Minimally Invasive Cancer Therapies
Debate between Baroness Blake of Leeds and Lord Kamall
Baroness Blake of Leeds (Lab)
The noble Baroness makes an incredibly important point. It is not just in this area that we have shortages in specialisms. The Government are committed to creating a much better environment for resident doctors moving through the process into specialisms and to giving them support. There is a whole raft of work, which I cannot go into now, on how we can make sure that those programmes are smoother, speeded up and more equitably spread around the country—to pick up on the important point regarding this type of specialism.
Lord Kamall (Con)
My Lords, I also thank the noble Lord, Lord Aberdare. I pay tribute to him and wish him a happy retirement. Only yesterday, he managed to offload two single-use defibrillators on to me as part of his clear-out. I thank him for introducing me to the world of defibrillators.
In speaking to charities that represent those with less survivable cancers, I am told that one reason why they are less survivable is that they are spotted only at stage 3 or stage 4—quite often too late to survive. However, there are a number of tests which could spot some of those cancers; for example, I was told about a trial of a breathalyser test that could identify certain biomarkers and has huge potential. As the APPG on Less Survivable Cancers says, that early diagnosis could save thousands of lives a year. What is the department doing to ensure that trials of such tests that are promising are conducted as quickly and as widely as possible so they can be introduced sooner if they prove safe and appropriate to identify these cancers?
Baroness Blake of Leeds (Lab)
The noble Lord has identified an unexpected spin-off of being a Minister or shadow Minister in this place.
The noble Lord makes a very important point. The fundamental basis of the 10-year plan is how we move to earlier diagnosis, with the three shifts, including moving treatment into the community. I have had personal experience; for example, where men who have been shy about going to a GP with concerns about their breathing have been taken out the GP route and allowed to go straight to a local X-ray department, where early stages have been picked up. All those innovative means already being used need to be rolled out. That is why the 10-year strategy is focusing on early prevention, shifting services to the community and making sure that we free up space within the acute sector for specialist services.
Independent Commission on Adult Social Care
Debate between Baroness Blake of Leeds and Lord Kamall
Lord Kamall (Con)
To make it easy, I will resolve it.
My Lords, I take this opportunity to pay tribute to the late noble Lord, Lord Lipsey. He was on the Royal Commission on Long-Term Care of the Elderly in 1998. Many noble Lords may not know this but, before he passed away, we were working on a cross-party proposal to raise awareness of existing later-life insurance products offered by mutuals and private insurance, so that taxpayers fund only those without sufficient assets or those who lived beyond the coverage of the insurance—usually five years. Can the Minister assure us that, whatever the Casey commission proposes, given that we are looking at solutions in the short term, the Government will raise awareness of later-life insurance products currently offered by mutual and for-profit insurers, especially for those who cannot wait for the Casey commission to report?
Baroness Blake of Leeds (Lab)
I thank the noble Lord for making reference to the work of our noble friend Lord Lipsey, who will be greatly missed on all sides. I cannot pre-empt what the noble Baroness, Lady Casey, will say—I have made that point repeatedly; it is absolutely right. The noble Lord raised an interesting point of view. I am sure he will take every opportunity to feed that into the work that is ongoing.
Duchenne Muscular Dystrophy: Givinostat
Debate between Baroness Blake of Leeds and Lord Kamall
Baroness Blake of Leeds (Lab)
The noble Baroness raises a very interesting point. The drug companies will provide the drugs for free, but it is down to individual trusts to pay the administrative costs. She highlights that one boy in one trust is being supported, while another boy is not. It is a difficult situation; I completely understand that, and my heart goes out to all the young people who suffer from this dreadful disease. It is critical that the trusts work together and look at other practice. It is not for the Government to intervene and force trusts to do as the noble Baroness proposes. However, if they choose to do so, companies can provide funding to enable the clinical administration of their products in advance of the NICE decision. Perhaps the noble Baroness could go back and recommend that as a course of action.
Lord Kamall (Con)
My Lords, we heard from the noble Baroness, Lady Kramer, that there is an early access programme for a new treatment of Duchenne muscular dystrophy in the UK. Can the Minister share any intermediate observations or results from the early access programme? As the noble Baroness, Lady Kramer, asked, are there any plans to extend or expand it?
