Breast Implants

Toby Perkins Excerpts

Wednesday 11th January 2012 Commons Chamber

[Mr Lansley]

I hope I did not say what the hon. Gentleman ascribes to me. Some 3,000 women, we think, had PIP implants, and of course, that is only a fraction of the number having breast reconstruction surgery. I think I can offer him reassurance. The MHRA withdrew authorisation in March 2010, and given that there was only one distributor of these implants in this country—Cloverleaf—they will not have been distributed for use after that date.

[Toby Perkins (Chesterfield) (Lab)]

A constituent in Chesterfield contacted me who is at her wits’ end. She has been in considerable pain since having a PIP implant fitted, and has been told by the private provider that she will have to pay £3,600 to have it replaced. What more can the Secretary of State do to ensure that her private provider follows the example of the other eight providers that are doing this free of charge? Let us put some pressure on these companies to make sure that all of them do the same as the NHS and replace the products they have fitted.

[Mr Lansley]

I think I have made it clear that not only the Government but, helpfully, the professional associations are looking to give no reason why private providers should not match that standard of care, especially if the implanting surgeons are willing to offer replacement surgery free of surgical charge themselves. It would be very helpful if the hon. Gentleman and other Members gave us details of such cases on behalf of their constituents. Clearly, his constituent will have had that implant before March 2010. The adverse incident centre has had 478 reports of ruptures over the whole period, which extends back many years. One of the things we want to understand as part of our review is why, if there were ruptures and, more to the point, adverse health effects associated with these implants, they were not disclosed to the adverse incident centre. As yet, we have not seen a range of health effects over a period of time that, in themselves, distinguish these implants from other, normal implants.

Health and Social Care (Re-committed) Bill

Toby Perkins Excerpts

Tuesday 6th September 2011 Commons Chamber

In its response to the opportunity provided by Report stage, the Labour party is being not progressive but reactionary, while the trade unions are being misleading in the presentation of their campaign. To be specific, the trade unions and other proxy organisations such as 38 Degrees have gone to some trouble to misrepresent the Bill in order to attack it.

[Toby Perkins (Chesterfield) (Lab)]

I am grateful to the Secretary of State for giving way. Does he think that the British Medical Association, too, is misrepresenting the position when it says that even after Report stage there will still be too much emphasis on using market forces to shape health services? Is the BMA misrepresenting the truth as well, or is it just the Labour party?

[Mr Lansley]

I was interested to read this morning a letter whose lead signatory was Hamish Meldrum, the chairman of the BMA council, whom I know well. It was curious because his objection to the Bill, which he wants to be amended, was about the introduction and extension of the role of “any qualified provider”. However, that extension is not in the Bill. It is not occasioned by the Bill; it is a consequence of the way in which commissioners—[Interruption.] No, it does not. If there were no Bill, it would be open to strategic health authorities and primary care trusts to extend “any qualified provider” and patient choice in the NHS to whatever extent they wished. The Bill does not make that happen.

The point is that under the legislation there is a stronger safeguarding process, because the commissioners—

[Toby Perkins]

rose—

[Mr Lansley]

I will finish answering the hon. Gentleman before letting him intervene again.

The safeguard structure will be stronger, because commissioners must ensure, for example, that they meet their duty of continuous improvement of quality, their duty of safety and their duty of integration of services and other duties, including a duty to promote patient choice—but of course they have to balance those duties. Whether they extend “any qualified provider” is a matter of judgment. If they took the view that the extension of patient choice would be inimical to the integration of services and the improvement of quality, they would not go ahead with it. The hon. Gentleman and his colleagues should recall that they have put in an NHS constitutional right for patients to exercise choice, so if the commissioners think it is possible to promote choice and improve quality by extending the any qualified provider remit, they can do it, but the Bill is not what enables it. It is therefore curious that the Bill should be attacked on that basis.

[Toby Perkins]

I am grateful to the right hon. Gentleman for giving way a second time. That was a very long answer to a short question, but I understand the Secretary of State to be saying that the BMA is wrong and the Labour party is wrong. Everyone I meet in the health service tells me that it is the Secretary of State who has got it wrong. He has come back here once again, confirming that he is not listening to what people are saying to him. He thinks the BMA is misleading people, but is it possible that he is the one who has got it wrong?

[Mr Lansley]

I will give the hon. Gentleman a shorter answer this time: he does not talk to enough people in the NHS.

