Human Bodies: Commercial Exhibition
Debate between Baroness Finlay of Llandaff and Baroness Manzoor(5 years, 9 months ago)
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Baroness Manzoor
My Lords, I am always happy to meet noble Lords to discuss this issue. As the noble Lord knows, changes to primary legislation will be required to activate the change that he is seeking. To be clear, the Human Tissue Authority ensured that the Birmingham exhibition met licensing standards and licensed it in line with the law. We have no evidence to suggest that the exhibition contained the cadavers of political or other prisoners from China.
Baroness Finlay of Llandaff (CB)
My Lords, do the Government recognise that in a statement in 2004 Gunther von Hagens, who is behind the plastination of bodies, said that he could not prove that the bodies had not been executed? He has publicly stated that he received fresh bodies from which livers had been removed only a few hours previously, indicating that this may be the tip of the iceberg of organ harvesting from prisoners of conscience. This has resulted in a call from the medical fraternity for 400 papers to be withdrawn from the literature, because consent has probably not been given by those people who were deemed to be patients.
Baroness Manzoor
My Lords, as I have said, written consent is deemed to be necessary in the UK. It is different for other countries. There are allegations and concerns about organs being removed from people who are being held, for instance, in re-education camps in Xinjiang province, though we do not have evidence to corroborate this. We are working closely with the HTA to ensure that consent is sought in line with the countries concerned.
Healthcare (International Arrangements) Bill
Debate between Baroness Finlay of Llandaff and Baroness ManzoorTuesday 19th February 2019
(5 years, 10 months ago)
Lords ChamberRead Full debate Healthcare (European Economic Area and Switzerland Arrangements) Act 2019 View all Healthcare (European Economic Area and Switzerland Arrangements) Act 2019 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: HL Bill 155-II Second marshalled list for Committee (PDF) - (19 Feb 2019)
Baroness Manzoor (Con)
My Lords, in Amendment 15 the noble Baronesses, Lady Wheeler, Lady Brinton and Lady Finlay, and my noble friend Lord Dundee raise an important issue on the importance of financial reporting and facilitating parliamentary scrutiny, which I can assure noble Lords that the Government are committed to ensuring. As the noble Baroness, Lady Wheeler, said, this was also the subject of Labour Front-Bench amendments in the Commons and is an issue that the Government have carefully considered. I would like to reassure the noble Baroness, Lady Wheeler, and my noble friend Lord Dundee that—as the Minister, my noble friend Lady Blackwood, set out at Second Reading—the Government are committed to openness in managing public money. I understand the desire for transparency in this area. Noble Lords can be reassured that, as indicated by the noble Baroness, Lady Wheeler, there are existing robust annual reporting processes, overseen by the Comptroller and Auditor-General, that are used today and cover reciprocal health and other departmental spending.
Expenditure by the Department of Health and Social Care relating to EU reciprocal healthcare arrangements is currently published to Parliament in the form of annual resource accounts, and this will continue. This reporting allows for scrutiny by both Houses of Parliament, as well as the Public Accounts Committee. As now, the department’s future expenditure on reciprocal healthcare will be subject to the existing government reporting requirements. However, the Government have heard the need for greater transparency in our administration and implementation of reciprocal healthcare arrangements. The Government are also committed to transparency and the prudent use of public money. This is why we have committed to going beyond the current reporting requirements.
As explained by the Minister, my noble friend Lady Blackwood, at Second Reading, the Government have committed to issuing an annual ministerial Statement on the operation of the reciprocal healthcare arrangements. The noble Baroness, Lady Wheeler, asked what this ministerial Statement would include. I am afraid that I cannot comment on that, because it is subject to any arrangements we enter into with the countries concerned. The Statement will be published as soon as is practical at the end of each financial year. It will include, but will not be limited to, reporting on the expenditure and income of reciprocal arrangements as a whole. This could include aggregated expenditure and income for the year, as well as country-by-country sums of expenditure and income. It could also provide an overview of the operation of arrangements, identifying areas of successful operation. I hope that that allays the fears that the noble Baroness, Lady Finlay, expressed. The types of reciprocal agreement entered into will determine the content of the Statement, as I said. However, I am happy to meet the noble Baroness to discuss these details further.
I hope that the noble Baroness, Lady Wheeler, and my noble friend Lord Dundee feel reassured on our commitment to ensuring that there are sufficient and appropriate checks and balances in place on reciprocal healthcare agreements and agree that it is not necessary to set out in the Bill detailed provisions on reporting. In any case, as I said, the frequency and detailed content of a financial report should and could only be determined once reciprocal healthcare agreements have been made. Currently, the UK and other EU member states are able to collect data and report both nationally as well as at EU level, as provided for in the relevant EU regulations.
