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Eye Examinations (Children)

8. Mr. Douglas Carswell (Harwich) (Con): What steps her Department is taking to ensure that children receive regular full eye examinations. [78467]

The Minister of State, Department of Health (Caroline Flint): Free sight tests are available under the NHS for children under 16, and for those in full-time education aged 16 to 18. Sight tests allow the opportunity to review all aspects of eye health, including investigations for signs of disease. Information about the extensive arrangements for providing help with NHS optical services
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and other health costs is set out in leaflet HC11, “Are you entitled to help with health costs?”.

Mr. Carswell: Last year, 2.8 million children received an NHS eye test, which is less than a quarter of the almost 12 million children who are entitled to a free eye test. How does the Minister think those figures reflect on her Department’s ability to implement its promises and ensure the good health of our children?

Caroline Flint: That does not necessarily mean that all children need an eye test. It would be a waste of money if we expected people to have eye tests when they do not need them. We provide every parent with a personal child health record, which gives them information about what to look for in terms of their child’s eyesight. The booklet “Birth to five” is provided for all first-time parents and gives advice and information. As part of the national service framework, we want to develop an orthoptist-led programme for pre-school vision screening, which ensures that eyes are working and developing normally. In those ways, we are making sure that when children have a problem, or are perceived to have a problem, they receive an eye test as required.

Mr. Kevin Barron (Rother Valley) (Lab): I accept the fact that all children may not need eye tests, but may I ask whether the Government have ever conducted any surveys to make sure that no children have fallen though the net, as they obviously will not know whether they need an eye test? In my childhood, such testing used to take place in schools.

Caroline Flint: My right hon. Friend is right about the measures that we should put in place to see whether children require a more extensive eye examination, which is why, as part of the national service framework for children, young people and maternity services, we have developed, as I said, an orthoptist-led programme of pre-school vision screening to check whether children’s eyes are developing normally and whether there are any developmental problems that require a more extensive eye test. That is a better screening procedure, but if parents have any worries, they can use the information that we give every parent after the birth of their child to make sure that they follow up any problems. If they are in doubt, they should seek an eye test, which, of course, is free.

Mr. David Heath (Somerton and Frome) (LD): There is a lot of talk about preventive medicine, but I do not remember a generic campaign on the need for regular eye tests ever taking place. If we wish to make an early intervention in eye disease or an early diagnosis of systemic disease, and if we are concerned about road safety or industrial safety later in life, eye tests are essential. Is it not time that the Department of Health encouraged everyone—and not just children—to have regular eye tests?

Caroline Flint: Of course we encourage them to do so. The research results of the last national campaign, I believe, did not receive a good evaluation, so we offer targeted support. As I said, every parent receives a personal health record for their child that includes
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information and advice so that they can find out whether there are any problems with their vision. All new parents receive a booklet, “Birth to five”, which explains problems to which they should be alert, including problems in their child’s vision. The national service framework, too, deals with pre-school screening and vision development. Our approach is targeted, and it includes a review of local optical services that gives primary care trusts a greater role in identifying people who do not take up the opportunity to have their children’s eyes tested so that they can target communities where such tests are needed. I hope that that review will give PCTs greater opportunities and flexibility to work with opticians and others to provide the service that the hon. Gentleman would like.

Mr. Bob Blizzard (Waveney) (Lab): After an eye examination, some children may need an eye operation, but hospitals in different parts of the country are paid different rates by their PCTs for performing the same operation. Why do we need those differential rates, as costs are uniform and there are national contracts on pay and conditions for consultants, nurses and all other staff in “Agenda for Change”?

Caroline Flint: Those different rates are the primary reason why we have looked at the tariff, as we wish to make sure that there is a level playing field for health services. Clearly, we can look at the issues that my hon. Friend has raised, but may I add that we introduced free eye tests for everyone over 60? I am pleased to say that, for people of advancing years, the wait for cataract surgery is three months or less.

Tim Loughton (East Worthing and Shoreham) (Con): I have to say that that was an extraordinarily complacent answer. If we do not test children’s eyesight, how can we know the extent of the problem? There is poor take-up of eye tests among school-age children, and, after their eight-month check, only 50 per cent. of children have their eyes checked before starting school, so it is more likely that sight defects will emerge as the visual system develops up to the age of seven, which can lead to permanent visual loss and subsequent problems keeping up at school. Why, therefore, did the hon. Lady’s Government fail to support Conservative amendments to the Health Bill in another place, which would have ensured that all children receive a proper eye examination before they start school?

Caroline Flint: I am not sorry that the hon. Gentleman does not like my answer, because I would not expect him to do so. I thought that I gave a comprehensive answer, as I explained the information that we give to parents, the pre-school screening programme that we have developed, and the local services developed by PCTs based on need. We are thus meeting the needs of both children and adults in the community. I am incredibly short-sighted and use both contact lenses and glasses, and my children, too, wear glasses. As a parent, I acted when the problem emerged, and we must make sure that parents have the right information so that they can act. Pre-school screening will help, but I do not see the sense of paying for unnecessary, full eye tests if they are not required.


