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Muscular Dystrophy

I am a fan of targets and I am pleased that the hon. Lady is, too. As I go on, perhaps I could offer suggestions on the issues that she raises. As we approach the mid-point of the NSF's 10-year implementation period, it is fair to say that there is no comprehensive and detailed picture of the extent to which the NSF has been implemented or of the difference that it is making to the lives of people with neurological conditions. However, there are many examples of good, innovative practice, and the successful implementation of the NSF over the next five years will depend on our ability to identify and disseminate that good practice, although the NHS is not always good at looking at good practice and learning from it. We therefore need to identify the champions who can support the weaker services. We have commissioned a mid-point review in 2010 to show what progress has been made towards implementation, to identify what works and why, and to lead to the adoption of good practice elsewhere. That will help us all to make better decisions in the design and delivery of services. The all-party group and others see the development and implementation of clinical standards and guidance as a means to drive up quality and secure improvements. The National Institute for Health and Clinical Excellence is an independent body, which welcomes suggestions for future guidance from a wide range of sources, including health care and public health professionals, patients, carers and the general public. Health professionals are free to use their clinical judgment and any national and international best-practice guidance to develop appropriate health and social care services to meet the needs of those living with muscular dystrophy. As the hon. Lady recognised, the new NHS is locally driven and looks outwards, not upwards. It is designed dramatically to improve the quality of care and the value that we get from our resources. Strengthening commissioning is, of course, at the heart of delivering that agenda, and that is where we have been concentrating our efforts to provide leadership on this crucial issue. It is important that I commend the West Midlands strategic health authority and the West Midlands specialised commissioning group. In response to the Walton report, they are undertaking a review of muscular dystrophy and related neuromuscular services to produce proposals to allow PCTs to improve services. I say to the hon. Lady and my hon. Friend that I will now urge the regional specialist commissioners to liaise with the all-party group and I will ask the national team to co-ordinate. We are still learning about commissioning, and some people are more advanced than others. The hon. Lady mentioned emergency admissions, and I am asking for a special study to look at the issue. As a former community practitioner, I believe that we will avoid emergency admissions if we invest in community care and a multidisciplinary team so that they can be as effective as possible. That requires us to have really positive champions and real clinical leadership.