Product Recall

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

Monday 23rd January 2017 Lords Chamber

[Lord Prior of Brampton]

Clearly, if we carry on selling products into the European Union—as we will—we will have to comply with the standards in the European Union, as we do in any other market in the world.

[Baroness Gardner of Parkes (Con)]

My Lords, I declare an interest in that my daughter has an interest in one of those flats that was burnt out in Shepherd’s Bush. She tells me that that could have been avoided by people just fitting a part—I think costing 10p—in front of the vent that was accumulating the dust. Suppliers of these white goods should be providing information about how essential it is to clean the filters.

[Lord Prior of Brampton]

My Lords, I bow to my noble friend’s expertise on the subject of laundry but there is no doubt that the instructions on these machines talk about cleaning the filters and removing the lint from the filters. That is clearly important. However, there is a problem in this particular machine that does require modification. There is no doubt that if everyone registered the product when they bought it, many of the recall problems that we are facing would be addressed. But only 47% of those who buy these tumble-dryers actually register the machine in the first place.

NHS: Community Pharmacies

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

Tuesday 6th December 2016 Lords Chamber

[Lord Prior of Brampton]

The pharmacy access scheme is being set up to deliver exactly what the noble Baroness is asking for—that rural pharmacies and those in very deprived areas will receive greater payments than others. I am not quite sure what report she is referring to. I will have to look at her question afterwards and write to her.

[Baroness Gardner of Parkes (Con)]

My Lords, are not people more willing to go to pharmacies for immediate help with dental conditions in particular because otherwise, they have to pay to have someone look at their mouth, and instead they can go in and ask for some sort of treatment if they have a pain? The pharmacist can diagnose at a very early stage any form of oral cancer—and indeed other conditions—which would otherwise not be noticed until perhaps too late.

Nurses: Training

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

Tuesday 22nd November 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, there were 3,500 more nurses working in the NHS in 2015 than there were in 2010. In retrospect, we did not anticipate in 2010 the Mid Staffordshire crisis and the Francis report, which led to a very substantial increase in nursing levels after about 2013. The noble Lord is right; we were short of nursing throughout that period. We are addressing that now with a 15% increase in nursing places and we expect that by 2020 there will be 40,000 more nurses than there were in 2015.

[Baroness Gardner of Parkes (Con)]

My Lords, is the Minister aware of the fact that the Blair Government introduced only one standard for nursing? You had to have five A-levels and take a university degree. The abolition of the state-enrolled nurses, who would have made—and did make—a marvellous contribution, has been very retrograde. Now we are dependent on a large number of foreign nurses. In every hospital that I have visited, we rely on them completely. Why can we not have that intermediate level of training back?

Cataract Operations

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

Wednesday 16th November 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, there is evidence of variation around the country, of that there is no doubt, although overall, the waiting times for cataract treatment are no longer than for other procedures. The RNIB has identified two issues of concern: second eye operations and follow-ups. We have asked NICE to bring forward further guidance in 2017 so that there is a proper evidence base for the threshold for cataract operations. As the noble Lord referred to in his Question, we are developing opticians in the high street to help do the follow-up consultations.

[Baroness Gardner of Parkes (Con)]

My Lords, I declare an interest: I am sure I am one of many in this House who has benefited from cataract operations—I went to the Western Eye Hospital, which is part of the Imperial College system in London. Is the Minister aware of the huge change in life for people who have cataract operations now? My father had to travel from Australia to Vienna in 1938—in fact he was there when Hitler marched in; he got out as quickly as he could after that, but with his eye bandaged it took a bit of time. But that was because one of the only people in the world who could do cataract operations at that time was this surgeon in Vienna. We really do not value what we are getting now, which is done so well.

[Lord Prior of Brampton]

The cataract operation is remarkable; it can literally give back people’s sight in the course of a 10-minute operation. I think I am right in saying to the noble Baroness that the first cataract operation was done in 1787.

