Health: Cancer Nurses

Debate between Baroness Hayman and Lord O'Shaughnessy

Wednesday 2nd May 2018 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness is quite right that the Macmillan report highlights some challenges around vacancy rates and the age profile of cancer nurse specialists. It was explicitly set out in the cancer workforce strategy that it would have a phase 2 of planning once the census had been published. This census has been published, so there is an absolute commitment by Health Education England to work with Macmillan and the cancer alliances to bottom out how many more staff are required to meet the standard that we have set out—for every patient to see a cancer nurse specialist by 2021—and how many extra people we would need to recruit for that, and therefore to deliver the funding that would enable that to happen.

[Baroness Hayman (CB)]

My Lords, I declare my interest as a member of the General Medical Council. What assessment have the Government made of the effect on cancer services of the repeated refusal of visas to overseas doctors qualified to work here, and who have been recruited by the NHS to work here, but not being allowed to enter the country because of Home Office policies? Given the severe shortages of doctors across the board in the NHS, not just in A&E, is it not time that the cap on tier 2 visas for doctors was lifted?

[Lord O'Shaughnessy]

The noble Baroness will know that the NHS benefits from many of those visas issued under tier 2, which obviously has great benefits for our workforce. It is in the long-term interests of this country that we recruit more of our staff, wherever possible, from the domestic workforce. On that basis, Health Education England has committed to increase the number of cancer consultants by more than 20% between 2016 and 2021, as well as increasing the number of radiographers and others.

Dental Care

Debate between Baroness Hayman and Lord O'Shaughnessy

Thursday 1st February 2018 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness is right. About 59% of children have seen a dentist in the last two years, but of course that leaves 41% who have not. I have to say that that is an improving picture. On her two particular issues, there is NHS England’s Starting Well programme, which is targeted on 13 local authorities that have the worst oral health outcomes for children. The range is really quite dramatic from one area to the next. It has also developed a core offer to help every local authority commission better dental health for children.

[Baroness Hayman (CB)]

My Lords, is not the issue of fluoridation of water just like the issue of adding folic acid to fortified flour, about which even more overpoweringly conclusive evidence was published this week? The Government need to take a more robust attitude towards public health.

[Lord O'Shaughnessy]

I return to the point that I have made: I do not think there is any doubt about the evidence on the benefits of fluoridation, but it is important to do it in a way that brings local people with you. I should also point out that a big programme of fluoride varnishing is going on for children’s teeth as well, so we are getting fluoride into children in other ways too.

Maternal Safety Strategy

Debate between Baroness Hayman and Lord O'Shaughnessy

Tuesday 28th November 2017 Lords Chamber

[Lord O’Shaughnessy]

The whole point of these reforms is that lessons should be learned, and they can be. The Francis inquiry, and other investigations that have taken place into poor practice, have led to dramatic improvements. The fact that there are over 10,000 more nurses on wards was a direct response to the Mid Staffordshire crisis and the finding that there were not enough staff on wards to look after patients and make sure that they were not vulnerable. It is possible to be optimistic about this. We are already seeing improvements through the learning from deaths programme and from the reduction in the number of stillbirths. The noble Baroness is shaking her head but that is rather a gloomy view, which does not reflect the support for these proposals in this House.

In answer to the point about staffing, there are more midwives in the service and more coming through training. We need to make sure that that continues so that the level of support that is needed is there.

[Baroness Hayman (CB)]

My Lords, like others, I welcome the Statement and the determination to deal with this issue. The Minister will recall that a few weeks ago I asked him about coroners’ inquests on stillbirths and I will address myself to that. Does he agree that, for many parents, the depth of their bereavement at a stillbirth means that they feel the weight and authority of a coronial investigation is absolutely warranted? I therefore welcome the discussions that are to take place. Can the Minister tell me a little about the timing of that and about the legislative vehicle? I understand that primary legislation will be necessary and a Private Member’s Bill that refers to this is currently in the Commons.

