Health Bill

Debate between Baroness Manzoor and Lord Patel

Committee stage
Tuesday 3rd November 2026 Lords Chamber

[Baroness Manzoor (Con)]

My Lords, I support the thrust of the amendments in this group, particularly Amendment 28 in the name of my noble friend Lady Shawcross-Wolfson. She has put her case forcefully and clearly, so I will not detain the Committee for long.

Poor long-term workforce planning creates significant challenges for NHS staff and patient care. Inadequate forecasting, insufficient investment in training and recruitment and poor staff retention contribute to persistent vacancies and skills shortages. This increases workforce loads, stress, burnout and sickness absence, resulting in low morale and higher staff turnover. The NHS becomes increasingly reliant on expensive agency workers and international recruitment, placing additional pressure on budgets. Consequently, services experience longer waiting times, reduced productivity, compromised continuity of care and potential risks to patient safety.

NHS England estimates an existing workforce shortfall of approximately 150,000 full-time equivalent staff, potentially rising to 260,000 to 360,000 by 2036-37 if there is no intervention. Effective long-term planning is therefore essential to develop a sustainable workforce, improve staff well-being, strengthen retention and ensure safe, high-quality patient care. I strongly urge the Minister to support this amendment. Ministers should be held accountable for the delivery of this workforce plan.

[Lord Patel (CB)]

My Lords, I strongly support the amendment in the name of the noble Baroness, Lady Shawcross-Wolfson, and I have added my name to it. She spoke so eloquently and made her case so strongly that I have put aside what I have written down because it would have been a repetition of what she had already said. I am going to take a slightly different tack but make the same point.

The noble Baroness quite rightly linked education, training and workforce planning. You have to know what workforce you might require for the health service you plan to have. I guess one can say that the Government’s 10-year health plan and the 10-year cancer care plan outline the kind of health service that the Government wish to see develop over the next 10 years. If that is the case, we need to address what kind of training and education and what kind of people we will need to deliver that plan.

I am guessing now that the reason why the 10-year workforce plan is delayed is because the premise on which it was to be formulated was that technology such as AI and digital technology would free a lot of clinical time, and hence the headcount need not be so high. That is a false assumption. It is false because we need to train people to use AI and digital technologies. The assessment is that, if you use these technologies, you might free about 40 minutes a day for front-line clinicians. With the pressure that the NHS now faces and the needs of the workforce it now faces, that time will be used to deliver better care to patients, particularly as the 10-year health plan identifies that technologies such as genomics and personalised medicine will be the way healthcare will go. There is an ambition by 2040 to have 50% of patients with some idea of their genomics, and the treatment is therefore based on that.

If you add all these together, and the Secretary of State now has responsibility for education, training and workforce planning, you ask the question: why is the workforce plan delayed? It is delayed because maybe the penny has dropped that, if you do not count the numbers and do not present a case about how technologies will reduce front-line clinical time, then you cannot plan the workforce.

Furthermore, I wonder whether the Bailie review of productivity in the NHS is based on the premise that greater productivity will be delivered in the NHS because of using technologies such as AI and digital technologies. We do not know that that will happen, but we have to wait until the Bailie review comes out. I wonder whether that is another reason—the Minister might comment on that—why the workforce plan is delayed.

It might be political pressures, it might be fiscal pressures or it might be the pressures from not knowing how to get the workforce numbers that we would require to deliver the 10-year plan and the cancer care plan that are holding up workforce planning. However, as the noble Baroness, Lady Shawcross-Wolfson, pointed out, if we do not have a plan, things will get worse. We will introduce technology, which will not be across the board, and we will then look for workforce that is not trained to deliver it. I hope the Minister will give us some answers about where we are going.

Amputees: Limb Fitting

Debate between Baroness Manzoor and Lord Patel

Thursday 2nd May 2019 Lords Chamber

[Baroness Manzoor]

I am very sorry to hear of the experience that the noble Baroness’s family has faced. Sepsis is an important issue, and we are dealing effectively with ensuring that we bring it under control. All amputations as a result of whatever issue are taken very seriously and we are offering the same kind of service so that we cut down the variations in the system. The current review will take into consideration all issues that patients have raised.

[Lord Patel (CB)]

My Lords, following on from the question asked by the noble Baroness, Lady Thornton, about the relationship between amputations and type 1 diabetes, the worrying aspect is the great variation in amputation rates across England. Does the Minister agree that areas that have high rates of amputation should be asked to look at how they can follow the guidelines issued by NICE to reduce the rates?

[Baroness Manzoor]

I agree that it is important that we reduce the variations and that NICE guidelines are followed. NHS England’s service specifications include a duty to reduce inequalities. They set out a number of issues to ensure that there is improved access, including flexible appointments, rehabilitation and reablement—but the noble Lord is quite right that we must address the variations.

Healthcare (International Arrangements) Bill

Debate between Baroness Manzoor and Lord Patel

Committee: 1st sitting (Hansard - continued): House of Lords
Tuesday 19th February 2019 Lords Chamber

[Baroness Manzoor (Con)]

My Lords, I thank the noble Lord, Lord Patel, for moving Amendment 11 and highlighting the importance of an appropriate definition of healthcare in the Bill.

