Ann Keen, Parliamentary Under-Secretary for Health Services, answered a range of questions on health issues in our Number 10 webchat. Read the transcript below:
Moderator says: We will be starting shortly. Ann is running slightly late. Keep the questions coming in.
Ann says: Hello. Ann Keen here. Looking forward to answering your questions.
Sarah: The founders of the NHS saw “the sale and purchase of medical practice as an evil in itself”. How would you summarise the current guiding vision of the NHS?
Ann replies: Couldn’t have a better question in the 60th year of the NHS - than the vision of the future of the NHS. We are all so proud of our National Health Service and I had the privilege to work as a nurse in the NHS for more than 25 years.
The future is concentrating on the personalised care that is delivered with the highest standard with modern technology and a full team working with the patient and the family. It is also very much focused on health and well-being so that inevitably means talking about prevention.
Dorothy M W Smith: I am concerned that every time there is a new government intervention in the structure of the NHS, it seems to slow down procedure, adding further to administration time and costs, and is counter-productive for the medical staff involved. How can one avoid this?
Ann replies: I agree with you, the NHS has been reorganised too many times. That’s why all future changes are concentrating on clinical practice and patient choice and not on administration.
paul fitzpatrick: Can you explain to me why I have to travel from Sheffield to Newcastle 4 times a year to get the appropriate treatment for my son who has Duchenne MD? and why we dread an emergency admission to a local hospital.
Ann replies: I recently met with parents and young people who are affected by DMD, and I agree that the travelling for the expert care is too much and I have asked for the Department of Health to work with DMD groups to see how we can spread this expertise to all areas. Also at that meeting, we addressed the serious issue of medical research and I am due to meet all parties again in the next few months to see the progress.
Debra Lomax: I hold a midwifery qualification but can’t return to practice as the course fee’s are unaffordable to me. Is there any further news on helping midwives return to practice in light of the continued midwifery shortage?
Ann replies: We are encouraging midwives to return to practice. The expertise that you have is so needed in our modern NHS. I stress the word modern because we need to be flexible and support you to return to us. We have made great progress on fees and your local Trust should be able to inform you.
Margaret Peacock: I feel the elderly are being given a raw deal. My 78 year old aunt had to wait 2 weeks to see her GP for an appointment. It is no better for all patients. Are you planning on introducing more flexible working times within surgeries covering early mornings/evening appointments.
Ann replies: That is totally unacceptable. We are working with GPs and all primary care workers to work much more flexibility. We have an agreement for much longer opening hours with the aim that you will be able to access a GP centre from 8 in the morning to 8 pm, 365 days a year.
Iris Barner: Diabetes UK is still receiving reports from parents who have to give up work to help their children to manage their diabetes at school. How is the Department of Health linking with the Department for Children, Schools and Families to ensure that all children and young people with diabetes receive the support they need in schools?
Ann replies: Alan Johnson and Ed Balls have regular meetings to ensure that health and schools are working together. Children with long term conditions need to be supported at school and I am continuing to work on this.
Carl Tilson: Hello Ann, we met at Richmond House in a meeting about Duchenne Muscular Dystrophy with the concern of funding for research. Anyway my question is as a young adult at 21 years old, at the wrong end of the disease and time isn t on my side, if a chance came up that a treatment was in the making (testing stage) but it wasn t ready for the market. Would I be able to take the chance to try the treatment by signing a disclaimer knowing full well the risks of trying out a new treatment? I would recommend a rule where people who have a terminal illness, if you feel your quality of life is not good enough anymore, you should be able to make the decision to risk yourself and try the treatment or not!
Ann replies: Hi Carl. Pleased you logged on. Your question is far too serious for me to answer in this way. Are you trying to put me on the spot! We must meet soon. Contact me at the Department.
Ray Richards: Good managers try different management techniques, ones that fail get disposed of and return to the original plan. We brought back MATRONS in the health service but in rank only, their job was far from that of the old Matrons. Are you going to correct this and then perhaps we will have no other issues such as MRSA ect.
Ann replies: I don’t think that the matrons would agree with you. They are a powerful force and have made a huge difference to the management of infection. We have given them the power to operate from the ward to the board and they are using that power, as is shown in the recent figures of infection control.
A matron’s charter: An action plan for cleaner hospitals
Sarah: What would you say are the best and worst points of the NHS?
Ann replies: The best points are the universal access to treatment of the highest standard, with a professional and dedicated workforce. I think it can at times be too bureaucratic.
Victoria White: People with long-term conditions rely heavily on the home delivery of specialist incontinence products and nurse visits. I am worried that the Government is cutting funding for these services with their current review with apparent disregard for patient well-being. Can you guarantee that patient services will not be disrupted?
Ann replies: Yes I can. It is vital that people who need this specialist service continue to see and be managed by a specialist nurse and have made available products that will help them to live at home.
