Black and Minority Ethnic Babies: Mortality Rates

Baroness Blackwood of North Oxford Excerpts

Wednesday 15th November 2023 Lords Chamber

[Lord Markham (Con)]

That is specifically what the Best Start for Life programme is all about. It is a joint Department of Health and DfE £300 million initiative focused on the 75 most deprived areas and local authorities. As the noble Baroness might be aware, the whole reason Andrea Leadsom wanted to come back as a Minister—I was talking to her about this yesterday—was to drive this programme, which she is passionately behind. That work is being done through family hubs, making sure that the whole family is involved and bringing in the dads. That sort of action is very much focused on making sure we tackle this.

[Baroness Blackwood of North Oxford (Con)]

My Lords, every year 4,000 babies die due to pregnancy-specific conditions such as pre-term birth and pre-eclampsia, but 73% of drugs given to pregnant women do not have any safety information and only one drug has been developed specifically for use in pregnancy over the last 30 years. During that time, 600 drugs have been developed for cardiac conditions. Will the Minister look at the report Safe and Effective Medicines for Use in Pregnancy: A Call to Action from the University of Birmingham, which offers sensible and effective ways to put this right and reduce deaths in pregnancy?

[Lord Markham (Con)]

Yes, I would be very happy to take up my noble friend’s suggestion and will make sure that the regulators, NICE and the MHRA, are linked into that as well.

MMR Vaccine

Baroness Blackwood of North Oxford Excerpts

Thursday 20th July 2023 Lords Chamber

[Lord Markham (Con)]

I do not necessarily believe that that is the reason for the reduction. What we saw during Covid, as with so many things, was a couple of years when people were not attending school so much and were not attending GP surgeries for their vaccinations. That is why we have had a series of catch-up campaigns, which are working. We are getting there, but clearly there is a long way to go.

[Baroness Blackwood of North Oxford (Con)]

My Lords, we learned from Covid that high-uptake vaccine programmes can be effectively delivered only with a firm foundation of high-quality data and surveillance. The UK measles and rubella elimination strategy set out by UKHSA commits to a target of rigorous case investigation and the testing of over 80% of suspected cases with an oral fluid test. Can the Minister update the House on our performance on surveillance so that we can get on top of falling vaccination rates?

[Lord Markham (Con)]

I thank my noble friend. I was speaking to the senior epidemiologist at UKHSA just this morning about this. My noble friend is right to point out the concerns in this area. On exactly where we are on oral fluid testing, I will need to write to her.

NHS: Allocation of Financial Resources

Baroness Blackwood of North Oxford Excerpts

Thursday 11th May 2023 Lords Chamber

[Lord Markham (Con)]

I am pleased to say that the figures announced today show that response times are coming down. For category 1, the most serious, we achieved the 15-minute target for 90% of calls. We are moving in the right direction, albeit there is a lot more that needs to happen in this space. That is what the investment in 800 new ambulances is about, as well as the £200 million of funding. Most importantly, it is about making sure we have the right services in place. Some 50% of ambulance calls do not result in a trip to the hospital. There are fall services, which are often best placed to help, which will pick people up in their home.

[Baroness Blackwood of North Oxford (Con)]

My Lords, I declare my interest as chair of Genomics England. Some 3.5 million people live with rare diseases but only 5% of those conditions have a specific therapeutic. Condition management is essential, but patients struggle to find it because of poor awareness and a shortage of specialist clinicians and nurses. The England Rare Disease Action Plan 2023 commits to a workforce strategy but it does not commit to anything on capacity. What are the Minister’s plans to resource the rare disease workforce?

[Lord Markham (Con)]

This will be another element covered in the long-term workforce plan, making sure that we have got every route covered. My noble friend mentioned signposting people to those services. We are shortly launching a new app service—some 30 million people already have it—to make sure we are signposting to the place where people can get the right treatment for everything, including rare diseases.

Diphtheria

Baroness Blackwood of North Oxford Excerpts

Tuesday 18th April 2023 Lords Chamber

[Lord Markham (Con)]

I am probably best placed to speak about how we engage with the Home Office, which we have been doing pretty successfully. I agree with the noble Lord about the role that those public health directors played during Covid and will play going forward. UKHSA is very much committed to doing that as well. As I said, our record on interactions with the Home Office speaks for itself—it is pretty good.

[Baroness Blackwood of North Oxford (Con)]

My Lords, I am very pleased to see that UKHSA has issued guidance in response to the increased number of cases, but it will be important to know how effective the response and the screening are. What plans are there for pathogenic screening and other forms of surveillance going forward?