[Lord O’Shaughnessy]

I am glad to be able to return to the topic, which the noble Baroness has raised before. There was a powerful story on “Today” this morning, about parents who wanted precisely that for the level of authority it would bring. The hospital was not necessarily treating them as well as it could. These independent investigations will provide a degree of authority and independence that is perhaps sometimes lacking. We want to see how this pans out, but the Secretary of State is committed to looking at coroners investigating stillbirths. This is obviously a complex issue, so I hope the noble Baroness will forgive me if I am not in a position to provide more detail at this point. However, there is a desire and willingness to look into this in the months ahead. When we have some more details, I will certainly write to her.

Medical Examiners and Death Certification

Debate between Baroness Hayman and Lord O'Shaughnessy

Wednesday 18th October 2017 Lords Chamber

[Lord O'Shaughnessy]

I think that the difference here is between handling mass deaths, which would obviously be an emergency situation—so we are talking about contingency and resilience planning—and looking at all deaths. About half a million people die each year. At the moment, only those who go through coroners receive that additional level of investigation, except in those pilot sites and early adopter areas that I mentioned. The new arrangements are about making sure that there is a system of verifying deaths from normal causes.

[Baroness Hayman (CB)]

My Lords, when considering these issues will the Minister look at the proposal made by bereaved parents and raised by the chief coroner in his report in 2016 that there should be coroners’ investigations of cases of stillbirth, so that the causes of stillbirths could be better understood and such tragedies could be averted in the future?

[Lord O'Shaughnessy]

The noble Baroness is quite right to highlight this point. Medical examiners are not involved in stillbirths, because the cause of death is before the point of birth. However, there is clearly a need for the involvement of coroners. I will look into the detail of that. I can tell the noble Baroness that the Government are taking the issue of stillbirths seriously. A new perinatal mortality review tool is looking at that and it is integrated into the learning from deaths scheme now going on in the NHS.

Gene Editing: Agriculture and Medicine

Debate between Baroness Hayman and Lord O'Shaughnessy

Monday 27th March 2017 Lords Chamber

[Lord O’Shaughnessy]

As we have discussed, there is huge potential regarding illnesses such as HIV. Clinical trials of gene therapies involving gene editing are still at an early stage, and are receiving support from the National Institute for Health Research. Any applications that go beyond the experimental and research stage would inevitably have to go through the Medicines and Healthcare products Regulatory Agency regarding safety and clinical potential. So the right system exists, investment is taking place at the early stage of research and before anything is done to any scale, it must be subject to the proper discussion and scrutiny.

[Baroness Hayman (CB)]

My Lords, as the Minister said, we have an enormously strong agriculture and genetic technology science base in this country. While this is not a magic bullet for food production, it could be a very important weapon in our armoury for meeting the world population’s future food needs. Given that, will he undertake that centres like the John Innes Centre in Norwich will continue to receive government support to develop genetic technology in agriculture, within a strong and ethical regulatory framework?

Nursing and Midwifery: Student Applications

Debate between Baroness Hayman and Lord O'Shaughnessy

Tuesday 7th February 2017 Lords Chamber

[Lord O'Shaughnessy]

The Government took the decision to change to a fee-based system precisely because a bursary-based system involves caps and only so many places can be commissioned. A fee-based system allows the cap to be removed, with the intention of increasing the places available by up to 10,000 people a year, which will increase the flow into the profession to address precisely the issue that the noble Lord raises.

[Baroness Hayman (CB)]

My Lords, can the Minister tell the House whether his department undertook a risk analysis of changing the basis of the funding for nursing education at a time when the age profile was as has been described, and when the security of the EU nurses on whom the NHS depends at the moment—and will do so for the continuing future—is so damaged by the uncertainty of their immigration status? If such risk analysis was not undertaken, might it be done now?

[Lord O'Shaughnessy]

As the noble Baroness will know, Health Education England is responsible for commissioning medical training places, and I am sure that all necessary impact and risk assessments would have been carried out at the time. As the noble Lord opposite recognised, I was not in post at that point, but I will certainly look at it. I would be surprised if that was not the case.