Oral Answers to Questions

Dan Poulter Excerpts

Tuesday 16th April 2013 Commons Chamber

[Christopher Pincher (Tamworth) (Con)]

4. What support his Department has given to local authorities and NHS commissioners to improve cardiovascular disease outcomes.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

On 5 March, we published the cardiovascular disease outcomes strategy, which included 10 key actions for commissioners and providers to ensure patients and carers get the best possible support. As set out in the strategy, we will continue to make data available to local authorities to see where their areas of greatest need are and to shape their own response accordingly.

[Christopher Pincher]

Will my hon. Friend support the efforts of local clinicians, Tamworth borough council and charities such as Tamworth in the Community, which are working with parents, teachers and children to educate them about the importance of healthy eating and exercise, to deal with the health challenges we have in Tamworth and tackle the rather unfair notoriety that Tamworth gained in the press?

[Dr Poulter]

I commend the work being done locally in Tamworth to address this issue. As we know, one of the biggest public health challenges facing this country is obesity. The risk factors for cardiovascular disease include diabetes and high cholesterol. If we can tackle obesity and improve lifestyles, we will address both those risk factors directly, so I wish my hon. Friend’s local organisations every success in tackling those challenges.

[Keith Vaz (Leicester East) (Lab)]

As the Minister has said, those with diabetes are five times more likely than others to develop cardiovascular disease, which currently costs the national health service £9.8 billion a year. Will he commit to a public awareness campaign and issue guidelines for local health and wellbeing boards so that they make this a priority?

[Dr Poulter]

I commend the right hon. Gentleman’s work in raising the profile of diabetes. A lot of the Government’s work is focused on the importance of improving public health in this country and in particular on obesity, and if we are to tackle that we have to deal with diabetes. As a key part of that, we are now giving 40% of the public health money to local authorities to do exactly what he has just described: to focus money in the right places to tackle cardiovascular disease in those communities that most need it, particularly in inner-city areas.

[Greg Mulholland (Leeds North West) (LD)]

The role of local authorities in scrutinising NHS decisions is now even more important, yet the joint health overview and scrutiny committee of Yorkshire and Humber councils was consistently denied a number of important documents, which was one reason the High Court ruled that the decision taken in the Safe and Sustainable review was unlawful. This is now in tatters. Will the Minister now confirm whether he will instruct NHS England not to appeal the High Court decision?

[Dr Poulter]

Surely the validity of evidence is a matter for the court. I am sure my hon. Friend would recognise that there has to be a distinction between what we do here in Parliament and what is done in the courts. If NHS England would like to appeal the decision and if it thinks there are good grounds to do that, it must do that. The decision will then ultimately be made in the courts, on the basis of how valid that appeal is.

[Liz Kendall (Leicester West) (Lab)]

The best way to improve outcomes for heart disease patients and get the best value for public money is to help people to manage their condition at home. Will the Minister therefore explain the thinking behind the Government’s strategy of cutting one in five district nurses, so that delayed discharges from hospital due specifically to a lack of NHS community services rise by 40%, costing taxpayers £6 million a month as a result?

[Dr Poulter]

The hon. Lady and Opposition Members are fond of saying that we are cutting the NHS. It is their party that has said it will cut; they think it is irresponsible to increase funding for the NHS. We on the Government Benches have invested £12.5 billion more in the NHS. There are 6,000 more clinical staff working on the ground, focusing specifically on early intervention, early strategies and lifestyle. We now have almost 1,000 more health visitors working in the NHS and we have expanded the family nurse partnership programme. All these things will make a difference. Indeed, there is now a lot more joint commissioning between hospitals and primary care, to ensure that commissioning arrangements are in place better to support the role of community nurses and district nurses in preventive care and better look after people with long-term conditions.

[Mark Menzies (Fylde) (Con)]

6. What steps his Department plans to take to improve dementia diagnosis rates and to reduce regional variations in such diagnoses.

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[Mr Graham Allen (Nottingham North) (Lab)]

9. If his Department will make early intervention a priority for clinical commissioning groups and public health officers.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

I commend the tremendous amount of work undertaken by the hon. Gentleman on early intervention. Yesterday, he and I attended the Early Intervention Foundation, which he has set up. We are talking a lot about legacies this week, and his legacy and the work that he has done to promote early intervention will certainly stand the test of time. The Government are committed to supporting that work, both through his foundation and through the work that we are doing to expand the family nurse partnership programme and the number of health visitors available to young families.

[Mr Allen]

I thank the Minister for those remarks, and I would like to thank those on both Front Benches for their support for the Early Intervention Foundation, which is greatly appreciated. Would the Minister accept that, in addition to having police and crime commissioners and councils promoting early intervention, the role of GPs, of directors of public health and of health and wellbeing boards will be absolutely central to getting early intervention plans and programmes to scale across the whole of England?

