NHS: Congenital Heart Disease

Debate between Baroness Chisholm of Owlpen and Lord Rennard

Wednesday 14th December 2016 Lords Chamber

[Baroness Chisholm of Owlpen]

I appreciate the concerns that noble Lords have raised and the concerns of the hospital trust. However, we must remember that no final decisions have been made and a public consultation will begin shortly. That is when all points can be raised and addressed.

[Lord Rennard (LD)]

My Lords, will the Minister agree that NHS England should review the unfair and inconsistently applied standards that may force the closure of congenital heart disease services at the Royal Brompton Hospital, putting lives and life-saving heart disease research at risk?

[Baroness Chisholm of Owlpen]

I want to share with noble Lords a little of what these standards are about. I feel quite strongly about this: it is so important, and it is the right way forward to determine where these operations should be done. The standards state:

“Each congenital cardiac surgeon must perform a minimum of 125 … congenital cardiac … surgical procedures … each year, averaged over a three-year period … Each consultant congenital interventionist must be primary operator in a minimum of 50 congenital procedures per year, averaged over a three-year period. There must be a designated lead interventionist who must be primary operator in a minimum of 100 procedures per year, averaged over a three-year period”.

This will ensure optimum outcomes for all patients.

Community Pharmacy in 2016-17 and Beyond

Debate between Baroness Chisholm of Owlpen and Lord Rennard

Thursday 20th October 2016 Lords Chamber

[Baroness Chisholm of Owlpen]

I thank the noble Lord for his questions. These reforms will make the necessary modernisation to provide the best possible service for the patient. He mentioned the problems with pharmacies closing and asked where that was going to leave us. We are investing £112 million to deliver a further 1,500 pharmacies in general practice by 2020. The NHS England pharmacy integration fund will be focused on the deployment of clinical pharmacies and pharmacy services in the community and primary care settings, including groups of general practices, care homes and urgent care settings, such as NHS 111. This will improve access for patients, relieve the pressure on GPs and A&E departments, ensure optimal use of medicines and derive better value, improving outcomes for patients.

The noble Lord also asked about pharmacies in deprived areas and rural communities. That is why we are setting up the primary access scheme and are today publishing the list of those pharmacies that will be eligible for funding from the pharmacy access scheme. These pharmacies will be protected from the full effect of funding reductions, and the scheme will include a review process to deal with any inaccuracies in calculations or any unforeseen circumstances. I hope that that answers the noble Lord’s questions.

[Lord Rennard (LD)]

The noble Baroness said in answer to my question on Tuesday:

“We are not suggesting that any pharmacies close”,—[Official Report, 18/10/16; col. 2225.]

but then went on to imply that some of them would be closed. Does she agree with the former Health Minister, Anna Soubry? She said in the House of Commons on Monday that,

“there is great concern about the proposals”,

and that if,

“there was ever a time to argue to increase the role of pharmacies, it is now”.—[Official Report, Commons, 17/10/16; cols. 593-94.]

Does the Minister accept that it will often be the smaller, independent pharmacies that will be under threat of closure and that closing them will reduce competition, restrict choice and increase prices? Can she say a little more about the integration fund? I understand that it was originally announced as being worth £300 million over five years, but it now seems to be worth £42 million in the next two years. Has the promised cash disappeared?

Will the Minister confirm that the access fund is largely coming out of the general pot to support pharmacies and that most of the expenditure through it will therefore be at the expense of support for other pharmacies? When local authority funding is being reduced for public health projects as a result of cuts in funding from NHS England, is not this another example of a false economy—making short-term savings that will lead to greater costs and pressure on the health service in future, in particular on GP surgeries?

[Baroness Chisholm of Owlpen]

It is important that we offer a level of certainty and stability to pharmacy businesses and contractors providing NHS pharmaceutical services under the community pharmacy contractual framework, which will receive £2.687 billion funding in 2016-7 and £2.592 billion in 2017-8. The pharmacy integrated fund, as I said earlier, will make a huge difference to the NHS integrated fund, which will focus on the deployment of clinical pharmacy services in the community and primary care settings.

