The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con) (Maiden Speech)
My Lords, first, I congratulate the noble Lord, Lord Wills, on introducing this debate today. As I would have expected, we have heard five powerful speeches and I stand here in some awe. This is my maiden speech and I want to say what a huge privilege and honour it is for me to join your Lordships’ House. I still have to pinch myself every time I come here to check that it is really true.
It goes without saying that I wish that my father were here today and not taking a leave of absence. I would have liked the chance at least once in my life to have addressed him as “my noble kinsman”—more respectful, if more other-worldly, than other epithets that I may have used to describe him in the past. He was elected to the other place in 1959 and introduced to this House in 1987. The spirit of “one nation” that inspired his politics is, I am glad to say, alive and well in today’s Conservative Party. What inspired him back in 1959 still inspires me today.
I follow in the footsteps of my noble friend Lord Howe, who is in the Chamber. He held the office that I now have with huge distinction in both government and opposition for some 18 years. Over that time, he deservedly won a reputation, on all sides of the House, for charm, humour, intelligence, integrity, good sense and fair play.
Noble Lords
Lord Prior of Brampton
He embodies all that is best about this House and he will be a very hard act for me to follow, although I shall do my best.
I also pay tribute to the former Minister for Care Services in the last Government, Norman Lamb. If not for him, I might well have still been in another place representing the constituency of North Norfolk. I congratulate him especially on his work on raising awareness of mental health issues and improving the standing of mental health services in this country. Both our families have been touched in different ways by the tragedy and tragic consequences of mental illness, and I imagine that many others in this House will have been similarly touched.
I am grateful to the noble Lord, Lord Wills, for raising the important issue of innovation in the National Health Service. If he will give me a little latitude, I will come back to him later on the points that he raised. We have already spoken outside the House about his particular concern, but I will address it towards the end of my speech.
Before I respond to the observations of the noble Lord, Lord Hunt, I would like to say how much I look forward to working with him. We have worked together over the last two years. He has a deep knowledge of and commitment to the National Health Service, and I know that there is much more that unites us than divides us. It is a shame that, sometimes, the adversarial nature of politics intrudes so deeply into health and social care. I endorse his words about his noble friend, Lord Carter, who has produced an extremely valuable report that will help the National Health Service to drive costs out of the way that we deliver care in acute hospitals, which can then be used more for innovation, new drugs and the like.
The noble Lord, Lord Hunt, was a Minister back in 2000, when the then Secretary of State for Health, Alan Milburn, described the NHS as a,
“1940s system operating in a twenty first century world”.
I think the noble Lord will agree that the project of transforming the system so that it is fit for today’s world is still far from complete.
The NHS Five Year Forward View is, I believe, a vision for the transformation of the NHS that all of us in this House can support. It is a vision for the NHS created not by the Prime Minister or the Secretary of State for Health—who is sitting to my left—or by any politician. It is a vision of the NHS by the NHS, for patients and taxpayers alike. It describes a future built on innovative new models of care and integrated models of care, which the noble Baroness, Lady Walmsley, mentioned in her speech, to meet the needs of today’s population.
My time as chairman of the Care Quality Commission taught me a great deal, but especially that great organisations require great leadership and very high levels of staff engagement. Staff engagement is probably the best predictor of care quality and overall performance of hospitals and, indeed, of primary care and social care. Doctors, nurses and other healthcare professionals are not primarily motivated by targets, financial incentives or contracts; they are driven overwhelmingly by their vocation. I much appreciated the words of a former president of the Royal College of Physicians, the noble Lord, Lord Turnberg, who understands that probably more than I or many others in the House do. We must never forget that it is their vocation that drives healthcare professionals.
I want particularly to mention how delighted I am that NHS England has appointed Yvonne Coghill to champion the cause of race equality. It is sad and wrong that so many people from BME backgrounds do not have the same opportunities as others in the NHS. This is not just morally wrong but has a direct impact on patient care.
It is important to remember that innovation, the subject of today’s debate, needs the full engagement and alignment of clinicians, staff and managers alike if it is to deliver the change that we want and need. Innovation in medicine has prompted enormous advances in healthcare. From the discovery of penicillin, through the pioneering of major organ transplantation and keyhole surgery, to increasingly targeted modern cancer treatments and, as I found out last week, the development of 3D-printed hip replacements, there is much to be proud of and indeed thankful for.