NHS: Cancer Patients

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

Wednesday 9th November 2016 Lords Chamber

[Lord Prior of Brampton]

The new cancer dashboard has given us much more transparency around the country, so at least we now know where the problems are. The noble Lord is absolutely right that the critical area is early diagnosis, which is why one of the targets coming out of the new cancer strategy is that everyone should have a definite diagnosis within 28 days of an urgent referral. He is also absolutely right that one of the major constraining factors is workforce. We will be training an extra 200 non-medical endoscopists over the next couple of years, which should help considerably, but it remains an issue and Health Education England is due to report back in March 2017.

[Baroness Gardner of Parkes (Con)]

My Lords, can the Minister tell me whether we are now widely using the form of radiotherapy for cancer which is much less invasive? I think it is called IMRT and we have discussed it in this House before. Is it widely in use now in the National Health Service?

[Lord Prior of Brampton]

My noble friend is right; the use of IMRT has increased from around 10% to about 40% in the past year—so it is increasing greatly. There is much less collateral damage with IMRT. We have also, as my noble friend will know, commissioned two proton beam centres, at the Christie and UCLH, which will also make a difference. We have just announced a £130 million investment in new linear accelerator machines. Those three developments will, I think, greatly improve our ability to deliver world-class radiotherapy.

Children: Oral Health

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

Monday 31st October 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, the evidence for fluoride is incontrovertible: it is good for teeth. There may be other issues attached to fluoride, but in terms of dental health it is unquestionably a good thing. It is interesting to note that in Birmingham, which has been adding fluoride to its water for many years, the incidence of child tooth decay is 29% whereas in Blackburn it is 57% and in Hull, which is considering fluoridation, it is 37.8%. The evidence is very strong, but it is up to local authorities to decide.

[Baroness Gardner of Parkes (Con)]

My Lords, when I have asked Questions, as I have done repeatedly, mainly for Written Answer, about the difference in health between Birmingham and Manchester, with people in Manchester having the worst teeth in the whole of the UK—that was where the problem was with blocking hospital beds—the answer has always been that the only difference in health pattern is in teeth. I have had that point queried and asked what research the Government have done and whether they can really substantiate that fact. I am very much in favour of fluoridation, but I think that people are confused and want to be clear that there is no other health implication of fluoridation. I respect that view. What action will the Minister take to ensure that thorough, general health tests, as compared with the two arrangements referred to, are undertaken?

Medical Students

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

Wednesday 26th October 2016 Lords Chamber

[Lord Prior of Brampton]

That is a very big question, which is hard to answer. My personal view is that I do not think that the training we give to our young doctors in management, leadership and how to structure new models of care is sufficiently broad. You could argue that the curriculum at medical school is too narrow and should be broadened.

[Baroness Gardner of Parkes (Con)]

Can the Minister tell me how many overseas doctors, particularly Commonwealth doctors—if he has a figure for that—are working in our National Health Service? On a separate topic, what can be done to encourage people to go into some specialties that we are told do not attract doctors, which is why there are not sufficient numbers in them?

[Lord Prior of Brampton]

My Lords, overseas doctors account for about 25% of the total number of doctors employed by the NHS, which is a very high number. I do not have the breakdown for the Commonwealth countries but it is an interesting question; I will research it and write to my noble friend. She is absolutely right that there are shortages in particular specialties. General practice and psychiatry are probably the two areas where there is the biggest shortage. HEE is determined to increase the intake in those areas. Certainly, the number of doctors going into GP specialty training this year is just over 3,000. That is an increase on last year but is still not enough.

Health: Diabetes and Obesity

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

Thursday 30th June 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, it is still our intention to announce the obesity strategy soon. Clearly, there have been other events, which may create some delay, but we will announce the strategy as soon as possible. When we do, I am sure that there will be clear recommendations on diet that will include not just sugar but saturated fats and salt. Finally, as the noble Lord knows, I am arranging for him and the noble and learned Lord, Lord Morris, to meet people from the research community to discuss the outlook for research into diabetes, and I am sure that it will include any impact that Brexit might have.

