Health Questions

:00:07. > :00:12.Good morning and welcome to BBC Parliament's live coverage of the

:00:13. > :00:17.House of Commons. MPs will be hearing a statement from David

:00:18. > :00:21.Cameron on the outcome of the G 0 summit in Turkey and the latest on

:00:22. > :00:25.the terrorist attacks in Paris. Jeremy Corbyn will be replyhng. He

:00:26. > :00:37.has come under criticism after telling the BBC he doesn't does not

:00:38. > :00:43.support a shoot to kill polhcy. There is continued debate of the

:00:44. > :00:46.Cities and Local Government Devolution Bill. This devolves power

:00:47. > :00:52.sound budgets to local budgdts under the control of a directly elected

:00:53. > :00:58.mayor. Join me for a round-tp of the day in both Houses of Parli`ment at

:00:59. > :01:06.11pm tonight. First, questions to the Health Secretary, Jeremx Hunt

:01:07. > :01:15.and his ministerial team. Order order. What questions to thd

:01:16. > :01:18.Secretary of State for Health. We are determined to ensure people with

:01:19. > :01:23.learning disabilities live independent lives with bettdr care

:01:24. > :01:28.and improved outcomes. Taking together big response to thd no

:01:29. > :01:34.voice and heard no right ignored consultation and the care programme,

:01:35. > :01:41.steps are to protect rights, strength of choice and meet physical

:01:42. > :01:46.and mental health needs by default. I would like to thank my honourable

:01:47. > :01:50.friend for his answer. My constituency are making an

:01:51. > :01:56.application to open a free school for autistic children. How does he

:01:57. > :02:02.feel that schools such as this could help education for children with

:02:03. > :02:07.autism? I thank my honourable friend for the question. Autism is a

:02:08. > :02:12.growing area of identified special educational needs at which requires

:02:13. > :02:15.a range of provision to meet the diverse needs of the power of pure

:02:16. > :02:20.elation. While it will be inappropriate for me to comlent

:02:21. > :02:24.where it is needed, a speci`l free school can and to the local

:02:25. > :02:34.provision in providing spechalist places and expertise that c`n be

:02:35. > :02:37.shared widely. The all-partx group on Spectrum disorders took dvidence

:02:38. > :02:42.on the link between alcohol consumed by mothers in pregnancy and growing

:02:43. > :02:50.incidences of learning disability and autism. In Canada, this has been

:02:51. > :02:55.widely known and the Canadi`n Government has invested heavily in

:02:56. > :03:04.raising awareness. When can we expect the same in this country I

:03:05. > :03:09.think the syndrome to which the honourable gentleman draws `ttention

:03:10. > :03:13.is well known here as well. I understand from my honourable friend

:03:14. > :03:18.the Minister for Public health, that there will be a consultation in

:03:19. > :03:22.relation to this and new guhdelines and response. The all-party group is

:03:23. > :03:26.right to draw attention to this and anything that can protect women

:03:27. > :03:32.during pregnancy and their children is of benefit to all. I havd one

:03:33. > :03:36.family in my constituency where three of the form youngsters have

:03:37. > :03:43.autism. We look at the works of the local authorities where thex are not

:03:44. > :03:47.working closely enough with the mother who has one idea abott how

:03:48. > :03:51.she would like a youngster to be educated and the local authority,

:03:52. > :03:55.which seems for cost reasons alone, simply not working with the parent

:03:56. > :04:01.and would like to see her prosecutors rather than working with

:04:02. > :04:07.her? I meet on a regular basis with families and others who havd had

:04:08. > :04:11.young people and older people in the system where there is a difference

:04:12. > :04:15.of opinion about what might be done. Some of the stories are

:04:16. > :04:23.distressing. Families will sometimes feel people have not listendd to

:04:24. > :04:28.them, but they can be -- thdre can be difficult clashes of opinion I

:04:29. > :04:32.know it is a perpetual issud. The important thing is to listen to

:04:33. > :04:36.those closest to a particul`r problem and that is likely to be the

:04:37. > :04:41.best way forward, even if there is a difference of opinion. If pdople

:04:42. > :04:45.feel they are listened to, there is an opportunity to explore what can

:04:46. > :04:51.be done. The autism numbers in Northern Ireland growing but it

:04:52. > :04:55.seems clear to me that therd is three departments that have a

:04:56. > :04:59.responsibility. Health, education and employment. We need to lake sure

:05:00. > :05:03.autistic children have the opportunity through their hdalth to

:05:04. > :05:07.be prepared for education and employment. Does the Ministdr have a

:05:08. > :05:10.strategy that takes all thrde of those Government departments on

:05:11. > :05:17.board and Dessie share that with other regions of the UK and Northern

:05:18. > :05:25.Ireland? -- does he share. Xes, I couldn't put it better. We have not

:05:26. > :05:30.as -- and autism programme which provides an opportunity to look at

:05:31. > :05:34.the Government strategy. It contains many different elements but in

:05:35. > :05:38.relation to work, we have sdt out a challenge to halve what is the

:05:39. > :05:42.disability employment gap bdcause we know more people with disabhlities

:05:43. > :05:47.want to take the chance of working and it has to be done in thd right

:05:48. > :05:52.way. Things like the autism insurance board give a chance for

:05:53. > :06:00.families to be involved right across the areas where there might expect a

:06:01. > :06:04.fund assistance. By 2020, all patients admitted to hospit`l in an

:06:05. > :06:09.emergency will have access to the same level of consultant assessment

:06:10. > :06:15.and diagnostic tests which dveryday they admitted. With evidencd

:06:16. > :06:21.suggesting that mortality r`tes at weekends, there is an incre`sed

:06:22. > :06:24.risk, does he recognise the importance of getting right to the

:06:25. > :06:29.proposal for a new emergencx hospital in the and Bournemouth area

:06:30. > :06:40.and ensuring Barack specialhst consultants 24/7. -- ensuring there

:06:41. > :06:46.are specialist consultants 24/7 The clinical standards say anyone

:06:47. > :06:49.admitted to hospital in an dmergency should be assessed by a consultant

:06:50. > :06:54.without -- within 14 hours `nd across every day of the week and all

:06:55. > :06:58.specialties. That only happdns in one in eight of our hospitals and

:06:59. > :07:10.that is why it is so import`nt to get this right. York no longer has a

:07:11. > :07:19.seven-day service or a one-day service in our hospital. Totally

:07:20. > :07:23.avoidable. Will he agreed to meet with me and to an independent

:07:24. > :07:33.enquiry so mental health patients are not put at risk again and we can

:07:34. > :07:37.have a full service before 2020 I know the Minister of State has been

:07:38. > :07:42.looking at this issue and is willing to talk to her about it. Thdre has

:07:43. > :07:47.been alternative provision lade and she is right to make sure hdr

:07:48. > :07:52.constituents have access to urgent emergency care seven days a week.

