on provision of healthcare services to those with autism. [4472]

The Minister of State, Department of Health (Mr Paul Burstow): We are committed to addressing the health care needs of people with autism and are fully supportive of "Fulfilling and rewarding lives: the strategy for adults with autism in England". Consultation on statutory guidance for health and social care bodies to support the strategy will begin shortly.

Vernon Coaker: May I thank the Minister for that reply? We have all been inspired by the parents of children with autism. One thing that they depend on perhaps more than anything is respite care. That provision has improved in the past few years, but with the pressure on budgets, will the Minister do all he can to ensure that respite care does not become an easy target for cuts, given the importance of the service to parents of children with autism?

Mr Burstow: I am very grateful to the hon. Gentleman for that question. He is right; carers are a valuable and valued resource. They make an incredible difference to the quality of life of the people for whom they care. The Government are determined, as we have outlined in the coalition programme for government, to develop respite services further and make them available through direct payments for those people.

Paul Maynard (Blackpool North and Cleveleys) (Con): Given the success of central Government in persuading child and adolescent mental health services to take the needs of those with learning difficulties more seriously,
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will the Minister commit to doing the same for those with autism, given that only 11% of CAMHS have specialist provision? Will he make a commitment to do the same thing for those with autism, please?

Mr Burstow: The hon. Gentleman makes an excellent point. We shall be getting some guidance from the National Institute for Health and Clinical Excellence in a year's time, and absolutely the answer is yes.

Barbara Keeley (Worsley and Eccles South) (Lab): May I congratulate the Minister on his new role. As my hon. Friend the Member for Gedling (Vernon Coaker) mentioned, carers of people with autism rely on respite care. However, carers organisations are reporting that cuts to local authority funding are already leading to cuts in funding for charities and other providers of support care. How do the Government plan to deliver the promised increase in access to respite care through improved community support provision, when that is already starting to fall away?

Mr Burstow: The hon. Lady makes an important point, but perhaps she will be a little cautious with her question, not least because the previous Government made a lot of promises to carers in respect of the amounts of money that were to be invested, only for carers to find that on the ground the money was not delivering changes in services. So this Government are determined to ensure that we not only make promises but deliver on them. That is the commitment that this Government have made.

Warrington Hospital

15. Helen Jones (Warrington North) (Lab): What percentage of patients at Warrington Hospital were treated within 18 weeks of referral in the last 12 months for which figures are available. [4473]

The Minister of State, Department of Health (Mr Simon Burns): At the Warrington and Halton Hospitals NHS Foundation Trust, in the 12 months up to April 2010, 93.2% of patients admitted to hospital for treatment and 97.8% of patients whose treatment did not require admission to hospital waited 18 weeks or less from referral.

Helen Jones: I am grateful to the Minister for that reply. What percentage of patients does the Minister now believe will be treated within 18 weeks, and which people exactly does he think deserve to wait longer than that?

Mr Burns: May I reassure the hon. Lady that in my lexicon no one "deserves" to wait longer. What I want, and my right hon. and hon. Friends want, is a first-class health service that makes decisions based on clinical reasoning and gives treatment swiftly and relevantly to those who need it. My right hon. Friend the Secretary of State has made some changes to some of the targets to ensure that clinicians and clinical decisions dominate, not political decisions by politicians and bureaucrats.

Long-term Care

16. Stephen Twigg (Liverpool, West Derby) (Lab/Co-op): What progress he has made on establishing his proposed commission on funding long-term care; and if he will make a statement. [4474]

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The Minister of State, Department of Health (Mr Paul Burstow): The coalition agreement sets out our plans to establish an independent commission, which will consider how we ensure responsible and sustainable funding for long-term care. Further details on the commission will be announced shortly.

Stephen Twigg: I am grateful to the Minister for his response. Can he assure us that when the commission is established it will consider all options for funding long-term care, including a compulsory inheritance levy?

Mr Burstow: The Government's intention is not to fetter the commission but to allow it to do its job.


17. Philip Davies (Shipley) (Con): What recent representations he has received on the appropriateness of the remit of the National Institute for Health and Clinical Excellence; and if he will make a statement. [4475]

The Secretary of State for Health (Mr Andrew Lansley): Since 7 May, the Department has received about 120 representations from hon. Members, noble Lords and members of the public on a range of issues concerning the National Institute for Health and Clinical Excellence, including its remit.

Philip Davies: May I urge the Secretary of State to get NICE to go back to what most people think it is for, which is monitoring the cost-effectiveness and clinical effectiveness of drugs? Many people do not think that it does a particularly good job on that, anyway, but it is currently indulging in empire building, with its ridiculous drivel in recent weeks about smoking breath tests for pregnant women, compulsory sex education for five-year-olds and subsidies for food companies to make healthier food. Surely it ought to go back to what it should be doing, and do it better, rather than empire building, as it is doing.

Mr Lansley: In 2005 the previous Government charged NICE with producing public health guidance as part of its work. As I establish a more integrated and effective public health service, I shall consider how the advice of NICE fits into that strategic framework.

