Topical Questions

Oral Answers to Questions — Health – in the House of Commons at 2:30 pm on 7th September 2010.

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Photo of Caroline Flint Caroline Flint Labour, Don Valley 2:30 pm, 7th September 2010

If he will make a statement on his departmental responsibilities.

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Photo of Andrew Lansley Andrew Lansley The Secretary of State for Health

My responsibility is to lead the national health service in delivering improved heath outcomes in England, to lead a public health service that improves the health of the nation and reduces health inequalities, and to lead the reform of adult social care that supports and protects vulnerable people.

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Photo of Caroline Flint Caroline Flint Labour, Don Valley

In recent years more research and evidence has demonstrated that the trans fats present in our food are a major heath hazard. That is how the National Institute for Health and Clinical Excellence has described them, and the World Health Organisation has described them as toxic, but many people do not even know they are in our foods because they are not listed on the front of our food packaging. Is the Secretary of State prepared to consider banning trans fats in our food, as is happening in other countries around the world, or at the very least consider making sure they are labelled on the products we buy so that we can make an informed choice?

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Photo of Andrew Lansley Andrew Lansley The Secretary of State for Health

The right hon. Lady will know that we have made progress in this country in reducing the amount of trans fats in foods. My personal view is that we should seek to eliminate them, rather than have them in foods and have them labelled. It is important that we have front-of-pack food labelling that identifies the extent to which there are saturated fats, and I am looking forward to making greater progress in getting a more consistent front-of-pack food labelling than we have achieved in the past.

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Photo of Tony Baldry Tony Baldry The Second Church Estates Commissioner

GPs and GP practice managers in my constituency are keen to get on with GP commissioning because they see that that can lead to better outcomes for local people but, unsurprisingly, they have a number of detailed questions as to how GP commissioning will work. Who will best answer those questions, and when will that happen?

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Photo of Andrew Lansley Andrew Lansley The Secretary of State for Health

My ministerial colleagues, and many other leadership colleagues across the NHS, are engaged in meeting staff and potential commissioners, and existing commissioners and patients and public across the country. I had a meeting of that kind in Hampshire just last week, which illustrated precisely the point my hon. Friend makes: people came from general practices across Hampshire, and they fully endorse the principle of this change and they just want to get on with it. They did not want to wait for the full transition, and they now wanted to go through some of the detailed questions. We issued a consultation document following the White Paper, which was focused on general practice commissioning. I urge my hon. Friend's constituents and others to respond to that before 11 October, which will enable us then to proceed to set out the full details of how general practice-led commissioning will work.

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Photo of Mary Creagh Mary Creagh Opposition Assistant Whip (Commons), Shadow Minister (Health)

The Secretary of State had a difficult summer, with his plans to scrap free milk for the under-fives being attacked across the spectrum and eventually vetoed by the Prime Minister, but he met the new chair of Unilever, Amanda Sourry, on 21 July. On the following day, Ms Sourry wrote him a letter, some of which is blanked out. She wrote that

"with a clear signal from you, I would be happy to engage with retailers and manufacturers to find resolution on front-of-pack labelling".

The Department has tried to black out that sentence, perhaps because it shows an unhealthy closeness between the Secretary of State and Unilever. Does the Secretary of State have an opinion on how food should be labelled, and, if so, will he tell the House what it is? Will he tell the House what other areas of food policy he plans to subcontract out to multinational food giants?

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Photo of Andrew Lansley Andrew Lansley The Secretary of State for Health

I hardly know where to begin due to the absurdity of some of the assertions in that question. How does the hon. Lady imagine that we are going to make progress on front-of-pack food labelling, on which her Government never made sufficient progress-there is no consistency on front-of-pack food labelling? This Government and this Parliament have no unilateral power to mandate what front-of-pack food labelling should look like and we have to achieve consensus in Europe and consensus in this country. We must do that with the manufacturers, the retailers, the charities and the health experts. That is precisely why our public health commission, when we were in opposition, brought together all those people around a table for the first time. I intend to create a realistic and effective partnership to deliver improving public health in this country, where her Government failed.

