If he will make a statement on his departmental responsibilities.

The responsibilities of my Department embrace the whole range of NHS social care, mental health and public health service delivery, all of which are of equal importance.

I suspect that neither the Secretary of State nor the Government will want any surprises in early August. So will the right hon. Gentleman ask all the chief executives of hospital NHS trusts to report to him personally by the end of May on their ability and preparedness fully to implement the European working time directive? I suspect that such reports will demonstrate the need for some more middle-grade doctors if we are to continue with existing services.

We debated that issue during an Opposition day a few weeks ago. Everyone is aware of the need to comply with the European working time directive by 1 August; I trust that Opposition Front Benchers are now aware that every individual has the benefit of the opt-out.

I called for a public inquiry into Stafford hospital. As that matter has been given a full airing already, may I ask whether the Secretary of State read the comments that I made in the House yesterday about Professor Alberti's review? Can he confirm that there will be no no-go areas at Stafford hospital for the Alberti review?

Yes, I can. I saw my hon. Friend's comments; obviously, I am particularly sensitive to how he, as the local MP, feels this inquiry is going. George Alberti has not only national but international renown on accident and emergency. As the Healthcare Commission report points out, accident and emergency is where the problem is in Stafford hospital. I assure my hon. Friend that there will be no no-go areas for Professor Alberti as he conducts his inquiry.

Yesterday, I had a meeting with Mr. Longhurst, a constituent of mine whose three-year-old daughter suffers from epilepsy. He is very worried that services are going to be concentrated at St. George's and moved away from St. Helier, our local hospital. Will the Secretary of State agree to meet parents, my hon. Friend Mr. Burstow and me to discuss parents' concerns? Furthermore, will he encourage the local trust to provide a speaker at a public meeting to discuss the issue? Finally, will he confirm that should services go to St. George's—

Order. Topical questions should be snappy, and three supplementaries is just not on.

Unless my memory is fading, I met the hon. Gentleman and Mr. Burstow very recently. But let me say this: services locally in their area have to be determined on the basis of what is best for patient care. I will become involved in the issue only if local politicians on the overview and scrutiny committee refer it to me. That is the right way for those issues to be resolved.

Since my right hon. Friend has been in post, has the Department of Health has ever lobbied the Treasury to put up the price of alcohol for health reasons?

I obviously cannot comment on the representations made in Government prior to each Budget.

What assessment have the Government made of the future impact of cardiovascular and kidney disease and diabetes on NHS resources, and what plans are being put in place to deal with what will clearly be an additional burden on the NHS?

There are a number of bits of analysis on this. The one that struck home more than any other was the Foresight report conducted by some of the world's most eminent scientists and epidemiologists about the effect of obesity, which is a major driving factor in type 2 diabetes, cardiovascular disease and, indeed, cancer. They said that if we do nothing about this, by 2050 not only will there be an enormous burden in terms of disease but enormous costs—they estimate the cost will be around £50 billion to the NHS and to society more generally. That is why we are introducing the abdominal aortic aneurysm ultrasound check from this year, the vascular check for every adult between 40 and 73, call and recall, and many other initiatives to deal with prevention. The hon. Gentleman raises a crucial point about what we have to do now to prevent this disease burden in future.

Last week, I attended a celebration of the Ear Foundation, which is a charity that was set up to fund the first cochlear implant procedure in the city of Nottingham. Now that the National Institute for Health and Clinical Excellence has decided that it is a good idea for profoundly deaf children to have implants for both ears, can the Secretary of State tell me what he is doing to ensure that primary care trusts listen to that advice?

The recommendations from NICE with regard to implants must be complied with within three months of the guidance being issued, which was 28 January. PCTs are required to do two things. First, they must make available the funds for clinical decisions to be taken on the patients who should receive that treatment. Secondly, where there are patients who have already been treated but would now benefit from the NICE recommendations, they must ensure that a proper assessment is made of whether they should have that treatment provided to them.

A particular area of concern for GPs in my constituency is the provision of psychiatric services. They say that those services are extremely thinly spread and greatly needed in all localities. Given that that need is expected to rise during the recession, does the Secretary of State accept that this is a problem in large rural areas such as Norfolk?

I would be very willing to look at the situation in the hon. Gentleman's own area. The roll-out of the IAPT—improving access to psychological therapies—initiative, described by Professor Layard as the most important reform in mental health since the NHS was created, will affect the hon. Gentleman's area as well as others. With 3,600 psychological therapists, on the back of a very successful trial in Newham and Doncaster, and the announcement made last Monday for the very reasons that he mentioned—the health problems associated with the global economic recession—we are bringing forward to this year the money, and recruitment, that was to be spent in 2010-11. That will make an enormous difference to the availability of psychiatric services.

In the private sector and in the public sector, those at senior levels who fail are too often allowed to walk away with money, not fired. Can the Minister tell me how many NHS chief executives and trust board members have been fired since 1997?

No, we do not keep those figures centrally. We know how many non-executive directors have been fired—seven since 2001, when the Appointments Commission took over the role and kept statistics. Executive directors are the responsibility of each employer and each trust, and we do not hold those figures centrally.