[Baroness Gardner of Parkes (Con)]

My Lords, will specialist diabetic nurses be involved in this? They are enormously valuable to patients and provide a very practical way of getting direct help to patients instead of involving consultants on all occasions.

[Lord Prior of Brampton]

My noble friend is absolutely right that specialist diabetic nurses have a huge role to play in helping to identify and then manage and treat people with type 1 and type 2 diabetes. I am sure that that role will grow over time.

Learning Disabilities: Transforming Care

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

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

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

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

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

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

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

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

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

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

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

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

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

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

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

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

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

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

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

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.

Health: Global Health

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

Monday 26th October 2015 Lords Chamber

[Lord Prior of Brampton]

My Lords, I agree with all the sentiments that the noble Lord mentioned—and, perhaps, one other, which is that in a number of other pioneering areas, such as genomics, dementia and antimicrobial resistance, the UK is very much at the forefront. The Government are following up the “Health is global” strategy that was initiated back in 2008 and will be reporting back in detail in 2016. I assure the noble Lord that we will take fully into account the findings of the all-party parliamentary group.

[Baroness Gardner of Parkes (Con)]

My Lords, does the Minister think it would be wise for us still to be learning from other countries, instead of learning only globally? For example, we have an appalling record on pancreatic cancer compared with many other countries. Is it not time for us to improve those things, and then we will be better able again to help others?

[Lord Prior of Brampton]

I agree with the noble Baroness that there is always plenty that we can learn from other countries. She cited one example, and I am sure there are many others. There is never any room for complacency. Other parts of the world are also making huge advances. One of the findings of the all-party parliamentary group’s report is that we face increasing competition not just from countries such as America, but from South Korea and Singapore, for example. The noble Baroness is right: we must always learn from others.

NHS: Mental Health Patient Assessment Needs

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

Monday 12th October 2015 Lords Chamber

[Baroness Gardner of Parkes (Con)]

I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I declare an interest, as my grandson is a severe case of autistic Down’s syndrome.

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, we have not considered creating such a pathway. We would expect a patient’s mental and physical health needs to be taken into account when they access NHS services.

[Baroness Gardner of Parkes]

I thank the Minister for his formal Answer but I should go on to explain that my grandson, Christopher, now 23, has no speech and is unable to explain what is happening to him. He has changed from an apparently happy boy and a loving family member to a person suffering violent outbursts, in which he hits his head as if in pain or he attacks others. His increasingly erratic behaviour results in him being excluded from the health groups from which he has benefited so much in the past. Clinicians have already identified the need for a scan but this must be done under general anaesthetic. They are unable to access any NHS team able to do this as there is no clinical pathway, and in some cases patients known to these clinicians have had to wait up to two years. Why should any mentally disadvantaged child—as he was but he is now growing up—not be able to access a full and necessary examination within weeks rather than years?

[Lord Prior of Brampton]

It is obviously not possible for me to comment on an individual case but it sounds like a very tragic and a very difficult case. Of course, someone in that kind of position ought to have access to normal NHS facilities and care, and I am at a loss to know why my noble friend’s grandson has not been able to get proper access. The fact that a general anaesthetic is required, and has been said to be required by a clinician, should not make it any more difficult to access that kind of care. I am very happy to look at this as an individual case and, if it is not just an individual case but an example of a broader problem, I shall be very happy to meet my noble friend outside the Chamber to pursue the matter with her.

Health: Skin Cancer

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

Wednesday 22nd July 2015 Lords Chamber

[Lord Prior of Brampton]

Health Education England is aware that insufficient time is spent on dermatology issues in the training of junior doctors, and it is considering that very seriously.

