NHS: Neurology Care

Debate between Baroness Fraser of Craigmaddie and Lord Markham

Monday 26th February 2024 Lords Chamber

[Lord Markham (Con)]

I thank the noble Lord. I had the opportunity to join the Neurology Alliance forum today, which was quite timely. I think its approach is entirely right in looking at what we can do to help people get on with an active life and back into the workforce, understanding that the economic impact of that is key. We have set up the neuroscience transformation programme, which the Neurology Alliance is on board with, which we think will tackle many of the issues that the noble Lord mentions.

[Baroness Fraser of Craigmaddie (Con)]

My Lords, I declare an interest as chair of the Scottish Government’s advisory committee on neurological conditions and as chief executive of Cerebral Palsy Scotland. People with neurological conditions are faced with navigating a very complicated maze of services straddling primary care, secondary care and social care. Some conditions have well-defined pathways; many other conditions, such as cerebral palsy, do not. If the Government are not going to look at an overall neurological strategy such as the one that we have in Scotland, what practical steps will they take to help people with neurological conditions navigate these confusing services, so that they get the right support at the right time?

[Lord Markham (Con)]

My noble friend is correct. The important step towards this was our appointment of the first national clinical director of neurology over the last year. The task force put out a progressive neurological conditions toolkit which sets out the pathways exactly as my noble friend mentions. It shows the treatments for over 600 conditions. This is a complex area so it is vital that the pathways are understood in each area and patients can understand how to navigate them.

National Health Service: Major Conditions Strategy

Debate between Baroness Fraser of Craigmaddie and Lord Markham

Monday 18th September 2023 Lords Chamber

[Lord Markham (Con)]

Absolutely. The Government, and in particular my noble and learned friend Lord Bellamy on behalf of the whole MoJ team, fully support the noble Viscount’s remarks on the Powers of Attorney Bill and warmly thank him, Stephen Metcalfe MP and all the others for their efforts on the Bill.

[Baroness Fraser of Craigmaddie (Con)]

My Lords, I congratulate the Minister on concentrating on the importance of person-centred care, particularly for people with long-term conditions. I declare an interest as chief executive of Cerebral Palsy Scotland. Cerebral palsy is a good example of this, because we actually have very good NICE guidelines for the treatment of adults with CP but there seems to be nothing we can do to ensure that integrated care boards around the country follow those guidelines. Can the Minister explain why?

[Lord Markham (Con)]

My noble friend is absolutely correct, in that we are setting out the whole emphasis of what we are trying to do here. It is really ingrained in those pathways. It is about culture and behaviour as a whole, rather than a silo-based scheme, looking at the whole patient. Once we have got those pathways set up properly, it is Ministers’ job—I have mentioned before that we each look after six or seven ICBs—to hold them to account and make sure they are following those pathways.

Mental Health Services: Huntington’s Disease

Debate between Baroness Fraser of Craigmaddie and Lord Markham

Monday 12th June 2023 Lords Chamber

[Lord Markham (Con)]

The plan with the neuroscience transformation programme is to give that pathway to every ICS, which it should follow and commission to, to make sure that specific treatment is in place. It is a complex area, as we all know. Again, as I understand it, there are more than 7,000 rare conditions. I want to be open about the ability to put in place a specific individual care co-ordinator for every one of those, but we need to make sure that ICSs have enough skills in their locker—for want of a better word—so that they can recognise the situations and make sure they are commissioning to the plan.

[Baroness Fraser of Craigmaddie (Con)]

My Lords, I declare my interests as chair of the Scottish Government’s neurological advisory committee and a trustee of the Neurological Alliance of Scotland. This is an issue not just for people with Huntington’s disease but for people with other neurodegenerative conditions, such as Parkinson’s. NICE standards for people with Parkinson’s recommend the prescription of Clozapine for hallucinations or delusions, but only psychiatrists are enabled to prescribe it; therefore, people with Parkinson’s do not have access to this treatment because neurologists cannot prescribe it. Will the Minister look at this? Maybe this is one way to ensure that people get the treatment they need.

[Lord Markham (Con)]

Yes, I think is probably the best answer I can give in the circumstances. I will absolutely do that and will write to my noble friend.

Adult Social Care: Challenge Procedures

Debate between Baroness Fraser of Craigmaddie and Lord Markham

Wednesday 19th April 2023 Lords Chamber

[Lord Markham (Con)]

First, I take issue with the inadequacy comment. Some 89% of people expressed a high level of satisfaction with the social care provided, which, although not 100%, is pretty good, as I think everyone would agree. As I said, the workplace plan has been drafted. I am afraid I cannot give an exact date of publication—I believe there are local purdah issues now—but I can say that it will be soon.

[Baroness Fraser of Craigmaddie (Con)]

My Lords, one of the things this House has heard about many times is our reliance on unpaid carers and the important role they play in helping people who draw on adult social care to navigate the system. The 2014 Care Act put a duty on local authorities to identify unpaid carers, but that is not happening. What can the Government do to identify unpaid carers, so that we can support them more readily?

[Lord Markham (Con)]

I thank my noble friend for that question. The Government absolutely recognise the role that unpaid carers play—I have fulfilled such a role myself for a number of years—and it something we are working towards. We have introduced the leave provisions and a certain level of payments for them; that may be modest but it is a step in the right direction. Again, the whole idea of getting the CQC in this space is that it can start monitoring local authority provision and ensure that it is identifying unpaid carers, among other things.

Adult Social Care

Debate between Baroness Fraser of Craigmaddie and Lord Markham

Monday 20th February 2023 Lords Chamber

[Lord Markham (Con)]

Again, I would like to say that the big increases in funding—the 20% increase that we are talking about in two years’ time—are very much an acknowledgement that there is a demographic issue here, where more and more people are going to be coming into this situation. That is why we are putting those plans in place and working on the workforce; we are already seeing thousands of people being recruited every month to assist with capacity in the system. So we are putting in place the plans to address that.

[Baroness Fraser of Craigmaddie (Con)]

My Lords, one of the issues identified in the report of the Adult Social Care Committee, on which I had the privilege to serve with the noble Lord, Lord Laming, was the invisibility of unpaid carers. What are the Government doing to support services to identify unpaid carers, and what more targeted support can we give this vital population—more than just one week of carer’s leave?

[Lord Markham (Con)]

Again, as I said before, they are the backbone of the system; some of my personal experience attests to that. So I hope that what we were talking about will be seen as the start, rather than the end, of what we are trying to do. But we recognise that it is a decent start, because this issue has been out there for many years and we are starting to address it. Obviously, forums such as these make sure that it is something that more people are aware of. I accept at the same time that a week a year is a start in terms of a break; it is not the end of the situation.