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The Parliamentary Under-Secretary of State for Health (Ann Keen): It is the responsibility of the local NHS to improve access to safe services and to improve outcomes for mothers and babies. In 2008, the Healthcare Commission published "Towards better births: A review of maternity services in England", which assessed the quality, capability and efficiency of maternity services in England.
Angela Watkinson: Queen's hospital in Havering caters for 7,000 births a year, with the overflow going to King George hospital in Goodmayes. NHS London is proposing to close the maternity service at King George and transfer another 3,000 births a year to Queen's in Havering. Does the Minister share my concern that when Havering is over capacity, which it undoubtedly will be, new mothers will have to travel much further afield? Should the maternity service at King George not be retained and kept open?
Ann Keen: I thank the hon. Lady for the way she asked her question. She will of course be aware that the birth rate in north-east London is higher than that in the rest of the country and is expected to continue to rise over the next few years. That will put increasing pressure on maternity and newborn care services. I know that the aspect of service at King George that was mentioned is being clinically considered at the moment. That is all that will happen-it is way before any consultation process will even commence. Barking will open this summer, and that will also make a difference. I am fully aware that the clinical needs and safety of mothers and babies at all times must be taken into account.
12. Mr. Virendra Sharma (Ealing, Southall) (Lab): What steps his Department is taking to support people who require assistance with the cost of health care to enable them to continue living in their own home. 
The Secretary of State for Health (Andy Burnham): NHS continuing health care may be available to help people to continue to live in their own home if they are assessed as having a primary health care need. Going forward, providing more care in the patient's home can improve convenience, quality and value for money-for instance in areas such as renal dialysis-and there are more savings to be made from closer integration of health and social care.
Mr. Sharma: I thank the Secretary of State for his reply. Enabling people to continue living in their own homes when they need care is a crucial part of developing a national care service. Does the Secretary of State agree that to create a national care service will require a consensual and non-party political approach, which the Opposition seem unable to comprehend?
Andy Burnham: I said when we published the Green Paper last year that I was seeking broad consensus on this issue and that remains my objective. It is one of the biggest issues that we face as a society, and I think that the country is looking to politicians to work constructively towards a durable solution. Before we leap to criticise each other, we need to focus on the fact that there are people today in all our constituencies paying the cruellest taxes of all-the costs of care that mean that the more vulnerable people are, the more they pay. A national care service will create a national entitlement and end the local lottery in which councils set different rules. The principle of a national care service has been widely welcomed, and I call on all sides to help us to make it a reality.
Miss Anne McIntosh (Vale of York) (Con): The Secretary of State will be aware that North Yorkshire is going down the path of allowing people to remain in their own homes. What does he say to GPs who will say to the Department that in rural areas such as North Yorkshire it is very difficult for carers to visit and deliver care to as many homes as they might in urban areas? That is a great challenge that we face in delivering personal care in people's own homes.
Andy Burnham: I certainly agree and the hon. Lady makes an important point. The different geography and demography of local communities mean that home care will be more suitable in some areas than in others. However, in an area such as North Yorkshire, I think that telecare will have an important part to play in ensuring that people can be monitored daily without their having to travel to a clinic or hospital. There is great potential in this field, although of course it must be a local decision. It must not be imposed on people but, where people want it, it can be convenient for the public and can provide value for money for the taxpayer.
The Minister of State, Department of Health (Phil Hope):
The Department of Health takes its responsibilities under the Disability Discrimination Act 1995 seriously,
including helping people to access printed material. All Department of Health publications are published on our official website in the most accessible electronic format available with technology that can, for example, read aloud what is written. We also make publications available on request in Braille, audio, large print and other formats.
Miss Begg: The DDA notwithstanding, it is still difficult for individuals to access their health information via accessible formats, and it is not always working on the ground. Does the Minister accept that health information can be very sensitive and that it is wrong that people who are sight impaired should have to depend on relatives, and sometimes strangers, to help them to access that information?