[Dr Poulter]

The hon. Gentleman is absolutely right. The health and wellbeing boards in particular will be well placed to bring together and join up what goes on in early interventions and to break down some of the silos that have existed in education, social services and health care. It is through the health and wellbeing boards that a lot of the work being done by health visitors and others to improve the life chances of many children, particularly those in the poorest communities, can be taken forward locally in a much stronger way.

[Andrew Bridgen (North West Leicestershire) (Con)]

What steps are being taken to encourage and help local authorities to focus on illness prevention and help people to lead healthier lives?

[Dr Poulter]

My hon. Friend will be aware that local authorities are now receiving 40% of the public health budget. That allows local authorities to have a much more nuanced approach to how and where they direct their budgets. It is of course desirable to focus on the early years to give each and every child the best start in life, to set good and healthy eating patterns and to support the work being done in the health service in expanding the health visitor programme. This also allows local authorities to address other public health challenges in the area by focusing, for example, on areas with high rates of teenage pregnancy, smoking or cardiovascular disease death.

[Mr Speaker]

I am grateful to the Minister, but we do have quite a lot to get through, so shorter answers would help.

[Mr Peter Hain (Neath) (Lab)]

What sort of early intervention have the Government ordered to prevent a contagious spread of measles from the outbreak in the Neath and Swansea area of more than 700 serious cases? Thousands of parents across Britain will have been tormented by the choice of whether to vaccinate their children for measles, mumps and rubella because of the scare. Surely the Minister should take serious action to instruct public health officials to combat this issue.

[Dr Poulter]

We are taking exactly that action to make sure that the vaccine is available and to promote the uptake of it. The right hon. Gentleman will of course be aware that the problems and concerns about the failure of some families to take up the vaccine resulted from some mis-used data in the past. That was a regrettable incident concerning the use of medical data, and is unfortunately causing great problems now. We are committed to making sure that those vaccines are available to the children who need it.

[Paul Burstow (Sutton and Cheam) (LD)]

When it comes to early intervention with the one in 10 children in this country who have a diagnosable mental health problem, will the Minister confirm that it is the Government’s intention to ensure that those children all have access to talking therapies so that they get the right treatment at the right time, which will make a big difference for them?

[Dr Poulter]

In his time in office, my right hon. Friend did a tremendous amount to promote the cause of mental health and to get parity of treatment between mental and physical health. That is exactly what we propose to do with the money going into the talking therapies—to get in place those early interventions, not just for adults, but for children, too. We shall be taking that work forward in earnest in the years ahead.

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

Does the Minister agree that the most important form of early intervention is for the public to get prompt advice on their symptoms? Does he share my concern that a leaked report on the national performance of the 111 line shows that the service is in crisis with staff shortages, delays, abandoned calls, 11-hour waits for call-backs, staff being wrongly diverted to attend cats with diarrhoea and ambulance crews going without breaks for 12 or more hours? Is this not a trademark Government shambles?

[Dr Poulter]

The hon. Lady will be aware that it is important not to rush the roll-out of any service. That is why we kept in place the NHS Direct service in areas where rolling out the 111 service has been slower. A lot of good work is going on in early intervention; it focuses on giving local authorities the budget and the powers to make a difference to local communities. The Labour party should get behind that and do much more to support it. It is this Government who are making a difference in early years, and I hope that the Opposition can support us on that.

[Dan Jarvis (Barnsley Central) (Lab)]

10. When the Government plan to respond to the consultation on standardised packaging for tobacco products; and if he will bring forward legislative proposals on standardised packaging.

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[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

Following a referral from the joint Manchester and Trafford health overview and scrutiny committee, the Secretary of State requested initial advice from the independent reconfiguration panel. That was received on 27 March 2013. The Secretary of State will consider the advice and make a decision in due course.

[Kate Green]

This issue is of huge importance to my constituents, who are concerned about access to accident and emergency and acute services and about delays in discharge into the community in the absence of adequate community provision. So far, Ministers have refused to meet me so that I can make representations about my constituents’ concerns. Will the Minister give me an undertaking that no final decision will be taken until that meeting can take place so that local concerns can be properly taken into account?

[Dr Poulter]

I am sure that we would be happy to meet the hon. Lady; I am certainly happy to do so. A number of the concerns she has outlined in the House and at a local level will be taken into consideration by my right hon. Friend the Secretary of State when he considers the report.

[Mr Graham Brady (Altrincham and Sale West) (Con)]

I welcome the Minister’s undertaking to meet local Members to discuss these important matters and I endorse the comments made by the hon. Member for Stretford and Urmston (Kate Green) about the importance of a timely resolution. The longer this goes on, the greater the cost will be to local health services.

