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The Secretary of State for Health (Ms Patricia Hewitt): I am glad to say that, following the strategy of moving services into the community, we have recently announced a dermatology service in Hull, which is one of the 30 care closer to home demonstration sites that we announced last week. It will make care more convenient for patients in my hon. Friends constituency.
Ms Johnson: I very much welcome the move of the NHS into the community, but I am concerned about the delay in receiving that good quality community facility in Orchard Park, which is one of the most deprived wards in my constituency. Will my right hon. Friend look into the delays that have been caused by Hull city council dragging its feet on planning permission?
I very much understand my hon. Friends concern about the delays in the Orchard Park scheme. My understanding is that there were changes to the design and the site that have caused some delays. I am told that the local NHS is now finalising its discussions with Hull city council and they should close the
agreement for the scheme in a matter of weeks. It will then go ahead along with the other LIFTlocal improvement finance trustschemes in Hull that are so significantly improving local health care for my hon. Friends constituents.
The Minister of State, Department of Health (Caroline Flint): Last years status report on health inequalities shows progress in some areas, notably in terms of child poverty and housing quality. The inequalities in deaths from coronary heart disease, stroke and cancer have also been reduced. Although life expectancy is improving for all groups and infant mortality is at an historically low level, the long-term trend in widening health inequalities has continued. That suggests that there is more work to be done.
Fiona Mactaggart: I am glad to say that that has not been the pattern in Slough. Health inequalities, both in my constituency and between it and the surrounding areas, have narrowed, but the biggest killer remains coronary heart diseasewhose primary cause is povertyfollowed by diabetes, smoking and obesity. Those are the biggest predictors of early death. Will my hon. Friend assure me that tackling those factors in the poorest areas will be a high priority for the Government?
Caroline Flint: I very much want to take this opportunity to congratulate all those in Sloughs local authority and health services on their efforts to reduce health inequalities. For example, some fantastic work has been done on testing for diabetes in the south Asian communities. However, I agree that more has to be done, and that is why health inequality targets will be mandatory in the local area agreements from next year.
Anne Main (St. Albans) (Con) St. Albans is nowhere near Hull, but the issue is the same. I have written to the Secretary of State about the inequalities in provision that prevent equality in health outcomes in my constituency, where district nurses are in short supply. They seem to have to beg, borrow or even steal supplies to treat patients. [Hon. Members: Steal?] I use the word in a general sense. I know that the right hon. Lady has received my letter. Will the Minister ensure that my constituency gets the right amount of funding to enable the right amount of health care to be delivered to those patients who are suffering under the present system?
I hope that everyone heard that plea for more funding for the NHS. I cannot comment on the hon. Ladys letter as I have not seen it, but more health professionals are working in the community
than ever before. The inroads on health inequalities that we are achieving are due to the fact that we are working on prevention as well as just treatment. Moreover, there is more help in the community available for those who have suffered heart attacks or cancer. Those who plan health services must look closely at what works and what does not. There are plenty of good examples around the country, and I urge the hon. Lady to come and see how that planning can be done well.
Andrew Mackinlay (Thurrock) (Lab): When this Question Time is over, will the Minister look at the indices of health deprivation and inequality in the borough of Thurrock? I remind her that I advised against abolishing the Thurrock PCT. Contrary to my wishes, it was abolished and merged with something else, even though the Government planned widespread growth in my area. The inequalities in single-practice GPs, and their age profile, need to be addressed by the urban development corporation and the Government. The new PCT is not sufficient for purpose: it is unable to address the inequalities in my constituency today, or the ones that will come about unless my hon. Friend intervenes.
Caroline Flint: I want to say two things to my hon. Friend. First, I accept that the reorganisation of the PCTs may not have been everyones desired outcome, but we have made sure that dealing with health inequalities is an essential part of their role and responsibility when it comes to commissioning services to meet the local populations needs. Therefore, every PCT, regardless of shape, must look at where the health inequalities are in its area and make sure that it delivers appropriately.
Secondly, we are devoting more attention to dealing with the different determinants that affect peoples life chances and health. Our work with local authorities is very important in that respect, as are the mandatory targets for health inequalities in local area agreements. The forthcoming White Paper will ensure that there is a good working partnership with local communities in the delivery of health. However, I will look at what my hon. Friend has said and get back to him.