Weight Loss Medication
Debate between Baroness Blake of Leeds and Lord Kamall
Lord Kamall (Con)
My Lords, I want to follow up on what the Minister has just said and the previous question from the noble Baroness. As we have heard from the personal testimonies of noble Lords, these medications have the potential to reduce obesity and the long-term cost to taxpayers. Unfortunately, a recent study by the MHRA has found that a group of these drugs, including Mounjaro, Wegovy and Ozempic, may be associated with health problems such as inflammation of the pancreas.
Given that, and some of the previous questions, first, what assessment of the long-term impact on health have the Government made of these weight-loss medications? What data do they have as of now, and what data are they waiting for? Secondly, as the noble Baroness, Lady Boycott, said, how do we ensure that, when patients come off these medications, they do not just put all the weight back on? How do we make sure that they are part of a wider programme to keep the weight off?
Baroness Blake of Leeds (Lab)
Quite a few points were made there. I think the noble Lord is referring to reports about acute pancreatitis, for example. The MHRA has done a thorough review of the suspicions around these medicines. No new safety concerns were identified but, every time something comes up, it will be looked into. The noble Lord is absolutely right that we need to support the longitudinal studies that are happening, but going on beyond the initial licensing will also be critical. As I answered previously, work in other areas to encourage healthy lifestyles will be ongoing, and this will need to be taken seriously by patients from a very young age.
NHS England: Staff Costs
Debate between Baroness Blake of Leeds and Lord Kamall
Baroness Blake of Leeds (Lab)
My Lords, the evidence for that is becoming only too clear. That is why the Government have taken the action that they have to move at pace towards dealing with the situation. Too much money is going into bureaucracy and therefore not enough into front-line services. That needs to change, and this has been welcomed from all sides of the House.
Lord Kamall (Con)
My Lords, following the previous questions, I am sure that many noble Lords would agree with reducing staff, especially where there is duplication or where it may make more resources available for front-line staff. However, given that there was no impact assessment before the announcements were made—as the noble Lord, Lord Scriven, said, and as the noble Lord, Lord Hunt, has called for—will the Minister tell the House how the Government will ensure that front-line services will not be impacted, especially in areas of high deprivation?
Baroness Blake of Leeds (Lab)
There is an absolute commitment running throughout this that front-line services will not be affected by the work that continues. The decision was taken to move swiftly, and impact assessments will be done as we go through the journey. The Government have also committed that this will be as transparent a process as possible. Parliament will be kept fully apprised of the work that is done, particularly of how front-line services are being protected.
Advertising Restrictions on Less Healthy Food
Debate between Baroness Blake of Leeds and Lord Kamall
Baroness Blake of Leeds (Lab)
The noble Baroness is right, and I have alluded to this in my previous answers. The issue of tackling obesity is multilayered and complex. We have the evidence based on experience that working with families and creating excitement around healthy food is incredibly important. One of the most important things we have done, just in the last week or so, is announce mandatory healthy food sales reporting, making sure that shops take responsibility. It is heartbreaking walking into big supermarkets and seeing the amount of shelving space dedicated to attracting young people that, quite frankly, does not live up to healthy eating standards.
Lord Kamall (Con)
My Lords, as a number of noble Lords have said during this Question, there have been many top-down efforts over the years to reduce unhealthy eating and obesity, but they have all had variable levels of success. Noble Lords have said that it is important that we work with local families. Some of the best organisations, such as BRITE Box or FEAST With Us, which work with local families to help them eat healthily on a budget, are doing fantastic work in our local communities. Rather than always top-down solutions and bans, what are the Government doing to work with local community organisations to ensure that they get to families to help them to budget and eat healthily?
Baroness Blake of Leeds (Lab)
I completely agree with the noble Lord and I have personal experience from my background. It is empowering when a parent presents at a community organisation with a child who has an eating disorder or who is becoming obese, and they work together through cooking, education and shopping. All those things are fundamental and they need to be reinforced in schools, and I agree with the noble Lord that we need to tackle this on all levels. We obviously have to have the top-down measures that we were talking about earlier, but changing habits is going to be transformational.
NHS 10-Year Plan
Debate between Baroness Blake of Leeds and Lord Kamall(3 weeks, 5 days ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Blake of Leeds (Lab)
My Lords, I also start by sending my very best wishes to my noble friend Lady Merron. No one more than me is looking forward to her making a very speedy recovery. I am very pleased to hear from her that she is making good progress, so we look forward to her return. I think it is appropriate that I declare an interest: my son is a GP, which I think is perhaps slightly relevant to the debate before us today.
