Oral Answers to Questions

David Tredinnick Excerpts

Tuesday 10th January 2012 Commons Chamber

[Mr Lansley]

I should be grateful if the hon. Lady wrote to me about that case and gave me the opportunity to look at it, which I would be pleased to do. From my point of view, we do not countenance such requirements, through charging, denying patients access to any NHS treatment.

[David Tredinnick (Bosworth) (Con)]

In addition to approving drugs, NICE has also approved acupuncture for lower back pain. Should this not be widely available on the health service now?

[Mr Lansley]

Of course, my hon. Friend will know very well that choice of treatment is a shared decision between patients and their clinicians. NICE appraisals are about whether treatments are available in the NHS and giving information to clinicians about their relative clinical and cost-effectiveness, not prescribing that treatments should be available in specific circumstances.

Oral Answers to Questions

David Tredinnick Excerpts

Tuesday 22nd November 2011 Commons Chamber

[Mr Burns]

I heard what the hon. Gentleman said, and I was disappointed that we did not reach his question on the Order Paper earlier, because he has been extremely concerned about the A and E in his own area in Hartlepool. That decision was taken on safety grounds. Emergency care has been provided at the One Life centre. The decision was taken with the support of the local overview and scrutiny committee, which he will appreciate has democratic accountability. That was the right decision. Where there are clinical reasons for taking such decisions, they should be taken.

[David Tredinnick (Bosworth) (Con)]

Has my right hon. Friend the Secretary of State or any of his ministerial colleagues been able to visit the People’s Republic of China to consider traditional Chinese medicine?

[Anne Milton]

I thank my hon. Friend for that question. He must be psychic, because I recently visited China, and it was fascinating to meet Ministers there. He will also be very pleased to hear, as I am sure the whole House will, that I visited a hospital and community centre that combines western medicine and traditional Chinese medicine.

Oral Answers to Questions

David Tredinnick Excerpts

Tuesday 18th October 2011 Commons Chamber

[Paul Burstow]

The hon. Lady is spreading yet more myths and misconceptions about the reforms that this Government are making. If she had researched the matter more thoroughly, she would know that there is a code of conduct for the promotion of NHS-funded services, which makes it clear that providers of primary medical services cannot directly or indirectly seek or accept from any of their patients payment or other remuneration for any treatment. As a result, the PCT is questioning that clinic about how it has used patient information and will continue to pursue the matter.

[David Tredinnick (Bosworth) (Con)]

Does my hon. Friend agree that many patients look to NHS Choices for accurate and unbiased information? Is he aware that its site on homeopathy is both biased and inaccurate? As the Department has had a long-standing review that has not reported, will he—

[Mr Speaker]

Order. I call the Minister.

Health and Social Care (Re-committed) Bill

David Tredinnick Excerpts

Wednesday 7th September 2011 Commons Chamber

[Owen Smith]

I accept that there are obviously different needs and that there is a good case for a needs-based assessment model being used by PCTs in the current situation or by CCGs. Indeed, one of the amendments tabled by Liberal Democrat Members on a needs-based assessment is excellent and I wish that we had tabled it. However, the crucial difference, which I alluded to earlier, is that previously the Secretary of State has had a direct duty under section 3 of the National Health Service Act 2006 to provide and secure a whole range of relevant and necessary pieces of the health ecosystem, such as hospitals, within a given area. Under the Bill, that duty will pass to clinical commissioning groups. That is a further crucial removal of responsibility and accountability from the Secretary of State and transference of them to CCGs.

Under the aegis of the Bill, many CCGs may well plan well for their local population, and perhaps better than primary care trusts, but what if they do not? What if they get it wrong and determine for clinical reasons—or, dare I say it, because in this new world they are sitting cheek by jowl in the boardroom with commercial players who have a stake and a skin in the game financially—that they no longer feel it is “reasonable”, as the Bill puts it, to provide certain services? I think that is perfectly foreseeable.

