Mental Health Patients: Discharge

Baroness Manzoor Excerpts
Tuesday 5th March 2024

(3 weeks, 3 days ago)

Lords Chamber
Read Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

The noble Baroness is correct; the question is of the utmost importance. It is about putting more care into the community—that is why we have put £1 billion of extra spend into community support for mental health. Some 160 local mental health infrastructure schemes are being set up, with 19 in place already, and they are starting to work. The crisis cafés have resulted in an 8% decrease in admissions, while the telephone helpline has resulted in a 12% decrease.

Baroness Manzoor Portrait Baroness Manzoor (Con)
- Hansard - -

My Lords, my noble friend will be aware of the link between mental health and homelessness. He will also be aware that 50% and more of those who suffer from mental health illness have been homeless for over a year. What action are the Government taking to work with other government departments to ensure that this issue can be alleviated as soon as possible, and what help and mental health services are these homeless people entitled to?

Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

My noble friend is correct. In fact, 48% of the reasons for the delayed discharge of mental health patients is because of a lack of suitable housing. That is why we have introduced the specialist housing fund; we are working with Homes England and DHLUC so that supported housing runs alongside more support in the community from the extra mental health services.

NHS: Dementia Commission Report

Baroness Manzoor Excerpts
Thursday 22nd February 2024

(1 month ago)

Lords Chamber
Read Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Markham Portrait Lord Markham
- Hansard - - - Excerpts

I thank the noble Baroness for this Question. As ever, I have found that one of the real strengths of being in this position is that the questioning here makes me explore an area. This has been another area which I have enjoyed and found fascinating. Early detection is absolutely key, and what I have been learning from that is that, yes, we need to arm primary care staff and a potentially vital front line in terms of primary care staff are opticians, because retinal scans are a really good way to early diagnose. Apparently, people more than ever will have a frequent eye check. I have pulled together a panel to understand this more, and I invite the noble Baroness and others so that we can look at the latest research and really understand this more.

Baroness Manzoor Portrait Baroness Manzoor (Con)
- Hansard - -

My Lords, I welcome the additional sums of money that the Government are putting into this service, which is very important, but, as the Minister will be aware, and as he indicated in his response to the noble Baroness, Lady Wheeler, around 36% of those with this condition are undiagnosed, and that rises to around 50% in some authorities. The Minister will be aware that some exciting new drugs are coming on to the market that help to delay the onset of this terrible condition. What are the Government doing to raise awareness so that there is early diagnosis and those with the condition can access those services much sooner?

Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

My Lords, I thank my noble friend, who is absolutely right. This is where things such as the Barbara Windsor Dementia Mission have been successful in raising awareness, as she states. The challenge in all this, as I have learned, is that because it is such a slow-moving disease it is difficult to see how it progresses. Apparently, it has one of the lowest failure rates in terms of drugs because it is really hard to monitor the progress behind it. That is why work is being done, such as retina scans, where you can measure data objectively. There is real hope in all this, and it means that we need to make all primary care workers aware of the situation.

Care Home Staffing

Baroness Manzoor Excerpts
Thursday 18th January 2024

(2 months, 1 week ago)

Lords Chamber
Read Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

The Home Office has made an impact assessment of that. It thinks it will impact about 20,000 staff; we recruited about 100,000 last year. The main thing is that, by making sure that only CQC-registered bodies are able to recruit in this way, we are trying to make sure it is done in the correct, ethical manner by high-quality providers, which I think we would all agree is the right approach.

Baroness Manzoor Portrait Baroness Manzoor (Con)
- Hansard - -

I welcome the additional care staff that my noble friend mentioned, but there are some real pressures in rural areas where people cannot get carers to come and work. Can he say what is being done about that? Also, because he mentioned it previously, can he give an indication of whether there is a greater number of community hospitals that patients could be discharged into?

Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

I thank my noble friend for the question. The whole point of trying to develop the career structure that we talk about is to make sure that it is a career that people want to go into across the board, be it in urban or rural areas. Part of that is putting in place about 100,000 training places—this is the first place in the world that has been set up—to try to set up a real career structure. We are starting to see early signs of it working. The number of beds blocked has decreased by 10% in the last few months. It is early days, but it is beginning to work.

Health: RSV Immunisation

Baroness Manzoor Excerpts
Wednesday 17th January 2024

(2 months, 1 week ago)

Lords Chamber
Read Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

First, I thank the noble Baroness. She has been a tireless campaigner on this issue and very good—quite rightly—at holding our feet to the fire. The exciting news is that the new vaccines that are coming along for both mothers and infants, as well as the over-75s, are now cost effective; that was recognised in the JCVI’s analysis. As part of that, we have plans to fund the programme, as mentioned. I would rather not go into the details of the actual budgets, because they depend on the tender and I do not want to give that information out to the market—but I can reassure the noble Baroness that plans are in place.