Health: Diabetes

Debate between Baroness Chisholm of Owlpen and Lord Rennard

Tuesday 18th October 2016 Lords Chamber

[Baroness Chisholm of Owlpen]

As I said, we are encouraging all NHS trusts to take up the multidisciplinary approach. We are disappointed in the take-up, and we think there are several reasons for it. The Department of Health and Diabetes UK are working together on ways to improve the take-up of structured education and considering more diverse provision in this area. It is also important to remember that a lot of people, when they go to see the doctor, do not say that they have a problem with their feet. We need to educate healthcare professionals to be able to ask the right questions, one of which should be not, “Have you got any problems?”, but, “Do you have a problem with your feet?”. A lot of people are embarrassed to say that they have a problem, so education could be done on both sides.

[Lord Rennard (LD)]

My Lords, the Minister will be aware of the importance of community pharmacies in supporting people with diabetes in relation to their foot care. Does she accept that the planned significant reduction in the budget to support community pharmacies will force many people who have foot complications to try to go to overcrowded GP surgeries, adding to the problems there? That could mean more long-term complications being treated later in hospital, in the secondary sector. The planned reductions are a completely false economy that should not be made if they are going to force more people to seek treatment other than in their community pharmacy, as at present.

[Baroness Chisholm of Owlpen]

I think the noble Lord was in the House yesterday when I repeated an Answer to an Urgent Question on this subject. We have to think of the most effective ways to save money in the NHS. We are not suggesting that any pharmacies close, as the noble Lord knows. We are suggesting savings for pharmacies over the next two years. That is not to say that there will be any pharmacies closed, but we need to make them more efficient. There are some places where there are three pharmacies in one high street, which is slightly ridiculous. However, we are ensuring that rural pharmacies will be in place.

Community Pharmacy

Debate between Baroness Chisholm of Owlpen and Lord Rennard

Monday 17th October 2016 Lords Chamber

[Baroness Chisholm of Owlpen]

I thank the noble Lord for those questions. The decision on the impact assessment has obviously not been made yet because the Government are thinking about the problems that have just arisen due to the PSNC not accepting the decisions that we thought had been made. There is no reason why this package should in any way affect the efficiencies of pharmacies at the moment. It is important to remember that the Government fund community pharmacies to the tune of £2.8 billion, and the average pharmacy receives £220,000 per year in NHS funding. We believe that the sector, which is made up of private companies that are often densely clustered together, can withstand this, and that the quality of services provided to patients will not be affected as a result. We know that 40% of pharmacies are in clusters of three or more, which means that two-fifths of pharmacies are within 10 minutes’ walk of two or more other pharmacies.

[Lord Rennard (LD)]

My Lords, the Minister will be aware of the report, commissioned for the Pharmaceutical Services Negotiating Committee and published last month, which showed that in 2015 community pharmacies provided 75 million minor ailment consultations and 74 million medicine support interventions. Does she not think that reducing the provision of community pharmacies may make it even harder for many people to see their GP and will add to the already considerable problems at many A&E units?

[Baroness Chisholm of Owlpen]

The Government are modernising the pharmacy sector and are investing £112 million to deliver a further 1,500 pharmacies in general practice by 2020. We are ensuring that no area is left without access to community pharmacy due to the pharmacy access scheme, and as the Minister for Community Health and Care announced on 13 October we are also introducing the pharmacy urgent care programme, a pilot scheme which will embed pharmacy into the urgent care pathway by expanding the service already provided by community pharmacies in England for those who need urgent repeat prescriptions and treatment for urgent minor ailments and common conditions. The move means that, in pilot areas, patients who need urgent repeat medicines will be referred from NHS 111 directly to community pharmacies. NHS 111 will develop and evaluate a new approach that will ultimately enable the service to refer patients with urgent minor ailments such as earaches to community pharmacies.

Electoral Fraud

Debate between Baroness Chisholm of Owlpen and Lord Rennard

Monday 12th September 2016 Lords Chamber

[Lord Rennard]

To ask Her Majesty’s Government what plans they have to amend electoral legislation as a result of the report of Sir Eric Pickles’ review into electoral fraud.

[Baroness Chisholm of Owlpen (Con)]

The Government have received Sir Eric Pickles’s review and will carefully consider its findings and recommendations. We are committed to tackling any form of fraud in the UK polls and this report will help inform the debate to ensure that our elections have the highest integrity. We will look closely at the proposals set out in the report and provide a full response in due course.

