(12 years, 11 months ago)
Commons Chamber2. What progress he has made on the commitment that patients would have access to appropriate radiotherapy wherever they lived.
I am pleased to say that from 26 March £22.7 million of the Prime Minister’s fund to improve access to what is called intensity modulated radiotherapy—IMR in short—has already been committed. The money is being used to update machines and ensure that radiographers receive extra training if they need it. We are well on our way, especially as it is now a nationally commissioned service, so there is no reason why anybody should not have the access they need to this treatment.
I thank the Minister for that response, but is she aware that new guidelines released by NHS England for treating patients using stereotactic ablative radiotherapy—advanced radiotherapy—say that only commissioning for early stage lung cancer will be approved, and that other treatments for all other cancers can be paid for only in clinical trials? As no trials are being commissioned in England, can the Minister explain how the treatment for patients with prostate, liver and spinal cancer, who were receiving SABR treatment last month, will be funded in the future?
What I do know, having had a long meeting with my officials only this morning, is that the evidence, as they have explained it to me, is clear: SABR is effective only in a small number of people who have, unfortunately, a certain small tumour in their lungs, and it is not suitable for other treatments of cancers. However, if the hon. Gentleman wants to discuss the matter further, my door is always open.
(13 years ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
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It is a pleasure to serve under your chairmanship, Mr Amess.
I congratulate my hon. Friend the Member for Liverpool, Walton (Steve Rotheram) on securing this debate. It is a privilege to follow my hon. Friend the Member for West Lancashire (Rosie Cooper) and other Members who have made constructive contributions. Compared with some other debates that I have been involved with in recent weeks and months, the unanimity today is a refreshing change.
I pay tribute not only to my hon. Friend the Member for Liverpool, Walton and the other Members who are in Westminster Hall today, but to the people—more than 110,000 of them—who signed the online petition that was set up by the Oliver King Foundation. Indeed, I pay tribute to the King family, Jake Morrison and all those who have been instrumental in taking forward the campaign. I also thank the Minister for agreeing to meet campaigners; that is very important. It shows the public interest in and the importance of the issues that we are debating today.
As you might be able to tell from my accent, Mr Amess, I am not actually from Merseyside, Liverpool or the north-west.
Well, I am fifth-generation from that area actually, so I have a connection with it. However, I am from the north-east and I know that many colleagues from the north-east and from across the whole country are concerned and share the aims of the OK Foundation, so I hope the Minister will support the campaign to provide defibrillators in all public buildings.
My hon. Friend the Member for Liverpool, Walton referred to the protection that we enjoy here in the Palace of Westminster. I tried to find out precisely how many defibrillators there are in the Palace. There are notices about them at the end of every corridor, including my corridor, and I found that there are actually 16 defibrillators in the Palace. Somebody here obviously knows the importance of early defibrillation in the event of a cardiac arrest, and they are to be complimented for that. The general public should enjoy a similar level of protection.
This is a matter of life and death. As my hon. Friend said, an estimated 60,000 out-of-hospital cardiac arrests occur each year and, incredibly, of the 30,000 cases attended by medical professionals, fewer than one in five of the people affected receive the life-saving intervention they need following a survivable cardiac arrest. I did not realise until I looked at the numbers involved quite how mind-boggling they are. There are nearly 100,000 deaths each year in the UK due to cardiac arrest, which is more than 250 a day, making it one of the UK’s biggest killers.
Hon. Members have already mentioned the British Heart Foundation’s high-profile “Staying Alive” campaign and information film on hands-only CPR. The House will be relieved to know, Mr Amess, that I shall not attempt to sing it or repeat it, but that was a successful campaign. It is reported that in November 28 lives were saved by people who learnt how to administer CPR from the advert headed up the footballer Vinnie Jones, or were inspired by it to take further lessons and coaching, and I imagine that that number is even higher today.
I was surprised by the UK’s record on emergency life-support skills. A British Red Cross survey found that only 7% of people in the UK have first aid skills, compared with 80% of people in Scandinavian countries and a similar figure in Germany. I was surprised, because in the area where I grew up and have always lived, there was quite a strong tradition with the St John Ambulance, and so on, so I expected the figures to be higher, but perhaps it is a function of the society in which we live. That is a major omission and I hope that the Minister takes note of it.
