NHS Reform

Bob Blackman Excerpts

Thursday 16th July 2015 Commons Chamber

[Mr Hunt]

A lot of the efficiency will come from seven-day working, and I do not agree with the hon. Lady that there will be a simple cost increase. The cost to a hospital of cranking down all its services on a Friday afternoon and then having to crank them up on a Monday morning is huge, and it is not efficient. Part of the savings will come from having more streamlined services that operate to a consistently high standard across the week.

[Bob Blackman (Harrow East) (Con)]

Many of my constituents complain about the lack of availability of GP appointments at weekends and outside normal hours. The consequence of that is that people who are ill turn up at A&E, causing pressure on it. I know that my right hon. Friend is taking action on that, but what is he doing to ensure that we have proper seven-days-a-week working across the NHS in primary care as well as in hospitals?

[Mr Hunt]

My hon. Friend is absolutely right to draw attention to the fact that our manifesto commitment was to a true seven-day service across hospitals and general practice. That is why, a few weeks ago, we announced in our new deal for general practice plans to recruit 5,000 GPs so that we can increase capacity and make sure that people can get routine appointments in the evenings and at weekends.

Royal National Orthopaedic Hospital (Stanmore)

Bob Blackman Excerpts

Wednesday 4th March 2015 Westminster Hall

[Bob Blackman (Harrow East) (Con)]

It is a pleasure to serve under your chairmanship, Sir Alan, in this vital debate that is important not only locally in my constituency, but nationally. The Royal National Orthopaedic hospital in Stanmore is a national and international institution par excellence. I will use a quote that I gleaned when doing some research. The RNOH delivers

“Outstanding clinical outcomes for patients”

in premises that are

“not fit for purpose—it does not provide an adequate environment to care and treat patients.”

I and the staff of the hospital could not have put it better. That is a direct quote from the most recent inspection by the Care Quality Commission in August 2014.

The hospital premises were built during the second world war to house airmen who were defending our shores and to ensure that facilities were available to treat our brave soldiers, airmen and seafarers returning home. Sadly, we still have the same premises that existed during the second world war. I want to put on the record my tribute to the brilliant work that is done by all the medical staff, all the clerical staff and the entire team who provide facilities and services at the hospital. Many charities that are associated with the work of the hospital also operate from the site.

I wanted this debate today because I took the then shadow Secretary of State for Health to Stanmore in January 2010 to see the hospital at first hand. He gave a commitment to the board, the staff and everyone associated with the hospital that, were there to be a Conservative Government after the election in May 2010, the hospital would be rebuilt.

Just before the election, in March 2010, the then Secretary of State for Health, who is now the shadow Secretary of State for Health, announced funding for the redevelopment. It is fair to say that immediately after the election, when hon. Friends discovered there was no money left at the Treasury, I had to work very hard with civil servants and elected politicians at the Treasury to ensure that the promised funding for the rebuilding of the hospital was safeguarded in the emergency Budget that took place immediately after the election.

Here we are now, four and a half to five years on, and there has been very little progress on the rebuilding work. The trust that runs the hospital—I have worked with the board of the trust and others—has responded to every question posed by the trust development authority. It seems almost impossible to get through the positively Kafkaesque process of repeated reviews. The only beneficiaries of that process are the management consultancy firms. Patients and the medical staff have not benefited one iota.

I believe—I stand to be corrected if this is not so—that some £75 million has been spent on management consultants. It has not been spent on the consultants who treat patients, but the people who come and do management studies. I think that that is a disgrace and a waste of public money. All 13 independent reviews have concluded that the orthopaedic hospital offers excellent, high-quality, world-class care. The CQC has rated outcomes as “outstanding”, and the trust is regularly in the top 10% of all hospitals in respect of infection control and friends and family tests.

All independent reviews concerning the hospital’s geographical location have concluded that there are no better alternatives to having the hospital on the Stanmore site. All independent reviews concerning the financial risks associated with the redevelopment have concluded that the Stanmore site development offers the best value for money and that no “more affordable” option is available.

In the meantime, the future of the trust continues to be reviewed, debated and deferred. As I have said, more than £70 million of costs have been incurred, with a severe waste of money on project fees of £20 million, maintenance costs of keeping these rotten buildings going of some £15 million and the lost efficiency opportunity of some £35 million. In this modern day and age, that cannot be right.