:07:53. > :07:56.Will my right honourable frhend agree that hospital services do not

:07:57. > :08:01.mean full services in every hospital and if we are to achieve our

:08:02. > :08:05.ambition of driving our accdss weekend deaths down, we havd to look

:08:06. > :08:11.at concentrating services in regional centres. In addition, make

:08:12. > :08:16.sure we network among smalldr hospitals where they exist. He

:08:17. > :08:21.speaks very wisely on this hssue. This is not about making sure every

:08:22. > :08:26.hospital is providing every service seven days a week. It is making sure

:08:27. > :08:31.in an emergency situation, people have access to the care that they

:08:32. > :08:36.need. High dependency patients are reviewed twice a day, even `t the

:08:37. > :08:40.weekends by consultants and that is something that only happens across

:08:41. > :08:44.all specialties in one in 20 of our hospitals, which is why it hs

:08:45. > :08:54.important to get this right. What assessment has the department made

:08:55. > :08:57.of the impact of reduced A and what assessment has that made on the

:08:58. > :09:05.implementation of a seven-d`y work plan? I am not sure what shd is

:09:06. > :09:10.referring to. We are not reducing A ours. We have invested hn 2 00

:09:11. > :09:16.more consultants and five ydars ago and we need to support strong A E

:09:17. > :09:20.departments as much as posshble Over the weekend, we learned of the

:09:21. > :09:25.close links between the leadership of the BMA and the party upset. They

:09:26. > :09:28.are more interested in putthng their own political agenda forward and

:09:29. > :09:34.security -- fans during thehr members. Can he shall be th`t they

:09:35. > :09:40.will hold their nerve and ddliver the seven-day NHS to make it more

:09:41. > :09:43.safer for our patients? I c`n give her that assurance. This is

:09:44. > :09:46.essential for the constituents of all honourable members of the House

:09:47. > :09:51.they are sitting on and this Government will always stand on the

:09:52. > :09:54.side of patients. The week `nd mortality rates are not accdptable

:09:55. > :09:59.and that is why we are doing something about it. Given the

:10:00. > :10:03.pressures on the NHS, we ard a long way from the vision the Secretary of

:10:04. > :10:10.State wants to get to. When he agree that there are thousands of care

:10:11. > :10:14.workers of Indian origin is -- who are trained in the NHS but xou have

:10:15. > :10:21.set the language bar so high that they are excluded from doing so

:10:22. > :10:26.Will he look again at the tdst? I would like to commend the

:10:27. > :10:33.contribution made by NHS front line workers of Indian orange in --

:10:34. > :10:37.origin. I do think it is re`lly important that people speak good

:10:38. > :10:41.English if they are going to be providing care in the NHS. Hn terms

:10:42. > :10:46.of clinical safety, there are real issues when the standard of English

:10:47. > :10:50.isn't high enough. We have ` lot of fantastic support from Eric -- from

:10:51. > :10:59.immigrants who do a great job on the NHS front line but good English is a

:11:00. > :11:05.prerequisite. The Government is determined to invest in diagnostic

:11:06. > :11:10.testing in primary care. Di`gnostics are key to 21st-century NHS and that

:11:11. > :11:14.is why we have set up the mddical technology strategy group which I

:11:15. > :11:19.chair. We set up the cancer strategy task force, the Access fund and new

:11:20. > :11:25.models of care programme. Wd are looking to accelerate these in the

:11:26. > :11:31.system and to the genomics programme, we are investing in

:11:32. > :11:40.molecular diagnostics which will shape the future. Point of care

:11:41. > :11:45.testing could reduce the nulber of prescriptions for antibiotics and

:11:46. > :11:49.contribute to the UK's strategy and save the NHS millions of potnds each

:11:50. > :11:52.year. Ahead of my adjournment debate next Monday on this issue, with the

:11:53. > :11:56.Minister agree to look at this type of testing as a way of saving the

:11:57. > :12:01.NHS money and provide an appropriate patient treatment?

:12:02. > :12:11.We are committed to tackling antimicrobial resistance and the

:12:12. > :12:15.reducing of antibiotic percdption is part of that. We have a grotp

:12:16. > :12:20.looking at improved diagnostic services in relation to that. It has

:12:21. > :12:26.already identified what diagnostics are in use and what new technologies

:12:27. > :12:30.are on the horizon, including the point of care testing. My honourable

:12:31. > :12:35.friend is looking forward to responding to herd debate on Monday

:12:36. > :12:40.to set up more of that detahl. The Government has done a good job of

:12:41. > :12:50.getting one year cancer survival rates into the DNA of the NHS as a

:12:51. > :12:59.means of encouraging CCGs to promote earlier diagnosis, cancer's magic

:13:00. > :13:03.key. We need to make sure that we do not just have diagnostic testing at

:13:04. > :13:09.my recap but we also increase referral rates and improve `wareness

:13:10. > :13:12.campaigns as a means of enstring that we save those thousands of lies

:13:13. > :13:18.that only does the lost -- boast thousands of lives that are lost

:13:19. > :13:27.through late diagnosis will stop I pray to be to do his work through

:13:28. > :13:34.this on the -- aye -- I pay tribute to his work on the task force for

:13:35. > :13:40.this. They have said that ndw guidelines on clear ambitions and

:13:41. > :13:49.standards for how quickly p`tients should be referred for diagnostics.

:13:50. > :13:58.There is good news. Compared to 2009-10, more diagnostics wdre used

:13:59. > :14:07.but we have more work to do. Every person lost to suicide is a tragedy.

:14:08. > :14:15.We continue to reduce suicide rates by working with the NHS comlunity

:14:16. > :14:21.and the voluntary sector. I want us to be more ambitious about suicide

:14:22. > :14:27.prevention. In Rochdale, suhcides have gone up by 25% since 2010. The

:14:28. > :14:34.rate is 11.8% against an avdrage in England for 8.9%. We have a much

:14:35. > :14:36.higher rate of male suicide. If the Government continued to get their

:14:37. > :14:41.be more and more needless ddaths. be more and more needless ddaths.

:14:42. > :14:50.Are they going to fund ment`l health services properly? Mental hdalth

:14:51. > :14:53.services is just part of wh`t we intend to do. More money is going

:14:54. > :14:57.into mental health. I will lention some other things as well. He is

:14:58. > :15:00.right in terms of male suichde. Men are three times more likely to

:15:01. > :15:03.commit suicide than women, `nd it is also a particular course thd concern

:15:04. > :15:09.amongst young men. Our national suicide rates remain politically

:15:10. > :15:12.low-income Harrison with others But it has been rising and I am worried.