A further survey of public support carried out by the British Heart Foundation found that 73%—almost three quarters—of schoolchildren wanted to learn how to resuscitate someone and give first aid, and more than three quarters of teachers and parents agreed that it would be a good thing to be taught in schools. I hope that the Minister will speak with her counterparts in the Department for Education and press for these life-saving first aid skills to be a core part of the national curriculum, to ensure that all young people leave school equipped with the ability to save a life. That would be really worthwhile.
We know that time matters when cardiac arrest occurs. For every minute that passes following a cardiac arrest and before CPR is administered, the chances of survival are reduced by around 10%. Although CPR can buy more time, defibrillation is the only effective treatment for cardiac arrest caused by ventricular fibrillation, where the heart quivers and stops pumping blood around the body. The British Heart Foundation has found that, for every minute that passes without defibrillation, chances of survival decrease by 14%. We have heard how CPR can improve the chances of survival. We have also heard about research that shows that applying a controlled shock within the first five minutes of collapse provides the best chance of survival. It is therefore essential that defibrillators are readily available, particularly in places where there is higher incidence of cardiac arrest or where it might be difficult for emergency services to arrive quickly.
I applaud the efforts of one of my local newspapers, The Northern Echo, which has been running the “A Chance to Live” campaign in my region, promoting the use of defibrillators in public places, particularly gymnasiums, where there is a greater risk of cardiac arrest occurring both before and after strenuous effort. I am pleased to note—we did a bit of a survey—that all the local authority and council-run gyms in the north-east have defibrillators and staff trained to use them. It has been reported, however, that 80% of private gyms do not have some form of life-saving equipment available; it does not seem to matter whether it is a small gym or one of the larger, more up-market leisure gyms. When challenged about the lack of defibrillators in their gyms, Bannatynes, headquartered in Darlington, issued a statement explaining that they did not have defibrillators because
“they are a specialist piece of medical equipment, which should only be operated by a qualified medical professional.”
I do not know if hon. Members have any contact with Duncan Bannatyne, or if he will get a copy of this debate, but having heard the comprehensive, complete and compelling case advanced by my hon. Friend, it is clear that it is not necessary to have comprehensive training to use a defibrillator. I hope that in the course of this debate we can put to bed this misconception.
As we have heard, modern defibrillators are designed to be used by untrained members of the public; they provide audio and visual instructions to the user and the machines will automatically diagnose the patient and deliver an electric shock only if it is necessary. To provide a medical opinion, as we have the Minister here, in my area in County Durham, Dr Harry Byrne, vice chairman of NHS Darlington clinical commissioning group, has described defibrillators as the
“single greatest advance in out of hospital cardiac assistance since the invention of chest compressions or CPR…You don’t have to be a trained first aider to use one. You just pull it out of the box and follow the instructions step by step. It even tells you what to do”,
as we have heard, from my hon. Friend and the hon. Member for Brigg and Goole (Andrew Percy).
A defibrillator is an essential life-saving piece of equipment and I hope defibrillators will become common, not just in schools, but in workplaces, too. Hon. Members have suggested that they should be in shopping centres and nursing homes. They should be in community buildings as well. Certainly, though, they should be in schools. I agree with my hon. Friend that they should be as common as fire extinguishers and smoke alarms. I hope that the Minister supports these measures and will be proactive in protecting the public and ensuring that everyone, no matter where they live and work, has the best chance of surviving cardiac arrest.
(13 years, 1 month ago)
Commons ChamberI thank the Secretary of State for his previous answer. Comparative data are essential in compiling an evidence base on which to plan effective health interventions. Will he use the radiotherapy data sets that his Department publishes as a basis to inform planned investments in advanced radiotherapy systems, particularly in regions like mine which lack such equipment?
I know that the hon. Gentleman asks a lot of questions about radiotherapy. We use a strict evidence base before we make any investments. We also want to embrace innovation, but our absolute priority is to save as many lives as possible from cancer. He will know that we are in the lower half of the European league tables when it comes to cancer survival rates, and that is something that we are determined to put right.