By way of background, the hospital is a centre of international expertise in the diagnosis and treatment of neuromusculoskeletal conditions, which include acute spinal injury, bone tumour and complex joint reconstruction. This centre of expertise is not replicated anywhere else within the national health service. It has the largest spinal surgery service in Europe, with a third of UK spinal scoliosis surgery and two thirds of specialist nerve injury work being carried out on the site.

Some 95% of patients rate the care as “good” or “excellent”, and 90% of staff and patients would recommend the hospital to their friends or relatives. The hospital was the longest-standing in London with no MRSA infections in the past five years. Without question, this hospital delivers services and medical treatment that are the best in class. The clinical excellence and innovation are beyond doubt. The problem is that the buildings were built to last for a limited period, but that has stretched to 70 years. It cannot be right that we insist on brilliant medical staff operating in substandard conditions that would shame the third world.

We need to ensure that the rebuilding takes place. I understand completely that the health service has a process for business cases and has to offer value for money. We would all support that in principle. However, as this is a specialist hospital of international renown, it has a special place within the national health service. Successive Governments and the health service have prevaricated on the future of the RNOH for decades—literally 30 years. We have to have a different, more proactive approach to resolve the problem. It is clear that the board that runs the trust will have to conclude at some stage that it can no longer offer safety to patients in the substandard conditions in which it operates.

The creditability of the Government, the national health service and everyone involved is on the line here. Political leadership is required to ensure the best interests of patients and taxpayers. I look to my hon. Friend the Minister for some suitable answers, because this has been going on publicly and privately for the past five years that I have been involved, and, before that, for the past 30 years.

So the RNOH has a track record of delivering financial and performance targets. It responds time and again, updating and revising financial plans and risk assessments and refreshing commissioner support. Every time the board responds, it appears that we do not move forward, but backward. That cannot be allowed to continue and we must reach an appropriate arrangement. We need an innovative and alternative financing option—that is not encouraged through the current NHS process—to ensure that the hospital is delivered.

We should be clear that the key to resolving this matter is the top-up of public money by capital or a loan of some £20 million. It should be understood that the board will build a private hospital alongside the NHS hospital, and that will generate income. The board will also sell off land for housing development, which the area needs, but the board takes the sensible view that it will realise the land receipts gradually as the need arises for the programme’s funding. That will maximise their value and provide a decent level of housing in the local area. Both those things have been positively embraced. The RNOH and the trust development agency have been developing the outline business case since September 2014. In March 2015, we are still waiting to see whether it will be approved and action taken, so that the redevelopment can take place.

It is time that the Department of Health acknowledged that highly specialist hospitals and providers such as the RNOH need a different approach from that taken with the generality of NHS providers. It cannot be right that a super, specialist organisation with such excellent results is denied facilities for the want of a relatively small amount of public money.

In summary, the RNOH is a vital national provider of treatment for the most complex orthopaedic conditions and the rehabilitation for people with life-threatening conditions, such as spinal cord injuries. It does vital work on the innovation of new treatments, leading-edge research and development, the manufacture of state-of-the-art prosthetics and the training of future orthopaedic specialists. The hospital has treated many famous individuals, including Lord Tebbit’s wife after the Brighton bombing and Princess Eugenie. Moreover, the RNOH recognises the financial constraints it operates within and has continuously demonstrated that mitigations to affordability risks are available. Demand for services grows every day. Major land sale receipts will be available. Planning permission is in place; there is no hold-up on that. Housing and employment for the local population will be increased by the proposal, and major private patient income will come in.

The RNOH has a track record of delivery against every target that it has ever been set. It has responded time and again to the requirements of the TDA and every other aspect of the health service. It is clear that every time there has been a step forward, there have been two steps back. Every time proposals have come forward on alternative financing options, we have just ended up spending more public money. If that £75 million had been invested in the project, we would now be looking at new hospital facilities on the site. We would have first-rate, world-class facilities for world-class medical professionals.