Let me return to the important point that I was about to make. I was saying that criticism of the Bill has typically developed to the point of literally misrepresenting the facts in order to attack the Bill, as was the case with 38 Degrees. I am indebted to my hon. and learned Friend the Member for Sleaford and North Hykeham (Stephen Phillips) for sharing with me a letter that he prepared for the better information of his constituents. He looked at the legal opinion obtained by 38 Degrees and concluded that it did not support the views that those behind the 38 Degrees website evidently wished it did.

For example, 38 Degrees claims that the Bill removes the Secretary of State’s duty to provide a comprehensive health service. However, its own legal advice makes it clear that the Secretary of State has never had a duty to provide a comprehensive health service—only a duty to “promote” a comprehensive health service, which is exactly reproduced in clause 1.

Clause 1 also makes it clear that the Secretary of State must secure the provision of that service. The “duty to provide” certain services to which 38 Degrees refers is a duty that I, as Secretary of State, currently delegate to primary care trusts. In future, the Bill will—in exactly the same way—pass that duty of the Secretary of State to the NHS commissioning board and to clinical commissioning groups. In other words, the situation will be legally unchanged. The Secretary of State has a duty, and discharges it through organisations to which he or she delegates that power. Strictly speaking, they have more direct statutory duties, but the duty to provide will not change.

38 Degrees also claims that the Bill opens up the NHS to competition law, but its own legal advice—which it obviously did not like—made it clear that there would be no change between the present competition regime and that which would operate if and when the Bill became law.

I am very grateful to my hon. and learned Friend, whose forensic analysis accords with our own view. The provision, under the Bill, of a comprehensive NHS is watertight, and it is equally clear that the Bill does not change the extent of the application of competition law and EU procurement rules. The 38 Degrees campaign should be seen for the distorting and misleading political propaganda that it is.

Future of the NHS

Toby Perkins Excerpts

Monday 9th May 2011 Commons Chamber

[Toby Perkins (Chesterfield) (Lab)]

I am glad to hear that the Secretary of State supports the staff of the NHS, but is it not the truth that the staff of the NHS do not support him?

[Mr Lansley]

That is complete nonsense. This is not about me: it is about what the staff of the NHS want. They want the ability to be able to deliver care for patients without being told what to do by the top-down bureaucracy and targets of the Labour Government. They want the ability to deliver the care that patients need, to join up health and social care and to integrate the pathways of care. Our Bill is about giving them the structure that will allow them to do that. They want every penny that we as taxpayers provide to the NHS to get into the hands of front-line staff, and for the absolute minimum to go in waste and inefficiency. That is what they want, and that is not about me, it is about them.

A stronger NHS will require change, so that it no longer spends £5 billion a year on bureaucracy.

NHS Reform

Toby Perkins Excerpts

Monday 4th April 2011 Commons Chamber

[Mr Lansley]

I am grateful to my hon. Friend. We are not only developing communication with GPs in pathfinder consortia, but, more importantly, creating a learning network among GPs in pathfinder consortia, so that these groups across the country will not only learn from each other, but, we hope, arrive at a set of views that help us to design a service that supports them.

[Toby Perkins (Chesterfield) (Lab)]

The Secretary of State, who tells us how much he studies the NHS, must know that the King’s Fund tells us that under the Labour Government, Britain’s NHS was the most efficient in the entire world. On that basis, a broad coalition of people, including health experts and the Liberal Democrats, is telling him that this policy is wrong. He apparently came here today to tell us why he is right and all those people are wrong. Is this a genuine consultation, or is it just a pause to get through the local elections before he does what he wants to do anyway?

[Mr Lansley]

The hon. Gentleman is wrong on almost every count. We have seen a decade of declining productivity in the NHS. The Office for National Statistics and the National Audit Office set that out recently. We have seen an NHS that, despite record increases in funding, which are welcome, is still not meeting the best European cancer survival rates, as was made clear by the NAO. We need to improve the NHS. The Government are not discounting anybody’s views on how we can best achieve that. In the spirit of continuous improvement in the NHS, there is a spirit of continuously listening about how to make that happen.