(13 years, 1 month ago)
Commons ChamberI will certainly do that, and I am grateful for my hon. Friend’s comments. I would just say that it is in some of those areas with the highest proportion of older people that the impact of the current lottery in care provision is so dramatic and needs addressing so quickly. I therefore hope that her constituents will welcome the certainty in these proposals, but I will certainly look at and identify whether any particular issues are raised in rural areas.
The Minister has concentrated on the impact on the frail elderly, but does he recognise the other care crisis highlighted recently in a report published by four leading disability charities? What will these proposals do to assist in providing social care to working-age disabled people, who make up about a third of social care recipients? The shortfall we have estimated is about £1.2 billion—that is the gap between social care budgets and needs.
These proposals will go some way to addressing that problem. First, children who reach adulthood— the age of 18—with care costs will continue to receive the support they need without any qualification at all. Adults who become disabled during their working life will have a cap, but it will be a lower one. So we will be able to offer very important support to both those groups.
(13 years, 2 months ago)
Commons ChamberI am happy to inform my hon. Friend that 25,000 people have benefited to date from the cancer drugs fund, which the previous Government failed to introduce. On top of that, 53,000 more people every year are being admitted for chemotherapy and 219,000 more cancer treatments are happening every year than happened in any year under the last Labour Government.
21. I have previously raised with the Secretary of State the opportunity cost—in terms of cost and effectiveness —of the proton beam therapy system. Given that expert opinion—in the form of the national radiotherapy advisory group—is divided, and given that the cost of the proton beam therapy system is 100 times more than other advanced radiotherapy systems that my region and others lack, why is he proposing to spend £125 million on it?
I recognise that the hon. Gentleman has a long-standing view on this matter. I am guided by clinical advice. Over the next two years, we will publish the cancer survival rates by multidisciplinary team across the country in all the major cancers for the very first time. That will give us a much better objective base from which we can work out what the most effective treatments are.
(13 years, 3 months ago)
Commons ChamberWe have heard a lot of bluster and nonsense today. At its heart is an extremely uncomfortable truth for the Opposition: this Government are spending more on the NHS than Labour would have spent. That spend has moved away from consultancy and the back office to the front line, so the NHS is now performing better—I know that it is uncomfortable, but it is true—than it ever did under Labour. That means more treatment—[Interruption.] This might not be what Opposition Members want to hear, but they might as well listen. That means more treatment, more care and more lives saved. The previous Government talked the talk on the NHS, but it is this Government who have delivered an NHS of which we can be immensely proud.
Let me say very gently to the right hon. Gentleman that he can hardly come to this House criticising us for an alleged cut in NHS spending if his own plans would have led not to higher but to lower NHS spending. We are increasing spending by £12.5 billion, and he thinks that that is irresponsible.
Will the Secretary of State at least acknowledge that the previous Labour Government increased resources in the NHS from £30 billion when we took office to over £100 billion when we left office in 2010?
I understand that the hon. Lady has a specific issue in her constituency, and I would like to point out one in mine: anyone in my constituency who requires radiotherapy treatment has to travel to Hillingdon in London to have access to the linear accelerators, with the typical journey being more than 4,000 miles during the course of the treatment. I do not want to blame any particular Government or party, but the reality is that there are difficulties everywhere. I have a campaign, which I would love all hon. Members to join, to bring cancer care closer to people’s homes, and I want to have a radiotherapy unit based in my constituency. There are discrepancies and disparities all over the country, and it would be great if we could iron them out.
Does the hon. Gentleman agree that a good use, not only in Stevenage, but across the country, of some of the underspend that has been mentioned by hon. Members from across the House would be to buy advanced forms of radiotherapy equipment?
That would be fantastic use of the money, but Hillingdon already has eight linear accelerators and a cyber knife, which reduces the course of someone’s treatment from about 25 visits to eight. The key for my constituents is that the people accessing that service are generally elderly and they would have to access it by public transport, which they find very difficult, so they rely on friends and family. I want that treatment to be brought closer to their home, which goes back to my point about the patient’s experience.
Earlier in the debate, Mr Deputy Speaker called for a little bit of Christmas cheer, so I have great pleasure in being able to announce that earlier this morning, when it was minus 6°, I was outside my local hospital having my photograph taken and the Government were announcing £72 million of funding for infrastructure in the Lister hospital—the money is part of an ongoing investment programme worth more than £150 million. That is the third of 11 projects. We are having a huge accident and emergency department rebuilt, and a lot of people are going to be accessing it; and we are having new ward blocks, theatres and endoscopy units. A huge range of services are coming to the Lister hospital in Stevenage; it is fast becoming a centre of clinical excellence. I know that many hon. Members think I am quite lucky, and I am very proud and happy about what is happening.
