Learning Disabilities: Transforming Care

Baroness Gardner of Parkes Excerpts

Thursday 9th June 2016 Lords Chamber

[Lord Prior of Brampton]

Yes, I am very happy to do that. There are some concerns about changes in social housing and rent caps, which might have the unintentional consequence of making it more difficult to build new houses that can accommodate these kinds of people. That is very much under review by the Government. We absolutely support what the noble Lord says.

[Baroness Gardner of Parkes (Con)]

My Lords, is the Minister aware that some of the establishments of the type just described by the noble Lord, Lord Pearson, are closing? The Camphill communities are an example of that. I was disturbed to see that, because we cannot afford to lose those facilities. Is he aware of that, and can anything be done to help?

[Lord Prior of Brampton]

I am not aware of the specific case of the Camphill communities, although I know about Camphill. Certainly, the preference is to have an environment where there are not too many people, with houses containing between, say, five, 10 or 15 people, rather than large organisations with sometimes many hundreds of people. I believe that Calderstones Hospital in the north-west, for example, has 223 in-patient beds. The intention is to close that and reprovide those facilities in the community. The key thing that we should always bear in mind is the best interests of the individual.

Dental Health: Children

Baroness Gardner of Parkes Excerpts

Tuesday 7th June 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, there is no doubt that fluoridisation is a critical part of good oral hygiene. This is up to local authorities. Public Health England will assist local authorities that wish to introduce fluoride into their water. I add that 3.5 million children in 2014-15 received a fluoride varnish. It is not the same as putting it in the water, but it is fully recognised that fluoride is a critical part of good oral hygiene.

[Baroness Gardner of Parkes (Con)]

My Lords, is the Minister aware that Manchester, which has had reports about hospitals being completely blocked by young children requiring full clearance under general anaesthetic, has no fluoride in the water? Australia has it pretty well everywhere, unless you live in the country, where there is only rainfall and a river. Birmingham, which has had it since the 1960s, has no difference with Manchester in its general health pattern except for the dental difference between the two. I have asked questions on this repeatedly and had Written Answers. Does he think that when Manchester has this new super-authority it might do something about this at last?

[Lord Prior of Brampton]

I agree with my noble friend. Fluoridisation has a huge and direct impact on oral hygiene. It will be up to Manchester to make that decision in due course. To pick up a point made by the noble Baroness, Lady Benjamin, social deprivation also plays a big part in the variation in the quality of people’s teeth. Interestingly, 75% of all children have no tooth decay now, but in some parts of the country—Blackburn, for example—the figure is as low as 40%.

NHS: Diabetes

Baroness Gardner of Parkes Excerpts

Thursday 26th May 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, there are clear NICE guidelines on the use of insulin pumps and blood glucose monitoring equipment. For type 1 diabetes, NICE does not recommend their use unless there is clear evidence that the patient will comply with such use at least 70% of the time. The advice from NICE is clear on the use of both.

[Baroness Gardner of Parkes (Con)]

My Lords, is the Minister aware of the very conflicting reports in the press at the moment about whether you should be eating more fat or less fat, or more sugar or less sugar? Does he not think it important for the Department of Health to bring forward some clear guidelines for people to avoid them having to go in for treatment? As regards treatment, will he acknowledge the very important part played by the specialist nurses?

[Lord Prior of Brampton]

Public Health England has clear guidelines, published under The Eatwell Guide, on what makes a healthy diet. However, I agree with my noble friend that the position is now quite confused following the report that was published earlier this week. Confusion is not something we want and I am sure that when we produce the obesity strategy later this summer, we will make it very clear what those guidelines should be.

Wheelchair Users

Baroness Gardner of Parkes Excerpts

Thursday 21st April 2016 Lords Chamber

[Lord Prior of Brampton]

The noble Lord is right: the variation in wheelchair standards around the country is wholly unacceptable. The truth is that we do not know the level of this variation because we have never collected the data before. The data are now collected and, of course, I can answer yes to his question. In fact, my honourable friend in the other place is making an announcement on 18 May, I think, about the support we are going to provide to local CCGs over wheelchair provision. I am sure that I can speak for him and say that he will be delighted to meet the wheelchair alliance.

[Baroness Gardner of Parkes (Con)]

My Lords, is the Minister aware of problems encountered with London buses? I declare an interest in that my daughter has used a wheelchair for many years, although just recently she has made a marvellous improvement after being given an electric impulse and has been able to walk for the first time for 30 years. Bus ramps have been broken by wheelchairs that are too heavy. She has done a lot of work to ensure that wheelchair manufacturers produce wheelchairs with a marked vehicle weight that will not damage buses. Therefore, there is a need for more uniformity in higher standards.

[Lord Prior of Brampton]

I totally agree with my noble friend that there is an absolute need for greater uniformity and standardisation. The level of variation around the country is wholly unacceptable.

Health: Neural Tube Defects

Baroness Gardner of Parkes Excerpts

Monday 21st March 2016 Lords Chamber

[Lord Prior of Brampton]

Fortifying bread with folic acid is not a silver bullet that would cure all babies with neural tube defects. The estimate is that it would have an impact on between 15% and 30% of babies. Some 965 babies suffer from neural tube defects a year, so we are talking about fortifying flour for the whole population in order to reach about 120 babies.

[Baroness Gardner of Parkes (Con)]

My Lords, is the Minister aware that we have debated this issue many times and that the view around the House has been almost unanimous that something should be done to deal with this problem? Why, therefore, is it not done? On a previous occasion, I clearly remember someone saying that if you do not want the supplement you can have bread that is specifically made without the additives. In that way, the ordinary population can be catered for. Of course, women need the supplements before they get pregnant, not afterwards, when it is already too late.

