The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart): Over the last 40 years, the fluoridation of water in selected areas has made a worthwhile contribution to improving oral health, but we are taking further expert advice on the effects of fluoridation before considering whether changes should be made to the current legislation which leaves the water undertakers to decide whether to agree to health authority requests for new fluoridation schemes.
Mr. Winterton: I am personally strongly opposed to the mass fluoridation--the mass medication--of the public water supply, so I ask the Minister how the present Government and the Medicines Control Agency can reconcile their policy and practice with United Kingdom and European medicines legislation, because the whole purpose of adding fluoride to drinking water is to treat, prevent or cure a disease. That is the intention of those authorising the process, and that is how the consumer perceives it. Is there going to be legislation compulsorily to medicate our total water supply?
Ms Stuart: It was our desire to establish a good scientific evidential basis for fluoridation. The York report was published last October and as a consequence of that we have asked the Medical Research Council to provide a better evidential base; but as the hon. Gentleman rightly pointed out, the purpose is to improve the dental health of this nation, so I hope that, despite the fact that we shall be asking for evidence, he welcomes the tremendous investment in South Cheshire health authority, which has approved some 27,000 extra registrations for dentists. He now has a dental access centre in his constituency, and some £60,000 was invested in the dental care development fund. We are therefore working on both fronts--to improve the dental health of the nation and to obtain better evidence.
Ms Stuart: Despite the number of applications that we have had for fluoridation, none of them has succeeded simply because we have made it absolutely clear that the majority of the population would have to be in favour of any extra fluoridation, should it be implemented.
Mr. Andrew Robathan (Blaby): But is not the evidence extremely mixed, including that from the York report? Although it appears that fluoride does have some good topical effect on teeth, too much fluoride discolours teeth and we do not yet know its long-term effects on the bone mass. Fluoride is, after all, a poison. Will the Minister comment on that?
Ms Stuart: Of course there are also hugely varying levels of naturally occurring fluoridation in the country--there are many areas where fluoride occurs naturally in the water. That is why there is a two-pronged attack. We are not only looking at the evidential basis of what adding fluoride would do, but at the same time improving access to and the quality of the dental services available. In particular, we are paying attention to what happens to children--setting up pilot projects that encourage young children to brush their teeth more frequently. We are working along both lines, to improve dental health and to do further research on fluoridation.
The Minister of State, Department of Health (Mr. John Hutton): An additional £105 million is being made available to the national health service for community equipment services over the three years from April 2001, and local authorities are receiving additional provision in their personal social services settlements. New guidance aimed at improving these services was issued last month and copies of the guidance are available in the Library.
Mr. Levitt: I thank my hon. Friend for that answer. In parts of the country such as my own, where assessments are carried out by social services in one local authority and the implementation of disability services in the home is carried out by the housing authority in another, there is some confusion. I am sure that the guidelines will be very helpful. Would my hon. Friend note that last Friday I opened a disability equipment loan centre organised by the British Red Cross in Buxton, and take this opportunity to welcome the co-operation of the voluntary sector in this way?
Mr. Hutton: Yes, I certainly would. May I start by wishing my hon. Friend many happy returns as I believe that it is his birthday? Also, I hope that he will have another happy return in the not-too-distant future.
I certainly agree with my hon. Friend about the importance of the voluntary sector and the role that it can play and the contribution it can make in this important area. I strongly agree that there is an overwhelming case for the integration of social services and NHS equipment services at a local level. My hon. Friend will be aware that the Government are committed to seeing that take place, and we have issued guidance to local authorities and the NHS to ensure that that can take place in 2004.
Mrs. Caroline Spelman (Meriden): Despite the Prime Minister's personal intervention, taking responsibility for community disability a year ago, it remains an area of failure, although we welcome the announcement of the money today. However, the Audit Commission's recent report--called, rather ironically, "Fully Equipped"--states that poor quality services are stripping disabled people of their dignity. Will the Secretary of State match our proposal to establish a single fundholder to pay out incapacity benefit and with the power to purchase physical aids, physiotherapy and a range of other medical treatments?