:15:13. > :15:19.I'm interested in this theory of zero suicide, more work to try and

:15:20. > :15:24.ensure that suicide is not seem as inevitable and more work in detail

:15:25. > :15:28.with particular affected colmunity. 'S particularly affected

:15:29. > :15:35.communities. And the work wd're doing with young people, ushng

:15:36. > :15:39.I'm interested in this area and we I'm interested in this area and we

:15:40. > :15:48.will have a debate on it later this week. As my right honourabld friend

:15:49. > :15:54.just said, we will indeed bd having a debate on this matter latdr this

:15:55. > :15:58.week, on Thursday, in Westmhnster Hall. It will be the first time that

:15:59. > :16:04.we have been able to mark International men's day and consider

:16:05. > :16:09.this issue of male suicide hn more detail. It will give us the

:16:10. > :16:11.opportunity to look at why ht is that the proportion of male deaths

:16:12. > :16:18.to female deaths has increased steadily since 1981. I am grateful

:16:19. > :16:22.to my honourable friend for raising the subject and of course the

:16:23. > :16:30.forthcoming debate. It does deserve to be looked at extremely c`refully.

:16:31. > :16:36.They should be neither complacency nor sensitivity about it. Wd need to

:16:37. > :16:47.look at what can be done. I have spoken to people who have h`d these

:16:48. > :16:52.tragedies in the family, and I am meeting this afternoon a gentleman

:16:53. > :16:58.well-known for having been hnvolved in a suicide prevention inchdent.

:16:59. > :17:01.The more people are prepared to talk about things that might cause

:17:02. > :17:06.suicide, the work we are dohng to reduce stigma and find placds for

:17:07. > :17:15.people to talk about things, the more the better. It is something we

:17:16. > :17:24.can give higher profile to ` -- and do more work on. Mr Speaker, last

:17:25. > :17:30.week, another report, this one from the King's fund, one of eight health

:17:31. > :17:33.system that is under pressure. Under this government's watch, just 1 % of

:17:34. > :17:37.patients feel that they havd received appropriate care in a

:17:38. > :17:41.crisis. We know that the nulber of mental health nurses has dropped and

:17:42. > :17:45.increasing numbness of people are having to travel hundreds of miles

:17:46. > :17:55.for a bed. But action for the minister take to turn his rhetoric

:17:56. > :17:59.into reality? Firstly, the lore we are looking at these issues, and

:18:00. > :18:01.this is across parties, it ht is important. We have made strhdes

:18:02. > :18:08.during the last government `nd in this one. We are investing lore

:18:09. > :18:11.money English into mental hdalth. This was the first covenant to

:18:12. > :18:14.introduce access and waiting times for mental health to try and put it

:18:15. > :18:21.on a parity with other condhtions that have not been that way before.

:18:22. > :18:24.We'll now be looking to makd sure that the money that goes in

:18:25. > :18:29.nationally is used locally hn order to provide assistance and to make

:18:30. > :18:33.sure that money that is put in for local use is used locally. There are

:18:34. > :18:37.other areas to look at and celebrate. We are world leaders in

:18:38. > :18:44.the access to psychological therapy, we want to build on those

:18:45. > :18:47.things, we know it is a service that has lacked in the past and that is

:18:48. > :18:51.why we are so determined to do much more about it and I think that is

:18:52. > :18:57.the view of the whole house, that we should be doing more about this and

:18:58. > :19:00.carefully to what the minister had carefully to what the minister had

:19:01. > :19:04.to say but I reinforce the point that in this country, the sticide

:19:05. > :19:08.rate is going up, not down, and it is a national scandal that we need

:19:09. > :19:11.to address. If I can return to his point about prevention which he

:19:12. > :19:17.referred to in his answer, the Government have confirmed that it

:19:18. > :19:20.will be making a ?200 million cut to local public health grants. This is

:19:21. > :19:24.a political decision, it will not save money and, apart from the

:19:25. > :19:28.devastating human price, it will cost our NHS and local authorities

:19:29. > :19:34.more as they deal with both physical and mental ill-health that could

:19:35. > :19:41.have been prevented. How can the Minister justify this? Firstly,

:19:42. > :19:47.?1.25 billion is going to create new ?1.25 billion is going to create new

:19:48. > :19:49.people's mental health servhces people's mental health servhces

:19:50. > :19:55.during the course of the parliament. That is not a commitment th`t the

:19:56. > :19:57.honourable lady's party madd before the general election. There is more

:19:58. > :20:04.being done in schools to provide a better base for mental health. We

:20:05. > :20:09.have appointed a minister focusing on mental health in schools. Public

:20:10. > :20:12.budgets are affected like everyone else's budgets, it is of thd

:20:13. > :20:23.pressures that are there. Those pressures in the NHS were mdt by

:20:24. > :20:26.their commitments, which were not made by the honourable lady or her

:20:27. > :20:32.party. When she is asking for more money to be spent, we are fhnding

:20:33. > :20:37.it. It is important that we take the position that we have to do as much

:20:38. > :20:40.as we can with what we have got but mental health services are loving

:20:41. > :20:42.forward and we should look `t the opportunity to say that and welcome

:20:43. > :20:49.what has been done. We have provided the resources in a way which her

:20:50. > :21:02.party did not. Question fivd, Mr Speaker. Mr Speaker, it is for NHS

:21:03. > :21:11.Trusts locally to set the ldvel of parking. My local trust has just

:21:12. > :21:14.increased parking charges at Dewsbury and did you charges for

:21:15. > :21:19.drivers with disabilities. They claim this is due to the judges from

:21:20. > :21:24.government. Is it right that people who are ill or in need of mddical

:21:25. > :21:28.attention or their loved onds are being penalised in this way? I say

:21:29. > :21:32.to the honourable lady that the financial settlement from government

:21:33. > :21:35.is more generous than the one promised at the last election by her

:21:36. > :21:42.party. It is committing ?10 billion over the next few years. I would ask

:21:43. > :21:45.her trust to look at the savings suggested by Lord Carter, where he

:21:46. > :21:49.is identified considerable savings that could be made. If they feel

:21:50. > :21:54.they need to increase car p`rking charges, they should refer to the

:21:55. > :22:00.guidance that makes clear that should be concessions for blue badge

:22:01. > :22:04.holders. Clearly, hospital parking charges are too high in the UK and

:22:05. > :22:08.he will agree that might right honourable friend, the membdr for

:22:09. > :22:12.Harlow, made an amazing campaign in the last parliament to reduce the

:22:13. > :22:22.charges. Will he confirm his commitment to reducing car parking

:22:23. > :22:27.charges? The principles that the Department published is that charges

:22:28. > :22:35.should be proportionate and fair and should be set at a level so that

:22:36. > :22:37.people can be assured that there is a car parking space. The problem

:22:38. > :22:41.with free parking is that there are not spaces for carers and for the

:22:42. > :22:46.sick turning up. Clearly, hospitals should exercise judgment in making

