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The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): In 200001, we invested £190 million in cancer research. By 2003, we will be investing an additional £20 million each year in the cancer research network and an extra £4 million in prostate cancer research. That new funding means that for the first
Mr. Bellingham: I welcome the Minister's announcement of that investment. I was recently contacted by a constituent of mine, Robert Blunden, whose wife tragically died of cancer last year after a very long illness. Is the Minister aware that the oncologist who treated Mrs. Blunden, and 27 other cancer specialists, recently wrote to the press deploring the fact that the National Institute for Clinical Excellence had refused to permit the use of two new cancer drugs, despite the fact that there is no oncologist on the appraisal committee? We will never know whether those two drugs could have saved Mrs. Blunden's life or helped to alleviate her pain. However, given the Minister's and the Secretary of State's huge commitment to cancer care, does not she agree that there should be a cancer specialist on the appraisal committee; and why is she trusting her political judgment rather than the expertise of 27 specialists?
Ms Blears: If the hon. Gentleman really understood how NICE works he would know that the NICE body includes a range of specialists, but not a representative from every single disease specialty. Members of NICE go out to consult clinicians working on the ground, health professionals and patients groups, exactly as they did in the case of those vital cancer drugs. They consulted all those bodies before they reached their decisions.
As a result of the Government's introduction of NICE, some 31,000 patients are benefiting from cancer drugs who would not have benefited before. That is a symbol of the Government's investment and of our determination to ensure that there is not a postcode lottery in access to such drugs. It is right that clinicians are involved.
On the case that the hon. Gentleman highlighted, he has received a letter from my right hon. Friend the Secretary of State giving him full information about all the oncologists and leading clinicians who were involved in the decision, and he knows full well that there was a deep and proper clinical examination.
Mr. Bill O'Brien (Normanton): Does my hon. Friend accept that one of the key agencies for helping cancer research and caring for cancer patients is the hospice movement? Does she recognise that the hospice movement, including the children's hospice movement, faces a serious problem as regards resources, which are required immediately? Will she do all she can to ensure that those services can continue?
Ms Blears: I am very aware of the excellent work that is done by the hospice movement and by children's hospices. We have made a commitment that, by 2004, an extra £50 million will be spent on specialist palliative care. We are world leaders in palliative care, mainly because of the excellent work that is done by the hospice movement. I know that concerns have been expressed about that money getting through to the front line, and I am looking forward to attending the all-party group on hospices tomorrow and having a good discussion with hon. Members in that forum. I can tell my hon. Friend
Dr. Andrew Murrison (Westbury): Earlier this year, Professor Gordon McVie, the director of the Cancer Research Campaign, expressed his concern that the £570 million earmarked under the NHS cancer plan was running into the sand. What guarantee can the Minister give that the funds that she has just described will not similarly run into the sand?
Ms Blears: As the hon. Gentleman knows, the Government have decided to make cancer a top priority. In 200102, we put in an extra £280 million; we shall put in an extra £407 million this year, and an extra £570 million next year. Part of those funds was centrally allocated to ensure that they would be directed to specific issues, but a large part of the extra money was put into baselines, so that people at local level could decidequite properly, under the shift in the balance of powerwhere they needed to spend the money to make improvements in the cancer plan.
I am delighted to tell the hon. Gentleman that we are on track to achieve the shorter waiting times, the investment in equipment, and the appointment of the extra 800 consultants set out in the cancer plan. All those outcomes are being achieved. It is clear that the extra money devoted by the Government to cancer care is delivering real returns for patients who need high-quality care. He needs to be aware that some courageous decisions must be taken about improving investment in the NHS to improve cancer services for patients, and that his party is not prepared to take them.
Mr. Lindsay Hoyle (Chorley): I welcome the Minister's comments on extra funding for palliative care. She may be aware of Derian House, and of St. Catherine's hospice, in Chorleyone a children's hospice, and the other a hospice for adults. They are experiencing severe problems in raising funds from the area and ensuring that the two hospices remain sustainable. I hope that she will give them some secure funding to ensure that both can continue to exist.
