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With what confidence does the Secretary of State believe that Dr. Kasp is wrong?

Andy Burnham: Obviously, I would refer Dr. Kasp to the chief medical officer. We are proceeding at all times on the basis of the best possible medical advice. The advice is that at this stage we should work to contain the spread of the virus at a local level. However, an important point is being made about the ability of the Health Protection Agency to continue working in that way. I was in the west midlands yesterday talking to staff from the agency and the extra flexibilities allowed to staff on the ground are helping give a more locally adjusted response within the national framework. Obviously, it is not possible to continue to test and to offer prophylaxis to all in the area affected and, accordingly, we are adjusting our response as conditions on the ground develop.

Mr. Jim Devine (Livingston) (Lab): As health is devolved to the Scottish Parliament and to the Welsh and Northern Ireland Assemblies, has my right hon. Friend met the appropriate Health Ministers in those bodies? Is there a consistent strategy throughout the UK?

Andy Burnham: The four Health Ministers have agreed a framework for handling the outbreak across the UK. I speak regularly to Nicola Sturgeon, Edwina Hart and Martin McGuinness and at all stages we are working together to make sure we adopt a consistent approach across the UK.

Mr. Andrew Lansley (South Cambridgeshire) (Con): You know you are getting older when Speakers look young.

In March this year, the Secretary of State’s Department said that the national pandemic flu line would be available by April or May 2009—that is, by now. Now he says that it will not be ready until the autumn. Can he explain the delay?

Andy Burnham: These are important developments and this is a new service for the national health service. It is absolutely right that the service was tested in detail so that we knew that it could deal with the demand that it would be placed under. There have been examples in other areas where national telephone lines or internet services have not been able to cope at the point that they went live. That cannot be the case here; the service had
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to be tested rigorously and thoroughly, and it has been. If the hon. Gentleman was listening, he will have heard me say a moment ago that an interim service could be launched within a week. That would, if necessary, relieve pressure on primary care.

Mr. Lansley: I am sorry but the Secretary of State has simply not answered the question. We are not talking about an interim service. In March the Department said that the service would be ready in April or May. Clearly the Department must have felt that it was close to implementation. Was it because the Treasury refused to sign the contract? Was it because BT was holding the Department to ransom on the NHS IT programme? Why precisely was there a delay of several months that had not been expected in March?

Andy Burnham: It is important for the hon. Gentleman to understand that, because of the outbreak, the full solution was put on hold while interim solutions were developed. He and I discussed this a week or so ago and I thought that he accepted that point. When the service goes live, it will have to be able to cope with demand. We have put in place a comprehensive plan to deal with the outbreak, of which the national pandemic flu service is one part. I can assure him that come the autumn it will be ready to go live and to deal with the outbreak to ensure that we take pressure off general practitioners around the country. I hope he would recognise that these preparations are good ones, consistent with securing good value and protecting the public.

Child Abuse

5. Mr. Graham Allen (Nottingham, North) (Lab): What steps his Department is taking to assist health professionals to reduce levels of child abuse in the long term. [281539]

The Parliamentary Under-Secretary of State for Health (Ann Keen): We are working closely with NHS and professional leaders to ensure high-quality training and support for the children's health work force on safeguarding children. The Government's action plan in response to Lord Laming's recent report set out a range of measures, including action to strengthen training and support for professionals, action on health visiting, and action to support GPs.

Mr. Allen: My hon. Friend will know that the abusers of 20 years hence are being born today. Does she accept that if we can intervene now with those babies, children and young people to create better, more adept and more socially and emotionally capable people, we will be doing a tremendous amount to reduce abuse in the long term, as well as doing the necessary things that we have to do in cases such as that of baby P and others? Will she particularly commend the work of the family nurse partnership, sponsored by her Department, which is doing so much with those young families?

Ann Keen: I congratulate my hon. Friend on the work that he has always done in his constituency and the House on the care of children. We are expecting to roll out the family nurse partnership in even more areas. May I also congratulate children’s trusts such as the Nottingham city partnership, which play a central role in improving arrangements to safeguard children?

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Mrs. Maria Miller (Basingstoke) (Con): One of the key recommendations agreed to by the Government in Lord Laming’s recent report was the reintroduction of a universal system of health visiting, seeing all children and developing strong relationships with families. How many new health visitors will the Minister be putting in place to make up the shortfall, which is currently estimated to be about 2,000 throughout the country?