Baroness Manzoor Portrait Baroness Manzoor (Con)
- Hansard - -

My Lords, RSV is a leading cause of infant mortality globally. Sadly, as my noble friend the Minister will know, 20 to 30 such deaths occur in the UK. I am pleased to hear about the progress that the Government are making to roll out the programme in the UK, but my noble friend will know that rolling out this programme will significantly reduce costs to the NHS by reducing GP visits, reducing attendance at A&E and reducing the 20,000 hospitalisations of infants aged under one year. Can my noble friend the Minister say, as we move towards autumn 2024 and the rollout of the vaccination programme, what the Government are doing to ensure that mothers and families know about the programme so that they can take up this vaccination when it is available?

Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

As I mentioned, the tender is in place with a view to rolling it out in the autumn. Whether we go for the maternal vaccination or the infant one will depend on the communication plan, but I can assure my noble friend that a communication plan will be part of this ground-breaking rollout. Only one other public health rollout like this has happened in the world—in Galicia, Spain—so I am proud to say that we will be top of the list.

NHS: Drug Shortages

Baroness Manzoor Excerpts
Wednesday 17th January 2024

(2 months, 1 week ago)

Lords Chamber
Read Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

I quizzed the team on exactly that Times newspaper report today, because like the noble Lord, they were saying that they did not recognise the numbers that the British Generic Manufacturers Association had produced. I wanted to understand why, and asked the team to sit down with them, and understand the differences, because one side or the other must be right. They are absolutely doing that, and will report back; I will be happy to update the House on the results of that.

Baroness Manzoor Portrait Baroness Manzoor (Con)
- Hansard - -

My Lords, the drug Ozempic has been described as a super-drug for the use of diabetic patients, in order to help them reduce weight. My noble friend the Minister will be aware that diabetes costs the NHS 10% of the budget—approximately £25,000 to £30,000 a minute—with 80% of that money spent on treating diabetic complications. Therefore, can my noble friend the Minister say why Ozempic can be prescribed privately but is not available easily to NHS patients as a result of demand and constraints in manufacturing? How can the Government address this?

Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

My noble friend is correct that this so-called off-label use of these diabetes drugs for weight-loss-type treatments is causing some of the shortages she mentions. That is exactly what we have been tackling, and we have been making sure that the only way you can get the Wegovy weight-loss drug is actually on a very tightly controlled weight management programme normally run through hospitals, and not through normal GPs, exactly to get on top of that issue.

Black and Minority Ethnic Babies: Mortality Rates

Baroness Manzoor Excerpts
Wednesday 15th November 2023

(4 months, 2 weeks ago)

Lords Chamber
Read Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

Yes. Obviously, we want to find every group and then understand the targeted action around them. Noble Lords will have often heard me say that one of the most effective bits of joined-up government I have ever seen was the Troubled Families initiative, led by the noble Baroness, Lady Casey, and I am interested in the 13 local authority pilots that are using wraparound services to identify community groups and troubled families in particular and provide them with cross-government help.

Baroness Manzoor Portrait Baroness Manzoor (Con)
- Hansard - -

My Lords, my noble friend will know that over the last four years the NHS workforce has grown by over 14%, but in the workforce for midwives there is a shortage of 2,500, according to the Royal College of Midwives. Can the Minister say what the Government are doing to ensure that we have sufficient midwives on the wards and, more particularly, a diverse workforce from ethnic minorities who will become midwives and health visitors? The numbers do not look great and of course this plugs in to the prevention strategy the Government have in place.

Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

Yes, it absolutely does fit into it. We have increased the number of maternity staff by about 14% since 2010, and the long-term workforce plan is all about making spaces for 1,000 extra students and having many routes into it. Noble Lords have often heard me talk about how my mother got into nursing as an older mum—she got into maternity services. There are apprenticeships and later-life opportunities. You should not only be a graduate; you often know much more about life when you are that bit older, especially if you are a mum.

Domestic Violence and Brain Injury

Baroness Manzoor Excerpts
Monday 23rd October 2023

(5 months, 1 week ago)

Lords Chamber
Read Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

Yes. The main thing is that £9.5 million is being invested into research on traumatic brain injury, but this is a platform to allow spin-off research from there. When speaking to people on this, I am clear that this is not a cap: if we get good research proposals put forward in areas such as the one the noble Lord mentioned, the money is there to pursue that.