We already know that because of the cost pressures that PCTs are under, they are having to make difficult decisions about which services they will provide and which they will not. They have always had to do that. It is just possible that CCGs will make duff decisions with which local residents disagree. As we heard earlier from my hon. Friends on the Back Benches, they will not be able to be held to account in the way that the Secretary of State, and eventually PCTs through the Secretary of State, can currently be. Those changes are critical, and I suggest that the Minister reflects on them.

Another crucial change to the Bill that we would like to be brought about is in respect of the costs of bureaucracy. We are changing from 150 PCTs to more than 250 clinical commissioning groups and counting. The latter are smaller and less strategic, and certainly less experienced in commissioning, than PCTs or strategic health authorities, and they are arguably too small to compete equitably with very large and financially powerful foundation trusts. That is a real risk. Crucially, they will also increase transaction costs, bureaucracy and administration costs.

That is why, in new clause 11, we have decided to ask the Government to put their money where their mouth is. The Minister asked earlier why we had chosen an “arbitrary” figure of 45% for a cap on the volume of expenditure on administration by CCGs. The answer is simple: it was the number that the Secretary of State came up with. He said that that was how many percentage points he was going to trim off the administration and bureaucracy costs of the NHS. He boasted that he could deliver 45% savings, so we are calling on him today to put his money where his mouth is and legislate for that. Let us measure him against that, because there is not going to be much else that we can hold him accountable for.

We have tabled new clause 10, on waiting times, because targets and standards absolutely matter in the NHS. No matter what the Government keep telling the public, we still believe in clinical targets, including some that the Government would denigrate as “bureaucratic” or “administrative” targets. In new clause 10, we ask the Government to take the power to set transparent regulations relating to waiting times. Waiting times are going up under this Government. There have been 400,000 people with long waits since the Tories came to power. The trajectory and the sense of history repeating itself are depressingly clear to me and my hon. Friends.

[David Tredinnick (Bosworth) (Con)]

I think the hon. Gentleman might inadvertently have misled the House. He said that waiting lists were going up in the NHS. My recollection is that they are going up in Wales. He is shadow Wales Minister, I think.

[Owen Smith]

I was waiting for that intervention and looking forward to it. I was slightly concerned, when the hon. Member for Central Suffolk and North Ipswich intervened and failed to mention the fair and beautiful country of Wales, that I was not going to get the opportunity to put the record straight. I hate to tell the hon. Member for Bosworth (David Tredinnick) this, but he is wrong. Waiting lists in Wales are coming down. We have been hitting 95% of our target week in, week out, month in, month out since September 2009.

--- Later in debate ---

[David Tredinnick]

I am most grateful for being called to speak and for the opportunity to follow my colleague on the Health Committee, the hon. Member for Walsall South (Valerie Vaz), and my hon. Friend the Member for Hexham (Guy Opperman), and to say how pleased I am to see my hon. Friend in his place. I know from experience—not personal experience—just how tough that operation can be, so many congratulations to him on his recovery.

I want to make a short speech on just one issue—patient choice, which is one of the most important, if not the most important, aspects of the Bill—and to challenge my right hon. Friend the Secretary of State on one or two points. Chapter A1 13H sets out the duty that the board has, in the exercise of its functions, to

“promote the involvement of patients, and their carers and representatives…in decisions about the provision of health services to…patients.”

That patient choice depends on clinical commissioning, the subject of the amendments before us, and that in itself hangs on the “any qualified provider” policy, modified recently from “any willing provider”. There I have some concerns.

The TUC brief summed up “any qualified provider” very well:

“Under AQP, patients will be able to choose which provider to use for their treatment, from a list of approved providers (private, public or voluntary sector) who perform the service in exchange for a locally or nationally set tariff.”

Where I have a slight problem is that although the categories of treatment that can be employed, certainly in the transitional year 2012-13, have been set out in the operational guidance, I think there is a strong case for the guidance to be in the Bill itself.