GPs: Anti-depressants and Alcohol

Baroness Blackwood of North Oxford Excerpts

Wednesday 16th November 2022 Lords Chamber

[Lord Markham (Con)]

I agree that the first step should normally be cognitive talking-type therapies. As the House will be aware, we have been investing quite considerably in the mental health space. We have had a 25% increase in referrals to talking therapies, to 1.8 million in the past year alone. I very much agree that there should always be action to see whether we can help with those cognitive behavioural-type therapies first before resorting to prescribing drugs.

[Baroness Blackwood of North Oxford (Con)]

For some patients talking therapies and CBT may be an appropriate treatment for depression, as discussed, but for others next-generation SSRIs may be quite literally life-saving, and I am sure that no one in this Chamber would want to shame or discourage any patient who has been appropriately prescribed such a therapy. The Minister, I know, would want to suggest that GPs should be spoken to before any such action would be taken.

[Lord Markham (Con)]

I thank my noble friend and agree. It should always be down to the GP, working closely with the patient, to decide the best form of treatment, whether talking therapies or drugs, and that is why we are quite clear in the guidance that first and foremost it has to be the local clinician who makes the decision.

Edenfield Centre: Treatment of Patients

Baroness Blackwood of North Oxford Excerpts

Thursday 13th October 2022 Lords Chamber

[Lord Markham (Con)]

I agree with the points that my noble friend makes. I have some personal experience of people with learning difficulties, and I completely agree that the right setting for them should actually be in the community. I know that is the direction of travel of this Government, and I know that there is an objective to make sure that that is the major place where they are cared for. I have some further details on that, which I would be happy to share, and to meet with my noble friend.

[Baroness Blackwood of North Oxford (Con)]

My Lords, I have been in the Minister’s place, answering on similar scandals, and I think that the whole House shares the dismay of my noble friend that we are in this place once again. I hope that the Minister will take back the condemnation of this House that such a thing should happen in this country. We want to say that it will never happen again, but I think that we feel as though we will be back here once more.

If I could raise one single point, it is that the CQC, the police, the Government and all those involved in the investigations that go forward should take particular care with the patients and families as they go forward, to have the utmost respect and transparency in the way in which they communicate. Too often in these cases, information is leaked to the media or there are failures in communication, which leads to even more distress over and above what has already happened. Please can that not happen in this case, and can those who have already been so grievously affected be protected going forward?

[Lord Markham (Con)]

I am grateful for my noble friend’s comments. She is absolutely correct that, although we are grateful to the likes of the BBC for highlighting these issues—and I speak here as a former director of ITV—and for the undercover work they do, I believe that there is a responsibility there as well, when they have found these sorts of cases, to allow the patients and the people affected some sort of early indication, because the impact on them is central to all of this. I do not know what the BBC did in terms of an early warning on this, to make sure that there were no surprises. I think it is a very good point. We need to make sure that, although independent journalists are correctly doing their job and highlighting important issues, for which we are grateful, we first and foremost need to make sure that when this happens, patients and their family are made aware first and that their concerns are foremost in any action that is taken.

Skills for Care Report

Baroness Blackwood of North Oxford Excerpts

Thursday 13th October 2022 Lords Chamber

[Lord Markham (Con)]

First, let me say that we value social care. As the noble Baroness will be aware, the £500 million was in addition to a £5.4 billion increase over three years. Again, that underlines the importance that we see behind adult social care and how it is a crucial part of our whole plan, as outlined in ABCD, not only to give the right conditions and dignity for the elderly people whom the noble Baroness mentions but as a vital way of releasing space in our hospitals—this drives right through the system—to create space both in A&E and through the rest of the care system. It is an area of vital interest and something that I can assure noble Lords has a lot of focus from the department.

[Baroness Blackwood of North Oxford (Con)]

My Lords, I strongly welcome the Government’s action to put care workers on the shortage occupation list this year, which is important for unlocking immediate supply. However, might I ask the Minister to note two key points from Skills for Care’s report, which are important for further action for sustainable care workers? The first is that, although the retention rate has remained more or less stable since last year, the starter rate has fallen from 37.3% to 30.8%. Can I suggest that the Minister looks at more incentives for starters? The second point is that, on average, employers with favourable work metrics such as high levels of learning and development have better CQC ratings. Given the UQ coming up later, that is another critical area to look at for improvement.

