§ 9. Mr. Hugo Swire (East Devon) (Con)How many performance indicators relating to cardiac treatment (a) are in place for NHS trusts for 2003–04 and (b) were in place in 2001–02. [148792]
§ The Secretary of State for Health (Dr. John Reid)There are five targets for cardiac treatment arising from the NHS plan. The total number of performance indicators across the whole of cardiac services, covering primary care, ambulance services, diagnosis, surgery and rehabilitation, is 37. None has been added since March 2000.
§ Mr. SwireI am grateful to the Secretary of State for that response, but as the Royal Statistical Society said, many of the clinical indicators for cardiac treatment are unreliable. Even with constant quality of clinical care, there are widely different outcomes. Despite his claims to the contrary, is it not the case that too many 1208 performance indicators are still being imposed on trusts? Given that between a third and two thirds of heart attacks occur outside hospital, often within the first few minutes of the onset of symptoms, should not the Government concentrate their efforts instead on training and encouraging paramedics in the administration of thrombolytics before patients get to hospital?
§ Dr. ReidAs I pointed out to the hon. Gentleman, the performance indicators cover ambulance services, paramedical primary care, diagnosis, surgery and rehabilitation. I am glad that he agrees with us on that point. On the question of whether we need to take more action to try to give relief to people who feel a heart attack coming on, I agree with him, and am glad that he supports the Government's introduction of rapid access chest pain clinics. I believe that he would also support all our five targets, some of which I outlined earlier: reducing deaths from heart disease, faster access to heart surgery, faster access to clot-busting drugs, improved services for patients with heart failure, and better primary care. We appear to be almost entirely in accord, which is heartening—along with the 25 per cent. reduction in deaths from heart disease. What a pity that the hon. Gentleman wants to cut by 20 per cent. all the investment that has contributed to that.
§ Dr. Brian Iddon (Bolton, South-East) (Lab)Just over two years ago, a committee was set up in Bolton with the aim of raising £1.3 million to bolt on a new coronary care unit to the existing facilities. Will my right hon. Friend join me in congratulating the committee on its success, as the building was opened a few weeks before Christmas? Will he also thank all the members of the public who have freely given their time and money to make that achievement possible?
§ Dr. ReidYes, I have no hesitation in joining my hon. Friend in thanking those people, and I hope that he will join me in thanking the 1.3 million staff of the national health service who are doing such a marginal—[HON. MEMBERS: "Oh!"] —such a marvellous job. I have no hesitation in saying that they are doing a marvellous job. Unlike Opposition Members, I am the last to belittle their efforts, which have brought such improvements. They are doing a marvellous job in Bolton and throughout the country.
§ Mr. Andrew Lansley (South Cambridgeshire) (Con)The Secretary of State will be aware that one of the principal recommendations in the Kennedy report on the tragic child deaths at Bristol royal infirmary was that we should ensure that there was adequate throughput for surgical teams engaged in paediatric cardiac surgery. In November 2002, the review group said that it would seek a minimum of 300 such operations for a surgical team of at least three consultant surgeons. Given that the Secretary of State had the opinion of an expert review group, why has he preferred his own view and rejected that recommendation?
§ Dr. ReidBecause it would require us to close some of the most successful cardiac centres in the country, and I am not going to do that.
§ Dr. Phyllis Starkey (Milton Keynes, South-West)(Lab)Does the Secretary of State not agree that performance indicators have a role to play in pushing up the quality of cardiac care? In that context, the clinical decision unit at my hospital in Milton Keynes is now affording a route for GP referrals on cardiac disease, so that people can be referred there and thence to the wards, rather than going through accident and emergency? Would he like to confer with the hon. Member for South Cambridgeshire (Mr. Lansley), who visited that unit yesterday and is reported in the local press as commending it and its staff, as well as the efficient use of resources provided by the Government to improve health care for my constituents?
§ Dr. ReidYes, I am glad to do so. A peculiarity of Opposition Front Benchers is that they join in praise for the achievements of the Government and the staff whenever they make local visits, but condemn those achievements whenever they speak at the Dispatch Box. I certainly join my hon. Friend in congratulating everyone involved in that unit. The proof of the pudding is in the eating. There has been a reduction of approximately 24 per cent. in mortality for the under-75s from heart-related disease in five years. Surely, as there has been a reduction of almost 25 per cent. in the scandalously high figure that pertained before, even Opposition Front Benchers can find it in themselves to congratulate, if not the Government, at least the staff who have contributed to that reduction.