Women’s Health Strategy
Baroness Burt of Solihull Excerpts(1 week, 1 day ago)
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Baroness Merron (Lab)
I very much share the noble Baroness’s assessment of the value of women’s health hubs. She will know that I have taken a considerable personal interest in this. The target to establish a women’s health hub in every ICB was the purpose of a time-limited pilot established by the last Government, and that target was met. Women’s health hubs are absolutely effective when it comes to improving access to and experiences of care for women. I have promoted them as the best example of community-based and joined-up healthcare. That is why, as the noble Baroness will have seen in the 10-year health plan, the women’s health hub in Tower Hamlets was specifically highlighted as a best-practice example of neighbourhood health, and we continue to support ICBs to improve their delivery of women’s health hubs.
Baroness Burt of Solihull (LD)
My Lords, the latest data from October this year shows that there are over 576,000 women on gynaecology waiting lists and there were 130,000 new referrals in October. How will the Government address this unacceptable wait in the refreshed strategy?
Baroness Merron (Lab)
My examination of the gynaecology waiting lists shows a gradual decline since August 2023. However, I absolutely agree with the noble Baroness that the waiting lists are far too long: it is unacceptable. We are now seeing 57% of gynaecology referrals being seen within 18 weeks, compared with 62% across all specialities. I do not want to hide behind improvement, welcome though it is, but we also know that almost nine out of 10 women on the gynaecology waiting lists are waiting for an outpatient appointment. That is why the big change through the 10-year plan is absolutely crucial, as we move from hospital to community. In the women’s health strategy renewal we will be focusing very much on improvement of gynaecology care. I share the noble Baroness’s view on that.
Breast Cancer
Baroness Burt of Solihull Excerpts(1 week, 2 days ago)
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Baroness Merron (Lab)
I should be able to answer, I admit, but I would rather be honest with the noble Lord: I would prefer to write to him because of the specific nature of his question. I am content with the role of the research trial and that we are now harnessing AI tools through the EDITH trial backed by some £11 million of government support. Using cross-cutting AI tools in respect of the breast cancer screening pathway will be of great assistance.
Baroness Burt of Solihull (LD)
My Lords, I feel quite shocked after the question from the noble Baroness, Lady Hodge. I recently went for my final invited mammogram, so I did a little research. I did not come up with that figure, and I wish I had because it changes everything I was going to say; it is very important. People who do not necessarily enjoy the wonders of the world of AI and all these other things do not know all this. They are told, “Right, you’re over 70, you’re pretty much all right now”. Some people do not get any advice and, given what the noble Baroness, Lady Hodge, said, we should review this as a matter of urgency.
Baroness Merron (Lab)
I hope I have outlined to your Lordships’ House how the AgeX trial will greatly assist. Clinical evidence, as and when it is available—it is sought actively—is acted on by the National Screening Committee. I emphasise to the noble Baroness and the noble Earl who raised it previously that, as I said to my noble friend, NHS England is producing public-facing information to communicate to women aged 71 and over that they can have screening every three years if they so wish, and I hope that women will take that up if they so wish.
HIV: Testing and Medical Care
Baroness Burt of Solihull Excerpts(2 months ago)
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Baroness Merron (Lab)
As I am sure the noble Lord is aware and welcomes, alongside South Africa, the UK is leading the campaign to raise investment for the Global Fund’s next three-year funding cycle. I assure him that we will, as he does, continue to champion global health and certainly remain committed to UK support for the Global Fund. UN aid also plays a very important role in the response and our funding has contributed towards preventing new cases in key populations. Long may that continue.
Baroness Burt of Solihull (LD)
My Lords, today, contracting HIV is no longer a death sentence as it once was, unless it is not spotted and treated in time. Testing is freely available, but we need greater awareness among all the communities affected. The currently growing groups tend to be heterosexual communities, and particularly women and ethnic-minority groups. We will not eradicate HIV if we do not spend the money on telling people about it. Are the Government planning to step up to this challenge and finance the eradication of this terrible blight?
Baroness Merron (Lab)
We are currently in the process of reviewing existing mechanisms as well as options for improving retention and re-engagement in care for people who live with HIV. This is a crucial part of the new HIV action plan, for which we will not be waiting very long. The noble Baroness makes an important point: there are all sorts of reasons for disengagement from care. It can be due to complex mental and physical needs but also the fear of stigma, as she referred to, particularly in the most vulnerable population groups, which means that they are disproportionately challenged. However, I assure her and your Lordships’ House that the plan will take account of that. Indeed, the 10-year health plan already makes that commitment.
Alzheimer’s Disease
Baroness Burt of Solihull Excerpts(2 months, 1 week ago)
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Baroness Burt of Solihull (LD)
My Lords, as we know, Alzheimer’s is the main form of a number of types of dementia. Early diagnosis allows for help to identify the specific type of dementia, leading to targeted treatment and access to support services, which have been discussed already this afternoon. However, the expected time from someone presenting at a GP surgery to diagnosis has increased from 13 to nearly 18 weeks. This is going in the wrong direction. What will the Government do to speed up this diagnosis, so that more people can benefit from some of the treatments that the Minister has referred to?