Phil Hope: I totally agree. It is wrong for the NHS not to provide information in alternative or accessible formats for people who are blind or partially sighted. My hon. Friend will be pleased to know that the Department has issued guidance to every GP practice, primary care trust and strategic health authority to support service improvements. It will include guidance on improving the experiences of people with sight loss in receiving health care and advice.
Mark Pritchard (The Wrekin) (Con): Will the Minister consider the merits of transferring the money that is currently spent on translating documents into foreign languages to ensuring that more documents are translated into and are available in Braille? He will know that people can learn English, but that people who have no sight cannot just see instantaneously.
Phil Hope: I understand the hon. Gentleman's point. It is a challenge for all health care providers to ensure that such service users can access and use services by gaining access to written material. That is a matter for local decision making, but I hope that local providers will consider the needs of local populations and ensure that people from all communities can access the information that they need in a format that is suitable for them.
The Parliamentary Under-Secretary of State for Health (Ann Keen): In the latest period for which statistics are available, 98 per cent. of patients started their first treatment within 31 days of being given a cancer diagnosis. Some of those patients will have benefited from the two-week wait, the 62-day standard and the new waiting time commitments in the cancer reform strategy.
Ms Smith: I thank my hon. Friend for her response. Does she agree that it is now critical that the Government should proceed to implement the promised guarantee that patients will see a cancer specialist within two weeks? That is what the country expects and wants.
I thank my hon. Friend for making that point, because that is of course the case. We have used this year's operating framework to ask all primary care trusts to examine GP practice and use of the two-week
referral pathway. From 1 April this year, there will be a new right in the NHS constitution for patients to be seen by a cancer specialist within two weeks of urgent GP referral.
The Secretary of State for Health (Andy Burnham): Today the Government are launching their consultation on a strategy for treating chronic obstructive pulmonary disease, which is the UK's fifth largest killer. The strategy seeks to improve diagnosis and treatment of the condition, which affects more than 3.2 million people in England. Tomorrow we will publish the independent inquiry by Robert Francis QC into failures at the Mid Staffordshire NHS Foundation Trust. On Thursday, we will hold the first dignity action day.
Harry Cohen: I welcome the strategy on COPD, but let me return to cancer. The Secretary of State will be aware that the incidence of cancers is higher than average in parts of north-east London such as my constituency. That is the case for prostate and bowel cancers. What significant plans do the Government have to improve early detection, treatment and care for those who are most affected?
Andy Burnham: Waltham Forest was one of the early adopters of the Government's bowel cancer screening programme, ahead of national implementation. We take these matters incredibly seriously, and, as my hon. Friend will know, we have extended the bowel cancer screening programme to men and women aged between 70 and 75.
When we came to government, we set ourselves the objective of reducing deaths from cancer among under-75s by 20 per cent. The latest report from the national cancer director says that we are well on the way to meeting that target, as the figures have come down by 19.3 per cent. We hope that we can make further progress, and my hon. Friend is absolutely right to say that this issue is a top priority for the Department and the Government. Going forward, we will have a one-week entitlement to tests for suspected cancers, because we believe that early diagnosis is absolutely fundamental to cutting premature deaths from cancer.
T2.  Paul Rowen (Rochdale) (LD): Primary care trusts in the north-west currently have a year-to-date deficit of £15.3 million. Will the Secretary of State tell us, or give us a guarantee, that important services to patients will not be sacrificed in trying to reduce those deficits?
The Minister of State, Department of Health (Mr. Mike O'Brien):
We have made it very clear that managers need to focus on ensuring that they deliver the best
quality of care. The issue of finance comes second to quality. I can assure the hon. Gentleman that managers have been given that very clear guidance.