The department is currently working to ensure that UK nationals can continue to access healthcare in the EU in the same way as they do now, either through an agreement at EU level or through agreements with relevant member states. In either case, we will have to agree how eligibility is evidenced, the way that and frequency with which information is exchanged and the reimbursement mechanisms that will govern these new agreements. Each of these could differ from country to country. Such agreements will have to take into account the operational possibilities and limitations of each contracting party to ensure the smooth operation of reciprocal healthcare arrangements. This should include how NHS trusts in the UK can evidence eligibility for the treatment of non-UK citizens in the most efficient and least burdensome manner. Once these administrative details are known, the Government will be able to confidently speak to the specific measures that can be reported for each country. It is therefore unnecessary to set out detailed reporting provisions in the Bill for aspects that are subject to negotiations.
It must not be forgotten, however, that regardless of the specifics of any arrangements entered into, as with all departmental expenditure, reciprocal healthcare costs are and will continue to be authorised by the Treasury supply process and included in the department’s annual estimates, as well as being included in the annual resource accounts, which, as I said, are audited by the Comptroller and Auditor-General.
The noble Baroness, Lady Finlay, raised this issue, and it was raised earlier this evening. Let me be very clear that we do not need new front-line NHS processes to charge visitors and tourists from the EU, either directly or via reciprocal healthcare arrangements. We already have processes in place for non-EU visitors. After exit day, instead of identifying EU visitors for the purposes of EHIC claims, they will be identified for the purposes of whether they are chargeable directly or covered by a reciprocal healthcare arrangement, in the same way as non-EU visitors are currently identified. They will then be charged as appropriate.
I will end by saying this. As well as the auditing that will be done by the Auditor-General, as I have mentioned, the Government have committed to lay before the House an annual ministerial Statement, which will provide an additional check and balance on the Government’s reciprocal healthcare arrangements. I hope that I have a given sufficient assurances to noble Lords, and that the noble Baroness will feel able to withdraw the amendment.
Baroness Finlay of Llandaff
Can the noble Baroness confirm whether she is absolutely confident that the current systems in place to pick up those coming from abroad who should not be treated on the NHS and who should be charged for their care are 100% effective? How many of those systems are not effective? I am concerned that, with a potentially increased number of people coming into the system, any system that is already not functioning well will just fall over unless more people are put in to administer it.
Baroness Manzoor
My Lords, no one can ever be 100% confident, but we are putting in place robust charging mechanisms. Each trust has an accountable person to look at how charging is working. We are working very closely with NHS organisations to ensure that, where charging needs to take place, it is done effectively and efficiently.
NHS Staffing: Long-term Plan
Debate between Baroness Finlay of Llandaff and Baroness Manzoor
Baroness Manzoor
I thank my noble friend for that question. I am certainly aware of the Singapore model. I reassure him that we are expanding undergraduate medical education by funding an additional 1,500 medical school places in England. We have also recently announced the removal of doctors and nurses from the ambit of the cap on tier 2 visas, which means that all overseas doctors needed in the UK should be able to come and work here. We have more doctors than ever before, but there is no doubt that the pressures are huge. That is why we want to train more doctors. However, I understand the point that my noble friend makes, which is perhaps something we need to consider.
Baroness Finlay of Llandaff (CB)
Do the Government recognise the GMC’s statement that the medical profession is on the brink of breaking point, that up to a third of doctors report being burnt out and that around 10% at times have depression? There is evidence that errors are twice as likely to be made by people who feel burnt out. Do the Government recognise that this is urgent and whatever plans they have to train more people will take several years to come through the system?
Baroness Manzoor
I agree with the noble Baroness: we need to take care of our workforce and ensure that supportive mechanisms are in place so that there is greater flexible working. We are already looking at medical training and different modules. We want a first-class workforce and we will do everything in our power to support doctors so that they stay and remain healthy while they work in the NHS.
Sepsis: National Register
Debate between Baroness Finlay of Llandaff and Baroness Manzoor(5 years, 10 months ago)
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Baroness Manzoor
My Lords, that is a very good question. We are working very closely with clinicians to ensure that they have the tools to diagnose this very serious condition. We do not yet have good data on all the long-term effects of sepsis, but we have developed data analysis tools that look at all people admitted to hospital with infections, or sepsis, to see the impact of actions over a long time. Of course, we are training junior doctors and others to recognise sepsis in the early stages of the illness, as people are admitted to accident and emergency, and we have set up data collection for serious incidences of sepsis.