To recap before I go into more of the details, I emphasise that this plan is different in so many ways to the NHS plans that have come before it. As we have heard, it is a road map for radical reform that is built on three fundamental shifts. Those of us that have been around the health agenda for a while recognise the past aspiration for some of these measures, but there was never a bold, innovative, collaborative plan to take our ambitions forward.
From hospital to community care, bringing care closer to home and making access to GPs faster and simpler is absolutely fundamental, particularly in the current climate—and from analogue to digital, giving staff modern tools and patients the kind of convenience and control they expect elsewhere in their lives. All of us have heard heartbreaking stories of patients who go from one specialist to another, and there is not that join-up. This has to be changed. There is no reason why this cannot apply across all the experiences the public have, regardless of where they are seeking services.
Many of us have been talking about the need to move to prevention in so many areas of life. Where better than people’s health, looking at the root causes of poor health and making healthy choices? It is the easy choice, but at the moment it is not that easy.
The new NHS has patients at its heart, will deliver equity and quality, is devolved and decentralised so that we are more responsive to local community needs and the front line is freed up to harness innovations, and the rules and incentives in the system support clinicians and lead us locally to be able to make the right decisions. This means that there is no simple chapter or section within the plan for individual conditions or groups setting top-down actions. The impact on particular services and outcomes will be through successfully transforming how our health ecosystem works. As we will come on to with the more specific questions, this is very much a work in progress. I am delighted by the reach the consultation has had over the last year. That has informed the debate and the outcome that is seen in the plan, so there have been no surprises. Many people who have been involved recognise what is in the plan.
The plan is backed by £29 billion per annum of extra investment by the end of the review period and, crucially, by a drive to cut unnecessary bureaucracy and empower front-line staff, giving them the tools to do what they do best: caring for patients.
I thank the noble Lord, Lord Kamall, for his very constructive comments; they were exceptionally helpful. Across the House, we all look forward to taking this extremely seriously and moving forward.
Turning to the comments of the noble Lord, Lord Scriven, on social care, he and I share a very positive background in local government, and nothing could be closer to our hearts than working out how we are going to bring the two together. That is fundamental. Both noble Lords made the point very clearly, and we welcome that.
Over the next three years, we will focus on the neighbourhood health approach to those most let down by the current system. That includes older people with frailty and those in care homes. Social care professionals will work alongside NHS staff in local teams, supporting recovery, rehabilitation and independence. We have examples from around the country where this is already happening: services are joined up and the cultural differences between the NHS and local government have been successfully broken down. We need to make sure this is replicated and spread to every part of the country. We need to enable care professionals to take on many more health-related responsibilities, such as blood pressure checks and reducing avoidable hospital administrations. Of course, pay terms and conditions have to be improved through fair pay agreements.
In the longer term, the noble Baroness, Lady Casey, will produce an interim report next week, but it is very much a work in progress.
Baroness Blake of Leeds (Lab)
Sorry, I meant next year—I was just testing that everyone was still with us—in anticipation of the in-depth work she is already involved with. There will be cross-party discussions and a real engagement with stakeholders.
On the single patient record, I will have to write to the noble Lord about how the merging of the different systems will be achieved, but it will very much be about the patient being in control and giving a full picture for staff moving forward. The digital red book for children is absolutely fantastic.
On the shift to the community, as we have made clear, we will initially prioritise those living in areas of greatest deprivation. We will be opening neighbourhood health centres in places where life expectancy is low. There will be principles that we will follow, bringing all the multidisciplinary teams together.
On the fracture liaison service, I will have to respond in writing. I am sorry but I do not have the specific details in front of me.
Returning to the noble Lord, Lord Scriven, and his comments about social care, it is critical that we get this right and make sure that local leaders are right in there, responsible for delivery, proactive, providing a co-ordinated response and building on the work already being done.
On the funding, £29 billion is quite a significant amount of resource to work from. We recognise that there are challenges, and it would be wrong of me to pre-empt the work of the noble Baroness, Lady Casey. But I know she has been encouraged to work with the best of the best, and I look forward to the outcomes.
I have to finish—I am sorry; there is never enough time. Our health system is in crisis, and we need to act now. We must make sure that the NHS continues as a publicly funded service free at the point of use. We need to seize the opportunities provided by all the new technologies and medicines outlined in the plan, go forward with innovation and make sure that the patients are at the heart of everything we do.