§ The Secretary of State for Health (Mr. Alan Milburn)
Improving heart services is a priority for the national health service. Our 10-year blueprint for reform includes speeding up waiting times for heart operations and expanding primary care services to try to prevent coronary heart disease in the first place.
§ Mr. Crausby
I thank my right hon. Friend for that reply. The national service framework for coronary heart disease mentions smoking and tobacco advertising. Can we be reassured that, by banning tobacco advertising, the Government are determined to help people to stop smoking?
§ Mr. Milburn
Yes, that is our manifesto commitment. As my hon. Friend is aware, the manifesto is for a Parliament and not only for a year. We remain committed to that measure and will try to find the appropriate time for it, although he will be aware of the special pressures on the legislative programme now. None the less, we will try to do so as soon as we are able. We also remain absolutely committed to tackling the health impact of tobacco consumption. That is why we have moved our position from one of simply exhorting people to give up smoking to providing help so that they can do so.
1042 Probably one of the most important things that we have done, and it is one of the most important public health measures to be introduced in recent decades, is to make nicotine replacement therapy and Zyban available on prescription. The results have been very welcome indeed. We estimate that about 65,000 smokers have been helped to give up thanks to the additional assistance that we have been able to make available to them. That will have a long as well as a short term impact on both coronary heart disease and cancer.
§ Dr. Evan Harris (Oxford, West and Abingdon)
The right hon. Gentleman will be aware that those working in primary care, who are struggling to implement the NSF, want smoking cessation clinics and they want to increase the prescription of cholesterol-lowering drugs, but no earmarked funds are available. Many general practitioners have told me that they have to cut another service to provide for those. Does he also recognise the problem that exists in respect of elective heart surgery? On the one hand he says that the top priority is to ensure that no patient waits more than 18 months—it is soon to be 15—but on the other he says that clinical priorities should determine the order in which patients are treated. Patients who used to be operated on within four weeks for unstable angina or for a bypass often have to wait months because the 18-month waiters jump the queue as a managerial rather than a clinical priority.
§ Mr. Milburn
That was a long shopping list, but not as long as normal from the hon. Gentleman. On those two issues, I can offer him a double reassurance. On prescribing statins, for lowering cholesterol levels to prevent against further heart attacks, and aspirin and beta blockers, there is real progress. I can report to him that in the last year alone the number of prescriptions for statins has increased by well over one third—by 37 per cent. That is real progress. We all know that although it is often the glamorous side of cardiac care that attracts most attention, actually the biggest impact that we can make is probably in primary care, so that is a welcome move in the right direction.
As for the other issues about which the hon. Gentleman is concerned, let me be candid with him: people wait far too long for a heart operation in this country. That is undoubtedly true and he knows the reasons. There has been a history of neglect and underinvestment, particularly in our cardiac services. It is that that we are trying to put right. There is extra, earmarked money going in. I put an extra £50 million in to ensure more heart operations, and I am pleased to be able to tell him that the NHS has made very, very good progress indeed. We were originally due to complete a further 3,000 heart operations by March next year; in fact, that target has been achieved ahead of schedule. That is bringing life-saving surgery to many thousands of people, and I hope that before too long we can make even faster progress to ensure precisely that the cases with the highest clinical need are dealt with most quickly.
§ Helen Jackson (Sheffield, Hillsborough)
I thank my right hon. Friend for making the right decision as regards the continuation of the transplant unit at the Northern general hospital in Sheffield. Will he accept that this has been a hugely popular decision? We recognise that advice had been given to the Secretary of State to the contrary, 1043 and we are always happy to offer congratulations when Ministers use their own judgment—and that of the public in Yorkshire and round about—and make the right decision.
§ Mr. Milburn
The Under-Secretary of State, my hon. Friend the Member for Salford (Ms Blears), has just whispered to me that I must be losing my touch because I have made a popular decision. I am glad to accept the congratulations of my hon. Friend the Member for Sheffield, Hillsborough (Helen Jackson). It was the right decision to take. We want to expand heart services to the public and we want to undertake more transplants rather than fewer; and of course there is a big effort being made across the country to increase the number of organ donations. In those circumstances, it seemed pretty odd to me to be reducing cardiothoracic transplant services, not only in Sheffield but in Birmingham and Manchester too. I am pleased to be able to say that the right decision has been taken, that those services can now look forward to a good future and that, hopefully, we can help to bring some good to many people.