Ms Blears: My hon. Friend is right to raise the excellent example of children's hospice care in his constituency. Children's hospices provide a relatively new form of care. Funding under the new opportunities scheme for those services is now open for bids, particularly from children's hospices, and I am sure that his local hospices will be preparing submissions to it. We have also increased carers grants and provision for respite care to provide breaks for families. The significant thing about children's hospice care is that it provides not only terminal care but respite care to enable children and the rest of their familiesincluding their brothers and sistersto have a break from what can be extremely trying circumstances.
Mr. John Wilkinson (Ruislip-Northwood): May I remind the hon. Lady of the unsurpassed work of the Gray cancer institute at Mount Vernon hospital in my constituency? May I urge her to get the Secretary of State to reply to the letters that he has received from Professor Wardman, the director of the institute, who is, rightly,
Ms Blears: I cannot comment on the particular issue that the hon. Gentleman raised, but I shall certainly look into replying to the correspondence to which he referred. I would say, however, that the Government have set up translational cancer centres, which address exactly the issue that he raised: how we translate scientific research into clinical research that can make a difference to patients. We have now set up eight centres of excellence that are involved in the national translational cancer research networkNTRACprocess. They are bringing the benefits of scientific research to the clinical trials that matter for patients. It is because the Government have set up the cancer research networks that we are now seeing the benefit of the investment in that vital research.
The Minister of State, Department of Health (Mr. John Hutton): Three hundred and three primary care trusts have been established and are now operational. The trusts will be accountable to the new strategic health authorities, which will assess their performance. In addition, the Commission for Health Improvement will undertake routine assessments in every NHS trust, strategic health authority and primary care trust.
Laura Moffatt: Does my right hon. Friend agree that our primary care trusts will be judged on how well they work with other organisations in the community to improve people's health and well-being? Does he welcome plans such as those of Crawley PCT to commission partnership posts jointly with social services and the local borough council, to get the very best out of the jobs and ensure that people understand that there is now a cohesive health system in our communities and that the power has gone back right to where it belongs, with our GPs?
Mr. Hutton: Yes, I agree strongly. One of the key jobs of the new primary care trusts will be to bring about the closer integration between health and social care that my hon. Friend described. Most of our constituents see health and social care as one system, and they want them better integrated. We will do all that we can in the Department to encourage that. We have already changed the legislation and we are putting in the investment to ensure that we get that closer integration. I had the good fortune of visiting my hon. Friend's constituency recently and had the chance to discuss this and other developments with the leaders of her primary care trust. They are doing a brilliant job, and so is she.
I endorse what the hon. Lady said. I had a very good meeting last Friday with the chairman and chief executive of the new Mid Sussex primary care trust. What guidance does the Minister give PCTs for the Olympian decisions that they have to take on funding very worthy organisations that approach them for help in preventive health care, for example, such as Homestart? PCTs do not seem to have the money available, and perhaps the new injection of funds will improve that. What guidance is offered on the help that should go to admirable outside organisations that badly need the funds?
Mr. Hutton: In his own way, the hon. Gentleman does do a brilliant job. He has a long association with Crawley, too, but let us not dwell on that. I agree with him strongly about the important role that primary care trusts will playactively, we hopein supporting voluntary organisations and helping to improve the delivery of front-line services. There may be some disagreement on this point. He and many others may make the argument for devolution to the front line, which is absolutely right, but then ask us to issue guidance on how the functions should be delivered. There is a balance to be struck. There are key responsibilities for primary care trusts on which it is perfectly appropriate for Ministers to issue guidancecommissioning and a range of other important servicesbut we trust PCTs to make the right decisions. Their resources are growing substantially, with a 10 per cent. cash increase this year alone. That will also benefit him and his constituents. We want to leave the PCTs free to make their own decisions.
Dr. Brian Iddon (Bolton, South-East): Under the previous health authority, my constituency was one of the most underfunded in the entire country. Now that we have the Bolton primary care trust, and following the Chancellor's excellent announcement yesterday, will my right hon. Friend assure my constituents that he will look again at the most underfunded areas in the country and bring them up to target faster than hitherto?
