It is a pleasure to follow David Tredinnick and I can reassure him that in the cancer units that I know, acupuncture, aromatherapy and reflexology are routinely used. However, I have to take issue with him about irritable bowel syndrome. The manoeuvres that he mentioned—colonoscopy and sigmoidoscopy—are not part of the treatment. They are necessary in the diagnostic work-up, before one can begin to treat irritable bowel syndrome, because it is a diagnosis of exclusion.
I welcome the comments from Dr. Naysmith, who is an expert on the draft Mental Health Bill, having served through many sittings of the Committee. I shall study his comments and talk to him before deciding my reaction. I welcome the contribution of Helen Jones and particularly her tribute to the good qualities of our young people, which I echo. I also welcome the fact that the Government have included in the programme educational reform that will continue to raise standards in schools. The educational reform taking place on my patch is proving extraordinarily difficult and there are tremendous problems to overcome.
Before I talk about the modernisation of health care, I must join the argument about job losses and staff reductions. Like my eminent predecessor, A. P. Herbert, I sometimes see myself as a referee between the warring factions on either side. What we need in the case of job losses, or staff reductions—whatever we call them—is the truth. The Conservative Front-Bench health spokesman, Mr. Lansley, began to try to unravel the patterns. We have to separate compulsory redundancies, voluntary redundancies, retirements when people are not replaced, promotions when people are not replaced, the vacancy freeze, and natural turnover. My acute trust has a natural turnover of approximately 10 per cent., which is 450 jobs. If those are not replaced, that means 450 fewer people doing the work. We need a list of the 300,000 new posts, which the Government cite and which I do not dispute, broken down into clinical staff and administrative staff—we need the detail—and they should then be matched with all the categories that are being reduced because of the various sorts of staff reduction.
I want to talk about two aspects of the modernisation of health care in particular: the National Institute for Health and Clinical Excellence and hospital reconfigurations. NICE has been much maligned recently, particularly because it appears to be stopping extraordinarily useful drugs getting to patients, and appears to be impeding innovation. It is partly responsible for the UK's slow uptake of new drugs, which is not half a bad thing when one considers the speed with which Vioxx was taken up, and the problems that that caused.
I strongly support NICE, but several criticisms of it can be made. Does it do everything right? Does it get the selection of expert advisers right? The technology appraisal committees are all generalist in nature, so they must depend on expert advisers; the system must be absolutely right. Is the NICE process as fast as it should be? Is the method of selecting the therapies that it examines appropriate? Somehow we must allow it to approve more drugs for use, which means lowering the cost-benefit ratio so that drugs to combat diseases such as Alzheimer's become affordable.
There is a great deal of discussion about drugs for wet age-related macular degeneration. I believe that they will cost about £6,000 a course, per patient. The chief executive of my primary care trust tells me that this will cause such a crisis in the NHS that it could well lead to a major rethink of the role of NICE and the way in which it works.