Topical Questions

T1. [4484] Mike Gapes (Ilford South) (Lab/Co-op): If he will make a statement on his departmental responsibilities.

The Secretary of State for Health (Mr Andrew Lansley): My responsibility is to lead the NHS in delivering improving health outcomes in England; to lead a public health service that improves the nation's health and reduces health inequalities; and to lead the reform of adult social care that supports and protects vulnerable people.

Mike Gapes: When the new Secretary of State intervened to stop the reorganisation of health services in London, he said that there would be no forced closures. Can he give me an unambiguous and categorical assurance that
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he will not allow the closure of the accident and emergency department, the children's surgery or the maternity services at King George hospital in Ilford? Yes or no?

Mr Lansley: The hon. Gentleman's question seems rather churlish, given that he wanted to stop the top-down configuration that NHS London imposed so that people in his area-GPs, the local authority, local people and patients-could have an opportunity themselves to decide how services might best be designed for local people. That is the pledge that I have made. Those criteria will enable that process to be led locally, rather than imposed and forced on people.

T4. [4487] Lorraine Fullbrook (South Ribble) (Con): St Catherine's hospice is used by many of my constituents, and they will be pleased to be able to go ahead with the hospice's planned improvements, which will be funded through the capital grants programme. Does the Secretary of State agree, however, that the excellent work of such hospices goes far beyond the hospice building? What will his Department do to ensure that hospices play a greater role in providing services to the local community?

Mr Lansley: I am very grateful to my hon. Friend, who will know that I entirely understand and applaud the work of St Catherine's hospice, because we have visited it together. She makes a very important point, because those whom I know in the hospice movement want to think not just about the service that they provide in their buildings, but about an holistic service for patients' families and for those who require palliative care. I might just say that on Saturday I made it clear that up to £30 million will be available in this financial year to support children's hospices, specifically, in extending their work so that they can provide a service in the community for children with life-limiting illnesses.

Andy Burnham (Leigh) (Lab): The right hon. Gentleman will remember our exchanges at the election hustings, where there was a real difference between us: we said that we would protect the NHS budget in real terms, and I stand by that commitment; the right hon. Gentleman said that he would increase the NHS budget. After last week's Budget, however, we now know the price of that commitment: 25% cuts to social care will mean vulnerable people either left without the support that they need or facing higher charges to pay for care, and huge pressure on carers. It means also that the NHS itself stops working, because it cannot discharge people from hospital when there is no support in the community. That unbalanced approach to public spending is dangerous and will decimate services on which the NHS depends. Is it not time to drop a pledge that had more to do with votes and nothing to do with people's lives?

Mr Lansley: So there we have it, Secretary of State. [Hon. Members: "Secretary of State?"] I meant "Mr Speaker"-you are far more elevated than a Secretary of State, Mr Speaker.

The shadow Secretary of State's belief is that the NHS budget should be cut. I fail to see how that could help social care. We are going to look much more positively at how we can join up the work of the NHS and social care. What my colleagues and I have announced on 30-day support for patients leaving hospital, including
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rehabilitation and re-ablement, will do precisely that, relieving some of the pressures on social care by seeing the NHS as a more holistic service for patients.

T5. [4488] Dr Julian Huppert (Cambridge) (LD): Does the Secretary of State accept the conclusions of the Science and Technology Committee's report "Evidence Check 2: Homeopathy"? Earlier, the Under-Secretary of State for Health, the hon. Member for Guildford (Anne Milton) gave a commitment to an evidence-based approach and today the British Medical Association passed a motion about homeopathy. Given the financial constraints in which we all share, can the Secretary of State defend spending millions of pounds of NHS money on methods that simply do not work?

The Parliamentary Under-Secretary of State for Health (Anne Milton): I thank the hon. Gentleman for his question. He obviously knows how much is spent on homeopathic treatments, although no one else seems to know exactly. The decisions should be taken by doctors locally, and the effectiveness, safety and efficacy of a treatment should be taken into account. The estimate is that 0.001% of the drugs bill is currently spent on such treatments. At present, we are looking at the Science and Technology Committee's report. We hope to respond to it before the summer recess.

T2. [4485] Toby Perkins (Chesterfield) (Lab): My right hon. Friend the shadow Secretary of State referred to the Commonwealth Fund report, which said that Britain's NHS was the most efficient. Does that not make it clear that after 13 years of a Labour Government, the NHS is not just so much better for patients, but efficient? To say that it is not is an insult to the people who have worked so hard to make it great.

Mr Lansley: I have looked at the reports of the Commonwealth Fund for a number of years; it regards the NHS as efficient because it spends relatively little in comparison with other health economies. In this country, we need to recognise that the NHS does not spend very much in comparison with other countries but it could spend it more efficiently. There has been declining productivity for 10 years. [Interruption.] The shadow Secretary of State needs to recognise that NHS management costs went up by 63% while nursing costs went up by just 27%. My colleagues and I are committed to halving NHS management costs and to reducing the costs of the NHS, through efficiency, by £20 billion. Every penny of that will be reinvested in meeting the rising demand for the NHS and the improvements in quality that we require.

