Epilepsy
Valerie Vaz Excerpts(11 years, 3 months ago)
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Kate Hoey
Although things may have improved, the position in education authorities across the country is patchy. I hope that the Minister might refer to that in his speech.
I am pleased that my hon. Friend the Member for Walsall South, who introduced a ten-minute rule Bill on this matter, is now in her place. I know that she will want to say something at some stage.
I referred to the Epilepsy Action report, and it is important that people look at it because it showed some worrying results. I am sure that the Minister will have read it. Two thirds of the clinical commissioning groups—66%—do not have or do not intend to produce a written needs assessment of the health and social care needs of people with epilepsy. Only 27% of the 113 out of 149 local authorities that replied included a section in their joint strategic needs assessment mentioning the care of people with epilepsy. Only 17% of the clinical commissioning groups have appointed a clinical lead for epilepsy and only 20% of acute trusts stated that the average waiting time for an adult with suspected epilepsy to see an epilepsy specialist consultant was two weeks or less.
Crucially, only half of the people interviewed by Epilepsy Action told the interviewer that they had seen an epilepsy specialist nurse. I cannot overestimate the importance of specialist epilepsy nurses, and I am sure that other hon. Members will agree. Specialist nurses are vital and there is still concern that there are not enough of them. In its guidance, the National Institute for Health and Clinical Excellence said that they should be an integral part of the medical team providing care to people with epilepsy, but it seems that in 2013 half of our acute trusts and primary care trusts in England still do not have that provision.
The report contains many more worrying statistics, but I shall not go through them all. All in all, however, there seems to have been no major improvement in services although I stress that, as with so many other matters, the provision is patchy, with some excellent services in some parts of the country. My local trust, Guy’s and St Thomas’, does an excellent job with the resources it has. Dr Michael Koutroumanidis leads the team and as well as running the tertiary clinic runs a first-time seizure clinic once a week. Much more could be done, however, with more resources and if greater priority were given to those services.
I have some questions for the Minister. If he has read the report, perhaps as his bedtime reading last night, he will be aware of some of them. Will he ask the Secretary of State for Health to refer the whole of epilepsy services to the National Audit Office and invite it to conduct a value-for-money inquiry? That is one of the key requests from Epilepsy Action. Way back in 2007, the all-party group estimated that the avoidable cost of providing the current poor NHS service was £189 million a year based on the NICE figures. The main reason that such money could be seen as wasted is the shocking misdiagnosis rate, which is 20% to 30%, and the poor access to specialist skills. The financial consequence is that patients receive inappropriate, costly and ineffective treatment at the expense of the NHS and the public, never mind the personal consequences of their true condition not being treated. I hope that the Minister can say that that might be a useful piece of work for the Audit Commission.
I ask the Minister to ask the NHS Commissioning Board to include outcomes indicators in the NHS framework. I hope that people can get to the bottom of what all these terminologies mean. The hon. Member for Beckenham (Bob Stewart) has previously referred to the NHS using terms that mean little to the average member of the public, but it is important that we have the statistics to address the unacceptable number of avoidable deaths and the still unacceptable rates of seizure freedom.
Another issue that I want to ask the Minister about is the revised NHS constitution, where the word “pledge” will be used. We want to give people the right to involvement in discussions about the planning of their care and the right, as opposed to a pledge, to be offered a written record of that agreement. Again, published research shows that only 14% of people with epilepsy have a care plan. All those things are important. If the current review of the NHS constitution recommends making care planning a pledge from the NHS to patients, that should be toughened up to encourage a programme of care planning and by making it a right for people.
The Minister could ensure that as a matter of urgency the chief executive of the NHS raises the lack of engagement by the clinical commissioning groups in assessing the needs of people with epilepsy. It seems that that has been ignored by many of them, or lumped together with a number of other health issues that do not necessarily cover epilepsy’s particularly special nature.
There is a whole debate to be had about children with epilepsy, and not just in relation to their school education. There is a long history of children with epilepsy not achieving their full educational potential, yet with the right support there can be huge improvements. Epilepsy can affect the child’s education either because of the underlying cause or because they might have to miss lessons or interrupt them to take medication.
Valerie Vaz (Walsall South) (Lab)
I thank my hon. Friend for securing this debate, and I congratulate Epilepsy Action on producing the report. This is a wonderful opportunity to remind the Minister of my ten-minute rule Bill, in which I ask for two simple things. First, immediate referrals from GPs to specialists are needed. That is where the costs arise—both monetary costs and the cost in lives. If people can be referred directly to a specialist, they need not go through an interim stage to someone who is not a specialist. This covers a wide range of conditions, although it manifests itself as epilepsy—other related conditions might not manifest themselves at all—so anyone might have absences, and they need to know why. Secondly, we need an action plan for children in schools that is similar to that under the Autism Act 2009.
Oral Answers to Questions
Valerie Vaz Excerpts(11 years, 3 months ago)
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Valerie Vaz (Walsall South) (Lab)
How will the Secretary of State assess the effect of the cancer drugs fund on cancer survival rates?