We have adapted the definition set out in the Health and Social Care Act 2012 to include the additional element of ancillary care, as the noble Lord noted. This is to reflect where current arrangements provide for ancillary costs, such as travel costs, which do not strictly fall within the definition of healthcare. This would be for use in such circumstances as in France, where residents are reimbursed with a contribution to their travel costs when attending healthcare appointments. The definition of healthcare in Clause 3 ensures that we can implement arrangements that are based on the current EU arrangements, if negotiated in future.

The noble Lord indicated that this is a probing amendment and, as a former clinician, he will understand that limiting the definition to exclude certain conditions would be inappropriate, as it is not in the UK’s jurisdiction to determine what level of access to healthcare should be provided in another country. It is up to each country to determine what is available as part of its public healthcare system, as we do here in the NHS. The government definition would enable individuals to access healthcare on those terms under reciprocal healthcare agreements. The Government are committed to ensuring access to healthcare in line with current arrangements, and that UK nationals can continue to benefit from them, as they do now.

The Government have been clear during the passage of the Bill—this alights at the heart of the noble Lord’s question—that access to social care in England would not be provided through any reciprocal healthcare agreement. However, it is worth noting that some types of treatment related to dementia care can be medical in nature and may be provided by the NHS. As the noble Lord knows, in the UK, we treat all people with any physical or mental health condition. This demonstrates the complexity of the issues that narrowing the scope of such an important definition in the Bill may afford. I hope the noble Lord, Lord Patel, will therefore agree that the definition used in the Bill is the most sensible. However, I thank him—he is a noble friend—for raising this important issue. With the assurances I have given, I hope he will feel able to withdraw his amendment.

[Lord Patel]

My Lords, I thank the Minister for her comments. I raised this issue only to make sure that whenever such agreements are made, it is borne in mind that there may be implications for other conditions not directly regarded as mental or physical health conditions; for example, an increasing number of people have dementia. On that basis, I beg leave to withdraw the amendment.

Health: Medicines Shortage

Debate between Baroness Manzoor and Lord Patel

Tuesday 22nd January 2019 Lords Chamber

[Baroness Manzoor]

The Government are taking a number of steps. We have introduced the six-week stockpiling, which I have already mentioned. We are also looking at transportation issues and addressing whether there are shortages. We are working with supply chains and manufacturers to get an early indication of where these shortages may arise. I reassure the noble Lord that shortages of various drugs happen throughout the year. This is not a new phenomenon, and we are not clear that it is Brexit related.

[Lord Patel (CB)]

My Lords, I want to reinforce what the noble Lord, Lord O’Shaughnessy, said. In the past, we have experience in this country of wholesale providers of over-the-counter drugs hoarding medicines to demand higher prices later, and the NHS had to pay up. It is right that the NHS agrees to take powers if that is found to be the case, and I hope that the Minister will confirm that.

[Baroness Manzoor]

I can confirm that. We are talking about concessionary pricing as well. However, I restate that our primary concern is to ensure that patients continue to get their medication and that community pharmacies are reimbursed fairly for the products that they use. The answer is yes.

Breast Cancer: Women Over 73

Debate between Baroness Manzoor and Lord Patel

Tuesday 15th January 2019 Lords Chamber

[Baroness Manzoor]

My Lords, the noble Baroness makes a very interesting point but the NHS breast screening policy is based on strong peer-reviewed evidence. The decision to offer routine screening to women between the ages of 50 and 70 followed support from the Marmot review, which estimated that inviting women between the ages of 50 and 70 reduces mortality from breast cancer in the population invited by 20% and saves an estimated 1,300 lives a year. It also stated that evidence to support screening outside the 50 to 70 age group was not strong enough to allow older women to be invited for screening routinely.

[Lord Patel (CB)]

My Lords, does the Minister agree that although the evidence from the study leading to the introduction of screening between the ages of 50 and 73 was strong, the evidence for screening beyond 73 exists only in observational studies carried out in the United States and Australia? Would it therefore not be wise to ask NICE to conduct the same type of study it carried out before and assess the cost-benefit analysis, which includes the health benefits, relating to women over 73 who are offered regular mammography?

[Baroness Manzoor]

On the NICE review, NHS England has asked Sir Mike Richards to lead a review of the current cancer screening programmes and diagnostic capacity. He will make initial recommendations by Easter this year and the review should be finalised in the summer of 2019. The review aims to further improve the delivery of the screening programmes, increase uptake and learn lessons from the review and recent issues. I cannot say any more until the review has completed its work.

NHS Workforce: Mental Health

Debate between Baroness Manzoor and Lord Patel

Thursday 17th May 2018 Lords Chamber

[Baroness Manzoor]

That is an interesting question. As I have alluded to, NHS Improvement already has a programme to incentivise employers to ensure that they have good workplace strategies in place for well-being and mental health. It is looking to roll that out even further.

[Lord Patel (CB)]

My Lords, I am sure the Minister recognises that there is good evidence to show that an efficient occupational health service, run by any major organisation, that is confidential and provides good counselling reduces stress and mental ill-health in its workforce. Does she agree that such a service should be available in every major hospital trust?

[Baroness Manzoor]

Absolutely. Staff survey evidence shows that improving staff health and well-being leads to higher staff engagement, better staff retention and better patient care. I totally agree with the noble Lord.