Learning Disabilities: Transforming Care

Debate between Baroness Hollins and Lord Prior of Brampton

Thursday 9th June 2016 Lords Chamber

[Baroness Hollins (CB)]

My Lords, I beg leave to ask the Question standing in my name on the Order Paper and to draw attention to my interests in the register.

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

My Lords, the data show a small but sustained reduction in in-patient numbers over the last year. Some 2,565 patients were recorded in hospital at the end of April 2016, compared with 2,800 at the end of March 2015. Forty-eight local transforming care partnerships have mobilised to deliver the three-year service transformation detailed in Building the Right Support, which was published in October 2015, with a national ambition of closing 35% to 50% of in-patient capacity and building community-based support.

[Baroness Hollins]

My Lords, I thank the Minister for his reply. Does he agree that this programme will succeed only if robust community support helps people to live in their own homes and prevents new admissions? Is the Minister confident that enough money is being provided to local areas to develop and commission the right support and services, as outlined in the NHS England service model, in particular to develop a trained and supervised social care workforce, which is currently seriously underdeveloped?

Health: Alcohol

Debate between Baroness Hollins and Lord Prior of Brampton

Thursday 12th May 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, the new guidelines published by the CMO are very clear about how much alcohol should be drunk and the implications it has for health. I do not know whether the noble Lord has been on to the One You website or has downloaded the drink tracker app. The information is out there. A campaign is being conducted by Public Health England, and we are making some progress.

[Baroness Hollins (CB)]

My Lords, does the Minister agree that introducing the evidence-based minimum unit price for alcohol would send a strong message from the Government about their concerns about the health dangers of alcohol? I should draw the attention of the House to my interests shown in the register.

[Lord Prior of Brampton]

Public Health England is conducting an evidence review of the harm done by alcohol, and minimum unit pricing will be an aspect that is addressed. To express a personal view, if we are going to address alcohol consumption by increasing the price, is it best that the benefit of that should go to the drinks companies through charging higher prices, or is it better that it should go to the Government through taxation? That is a question that the House might want to ponder.

NHS: Mental Health Services

Debate between Baroness Hollins and Lord Prior of Brampton

Monday 14th March 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, I can give the noble Lord the assurance he wants. There are no plans to change the way in which funding for the training of psychotherapists is done at the moment.

[Baroness Hollins (CB)]

My Lords, given that people with learning disabilities and autism are at high risk of mental health problems, what specific support, and clarification of that support, will the Government commit to giving to address their needs?

[Lord Prior of Brampton]

My Lords, our strategy for this area was set out in Transforming Care, a paper produced by NHS England some six weeks ago. It shows that we are absolutely committed to treating more and more of these people outside institutional settings and back in the community.

National Health Service: In-Patients with Learning Disabilities

Debate between Baroness Hollins and Lord Prior of Brampton

Monday 18th January 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, this is a very important question. The fact that so many people with learning difficulties die much younger than people without them is of concern to everybody in this House. The review being conducted by Sir Bruce Keogh, to which the noble Lord referred, is a self-assessment tool. It is due to report quickly—by April—so is a short-term attempt to get the bottom of this. It is not a long-term effort, which would be much more comprehensive. We have two forms of looking at avoidable or excess deaths. One is the standardised system, which is a statistical basis for looking at the number of excess deaths. The other looks at avoidable deaths and is done by looking comprehensively at a wide sample of case reviews to give us a much more accurate picture of what is really happening.

[Baroness Hollins (CB)]

My Lords, as the noble Lord says, we know a great deal about why people with learning disabilities die sooner than they should. What has been missing so far is a mechanism for taking that learning forward into practice. Such feedback mechanisms, and the fact that their reviews are mandatory, are the strengths of the other confidential enquiries. Will the Minister explain why the new national learning disability mortality review has not been established on the same footing as, for example, the national child death review?

Sugar Tax

Debate between Baroness Hollins and Lord Prior of Brampton

Wednesday 13th January 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, I think the Prime Minister’s position is that he will want to think long and hard before imposing a tax that would fall by and large on those least able to afford it. On the other hand, the Prime Minister and the Secretary of State for Health recognise that obesity is a scourge in this country, affecting young people in particular, and will want to implement a comprehensive range of measures to tackle it.

[Baroness Hollins (CB)]

My Lords—

--- Later in debate ---

[Baroness Hollins]

My Lords, what assessment have Her Majesty’s Government made of evidence provided by the BMA—I should declare an interest here as chair of the BMA’s Board of Science—Public Health England and others on the anticipated positive impact of implementing a sugar tax? Does the Minister agree that we need a range of regulatory and educational measures to reduce the intake of added sugars, particularly among children and young people, but also adults with learning disabilities who are vulnerable to some of the same market pressures?

[Lord Prior of Brampton]

My Lords, the Government have taken into account a range of evidence from Public Health England, the McKinsey institute, the SACN and others in coming to their strategy. The noble Baroness is absolutely right that the response will need to take into account issues such as reformulation, portion size, availability and a whole range of other issues that affect sugar intake.

Down’s Syndrome: Do Not Resuscitate Orders

Debate between Baroness Hollins and Lord Prior of Brampton

Tuesday 15th December 2015 Lords Chamber

[Lord Prior of Brampton]

My Lords, the right reverend Prelate makes a number of very important points. This is a society issue as much as a medical issue. Before coming into the Chamber today I discussed with the noble Baroness, Lady Hollins, the importance of teaching students at medical school how to value people with learning difficulties, and the important role that people with learning disabilities might play by going to medical schools and directly telling medical students about their lives and concerns.

[Baroness Hollins (CB)]

The assumption that pregnant women who are expecting a baby with Down’s syndrome will abort that child affects public and medical attitudes. As one woman with Down’s syndrome put it when speaking at a conference on prenatal diagnosis, “You want to kill us”, which is a hard perspective for an adult with Down’s syndrome to hear. I am grateful to the Minister for picking up the point that medical nursing students need to learn from people with learning disabilities, so that their attitudes change. That familiarity with and being comfortable with people with learning disabilities will change things. Will the noble Lord commit to asking the General Medical Council, the Nursing and Midwifery Council and the Medical Schools Council to make this a priority and to teach not just knowledge and skills but practical attitudes to people with learning disabilities?

[Lord Prior of Brampton]

My Lords, the noble Baroness makes a profound point—that medical education and training is not just about passing exams and the technicalities of medicine but about attitudes and how you work and deal with people, particularly people such as those who suffer from learning difficulties. I will certainly do what I can to encourage medical schools and nursing schools to adopt the noble Baroness’s suggestion.

Alcohol

Debate between Baroness Hollins and Lord Prior of Brampton

Wednesday 9th December 2015 Lords Chamber

[Lord Prior of Brampton]

My Lords, we have asked the London School of Hygiene and Tropical Medicine to review the impact of the responsibility deal, which it will do later in 2016. There have been, however, some benefits from it on alcohol, to which the noble Lord referred particularly. The number of units not sold as a result of it is 1.3 billion and the package labelling on alcohol products has improved substantially.

[Baroness Hollins (CB)]

My Lords, does the Minister agree that it would be better named the “irresponsibility deal” and that it is time for effective policies to be introduced, including a minimum unit price; zero tolerance for drinking and driving; and clear and unequivocal advice for pregnant women not to drink?