Midwives: Bullying
Debate between Baroness Cumberlege and Lord Markham(7 months, 1 week ago)
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Lord Markham (Con)
I will come back to the noble Lord with the exact number, but he is correct: the long-term workforce plan is all about making sure that we have the right resources and infrastructure to train the required number of people. Behind that, we have funded an extra 150 spaces this year and we have a target to increase them by 1,000 by 2026. It is absolutely as the noble Lord maintains: we are putting training in place domestically, as well.
Baroness Cumberlege (Con)
My Lords, does my noble friend share my view about the evidence that, when midwives and other clinical staff understand the importance of continuity, it leads to safer care and better outcomes for both the mother and the baby? One of the midwives quoted in chapter 2 of the report that was sent to us—I thank my noble friend for that—says that working in a continuity team was the best, most rewarding time in their career. Continuity is absolutely critical; it comes up in a number of reports, some of which I have had a part in writing. We know that you need continuity if you are going to make a real impression on the midwifery service and that the women who are party to it must really understand what continuity does and can achieve.
Lord Markham (Con)
I thank my noble friend, who has been a tireless campaigner on continuity of care. I challenged the chief midwife on this just this morning, and the objective behind the long-term workforce plan is to make sure that we have the resources in place to maintain that, starting with ethnic minorities. We all know that there is a disparity of outcomes in terms of inequality, so the first priority for continuity of care is that setting, but the objective is to spread that across the whole system.
Sodium Valproate and Pelvic Mesh
Debate between Baroness Cumberlege and Lord Markham(8 months ago)
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Baroness Cumberlege
To ask His Majesty’s Government what are the timescales for, and what progress has been made on, a response to the Patient Safety Commissioner’s report on options for redress for those harmed by sodium valproate and pelvic mesh, published on 7 February.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)
The Government commissioned the Patient Safety Commissioner to produce a report on redress for those affected by sodium valproate and pelvic mesh. We are grateful to the commissioner and her team for completing this report and our sympathies remain with those affected by sodium valproate and pelvic mesh. The Government are now carefully considering the PSC’s recommendations and will respond substantively, hopefully in the coming months.
Baroness Cumberlege (Con)
My Lords, I thank my noble friend for that reassuring reply. However, as it has been five months since the Government received the advice from the Patient Safety Commissioner in October 2023, how much more time do patients and families need to wait for the redress that they so desperately need?
Lord Markham (Con)
My Lords, I thank my noble friend for her tireless work in this area. It is something which, in the Chancellor’s very own words—because it was the Chancellor who, as Health Secretary, first commissioned the report—remains a top priority to both him and the Government. That remains the case. I spoke to Minister Caulfield about it just this morning, and it is a complicated area, but it is something that we are very keen to redress in the next few months.
Sexually Transmitted Infections
Debate between Baroness Cumberlege and Lord Markham(11 months, 3 weeks ago)
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Lord Markham (Con)
I will need to come back with the exact figure for the vaccination rate. I know that it is proving quite effective, which is important. On the measures we are taking, we are investing £25 million in women’s health hubs precisely to enable these sorts of vaccination programmes. I will happily follow up in writing with the detail.
Baroness Cumberlege (Con)
My Lords, does my noble friend the Minister agree that, in this technological age, it is very important that people are able to access everything they need from the NHS via their phone or a laptop? I am working to ensure that all women have access to their maternity record via the NHS app, but only 23% of sexual health clinics currently allow online booking. Can my noble friend tell me how the Government plan to address this issue?
Lord Markham (Con)
I thank my noble friend. As she knows, I am a big advocate of everything that we can do with the app. We are absolutely looking to extend its services, which will include sexual health clinics. In the past year alone, we have increased from around 10% of GPs allowing someone to see their records to around 70% today. Sexual health clinics are clearly an area that we need to look at next.
Sodium Valproate
Debate between Baroness Cumberlege and Lord Markham(1 year, 5 months ago)
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Baroness Cumberlege
To ask His Majesty’s Government what further steps they are taking to protect patients and families from the harmful effects of sodium valproate taken during pregnancy, and what is their timetable for doing so.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)
Our aim is to reduce and finally eliminate the harms of valproate in pregnancy. In December, we announced additional measures to protect women and families through a requirement for two prescribers, further warnings in the valproate product information, and improved educational materials. No woman of childbearing potential should receive valproate unless no other treatment is effective or tolerated. Implementation plans are now being finalised, with engagement with healthcare and patient organisations.
Baroness Cumberlege (Con)
My Lords, I thank my noble friend for that Answer. It goes some way, I think, to reassure many of us who have been very concerned about sodium valproate being given to pregnant women, and the result that that has had. I am seeking to ensure that, with the plain boxes which contain sodium valproate, those tablets are not actually opened without a clear warning, so that people know exactly what is contained in those boxes and the harmful effects it could have on their babies. Can the Minister tell me what is actually happening to those plain boxes, because sodium valproate should not be prescribed without a really clear warning about what it could do to babies and women?