Baroness Manzoor Portrait Baroness Manzoor (Con)
- Hansard - -

My Lords, it is good news that research is going to happen in this area. We all know that women suffer through domestic violence much more greatly. However, there is also research that shows that young girls in sports suffer more from concussion. Can we look at the preventative elements to ensure that girls are safe in sport, and by working closely with DCMS?

Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

The hope from this research is understanding all the different causes and some of the protocols. I know it is controversial sometimes, because, speaking as a centre half myself, heading the ball is a key part of the game. However, making sure that children under a certain age are not heading the ball a lot is one of the things that we should be looking at as prevention.

Nursing Courses: Reduction in Applications

Baroness Manzoor Excerpts
Tuesday 19th September 2023

(6 months, 1 week ago)

Lords Chamber
Read Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

We are delivering on a number of routes to recruit nurses. Obviously, the graduate route is one route, which, as mentioned, is above pre-pandemic levels; apprenticeships is another route, which is proving very successful; and associates is another route again. So there are many routes in, and the result is that our applications are 20% up on pre-pandemic levels. We set ourselves a target of recruiting 50,000 more nurses by the end of this Parliament and we are currently on 45,000, so we are going to hit it.

Baroness Manzoor Portrait Baroness Manzoor (Con)
- Hansard - -

My Lords, I welcome what my noble friend the Minister said regarding the number of nurses joining; nevertheless, the number of nurses leaving the NHS is higher than we would expect. Would my noble friend say exactly whether we are collating this information and understanding why those people are leaving, because they have a very valued skill?

Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

Yes, absolutely. Clearly, we want to recruit, but we also want to retain our workforce and again that is what the long-term workforce plan is all about—trying to look at a clear professional development path and other things we can help with, such as childcare support and the culture and leadership, and really make nursing a very successful and rewarding career structure. There is a lot to do on it, but I think there has been a lot of good progress as well.

Stroke Care

Baroness Manzoor Excerpts
Monday 24th July 2023

(8 months, 1 week ago)

Lords Chamber
Read Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

First, I thank the noble Baroness for the work that she does in this area; I know that it is very close to her heart. I have set up a meeting with the NHS COO David Sloman and with Sarah-Jane Marsh, and would be delighted if the noble Baroness would like to join me. The benefit of these sessions is always the shining of a light on areas.

It is vital that people are seen within the first hour; currently 59% of people are, which is an improvement on the last couple of years when the figure was 55%. However, we would all agree that we want that number to be as high as possible. The SQuIRe managers’ job is to make sure that all the different integrated care boards are delivering best practice in each area.

Baroness Manzoor Portrait Baroness Manzoor (Con)
- Hansard - -

My Lords, what role will NHS England play in first collecting information, monitoring it, evaluating it and disseminating it across the UK to ensure best practice, and how often does it undertake to do this?

Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

I thank my noble friend. The NHS delivery plan set out in January 2023 was trying to set out the best practice in this area. It is then the job of the SQuIRe managers to make sure that that is implemented in each area. One example is that they are trialling having videos in ambulances in certain areas so that paramedics can speak to stroke experts. We all know that getting patients to the right place quickly is vital, so I hope that that is another example of best practice that we can roll out.

MMR Vaccine

Baroness Manzoor Excerpts
Thursday 20th July 2023

(8 months, 1 week ago)

Lords Chamber
Read Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

Yes. This whole campaign is looking particularly at hard-to-reach communities. The concern is particularly in London. Whereas we have about 85% take-up across England as a whole, in London it is around 75%, so that is where the particular outreach is. That also involves looking at children who are not able to go to school or who are home-schooled.

Baroness Manzoor Portrait Baroness Manzoor (Con)
- Hansard - -

My Lords, I welcome the catch-up campaigns that the Government are running. They are very welcome. I particularly note the campaign in London. As the Minister will know, there is variation across the country. The WHO stipulates that 95% is the target reach, yet we are at 89%. So how are those hard-to-reach communities, particularly the ethnic-minority communities, being targeted? The uptake is slightly lower in those particular areas.

Lord Markham Portrait Lord Markham (Con)
- Hansard - - - Excerpts

There are two main approaches. If a child is under 11, we would prefer to have a parent present, for obvious reasons—because it involves a vaccination—so that is normally done through the primary care system, through nurses. Post 11, because you do not need the parent there, that is where schools really come into effect. In particular, there is a school-age assisted immunisation providers programme that goes into every school in a particular area, targets it and speaks to every child to see whether they have had their vaccination—and they can give it on the spot if they have not.