We know that the increase in the number of live births has outstripped the increase in the number of midwives by a ratio of 3:1 in the period since 2001. The impact of that is particularly acute in areas of high population growth, such as my constituency. The Royal College of Midwives states that 3,600 new midwives are needed in such areas. Two weeks ago, six expectant mothers were turned away by the maternity unit at Peterborough district hospital and forced to travel 35 miles to King's Lynn. What is the Minister going to do about that?

We are actively recruiting midwives, and working very closely with the Royal College of Midwives. If an expectant mother were turned away from a unit it would be for reasons of safety—for the mother and the birth—because there was not enough capacity. We have an escalating birth rate and an active recruitment programme of midwives. We are also encouraging return to practise. I am sure that the hon. Gentleman would agree that the safety of the mother, and the circumstances of the birth, is paramount and it is better for a mother to travel elsewhere than for her to be admitted and made unsafe. It is unfortunate when a woman has to travel further to give birth, but it is a matter of safe practice.

What can the Secretary of State do to encourage NHS chief executives to listen to and take note of staff whistleblowers so that they do not feel that they are putting their jobs and careers in jeopardy?

The hon. Gentleman raises an important point. Some of the evidence from Stafford—and we do not have it all yet—shows that staff were raising complaints, but they were never reported to the board. Indeed, the board, when it discussed such issues, met in private, and all the indications are that it did not consider individual cases. It dealt with high-level issues.

The hon. Gentleman will accept that the NHS constitution, which has a substantial section on staff responsibilities, and the Public Interest Disclosure Act 1998, which was introduced by this Government, ensure that if there are whistles available, someone to blow them and something to be blown about, that should happen, and we should know about it. One of the great abiding mysteries of Stafford is that no such whistle was blown.

Will the Secretary of State look into the situation where Newcastle hospitals have withdrawn from the joint partnership on laundry services with the Queen Elizabeth hospital in Gateshead in my constituency? They are now transporting laundry to Leicester—364 miles there and back. That is a ridiculous thing to do when the cost of the contract is exactly the same.

At face value, that seems rather strange, environmentally as well as financially. If my hon. Friend contacts me about the matter, I would be willing to look into it.

While Sir Liam Donaldson's comments about tackling alcohol abuse might have been well meaning, does the Secretary of State accept that for many of my constituents—perfectly ordinary people struggling in this recession—the idea of a huge tax increase on relatively cheap bottles of wine is quite unreasonable?

I share the right hon. Gentleman's view on that. For 150 years, the chief medical officer has been producing such reports—not the same person, of course—that have made a huge contribution to public health in this country, sometimes years after a report has been published. I respect the integrity of the chief medical officer, as I am sure the right hon. Gentleman does, but I just happen to disagree with that solution.

Incidents of methicillin-resistant Staphylococcus aureus in my three local hospitals have drastically reduced in the last few months, but will the Secretary of State look at the methodology currently used for determining incidents of MRSA in hospitals? In Barnsley, we had an incident where a patient had an infection after his pacemaker had been fitted in an independent treatment centre. Because it took some time to discover how he had been infected in the hospital, the infection was counted as three separate incidents of MRSA for that same patient. That seems a bit unfair to me, so will my right hon. Friend look into that?

My hon. Friend is right to point to the 65 per cent. reduction in MRSA against the baseline of 2003-04, and there has been a 47 per cent. reduction in cases of clostridium difficile compared with the same quarter last year. He raises an important point, and one case of MRSA, clostridium difficile or any hospital-acquired infection is one case too many. We must consider sensible points such as his to see whether we can eradicate another source of health care-acquired infection.

Two constituents came to my surgery a few weeks ago to talk to me about a hospital in the west midlands— not Mid-Staffordshire hospital. They showed me photographs of mouse holes, mouse droppings in the operating theatre and blood smeared in wards. One is a consultant surgeon and both were frightened of being whistleblowers and feared for their jobs. What sort of ethos exists in the health service if people like that can be afraid of revealing the truth?

I know about that case, because the hon. Gentleman dropped me a note about it after the debate last week, and I am looking into it. As he did not mention the hospital, neither will I, but the fact that he has now placed the matter on record allows me to respond to him more formally than I would otherwise have done.

I do not understand why clinicians whose primary role is the safety of their patients are somehow concerned about whistleblowing. Indeed, knowing the number of people in various occupations who are not slow to make people aware of such difficulties, it amazes me that that did not happen at Stafford. The hon. Gentleman has taken a great interest in the matter, and I shall make absolutely sure that the issue that he has raised with me is thoroughly examined. Incidentally, I would also like to talk to the consultant concerned to find out why they were so frightened to raise the matter.

The Minister will know that I have already raised the issue of the mental health of adolescents in the north-west. Can he tell me why the north-west has the greatest number of adolescents in adult wards in the country, contrary to the spirit of mental health legislation?

We are waiting for the latest statistics, but we want no children under the age of 16 with mental health problems to be treated on adult wards. There is a discussion about what is in the best clinical interests of adolescents aged 17 and 18 to meet their needs, but until those statistics are published I am unable to comment on the specifics. I am happy to examine the details that the hon. Gentleman mentions.