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The Parliamentary Under-Secretary of State for Health (Yvette Cooper): Consultation on the sexual health and HIV strategy ended on 21 December. An action plan is being developed. In addition, we have started to prepare for implementation by asking health authorities to undertake a baseline review, and by seeking expressions of interest in chlamydia screening.
Sandra Gidley: Is not the truth that the long-awaited strategy is little more than an HIV/AIDS strategy with a teenage pregnancy policy added on? Worthy as those matters are, should not the strategy include issues such as sexual dysfunction and endometriosis, which have a huge impact on people's lives? Most damaging, there is little emphasis in the strategy on barrier methods of contraception. I am glad that chlamydia screening has been mentioned because chlamydia rates have doubled in the past five years, along with those for other sexually transmitted diseases. But is it not too little, too late? Is not the Government's record the sexual equivalent of fiddling while Rome burns?
Yvette Cooper: I completely disagree. It is the first time that this country has ever had a comprehensive sexual health strategy. It covers issues around all kinds of sexually transmitted infections, contraception and abortion. It sets clear targets, including on preventing new transmissions of gonorrhoea. It has been widely welcomed across the country for focusing not simply on prevention but on integrating prevention and HIV/AIDS and sexual health services.
Ms Meg Munn (Sheffield, Heeley): Will my hon. Friend join me in congratulating young people in my constituency who have been involved in producing the local sexual health strategy? Does she agree that involving young people in producing such strategies is the best way
Yvette Cooper: I welcome the work to which my hon. Friend refers. It is true that a lot of the work on prevention is effective only when the groups at whom the work is aimed are involved in its development. With teenage pregnancies and preventing teenage pregnancies, it is particularly important to get teenagers involved. We are aware of the broad health impact of teenage pregnancies not simply on teenagers but on their children. That is why it is so important to keep on bringing the rates down.
The Minister of State, Department of Health (Jacqui Smith): The proportion of babies born by Caesarean section has risen gradually over the past five years. To help set standards on the use of Caesarean sections, the Department commissioned the national Caesarean section audit. The findings will form the basis of clinical guidelines to be issued by the National Institute for Clinical Excellence and the development of the national service framework for children.
Dr. Cable: Does the Minister share the assessment of the Royal College of Midwives that the number of operations at presentapproximately double the level considered safe by the World Health Organisationis unnecessary, unwanted, a major drain on NHS funding and a risk to mothers? If she does share that assessment, why are the Government not moving more urgently to reverse the trend?
Jacqui Smith: I think that I explained that the Government are moving urgently. There is no clinical consensus about the right level of Caesarean sections. Through NICE, we will be able to develop guidelines that mean that instead of focusing on overall levels we are able to ensure that the advice and the service that any individual woman receives, whether a Caesarean section or other forms of delivery, is appropriate. It is right that, building on the work that the Department has already done in gaining information, we now develop guidelines to ensure that the processes are appropriate for each woman. Alongside that, I am sure that the Royal College of Midwives recognises and appreciates the extra investment that the Government are putting into maternity services and into increasing the number of midwives available to support women.
Ms Julia Drown (South Swindon): The Minister has spoken of the advice that parents should be given. The pregnancy book given out to parents-to-be says that the Caesarean operation is "safe", rather than pointing out that it is still a major operation and spelling out the risks, as the risks associated with other forms of childbirth would be spelled out. Will the Minister ensure that the guidance
Jacqui Smith: As I told the hon. Member for Twickenham (Dr. Cable), I think the information that individual women receive is crucial. Some of it will be given during discussions that they have with their obstetricians, and some will be published. One of the important jobs for the maternity component of the national service framework for children will be ensuring that the information we provide for women is available to them, so that they and their clinicians can make the best choices in each case.
Mr. David Tredinnick (Bosworth): Would not one way of reducing demand for Caesarean operations be to increase the supply of acupuncturists? At Derriford hospital in the constituency of my hon. Friend the Member for SouthWest Devon (Mr. Streeter), only 7.5 per cent. of babies are delivered by Caesarean.
The working group on herbal medicines established by the Minister's Department, under Professor Pittilo[Laughter]not my right hon. Friend the Member for Kensington and Chelsea (Mr. Portillo). The working group will be looking at the regulation of acupuncture. Does that change in Government strategy represent original thinking?
Jacqui Smith: We wondered who would get the alternative medicine question todaybut the hon. Gentleman makes an important point about the good work that is going on at Derriford hospital. When I visited a Walsall hospital maternity unit, I saw interesting work going on there as well. Midwives are being trained to use complementary therapies; indeed, more midwives are being trained throughout the country to use such therapies, and use them when appropriate.
The remit of the working group under Professor Michael Pittilothis is not, as some thought, a new job for one of the hon. Gentleman's colleagueswill be to present proposals to make self-regulation statutory for practitioners of herbal medicine, and proposals to revise provisions in the Medicines Act 1986 relating to the administering of such medicine. The group's recommendations will form a basis for wider public consultation before proposals are finalised and put to Parliament. I have no doubt that the hon. Gentleman will follow developments with the assiduity with which he follows all such matters.
The Secretary of State for Health (Mr. Alan Milburn): Provisional figures show that 10,000 more nurses were working in the NHS in 2001 than in 2000. That is a consequence of better pay, improved child care and more flexible working.
Mr. Milburn: The news about recruitment is indeed very good. I well remember that when we announced the NHS plan in the House, the Opposition said we would never hit the target of an extra 20,000 nurses by 2004. Now, at the beginning of 2002, there are already 16,000 more. We are not just on target; we are well ahead of target. The RCN has played an important part in that, as have Unison and the other trade unions representing nurses at all levels in the NHS. We work closely together precisely to try to get the policies right, and not just bring nurses into the NHS but ensure that they stay.
Mr. Milburn: It is one of the joys of my life that I am not responsible for all things Welshnot that all things Welsh, as personified by hon. Members of all parties, are not absolutely admirable. There is very good news about nurse training places. I note that the Universities and Colleges Admissions Service reports that the number of people applying for nursing degrees has risen by 18 per cent. in one year. The news is better with regard to applications for nurse diploma courses: they are up by 83 per cent.