:22:47. > :22:51.sure that carers and people on frequent visits should get `

:22:52. > :22:55.discounted rate so it is not any betterment to access to fred health

:22:56. > :22:58.care. Hospitals have recently imposed charges for blue badge

:22:59. > :23:01.holders. Constituents have told me that as a result they will struggle

:23:02. > :23:07.to attend their appointments. The trust admitted that they have not

:23:08. > :23:13.considered the impact of thd admission rate. It could add a

:23:14. > :23:16.financial burden on the vulnerable and it will deny them access to the

:23:17. > :23:26.care they need to mark the honourable lady raises a surprising

:23:27. > :23:32.point is -- in that the hospital did not think of the impact. Disabled

:23:33. > :23:41.driver should get concessionary rates and charges sometimes need to

:23:42. > :23:46.be higher for disabled -- to allow for disabled drivers. The trust

:23:47. > :23:53.should have thought of that. Question other six, Mr Speaker. Mr

:23:54. > :24:01.Speaker, the Department is looking at a whole number of fronts at how

:24:02. > :24:07.it can improve medical outcomes It is introducing a seven-day NHS and

:24:08. > :24:10.by looking at the number of consultants and doctors to lake sure

:24:11. > :24:16.we can improve medical outcomes across the service. I welcole the

:24:17. > :24:20.Government's commitment to hmproving outcomes of patients admittdd at

:24:21. > :24:23.weekends. Seven-day services are needed not just in hospitals but

:24:24. > :24:29.also in primary care, the community care, social care is, and in mental

:24:30. > :24:34.health services. All my honourable friend advise on what steps are

:24:35. > :24:39.being taken to make sure th`t seven-day services are being made

:24:40. > :24:45.available where they are nedded The point is well made. A seven,day NHS

:24:46. > :24:49.will only work if it works `cross all areas of care, that is why it is

:24:50. > :24:53.part of the wider vision th`t we have in the NHS to see a local

:24:54. > :24:59.integration of care and health services. I would urge her to look,

:25:00. > :25:10.when it is published, at th`t Sir Bruce Keogh's report on the social

:25:11. > :25:13.care. It envisaged is a scenario where they receive the corrdct

:25:14. > :25:20.attention and therefore thex are not going to hospital and can bd dealt

:25:21. > :25:31.with in Trinity care -- comlunity care situations. There was ` Bill

:25:32. > :25:34.which would have provided bdtter clinical outcomes by making drugs

:25:35. > :25:39.more available. There was an alternative pathway that thdy

:25:40. > :25:45.government could be considering that you said what that will be My

:25:46. > :25:51.honourable friend, who is ftlly committed to the ambition which is

:25:52. > :25:56.Bill proposed, feels that the mechanisms do not work but has set

:25:57. > :26:00.up a working party to ensurd that the ambition can be taken forward. I

:26:01. > :26:03.know he would welcome the ftll engagement of the honourabld

:26:04. > :26:08.gentleman in order to make sure it happens. If we are to improve

:26:09. > :26:23.patient clinical outcomes, surely we need to look more at patient

:26:24. > :26:25.experiences. shouldn't now that the Society of homoeopathic is regulated

:26:26. > :26:31.by the professional standards authority, we spent more th`n an

:26:32. > :26:36.paltry ?100,000" homoeopathhc medicine in the NHS? The

:26:37. > :26:40.Department's position, desphte repeated questioning from mx

:26:41. > :26:46.honourable friend, is consistent and remains the same. Repetition is not

:26:47. > :26:55.Commons! 80% of end of life patients Commons! 80% of end of life patients

:26:56. > :27:00.died in hospital, where is 80% of life patients want to die at home,

:27:01. > :27:05.assisted by the hospice movdment was that I have discovered that the GPs

:27:06. > :27:09.are taking the end of life box on the framework form, but that

:27:10. > :27:12.information is not being automatically passed to loc`l

:27:13. > :27:20.hospices. What can the Department do about that?

:27:21. > :27:25.Clinical outcomes can only be assessed in a complete sensd a

:27:26. > :27:30.complete sense of it includds end of life care for those that thdre is no

:27:31. > :27:37.clinical outcome. If that is what is happening in his area, it is

:27:38. > :27:42.unacceptable. I would point him in my direction of the work thd

:27:43. > :27:47.Government is doing. The kind of bureaucratic model which he has

:27:48. > :28:03.identified each. -- would not happen any further. The project Genomics

:28:04. > :28:06.England, launched, we are the first organisation to commit to sdquence

:28:07. > :28:11.and we combine with patient records to unlock NHS and UK leadership in

:28:12. > :28:17.the emerging field of genomhc medicine. I am delighted to report

:28:18. > :28:27.we have 5000 patients fully sequenced and the centre is set up.

:28:28. > :28:35.2500 researchers are in bold -- involved in the project and NHS

:28:36. > :28:40.England are setting the standard on genomic medicine. Would the Minister

:28:41. > :28:42.agree with me that the world's leading Genomics England will

:28:43. > :28:47.deliver personalised and patient centred revolution to modern health

:28:48. > :28:56.care by combining the talent of global companies such as alongside

:28:57. > :29:00.UK based companies. Not onlx to the benefits of patients with c`ncer and

:29:01. > :29:04.other rare diseases but to the vitality of our NHS and through jobs

:29:05. > :29:12.and innovation come to the strength of our economy. I pay tribute to the

:29:13. > :29:15.work of the small company in Cambridge who are doing

:29:16. > :29:25.extraordinary work. I opened a globe all company and as well as the

:29:26. > :29:30.research in the UK, NHS England is leading genomic medicine is across

:29:31. > :29:37.the whole of the UK, not just in the Cambridge, Oxford London trhangle.

:29:38. > :29:45.We bring genomic diagnostics to the benefit of everyone. In the case of

:29:46. > :29:52.Lila Richards, she was saved from leukaemia by genomic, what `dvice

:29:53. > :30:01.can he give on this pioneerhng work? Genomic editing is a suite of

:30:02. > :30:06.technology emerging through genomic. We are supporting those tools and

:30:07. > :30:10.technologies and through thd accelerated Access review, we are

:30:11. > :30:14.looking to harness those breakthroughs to support new

:30:15. > :30:23.treatments and new flexibilhty for NICE and other treatments. H would

:30:24. > :30:27.like to take questions eight and nine together. Junior doctors are

:30:28. > :30:30.the backbone of the NHS and it is highly regrettable that the union

:30:31. > :30:34.has let them down by refusing to negotiate a new contract th`t would

:30:35. > :30:40.be better the doctors, sick of the patients and is delivered the

:30:41. > :30:43.seven-day were once. Can I thank my right honourable friend for that

:30:44. > :30:48.answer but has he had an opportunity to speak to medical schools about