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Photo of Philip Hollobone Philip Hollobone Conservative, Kettering

Kettering general is a wonderful hospital but recently its paperwork has got out of control. Some 30 occasional chaplaincy visitors from the local Catholic Church, many of whom are retired, have recently had to complete Criminal Records Bureau checks, employer references and an intrusive personal health questionnaire. Does the Minister agree that if we are to create the big society that the Prime Minister would like us to create, such bureaucracy must be minimised?

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Photo of Simon Burns Simon Burns The Minister of State, Department of Health

I have considerable sympathy with the problems that my hon. Friend's constituents had. Although they are necessary, I would like to think that vital checks could happen through a process that is easy to manage for those who have to go through them. My view is that hospitals must ensure that checks on volunteers are proportionate and do not discourage good and well-meaning people from becoming involved in local care. I hope that my hon. Friend is reassured by the fact that my right hon. Friend the Home Secretary announced on 15 June that the CRB regime would be scaled back to common-sense levels. The Government will announce the terms of reference of the review shortly.

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Photo of Keith Vaz Keith Vaz Chair, Home Affairs Committee, Chair, Home Affairs Committee

Some 1,800 patients in the Belgrave area of my constituency have been left without their local surgery because it has closed. Will the Minister assure me that despite the scrapping of the primary care trust, the new Belgrave health centre will be built? If he cannot tell me now, it would be very helpful if he could write to me.

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Photo of Andrew Lansley Andrew Lansley The Secretary of State for Health

I am grateful to the right hon. Gentleman, but in the absence of notice of that question, I fear that I shall have to tell him that I shall certainly look into that and write to him.

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Photo of Anne McIntosh Anne McIntosh Chair, Environment, Food and Rural Affairs Committee, Chair, Environment, Food and Rural Affairs Committee

The Minister of State wrote to me on 25 August to say that all future service changes must be led by clinicians and patients. How can it be that, although all the clinicians and patients oppose the downgrading and possible closure of the Ryedale ward of Malton hospital, that can proceed? Will he please use his good offices to block any such change?

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Photo of Simon Burns Simon Burns The Minister of State, Department of Health

I am very grateful to my hon. Friend and would like to tell her that I have been informed by NHS Yorkshire and the Humber that NHS North Yorkshire and York has proposed incrementally to alter the balance between resources in the community and the in-patient areas by slowly reducing the number of beds open for admission and slowly transferring staff into the community. We understand that that forms part of the PCT's ongoing strategic plan for Malton. However, given my hon. Friend's concerns, I would be more than happy to meet her to discuss the issue further.

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Photo of Gloria De Piero Gloria De Piero Labour, Ashfield

When the Government say that the NHS budget will be ring-fenced, people might assume that whatever cash a hospital gets in this financial year will be matched next financial year. So could the Health Secretary explain why the King's Mill hospital in my constituency has been told to expect its budget to treat patients next year to fall by 8.2% or £14.9 million?

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Photo of Andrew Lansley Andrew Lansley The Secretary of State for Health

The answer to the hon. Lady's question is probably because that is what the Labour Government's spending intentions implied. All over the country primary care trusts are telling their hospitals that they can expect a zero increase in tariff and a reduction in activity, and hence a reduction in budget. I am making it clear that we are intending an historic commitment by this coalition Government to increase the resources for the NHS in real terms. That does not mean an increase in real terms for every part of the NHS all the time. It does mean, however, that resources will be realised through efficiency savings and that increase to enable us to improve the service we provide through the NHS and to meet rising demand.

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Photo of John Baron John Baron Conservative, Basildon and Billericay

Is any flexibility available to allow the interim cancer drug fund to review earlier and more speedily adverse National Institute for Health and Clinical Excellence decisions-because in certain cases, as we know with Avastin for late-stage bowel cancer, a few months, or even a few weeks, can make a big difference to patients.