NHS Commissioning Board (Mandate)
Valerie Vaz Excerpts(11 years, 5 months ago)
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Mr Hunt
There is something critically important in the mandate that will do that, which is that by making the NHS operationally independent we are giving commissioning responsibilities to local GP-led groups for the first time, and GPs understand the importance not just of primary care but of prevention. So I think we will see much more innovation, along with the co-operation that the NHS has with local authorities and the new health and wellbeing boards, to make sure that there is a much bigger focus on prevention than there has been in the past.
Valerie Vaz (Walsall South) (Lab)
Will the Secretary of State confirm that if there is an underspend in the NHS Commissioning Board financial allocation, that will stay in the NHS and not go back to the Treasury?
Mr Hunt
As the hon. Lady knows, we manage our finances extremely carefully but we do have underspends. We try to minimise them and there has been a real-terms growth in spending—actual money spent in the NHS, compared with Labour’s plans. In the first year of the review there was a real-terms increase and we will continue to manage NHS finances with a commitment to protecting the budget, which did not ever happen when the right hon. Member for Leigh was in post.
Oral Answers to Questions
Valerie Vaz Excerpts(11 years, 6 months ago)
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Valerie Vaz (Walsall South) (Lab)
Given the apparent increase in spending in the NHS and the £4 billion surplus, will the Secretary of State look at lifting the pay restraint for lower-paid workers, to increase morale and boost productivity?
Mr Hunt
The £12 billion increase in spending on the NHS under this Government, which the right hon. Member for Leigh (Andy Burnham) thought was irresponsible, means that we will be able to do a lot more for patients, but there is also rising demand. If we do not have that pay restraint, we will not be able to meet the needs of an ageing population.
Business of the House
Valerie Vaz Excerpts(11 years, 8 months ago)
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Mr Lansley
I am pleased to hear what my hon. Friend has to say, and I welcome what he said about Holmfirth high street. Indeed, we have accepted and implemented virtually all Mary Portas’s review recommendations. I hope that the pilots will show how we can extend some of the lessons further to invigorate high streets across the country—something that, as my hon. Friend illustrates, can be achieved.
Valerie Vaz (Walsall South) (Lab)
I welcome the Leader of the House to his new position and place on record my thanks to the right hon. Member for North West Hampshire (Sir George Young) for the helpful and courteous way in which he dealt with Back Benchers. I hope that that will continue.
Can we have an urgent debate on the Sunday trading laws, given that the announcements outside this House are at variance with the undertakings given inside it? If there is any consultation, will the Leader of the House ensure that retail staff, the unions, the Churches and the Association of Convenience Stores are included?
Mr Lansley
I am grateful to the hon. Lady for her kind words about my predecessor. I do hope to emulate in many respects the way in which he fulfilled his responsibilities so wonderfully. As to Sunday trading legislation, however, I do not accept the premise of her question. I do not think there is any variance between what the Government said when we introduced the legislation about the extension of Sunday trading hours during the summer and what has been said subsequently.
National Health Service
Valerie Vaz Excerpts(11 years, 9 months ago)
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Mr Burns
I shall make a little more progress.
Let us not stop at waiting times. The £600 million cancer drugs fund that has helped more than 12,500 patients to access the drugs previously denied to them, the screening programmes for breast and bowel cancer, potentially saving an extra 1,100 lives every year by 2015, the world-leading telehealth and telecare whole systems demonstrator programme, which saw a stunning 45% fall in mortality and is set to transform of 3 million people with long-term conditions over the next five years—
Mr Burns
My hon. Friend is right. As he would probably expect, I shall deal with that issue later in my speech. While I am responding to his intervention, let me say that not only was his hospital fortunate in having that fantastic equipment to look after his constituents, but I had the pleasure last week to be in his constituency to visit Elekta and Varian, which are world leaders in making equipment to help with radiotherapy.
Valerie Vaz
The Minister is very fond of statistics. Can he say whether GP referrals have gone up, and whether A and E admissions have gone up or down?
NHS Annual Report and Care Objectives
Valerie Vaz Excerpts(11 years, 10 months ago)
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Mr Lansley
One reason why the NHS continues to deliver such significant improvements in performance is that through the transition, we are increasing clinical leadership, which will make an important, positive difference, and can already be shown to have done so. For example, we are managing patients more effectively in the community, and reducing reliance on acute admission to hospital. The number of emergency admissions to hospital in the year just ended went down, which is a strong basis on which to develop services in future, and that is happening not least because of leadership in the primary care community. I hope that my hon. Friend from Cornwall, along with other Members, supports the assumption of clinical leadership through clinical commissioning groups by those clinicians.
Valerie Vaz (Walsall South) (Lab)
Like my right hon. Friend the Member for Rother Valley (Mr Barron), the former Chair of the Select Committee on Health, I have not had sight of the report, but will the Secretary of State say what the cost to the public purse of the pause and the reorganisation will be?
Oral Answers to Questions
Valerie Vaz Excerpts(11 years, 11 months ago)
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Mr Speaker
On both the Front Benches and the Back Benches in all parts of the House, I suspect.
Valerie Vaz (Walsall South) (Lab)
How do the Government intend to ring-fence the public health money that will be given to local authorities?