That investment highlights one of the issues I want to raise. When we have these debates, we often find that the passions of hon. Members on both sides about small amounts and figures can create a sense of fear in the NHS that services are being delivered poorly day to day. In my constituency, for the past two years, construction has been going on and new services have been coming to my local hospital, with a range of users able to access them. That building will go on until 2014 to early 2015, and it is what we are calling phase 4. I refer to my radiotherapy campaign as phase 5—people are not aware of that, but we are keen to access the money for it. The hon. Member for Easington (Grahame M. Morris) suggested using the £1.6 billion underspend, and it will now be my target for where we get the funding.
In my constituency, the NHS is daily delivering better and better care; a legion of doctors, nurses and clinical staff, backed up by great administration staff, are providing a fantastic level of service and improving the NHS. I am proud of the NHS and of the staff in my constituency who work in the NHS, and I am delighted that we have had the opportunity to have this debate.
I rise to speak in favour of the motion tabled by my right hon. and hon. Friends on the Opposition Front Bench. The Deputy Speaker suggested that we might introduce a bit of Christmas cheer into the proceedings, and the hon. Member for Stevenage (Stephen McPartland) certainly painted a very rosy picture of investment in his constituency. I thought he made a very good speech, incidentally.
In case Ministers are making their Christmas lists, let me tell them that one of the first things that this Government did was cancel a new hospital that served part of my constituency in order to save £464 million. Restoring that funding might be a good use for some of the £3 billion underspend. It was not a private finance initiative scheme but a scheme that was approved by the Department of Health and the Treasury but stopped in the emergency Budget.
I want to concentrate on two specific issues that are directly linked to the motion and on the important question of trust in the Government’s pledge on the funding of our NHS. I believe that the Government are keeping the public in the dark about a range of issues relating to publicly funded contracts delivered by private sector organisations, including on cancer care.
On trust, none other than the Prime Minister broke yet another pre-election promise. Having said before the election that he would extend the Freedom of Information Act 2000 to all publicly funded organisations, he did not do so. As a result, the public cannot access information about private sector providers in the NHS. This does not apply just to the NHS. In his comments, the Prime Minister referred to other publicly funded organisations such as the Carbon Trust, the Energy Saving Trust, the Local Government Association, and traffic penalty tribunals. It is increasingly apparent that many of the large corporations that apparently enjoy cosy relations with this Tory-led Government are extremely anxious that the Prime Minister does not extend the Freedom of Information Act to them. Currently, it instead allows them to hide behind a cloak of commercial confidentiality as billions of pounds of taxpayers’ money are awarded to them in barely transparent contracts. The public are deliberately being kept in the dark, and I have no doubt that an expensive lobbying campaign is under way to ensure that the Prime Minister and the Tory party do not change their minds on this issue.
Meanwhile, private companies benefit by gaining intimate knowledge of public sector bodies through their own submissions of freedom of information requests. That information is then used to undercut or outbid the very same public sector bodies when contracts are tendered or put up for renewal. Members might ask what the relevance of this is in the NHS context, but as someone who worked in the NHS, who is passionate about it, and who has tremendous admiration for the people who deliver the service, I can say that it is a huge concern to me. The area that I worked in—the pathology service that carries out diagnostic tests—is under threat. This huge uncertainty continues, and we need to know precisely what the position is.
Virgin Care, Circle, Serco, Care UK and any other private sector companies awarded a public contract to provide hospital, community or even specialist diagnostic cancer services are not subject to the FOI Act. We have no idea how these companies went about winning those lucrative, taxpayer-funded contracts. Under current arrangements, the best that may be hoped for in terms of any rudimentary accountability is achieved through a Commons Select Committee inquiry of the type conducted by the Public Accounts Committee chaired by my right hon. Friend the Member for Barking (Margaret Hodge). However worthy this process, it is by its very nature very limited in scope, and such inquiries can only ever touch the tip of the iceberg.