No one believes that anyone wants to see the facility closed down, but the reality is that the Department of Health has to move forward and instruct the TDA to abandon the position that it has adopted, so that the RNOH can move forward to development. If we do not do that, we might as well close the hospital. That would be an absolute tragedy for all the specialists, medical staff and patients. By bringing those services together, the medical professionals have developed world-class techniques and an ability to cure individuals of very serious problems. Indeed, the medical staff of the RNOH provide national and international services way beyond the bounds of the hospital. I urge the Minister to give us some good news and to ensure that we get the funding required for the hospital to be rebuilt and for facilities to be provided for the brilliant staff, who do a brilliant job for the patients.

[Sir Alan Meale (in the Chair)]

Before you begin, Minister, I want to pass a message on. Generally when debates are answered in this place, the Parliamentary Private Secretary is present. There was not a PPS in the last debate or this debate, and that might happen in the next debate, because I see the Minister for it standing by. When a PPS for the Minister is not present, it is usual for someone from the Whip’s Office to be involved. Sometimes mysterious pieces of advice appear from other places and have to be passed forward to the Minister. When those people are not present to do that, we have to rely on House of Commons staff. They have enough to do, and we should try to help them where possible. I am not saying that it is anything to do with the Minister, but I would be grateful if he could pass that expectation on to the Whips or the PPSs.

Five Year Forward View

Bob Blackman Excerpts

Thursday 23rd October 2014 Commons Chamber

[Mr Hunt]

Not at all—I take full responsibility for the NHS. Given the pressures created by having nearly 1 million more over-65s than we had four years ago, and the fact that the Government have had to cope with the deepest recession since the second world war, I believe that the NHS is doing remarkably well, and this document gives it a blueprint for the future that we can all welcome.

[Bob Blackman (Harrow East) (Con)]

Under this Government, the number of young people taking up smoking has fallen dramatically to some 3% and the number of people giving up smoking has increased. I welcome that very good news. We can now aspire to a smoke-free Britain over the next five years. Personally, I would like to see the tobacco companies taxed out of existence, but is it not irresponsible to base future spending plans on the basis of a tax on companies that will cease to exist?

[Mr Hunt]

That is a very good point and I agree with my hon. Friend that we should aspire to a smoke-free Britain. We are making remarkable progress. The point the report makes—this goes alongside what my hon. Friend has said—is that we need to integrate our thinking about public health with our thinking about the services the NHS delivers. The better care fund has shown how it is possible to get excellent collaboration between local authorities and the local NHS for the delivery of social care. Transformational things are happening up and down the country right now. I would like to see the same thing for public health as well.

Hospital Car Parking Charges

Bob Blackman Excerpts

Monday 1st September 2014 Commons Chamber

[Bob Blackman (Harrow East) (Con)]

It is an honour to follow my hon. Friend the Member for Harlow (Robert Halfon), who has been at the forefront of this campaign. I trust that, now that he has the ear of the Chancellor, he will use that power to persuade our right hon. Friend of what needs to be done. Earlier this year, I went to see the Chancellor with a delegation led by my hon. Friend the Member for Shrewsbury and Atcham (Daniel Kawczynski), and we put it to him that hospital parking charges should be scrapped altogether. I note that it is now estimated that the cost of doing so would be £200 million. At the time, it was £90 million.

We should look at this matter strategically and say that anyone who is going to hospital for treatment or to visit people who are suffering in hospital and who need to be there for an extended period of time should be exempt from all charges. It is difficult to introduce such a policy across the country for the simple reason that hospitals are in different locations. Some are co-located with stations, for example, and have decent public transport links. Others do not, however. We need a policy whose presumption is that anyone using the hospital car park because they are using the hospital services as I have described should be able to do so free of charge.

Such a policy could be implemented by requiring people to pay on exit. They could obtain a ticket on entry and have it stamped by a ward sister or a similarly appropriate medical person in order to exempt them from paying the charge. That would prevent commuters and others from abusing free hospital parking places.

I trust that we can look at this matter as a sensible investment. We clearly cannot expect the Department of Health to find the money itself. We expect it to provide the funding for treating people who are sick. We should look to the Treasury to provide the health service with the necessary funds to enable this initiative to take place.