:30:49. > :30:55.the new contract with junior doctors, especially the Penhnsula

:30:56. > :31:01.medical School in my constituency? NHS employers are in regular

:31:02. > :31:03.discussions with the medical schools Council which represents thd

:31:04. > :31:07.Peninsular Medical School and we do think although the training of

:31:08. > :31:10.doctors is not the specific contractual dispute that is in the

:31:11. > :31:14.headlines, this is something where we could make improvements `nd we

:31:15. > :31:18.want to use this opportunitx to work with medical schools and thd Royal

:31:19. > :31:22.colleges to see if we can bring back some of the continuity of trading

:31:23. > :31:25.that used to be an important feature of junior doctor's training. The

:31:26. > :31:31.person that has let the junhor doctors down is none other than the

:31:32. > :31:35.Secretary of State himself. It is insulting to those doctors to imply

:31:36. > :31:39.that they are not already working seven days and will he listdn to the

:31:40. > :31:41.professionals both the junior doctors and their senior

:31:42. > :31:47.counterparts who support thdm and drop this threat to impose the

:31:48. > :31:53.contact, so meaningful talks can take place? What was she sax to her

:31:54. > :31:57.constituents who are not getting the standard of care that they need to

:31:58. > :32:02.get seven days a week? Is she going to stand side-by-side with them or

:32:03. > :32:05.with a union that has risen -- misrepresented the Government's

:32:06. > :32:11.position. There are no preconditions to any talks except that if we fail

:32:12. > :32:15.to make progress on the crucial issue of seven-day reform, we

:32:16. > :32:19.reserve the right to implemdnt a manifesto commitment. That has to be

:32:20. > :32:24.the way forward and I urge the BMA to negotiate rather than gr`ndstand

:32:25. > :32:32.so we can get the right answer for everyone. I am concerned about the

:32:33. > :32:39.impact on patient care if these three days of industrial action will

:32:40. > :32:44.go ahead. What offence -- advanced preparation is going ahead to a job

:32:45. > :32:48.patient safety and are therd any preconditions that can act `s

:32:49. > :32:52.barriers that the BMA have to agree to before negotiations can take

:32:53. > :32:56.place? I can give her that reassurance. There are no

:32:57. > :33:03.preconditions and I have wrhtten to the BMA to reiterate the pohnt. If

:33:04. > :33:05.we fail to make progress, wd have to implement manifesto commitmdnts We

:33:06. > :33:09.are willing to talk about everything. I agree with her that it

:33:10. > :33:15.is going to be difficult to avoid harm to patients during these three

:33:16. > :33:22.days of industrial action. The delaying of cancer clinic mdans

:33:23. > :33:25.somebody will a later diagnosis delaying a hip operation, these will

:33:26. > :33:28.be hard to avoid and impact on patients and I would urge the BMA to

:33:29. > :33:38.listen to the Royal colleges and others. It is 40 years sincd the

:33:39. > :33:43.last junior doctor's strike. Does the Secretary of State perh`ps, with

:33:44. > :33:50.the ballot tomorrow, regret the ad agonistic approach he took before

:33:51. > :33:55.the summer to float for -- vote against these doctors rather than

:33:56. > :34:00.working with them to reach ` stronger emergency seven-dax

:34:01. > :34:04.service? Let me say to her, I don't know what she thinks is ant`gonistic

:34:05. > :34:08.about having reasonable discussions with doctors the three years to try

:34:09. > :34:15.and solve the problem of seven-day care. That ended with a BMA after

:34:16. > :34:20.two and a half years, walking away from negotiations last October. We

:34:21. > :34:22.made a manifesto commitment that whatever seven-day NHS do the right

:34:23. > :34:27.and the patients and were shmply ask the BMA to sit round the table and

:34:28. > :34:32.talk to us about it and I'm confident we can find a solttion. In

:34:33. > :34:38.July, claiming that senior doctors didn't work as 95 was maybe felt to

:34:39. > :34:43.be antagonistic. Contrary to the figures quoted by the honourable

:34:44. > :34:49.member for Dudley North last Monday, the A figures that NHS England are

:34:50. > :34:52.5% below those in Scotland. The disappointing figures beford we even

:34:53. > :34:57.get into winter or face a work to rule and the presence of eyd

:34:58. > :35:02.watering deficits, how does the Secretary of State plan to support

:35:03. > :35:06.hospital trusts through this winter? Could I ask her to correct for the

:35:07. > :35:09.record her a wholly untrue statements that I ever said that

:35:10. > :35:14.doctors don't work outside 8-to 5. That is exactly the kind of

:35:15. > :35:17.inflammatory comments that lake the contest -- that make the current

:35:18. > :35:21.situation worse than it needs to be. I have always work and -- I have

:35:22. > :35:24.always recognised the work that doctors do what we can but we have

:35:25. > :35:29.less cover at weekends and that means mortality rates are hhgher

:35:30. > :35:32.than they should be. With rdgard to A performance, we are takhng

:35:33. > :35:37.measures to say -- to make sure the NHS is prepared for the winter.

:35:38. > :35:43.Unnecessary avoidable industrial action by the BMA will make it

:35:44. > :35:47.worse. Will my right honour`ble friend agree with me that the failed

:35:48. > :35:51.attempt by the BMA to get an injunction against the GMC to stop

:35:52. > :35:57.them issuing guidance as to how doctors should behave responsibly

:35:58. > :36:01.towards patients if there w`s to be a strike, undermines the BM@'s

:36:02. > :36:03.claimed that it is putting patient safety first? Can my right

:36:04. > :36:10.honourable friend assure thhs house that the BMA will have no vdto over

:36:11. > :36:15.a seven-day NHS which was a manifesto commitment of ours and

:36:16. > :36:19.what the vast majority of pdople in this country want? I would like to

:36:20. > :36:22.thank my right honourable friend. He championed the cause of pathents

:36:23. > :36:25.when he was a Health Ministdr and we must continue to do the right thing

:36:26. > :36:31.patients, which is also the wedding the doctors. It is inexplic`ble that

:36:32. > :36:34.the BMA should guide the GMC on issuing guidance to doctors about

:36:35. > :36:38.their professional responsibilities. The most hmportant

:36:39. > :36:46.thing is whatever the disagreements, we should keep patients safd. I am

:36:47. > :36:51.sure both sides of the Housd to appreciate the excellent work done

:36:52. > :36:54.by all staff within our NHS which at a time of unprecedented str`in

:36:55. > :36:58.relies more than ever on thd goodwill of its employees to keep

:36:59. > :37:04.going. We have to support and value our staff, not criticise thdm and

:37:05. > :37:07.provide them by disagreement. Calling junior doctors militant is

:37:08. > :37:09.not the way to end a disputd and we have heard more of the same matter

:37:10. > :37:15.at this morning. Industrial action is or was the last resort when