T5.  Mr. Eric Illsley (Barnsley, Central) (Lab): Last year, a constituent of mine paid £4,000 for a private operation that she required to save her sight. A few months later, the operation was made available on the NHS by the National Institute for Health and Clinical Excellence. My constituent has obviously lost out. Will the Minister look again at the NICE appraisal system, and improve its transparency and speed of decision making, to avoid this situation in future?
Mr. O'Brien: I agree that transparency is important in all aspects of NICE's work. Full details of its forward work programme are readily available on its website, wherever possible accompanied by expected publication dates for specific pieces of guidance. NICE consults publicly on each piece of draft guidance before making a recommendation.
Robert Key (Salisbury) (Con): Do Ministers agree that the work of the Health Protection Agency Centre for Emergency Preparedness and Response at Porton Down is absolutely crucial to the security of our country? In view of the work that that extraordinary organisation has done on swine flu and vaccinations, why on earth are they proposing to move it? Not only does it do research into the most dangerous pathogens that might afflict our country, but it puts practical science to work in making vaccinations against them. Why are Ministers proposing to move the establishment and its pathogens to Harlow in Essex?
The Minister of State, Department of Health (Gillian Merron): I can assure the hon. Gentleman that no final decision has been taken, and I certainly share his views about the excellent work done by his constituents and others at Porton Down. I also understand that he had a very useful meeting to discuss the future there. I know he will understand that the HPA has to look at all options to further and develop the very important work being done for the future.
Hugh Bayley (City of York) (Lab): Since 2003, the median waiting time for in-patient treatment at York hospital has fallen from 15 weeks to five. Does the Minister agree that setting targets for waiting times has helped to bring them down and that abandoning the targets, as the Conservatives suggest, would cause waits to increase?
Andy Burnham: My hon. Friend will know that at the last election we set a challenge for the NHS to ensure that no patients waited longer than 18 weeks, other than those who opted out for clinical reasons or by choice. We have made amazing progress towards that goal. The NHS has risen to the challenge and 18 weeks is now the outside, with many patients being treated, as he says, on a much shorter timetable. In my view, removing the target would bring about the return of differential waiting standards across the country-what the public would describe as postcode prescribing or a postcode lottery. We will enshrine the right to treatment within 18 weeks in the NHS constitution as a patient guarantee.
Andy Burnham: We published a Green Paper and are looking at all the options for building a lasting consensus on this issue, which is one of the most important facing the country. We would welcome Opposition Members rejoining the search for a national consensus, rather than making cheap points at Health questions today. It is a complicated issue that deserves a considered approach. I do not believe that making cheap remarks like that will help.
Dr. Howard Stoate (Dartford) (Lab): To ensure that GPs maintain their clinical skills, they undergo appraisal every year. Starting from next year, of course, that will lead to reaccreditation by the General Medical Council, but unfortunately the NHS appraisals toolkit has gone offline at the critical time in the year when GPs need to get their appraisals sorted out. Will the Minister make a statement to the House on where we are with that website, so GPs can be reassured that their skills will be tested in the right way and in due time?
Mr. Mike O'Brien: It was found that the toolkit had the potential to be compromised. We therefore took the view that it needed to be examined properly and in effect repaired, to ensure that it cannot be accessed by hackers. Work is now ongoing: it is on schedule at the moment, but I will keep GPs and my hon. Friend informed about its progress.
T4.  Mr. Hugo Swire (East Devon) (Con): Following a seminar on Lyme disease that I hosted in the House in October 2008 and a question that I raised in the House in December 2008, the Under-Secretary of State offered to host a meeting about Lyme disease. I followed that up with three telephone calls to her office and one letter. Given the fact that there has been an increase of 90 per cent. in cases of Lyme disease since 2006, what kind of message are the Government trying to send to people suffering from the disease?
Mr. Mike O'Brien: We want to ensure that primary care trusts are the main way that patients ensure they get the services that they deserve. Sometimes it is better to ensure that those services are provided by organisations with which the PCT can act at arm's length to supervise properly and ensure that they are acting on behalf of the patient and the taxpayer.
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