This is a national scandal that has prompted me to table early-day motion 773, which has attracted quite a wide range of support, mostly from Labour Members. It calls for the FOI Act to be extended to private sector bidders for public service contracts, particularly in organisations such as the NHS.
My concern is that this has overtones of the Government’s response to Leveson, in so far as I do not believe that the Government want their corporate friends to be accountable to Parliament, even though our public services are being awarded to those companies in ever greater numbers. We should follow the public pound and ensure that we know who is getting it, and how and why they are spending it.
The Secretary of State has said that there will be no large expenditure projects that are not fully thought out and properly costed. That brings me to my second point. Responses to FOI requests from my hon. Friend the Member for Leicester West (Liz Kendall) have made it clear that the Secretary of State is presiding over cuts to essential cancer networks, yet we know that he is planning to spend £250 million of taxpayers’ money on two proton machines, even though, according to the Department of Health’s own report, there is little evidence that they provide any benefit. There are no clinical trial data and no randomised control trials, which are the gold standard by which the National Institute for Health and Clinical Excellence judges the effectiveness of clinical therapies. Indeed, the new chair designate of NICE appeared before the Health Select Committee earlier this week and said exactly that.
The economic justification for purchasing those two machines has been based on informal discussions with the manufacturers who make them. If the machines are to be viable for the two hospitals that are to have them, they will need to treat 1,350 patients a year at a cost of £40,000 per patient. However, according to the Department of Health’s own dataset, the highest number of patients ever treated with proton therapy in one year is 79.
I would like to draw the House’s attention to the situation in Germany, which has invested more than most in proton therapy. Today, two of the three proton machines in that country are being mothballed. In Kiel, €250 million was spent last year on a machine, but it is now being dismantled and put into storage because of a lack of demand.
Can my hon. Friend explain to the House what a proton machine actually is?
Probably not, in the very limited time available, but I can tell my hon. Friend that proton therapy is a form of advanced cancer treatment.
My argument is that the money the Department is proposing to spend on those incredibly expensive machines would be far better spent on advanced radiotherapy machines such as the stereotactic body radiation therapy machines that the hon. Member for Stevenage mentioned. There are other forms of therapy that are far more cost- effective. I might add that we in the northern region have no access to such therapies. Indeed, whole regions of the country do not.
The one remaining proton machine in Germany is at the university of Heidelberg, and it treats a maximum of 1,200 patients each year. The German Radio-oncology Society has said—[Interruption.] I hope that the Minister will listen to this. The society has said that
“for the vast majority of cancers there is no proof that proton therapy is more beneficial than other forms of innovative radiotherapy that are one hundred times less expensive”.
This proton debacle highlights the perversity with which the Government are running the NHS budget, and these questions lie at the very heart of whether we can trust Conservative promises on the NHS.
The Prime Minister tells the public that by April next year every cancer patient who needs innovative radiotherapy will get it, while at the same time the Secretary of State for Health starves dozens of hospitals and cancer networks of vital money needed to buy innovative radiotherapy equipment. We now know that money is being redirected into those two highly dubious projects. The Secretary of State needs to cancel those projects now and redirect the money into radiotherapy machines that will help tens of thousands of people in my constituency and across the country. This has the potential to be a monumental scandal and a waste of public money. I urge hon. Members who share my concern to sign early-day motion 773, to lobby the Health Secretary and ask him to reconsider his spending priorities in relation to cancer therapies, and to support the motion on the Order Paper.
I call Jim Shannon. I am not putting the clock on him, but he must resume his seat by 4.44 pm.
(13 years, 3 months ago)
Commons ChamberI agree absolutely. One of the great scandals of this whole saga has been the extent to which local authorities and primary care trusts let people down. The father of a patient at Winterbourne View told me how the concerns he raised were ignored, how he watched as his son became more zombie-like because of the use of antipsychotic drugs and how he felt guilty himself—how shocking that a parent ends up feeling guilty through no fault of his own. He was powerless to do anything. It is shocking that public authorities let people down in that way. That is why I say that everyone in the system has to step up to the plate and recognise the need for a complete change of culture to recognise that everyone with learning disabilities has exactly the same rights as the rest of us.
I thank the Minister for his statement and hope that he will reflect on some of the questions posed by my hon. Friend the Member for Leicester West (Liz Kendall), who made a powerful case for private providers being subject to freedom of information requests—I draw his attention to early-day motion 773, which embodies that principle.