Johnathon David: Are steps being taken to end the inconsistent “postcode lottery” in regard to expensive treatments, which require approval from primary care trusts?
Ann replies: We have stated in the consultation on the NHS constitution that NICE (the independent body) will be speeded and more transparent.
Have your say on the NHS Constitution
Patricia Fairbrother: What is the Government doing to ensure that there are appropriate resources and infrastructure in place to implement the roll out of digital mammography by 2010, a key commitment made by the government in the cancer reform strategy ?
Ann replies: We have already given a commitment to these resources.
Joyce Lawrence: My husband and I are “Carers” for my mother-in-law, who is now entitled to 6 weeks respite care every month. To be accepted for respite care mother-in-law must have medication made up in “Dossett Boxes”. Our problem is that our doctor will not issue her prescription weekly and our pharmacist will only accept weekly prescriptions to be made up in the required boxes. Without these boxes we stand to loose our very much needed breaks. I need her medication in a box for one week every other month. Other than this simple oversight on your part I think NHS is great. Any simple solution, please? Joyce Lawrence
Ann replies: This is making me feel very frustrated. You are, of course, entitled and need respite care for your mother-in-law. This is very obviously a local issue between your GP and pharmacist. I would suggest you call the district nurse to help you resolve this. Very best wishes.
Toby: Can you ever completely eradicate MRSA from our hospitals?
Ann replies: MRSA is managed best if you screen every patient in advance of admission where healthcare is able to do this. For example, when you do not have an A&E admission system and all patients are booked to come in you can be MRSA free.
tony rhodes : When is the government going to tackle carer poverty, the last carer strategy paper released not long ago was a total waste of time as far as carers go, another ten years will be too late, this government have already been in power for elleven odd years?
Ann replies: I’m sorry you feel that we haven’t improved the new deal for carers published in June of this year has been well accepted by carers organisations as a good step forward. But I am aware that we have more to do.
Philip Needham: Is universal access more important than “free at the point of delivery” and is that why I can no longer get NHS dental treatment?
Ann replies: We all have the right to NHS dental treatment. Your local PCT has had money allocated to secure this for you. They will have a helpline informing you of a local dentist or NHS direct can also advise you.
Karen Hodgson: Are there any plans to encourage screening units to improve their uptake figures? My local unit slightly exceeds the national average of 70% but shows no interest in initiatives to increase the uptake further.
Ann replies: Prevention and screening are the major changes to NHS care. We are seeing great improvements, in particular with cardiac risk assessments. But I am aware that there are still inequalities and we need to advertise and use imaginitive ways to access people. We need to be in the heart of all communities.
A nurse describes cardiac risk assessments
Miriam Potter: What is the government doing to help people who have ME, on a day to day basis, and what are they doing to help find out what causes it and the cure for it? Thanks.
Ann replies: The government allocated 8.5 million to set up specialist CFS/ME services where non existed previously. This will used to establish centres of expertise across the country to champion the development of services and improve clinical care. Also, to access specialist assessment diagnosis and advice on clinical management to patients and families, and most importantly, create capacity for research.
nick wells: Ann, Toby asks Can you ever completely eradicate MRSA from our hospitals?” I would like to ask the Question, why has the NHS become addicted to antibiotics, when there are well founded alternatives in use in Eastern Europe that have been developed and in use as long as the NHS has existed?
Ann replies: I share your concern about the overuse of antibiotics which is why we recently launched Antibiotic Awareness aimed at the public but also most importantly doctors who prescribe. We have had some encouraging results but need to continue with the campaign.
Antibiotic resistance campaign 2007-2008
George Pitcher: I am terminally ill with Prostate cancer which has progressed to my bones, it was purely chance that I was diagnosed and I was told by my consultant that if it was discovered 6months earlier I could have been successfully treated. My question is why isn’t there a screening for prostate as there is for cervical cancer in women.
Ann replies: I am sorry, George, to read your diagnosis. We are developing appropriate screening techniques and we are seriously reviewing the research underway in both Europe and the USA.
We launched the prostate cancer risk management programme which involves a PSA test. We need further development of this test to ensure accuracy. Progress is being made. It is more complicated than testing for cervical cancer.
Caroline: What do you think about new robotic surgery being introduced in the NHS?
Ann replies: I think it’s amazing and of course was pioneered by our government minister Lord Darzi.
Grace Filby: I thought that Carl’s question (7) was vital. Are you saying that anyone whose life is being threatened by HCAIs e.g. MRSA or P.aeruginosa and wants phage therapy as a last resort should be contacting you at the Department and meeting up soon with you?
Ann replies: No, it is to continue a dialogue that is personal with Carl and myself related to his condition. It is always best that you consult your local health provider as a first stop.
Ann says: Thank you for all your questions and for all the interest you have shown in this session. I’m sorry I haven’t been able to answer all of them today but if you wish to forward them to me at the Department I will do my best to see they are answered. Good health!
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