T7. [4490] Duncan Hames (Chippenham) (LD): What encouragement is the Secretary of State giving to primary care trusts to restore minor injury services to towns such as Melksham in my constituency? It saw its minor injuries unit close under the last Government.

The Minister of State, Department of Health (Mr Simon Burns): I am very grateful to the hon. Gentleman for that question. It is up to local communities and local health providers to identify what they believe are the local needs of their communities and then go through the procedures, measures and mechanisms to seek to achieve what they want-in this case, that could be a new A and E. It is not for Ministers to promise such
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provision; there are proper procedures, from the local area upwards, for achieving such aims.

Several hon. Members rose -

Mr Speaker: Order. I have just had Members complaining that they cannot hear. The Minister must face the House. It is a very simple point; I have made it to others and they have understood it.

Jim Shannon (Strangford) (DUP): One of the concerns of a great many of us recently has been the availability of cancer care drugs. [Interruption.] Right across-right across, Mr Speaker, the whole United Kingdom, and Northern Ireland in particular, a great many people have not been able to access cancer care drugs and have had to endure sickness and illness without them. Can the Secretary of State assure the House today that cancer care drugs will be made available and that those who are ill and suffering from cancer can rest easy?

Mr Lansley: We have been very clear that it is a scandal that we have some of the finest cancer research anywhere in the world and some of the best cancer medicines have been developed in this country, yet in the past in this country NHS patients have often been the last to have access to those drugs. That is why at the election we made it clear that we will introduce from April next year a cancer drugs fund, the purpose of which will be to ensure that patients get access through the NHS to the cancer medicines that they need, on clinical recommendation and advice, and that they are not unduly delayed in getting that access.

T9. [4492] Julian Sturdy (York Outer) (Con): I am sure that the Secretary of State will remember visiting my constituency earlier in the year and listening to constituents' concerns about the withdrawal of spinal injections on the NHS. Given that the PCT's decision is set to become another example of the postcode lottery in the health service, will his Department consider the ongoing debate about spinal injections in York and support the attempts of my constituents as they seek to shape local health services around their specific needs?

Mr Burns: I am a bit confused as to where to look. [ Interruption. ] Right, I will look forward.

My right hon. Friend the Secretary of State well remembers his visit in April to meet the York and District pain management support group. He made it plain at the time that it should be for GPs and their patients to decide what treatment should be given, as opposed to a decision by the PCT to veto spinal injections for all sufferers of long-term chronic back pain. We will, in due course, set out our proposals to put more power in the hands of patients and GPs.

T3. [4486] Vernon Coaker (Gedling) (Lab): Does the Minister agree that it is crucial for patients to have information if we are to make a reality of choice within the NHS? In that respect, does he agree that if we are to give people a real choice as regards the choose and book system that GPs operate, there is a need to ensure that patients have the information about the success rates of different hospitals, and different surgeons, as regards operations?

Mr Lansley: I agree with the hon. Gentleman-it is just that that did not happen under a Labour Government in the way that it should have done. For example, the
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national quality registers in Sweden have 69 areas of clinical practice for which such comparative data are published. I have made it clear that one of our priorities is that we focus on outcomes and on giving patients real empowerment. To do that, information for patients on outcomes will be absolutely critical.

T10. [4493] Dr John Pugh (Southport) (LD): I have here a letter from my local PCT indicating that the clinical review of the safety of a proposed children's walk-in centre in Southport is to be conducted by Dr Sheila Shribman and the Minister's Department. Will the Minister arrange to meet me and relevant officials to ensure that the Department is properly aware of the background to this vital access issue and that we have a clinical network suitable for patients, as well as for practitioners?

Anne Milton: I thank the hon. Gentleman for that question, of which he gave our office prior warning. It is important that decisions made locally focus on outcomes for people, that they are about choice, that they have support from local clinicians and commissioners, and that they are based on sound clinical evidence. I would be happy to meet him to discuss this further.

T6. [4489] Mrs Mary Glindon (North Tyneside) (Lab): Every year in the north-east, 300 children are born with congenital heart disease. These very sick children receive expert treatment locally in the world-class cardiothoracic unit at Newcastle's Freeman hospital. Can the Minister assure my constituents, who value this vital local service, that the findings of Sir Ian Kennedy's review of children's heart surgery centres will be implemented without financial constraint?

Mr Lansley: I should tell the hon. Lady that it is premature to make any commitment about the review, because we now need to have proper engagement with local people, patients and those who are responsible to focus on how we can make absolutely certain that the outcomes that we achieve for children requiring cardiac surgery are as good as we can possibly make them.

Robert Halfon (Harlow) (Con): Will the Minister review the problem of highly priced patient lines and introduce competition so that patients in Harlow and elsewhere no longer pay extortionate prices to watch TV or make phone calls?

Mr Burns: I am extremely grateful to my hon. Friend for raising an issue that I know is of concern to many people. Although I cannot make promises about the outcome of any review, he has my assurance that we will be looking into this, and that we take on board the concerns that have been expressed over a number of years.

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