[Mr Marcus Jones (Nuneaton) (Con)]

I completely agree with my hon. Friend that hospital parking charges should be scrapped. In the meantime, however, does he agree that when a hospital is at fault for delaying or cancelling an appointment, the patient should not have to pay more for their parking as a result?

[Bob Blackman]

I thank my hon. Friend for that intervention.

I was just coming on to the specifics of my area. My constituency and others now have centres of medical excellence, which means that people have to travel long distances for the treatment that they need. Many of them have to use their cars, because public transport is not an option. Over the past 18 months, I have witnessed people suffering when their appointment was delayed and they had to rush out to the car park to pay more at the pay and display machine. Such an encumbrance is unfair on people who need to receive important medical treatment, and it should without doubt be scrapped.

The guidelines should also stress strict adherence to a policy of paying on exit for the appropriate length of time spent in the car park, as opposed to using pay and display arrangements that involve people guessing how long they are going to spend in the hospital. I have witnessed at first hand people having to guess in that way and then finding that they do not need all the time they have paid for.

In my own area there is Northwick Park hospital, which is the centre at which many people from north-west London are treated, and Central Middlesex hospital, which is in the middle of an industrial estate and almost inaccessible by public transport, so anyone going there has to drive. There is no pay-on-exit facility available. In fact, the trust took away that facility and insisted that the parking area that was built for it be replaced with pay-and-display parking. It was a nonsensical decision, and I trust that the trust will review it and revise it accordingly. We also have Ealing hospital, which has a similar problem of not being anywhere near any public transport facilities. The tube lines run into the centre of London rather than radiating around the outside, so people travelling locally have to drive and use the car parking facilities.

I wish to touch on a specific case that I came across recently: Mr Francis Bacon, a registered disabled driver suffered a serious puncture while driving to a hospital appointment. He was unable to move his car, which some good samaritans pushed on to the pavement while he went to get help to change his tyre. He got his tyre changed by some good people who came and helped him and put him on his way. Sadly, a parking operative from Ealing council had come along and put a penalty notice sticker on the car, because Mr Bacon had had the temerity to park on the pavement. He could not move his car—his car was disabled, and he was disabled—yet he still got a parking ticket. Despite protestations from everyone concerned, Ealing council refused to cancel the ticket, which is typical of the wrong attitude of both local government and hospital trusts themselves. We need them to work in harmony to promote parking arrangements that suit and protect everyone. I trust that we can use this opportunity to encourage the Chancellor to provide extra funds so that we can do away with car parking charges once and for all.

NHS Investigations (Jimmy Savile)

Bob Blackman Excerpts

Thursday 26th June 2014 Commons Chamber

[Mr Hunt]

We are having an overarching independent inquiry—that is what Kate Lampard is doing—but on whether we need to have further inquiries, we need to wait until we get the response, which we are hoping for this autumn, because at the moment, we have published individual reports, but we have not drawn any wider lessons for the NHS system-wide. One of the things that I hope will be a consequence of today is that if there are any victims who were abused at the RVI, they will use today as some encouragement to come forward. I have given instructions and I am absolutely clear as Health Secretary that I want every single one of the concerns of anyone who comes forward to be investigated thoroughly—as thoroughly as all the ones that are tragically coming to light today.

[Bob Blackman (Harrow East) (Con)]

It is astonishing that this catalogue of abuse was allowed to happen and that no action was taken at the time. I commend my right hon. Friend for his statement, both for the way he has delivered it and for the content, but can he elucidate for the House what specific changes he foresees in legislation, although legislation has moved forward, and any specific changes to procedures that now need to be taken as a result of the publication today?

[Mr Hunt]

I hope my hon. Friend will forgive me if I do not try to predict Kate Lampard’s recommendations before she makes them, but I think the obvious question to ask is whether we have the procedures in place that ensure that someone like Savile would not be given the keys to an institution in the way that he was. I do not believe that would happen today. My understanding of the way that NHS organisations work is that it would be impossible for someone to be given the freedom of a trust in the way that he was at Broadmoor, but I do not want to take that as a fact. I want Kate Lampard to look at that, so that we can be absolutely sure that it would not happen. I think the other obvious area for her to consider is the functioning of the disclosure and barring scheme, and to make sure that it really is set up in a way that would make it more likely for us to catch someone like Savile. Again, I think it is likely that he would be caught by the DBS, but I would like Kate Lampard to look at that and give me her views.