Ann Keen: The hon. Lady is absolutely correct about the importance of health visiting: it is crucial for children and family development. We will expand the family nurse partnership programme in England to 70 test sites by 2011, and we also recently launched the action on health visiting programme, in which the Department is working very closely with the Community Practitioners and Health Visitors Association and other bodies in order to recruit staff, particularly to improve retention, and most importantly to try to bring us back up to the previous number of health visitors. We have lost some for a variety of reasons—in order to raise families, perhaps—and many might not be aware of the new flexible employment practice within the NHS.

Rheumatoid Arthritis (Prescription Charges)

6. Mrs. Linda Riordan (Halifax) (Lab/Co-op): What recent representations he has received on exempting people with rheumatoid arthritis from prescription charges. [281540]

The Minister of State, Department of Health (Mr. Mike O'Brien): The Department of Health has received three letters from Members and has seen two submissions from patient groups.

Mrs. Riordan: I welcome the promise made by our Prime Minister at the Labour party conference in 2008 to abolish prescription charges for those suffering from long-term conditions. Will the Minister now outline a clear timetable for the abolition of these charges for those with chronic diseases, to help alleviate their problems?

Mr. O'Brien: I certainly agree that we need to reform the current arrangements for exemption from prescription charging in England to ensure that we have a fairer system. Professor Ian Gilmore is due to report in the autumn on how that may be done—it is quite a complex exercise—and we will then set a timetable for how we will be in a position to implement it.

Mr. Henry Bellingham (North-West Norfolk) (Con): Can the Minister tell the House how much his Department is spending on research? I have a number of constituents who suffer from this appalling ailment, and they tell me that, as well as exemption from prescription charges, their big priority is more research into this debilitating disease. Can the Minister tell the House the exact figures?

Mr. O'Brien: It will not surprise the hon. Gentleman to learn that, off the top of my head, I cannot tell him the exact figures for research, but I can tell him that a considerable amount of research is going on in this important area. We want to ensure that we get the drugs that will enable people to be assisted.

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Smoking (Young People)

7. Ann Coffey (Stockport) (Lab): What plans he has to reduce the number of young people taking up smoking. [281541]

The Minister of State, Department of Health (Gillian Merron): Government action has helped reduce smoking among 11 to 18-year-olds from 18 per cent. in 1998 to 11 per cent. in 2007. The Health Bill goes further still by prohibiting tobacco promotion through display and preventing under-age sales from vending machines. I look forward to publishing a new tobacco control strategy this year, setting out additional action.

Ann Coffey: I thank the Minister for that reply. Although the number of young people in Stockport who smoke has significantly decreased, there are still twice as many young smokers in those areas where people have a lower life expectancy than in those areas where people have a higher life expectancy. I recently met health workers and Brinnington residents who are piloting a Lose the Fags scheme, where local people who have stopped smoking are the role models to encourage others to quit. Does my hon. Friend agree that more encouragement needs to be given to such innovative schemes if we are to ensure that inequalities in life expectancy are tackled in my constituency and elsewhere?

Gillian Merron: My hon. Friend is a great champion for quitting smoking. I am delighted to hear of the success of the scheme, and I congratulate her constituents on taking this action. We want to support a culture of quitting. That is why we are spending an additional £2.5 million this year on 25 local authorities in circumstances precisely such as those she describes—those areas with high smoking rates where local programmes are most needed. That is also why the Government are seeking to take even further action through provisions in the Health Bill.

Philip Davies (Shipley) (Con): There is nothing to suggest that the ban on tobacco displays will reduce the number of young people taking up smoking; that ban is merely another triumph for the nanny state and for this Government, who are obsessed with headline-grabbing but pointless initiatives. Will the Minister reconsider this decision, given the negative impact that it will have on small shops, which are already struggling through the recession?

Gillian Merron: The simple answer is no, and the reason why is that removing tobacco displays is not going to close shops, no matter how much the hon. Gentleman and others in the House spread myths; I have just written to Members of Parliament to outline the reality. The other truth—I look forward to discussing this issue in the Health Bill Committee this afternoon —is that there is a great deal of evidence that tobacco displays not only encourage young people to take up smoking, but discourage people from quitting.

Mr. David Clelland (Tyne Bridge) (Lab): If the display of tobacco products encourages young people to take up smoking, what influence do the crowds of people whom we see on the streets outside pubs and clubs have on young people? Would it not be better for these
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smokers to be hidden away—inside the building in a controlled environment, rather than on the streets, where children can see them?