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Mr. Brian Jenkins (Tamworth) (Lab): When I was at school, it became obvious to me, and to the teachers, when I needed to be sent for an eye test. I was sent for a test after being moved from the back of the class further and further forward, until I got right up to the chalk board; no one sent me for one before then. However, I am still disappointed in some respects. How much research has been done into the effects on young developing eyes of old-style cathode ray tubes and new LCD and plasma screens? If tests have been done showing that long exposure to such screens has a detrimental effect on young eyes, can we let parents know as quickly as possible, because many of them would like to limit exposure to that risk?

Caroline Flint: I will write to my hon. Friend with any information that I can supply on what research has been done. However, it is common sense to say that too much time spent in front of a screen is not good for anyone—not only for their eyesight but for their general well-being, given the lack of physical activity. Less is more, I would say.

Pennine Acute Hospital Trust

9. Paul Rowen (Rochdale) (LD): If she will make a statement on the financial position and proposed job losses at the Pennine Acute Hospitals NHS Trust. [78468]

The Minister of State, Department of Health (Ms Rosie Winterton): The 2005-06 provisional out-turn figure for the Pennine Acute Hospitals NHS Trust is a £56,000 surplus. However, I am aware that the trust faces a challenging financial situation in the current financial year, and it is in discussion with the strategic health authority on how to achieve efficiency savings.

Paul Rowen: On 7 June, the Secretary of State said that

Can the Minister explain why the Pennine acute trust, which covers Rochdale, Oldham and north Manchester and has huge health service needs, is predicting an overspend of £28 million, despite, as she said, having balanced its books last year?

Ms Winterton: Obviously, the trust will have benefited from the massive investment that has gone into the NHS generally. However, one of the trust’s problems has been higher than average costs associated with delivery of services. That is why it is getting particular help in looking at how it can make efficiency savings. When payment by results is introduced, difficulties will arise unless it can reduce some of its current costs by making some of the changes to service delivery that have been made in other parts of the country, so that services are delivered in the most effective manner without patient care being compromised.

Jim Dobbin (Heywood and Middleton) (Lab/Co-op): The Pennine Acute Hospitals NHS Trust is the second largest hospital trust in the country, serving four district general hospitals and covering 10 constituencies and a
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population of some 700,000. In addition to the problem highlighted by the hon. Member for Rochdale (Paul Rowen), there are two or three more that need to be considered, including the reconfiguration of that very large trust and board appointments. I want to put on the agenda the independent Appointments Commission and the problems that it is raising in different parts of the country. I should be glad if my hon. Friend expedited the meeting that we have requested for the 10 hon. Members served by the Pennine Acute Hospitals NHS Trust.

Ms Winterton: I know that my hon. Friend has pressed the case on his constituents’ behalf about the issues that he has just raised. His persistence has led to a meeting being arranged within, I think, the week, and I look forward to discussing all the issues that he has raised with him and his colleagues.

Health Trainers

10. Ms Diana R. Johnson (Kingston upon Hull, North) (Lab): What progress has been made in recruiting health trainers. [78469]

The Minister of State, Department of Health (Caroline Flint): Nearly half the NHS has signed up to the health trainer scheme. Currently, 228 NHS health trainers are recruited to the programme, of which 206 are now in, or have completed, training. I was delighted to launch the Hull health trainer partnership in March with my hon. Friend the Member for Kingston upon Hull, North (Ms Johnson).

Ms Johnson: I thank the Minister for that answer. Will she join me in congratulating Hull on the pioneering way in which it has looked at the role of the health trainer? It has not just moved health professionals into the role of health trainers, but has recruited people from the local community who can really get alongside those groups that it has been hardest to reach in the past.

Caroline Flint: I endorse my hon. Friend’s comments. I met Paula Tomlinson, who is a Hull health trainer, in Hull and when she attended an event at No. 10. She said:

I am pleased that there are plans to get customer care assistants working in the scheme, and also community wardens. We are looking to them being part of a wider group of health trainers, in addition to those within the health services.

Dr. Richard Taylor (Wyre Forest) (Ind): Will the Minister assure the House that NHS training budgets will not be selectively or excessively targeted in the drive to reduce NHS deficits?

Caroline Flint: We continue to invest in training—more than ever before. Health trainers are a support for people in communities who need additional help with healthy choices for their lifestyles. I am really pleased that we are going to be on target and to have 1,200 of
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them in the NHS in the next year or so. That is a credit to those who care as much about prevention as treatment.

Ms Angela C. Smith (Sheffield, Hillsborough) (Lab): Is it not the case that, in the long term, this initiative not only promises to be cost-effective and to save the health service money, but to offer long-term improvements in health care for our population?

Caroline Flint: I think that it does. There is a substantial amount of evidence that underpins the interventions of NHS health trainers. We have “Health Behaviour Change: A Guide for Practitioners” and various other pieces of work. We have had health psychologists in the Department working with us to ask why those most in need of our support are sometimes deterred from seeing GPs or others. The initiative is about a practical way to tackle the health inequalities that exist in too many of our communities. So far, it seems to be working well, but, of course, we will evaluate the programme as it develops and expands.