Oral Answers to Questions

Bob Blackman Excerpts

Tuesday 1st April 2014 Commons Chamber

[Jane Ellison]

The hon. Lady is right to say that pharmacists have a great role to play, and she has given a good example of their helping people to manage long-term conditions and helping people with their medication. NHS England’s community pharmacy call to action has stimulated the debate about where community pharmacies should sit. We see them as a vital part of front-line services, and I am glad that the NHS is looking at their role in the round, because it is a really important one.

[Bob Blackman (Harrow East) (Con)]

What representations has my hon. Friend received in relation to the sale of e-cigarettes in community pharmacies, given that they form part of the smoking cessation process?

--- Later in debate ---

[Mr Jeremy Hunt]

The review the hon. Gentleman refers to is a consultation by NHS England to ensure that we commission specialist services better. There has been a 23% increase in the number of cancer sufferers getting treatment under this Government. We want to improve on that record even more, which means having sensible discussions on how to improve specialised commissioning, and that is what is going on.

[Bob Blackman (Harrow East) (Con)]

T6. In 2010 the Chancellor specifically set aside funding for the rebuilding of the Royal National Orthopaedic hospital in my constituency. The site has planning permission. Will my hon. Friend update the House on progress so that we see work on the ground before 2015?

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

My hon. Friend will be interested to know that the NHS Trust Development Authority is reviewing the trust’s business case and is working with the trust to ensure that its plans are affordable. I know that my right hon. Friend the Secretary of State has visited the hospital and is a great champion of it. I will ask the TDA to keep my hon. Friend fully up to speed.

Cancer Priorities

Bob Blackman Excerpts

Thursday 13th February 2014 Commons Chamber

[Bob Blackman (Harrow East) (Con)]

It is a pleasure to follow my hon. Friend the Member for Salisbury (John Glen). On behalf of the Backbench Business Committee, I thank my hon. Friend the Member for Basildon and Billericay (Mr Baron) not only for securing this important debate, but for agreeing to host it on such a difficult day—the last day of term before we break up for the recess.

I speak as someone who has a personal, family experience of cancer and I speak on behalf of my constituents. As I have said in the House before, both my parents died of cancer, as did three of my immediate family—uncles and aunts. They died many years ago, when the treatments now available were not available. Had they been, there is no doubt that they would have survived far longer. The good news is that progress has been made over many years in cancer treatment.

Most of this debate focuses on health matters, but I want to flag up an issue that can also affect people who suffer from cancer. A constituent came to see me. He had worked all his life, for 40 years, in a particular industry, doing quite heavy work. He was suddenly diagnosed with life-threatening cancer. He went to the jobcentre to get benefit while he received treatment. He was denied any benefit, for the simple reason that his doctor’s letter stated that his treatment was likely to last six months. He was therefore disqualified from receiving benefits. He was down to his last few hundred pounds to sustain his family. Fortunately, I was able to intervene and it was found that his treatment would last a minimum of six months, and more likely a year or longer, so he would be out of work for that period. Unfortunately, in many respects the way benefits are dealt with is not helpful to cancer sufferers. I do not expect the Minister to respond to that point today, but it is something we should flag up for Ministers in the Department for Work and Pensions.

I also speak from another perspective. When I was a local councillor, St Luke’s hospice in north-west London was founded in my ward. It has gone from strength to strength. It started out as an outreach service for people suffering from life-threatening diseases or who were at the end of their life; it helped them at home. It has now moved to its own headquarters, which is also a headquarters for Macmillan nurses. It treats many thousands of cancer sufferers across north-west London in an excellent way. St Mark’s hospital, which is world-renowned in the treatment of bowel-related diseases, particularly cancer, is also in my constituency.

As some Members may know, over the past year, I have been under the care of St Mark’s hospital following medical treatment, and I have personally witnessed the terrible distress that individuals go through when they are told that unfortunately they are suffering from some form of cancer. It is not until you see those people and see the terrible effect not only on them, but on their relatives and friends, that it really comes home to you what a terrible thing this disease is and how important it is that we continue to treat people in an appropriate and sympathetic manner. However, the good news is that just because someone has been diagnosed with cancer, that does not mean it is the end. There is treatment available and the capability of a full recovery, but often people do not realise that until they are thus affected.