However, I am very pleased to see at the top of the list musculoskeletal services for back and neck pain, and I presume, although it is not set out, that that means greater use of osteopathy and chiropractic, both regulated by Acts of Parliament, in 1993 and 1994. I had the honour to serve on the Committees considering those Bills. As the public are to have greater choice, we must look at providing that choice, and they will be asking for those services. They will also want acupuncture for musculoskeletal problems. Acupuncture has been approved by NICE and there are now NICE guidelines supporting acupuncture for use in these services. I would like my right hon. Friend the Secretary of State to consider at some point making a more positive, more specific commitment to the use of those services in the provision for patient choice.

There is a strong case for the “any qualified provider” policy to be set out in the Bill too, although it is set out in the operational guidance. The problem that may occur is in the qualification process. I have no problem with its asking for safe, good-quality care or with the governing principle of qualification being that practitioners be registered with the Care Quality Commission and Monitor, but what about those therapies that do not have those badges in their passport? What about traditional Chinese medicine, which is about to be regulated by the Health Professions Council? May we have a specific assurance that its practitioners can be part of this patient system? Traditional Chinese medicine and acupuncture have increased in popularity dramatically—Chinese practitioners may now be found in any town in the country.

I suggest to my right hon. Friend the Secretary of State that other therapies should be included in the list. He has produced a second list of services to be introduced in 2013-14, which includes community chemotherapy and home chemotherapy. If we are to offer patients choice on those chemotherapy services, we really ought to consider those who can support people who are exhausted after chemotherapy and radiotherapy. I am thinking of not only those who practise traditional Chinese herbal medicine and acupuncture, but the healing fraternity and those who use therapeutic touch, many of whom now work in NHS hospitals to great effect.

I should also like to refer to homeopathic medicine, which I have discussed when you have been in the Chair before, Madam Deputy Speaker. I think I am right in saying that your constituency is not far from the Bristol homeopathic hospital, so perhaps you will not call me to order on this, especially as I am trying to stay in order. Many people use homeopathy every day to cure simple ailments, because it is cheap, easy to understand and very effective. Even if there are not umpteen double-blind placebo-controlled trials, there is a wealth of evidence that it works. I would draw my right hon. Friend’s attention to the fact that the Royal London hospital for integrated medicine, which used to be called the Royal London homeopathic hospital, has the highest patient satisfaction rating of all hospitals in the United Kingdom.

There is a case for including in the Bill clearer direction about the services that will become available. I ask my right hon. Friend to smile on those other disciplines that do not have statutory regulation but perhaps have robust non-statutory, voluntary regulation, such as acupuncture, and ensure that when patients go to their doctors and say, “Doctor, this is what we’ve used; this is what we really want,” they will not be turned away.

[Joan Walley (Stoke-on-Trent North) (Lab)]

Following the hon. Member for Bosworth (David Tredinnick) illustrates the problems that we have with the Bill: even at this stage, specific details need to be discussed and have a case made for them, so that the future of NHS provision can be fully taken on board. At the same time, because of how the Bill has been handled—we have had a re-committal—we have a political debate.

The debate on this specific group of amendments is taking place on two levels. I certainly want to ensure that the true principles of the NHS and its founding fathers, such as Nye Bevan, are followed in future provision. We need that political debate to ensure that the NHS is politically accountable. We have almost lost that opportunity, because we are in this mess, with all this uncertainty and not knowing how the Bill will shape up and go forward. We risk losing the whole of the NHS altogether.

Many people who are part of the medical profession and others who are concerned about their own future health care have contacted me, because they want the Government to be in control and the Secretary of State to have a duty to procure and provide services. This is a political debate, as much as anything else, but it is difficult to have that political debate within the confines of the amendments, although they are central to that debate.