[Lord Prior of Brampton]

My Lords, speakers in this House have by and large very much supported the views of the noble Lord, Lord Rooker—I entirely accept that. But I do not think that the case has been made outside this House perhaps as strongly as it has in other areas. If we are going to change the way we produce white bread in this country, a much stronger and broader case has to be made.

National Health Service: Nurses

Baroness Gardner of Parkes Excerpts

Tuesday 26th January 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, I thank the noble Lord for wishing the scheme well. It is intended to increase the supply of young men and women going into the nursing profession, with which I think everyone in this House would agree. It is true at one level to say that people receiving loans rather than bursaries will have a debt of about £50,000 at the end, but the repayment of that is, as the noble Lord knows, graduated, and only 9% of the excess over £21,000 a year will be payable, not the full amount, as he suggests.

[Baroness Gardner of Parkes (Con)]

My Lords, I have previously raised the question of the abolition of the SENs, and the Minister has told me that thought is being given to training which will not require university entrance. Are the Government making any progress on that, as there are many wonderful nurses—I am sure that we have all known some—who could never have got enough academic points to come in at the university training level?

[Lord Prior of Brampton]

My Lords, I completely agree with my noble friend’s sentiments. She will be pleased to know that from August of this year, Health Education England will be funding 1,000 new nursing associates, who will not be taking a degree but will effectively do a nurse apprenticeship, although they will be able to switch over to doing a degree later in their career if they so choose.

Health: Hormone Pregnancy Tests

Baroness Gardner of Parkes Excerpts

Thursday 21st January 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, the noble Lord is clearly an expert in this field. If the advice is that pregnant women should not take any kind of drug during pregnancy, that must be the right advice. I agree with him that many of these documents go right back to the early 1950s and many are in German rather than English. The quantity of documentation is enormous. That is one reason why this review has taken so long. However, the people on the expert working group are very distinguished clinicians and are doing the best they can in very difficult circumstances.

[Baroness Gardner of Parkes (Con)]

My Lords, will the Minister confirm the reply he gave that no one will be asked to take any of these experimental things without being aware of doing so, because pregnancy is a time of great anxiety, particularly in view of the accidents that have happened in the past?

[Lord Prior of Brampton]

All I can do is entirely agree with what my noble friend says. That must be right.

Pregnancy: Neural Tube Defects

Baroness Gardner of Parkes Excerpts

Monday 21st December 2015 Lords Chamber

[Lord Prior of Brampton]

My Lords, as I said in my response to the noble Lord, Lord Rooker, this matter is being actively considered by the Minister for Public Health, and she expects to come to a decision very early in the new year.

[Baroness Gardner of Parkes (Con)]

My Lords, we have unanimous feeling here. I was going to quote the statement made on a previous occasion by the noble Lord opposite that, really, we in this House are pretty well unanimously in favour of this and cannot see anything wrong with it, and yet the action has not followed.

[Lord Prior of Brampton]

My Lords, when my noble friend says that this House is almost unanimously agreed she may well be right. However, the decision on this matter has to be taken in the other House. As I said, my honourable friend Jane Ellison, the Minister for Public Health, is going to come to a decision very quickly.

Accident and Emergency Departments

Baroness Gardner of Parkes Excerpts

Monday 30th November 2015 Lords Chamber

[Lord Prior of Brampton]

That is an interesting question. However, the report shows clearly that the main problem exists with the under-fives. Of course, there are issues at all ages, including falls and other aspects of accident prevention at the end of life. The interesting work that LifeForce has done in Birmingham shows that, for not very much money, we can have a big impact. Using the health visitors who are now employed by local authorities is a very important way in which we can address this important issue.

[Baroness Gardner of Parkes (Con)]

My Lords, while I strongly support the referral of accident cases, is the Minister aware of the report in today’s paper which says that all sorts of unnecessary referrals are made in response to telephone calls for advice on what are often simple things, such as the common cold? Does he not think that resolving that would be an alternative way to take some pressure off accident and emergency services?

[Lord Prior of Brampton]

My noble friend makes a very important point. Many people go to A&E departments who need not go there. The review of Sir Bruce Keogh, the medical director of NHS England, concerning how we structure emergency care in this country will be very important. Clearly, we can make much more of NHS 111.

NHS: Food Banks

Baroness Gardner of Parkes Excerpts

Thursday 26th November 2015 Lords Chamber

[Lord Prior of Brampton]

It is interesting that the previous Secretary of State for Energy and Climate Change, Ed Davey, said that there was no statistical link between the Government’s benefit reforms and the provision of food banks—so I am not sure that there is that link. It is also a paradox that we have this issue with food banks at a time when obesity is one of the biggest threats to the future. It is a strange situation around the world when we have both a problem of obesity and an issue of nutrition.

[Baroness Gardner of Parkes (Con)]

Will the Minister assure me that the decision in these matters will be up to hospitals themselves, as some hospitals have adequate space and are ideally situated for this purpose whereas others may not be? The Minister said that food banks already exist in some hospitals, which means that there is no bar from the Department of Health on having them. Food banks are doing very important work, but their locations should be assessed against where else would be more convenient. That point has been brought out in the debate. There are many aspects to consider, and it should be a free choice on the part of the hospital and the people who live in that area who may see that as the best place.

[Lord Prior of Brampton]

I thank my noble friend for that remark. It is entirely up to local organisations and local institutions, and those doing the work in Birmingham and Tameside are to be congratulated.