[Baroness Gardner of Parkes (Con)]

My Lords, as someone who had skin cancer 40 years ago, I have a check-up every year. The services are excellent but the most important thing in the context of this Question is that we are now getting the early diagnosis. Does the Minister agree that the most important thing is to raise public awareness, as has been done in Australia, where malignant melanoma, it is believed, can pretty well be eliminated? The important thing is to raise public awareness so that the public go to their doctors and demand to be referred. That is how we will continue to catch more cases at a stage when they can be treated.

[Lord Prior of Brampton]

I agree with my noble friend. What is needed is a combination of public awareness and early diagnosis.

Police: Ambulance Support

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

Thursday 16th July 2015 Lords Chamber

[Baroness Gardner of Parkes (Con)]

My Lords, I am sitting next to a living example of the situation that we are discussing about the police helping. We are all delighted to welcome back my noble friend Lady Knight. She was found in her garden by her gardener, who was convinced that she was dead. He was terrified and immediately decided to call the police. Eventually she got to hospital by ambulance in enough time, but under those circumstances, when you call the emergency services, how much time does it take to decide who you are going to send—the police or an ambulance? Naturally, if she had been dead, the police would have been the most appropriate people.

[Lord Prior of Brampton]

I am sure that my noble friend will never die; she is clearly immortal. When you dial 999, the ambulance service has eight minutes to respond in such a serious matter as my noble friend has described. Then a fully equipped ambulance must arrive within 19 minutes. In the last two months, 75% of all such “A Red” calls have been met by the ambulance services.

National Institute for Health and Care Excellence

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

Monday 13th July 2015 Lords Chamber

[Lord Prior of Brampton]

I think it might be worth while for the House if I read out four lines from the NICE guidance on safe staffing:

“There is no single nursing staff-to-patient ratio that can be applied across the whole range of wards to safely meet patients’ nursing needs. Each ward has to determine its nursing staff requirements to ensure safe patient care. This guideline therefore makes recommendations about the factors that should be systematically assessed at ward level to determine the nursing staff establishment”.

I read out that paragraph because it is important to realise that every ward is different. Where there are tools to help assess the acuity of patients in wards, those tools will be used. I do not think we are planning to mandate any particular tool at this time.

[Baroness Gardner of Parkes (Con)]

Twice I have raised with the Minister the question of a different standard of training, particularly that of entrants to nurse training. We face this great shortage. He has replied to say that the Government have it in mind to introduce such a thing. Will he tell us more about what they are proposing and when?

[Lord Prior of Brampton]

I am sorry—I did not quite understand the question. I realise that I cannot ask my noble friend to repeat it, so I wonder whether I could pick it up with her outside the House.

General Practitioners

Debate between Baroness Gardner of Parkes and Lord Prior of Brampton

Monday 22nd June 2015 Lords Chamber

[Lord Prior of Brampton]

The right reverend Prelate is right. Many GPs are concerned about the level of bureaucracy in their practices. As he probably knows, we have reduced the number of QOF indicators by a third—that is, by 40—from a staggering 120. This is a big concern. NHS England is looking at other ways in which we can reduce the bureaucracy. If the right reverend Prelate’s daughter has any ideas, perhaps she will be kind enough to give me them.

[Baroness Gardner of Parkes (Con)]

What is the position as regards assistants in surgeries? This morning, we heard about the shortage of nurses that we are going to have. The abolition of the SEN position has been fatal, as a lot of the right people who wanted to enter nursing have not done so because they do not have the necessary academic qualifications. However, would not these SENs now be extremely valuable in taking some of the workload, particularly form filling, off GPs, who are burdened with huge amounts of paperwork?

[Lord Prior of Brampton]

My noble friend is quite right. We are looking carefully at introducing a new position of a qualified nurse who would not have to have the same academic qualifications as existing nurses. As she may know, we are also introducing a new position of physician associates, who will be able to take some of the burden off GPs.