Richard Younger-Ross (Teignbridge) (LD): Does the Minister accept that the health indices are a broad measure of difficulties, but that rural areas face particular problems? In those areas, the indices do not point out the inequalities and poverty that exist. In her drive to ensure that GPs are able to provide better services for their communities through undertaking more diagnostic services, will she ensure that those in rural areas are given additional funding? That is needed, because it costs more to take such services into rural areas than into towns and cities.
The hon. Gentleman makes an important point. Based on disease, it is clear that in some parts of the country greater numbers of people suffer from cancer, heart disease and so forth, and we have to address that. We also have to recognise issues around older populations and access to services, which is why I ask the hon. Gentleman to join us in continuing to make the case for services outside hospitals, such as the use of mobile units where people
actually live, rather than expecting them to go to a building that, with the best will in the world, does not necessarily serve their interests. That is also why we have improved opportunities for nurses to do many of the tasks that, 20 years ago, could be done only by GPs.
Jane Kennedy (Liverpool, Wavertree) (Lab): I invite my hon. Friend to consider how better partnership working might improve our severe health inequalities in Liverpool. Does she know that last month, in the very same week that the NHS announced its welcome stroke care pathway, Lib Dem-led Liverpool city council announced the proposed closure of one of the two venues from which the pathway was to be run, dispersing the staff who had just been trained to run it? I invite her to give the NHS the strongest possible encouragement to continue with its excellent work, which seems to be one of the few ways in which we can make a serious effort against health inequalities in Liverpool.
Caroline Flint: I thank my right hon. Friend for that information. There is no doubt that stroke and conditions such as diabetes and coronary disease are among the biggest diseases facing the NHS. The issue is not just about helping people so that we can prevent them from acquiring those diseases, but about giving them support to allow them to live longer once the disease has become part of their life. Although it is difficult for me to comment in depth, I suggest that the Lib Dem council has taken a rather short-sighted approach in respect of the unit.
Sir Patrick Cormack (South Staffordshire) (Con): If the Minister truly believes that those who suffer from cancer should have an equal chance wherever they live, will she explain to the Parliament of the United Kingdom why those who live in Scotland seem to stand a better chance than those who live in England?
Caroline Flint: It was a decision that Parliament made when we decided to devolve different powers to Scotland. In fact, we have the shortest waiting times on record and we are working to reach our 18-week target. Fewer people are dying from cancer, coronary heart disease and stroke than ever before [Interruption.]
We want the sort of services that meet peoples needs, which currently may not be met. That means re-evaluation of services run in hospitals, to see where better they might be provided, so that we can make sure that everybody, regardless of where they live, has access to a good service.
Mr. Stephen Hepburn (Jarrow) (Lab): Eight people in the UK die every day from mesotheliomaan asbestos-related cancer contracted predominantly by poorer working-class people who were exposed to asbestos in their workplace. One of the best ways to address inequalities in the health service is to treat those people, so when will the Minister put her weight behind prescribing the drug Alimta, which is the only effective treatment for mesothelioma, so that it is freely available on the NHS to those people who need it?
Caroline Flint: At this point, all I can say to my hon. Friend is that I am sure that NICE will listen to representations from people on the advanced case list, but as the Minister of State, my hon. Friend the Member for Leigh (Andy Burnham), said earlier, we have to have an independent approach to the licensing of drugs and to guidance for the NHS. However, I appreciate my hon. Friends points, and if he would like to make representations to NICE on behalf of his constituents, I am sure that they will be listened to.
Dr. Andrew Murrison (Westbury) (Con): When Health Ministers, their officials and the Labour party chairman pore over the NHS heat map that they have created to put Conservative and Liberal Democrat areas out into the cold, and when they divert health funding away from the constituencies of their political opponents, what account is taken of the likely impact on deteriorating health inequalities in those parts of our country where there is no immediate prospect of party political advantage for Labour?
I have been in a number of debates with members of the Opposition Front Bench and on many occasions I have heard them say that they understand and appreciate that there are different health inequalitiesat least that is what they purport to think in those debates. The fact is that there are inequalities in life expectancy, and higher rates of cancer and heart disease in some parts of the country than in others, and within areas. That is why my hon. Friend the Member for Slough (Fiona Mactaggart) is right to raise her point about her needs in terms of the wider health prospects for people living in Berkshire. The Conservatives approach to funding is
The Minister of State, Department of Health (Ms Rosie Winterton): As in England as a whole, cancer patients in Hendon are treated faster than ever before. At the Royal Free Hampstead NHS Trust, where most cancer patients in Hendon are treated, 100 per cent. of patients are seen by a cancer specialist within two weeks of GP referral and receive treatment within two months.