David Simpson (Upper Bann) (DUP): Will the Minister tell us the likely impact that the new immigration arrangements will have on the number of medical students being recruited and encouraged to come to the United Kingdom, given that they state that permits will be for only two years?

Caroline Flint: I am not sure that that question has anything directly to do with health trainers. I am happy to write to the hon. Gentleman about what health trainers are about. I understand that extensive consultation is going on with the different organisations that are concerned about the matter.

Nurses (Gateshead, East and Washington, West)

11. Mrs. Sharon Hodgson (Gateshead, East and Washington, West) (Lab): How many nurses were employed in the Gateshead, East and Washington, West constituency in 1997 and at the most recent date for which figures are available. [78470]

The Minister of State, Department of Health (Ms Rosie Winterton): In 1997, there were 1,131 nurses employed in the NHS organisations in the Gateshead, East and Washington, West area. The current figure is 1,462. That is an increase of 29 per cent.

Mrs. Hodgson: I thank my hon. Friend for that answer. That is excellent news. I am sure that she will be aware that I recently tabled a written question about the number of nurses nationally in various periods since 1979. I was astonished by the answer, which proved categorically that in nine years we have done much more than the Tories did in 18 years to increase the number of qualified nurses in my constituency and nationally. Does she accept that when people ask where the money goes, we should shout from the rooftops that it goes on increasing staff numbers and pay, which is a major part of recruiting? Does she also—


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Mr. Speaker: Order. The Minister has the gist: the hon. Lady is very pleased with the situation.

Ms Winterton: As it happens, I could not agree more with my hon. Friend, particularly about shouting from the rooftops about some of the changes that have been made and the improvements in the pay and number of nurses. It is important to add one other thing: we have also managed to reform the way in which nurses work, giving them extra responsibilities and making sure that there are new posts, such as nurse consultant posts. All that means that—when she talks about recruitment and retention—under a Labour Government, we have made it easier not only to go into nursing, but to stay in nursing. We can all be proud of that.

New Pharmacies

12. Jeremy Wright (Rugby and Kenilworth) (Con): What plans she has to review the operation of control of entry regulations governing new pharmacies. [78471]

The Minister of State, Department of Health (Andy Burnham): The Secretary of State for Health announced a review of progress on reforms to the control of entry system for NHS pharmacies in England in a written
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ministerial statement on 13 June 2006, along with a wide-ranging three-month public consultation.

Jeremy Wright: I think the Minister for that answer. He will realise that it is sometimes difficult and expensive for smaller community pharmacies to set up in business. When the review takes place, will he ensure that as much help as possible can be given to such pharmacies, perhaps in particular by looking again at the exemptions to the control of entry regulations and allowing pharmacies that comply with those exemptions to open for 80 hours a week, instead of 100 hours, so that people can continue to get their medication from not only supermarkets and large chain pharmacies, but smaller community pharmacies?

Andy Burnham: The hon. Gentleman may be aware that the issue provoked considerable debate in the last Parliament. The proposal at the time was for the Office of Fair Trading to take away all controls of entry to pharmacies. The Government adopted a different approach by retaining the ability of primary care trusts to control their pharmacies’ position, but did not rule out innovation in local pharmacy services when possible. It is my guess that the arrangements have served us quite well, but we will find out when we see the results of the review that has been commissioned.


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School Record Keeping

3.31 pm

The Secretary of State for Education and Skills (Alan Johnson): Protecting children is paramount. In January, my predecessor asked Ofsted to investigate vetting practices in schools, colleges and local authorities. Ofsted has today published its report, which is available in the House of Commons Library. I thank the chief inspector for this thorough and diligent piece of work.

The report shows that all those involved in the recruitment of staff are committed to child protection, that they almost always demonstrate good practice, and that, crucially, vital checks on prospective employees are being carried out—there were 700,000 last year alone. However, Ofsted is equally clear that not enough is being done in our schools and colleges to keep proper records of what, when and against whom checks are being made. We will act quickly, but carefully, to tackle the failings that Ofsted has identified.

We are writing to all schools and local authorities today to set out clearly the measures necessary to strengthen the system. Copies of those letters will be placed in the House of Commons Library. I am asking all schools to make sure that they have the records that they need to demonstrate that they have checked the identity, qualifications and any criminal record of their staff. To be absolutely sure that that happens, I will lay regulations to that effect.

Secure, reliable and up-to-date records must be maintained in an accessible location. If schools do not have a record that a check has been made, a further full Criminal Records Bureau check will have to be conducted and a record kept. My Department and the CRB will work together to ensure that that takes place as speedily as possible. I want similar processes to take place in colleges, so we will work with the Association of Colleges to take that forward. To ensure compliance, Ofsted will check that adequate records and systems are in place as part of its regular school inspection regime.


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