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9. Miss Julie Kirkbride (Bromsgrove)
(Con): How many operations were cancelled in (a) Worcestershire NHS Acute Trust and (b) England in the last year for which figures are available. 
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The Minister of State, Department of Health (Ms Rosie Winterton): The Department of Health collects figures on operations that have been cancelled for non-clinical reasons on either the day of admission to hospital or after admission, on the day when the patient is admitted. There were 943 operations cancelled at Worcestershire NHS Acute Trust during 200405. Nationally, the figure was 68,576.
Miss Kirkbride: Is not the Minister remotely ashamed of the figures that she has just announced, given the human misery that they represent? Does she realise how upsetting it is for hospital staff to have to ring people on the day of a cancelled operation to say that they should not come in, despite their acutely painful condition? Does she appreciate the trouble that it causes the people involved, who might well have suffered a sleepless night and made extensive arrangements with their friends and family to cover their time in hospital? Does she not accept that the Government's focus on targets, targets, targets, instead of clinical priorities makes those figures so shameful?
Ms Winterton: It would be interesting to know which targets the hon. Lady would like to scrap. I would have thought that she would be congratulating her local NHS staff on reducing the number of cancelled operations from about 2.3 per cent. in 200405 to 1.9 per cent. now. That figure is still higher than the national average, but her local staffwhom I hope she will supportare working on the issue of bed management within the local trust. One of the difficulties has involved increased admissions through accident and emergency units. The purpose of the work is to ensure that people are discharged early from hospital and not kept there inappropriately, and that there are no inappropriate admissions through A and E. I would have thought that the hon. Lady would congratulate her local NHS staff on that work, because they are working very hard to give the highest quality services to patients.
Mr. Michael Foster (Worcester) (Lab): Will my hon. Friend explain how the number of cancelled operations in Worcestershire would have been reduced if the Conservatives had won the last election and taken £1 billion out of the national health service budget
Peter Luff (Mid-Worcestershire) (Con): The Minister will know that the Worcestershire Acute Hospitals NHS Trust is under great financial and practical pressure, and that it regularly operates at or beyond its designed capacity, hence the problem with cancelled operations. In that context, will she explain how the proposal to close two wards at Evesham community hospital, to transfer services away from that hospital and to remove GPs from caring for patients there will result in the increase in capacity that Worcestershire's health economy so desperately needs?
First, I should point out that the local PCTs in the hon. Gentleman's area have received about £43 million extra funding this year. I understand that the issue that he has raised is still being considered. I know that it has been the subject of an Adjournment debate,
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and I gather that it has been under consideration since that time. I am perfectly prepared to write to the hon. Gentleman to update him on the situation if that would be helpful.
The Secretary of State for Health (Ms Patricia Hewitt): From the end of this year, national health service patients will be able to choose from four or more hospitals when referred by their general practitioner. By 2008, they will be able to choose from any health care provider that meets NHS standards and prices.
Mr. McFadden: I thank the Secretary of State for her reply. Does she agree that, where choice has been introduced so farfor example, in offering patients a shorter waiting time in exchange for having their operation done somewhere other than their local hospitalit has been a success? Does she also agree that while choice will not operate in exactly the same way in the public and private sectors, it is essential that as the Government increase investment in the NHS to record levels, it should be matched by the empowerment of patients to ensure that they have increased control over the timing, nature and location of their treatment?
Ms Hewitt: I entirely agree with my hon. Friend. Patients are telling us very clearly that they want more choice and more control over their health care. We can see the policy of increased patient choice working very well in the city of Wolverhampton in my hon. Friend's constituency. For example, since the beginning of this year, patients there have had a choice of two or more hospitals for cataract operations, which has helped to bring the maximum waiting time for such operations down to three months, four years ahead of the target that we set in the NHS plan. Similarly, since April, NHS patients in Wolverhampton have had a choice of two or more hospitals for heart treatment and cardiac surgery, which improves the quality of care available to them.
David Tredinnick (Bosworth) (Con): Does the Secretary of State agree that choice for NHS patients will be dramatically reduced if the food supplements directive is introduced in its present form? A decision on that matter was upheld by the European Court today. What will she do to secure an opt-out from the directive? Does she agree that many hundreds of safe nutrients will be taken off the shelves as a result of its introduction? The measure is deeply unpopular and the Government have done nothing like enough to get involved and to stop it.
