Domestic Abuse: General Practitioner Charges

Baroness Corston Excerpts

Thursday 15th November 2018 Lords Chamber

[Baroness Corston (Lab)]

My Lords, is the Minister aware that during the time of the Labour Government, our noble and learned friend Lady Scotland of Asthal, when she was a Home Office Minister, took legislation through the House that provided for independent domestic violence advisers in courts? Those positions were abolished by the coalition Government. Will he consider reinstating them?

[Lord O’Shaughnessy]

The noble Baroness will appreciate that this is not a matter for the Department of Health and Social Care, but it is something that I will be happy to look into. What I do know is that the draft domestic abuse Bill is looking to establish a domestic abuse commissioner. It may be that it is through that route that support of that kind may be made available.

Health: Contraceptive Services

Baroness Corston Excerpts

Thursday 11th October 2018 Lords Chamber

[Lord O’Shaughnessy]

I agree that there can be a negative impact. Indeed, one of the things that Public Health England has done recently is publish a consensus statement about sexual and reproductive health policy and actions, and it is updating its action plan. Nevertheless, it is important to point out that there were more attendances in clinics in 2017 than in 2013, which shows that it is possible to get appointments to be seen.

[Baroness Corston (Lab)]

My Lords, in how many areas are sexual health clinics now staffed by nurses rather than doctors because it saves money? I know of two. If he does not know the answer, will he write to me and put a copy of his answer in the Library?

[Lord O’Shaughnessy]

I am afraid that I do not have those figures with me, so I will certainly write to the noble Baroness and place a copy in the Library.

NHS: Staffing

Baroness Corston Excerpts

Wednesday 10th October 2018 Lords Chamber

[Lord O'Shaughnessy]

The immigration surcharge, which applies to all people coming to work here from outside the EU, is about making sure that there is a fair contribution to the running costs of the NHS. That is a reasonable thing to do—it is what the public would expect us to do—but it is important to ensure that it is done in a fair and reasonable way, which represents the average costs incurred by people coming from outside the EU.

[Baroness Corston (Lab)]

My Lords, the Minister said in response to one of my colleagues on these Benches that there were 12,000 more doctors now in the National Health Service. Can he tell us how many of them work part time?

[Lord O'Shaughnessy]

I gave the wrong number: there are actually 14,000 more doctors. I am sure that the noble Baroness would welcome that. I do not have the figures on part-time working but we know, for example, that in general practice there is increasing interest in part-time work. That of course means we need to recruit even more people, which is why it is encouraging that this year there are more GPs in training than ever before.

Health: Cancer Nurses

Baroness Corston Excerpts

Wednesday 2nd May 2018 Lords Chamber

[Lord O'Shaughnessy]

What comes to life in the cancer workforce strategy and the Macmillan report is the complexity of the workload that these nurses carry out, so a very high level of qualification is required. One thing we do not have at the moment is a national competency framework, which is being designed. Funding for nurses is obviously a topic that we come to often in this House and it is worth noting that the income point at which repayment of the loan starts has been increased by this Government, to make sure that lower-paid nurses and other staff are alleviated from that burden.

[Baroness Corston (Lab)]

My Lords, how many nurses from overseas have applied to work in the National Health Service and have been refused permission on the grounds of the arbitrary target set by the Prime Minister, as exemplified by the 100 Indian doctors who wish to work here and have fallen foul of this arbitrary rule?

[Lord O'Shaughnessy]

I do not believe that nurses would have fallen into that category as nursing is named as a shortage profession in the immigration system, but I would have to check those figures and I will write to the noble Baroness.

Junior Doctors: Contract

Baroness Corston Excerpts

Thursday 5th May 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, rather than getting ahead of myself and addressing that issue, I would just say that we have five days to talk and for the Government and the BMA to try to come to an agreement. All our efforts over the next five days should be focused on that.

[Baroness Corston (Lab)]

My Lords, during the five-day process, will the Minister guarantee to revisit the department’s own equality analysis of the effect of the contract, given that it has expressly accepted that the contract discriminates against women in terms of unsocial hours and caring responsibilities but makes the amazing suggestion that this is a legitimate means of achieving a purpose? That is not fair to a profession that is becoming feminised, about which we should be pleased.

[Lord Prior of Brampton]

My Lords, I think we recognise the huge and vital role that women play. Some 60% of all medical students qualifying now are women. If we do not take care of women, we are not taking care of over half our workforce. Again, I do not think anything is to be gained from my making statements on this in public at the moment.

NHS: Health and Social Care Act 2012

Baroness Corston Excerpts

Monday 16th March 2015 Lords Chamber

[Earl Howe]

My Lords, I should be more than happy, as I always am, to meet the noble Countess. I am sorry if there has been a delay in that respect. I would be happy to talk to her one to one on that matter.

[Baroness Corston (Lab)]

My Lords, does the Minister accept that one of the—I hope unintended—consequences of the Health and Social Care Act has been the disastrous effect on the recruitment of GPs, the number of people going into the GP profession and the number of people leaving the profession or who have said that they will be retiring early? It was described to me recently as an impending car crash.