Oral Answers to Questions

David Tredinnick Excerpts

Tuesday 7th June 2011 Commons Chamber

[David Tredinnick (Bosworth) (Con)]

Will commissioners be able to approach specialist integrated cancer services, such as the Penny Brohn cancer clinic in Bristol, and will that clinic and others be represented on health and wellbeing boards in future?

[Paul Burstow]

The membership of health and wellbeing boards will be a matter for the local authorities that will set them up. The Bill provides de minimis provisions for involving local councillors, representatives from commissioning consortia, public health directors, social services and children’s services, but I am sure that many of the pilots that are currently going on across the country are looking at innovative ways of involving others as well.

Childhood Obesity

David Tredinnick Excerpts

Tuesday 3rd May 2011 Westminster Hall

[David Tredinnick (Bosworth) (Con)]

I congratulate my hon. Friend the Member for Brentford and Isleworth (Mary Macleod) on securing this crucial debate, and my other hon. Friends who have spoken.

I was in the Mall on Friday for what everybody agreed was a most wonderful royal wedding. However, my heart sank when I saw a very large, hugely overweight man hanging on to a railing for dear life and panting. He may have had a problem caused by steroids or something else, but it is most likely that he was obese. I thought how unhappy he must be with his life—my hon. Friend the Member for North Swindon (Justin Tomlinson) touched on the issue of happiness. One point we must get across to people who are obese is that they can be much happier if they overcome obesity.

My hon. Friends have made many points, but I want to touch on three issues. First, I want to look at the Change4Life programme and the changes that the Minister proposes to make. Secondly, I would like to say something about the impact of high-energy drinks that contain a lot of sugar and caffeine. Thirdly, I will speak about sizes of portions and clothes.

I will start by referring to the October 2007 Government report, “Tackling Obesities: Future Choices”, on what the human body is designed to do. It points out, with classic understatement, that our biological system is,

“not well adapted to a changing world, where the pace of technological progress and lifestyle change has outstripped that of human evolution.”

Many years ago in this Chamber—the old Grand Committee Room—I listened to a debate one evening, instigated by the food and health forum, that I have never forgotten. The speaker was a professor of nutrition and he said, “Look, in a nutshell, if you want to stay healthy, remember that we have not really evolved since the stone age; we are essentially stone-age people in the 20th century.” He said that if we want to be healthy, we should live like stone-age people. We should walk most of the time and run occasionally, eat berries and vegetables in season, catch fish when possible, and eat meat rarely. I was struck by that speech. Generally, our health problems arrive when we deviate from that simple model.

Last week, The Daily Telegraph looked at the problem of obesity as it affects parents. It pointed out that British men are among the fattest in Europe and that according to the World Health Organisation, we do less exercise as a nation than almost every other country in the world. In another article, I read that the World Health Organisation believes that in the regions of Europe, the east Mediterranean and the Americas, over 50% of women are overweight.

We have an enormous problem. All my hon. Friends have drawn on statistics. We tend to follow what happens in America, so we should be aware of what is happening in that country, where the problem is greater—obesity rates are 36% among women and 32% among men. The number of obese men in England has doubled since 1993, and the number of obese women has risen by half.

My hon. Friend the Member for Harlow (Robert Halfon) referred eloquently to issues in his constituency, but in my constituency we do not have the problems that affect many others. For example, the prevalence of obesity among reception-age children in the east midlands is just under 10%, and for year six children by region it is 18%. In Hinckley and Bosworth, the figures are smaller at just over 7% and under 16% respectively. Those are still enormous figures, however, and we must put that in the context of my original point about happiness. How many of those children are very unhappy with their lives?

The Minister inherited the Change4Life programme from the previous Government and I hope she will say a few things about the changes that she proposes to make. As I understand it, the funding for that programme is to change and she will be looking for contributions from the food industry. That may be a good thing, but I would like reassurances that the food industry will not be driving the agenda. I know that she has already said that we will not legislate further to bring in a range of new standards, but I think the quid pro quo is that we must know that the food industry will be very supportive of measures that do exactly what has been suggested and ensure that we see a reduction in sugar. There is far too much sugar in cereal, for example. I suggest to my hon. Friends that if they really want a cereal that is sugar-free, they should make it themselves; it is not difficult. I look to the Minister for support on that issue.