On the failings that brought about this terrible tragedy, the Care Quality Commission was overly concentrating on process rather than its main job of ensuring that the required standards were met and looking at quality and risk profiles. There was a big disconnect between the perceptions of carers and families and the views of the CQC. Fundamentally, unless we address the lack of resources, will we not see a series of these disasters in the future?
In the aftermath of Southern Cross, we have seen the need for much greater transparency in these large corporate bodies to ensure that we know exactly what their financial structures are like and where the risk exists. The hon. Gentleman mentioned funding. The great scandal is that we are spending vast sums of public money putting people at risk and into inappropriate care settings. Visiting places such as Tower Hamlets, we discover that the right care package for individuals—most often, supported living in their own community—is much cheaper and gives them a quality of life they never experienced in these institutions. This is not about money, therefore, but about the system stepping up to the plate and ensuring that individuals are respected in their own right.
(13 years, 4 months ago)
Commons ChamberI am more than happy to do that, because when it comes to conditions such as dementia there is no one right solution, and doctors’ surgeries and hospitals will have different approaches in different parts of the country. We want everyone to take ownership of the problem. I hope that what is happening in Crawley will be noticed by other parts of the country, so that we can spread best practice everywhere. That is the point—we want to allow innovation to happen in a way that has never happened before.
This is a hugely significant occasion. It is the one opportunity that Parliament will have to call the Secretary of State to account for the priorities that he sets for the NHS Commissioning Board, so may I refer him to his pledge to improve cancer outcomes? Given that he made a pledge to the House on 23 October to make available to anybody who required it innovative radiotherapy, how does that square with giving back to the Treasury £3,000 million that could otherwise be used to buy advanced and innovative radiotherapy equipment?
Let me remind the hon. Gentleman, as I reminded the right hon. Member for Leigh, that for the four years that preceded this Government, there were underspends, including when the right hon. Gentleman was Health Secretary, and in three of those four years the underspend was higher than it was in our first year in office. But we do want innovative cancer treatments to be available. That is why we introduced, among other things, the cancer drugs fund, which was not introduced by his Government and which has transformed the lives of thousands of cancer sufferers.
(13 years, 5 months ago)
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I tend to the view that we have had too many changes of regulator over a number of years, and that continuity would be a good thing. An assessment of the CQC earlier this year indicated that it was on the right track. I have met the new chief executive and am reassured by the plans he has in place. It is seductive to believe always that it is an attractive proposition to abolish an organisation and set up a new one, but is there any more chance that a new organisation will be better? Let us therefore make the CQC work properly.
I welcome the Minister’s response—he is sincere in his desire to address these issues. Does he recognise the important role of whistleblowers? Does he have any information on concerns raised by whistleblowers in respect of the alternative provision before Winterbourne View patients were transferred?
The role of whistleblowers is central. Importantly, the Government have funded a whistleblowing helpline, which is available to any worker in the care sector—it covers all care homes. It is important that any worker at any stage feels they can raise their concerns with the relevant authorities so that they are properly investigated. What happened with the whistleblower at Winterbourne View was not acceptable, because their concerns were not taken up effectively.
(13 years, 5 months ago)
Commons ChamberI absolutely agree with my hon. Friend. Indeed, last week we announced that waiting times are at near-record lows. The number of hospital-acquired infections continues to go down and mixed-sex wards have been virtually eliminated. I am very pleased that my hon. Friend has an urgent care centre, and am sure that Mrs Bone will appreciate it even more than he does.
Does the Secretary of State recognise that the Office for National Statistics survey shows that the mortality rate in north-east England is 12% higher than that in the rest of the UK? Does he recognise the need to invest in more advanced radiotherapy equipment, bearing in mind that 70 of the 212 systems will need to be replaced by 2015?
I would not necessarily expect the hon. Gentleman to follow announcements that are made at the Conservative party conference, but we did make the big announcement that access to radiotherapy will be transformed, making it available to everyone for whom it is clinically necessary and cost-effective. Improving mortality rates is extremely important. As I have set out, one of my key priorities is to transform the NHS so that we have the best mortality rates in Europe. I hope that that is welcome news for his constituents.