Oral Answers to Questions

Toby Perkins Excerpts

Tuesday 8th March 2011 Commons Chamber

[Paul Burstow]

First, there has been a 3% average increase in the funding that is available to PCTs, and, as my right hon. Friend the Secretary of State said in answer to an earlier question, we are currently in that process of negotiation between hospital trusts and PCTs. It remains to be seen where the final figures will settle, but the money is in the system: the Government are committed to putting £10.7 billion extra in the system—something that the Labour party actually opposed.

[Toby Perkins (Chesterfield) (Lab)]

As someone whose mother died of cancer, no one needs to tell me how important cancer is within the NHS, but it is noticeable that nine out of 13 questions asked by Conservative Members are about cancer; it seems to be the only part of the NHS which the Government are happy to talk about. But cancer cannot be taken in isolation from the rest of the NHS, when there is a massive reorganisation costing billions of pounds which only one in four GPs thinks will actually improve the service. How can that possibly involve doing the best for cancer patients?

[Paul Burstow]

Again, I suspect that the hon. Gentleman is trying to re-run the Second Reading of, in this case, the Health and Social Care Bill, but in fact this Government are committed to seeing improvements across the board. That is why in the NHS outcomes framework we do not just talk about cancer, we identify other areas as well. If hon. Members table the questions, I am certainly happy to answer them.

Swine Flu

Toby Perkins Excerpts

Monday 10th January 2011 Commons Chamber

[Mr Lansley]

I take this issue seriously, even if the right hon. Gentleman does not. As it happens, I fall into one of the at-risk groups, because I had a stroke in 1992, so I have had the flu jab. I would not ask members of my ministerial team who are not in the at-risk groups to have the vaccination, because it is not recommended.

[Toby Perkins (Chesterfield) (Lab)]

The biggest tragedy is that the Secretary of State has learned no lessons whatsoever from what has happened. As a result, it is likely that the same mistakes will be made in the future. His answers about the advertising campaign are completely unconvincing. Will he explain why he cancelled the advertising campaign, which GPs were demanding at the time, to increase the take-up of vaccinations?

[Mr Lansley]

I cancelled no campaign; I proceeded only with the awareness campaign on respiratory and hand hygiene. An advertising campaign aimed at the general population would not have been effective, and I was advised that there was no evidence that it would be effective. We knew who the at-risk groups were, and it was possible to reach them directly rather than engaging in wider advertising.

Oral Answers to Questions

Toby Perkins Excerpts

Tuesday 7th December 2010 Commons Chamber

[Mr Lansley]

I agree with my hon. Friend, who is obviously an advocate for his constituents to the Welsh Assembly Government. These are matters for the devolved Administrations and they must decide how to allocate their resources. In this instance we have shared with the devolved Administrations the consultation on the cancer drugs fund, which will start next April, although the policy proposed will apply in England alone.

[Toby Perkins (Chesterfield) (Lab)]

2. What recent representations he has received on the effect of the abolition of primary care trusts on the co-ordination of preventive health care.

[The Minister of State, Department of Health (Paul Burstow)]

The Government have set out a number of proposals to support integrated working and preventive action, including ensuring that local councils take a key role in joining up local NHS services, social care and health improvement. There is a strong preventive focus in the NHS public health and social care outcome frameworks, and an additional £1 billion will be provided by 2014-15 for the NHS to support social care. Some of that money will be spent on preventive services. The public health White Paper sets out the Government’s plans to return the leadership of public health to local government. That proposal has been widely welcomed.

[Toby Perkins]

Before the Secretary of State and the Minister embarked upon the biggest reorganisation of the NHS in the past 60 years, what consideration did they give to the impact that such changes will have on the co-ordination of services? Primary care trusts are being described as in meltdown at the moment. PCT staff whom I meet are deeply worried about the co-ordination of services, as linking such services is about so much more than the work of GPs.

[Paul Burstow]

Let me start with the point of agreement: this is about more than just the work of GPs. That is why the Government are proposing the establishment of health and well-being boards in local authorities to drive the integration that was never delivered under the Labour party. Services were not integrated and, for many people, services did not fit around their lives as a consequence. This Government will change that. It seems that the hon. Gentleman is putting forward the campaign slogan, “Save the PCT; don’t trust your GP.” That is not a good campaign slogan.