The noble Baroness, Lady Walmsley, mentioned infection control. The noble Baroness is right: it is not just about the high tech; sometimes it is about just washing your hands. The extraordinary improvements that we have seen in the reduction of MRSA and C. difficile in our hospitals—although there is further to go—is testament to that.
As the noble Lord, Lord Giddens, rightly identified in last week’s Queen’s Speech debate, we now stand at the brink of a new technological revolution in healthcare, with the emergence of advanced digital technologies, greater connectivity and the widespread use of smartphones opening up unprecedented opportunities for treatment and prevention. In addition to the wide array of wearable technologies, there are no fewer than 100,000 health apps, allowing people to take more control over their health and well-being. I think that self-care will be a major addition to the armoury of health prevention as we go forward.
We are determined to seize these opportunities and have established the National Information Board to drive the digital transformation of the health and care system. I share the concerns expressed by noble Lords in this House that restoring public confidence and trust in care.data is an imperative and is very important.
Noble Lords will know that in its Five Year Forward View, NHS England and all the ALBs have committed to driving improvements in health through developing, testing and spreading innovation across the health system. This aspiration is evident in the creation of the Vanguard programme. Noble Lords will be aware that in January the NHS invited organisations to apply to become vanguard sites for the new care models programme—a highly innovative programme. More than 260 organisations expressed an interest in developing such a model, with the aim of transforming how care is delivered locally. In deciding which models of care to support, NHS England and ourselves will be guided by the view of a previous Prime Minister, recently repeated by Liz Kendall MP, that “we will back what works”.
Let me provide a few further examples of where we are making progress. First, the test beds initiative, launched in March this year, will produce real-world sites for evaluating innovations that integrate new technologies and other novel approaches that offer the prospect of better care at lower cost. Secondly, noble Lords will be aware that England was the first country in the world to establish a system of academic health science networks, supporting local economies to improve local health outcomes, and maximising the NHS’s contribution to economic growth by enabling and catalysing change through collaboration. This builds on the success of our six world-leading academic health science centres, designated following review by international experts. Having met with the Chief Medical Officer, Dame Sally Davies, this afternoon, anyone in this House who believes that research will not have a high priority for this Government will have to tangle with Dame Sally. It is remarkable for a country the size of England to have six world-class institutions in this field.
Thirdly, I am proud that we are leading the world in whole-genome sequencing. NHS England is a key partner in the landmark 100,000 Genomes project, working to sequence 100,000 genomes of NHS patients with cancer or rare diseases. The 11 genomics medicine centres across the country are playing a vital role in identifying patients with rare diseases and cancers with a view to providing more personalised and targeted treatment. It will not be long before we are the first mainstream health service in the world to offer genomic medicine as part of routine care for patients.
Last but not least, to pick up the concern expressed by the noble Lord, Lord Turnberg, the accelerated access review was launched by the Minister for Life Sciences in March and is independently chaired by Sir Hugh Taylor. It will make recommendations later in the year on how we can speed up patients’ access to innovative medicines and medical technologies, taking time and cost out of the development pathways for new products. This will have wide benefits for innovators, for pharma companies, the NHS and, of course, for patients.
We must not, of course, become complacent. Health has always been a hotbed of innovation, and innovation has allowed the NHS to provide ever more advanced care to patients. But the wider world offers many examples of innovation in the way care is delivered from which we can take huge inspiration—whether it is Kaiser Permanente in California, Aravind in India, or the extraordinary work that is being done with data in Singapore and Australia. We must never fall into the trap of “not invented here”.
Finally, turning to the issue raised by the noble Lord, Lord Wills, concerning giant cell arteritis, I should add that this is not as specific as I thought and raises more general issues about NHS England than were raised by the noble Lord opposite. The Government recognise that early diagnosis and treatment of giant cell arteritis is extremely important to prevent sight loss. I was touched by the human concerns and the human impact of giant cell arteritis expressed by the noble Lord as well as the financial issues that he raised.
I have raised the issue with Sir Bruce Keogh, the national medical director of NHS England, who is happy to meet the noble Lord, along with the Minister for Life Sciences, George Freeman. But in view of the more generic issues that have been raised, and the fact that it is not just this specific matter, I would like to join the meeting—to discuss not only Professor Dasgupta’s work but the wider issues around commissioning treatments for these rare and specialised conditions. I hope that the meeting is productive.
I am conscious that I have not addressed all the questions today, but on this occasion I hope that your Lordships will forgive me as it was my maiden speech. I want to say how much I am looking forward to working with noble Lords on all sides of the House in the years to come.