Baroness Merron (Lab)
As the noble Baroness says, diagnosis is absolutely crucial. I feel our health system has struggled somewhat to support those with complex needs, including those with dementia. That is why I emphasise the role of the modern service framework in this area; it is the first time we have had one and it takes a whole view, which I think has been sorely lacking. It will be informed by the independent commission on social care next year—so we are looking at next year, not waiting for years. The final point I make is about the dementia diagnosis rate for patients aged 65-plus. The Government are committed to recovering that to the national ambition of 66.7%; at the end of August, it was 66.1%.
NHS and Social Care: Joint Working
Baroness Burt of Solihull Excerpts(5 months, 4 weeks ago)
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Baroness Merron (Lab)
I certainly agree with the noble Lord about the importance of the individual needs of the person at the centre. For too long—and part of this is a lack of integration—the needs of the person who receives, wants and needs that care and support have not been at the front. On his suggestion, I would just counsel waiting for the 10-year plan. It may not do exactly what the noble Lord says, but it will set out a way forward on how we will resolve such matters. I am sure that he will participate in further discussions about how we can get to the place that we all want.
Baroness Burt of Solihull (LD)
My Lords, I was very pleased to hear the Minister’s words on the progress and planning for this NHS 10-year plan. I was looking through, well, everything that I could find, really, and I could not find that any progress had been made, so I wonder whether the Minister could update the House on what is happening now and when she thinks we might start implementing this programme.
Baroness Merron (Lab)
I am not entirely sure, but I think that the noble Baroness is referring to my first Answer.
Baroness Merron (Lab)
Good—thank you. This derives from the review by Sir Gordon Messenger. The first review was in 2022 and Sir Gordon came up with seven recommendations to strengthen leadership and management. To build on that, in November, Secretary of State Wes Streeting asked Sir Gordon to deliver further recommendations. That is why we now have a new national entry-level induction for new staff. As of 25 April this year, for example, it is being used by nearly 70% of trusts and ICBs to support staff enrolment. That shows how much it was needed and how much change it will make.
Musculoskeletal Health: Chiropractors
Baroness Burt of Solihull Excerpts(9 months, 4 weeks ago)
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Baroness Burt of Solihull (LD)
My Lords, 30% of GP consultations are for people with musculoskeletal problems. As a previous back sufferer who has made use of chiropractors in the past, I know personally the transformation that chiropractic treatment can achieve. I can afford that treatment, but many NHS patients cannot, so why can chiropractors not practise across the NHS, when waiting lists for treatment on the NHS are causing the loss of over 6 million working days every year?
Baroness Merron (Lab)
The noble Baroness is absolutely right to highlight the extent of the impact of MSK conditions not just on individuals but on our economy and our health service. However, to extend my earlier comments, chiropractic care is regarded as being in the category of complementary and alternative medicines. Some treatments have an evidence base that is not recognised by the majority of independent scientists, whereas others have been proven to work for a limited number of conditions. I appreciate the point that the noble Baroness is making, but probably the simplest way I would wrap it up is in talking of sufficient and reliable evidence, because that is what NHS commissioning at a national level is based upon.
Musculoskeletal Health
Baroness Burt of Solihull Excerpts(10 months, 3 weeks ago)
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Baroness Merron (Lab)
I thank the noble Lord for allowing me to reiterate that the department is working closely with NHS England to look at a whole range of options to provide better-quality care and access to those important preventive services. I emphasise that this is part of ending the postcode lottery. I remind your Lordships’ House that integrated care boards are responsible for the delivery of these services. We will continue with the further actions that we are taking, some of which I have already referred to, which will ensure that patients are getting the service they need.
Baroness Burt of Solihull (LD)
Integrated Care Journal has indicated the potential to improve access pathways, giving an example of an AI physiotherapist service at home and covered by CQC. Will the Government develop and adapt something like this?
Baroness Merron (Lab)
The noble Baroness raises an interesting point and I will be happy to look into what she suggests. I know she is aware that one of the main pillars of change will be about analogue to digital, and in that I put the contribution of AI. Just this afternoon I will speak to a conference about the role of AI in respect of women’s health, and osteoporosis will be very much part of that.
Prisons: Health Services
Baroness Burt of Solihull Excerpts(11 months, 1 week ago)
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Baroness Merron (Lab)
Substance misuse in prison, to which the noble Baroness refers, is of course a major issue, and prison security has a crucial role to play in reducing it. I should also say that the use of illegal drugs can impact on routine healthcare for all prisoners, as resources have to be directed to the more immediate cases. Noble Lords may remember that we recently had delegated legislation to ensure that nasal Naloxone could be administered, including by prison staff, to prevent opioid-induced emergencies. All these things will help, and substance misuse support is available in all prisons in line with the national service specifications, but we are working across government to see what more we can do. It is a big issue.