[Lord Rennard (LD)]

My Lords, does the Minister accept that a report proposing changes to the way in which we conduct our elections would have greater credibility if it was not simply the work of a former chairman of the Conservative Party? Why does she think that the report did not look into such important issues as the underregistration of voters, which distorts the outcome of our elections and the Boundary Commissions’ processes?

Constituency Boundary Revisions

Debate between Baroness Chisholm of Owlpen and Lord Rennard

Thursday 30th June 2016 Lords Chamber

[Baroness Chisholm of Owlpen]

If I understand the noble and learned Lord’s question correctly, the work is based on boundary reviews being carried out so that the number of MPs will go down from 650 to 600.

[Lord Rennard (LD)]

The Government acted speedily a few weeks ago to extend the deadline, allowing another 400,000 people to be included in the voting register. Should they not now act speedily to ensure that the 2 million-plus people added to the electoral register since 1 December are included in the boundary review? They could, as they did in 1992, simply speed up the process of the Boundary Commissions, put a little more resource into it and make sure that we get what they say they want—boundaries based on equal numbers of electors in each constituency—but only by letting the Boundary Commissions act on the basis of the registers as they now are, not as they were last December.

[Baroness Chisholm of Owlpen]

There simply is not time. It was decided that this is the way forward and it is going to happen. The Boundary Commission started its work in February of this year and it will be completed in time for 2018. Any delay would mean that we do not get it done in time for the election. The noble Lord, Lord Tyler, said in 2010 that votes should have equal value and equal weight, whether they are in the furthest reaches of rural Cornwall or in the inner cities, or in England, Wales, Northern Ireland or Scotland. Any delay will mean that that takes longer and longer to happen. We just need to get on with it.

Voter Registration

Debate between Baroness Chisholm of Owlpen and Lord Rennard

Thursday 12th May 2016 Lords Chamber

[Baroness Chisholm of Owlpen]

I can understand where the noble Lord is coming from, but as I said in my earlier answer, we feel that the best way is to work with civic groups to make sure they can make the young aware of how important it is to vote in all elections, not just the EU referendum. The grants we are giving to these civil society organisations are helping to make people aware of how important it is.

[Lord Rennard (LD)]

My Lords, does the Minister accept that some of the problems with the administration of the elections last week and with the general election showed the need to update and modernise our electoral laws, the language of which is often more relevant to the 19th century than the 21st? Will the Government take forward the recent Law Commissions’ report, which has said how that law should be modernised? In particular, will they accept that we need to clarify the difference between national election expenditure and local constituency election expenditure so as to avoid any potential ambiguity being exploited unfairly in elections?

[Baroness Chisholm of Owlpen]

IER certainly reduces the risk of all that, and it is why we have these very clear plans to clean up the electoral register. That is certainly supported by the international election watchdog, the election judges and the Association of Electoral Administrators.

General Election: Postal Voting Fraud

Debate between Baroness Chisholm of Owlpen and Lord Rennard

Thursday 4th June 2015 Lords Chamber

[Baroness Chisholm of Owlpen]

My Lords, I am not quite sure how that is about electoral fraud, which is what we are discussing today.

[Lord Rennard (LD)]

My Lords, given the widespread abuse of the postal voting system and the ease with which it was possible to cheat in the most recent Tower Hamlets mayoral election, will the Government accept the need to review our election laws to provide more safeguards for democratic principles? If so, what is the justification for the abolition of the Political and Constitutional Reform Select Committee, which examines such matters?

[Baroness Chisholm of Owlpen]

My Lords, the Tower Hamlets situation was dealt with in the courts, so I do not want to comment on that. I am sorry, but can the noble Lord just repeat the other part of the question?

[Lord Rennard]

I understand. If election law were to be revised, in the previous Parliament the Political and Constitutional Reform Select Committee in the other place would have looked at that revised law. However, the Government are now abolishing that Select Committee, which I believe cannot be justified. What is the justification for the abolition of that Select Committee?

[Baroness Chisholm of Owlpen]

My Lords, as is known, the Government do not get involved in Select Committees, so that is not a point for me to answer here.