Of course, as we all live longer and live healthier lives, there is a greater risk of suffering from cancer. As my hon. Friend the Member for Basildon and Billericay said, within six years, one in every two people will be diagnosed with some form of cancer. That means that every family in the country will experience the terrible problem of having a relative diagnosed with cancer and the impact that that has on the whole family. We need to understand that this will not go away but get worse as a potential problem.

I congratulate the Government on the introduction of the cancer drugs fund, which categorises money and makes it available for treatment of cancer-related diseases. The sad fact is, however, that it is time-limited; it will end in 2016. Concerns are being raised—they are raised very strongly in the report by the all-party group—about what will replace it and what the impact will be on funding for treatment of the various diseases.

There is another big challenge in relation to the clinical treatment of cancers: quality of life issues versus the age of the patient and their ability to recover from the treatment—whether the treatment will actually kill the patient is a concern. More importantly, such issues are balanced against the cost of the treatment to be provided. If a patient is going to have their life prolonged by a week, the clinician can be asked whether it is worth the huge amount of money that may be invested in doing so. However, if they will be given another five years, there is no question about what should be provided. Then the challenge is what to do in between those time frames. That is a direct challenge to our clinicians and to all those making decisions about funding the cost of treatment and the provision that we make for it.

During this debate, we have talked about early diagnosis. There is no question but that if people are diagnosed early, their treatment is less severe and the chances of recovery are far greater. Women, in particular, have had strong advice over many years to check themselves for breast cancer. Smears have been available, as have other forms of treatment and checks. Men often do not want to talk about the fact that they may be suffering from early signs of cancer. They do not go to doctors early enough. They do not consider themselves to need treatment, and of course, by the end, it may be too late for that treatment to take place.

A system of screening across the country for the most common forms of cancer needs to be available for every single patient on the NHS. However, there must be a word of warning—after screening, the patient may be shown not to be suffering from a form of cancer at the moment, but that does not mean that they will not suffer from it next week, next month or thereafter. The risk is that people may feel that they are safe as a result of screening, but they are not. Therefore, screening must take place regularly so that people can understand that early treatment can get them into a good position.

There is also the aspect of specialist treatment that must be available. There are a number of rare cancer diseases where the cost of treatment is quite high but the number of cases is relatively few. We should therefore ensure that the people who suffer from those rare forms of cancer have a good chance of recovery through proper treatment, proper drugs, and proper specialist care.

I want to highlight in particular the work being done at University College hospital on blood cancers. One of the problems is that, while treatment kills many cancer cells, it leaves behind small numbers that are very difficult to detect and that at some future stage may spring back into action and infect the whole body via the blood. University College hospital depends on donations from members of the public for the equipment it uses. In my view, there should be far greater investment from the NHS in that research, which enables experts to make diagnoses and produce the detailed treatment needed by those suffering from blood cancer in particular.

Another issue is the drug companies that produce the drugs that treat cancers, be they common or rare. It is clear that the cost of research is enormous, that the failure rate of the drugs is difficult to determine and that there is a challenge—this is particularly true of rare cancers—with regard to the number of patients who can be treated. Will the Minister consider an open-book policy for the drug companies whereby they would say, “We’ve spent this much money on research and this is how much it has cost us to develop these drugs, so this is how much we need to recover from treatment using these drugs”? At the moment, there seems to be a battle between the drug companies, the National Institute for Health and Care Excellence and the NHS with regard to the cost of treatment. It is clear that that needs to be addressed.

It would be remiss of me, during a debate on cancer, not to say that individuals also have a responsibility. If we can educate young people to have a better diet and not to start smoking in the first place, and if we can educate people who do smoke to give up, we have a chance of reducing the risks of contracting cancer. I congratulate my hon. Friend the Minister, who has been a Health Minister for only a short period, on the major change earlier this week to the Government’s policy on smoking in cars when children are present and on the issue of standardised packaging of tobacco products. She has made a huge impact.

