Epilepsy: New Treatments
Debate between Baroness Jolly and Lord Walton of Detchant
Baroness Jolly
The noble Baroness asked quite a few questions. I think that parents will always want to look on the internet, now that that is a fairly safe area for advice. Clinical commissioning groups are responsible for planning the majority of epilepsy care, apart from the critical care, which is handled by NHS England. Two trials of cannabidiol are taking place in the UK and plenty in the States. I am sure that NICE will be keen to approve anything that is proved to be safe and effective as soon as possible.
Lord Walton of Detchant (CB)
My Lords, in the course of my career in neurology I have treated many patients with epilepsy at all ages and in all its variants. There is no doubt that there has been a remarkable transformation in the management of all the types of this condition as a result of research in our universities and in the pharmaceutical industry. Nevertheless, there are still some patients in whom seizures are intractable and do not respond effectively even to the most modern drugs. Quite apart from what the Neurological Alliance has said, is the Minister aware that the Association of British Neurologists has identified a striking unevenness in the quality and availability of specialised neurological care throughout the country? What are the Government doing to make certain that these facilities, which are so necessary in treating this condition, are more properly and evenly distributed?
Baroness Jolly
There are four such facilities in the UK: one in Bristol, Alder Hey in Liverpool, one in London and, I am sorry, I have forgotten offhand the fourth. The Government certainly are on to this and are sympathetic to the comments that the noble Lord has made.
General Practitioners: Hippocratic Oath
Debate between Baroness Jolly and Lord Walton of Detchant
Baroness Jolly
My Lords, the 2004 contract has been reviewed and renewed on an annual basis, and has proven to be a fairly robust document. The Government are not at the moment minded to change its basis. As for out-of-hours services—the nub of the Question—GPs can decide whether they opt out. Where they do opt out, the providers are inspected by the CQC and the local CCG.
Lord Walton of Detchant (CB)
My Lords, does the Minister accept that although there are several absolutely admirable principles embodied in the Hippocratic oath, its archaic language is totally inappropriate to the 21st century? For example, I do not believe that the noble Lords, Lord McColl and Lord Kakkar, would be prepared to swear that they would not cut for stone—and many doctors would be unwilling to honour their teacher as they do their parents. Is the Minister aware that the full original Hippocratic oath is fully reprinted in the Oxford Medical Companion, which I had the privilege to edit many years ago—and of which there is a copy in the Library?
Baroness Jolly
The noble Lord is absolutely right. I congratulate him on his editorship. I had to rely on Wikipedia.
NHS: Hospital Medication
Debate between Baroness Jolly and Lord Walton of Detchant
Baroness Jolly
The noble Baroness speaks from a position of much expertise as the chair of the APPG on Parkinson’s. It is really important that people with Parkinson’s disease get the medicines that they need when they need them, whether they are being cared for in their home, in a care home or in hospital. The NHS is working to improve services for people with Parkinson’s disease. This includes ensuring that staff are properly trained to support people with Parkinson’s and other neurological conditions.
Lord Walton of Detchant (CB)
My Lords, does the Minister agree that the management of drug therapy for patients with parkinsonism may require exceptional skills? It is not a matter of taking tablets two or three times a day. The dosage and its timing must be tailored specifically according to the needs of the individual patient. If the timing of a particular dose is unduly delayed, this may result in what is called the on/off phenomenon, with a sharp return of disabling symptoms. It is therefore crucial that this matter be taken on board. Does the Minister believe that this issue, highlighted by the Question tabled by the noble Baroness, Lady Gale, is being properly handled in the NHS at present?
Baroness Jolly
I can tell the noble Lord that NICE guidance suggests that people with Parkinson’s disease should have their medicines given at the appropriate time, not on the ward round with the trolley of regular medication. Where it is absolutely appropriate and possible, this may mean allowing self-medication.