[Dr Poulter]

My hon. Friend is absolutely right, and it is important that a timely conclusion is reached. It is also right, as the hon. Member for Stretford and Urmston (Kate Green) said, that the need to improve community services and preventive care and to provide better support for people with long-term conditions in the Trafford area should be considered.

[Paul Goggins (Wythenshawe and Sale East) (Lab)]

I also welcome the Minister’s agreement to meetings. Will he and the Secretary of State carefully consider the likely impact of downgrading accident and emergency facilities at Trafford general and the implications for nearby Wythenshawe hospital? Does the Minister agree that a failure to provide proper facilities at Wythenshawe for the anticipated additional 4,500 accident and emergency patients, the additional admissions stemming from that and the extra beds required could lead to long delays and a diminution in the service?

[Dr Poulter]

My right hon. Friend the Secretary of State has visited Wythenshawe hospital and can pay testament to the high-quality care available there. All the points that the right hon. Gentleman has raised will, of course, be taken into account when a decision is made.

[Mrs Linda Riordan (Halifax) (Lab/Co-op)]

16. What steps the Government plans to take to improve public awareness of the signs and symptoms of early rheumatoid arthritis.

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[David Morris (Morecambe and Lunesdale) (Con)]

17. Whether there are plans to close the accident and emergency department at the Royal Lancaster Infirmary.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

I would like to reassure my hon. Friend that there are no plans and never have been any plans to close the accident and emergency department at Royal Lancaster Infirmary.

[David Morris]

I thank my hon. Friend for that robust answer. Does he agree that the local Labour party fabricated the scare story that the A and E department was going to close? It was never going to close, as he has just stated. Will he assist me in taking the local Labour party’s bogus petition offline?

[Dr Poulter]

My hon. Friend is right to highlight the fact that it is wrong of any political party—in this case, the Labour party—to focus on scaremongering when there is no basis in truth. At no point have there been plans to close Royal Lancaster Infirmary.

[Mr Philip Hollobone (Kettering) (Con)]

18. What assessment he has made of (a) the pressures faced by Kettering general hospital’s accident and emergency department and (b) what can be done by Kettering general hospital to achieve national accident and emergency transition time targets.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

Local health care commissioners have worked with the trust, Monitor and NHS England’s Hertfordshire and South Midlands local area team to ensure that robust plans are in place to improve the trust’s performance against accident and emergency waiting time performance indicators.

[Mr Hollobone]

The greatest difficulty for Kettering is that it has the sixth fastest household growth rate in the country, and A and E admissions are up 12% year on year. Will the Minister ensure that the NHS Commissioning Board makes sure that population estimates are put into its funding formula?

[Dr Poulter]

My hon. Friend makes a very good point. I will take up the matter further with the NHS Commissioning Board because it is important that when we are commissioning services we take into account future population growth.

[Andy Sawford (Corby) (Lab/Co-op)]

Along with the hon. Members for Kettering (Mr Hollobone) and for Wellingborough (Mr Bone), I shall meet the chief executive and chair of Kettering general hospital this Friday to discuss the latest steps in the Healthier Together review. Does the Minister agree that it is important that we urge on Kettering general hospital and all the other decision makers that we must maintain our proper accident and emergency and other vital services at Kettering general hospital?

[Dr Poulter]

It certainly sounds as though there is a need for an accident and emergency department in Kettering. These are matters for the local commissioning boards to take forward, but it would be wrong for the hon. Gentleman or anyone else to say that as part of the Healthier Together programme there are any site-specific proposals that would in any way threaten Kettering accident and emergency department.

[David Rutley (Macclesfield) (Con)]

T1. If he will make a statement on his departmental responsibilities.

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[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

That is an absolutely extraordinary question given that it was the previous Labour Government’s decision to contract out out-of-hours services in the first place, which has led to the massive pressure on so many A and Es. The regulations in place for many of these arrangements were laid by the previous Labour Government.

[John Pugh (Southport) (LD)]

T9. What is the Department doing to deal with the difficulties presented by poor data sharing between health and social care agencies and the threat to integration that that presents?

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[Andrew George (St Ives) (LD)]

If there is a smidgeon of space in any of the Ministers’ diaries, is there a chance that they could meet me and representatives of the nursing profession to address not the issue that I think the Government are saying they are opposed to—mandatory nurse to patient ratios on wards—but that of adequate registered nurse levels on hospital wards?

[Dr Poulter]

Of course, I would be very happy to meet my hon. Friend to discuss this matter further. He can be reassured that I have regular discussions on these matters with representatives from the nursing profession, both in my clinical work and, more specifically, in my ministerial roles.

[John Cryer (Leyton and Wanstead) (Lab)]

The Secretary of State said earlier that 1 million extra people are attending A and Es annually, but a few minutes later he said that the figure was 4 million. Which one is it?