I am sure that my right hon. Friend would agree that that record would not have been achieved without the setting of targets. Will she commend the new out-patients oncology department at the Royal Free, which has state-of-the-art facilities? Will she also look at ensuring that patients who go to Barnet hospital
who are in need of tertiary care are referred to the Royal Free, rather than Mount Vernon hospital as at present? That would enable them to take advantage of the excellent record at the Royal Free and would mean that they could have treatment closer to home, using transport links rather more effectively.
Ms Winterton: My hon. Friend is quite right to point to the advances that have been made in terms of the extra investment that has gone into cancer treatment, and the increased number of cancer consultants and clinical nurse specialists. That has made a real difference to the outcomes for cancer patients. Of course, the cancer networks look at the referral patterns and I shall certainly make sure that the cancer network that oversees his area is aware of the points that he has made.
Mr. Peter Lilley (Hitchin and Harpenden) (Con): Is it still intended to move the Mount Vernon cancer centre, which also serves the people of Hendon, to central Hertfordshire, as promised at the last election, or is it the case, as the local health trust now says, that it is precluded from including a cancer centre in the proposed new hospital in central Hertfordshire for financial reasons, if indeed such a hospital is ever to go ahead? Will the Minister clarify that?
Ms Winterton: The East of England strategic health authority is reviewing acute hospital services in the east of England and the needs of cancer patients will, of course, be taken into account in that review. Any reconfiguration of cancer services will be in line with the NICE guidelines for improving outcomes, which are designed to improve the overall quality of care for cancer patients.
The Minister of State, Department of Health (Caroline Flint): We are fully committed to ensuring that all young people receive high quality personal, social and health education. We have made sex and relationships education a mandatory requirement of the new healthy schools standard, which 80 per cent. of schools are working towards. That is a voluntary programme. We have continued to fund a PSHE certificate for teachers and nurses to improve the quality of delivery, and we have announced the creation of a new PSHE subject association in line with other curriculum subjects in order to raise the status of sex and relationships education.
Natascha Engel: Will the Minister consider adopting the proposals outlined in the recent Institute for Public Policy Research report by Julia Margo, which recommends the teaching of sexual health and education at primary school, before children reach secondary school level, as a way of dealing with the rise in the number of teenage pregnancies and sexually transmitted infections?
Caroline Flint: I have not seen the IPPR report yet, so I cannot commit myself to it, but it is important that we are able to have a mature debate about sex and relationships education. That education has to be age-appropriate, but it is part and parcel of how we support young people as they grow up so that they can make informed decisions at appropriate points in their lives and be confident adults. [ Interruption. ] I do not understand the shouting and sniggering that is coming from the Opposition Benches.
There has clearly been a wish from parents to have more support. My colleagues in the Department for Education and Skills are looking at how they can support parents in having the right conversations with their children at the right time, because that is where some of the support needs to be directed.
Sandra Gidley (Romsey) (LD): The Minister will be aware of the report on her Departments website that shows a clear correlation between educational qualifications and the method of contraception used. For example, a woman with no qualifications is four times as likely to be sterilised as a woman with a degree, and a woman with a degree is three times more likely to use condoms than a woman with no qualifications. Does that not signal to the Minister that we are getting PSHE badly wrong? We need more information earlier, and it would be better to have specialist subject teachers to deliver that part of the curriculum, rather than geography or maths teachers.
Caroline Flint: As I said earlier, we think that part of the way in which quality will be raised will be through the PSHE certificate for teachers and nurses, which will increase their confidence in delivering the subject. However, there are good examples of schools that are working in partnership with othersboth inside and outside the schoolto deliver the sort of sexual health services that young people require. We need to make sure that appropriate information is given, although that can be delivered by a number of different individuals and organisations. Young people certainly complain about the patchy nature of PSHE. As they grow into young adults, clearly the process must be continued with good advice about the range of contraceptives available that NICE supports the use of, and the promotion of by our GPs.
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