My next point relates to high-energy drinks. I have not heard a word about high-energy drinks this morning; I think that that is a forgotten area. Children and adults are consuming drinks that have two or three times the recommended caffeine level and a very high sugar content. If people have far too much caffeine, they get behavioural disorders. It is very bad for them. It increases their heart rate, and there have been instances of children going to hospital in such circumstances. It is extremely dangerous.

I recommend that the Minister look at the research conducted by Johns Hopkins university, which concluded that energy drinks should be labelled with highly visible health warnings aimed at young people. I will not quote from the study extensively, but it based its recommendations on research that discovered that certain drinks contained as much as 14 times more caffeine than the average can of cola. That is the same as drinking seven cups of coffee.

While we are on the subject of coffee, is it not extraordinary that we are now being invited by coffee shops to drink half-pint mugs of coffee? Have we taken leave of our senses? Have we all gone mad? If I stop for a cup of coffee with a friend, I often order the smallest cup of coffee and split it into two mugs because it is too much. In the 19th century, coffee cups were tiny. That is another issue that we must address.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

Drinking half a pint of coffee would be one thing. Is not the problem with coffee shops that often people are also drinking coffee with cream, sugar and additives? Sometimes with these half-pint cups of coffee, people would get fewer calories in an ordinary meal.

--- Later in debate ---

[David Tredinnick]

I absolutely agree. What is going on in coffee shops is a debate in itself, but coffee used to be taken in very small quantities. It was not intended that we should have so much caffeine in our system.

My last point is about size—the size of portions and the sizing of clothes. I was very touched when, on the day we came back from the recess last week, one of our colleagues came into the Chamber and my hon. Friend the Member for Harlow and one or two others were saying how slim and how wonderful he looked—he had better be nameless because I did not talk to him about the fact that I might refer to him in this debate. He said, “Yes, I’ve lost a lot of weight,” and I think that it was my hon. Friend who said, “How did you do it?” He said, “I’m eating half as much food as I used to eat.” He is eating half as much food—it is not rocket science.

How about suggesting to people that sometimes they do not need to eat as much food? For those who have a faith, may I remind them that gluttony is one of the seven deadly sins? This wonderful stone-age body that we have knows when it has had enough food. The problem is that we override the system too much. We are not taught moderation. Instead of trying to eat smaller portions, we tend to overeat and eat very large meals. We are not helped by the restaurant industry and the food industry, which are constantly trying to pile our plates higher and higher, with triple or quadruple deckers and vast portions. The same applies to children’s food. That is a problem.

On the sizes of clothes, I have some reliable research from someone well known to me. In the mid-1970s, a lady weighing 7 stone with a 24-inch waist would buy a skirt in a size 10; in 2011, the same person, whose waist has increased by three quarters of an inch, buys a size 8 or 6 because the size 10 is far too large. The industry has created a completely new range of sizes to accommodate the population. The largest size used to be size 18; it is now 20 to 22. People who are buying a particular size, thinking that they are a certain weight, are actually much larger than they think they are. That is very unsatisfactory.

Some of my hon. Friends touched on sport. Sport is fantastic; it is so important, and we have the Olympics coming to this country next year. Obese children do not play much sport. They cannot because they cannot get on the pitch—they are too big—so they miss on that wonderful opportunity. With the Olympics round the corner, surely this is the best time to take every possible measure and all steps in the Minister’s power to reduce obesity among children.