Lord Markham (Con)
First, I thank my noble friend for all the vital work that she has done in this space. She is absolutely correct. The key thing is that there are circumstances where sodium valproate is the only effective treatment for bipolar and epilepsy-type disease problems. However, we have to ensure that if people are taking it, they are going into it with their eyes completely open, so that they fully understand the risks. That is absolutely to do with the packaging. It is also about making sure that if that packaging is split up there are leaflets in every part, and that everyone signs a consent form at least once a year, fully acknowledging the risks. Thereby, if people take the treatment, they are doing so with their eyes fully open.
Life Expectancy: Pensions, Health and Insurance
Debate between Baroness Cumberlege and Lord Markham(1 year, 7 months ago)
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Lord Markham (Con)
As noble Lords are aware, we have been putting significant investment into mental health; from memory, there has been a £2 billion-plus increase over the last year. In recognition that learning disability is an issue we particularly need to tackle, as the noble Baroness is aware, we are putting investment into schools so they can identify it early on. Some 35% of schools now have the right educational leads in this space, and the figure will rise to 50% next year. It is a big improvement, but do we need to do more? Absolutely.
Baroness Cumberlege (Con)
My Lords, my noble friend will be aware that for many years, the UK has enjoyed increases in life expectancy but now we are getting reports that the rate of increase is declining. What plans—I have given my noble friend notice of this question—do the Government have to reverse this trend?
Lord Markham (Con)
My noble friend, whom I thank for that question, has characterised this issue in exactly the right way. Life expectancy is still increasing, but not at the rate it was. That is why the major conditions strategy was launched. I can give one example: cancer is one of the six major killers, and we are seeing 20% more cancer patients this year than we were pre-pandemic. So there are improvements in this space, and that is what the major conditions strategy is all about; but clearly, the record investment we are putting in needs to show that sort of output.
Maternity and Neonatal Services
Debate between Baroness Cumberlege and Lord Markham(2 years ago)
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Baroness Cumberlege (Con)
My Lords, I beg leave to ask the Question standing in my name on the Order Paper and, in so doing, I declare that I am remunerated for chairing the independent maternity review.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)
I am grateful to Dr Kirkup for this report. Our intention is to review the recommendations alongside existing work to improve maternity outcomes, including the recommendations from Donna Ockenden’s final report. With NHS England, we have established an independent working group chaired by the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists that we will use to support our considerations.
Baroness Cumberlege (Con)
My Lords, I thank my noble friend for that reply. Does he agree that as this has been a series of maternity tragedies across England, we must do all we can to prevent further disasters? Will he, with NHS England, introduce a maternity signalling system that identifies units providing poor care before they cause widespread harm?
Lord Markham (Con)
I thank my noble friend. I agree. This was captured in recommendation 1 by Dr Kirkup about having early warning indicators in place. That is what we have set up in the maternity quality surveillance framework, which has the oversight in this area and can escalate concerns and effectively report to the national maternity safety surveillance and concerns group, which can then put the trust into special measures.
East Kent Maternity Services: Independent Investigation
Debate between Baroness Cumberlege and Lord Markham(2 years, 1 month ago)
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Lord Markham (Con)
The noble Baroness is right to say that it is clear that we have not got it right to date, as shown by the fact that these instances have come up. We are taking the right steps with the Maternity Safety Support Programme that we have put in place, and its ability to put trusts into special measures—as I say, that has already been done on 23 occasions and it is being considered for another 10. I believe we have got those early warning indicators in place now, and trusts are being held to account. At the same time, we have to be open, to make sure that we continue to look at and review this, to see whether it has sufficient teeth and, dare I say, intelligence to properly identify these areas. If it does not manage to do that, we must make sure we put in something else, in addition to what is there already.
Baroness Cumberlege (Con)
My Lords, I have had a very long interest in maternity services, and it seemed to me, on this occasion, that I could make a few comments. This report is truly remarkable. It is investigating the tragedies and failures, the lack of care, the divisive attitudes among professionals, and the lack of teamwork and much else. The report is really here partly due to the pressure of patients and the public, who wanted to bring to the attention of the Government the failures in East Kent.
I thank my noble friend for his report. The recommendations are different from the usual recommendations, in that they go much wider than just East Kent; they go across the country as a whole, and they are very important. On reading that report, has he any ideas about how to stimulate the doctors, nurses, midwives, obstetricians, managers and leaders not only in East Kent but across the country to take note of what it is saying? It very much affects not just them but parents, families, friends and childbearing women, and it is important that they have optimal care that is kinder, compassionate, more personal and safer. What action are the Government going to take, working with NHS England, because there are a lot of partners in this area of maternity? Will he ensure that the recommendations are not ignored—that they are not just put on a shelf and forgotten—and will he come back to Parliament within, say, four to six months to explain what progress has been made in implementing them in the four areas cited for action? I would very much welcome that, because I want to see this report implemented and not just put on another shelf.
Lord Markham (Con)
I thank my noble friend for her question; I know this is an area in which she has longstanding interest and expertise. She refers to embedding compassionate care and, perhaps like all of us, I am surprised to learn that, unfortunately, we may need training in this area; but I agree that it needs to be done because it is fundamental. A culture and leadership programme has been put in place, and we have set up national guardians, the idea being that everyone in every trust has the freedom to speak up. There are 800 of them as of today. I take this issue seriously and I commit—if I am here—to come back within four to six months to report to the House on the progress made, as requested.