:37:16. > :37:19.negotiations have failed. Does the Secretary of State accept

:37:20. > :37:22.responsibility for that failure I accept total responsibility for

:37:23. > :37:28.doing the right thing to save patient's lives. I have to say

:37:29. > :37:32.anyone who is a hold of this office will be doing wholly the wrong thing

:37:33. > :37:36.if they were to try and brush under the carpet six academic studies we

:37:37. > :37:40.have had in the last five ydars that says we have higher mortality rates

:37:41. > :37:43.at weekends than you should expect. This Government is on the shde of

:37:44. > :37:53.the patients and this Government will do something about that. I am

:37:54. > :37:57.aware there is an increased risk of a recessive genetic conditions in

:37:58. > :38:02.both that occurs as a result of first cousin marriages. It hs a

:38:03. > :38:09.complex issue and stop experience health professionals used m`terials

:38:10. > :38:12.and they have some specialist clinicians in my honourable

:38:13. > :38:20.friend's areas that are looking at this important issue. Given the

:38:21. > :38:23.severe medical conditions that are caused by first cousin marrhages,

:38:24. > :38:27.isn't it time the Government considered the only proper solution

:38:28. > :38:33.to this which is outlawing first cousin marriages in this cotntry?

:38:34. > :38:38.Such a change in the law wotldn t be for the Department of Health. Let me

:38:39. > :38:42.reply to the point about localised challenges. He might be intdrested

:38:43. > :38:45.to know in May 2012, there was a major conference on this issue ads

:38:46. > :38:51.leads Town hall with groups drawn from across the area he represents.

:38:52. > :38:54.We look at these issues. I have written to the Public health

:38:55. > :38:59.director Byford as skiing about what they are doing locally to address

:39:00. > :39:03.this and I suggest that it will be useful of my honourable fridnd to

:39:04. > :39:10.follow-up on that and I will be interested to how that convdrsation

:39:11. > :39:13.goes. Of education in England, working with NHS England, is charged

:39:14. > :39:17.with ensuring there is suffhcient staff with the right skill lix to

:39:18. > :39:21.support the delivery of the improving access to psychological

:39:22. > :39:29.therapy programme. An annual workforce monitors this. Eight -

:39:30. > :39:36.plans for 2015/16 to train additional individuals, 25% increase

:39:37. > :39:39.on last year. As well as providing adequate numbers of high qu`lity

:39:40. > :39:43.specialised staff, given thd prevalence of mental health issues

:39:44. > :39:48.in our society, is it not ilportant that general awareness is r`ised

:39:49. > :39:52.from mental health issues and the available treatments amongst all

:39:53. > :39:56.medical professionals and GPs and what future steps could the

:39:57. > :40:01.Government take to improve training? There is particular ways to do this.

:40:02. > :40:07.First, to enhance GP training and work is going on to do that.

:40:08. > :40:11.Secondly, continuing development where RCGP and health education in

:40:12. > :40:16.England are combining to make sure there is a good range of materials

:40:17. > :40:30.for clinicians and others to improve skills in this area. I would like to

:40:31. > :40:36.group this with question 16. We are looking to work to improve the life

:40:37. > :40:40.chances of children. Tackling the real cause of child poverty and to

:40:41. > :40:43.improve the prospects for the next generation. That involves t`king a

:40:44. > :40:47.broad approach to improving poor health, tackling health

:40:48. > :40:55.inequalities. We embedded that within the law and tackling

:40:56. > :40:58.inequalities but the wider causes worklessness -- wider coursds are

:40:59. > :41:01.being addressed at the moment. We have record numbers of people in

:41:02. > :41:04.work and a dramatic drop in the number of children living in

:41:05. > :41:09.workless households. That goes to the heart of some of the broader

:41:10. > :41:14.drivers of ill health and poverty. I'm pleased the Government has

:41:15. > :41:17.accepted there was a link bdtween poverty and poor health outcomes.

:41:18. > :41:21.They will know there is widdspread concern that the proposed changes to

:41:22. > :41:27.the tax credits regime will result in greater poverty, which whll cause

:41:28. > :41:32.poor health outcomes and maple pressure on the NHS. Could H ask if

:41:33. > :41:36.the Department will consider putting in place mechanisms to monitor the

:41:37. > :41:42.effect of the tax credit ch`nges on demands in the National Health

:41:43. > :41:46.Service? We do far more than monitor issues like health inequalities We

:41:47. > :41:49.are taking action to deal whth them. The heart of my portfolio is

:41:50. > :41:53.entirely comprised of tacklhng health inequalities in our nation to

:41:54. > :41:59.give a couple of examples. The expanded troubles families ,-

:42:00. > :42:03.troubled families programme, the partnership where we support some of

:42:04. > :42:06.the most vulnerable young p`rents in the earliest years of their

:42:07. > :42:11.children's lives. These programmes at the greatest impact on otr most

:42:12. > :42:16.disadvantaged communities. What I am trying to do is act on health

:42:17. > :42:19.inequalities and the issues that he raises are matters for other

:42:20. > :42:22.departments. I want to give the House this reassurance. This is core

:42:23. > :42:24.business but the Government, improving the life chances of all of

:42:25. > :42:33.our children. An interesting answer but not the

:42:34. > :42:41.answer to the question that my honourable friend related. There is

:42:42. > :42:45.a clear indication that although there is a strong link betwden

:42:46. > :42:50.poverty and poor health, th`t link is not inevitable and should not be

:42:51. > :42:55.allowed to become inevitabld. What will the Government do with this

:42:56. > :42:59.policy so that that link cannot be broken? I have given examplds of

:43:00. > :43:02.what the governorate is doing to tackle health inequalities hn our

:43:03. > :43:10.nation. I will give another example of a practical aspect, tobacco, the

:43:11. > :43:13.burden of disease that it brings false is proportionately on pork

:43:14. > :43:20.amenities. On top of the action we have taken with standardised

:43:21. > :43:23.packaging and smoking in cars with children, at the heart of that

:43:24. > :43:30.strategy has got to be effective action to look at the areas in which

:43:31. > :43:33.tobacco falls most heavily, that is in disadvantaged communities. There

:43:34. > :43:37.are a range of ways in which we are taking practical action to close

:43:38. > :43:49.those gaps in health outcomds. Question 13.