--- Later in debate ---

[Mr Lansley]

My hon. Friend will know that all that has not yet come to me, so I will not prejudge this issue. However, I have made it clear, not least in a letter I recently sent to Baroness Margaret Wall, who is the chair of the Barnet and Chase Farm Hospitals NHS Trust, that I expect us to examine not only the Barnet, Enfield and Haringey proposals, but any other proposals that the trust might put forward about the level of acute services provided through Chase Farm.

[Toby Perkins (Chesterfield) (Lab)]

T9. The Secretary of State seemed to suggest, in his answer to the shadow Secretary of State, that his definition of a real-terms increase includes changes in inflation. If he does not accept the Office for Budget Responsibility verdict that the increase in inflation means a real-terms cut in 2012, which definition of inflation is he using?

[Mr Lansley]

What I said to the shadow Secretary of State was entirely accurate.

Oral Answers to Questions

Toby Perkins Excerpts

Tuesday 2nd November 2010 Commons Chamber

[Mr Lansley]

My right hon. Friend makes an excellent point, and I invite the shadow Secretary of State to respond to it in due course. We will ensure that the NHS uses resources more efficiently to meet increasing demand and costs in the NHS. Savings of that order are required, and the NHS is on track to make them.

[Toby Perkins (Chesterfield) (Lab)]

I would like to return to the subject raised by my hon. Friend the Member for North East Derbyshire (Natascha Engel) about the national hereditary breast cancer helpline. The Minister’s response was inept. She said that a national service will be funded by tons of different GP commissioning groups. That just will not happen. She said nice words about Wendy Watson, but her Government’s policies will see the end of that helpline unless she intervenes. Will she please ensure national funding for a national service?

Oral Answers to Questions

Toby Perkins Excerpts

Tuesday 29th June 2010 Commons Chamber

[Mr Burns]

It is not waffle. The right hon. Gentleman is clinging to an outdated philosophy, and he is in denial about the need to change it.

[Toby Perkins (Chesterfield) (Lab)]

3. If he will take steps to increase the number of dentists providing NHS services in Chesterfield; and if he will make a statement.

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

I assure the hon. Gentleman that the Government have committed to improving access to NHS dentistry, and the introduction of the new dental contract, focusing on achieving good dental health and increasing access to NHS dentistry, will be vital.

[Toby Perkins]

I thank the hon. Lady for her response. The Stubbing Road medical centre is a brand-new building in Chesterfield providing doctor services to people who are among the most deprived in Derbyshire. One floor there was also meant to provide dental services, but in the last week we have been told that that might not—indeed, that it will not—go ahead, although the primary care trust is paying the rent on the building and its new suite. Can the hon. Lady assure the people in the Rother ward who have been waiting so long for those services that the guarantee that everyone in Chesterfield will have access to an NHS dentist by March 2011 will remain in place?

[Anne Milton]

I cannot comment on the specific circumstances, but I would be happy to meet the hon. Gentleman if he would like. I must point out to him, however, that the number of people now seeing an NHS dentist remains lower than when the previous Government introduced the new contract in 2006. He mentions children, but there is no doubt that the inequalities in the oral health of children are scandalous.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

I thank the hon. Gentleman for his question. He obviously knows how much is spent on homeopathic treatments, although no one else seems to know exactly. The decisions should be taken by doctors locally, and the effectiveness, safety and efficacy of a treatment should be taken into account. The estimate is that 0.001% of the drugs bill is currently spent on such treatments. At present, we are looking at the Science and Technology Committee’s report. We hope to respond to it before the summer recess.

[Toby Perkins (Chesterfield) (Lab)]

T2. My right hon. Friend the shadow Secretary of State referred to the Commonwealth Fund report, which said that Britain’s NHS was the most efficient. Does that not make it clear that after 13 years of a Labour Government, the NHS is not just so much better for patients, but efficient? To say that it is not is an insult to the people who have worked so hard to make it great.

[Mr Lansley]

I have looked at the reports of the Commonwealth Fund for a number of years; it regards the NHS as efficient because it spends relatively little in comparison with other health economies. In this country, we need to recognise that the NHS does not spend very much in comparison with other countries but it could spend it more efficiently. There has been declining productivity for 10 years. [Interruption.] The shadow Secretary of State needs to recognise that NHS management costs went up by 63% while nursing costs went up by just 27%. My colleagues and I are committed to halving NHS management costs and to reducing the costs of the NHS, through efficiency, by £20 billion. Every penny of that will be reinvested in meeting the rising demand for the NHS and the improvements in quality that we require.