[Earl Howe]

My Lords, I think we all recognise that general practice is under unprecedented pressure but I would not attribute that to the 2012 Act; I would attribute it to the unprecedented rise in demand from patients. The NHS across the piece is busier than ever before and naturally that has an effect on morale. We are, however, taking steps to promote recruitment into general practice and to reduce the day-to-day burdens that are imposed on general practitioners.

Women: Postnatal Depression

Baroness Corston Excerpts

Thursday 5th February 2015 Lords Chamber

[Earl Howe]

The noble Baroness is, of course, quite right. Again, midwives and health visitors involved in family nurse partnerships are trained to look at the welfare and well-being of all members of the family.

[Baroness Corston (Lab)]

My Lords, does the Minister agree that there is still a social stigma attached to postnatal depression? I have heard people say, “She’s got a new baby, what’s she complaining about?”. What steps are the Government taking to increase public understanding of the fact that this is a mental illness, unbidden, which affects women who would like to be able to bond with their babies and be proud of them like the rest of us are?

[Earl Howe]

The noble Baroness makes an extremely good point. I think that the stigma attached to mental illness is slowly diminishing, although there is a long way to go. But she is right that there are common misconceptions around the baby blues and postnatal depression. One of the most important things we can do is inform mothers-to-be of the risks and signs of those syndromes. If we can do that and prepare mothers for the possibility that they will experience this, we are more than half way there.

Mental Health: Funding

Baroness Corston Excerpts

Tuesday 18th March 2014 Lords Chamber

[Earl Howe]

I do not have a figure to quote to the noble Lord, but our aim, as he says, must be to support children and young people with mental health problems wherever possible in the community in which they live. Admission to hospital should be a last resort for a young person. We have done a great deal to improve mental health services for young people in the community. We also recognise the difficulties for young people and their families if they are treated in hospitals some way from home, but the decision about where they are treated is bound to depend on what is available and what facilities are needed to meet their particular clinical needs.

[Baroness Corston (Lab)]

My Lords, given that there should be parity of esteem not only between mental and physical health services but between people in the community and those in prison, and given that up to 70% of women in our prisons are mentally ill, what provision is now given under the Health and Social Care Act regime for the commissioning of those services for these women?

Health: Prescription Drugs

Baroness Corston Excerpts

Thursday 11th July 2013 Lords Chamber

[Earl Howe]

I do, of course, agree with the noble Lord. I am sure that we have to be realistic about the extent to which every GP can be fully informed about this area. I can only say that it has risen in prominence in recent years, not least thanks to the efforts of the noble Earl. There is growing concern that this particular cohort of patients has been poorly served in the past and that is why the extent to which these drugs are being prescribed has diminished significantly over recent years.

[Baroness Corston]

My Lords, will the Minister confirm that the Committee on Safety of Medicines and the Royal College of Psychiatrists said many years ago that benzodiazepines are unsuitable for long-term use and should be prescribed for periods of two to four weeks only? And will he revisit a Written Answer he gave me recently saying that there was no connection between benzodiazepine addiction and suicide, when there is 30 years of eminent research to show that that is indeed the case? I declare an interest as the patron of Battle Against Tranquillisers, the foremost charity campaigning in this area, whose mission statement is:

“To lessen the harm caused by benzodiazepine and z drug tranquilizers and sleeping pills”.

[Earl Howe]

My Lords, of course I will revisit that Answer, and I will come back to the noble Baroness if I find cause to correct what I have said. However, I agree with her that the risks associated with long-term use of tranquillisers have been well recognised for many years. There are several authoritative sources for guidance for prescribers on this issue. I believe that that guidance is having an effect because, as I said, the prescribing rate has considerably diminished of late. There is no shortage of guidance out there. There is the national formulary, which already describes the importance of gradual withdrawal from benzodiazepines, and there is a wide variety of other impartial and trustworthy information resources to support prescribing.

Homeopathy

Baroness Corston Excerpts

Tuesday 19th March 2013 Lords Chamber

[Earl Howe]

My noble friend makes an important point. We are clear in recommending that patients should talk to their GPs before stopping any treatment that has been prescribed by a doctor in favour of homeopathy and before they start taking homeopathic remedies. It is important that people understand that homeopathy may not be effective in many situations.

[Baroness Corston]

My Lords, given that many GPs ask for training in homeopathy and become homeopaths using both conventional and homeopathic medicine, and speaking as someone who personally uses homeopathic remedies, will the Minister ensure that the views of people such as the noble Lord, Lord Taverne, with which we are all familiar, are not given such credence within the National Health Service that those who wish to use homeopathic remedies do not have that choice?

[Earl Howe]

My Lords, I take the noble Baroness’s point. Again, we have consistently said, in this and in other areas, that clinical responsibility for an individual’s health condition rests with their GP, who must therefore be able to justify clinically any treatment to which he or she refers someone. As she said, there are GPs who have a speciality in homeopathy. We recommend that a patient who is interested in homeopathic treatment should go to such a GP.