:43:50. > :43:55.Those affected by the contalinated blood tragedy are entitled to

:43:56. > :44:00.receive DWP fuel winter paylents if they meet the criteria. It hs worth

:44:01. > :44:03.me explaining for the House that separate to that, the progr`mmes of

:44:04. > :44:07.support, the bodies that actually put support in place for thd

:44:08. > :44:14.affected individuals also provide some winter payments, and those two,

:44:15. > :44:19.if they are getting something from the bodies, does not includd them

:44:20. > :44:26.getting a deed of EP winter payment if they meet those criteria. They

:44:27. > :44:29.are two different schemes. With the UK governorate dragging its feet on

:44:30. > :44:33.the ?25 million transitional compensation payments for those in

:44:34. > :44:37.receipt of infected blood products, receipt of infected blood products,

:44:38. > :44:42.will they now make a firm commitment to supporting these patients through

:44:43. > :44:48.this winter and then get on with the business of giving a just and

:44:49. > :44:54.lasting settlement? I have had conversations with my opposhte

:44:55. > :45:00.numbers in Scotland, as he knows. I was written to about this. We're

:45:01. > :45:05.looking at wider scheme of form I have also shown that my offhcials

:45:06. > :45:08.are talking to the other devolved administrations about this `s we

:45:09. > :45:16.move forward to a better solution to this tragedy. Number 14. Thd

:45:17. > :45:27.governorate is committed to transforming care for everyone. My

:45:28. > :45:30.right honourable friend's own area has in place another of initiatives

:45:31. > :45:34.such as the community treatlent team and intensive rehabilitation service

:45:35. > :45:39.which is rated highly in her local community. My right honourable

:45:40. > :45:43.friend will be aware that elderly people deteriorate rapidly `nd lose

:45:44. > :45:47.their independence skills when they are admitted into hospital. What

:45:48. > :45:51.discussions have been held with local authorities to ensure that

:45:52. > :45:57.their is an adequate supply of care is to ensure older people to remain

:45:58. > :46:01.in their homes whenever possible? I meet regularly, as does the

:46:02. > :46:06.Department, with our partners providing social care, a new

:46:07. > :46:13.strategy has been launched to look particularly at how to make sure

:46:14. > :46:18.more carers are provided in the home environment. My right honourable

:46:19. > :46:25.friend is right to raise thhs. There is a report about the care collapse

:46:26. > :46:30.on a residential care systel, which is in crisis. It is faced whth an

:46:31. > :46:35.unsustainable combination of declining funding, rising ddmand for

:46:36. > :46:43.services and increasing liabilities. A ?1 billion funding gap will result

:46:44. > :46:50.in loss of 37,000 care beds, and that is bigger than the Southern

:46:51. > :46:53.Cross collapse. The most likely outcome is that those older people

:46:54. > :46:56.will end up in hospital. Can the Minister tell us what he is doing to

:46:57. > :47:06.protect the care sector frol catastrophic collapse? As the House

:47:07. > :47:09.is aware, social care is a latter of great importance as we head towards

:47:10. > :47:13.the spending review round. We are aware of pressures in the sxstem,

:47:14. > :47:16.and there are always contingency plans looking at whether thdre may

:47:17. > :47:20.be any particular problems. We're working hard with the care

:47:21. > :47:25.Association in order to improve the quality of care provided in the

:47:26. > :47:32.sector itself, but my right honourable friend the Secretary of

:47:33. > :47:35.State has asked experts to look at inner qualities in the care home

:47:36. > :47:38.sector to see if we are abld to meet the challenges. Once again, if

:47:39. > :47:43.challenges require more mondy, which they always seem to do from the

:47:44. > :47:49.honourable lady's position, she does not come up with any ideas of how to

:47:50. > :48:04.come up with that money. It is our challenge to meet those challenges

:48:05. > :48:09.within our aims. I know the House will also like my reassurance that

:48:10. > :48:13.following the tragic events in Paris, we can regulate revidw and

:48:14. > :48:19.stress test the NHS's preparedness for responding rapidly to tdrrorist

:48:20. > :48:27.attacks, and I have written to my French counterpart to offer our

:48:28. > :48:32.solidarity and support. Just after the election, the Health Secretary

:48:33. > :48:38.called childhood obesity a national scandal. He put tackling he`lth and

:48:39. > :48:44.inequalities as one of his key priorities. Can the Minister explain

:48:45. > :48:53.how a flat rate cut in publhc health grants across all areas, in spite of

:48:54. > :48:59.specific health challenges, and a predicted cut of three main pounds

:49:00. > :49:05.in my constituency, due to the reformulation, how can this help you

:49:06. > :49:07.achieve your mission? Can I say to her that we have to find

:49:08. > :49:12.efficiencies in every part of the NHS, and we are asking the public

:49:13. > :49:16.health world to find the sale efficiencies as we are asking

:49:17. > :49:19.hospitals and GPs surgeries and other parts of the NHS, but that

:49:20. > :49:23.should not be at the expensd of service. I agree about childhood

:49:24. > :49:28.obesity and we'll be announcing some important plans shortly. Wh`t we

:49:29. > :49:34.need at topical questions is short enquiries without preamble hf we are

:49:35. > :49:40.to make progress. Let's be led by Fiona Bruce. This is alcohol

:49:41. > :49:44.awareness week. In Scotland, drink-driving offences have dropped

:49:45. > :49:49.in the last 70 months of a lower limit being introduced. In light of

:49:50. > :49:52.this, is the Mr's Department looking at the implications of revidwing the

:49:53. > :49:58.drink-drive limit as part of its review. I thank my honourable friend

:49:59. > :50:01.for that question and tacklhng drink-driving remains a priority for

:50:02. > :50:07.the Government. We will be interested to see a robust

:50:08. > :50:14.evaluation of the change to the Scottish drink-drive limit.

:50:15. > :50:21.Obviously, some of the issuds are for the Department of Transport and

:50:22. > :50:26.we'll be looking at that and I'll be interested in the evidence. On

:50:27. > :50:30.Sunday, independent experts at the Kings fund, the Trust and The Health

:50:31. > :50:36.Foundation had this to say `bout the coming winter. Expect the

:50:37. > :50:42.inevitable, more old people living on well, unsupported and misery

:50:43. > :50:46.more people dying on lengthdning waiting lists and a crisis hn

:50:47. > :50:53.Accident and Emergency. Are they all wrong? They are right about the

:50:54. > :50:57.pressures on the NHS, which is why we are investing ?5.5 billion more

:50:58. > :51:01.in the NHS than the party opposite promised. Those pressures whll be

:51:02. > :51:04.made a lot worse by the forthcoming strike, so will she clear up once

:51:05. > :51:11.and for all, that she condelned the strike? Yes or no? Mr Speakdr, let's

:51:12. > :51:15.be clear. If junior doctors do vote for industrial action, therd will be

:51:16. > :51:22.one person to blame, and th`t person is the Health Secretary. Mr Speaker,

:51:23. > :51:26.what the Health Secretary does not want to admit is that NHS ftnding

:51:27. > :51:30.isn't keeping pace with dem`nd and that, over the last five ye`rs, his

:51:31. > :51:36.government's deep cuts to social care have left the NHS bleeding Can

:51:37. > :51:42.the Health Secretary guaranteed that every penny of them money hhs

:51:43. > :51:48.Department set aside for implemented now postponed cap on care costs will

:51:49. > :51:53.go directly into funding social care? Mr Speaker, that is the

:51:54. > :51:58.difference. She follows the unions, I lead the NHS. When Labour had a

:51:59. > :52:02.big choice whether to support one for patients who desperatelx need

:52:03. > :52:08.better weekend care, they chose political expediency, and the whole

:52:09. > :52:16.country noticed. Saint Cathdrine's Hospice provides outstanding end of

:52:17. > :52:24.life care but receives little funding in bed to the national rate.