Anne Milton
Quite literally, by putting it in a ring fence. That money can be spent only on improving public health among the local population. There are 66 supporting indicators in the outcomes framework. The money will be given to local authorities on the basis that they will make progress towards achieving those outcomes.
Oral Answers to Questions
Valerie Vaz Excerpts(12 years, 1 month ago)
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Mr Speaker
The Minister’s power to anticipate what will be said to him is extremely impressive, and I congratulate him immensely warmly.
Valerie Vaz (Walsall South) (Lab)
One year on, are the pledges under the responsibility deal working?
Mr Lansley
One year on in the responsibility deal we are seeing successes, including the elimination of artificial trans fats, further reductions in salt in manufactured foods, and over 8,000 high street outlets sharing and showing calorie information. The monitoring and evaluation of the deal is vital. We are committed to this and we are making up to £1 million available to fund an independent evaluation.
Health and Social Care Bill
Valerie Vaz Excerpts(12 years, 1 month ago)
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Valerie Vaz (Walsall South) (Lab)
It is always a pleasure to follow the right hon. Member for Charnwood (Mr Dorrell), the Chair of the Select Committee. He said that Members on our side were looking raptly at my right hon. Friend the Member for South Shields (David Miliband). Members of the right hon. Gentleman’s party were looking raptly at him, wishing he was the Secretary of State for Health.
It is an important day when both Houses are discussing the Health and Social Care Bill, and the Prime Minister is in America. When they meet, President Obama will remind him that he said the NHS was
“something that Brits take for granted—a health care system that ensures you don’t go bankrupt when you get sick”.
The President’s stepmother said that she owed her life to the NHS, without which she would not have been alive to see him become President.
There is a kind of double-speak about the Bill. If the Bill was so good in the first place and so necessary, why did we need to have a pause and a rethink, and why were there so many amendments—almost 2,000? The Secretary of State says that the GPs are in control. If the GPs are in control, why are there commissioning support groups? Who are they accountable to? Who voted for the GPs to be in control of a business dealing with public funds? If GPs are so happy about this, why did a GP in Walsall tell me that they are demoralised, disengaged and uninspired? Maybe because they were not consulted.
Robert Flello (Stoke-on-Trent South) (Lab)
Will my hon. Friend give way on that point?
Robert Flello
I am most grateful to my hon. Friend. My persuasive charms work. Does my hon. Friend share the concerns of my constituents? They often find it difficult already to get a GP appointment. With GPs spending so much time with commissioning boards and more to come, will that not make it even harder to get time in front of a GP?
Valerie Vaz
My hon. Friend makes an important point. He should read the front page of the left-leaning newspapers, and he will see how much money is being spent on locums.
The GP in Walsall said that the pace of change is too fast. GPs are being forced into larger organisations. They have no experience of managing a business model. The Secretary of State says he wants to cut the numbers of managers. If the number of managers has been cut, why are the management consultants crawling all over the NHS? A group of consultants including McKinsey, KPMG and PricewaterhouseCoopers sealed a £7.1 million contract with 31 groups of GPs. Pulse found that four in 10 clinical commissioning groups across England have begun to enlist commissioning support from the private sector. That was the work that the PCTs did.
The Secretary of State says that change is happening anyway. So why have the Bill? The Secretary of State says that Monitor did not have a duty to promote competition. So why did the Government not approve the amendment tabled by Lord Clement-Jones that sought to designate the health service as
“a service of general economic interest”,
taking it out of EU competition law? That was not accepted.
The Government said that the role of Monitor is like that of Ofgem, Ofwat and Ofcom. David Bennett said:
“We did it in gas, we did it in power”.
Who are the shareholders? Look at Centrica. Its shareholders include Bank of New York Mellon, the Government of Singapore, the Government of Norway, the state of California, the Government of Saudi Arabia, and Goldman Sachs. The shareholders of the NHS are the people of Britain—but for how long?
The Secretary of State says he wants integration, but the Bill will effectively repeal the integration that started with the Health and Social Care Act 2001. Torbay is a classic example of that. What about the cost, which is £1.2 billion and counting?
Valerie Vaz
I am sorry, but I have nearly finished my speech and must press on.
There was a chorus of disapproval from professionals when the White Paper was published, as they wanted more information. As Rogers and Walters say in the sixth edition of “How Parliament Works”, if there is pre-legislative scrutiny, Ministers have less political capital at stake and changes are not seen as defeats; the scrutiny of a Bill in draft gives higher quality legislation. That is not a description of the Health and Social Care Bill. The pre-legislative scrutiny was in the Secretary of State’s head, not in a draft Bill.
What about my constituent Stephen Wood, who went to his local GP’s surgery only to be told that doctors would only refer him to a consultant privately, not on the NHS, as he had apparently used up his budget?
Valerie Vaz
It is true. This has become personal. The NHS is an organisation in which miracles sometimes happen, which is why people are fighting to protect and save the very essence of its existence. Those who have paid their taxes do not want the Bill, and the health professionals do not want it. From all parties, professionals and patients in the NHS, we can say that we oppose the Bill, and when the NHS unravels, as it is now beginning to, we can say, “We told you so.” I support the motion.