Baroness Finlay of Llandaff (CB)
Do the Government recognise that such a registry must go right across primary and secondary care, given that patients present at all parts of the pathway and 25% of survivors have long-term sequelae from sepsis? In that process, will the Government undertake to look at and learn from the 1000 Lives Improvement project in Wales and the HealthPathways project in Cardiff and the Vale, which have themselves learned from experience in New Zealand?
Baroness Manzoor
My Lords, the NHS takes this issue very seriously. NHS England and clinicians are working together very closely to make sure that we have good, clear datasets to enable us to diagnose this illness at a very early stage. Where good work is being done, we are looking at that very carefully.
Health: Chief Medical Officer’s Recommendations
Debate between Baroness Finlay of Llandaff and Baroness Manzoor
Baroness Manzoor
My noble friend is absolutely right: emerging technologies will transform healthcare and are doing so already. Variables can transform the prevention, diagnosis and management of long-term conditions such as diabetes. Indeed, information from monitors worn by patients with atrial fibrillation can be downloaded by their clinicians. We are also looking at more creative solutions regarding artificial intelligence, which will go a long way to improving the healthcare of patients.
Baroness Finlay of Llandaff (CB)
My Lords, given the target to halve childhood obesity in the areas of inequality, will the Government give urgent consideration to the recommendation that the soft drinks levy should be extended to sweetened milk-based drinks, and eliminate added sugar from commercial infant and baby foods?
Baroness Manzoor
My Lords, the Government have committed to review the soft drinks industry levy exemption for milk with added sugar in 2020, when we will have further information on the effectiveness of Public Health England’s voluntary reformulation programme. On baby food, product ranges that target babies and young children are now part of the Government’s reduction and reformulation programme.
Child Sexual Exploitation: Grooming Gangs
Debate between Baroness Finlay of Llandaff and Baroness Manzoor
Baroness Manzoor
I thank my noble friend for the question. We do not have sharia courts or an alternative legal system in the UK: UK law prevails in all circumstances.
Baroness Finlay of Llandaff (CB)
My Lords, do the Government recognise that separating children from a woman who has had the courage to come forward could act as a disincentive to other women to come forward? It is a major step. These children may, as they grow up, become vulnerable to abuse because they have not had security. We may need to rethink the way we manage support for families—with, for example, proxy support grandparents—to help the mother who has been traumatised bring up her children so that they are not as vulnerable as she was.
Baroness Manzoor
I entirely agree. This is an area that has been discussed on a number of occasions, both in this House and elsewhere. Protecting vulnerable children and those who see domestic violence or abuse is absolutely key to the Government’s strategy.
Health: Neural Tube Defects
Debate between Baroness Finlay of Llandaff and Baroness Manzoor(6 years, 3 months ago)
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Baroness Manzoor
The noble Lord is right that around 55% of pregnancies are unplanned. No other EU country has fortified flour with folic acid, but a range of other countries have. The noble Lord mentioned one, the USA, where there has been mandatory fortification since 1998, as he said. There was an immediate and stable 28% reduction in NTDs and no clear evidence of an increase in the prevalence of B12 deficiency.
Baroness Finlay of Llandaff (CB)
My Lords, neural tube defects occur in the first days to four or five weeks of pregnancy, often before the woman even realises that she is pregnant. The Government’s advice to women to take folic acid is not happening out in society. With the number of neural tube defects occurring, it has been estimated that the average lifetime cost to the NHS could be as high as £500,000. Even though some of these women go on to terminate their pregnancy, the emotional trauma to them of taking that decision is phenomenal and the emotional and physical difficulties in a family of coping with a defect that is completely preventable do not support the Government’s current policy.
Baroness Manzoor
My Lords, I fully understand the strength of feeling in the House about this important issue. The issue of the health of pregnant women and their unborn children is one that the Government take very seriously. I realise that noble Lords may have been hoping for a more definitive response from me today. All I can say is that the decision is with Ministers who are considering the issue very carefully.
NHS Workforce: Mental Health
Debate between Baroness Finlay of Llandaff and Baroness Manzoor
Baroness Finlay of Llandaff (CB)
My Lords, what discussions are the Government having with management and senior management at NHS England about front-line workers such as ambulance staff and those working in emergency and medicine? They are under extraordinary pressure, sometimes do not even have time for a cup of tea, and deal with major trauma after major trauma and large numbers of distressed people, yet sometimes feel that their own management will not back them up if something goes wrong.
Baroness Manzoor
There is significant pressure on front-line staff. The noble Baroness has not mentioned that there are also issues around harassment, bullying and violence. The Government are doing a significant amount through their frameworks to help and support these front-line staff. Certainly, NHS Improvement is looking to incentivise employers to do more.