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Photo of Andrew Lansley Andrew Lansley The Secretary of State for Health

My hon. Friend will be aware that we have proceeded as rapidly as we possibly can in finding savings this year, so that from 1 October the regional panels of expert clinicians can look at individual cases. It is not a matter of their reviewing NICE decisions; it is a matter of their looking at individual cases that cannot be funded under existing guidance or local decisions, but being able to apply clinical criteria to individual cases using an additional fund.

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Photo of Emma Reynolds Emma Reynolds Labour, Wolverhampton North East

Wolverhampton is the 28th most deprived local authority area in the country, resulting in major health inequalities. Can the Secretary of State reassure me that in future funding allocations, levels of deprivation will be taken into account?

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Photo of Andrew Lansley Andrew Lansley The Secretary of State for Health

Yes and more than that. I could make it clear that in the future, we will be moving-not for next year necessarily, but in years beyond, as we will make clear in the public health White Paper-to an explicit allocation of public health resources taking account of relative health outcomes and health inequalities, and those funds will be used to deliver improving public health. At the moment the formula to the NHS may take account of relative deprivation as measured by, for example, access to income support, but the money does not get spent on reducing those health inequalities and on an effective public health strategy. That is why we shall be very clear about separate, ring-fenced, public health resources used, together with local authorities, to deliver an effective public health strategy locally.

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Photo of Andrew Selous Andrew Selous Conservative, South West Bedfordshire

Leighton Buzzard is one of the larger towns in the country not to have a community hospital. What reassurance can my hon. Friend give me that the wishes of local GPs will be respected in deciding what services the proposed community hospital will have?

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Photo of Simon Burns Simon Burns The Minister of State, Department of Health

I think I am in the fortunate position of being able to give my hon. Friend considerable reassurance. NHS Bedfordshire has the full support of local GPs, and they continue to develop a business case for the primary health care facility in Leighton Buzzard. They will go to full public consultation on the proposals. The centre is planned to open in 2012 and would be funded by NHS Bedfordshire.

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Photo of John Mann John Mann Labour, Bassetlaw

Some 36,000 of my constituents, who voted by ballot, and every single GP in both local authorities, all believe that Bassetlaw accident and emergency department should remain a full 24-hour service. Can the Secretary of State conceive of any reason why that might not be the case during this Parliament?

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Photo of Andrew Lansley Andrew Lansley The Secretary of State for Health

The hon. Gentleman will be reassured to recognise that one of the commitments of the coalition Government in our programme was to stop the forced closure of accident and emergency departments. I am sure he will take comfort from the commitment of this Government, and from our commitment to increasing resources for the NHS in real terms each year, to enable the services that his constituents and others' require to continue to be provided and improved.

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Photo of Jo Swinson Jo Swinson Liberal Democrat, East Dunbartonshire

Information in a parliamentary answer given on 19 July showed that the cost to the NHS of emergency admissions in cases of anaphylaxis has risen by 45% in four years. Will the Minister look at how allergy support services could be enhanced in primary care to reverse the rising trend in emergency cases and in doing so save money and, crucially, lives?

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Photo of Andrew Lansley Andrew Lansley The Secretary of State for Health

Yes I will gladly do that. I have had the privilege and pleasure of visiting the specialist allergy service at my local hospital, Addenbrooke's, one of a small number across the country. I think it was the House of Lords Select Committee that produced an excellent report on allergy services, and I hope that this is one of those areas where clinical relationships between GPs and hospital specialists will enable both community and specialist services to be improved to meet this need.

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Photo of Kevin Barron Kevin Barron Chair, Standards and Privileges Committee, Chair, Standards and Privileges Committee

Given that 50% of health inequalities are created by tobacco use, will the Secretary of State give us an assurance that the targeted smoking cessation programmes in the national health service will survive?