Baroness Burt of Solihull (LD)
My Lords, many of the issues preventing prisoners getting equivalence of care with non-prisoners clearly relate to access to hospitals and health specialists. As we know, delays can exacerbate conditions. Will the Government ensure that the Nuffield Trust recommendations on improving transparency, prisoner escort numbers, reviewing the supply of prison escorts and increasing access to out-patient services via telemedical services are implemented as fully as possible?
Baroness Merron (Lab)
The use of technology is hugely important in all areas, particularly in respect of prison services, as the noble Baroness says. There is a policy specifying that escorts must consist of at least two prison officers, with at least one being of the same gender as the prisoner unless there are exceptional circumstances. I take this opportunity to say that every effort is made to ensure that female staff support women, particularly where appointments are specifically related to services such as gynaecology. It is very important that we are aware of the possibility of retraumatising women prisoners, and we have been particularly mindful of that in relation to escorts.
NHS: Single-sex Provision for Staff and Patients
Baroness Burt of Solihull Excerpts(11 months, 2 weeks ago)
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Baroness Merron (Lab)
The noble Lord raises an interesting point. In all cases with guidance, that is always the balance we seek to reach. I am also interested in the history of this, and I am sure the noble Lord will remember that the 2019 guidance on trans patients in single-sex spaces proved somewhat controversial, if I might put it that way. The guidance was meant to be updated under the last Government, but this did not happen. I am advised that it was delayed by a dispute between the previous Government and NHS England, which also delayed proposed updates to the NHS constitution. These again were consulted on under the last Government—which was a good thing—but nothing actually happened. So all these come to us as a new Government and will be given full consideration to get us into the right place.
Baroness Burt of Solihull (LD)
In the last few weeks alone, we have heard about the range of challenges facing our NHS: physically collapsing hospitals, extensive waiting lists and a social care review, to name but a few. More guidance in areas of uncertainty is to be encouraged. However, given that only 0.55% of the English population is trans, where does the Minister think that this should come in the order of priorities?
Baroness Merron (Lab)
I know that everybody in your Lordships’ House will take the view that the NHS is there both as an employer—as all employers are; this is not specific to the NHS—and in its service to patients. It is there to treat all with the right dignity and respect. We have a legislative framework to which reference can always be made. We will see what further guidance is needed—and that may be to all employers, not just the NHS. Again, I cannot emphasise enough the need for careful consideration and the involvement of all staff, on what has to be a trust-wide basis, because everybody is different in terms of their estate and what their challenges may be. It is not as simple as numbers: it is about fairness and dignity for all.
NHS: Patients with Allergies
Baroness Burt of Solihull Excerpts(1 year ago)
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Baroness Burt of Solihull (LD)
My Lords, I congratulate—with my horrible squeaky voice—the noble Baroness, Lady Ramsey, on securing this debate today. My concern is not so much adolescents as children.
In my hotel room this week, I was interested to find a card explaining what to do in the case of anaphylactic shock. This suggests to me that the concern about, and the volume of cases of, serious reactions to allergies is on the up, as well as the seriousness with which the hotel group took its responsibility towards its guests. Indeed, that is borne out by the facts: an estimated 21 million people—just under one in three of us in the UK—live with one or more allergies. For most of us, this can be managed and is not severe, but for some it can be life-threatening, as the noble Baroness has said. In the UK, between 1998 and 2018, more than 100,000 people were admitted to hospital for anaphylaxis, a life-threatening allergic reaction. While the number of hospital admissions has increased in recent years, the number of deaths, I am glad to say, has decreased.
Allergy UK advocates three policies to improve NHS services for people who suffer from allergic reactions. The first is to have an allergy nurse and dietician at primary level for each UK health region. That does not seem a huge ask to me but, apparently, there is a postcode lottery for specialist allergy services. Secondly there should be a national register to consolidate patient data across the country and track allergy diagnoses. Clearly, this would enable the identifying of areas where additional services were needed. Thirdly, prescription costs should be removed for those living with allergies to address the additional costs people face when managing their allergies. The estimated total cost is £3,000 per year; I tried to quantify that but had to give up. Suffice it to say that removing at least the prescriptions costs would be a very reasonable thing, because people live with these conditions.
Earlier this week, there was a reception for people interested in allergies by the Benedict Blythe Foundation. Benedict, a little four year-old, collapsed at school and died from anaphylaxis. Helen, Benedict’s mum, whom I met this week, has been campaigning for all schools to have the recommended allergy safeguards in place. Teachers need to be able to manage the average one to two pupils with an allergy in each class, but many feel underprepared to be able to deal with a child experiencing an anaphylactic reaction. Every teacher should feel prepared. Every parent delivers their child to the care of the school every schoolday. Surely it is the duty of the school to take care of the health and well-being of that child above all else and to hand them back to the parent at the end of the day as fit and healthy as when they went in. After all, if an individual hotel room can have a notice explaining what to do in the case of an anaphylactic reaction, should not all teachers who care for the children of others have that basic knowledge too?