Mr. Hutton: My hon. Friend will be aware that my right hon. Friend the Secretary of State is currently reviewing the funding formula and the method of allocating resources across the NHS. I hope that we will be able to make appropriate announcements on that in the near future. Many hon. Members of all parties have raised this important issue with me. We must set ourselves the important objective of improving the health of the poorest members of our community at the fastest possible rate. That is the challenge for this Labour Government. We welcome that, and we will take it onin stark contrast to the Conservative party, which could not even bring itself to mention health inequalities in the 18 years for which it had the stewardship of the national health service.
Dr. Liam Fox (Woodspring): First, I thank the Secretary of State for his comments, the sympathy expressed to the family of the road traffic accident victim, and for his support in the past few days. It is a pity that the friendship and courtesy that typifies the way we do business in this place most of the time is not the face that the public see.
Mr. Hutton: If the hon. Gentleman looks at the progress that has been made in recruiting new GP registrars, for example, he will see that a substantial number of GPsnearly 7,000are in training. From that figure, I think that we can meet our target of recruiting a minimum of 2,000 GPs by 2004. Key to that aim is the investment that we are putting into the national health service. The hon. Gentleman expresses concern about the rate of progress in recruiting GPs, but I should point out in the politest way that I can that we will take him and his colleagues seriously when they are prepared to match the investment that we are putting in.
Dr. Fox: Doctors should be recruited into general practice because it is a career that they want, not bought from a GP supermarket. In the past two quarters, there has been a huge increase in emergency admissions through accident and emergency, totalling almost 100,000 above trend. To what does the right hon. Gentleman attribute that increase, and what does it say about the current interaction between general practice and the acute sector, and particularly the burden on GPs?
Mr. Hutton: We are investing significantly in improving our accident and emergency departments, but is it clear that the hon. Gentleman cannot match that investment. I remind him of what I said a moment ago about the number of GPs who are already entering GP training. That is the cohort from which we will meet our target of recruiting additional GPs for the national health service. Across the various areas that he has drawn attention to, we are making progress.
I am glad that the British Medical Association has been able to announce the result of the ballot of GPs on the new general medical services contract. Some 75 per cent. of GPs consider that a sensible way to reform the GPs' contract. That will provide us with a sensible platform from which to continue to improve primary care services, particularly the relationship between primary care and accident and emergency departments.
Dr. Fox: Those answers smack more than a little of complacency. PCTs have staff shortages, they have failed to reach their IT targets, they must repay their deficits this year, and thus they say that little or no money will be available for primary care development. They also have to shoulder the inappropriate role of public health, and on top of that, they are concerned about the Government's plans to push ahead with foundation hospitals. How will the relationship between PCTs and foundation hospitals differ from current relationships?
Mr. Hutton: Basically, the hon. Gentleman is criticising the Government's reform agenda for the national health serviceour attempts to improve its efficiency, productivity and effectiveness. I repeat that we will take his concerns seriously when he can outline for us his reform agenda. Until he does so, most Government Members will be forced to reach the only rational conclusion: the bogus rhetoric of the Conservatives is a
Mr. Eric Illsley (Barnsley, Central): As my right hon. Friend is aware, the primary care trust that serves Barnsley is the biggest in the country. Unfortunately, it started life in April 3 per cent. short of its funding target. That shortfall, which equates to about £6 million, has been compounded by a further £1.5 million debt, and by the shortage of GPs, which costs us money. Will he look again at Barnsley PCT's funding?
Mr. Hutton: I am afraid that I can only repeat what I said to my hon. Friend the Member for Bolton, South-East (Dr. Iddon). I am aware of the issue to which my hon. Friend draws attention, and my right hon. Friend the Secretary of State and all Ministers in the Department of Health are fully committed to addressing it. However, it is worth pointing out that, despite the problems to which my hon. Friend rightly draws attention, Barnsley PCT received a very significant increase in its resources this year. Our challenge and responsibility is to keep that investment coming through, and I can confirm that that is what this Government will always do.