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Photo of Andrew Lansley Andrew Lansley The Secretary of State for Health

We are going to improve the effectiveness of our public health services. As the right hon. Gentleman will know from past debates, I entirely recognise the extreme importance of reducing tobacco use. After the introduction of legislation on smoking in public places, there was a reduction in prevalence, but at the moment there is no continuing further reduction, especially among manual workers and young people; we need to achieve that reduction, and we will continue to look at measures to do that. We will say more about the issue in our public health White Paper.

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Photo of Steve Brine Steve Brine Conservative, Winchester

Many of my constituents, and indeed many practitioners, have grave concerns about the pending closure of Winchester ambulance station. Will the Minister assure the House that no changes to static ambulance bases will take place until local consortiums, when they are formed, are happy that a suitable alternative is in place?

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Photo of Simon Burns Simon Burns The Minister of State, Department of Health

I am extremely pleased to be able to give my hon. Friend some reassurance. South Central strategic health authority has informed me that the service to the people of Winchester will not be affected, as there will be static provision for Winchester; ambulances will be deployed via a control centre in Otterbourne, 2 miles from Winchester. Those changes are set to take place in December, and the existing station will not be closed until there is new provision.

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Photo of David Lammy David Lammy Shadow Minister (Higher Education and Intellectual Property)

A decision has been taken in the past few days, without any consultation at all, to transfer the out-of-hours service for 950,000 north Londoners from the GP-run co-operative to a private provider. Will the Secretary of State intervene to ensure that local people and GPs make that determination?

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Photo of Andrew Lansley Andrew Lansley The Secretary of State for Health

I am aware of the matter. The right hon. Gentleman will be perfectly well aware of my view: we want to involve general practitioners much more in commissioning out-of-hours services. I will undertake to look at what is proposed by the primary care trusts in north London and see whether it is consistent with the development that we are looking for in the White Paper.

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Photo of Helen Grant Helen Grant Conservative, Maidstone and The Weald

If local GPs fail to support reconfiguration plans en masse-if, say, 97% fail to do so-what would be the Secretary of State's response?

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Photo of Andrew Lansley Andrew Lansley The Secretary of State for Health

As I said in response to a previous question, one of the four criteria that I set out on 21 May was that reconfigurations must have the support of local general practitioners as the future commissioners of services. To that extent, a reconfiguration that did not have the support of local general practices would not be able to meet that test.

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Photo of Ian Paisley Jnr Ian Paisley Jnr Shadow DUP Spokesperson (Work and Pensions), Shadow DUP Spokesperson (Environment, Food and Rural Affairs)

What discussions, if any, has the Secretary of State had with the Minister for Health, Social Services and Public Safety in Northern Ireland about making Avastin and other specialist cancer drugs available on the same terms and conditions under which they are available to people who suffer from cancer here on the mainland? Will those drugs be made available in Northern Ireland under the same terms and conditions?

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Photo of Andrew Lansley Andrew Lansley The Secretary of State for Health

I have had very helpful and productive conversations with the Health Minister in Northern Ireland, but I have to say that they did not include that particular subject. Of course, decisions on the availability of medicines in Northern Ireland are a devolved matter, but I should be perfectly happy to take account of those issues when we next talk.

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Photo of Sarah Wollaston Sarah Wollaston Conservative, Totnes

One year on from the implementation of the European working time directive, there is evidence that patient care is suffering. Handovers have been inadequate in some cases, and junior doctors' training time has been reduced. Will my right hon. Friend reassure me that he will take action to allow some acute specialities to opt out of the European working time directive?

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Photo of Andrew Lansley Andrew Lansley The Secretary of State for Health

Yes. I am very clear that, together with my right hon. Friend the Secretary of State for Business, Innovation and Skills, we need to take the European working time directive back to the European Union. We need to discuss it again. We need to go to the European Union with the intention of maintaining the opt-out and of giving ourselves, not least in the health context, the flexibility that we lack, so that junior doctors, in particular, have the capacity to undertake the training that they need. It is not that we want to go back to the past, when there were excessive hours-100-hour weeks and so on-but we want junior doctors to be confident that they will get the training that they require in the period allocated for training.

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