We have not completed the job yet and we look forward to the regulations being introduced, but now we have another challenge, which is the treatment of cancers through the use of various drugs that assist people who suffer from those terrible diseases. It is a new challenge and a new opportunity, and I am sure that the Minister will take it up with gusto and zeal and that she will achieve the same degree of success as she has in relation to smoking.

Children and Families Bill

Bob Blackman Excerpts

Monday 10th February 2014 Commons Chamber

[Bob Blackman (Harrow East) (Con)]

I speak as the secretary of the all-party group on smoking and health. There is only a brief time available, but the facts and figures have been presented to the House. The fact is that the younger people start to smoke, the more damage they do to their health and the shorter their lives as a result. The key point is that most young people start smoking because of their parents, siblings, friends or the media marketing of big tobacco. We need to take away the capability of big tobacco to market to young people, and I support wholeheartedly the measures on standardised packaging. Those opposing measures to stop parents smoking in cars carrying children should understand that a car contains 11 times more tobacco and nicotine than a smoky pub. Even more importantly, if a parent is driving a car with all four windows open, the level of pollution is treble the amount recommended by the US Environmental Protection Agency or the World Health Organisation. That is extremely damaging to children’s health, and I support the Lords amendment.

Health Care (London)

Bob Blackman Excerpts

Wednesday 8th January 2014 Westminster Hall

[Mary Macleod]

The London air ambulance service is an amazing organisation, so I would not change its structure. It rightly gets some funding from the NHS, but it also derives funding from many other sources, and it is important that we support that. The service does an incredible job, so if the hon. Gentleman knows anyone who can give it a spare helicopter, it would really appreciate that.

My local CCG is chaired by Dr Nicola Burbidge. It started early, it has been absolutely focused on patients and it has been very responsive to any issues I have raised with it.

On reconfiguration, I was recently thankful when, after a lot of campaigning by my hon. Friend the Member for Chelsea and Fulham (Greg Hands) and others, the Secretary of State announced that the A and E at Charing Cross hospital would not be closed, thus helping residents in my part of London. Saving lives and improving patient care is paramount.

[Bob Blackman (Harrow East) (Con)]

I apologise for not being here for the opening speech. Does my hon. Friend agree that one challenge now facing London is the increasing complexity of diseases and the treatments that are required, which means that additional money and expertise are needed? Such diseases often cannot be dealt with at a local level; they must be dealt with nationally. Although we have supported those suffering from cancer and other diseases, much more complex diseases remain to be resolved.

[Mary Macleod]

My hon. Friend makes a good point. I hope the Minister will respond to the issue of how we take up such challenges in London and get the necessary funding.

I shall list some issues on which I would like more improvement. We heard how difficult it is to get appointments at general practices—we call up and know that the answer is going to be no before we say anything. There are also issues with getting to see a specialist as quickly as possible. We want an effective complaints process in hospitals, changing the culture to allow people, whether staff or patients, to complain. There is an issue with how patients are moved around London, and the hon. Member for Westminster North made an important point about having to use public transport to get home. Mental health and community public health are other important issues.

My final comment is about dementia, which is a growing concern in London, as it is across the country. About 30% of patients who go into the West Middlesex hospital have dementia. They do not go there because of dementia, but they have it. There is a lot to be done, and the West Middlesex hospital has just opened a new dementia ward. There needs to be a greater focus on dementia, given our ageing population nationally, and the size of the population in London. We must ensure that we work together to support those who really need and deserve care and support in London. That will improve the NHS for us all.

Tobacco Packaging

Bob Blackman Excerpts

Thursday 28th November 2013 Commons Chamber

[Jane Ellison]

We have had a consultation and now we are having a short review of the emerging evidence base. I think that that is sensible. We want to make good policy that is robust, and this is the right way to do it.

[Bob Blackman (Harrow East) (Con)]

I congratulate the Minister on listening to the arguments and acting far more quickly than any Opposition Member did in 13 years. Will she assure us that the House will have the opportunity to vote in favour of standardised packaging so that we can demonstrate our cross-party support for this much-needed health measure?

[Jane Ellison]

At present, we are strongly minded to introduce regulations under the affirmative procedure.