Oral Answers to Questions

David Tredinnick Excerpts

Tuesday 26th April 2011 Commons Chamber

[Mr Lansley]

I am not sure that I necessarily subscribe to the hon. Gentleman’s premise. This issue is important and it warrants the kind of attention that we are giving to it, and there is an opportunity to listen, reflect and improve the Bill because we want to ensure that we can thereby strengthen the NHS. On strengthening the NHS, I am surprised that the hon. Gentleman did not take the opportunity to refer to the £12.9 million increase in the budget for Tameside and Glossop PCT this year—something that Labour would not have offered. The truth is that we are going to strengthen the NHS through the Health and Social Care Bill, as we are strengthening it through our commitment to the priorities of the NHS.

[David Tredinnick (Bosworth) (Con)]

Has my right hon. Friend had any further thoughts on the effect of HealthWatch England’s representatives being included in local health and wellbeing boards? Does he think that the provisions are sufficiently robust to ensure that they have an impact on commissioning?

[Mr Lansley]

As my hon. Friend knows, we intend health and wellbeing boards to bring together HealthWatch, plus councillors, commissioning bodies and providers, as part of the process of local representation, so that we can link up NHS commissioning with public health and social care, to see how they collectively meet the joint strategic needs assessment led by the local authority.

Oral Answers to Questions

David Tredinnick Excerpts

Tuesday 8th March 2011 Commons Chamber

[Mr Lansley]

The right hon. Gentleman should not believe what he reads in the newspapers.

[David Tredinnick (Bosworth) (Con)]

The cancer drugs fund is available only for pharmaceutical drugs, but can it be used for wider support services, such as healers, aromatherapists, those using therapeutic touch and other such practitioners?

[Mr Lansley]

We are finalising the design of the future cancer drugs fund from April, and we will publish shortly. The interim cancer drugs fund is designed to support new effective medicines, based on clinical panels’ assessments of the needs of individual patients.

Oral Answers to Questions

David Tredinnick Excerpts

Tuesday 25th January 2011 Commons Chamber

[Mr Lansley]

Let me remind the hon. Gentleman that at the general election we just fought we were the party that was committed to increased resources for the national health service. We are the coalition Government who, over this Parliament, will increase resources for the national health service by £10.7 billion, even in the face of the deficit we inherited from Labour. The hon. Gentleman’s party’s response was to tell us that we should cut the NHS, and we are not going to do it.

[David Tredinnick (Bosworth) (Con)]

Will my right hon. Friend the Secretary of State please explain why it is taking so long for him to come to the House about the regulation of herbal medicine? He has to do that before April to comply with European legislation. What is the hold-up?

[Anne Milton]

I thank my hon. Friend for his question and I know that he has a keen interest in this subject. I share his frustration that the previous Government spent a long time not doing anything about it. The Medicines and Healthcare products Regulatory Agency has identified the possibility of creating a national regulatory scheme, allowing authorised herbal practitioners to continue to commission unlicensed manufactured herbal medicines after 30 April. We are in discussions with the devolved Administrations, the Health Professions Council and the Complementary and Natural Healthcare Council about the feasibility of a statutory register. As I say, I share my hon. Friend’s frustration but we will make proposals shortly.

Contaminated Blood

David Tredinnick Excerpts

Monday 10th January 2011 Commons Chamber

[Mr Lansley]

What I have announced today will, of course, be funded from the Department of Health’s budget in England and the matter would be a responsibility for the devolved Administrations in relation to their budgets —from within the budgets set through the spending review.

[David Tredinnick (Bosworth) (Con)]

I, too, congratulate my right hon. Friend. I also congratulate the Under-Secretary of State for Health on all the work that she has done. The statement deals with what Lord Archer called the worst treatment disaster in the history of the national health service. It has to be said that the last Labour Government could have dealt with this, but they did not.

Following the comprehensive package that he has announced, will my right hon. Friend assure us that he will take active steps to contact the families of the bereaved and that no stone will be left unturned in making sure that all those who should have payments receive them?

[Mr Lansley]

I give my hon. Friend that assurance. We will take all the steps that we possibly can, not least on behalf of the bereaved families of those who died before 29 August 2003. That anomaly, among others, ought to have been rectified long ago.