Gillian Merron: My hon. Friend is, as always, very inventive in making his point. As I said, we are looking ahead to a new tobacco control strategy. We have just finished the consultation and 100,000 responses were received. I look forward to seeing what further measures we may take.

Influenza Pandemic (Cheadle)

8. Mark Hunter (Cheadle) (LD): What assessment he has made of the effectiveness of implementation of the pandemic influenza response strategy in Cheadle constituency. [281542]

The Minister of State, Department of Health (Gillian Merron): To date, we are not aware of any specific issues in relation to swine flu infection in either Cheadle or Stockport as a whole. The strategic health authority is keeping the situation under review and we will respond to any outbreaks in line with the national response.

Mark Hunter: I am grateful for the Minister’s answer. The Secretary of State confirmed earlier that the national flu hotline is in fact running six months behind schedule and will not now be available until October. In the circumstances, can the Minister reassure my constituents about the interim arrangements, and say whether the system will be able to cope satisfactorily with the expected influx of new cases later this year?

Gillian Merron: I can indeed give that reassurance. In the north-west, there are just 43 confirmed cases to contend with. Of course, the discussion earlier was about a national flu line, but I can give the reassurance that, should it be needed, the interim flu line will be available for the hon. Gentleman’s constituents—and, indeed, for constituents anywhere else across the country. However, should there be a need for a local response, we are working carefully and closely with local health services.

Improving Young People's Health

9. Mr. Barry Sheerman (Huddersfield) (Lab/Co-op): What steps he is taking to encourage the NHS to co-operate with other public services to improve the health and well-being of children and young people. [281543]

The Secretary of State for Health (Andy Burnham): “Healthy lives, brighter futures”, published in February 2009, sets out how we expect public services, including the NHS, to work together to improve the health and well-being of children and young people. This includes our action to strengthen arrangements for children’s trusts.

Mr. Sheerman: Does my right hon. Friend agree that much of the evidence given to the Children, Schools and Families Select Committee regarding the vulnerability of young children points to the fact that health personnel are the weakest partner, that GPs often do not turn up
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at meetings unless they are paid, and that GPs do not do their job in the fullest, most co-operative way as part of the partnership?

Andy Burnham: Obviously, we would take that evidence very seriously indeed. I am sure that my hon. Friend would agree that, across the country, there are some excellent examples of NHS organisations and individuals working closely with joint teams on the protection of children and children’s health more generally, but I am sure that there is more that the NHS can do, at times, to be a better partner. I look forward to discussing that issue in more detail with him and his Committee.

Mike Penning (Hemel Hempstead) (Con): Between 1 million and 3 million people in England and, obviously, thousands of children, do not get access to an NHS dentist. Would not one of the ways forward for improving child health be to reinstate inspections in schools, as our party has agreed to do, rather than ignoring the suggestion made in the review that came out yesterday?

Andy Burnham: I certainly will not be ignoring the review that came out yesterday, which has laid out an important vision for NHS dentistry, but I agree with the hon. Gentleman that improving children’s dental health is an important objective. I have always also favoured public health measures in this area, such as water fluoridation, and I am happy to reassert that today. However, I am also clear that we must work to make sure that every child can get access to an NHS dentist, and I would happily work with him on that objective.


10. Mr. Roger Williams (Brecon and Radnorshire) (LD): If he will bring forward proposals for a new compensation scheme for thalidomide victims in cases where the drug was prescribed on the NHS; and if he will make a statement. [281544]

The Minister of State, Department of Health (Mr. Mike O'Brien): Thalidomide victims have some compensation through a private settlement agreed by the Thalidomide Trust and Diageo plc. Government policy is not to make ex gratia payments to a patient whose health has been harmed by a drug, where the responsibility lies with a company.

Mr. Williams: The victims of thalidomide are now considerably older than they were when the initial scheme was established, and their needs are greater. Many are now unable to work, and the cost of acquiring the necessary equipment to support them is often prohibitive. Will the Minister look again at the funds that remain available for thalidomide victims, and will he have discussions with Treasury colleagues about the possibility of increasing that funding?

Mr. O'Brien: If the hon. Gentleman is talking about further compensation, I have already set out the policy position of the Government. If, however, he is talking about more tailored NHS payments, I am prepared to discuss that with those who represent thalidomide victims, who would perhaps be in a position to use some of the direct payment initiatives that we are considering in the Health Bill, which is currently before the House. That might provide us with some way of better serving those who are dealing with that condition.

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