:52:25. > :52:40.Will the Minister encourage CCG 's to expand their funding? NHS England

:52:41. > :52:45.is looking at a more transp`rent, clear funding advice for CCGs. I

:52:46. > :52:49.would encourage her CCG to look at that and compare themselves to a

:52:50. > :53:00.Dale, which put themselves `t the centre of the work they do to help

:53:01. > :53:03.patients. Myself and my colleagues support his comments about the

:53:04. > :53:11.atrocities in France at the weekend. I would like to ask him of the

:53:12. > :53:14.assistant he has made of how problems are contributing toward the

:53:15. > :53:20.problem with recruiting nursing staff in London in the NHS? It is a

:53:21. > :53:24.serious problem and people find it hard to live nearby to the hospital

:53:25. > :53:27.where they work on the parthcular where housing is very expensive and

:53:28. > :53:33.this is an issue we are looking at closely. Could the Secretarx of

:53:34. > :53:37.State assure me that the NHS funding review, which is currently tnder

:53:38. > :53:40.way, will deliver a fair formula for my constituents that many other

:53:41. > :53:49.across York and North Yorkshire by putting age and morality, some of

:53:50. > :54:06.the biggest drivers, at the heart of this review? The clinical commission

:54:07. > :54:08.formula, I can assure him that morbidity is taken into account It

:54:09. > :54:14.is or is a matter for local decision and discretion. Can the Health

:54:15. > :54:18.Secretary explain how cutting ? 00 million from pub health Budget is

:54:19. > :54:26.consistent with the emphasis on prevention as put forward in the

:54:27. > :54:34.five-year public review? I have already explained, but I wotld ask

:54:35. > :54:42.the Labour Party held they committed ?5.5 billion less? Some of our GPs

:54:43. > :54:49.surgeries are finding it hard to attract new GPs. What plan does the

:54:50. > :54:55.Government have to train new GPs in areas where it difficult to recruit?

:54:56. > :54:58.We are very colleges of the pressures on general practice and on

:54:59. > :55:04.the pressures of ensuring there are enough GPs available. The

:55:05. > :55:10.Government's plans are for 4000 more GPs to be working by 2020. Ht is

:55:11. > :55:16.supported by efforts to makd sure medical schools are doing anything

:55:17. > :55:21.they can to make sure gener`l practice is more attractive.

:55:22. > :55:26.According to Public Health Dngland, in the most deprived areas hn

:55:27. > :55:32.Bradford, life expectancy is 9. years lower for men at eight years

:55:33. > :55:34.lower for women. It demonstrates that there are clear health

:55:35. > :55:39.inequalities in urban areas in Bradford. The governor's attack on

:55:40. > :55:42.the poor make this issue worse. Can the Minister tell me what the

:55:43. > :55:46.Government is doing to tackle these inequalities to give people a

:55:47. > :55:50.Bradford the quality of lifd they deserve? The honourable gentleman

:55:51. > :55:56.will be aware of the answer I gave earlier to other questions. There is

:55:57. > :55:58.a wide range of aspects of the public health work that the governed

:55:59. > :56:03.is taking forward that attacks that very issue. The inequality that

:56:04. > :56:08.falls on some community is. I gave examples, the family nurse

:56:09. > :56:12.partnership, more widely, for example, the universal health

:56:13. > :56:15.visitor programme which has moved into commissioning by local

:56:16. > :56:23.government. It has signific`nt elements within it to support

:56:24. > :56:26.families in disadvantaged alenities. For the avoidance of doubt, please

:56:27. > :56:35.with the Secretary of State repeat again that he will enter into

:56:36. > :56:43.completely open-minded, negotiations with the BMA, because the ptblic

:56:44. > :56:46.needs to see this. We'll be doing everything we can to avoid `

:56:47. > :56:50.damaging dispute for patients. We do reserve the right to incremdnt our

:56:51. > :56:53.manifesto commitment to sevdn-day reforms if we failed to makd

:56:54. > :56:56.progress in those negotiations. Right now, in the interest of

:56:57. > :57:00.patients, the right thing to do is to sit around the table and talk

:57:01. > :57:06.rather than to refuse to negotiate and go ahead with the strikds.

:57:07. > :57:15.Rochdale infirmary has dementia help which helps the local peopld. Will

:57:16. > :57:22.he meet me there to see how it can be shared more widely? I am happy to

:57:23. > :57:25.do that and we have made progress in tackling dementia. There ard great

:57:26. > :57:28.examples across the country but we can still do a lot better and we

:57:29. > :57:32.need to concentrate not just on dementia diagnosis but on the

:57:33. > :57:37.quality of care we give people when they have a diagnosis. Could the

:57:38. > :57:44.Health Secretary outline will be available to patients over the

:57:45. > :57:51.winter. Norfolk hospital has declared an alert last week. We are

:57:52. > :57:55.preparing for this winter whth unprecedented scales. We ard

:57:56. > :58:00.learning from the experiencds of last some power -- Samantha would be

:58:01. > :58:03.support provided through thd winter to ensure we deal with the

:58:04. > :58:07.additional challenges that `re being thrown in the way of hospit`ls

:58:08. > :58:12.across the country by the jtnior doctors in their industrial action

:58:13. > :58:18.they are taking. Is the Secretary of State doing everything he c`n to

:58:19. > :58:22.ensure we secure extra dedicated investment in mental health at the

:58:23. > :58:27.Spending Review? To introduce the same access rights as everyone

:58:28. > :58:32.else, it requires hard cash and I am sure he will agree that we have to

:58:33. > :58:36.end this outrageous discrimhnation against those who suffer from mental

:58:37. > :58:43.ill-health. I congratulate him on his time given who is sitting on the

:58:44. > :58:48.bench right now. We will put extra resources into the NHS and will make

:58:49. > :58:50.sure we increase the proportion of those resources are going to mental

:58:51. > :58:56.health and I would like to congratulate him on his award last

:58:57. > :59:01.week on mental health, which was extremely well deserved. St`tement,

:59:02. > :59:05.the Prime Minister. With permission, I would like to make a statdment on

:59:06. > :59:10.the terrorist attack in Parhs and the G20 in Turkey this weekdnd. On

:59:11. > :59:11.Paris, the Home