HC Deb 06 July 1999 vol 334 cc815-6
10. Mr. Tim Boswell (Daventry)

What steps he is taking to achieve greater geographic evenness of clinical treatment in the health service. [88246]

The Secretary of State for Health (Mr. Frank Dobson)

We have introduced a number of measures to avoid the problem of the postcode providing unequal access to treatment in the NHS, which we inherited from the previous Government. One major development is the establishment of the National Institute for Clinical Excellence, which seemed to be endorsed for the first time by those on the Tory Front Bench today. It is there to provide guidance to doctors in every part of the country on the latest drugs and treatments.

Mr. Boswell

I am sure that the Secretary of State would allow a measure of autonomy to local health authorities and primary care groups in setting their local strategies and that it would be most inappropriate if he, as a politician, were to tell doctors what to do or what to prescribe. Would he nevertheless concede that, especially in relation to complex or expensive treatments, such as the prescription of beta interferon for multiple sclerosis, we really cannot accept for a moment longer than is necessary the continuing tyranny of prescription by postcode, and that people expect not merely more words about that but some effective action, whether from NICE or from himself, to ensure that it is ended as soon as possible?

Mr. Dobson

We will shortly hold consultations about the use of beta interferon, which will ultimately be considered by NICE, but, in fairness even to the previous Government, there are disputes in some parts of the country between clinicians about the appropriateness of the use of beta interferon and I do not want to poke my nose in if I can possibly avoid it.

Mr. Andrew Reed (Loughborough)

I am sure that my right hon. Friend is aware that one of the most effective ways of ensuring the even geographic spread of services is to ensure that resources are spread equally around the country. Is he aware that Leicestershire health authority is still below its weighted capitation fee, and will he ensure that, over the coming years, as the new money feeds into the national health service, Leicestershire makes up the gap between the 97 per cent. that it currently receives and the 100 per cent. that we believe it deserves?

Mr. Dobson

It is our intention to move all authorities near to their established norm, and that will certainly apply in Leicestershire as well as everywhere else.

Rev. Martin Smyth (Belfast, South)

The Secretary of State is to be congratulated on the moves to spread excellence around, but does he agree that treatment cannot be given if there is still ambiguity about diagnosis? Is it not time to concentrate more on the treatment of ME or chronic fatigue syndrome, which medical people in some parts of the country deny is a disease?

Mr. Dobson

This is one of those difficult matters on which there are almost savage disagreements between medical professionals not only about the possible treatment of the condition but about whether it even exists. Once again, that is best resolved by the people who at least in theory know what they are talking about, although if there are two diametrically opposed sides, one of them must be wrong. It is better for them to try to thrash these things out than for me to try to lay down the law. Secretaries of State should keep their powder dry and interfere over the availability of particular drugs only in extreme circumstances.