[Lord Markham (Con)]

My Lords, my noble friend is correct that this is also a labour supply issue. Part of the benefit of living in an economy with full employment is, of course, that there is little unemployment. Part of the downside of that is the competition for jobs. My noble friend rightly points out the need to recruit more in this sector; that is why I am pleased that she mentioned the work we are doing to add this sector to the essential workers list so that we can recruit people from overseas and get essential workers in.

NHS: Access to Treatments

Baroness Blackwood of North Oxford Excerpts

Wednesday 7th September 2022 Lords Chamber

[Lord Kamall (Con)]

We are looking at a number of different things when it comes to doctors across the service. One is clearly opening new medical schools in areas which are underserved: sometimes we have doctors, but not in the right areas. We are also looking at overseas recruitment but, on the specific issues, we are having discussions—let us put it that way—on the cap. That is constantly being debated and I will take that back to the department.

[Baroness Blackwood of North Oxford (Con)]

My Lords, NHS leaders have warned of a life-threatening situation in which clinically vulnerable people are being admitted to hospital after having their energy supplies cut off. This is obviously horrendous for the patients involved, but also risks putting tremendous pressure on NHS systems, which cannot bear that pressure at the moment. I urge the Minister to advise the incoming Health Secretary to take action to prevent the cost of living crisis becoming a health crisis when we can least afford it.

Paramedic Services

Baroness Blackwood of North Oxford Excerpts

Monday 4th July 2022 Lords Chamber

[Lord Kamall (Con)]

I begin by thanking the noble Lord for his engagement with me and the department on this issue. When the noble Lord has sent me details or suggestions, I have passed them to the relevant officials within the department. I hope I can assure that noble Lord that I have done that. As the noble Lord will know, within departments we have particular portfolios and I have to hand it on to the person responsible. In terms of the recovery plan, the NHS has published a 10-point action plan for urgent and emergency care. I will not go through the whole action plan, but it includes dealing with paramedics, recruitment and retention, and more space in A&E departments. At the same time, can requests be handled by telephone by clinicians and patients diverted to a more appropriate resource? All these have been looked at. I understand that the noble Lord thinks it is unsatisfactory, but we have been hit by the pandemic, we are trying to recover and there is a plan.

[Baroness Blackwood of North Oxford (Con)]

My Lords, the noble Lord, Lord Young, is right that handover times have a particular impact on ambulance services. I was pleased to hear the Minister mention recruitment and retention in A&E departments. This is a long-standing problem in emergency services. The Royal College of Emergency Medicine states that emergency medicine has a high attrition rate. I know that a number of steps have been set out. Can the Minister state what success they are having and, if they are not succeeding yet, what further steps the Government plan to set out? We need a change in direction as soon as possible.

[Lord Kamall (Con)]

I thank my noble friend for the question and also for the point that this happens at number of different points in the system. Clearly, there are recruitment campaigns for doctors and nurses. In addition, the number of ambulance and support staff has increased by almost 40% since 2010. Call handler numbers have also increased since the start of May 2022; we have 400 more. In addition, there are pledges to increase the training of paramedic graduates nationally by 3,000 per annum. All these will take time to get into the system, which is still recovering from the pandemic.

Vaccinations

Baroness Blackwood of North Oxford Excerpts

Wednesday 15th June 2022 Lords Chamber

[Lord Kamall (Con)]

The noble Lord is absolutely right; we have received advice on the flu vaccine and at the moment it is free to those aged 65 and over. The issue, frankly, is balancing resources. A number of people in the system are saying that if you keep mandating vaccines, it means they cannot get on with tackling the elective backlog. On balance, at the moment it seems better to focus on the elective backlog, but UKHSA and others are monitoring the situation very closely.

[Baroness Blackwood of North Oxford (Con)]

My Lords, the whole House will know that the great success of the Covid vaccine’s development was not built during the pandemic but over many years of visionary research and investment. What steps are the Government taking to invest in a similar amount of research in next-generation vaccines for things such as cancer and universal flu?

[Lord Kamall (Con)]

My Lords, I thank my noble friend for that question. She will know that we are investing in a number of different areas via NIHR and other research bodies. Those research bodies also welcome applications for research funds in specific areas. We do not necessarily ring-fence that funding, but we ask for applications. One issue we learned about is that there is the potential for future vaccines to cure, or be used as therapeutics for, a wider range of issues. In addition, we are looking at blood tests which can identify far more conditions.