Diana Johnson (Kingston upon Hull North, Labour)
I am delighted to serve under you today, Mr Weir, and I am pleased to have secured this debate on an issue that I know is of interest to a number of Members from all parties. I pay tribute to the Minister present, the Under-Secretary of State for Health, Anne Milton, who has taken a keen interest in this area, and with whom I have had a number of meetings. I am a little disappointed that the debate is a short one and that I can give only the headline figures. There are many issues to raise, but I will try to concentrate on just a few.
I pay tribute to my constituent, Glenn Wilkinson, and to his family, who first came to see me in 2010 to tell me their story, and to raise the scandal of how he and thousands of others had received contaminated blood products as part of their treatment as haemophiliacs. There are two main parts to what I want to say today: the first is on the ongoing treatment for haemophiliacs, and the second is on the care, support and treatment offered to people who have contracted viruses such as HIV and hepatitis C through NHS treatment for haemophilia. I also want to pay tribute to the work, over many years, of the Haemophilia Society, and of campaign groups such as TaintedBlood and the Manor House Group, and also to the work of the Newcastle initiative, which was born out of a multidisciplinary workshop on haemophilia care held in the city in autumn 2010.
Turning first to treatment, I want to concentrate on the need to ensure that the care and treatment of people affected by bleeding disorders is addressed in the NHS reforms that are currently before Parliament. The haemophilia community has been the subject of what Lord Winston described in his evidence to the Archer inquiry as the
“worst treatment disaster in the history of the NHS”.
There has been much progress in haemophilia treatment over the past decade, but it is now under threat, as is much else, from the Health and Social Care Bill, and I will go on to explain why. Standards of care vary considerably around the country, and there is the risk that the new commissioning arrangements for specialist services will result in a levelling down, rather than up, in haemophilia care.
Haemophilia services are currently commissioned by 10 regional specialist commissioning groups, with funds pooled from their constituent primary care trusts. The Department of Health has also injected extra funding for haemophilia care, which rose to £88 million per annum between 2003 and 2006, to finance the provision to all patients of recombinant rather than plasma-derived clotting factors. That money remains important to the quality of care, but has more recently been absorbed into PCTs’ baseline budgets, and I seek reassurance from the Minister that the money will still be available for haemophilia care post the NHS reforms. I understand that from April 2013 specialist services will become the responsibility of the NHS Commissioning Board rather than of the 10 specialist commissioning groups. That could mean that best practice is spread across England, but equally, there is the danger that under financial pressure standards will be levelled down.
I also want to raise with the Minister the question of where responsibility for haemophilia policy will sit. Because of the contaminated blood scandal, the Department of Health has taken a leading role in the development of that policy, and it is unclear whether after the passage of the Health and Social Care that role will be maintained, or all responsibility will pass to the NHS Commissioning Board. It would help if the Minister could set out her understanding of where that responsibility will sit. Also, will the twice-yearly liaison meetings between the Department and the Haemophilia Society continue? Those meetings were established in direct response to the Archer inquiry’s recommendation that a statutory committee be established to advise the Government on clinical, financial and other provisions for people with haemophilia. There is also a call for a new national policy statement on haemophilia care to replace health service guidance (93) 30, which is now nearly 20 years old and no longer reflects best practice. Can the Minister confirm that that will happen at this stage?
Does the Minister agree with the need to support the development of robust haemophilia networks to combine the best of local care with access to tertiary expertise 24 hours a day? For example, in a recent survey by the Haemophilia Society, only 15% of respondents were aware of having been offered a care plan. In both the report of that survey, entitled “Fit for the Future: Haemophilia Services in the New NHS”, and in the Newcastle initiative’s paper, “Learning from the past to inform the future”, it was found that standards of treatment and care were generally high, which is very encouraging, but that access to the provision of associated services, including dentistry, physiotherapy and psychological support, required significant improvement. The reports also concluded that patients must be given a comprehensive care plan, that they must be able to access home treatment, and that they must be involved in all decisions about all their treatment. Those goals are partially but not consistently met under the current system, and we would, of course, like to see consistency across the whole country.
All Governments have said that lessons about treatment have been learnt from the contaminated blood scandal and that there is a need to maintain the highest standards of care so to avoid any repetition of it.