Mr. Hutton: We need to be absolutely clear about one thing: the problems did not start on 1 May 1997. In fact, the report to which the hon. Lady refers represents just as much a description of the Tory years, when they were managing the NHS, as anything else. Of course, we would take her strictures on the subject a little more seriously if she and her hon. Friends would match our spending on social services, because she will be aware that the report deals with social services issues. She will also be aware that until and unless the Conservative party matches that spending, her words and her crocodile tears will be dismissed as completely contemptible.
The Secretary of State for Health (Mr. Alan Milburn): Some £95 million from the new opportunities fund and £100 million of NHS resources are being invested in cancer treatment facilities, and 56 new linear accelerators, 95 new CT scanners and 35 MRI scanners have now been allocated across the health service.
Mr. Pike: I thank my right hon. Friend for that answer. I am sure that he will be aware of the announcement last week of the additional resources for the Royal Preston hospital, which will ensure that the facilities in that hospital can meet the needs of the people of Lancashire. We welcome that, but can he assure us that that hospital will be able to meet the needs of all the people in Lancashire in the future and supplement the facilities that have been traditionally provided at the Christie hospital in Manchester?
Mr. Milburn: There is a very important role for both hospitals, and it is extremely important that we invest in more equipment and staff in those cancer services and, indeed, in greater prevention of cancer in the first place. As my hon. Friend is well aware, after decades of the shameful neglect of cancer services, the investment is now being made. It is worth my hon. Friend's reminding his
Mr. Peter Lilley (Hitchin and Harpenden): Is the Secretary of State convinced that the NHS has yet got the balance right between surgical and chemical or radiotherapy cancer treatments? Is he aware that this country has pioneered the microsurgical treatment of cancer, which increased survival rates and reduced the complications and indignities suffered by patients when it was adopted and disseminated abroad? Why is not more effort being put into disseminating those skills throughout the NHS?
Mr. Milburn: With all respect to the right hon. Gentleman, a big effort is being made to ensure that not only chemotherapy and improved radiography services and so on are available, but that more surgical options are available to cancer patients. As he is aware, during the past year or so, we have made great strides in ensuring that, although all the problems have not been solved, there is at least progress on the waiting times that cancer patients have to endure for initial outpatient appointments. We set a target for patients to be seen within a fortnight. Thankfully, about 100,000 women with suspected breast cancer have now been seen within a matter of weeks, rather than months, which was the situation previously, and they go on to a variety of treatments, including surgery.
The right hon. Gentleman is right to suggest that we must get the balance right, but to do so we must ensure that the investment is sustained. If he is as concerned as he says he is about those issues, he might have a word with his colleagues on the Conservative Front Bench to remind them that matching Labour's health funding for the NHS is an important priority for his party.
Mr. Michael Clapham (Barnsley, West and Penistone): I welcome the investment in cancer treatment, but, as my right hon. Friend will be aware, mesothelioma is a particularly nasty form of cancer, caused by exposure to asbestos. This year, there have been 1,500 deaths from mesothelioma, and Professor Peto's forecast is that that will rise considerably and peak in about 2010 or 2020. He will also be aware that the Macmillan foundation is training a network of nurses to provide care for people suffering from mesothelioma, but there is a need in the initial stages for an information line. Will he consider how an information line may be set up and co-ordinated in the first stages to support that network of nurses?
Mr. Milburn: If my hon. Friend cares to write to me with his suggestions, I will gladly consider them. He also made an important broader point, which is that inevitably in the NHS service we often focus on how we can improve treatment services. However, as we all know, a huge number of deaths from illnesses such as cancer and coronary heart disease are preventable by action in the workplace and by tackling such things as smoking. We are committed to such preventive action, and it will be worth my hon. Friend's reminding his constituents that while the Government are backing measures that mean
Mr. Philip Hammond (Runnymede and Weybridge): Labour's manifesto at the last general election pledged to end waiting for cancer surgery. Does the Secretary of State consider the pledge to have been met?
Mr. Milburn: As the hon. Gentleman knows, we set a target for reducing--[Interruption.] If the hon. Gentleman can wait before asking another question, he will get an answer to the first. We set a target for reducing the time that it takes to get people with suspected cancer into hospital. I am pleased to say that between 95 and 97 per cent. of women with suspected breast cancer are now being seen within a fortnight. We have set additional targets for people to be seen within a fortnight for all forms of suspected cancer, including lung and prostate cancer. As a consequence, we are reducing the waiting times for all forms of cancer treatment.