I discussed this very matter with Commissioner Kyprianou some two weeks ago, and my hon. Friend the Under-Secretary of State for Health, the hon. Member for Don Valley (Caroline Flint), discussed it with patients' representatives and the industry just last week. We will continue to press for the lightest touch possible implementation of the directive, and we will ensure that the providers who are already making
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available a wide and growing choice of vitamin and food supplements to the public in Britain and elsewhere can continue to do so. That is what the providers want to be able to do, it is what the public want, and we will ensure that they can continue to get it.
Dr. Doug Naysmith (Bristol, North-West) (Lab/Co-op): Does my right hon. Friend intend the choice agenda to apply to patients suffering from mental health conditions? If so, how does she envisage that it will work?
Ms Hewitt: The commitment that we have made in relation to choice, such as the choice of four or more hospitals by the end of this year, applies specifically to in-patient treatment. As my hon. Friend will be aware, there is rightly a growing emphasis in the treatment of patients with mental illness on treating them wherever possible in their own homes and in the community. There is a much wider agenda, however, to ensure that people with depression and other mental illnesses can exercise more choice and control over their treatment, for instance by having a range of different therapies available to them. That is widely welcomed, not only by users of mental health services but carers and families of mental health patients.
Ms Hewitt: Following the negotiation of the new GP contract, primary care trusts are making available to patients and users a range of out-of-hours services, including those provided by our ambulance service and emergency care practitioners. The new GP contract responded to the strongly expressed views of most GPs that they did not want to continue being responsible for providing that out-of-hours service themselves. That is why it is essential that primary care trusts in the right hon. Gentleman's constituency and elsewhere ensure that there is proper provision for out-of-hours service. It is also why we are continuing to expand NHS walk-in centres, which are available every day of the week, every day of the year.
Paul Farrelly (Newcastle-under-Lyme) (Lab): With respect to patient choice in the NHS, may I raise with my right hon. Friend the case of my constituent, Lynne Burton, who suffers from advanced breast cancer? At the moment, Lynne cannot be prescribed Herceptin, the drug of her consultant's choice, because she does not meet the rather restrictive criteria, and if she did, local funding might be problematic. When will the Department relax those criteria and license Herceptin for early-stage breast cancer to give women a better choice and a chance of fighting that terrible disease?
My hon. Friend raises an extremely important point. We are already urgently considering referring Herceptin to NICE for appraisal in relation to use in early-stage treatment of breast cancer. We have also asked Professor Mike Richards, our national cancer director, to consider the issues surrounding the introduction of Herceptin across the national health
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service, including managing the potential gap between licensing the use of the drug for early-stage treatment and publication of a NICE appraisal. He will report back to us in the autumn, and we will then make appropriate decisions.
Mr. Simon Burns (West Chelmsford) (Con): May I remind the Secretary of State, before she seeks to rewrite history, that it was her Government in 2001 who signed up to the food supplements directive lock, stock and barrel, without questioning any of its contents? May I also remind her that it is only due to the all-party group, the Opposition parties and the help of Carole Caplin that the Government have sought to get involved at this late stage? Given that we now hold the presidency of the EU for six months, is not it time for her to act on her Prime Minister's instructions and start to fight for Britain's interests and for those hundreds of thousands of people who need and rely on food supplements and vitamins, rather than pretending that the fault does not lie at her Department's feet for doing nothing for four years?
Ms Hewitt: It was, of course, this Government who helped to establish the four-presidency, now six-presidency, initiative to ensure that regulation in the European Union was proportionate, appropriate and light-touch in its implementation. As a user of vitamin and food supplements myself, I certainly intend to ensure that weas holder of the presidency of the European Union for six months and, separately, as representative of the United Kingdom's interestssecure the implementation of the directive, which has now been upheld by the European Court of Justice, in a sensible and light-touch manner so that users and the public here in Britain can continue[Interruption.]
Mr. Speaker: Order. The hon. Member for West Chelmsford (Mr. Burns) asked a favour of me: he asked me to allow him to put a supplementary question. Now he interrupts the Secretary of State when she replies. That is bad manners, and I will not allow it. Has the Secretary of State finished her reply?
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