Health: Chief Medical Officer’s Recommendations

Debate between Baroness Manzoor and Lord Turnberg

Monday 21st January 2019 Lords Chamber

[Baroness Manzoor]

My Lords, the Government take prevention very seriously. As the noble Baroness will be aware, the 2015 spending review made £16 billion of funding available for local authorities in England over a five-year period. That is in addition to what the NHS spends on prevention, including more than £1 billion in 2016-17 on our world-leading immunisation, vaccination and screening programmes. Of course, we also need to tackle wider detriments, which is why public health has been handed over to local authorities to look at wider determinates of ill health, including pollution, poor housing and the environment.

[Lord Turnberg (Lab)]

My Lords, how can it be acceptable that today the poor end of our society is deprived of eight years of life compared with the most affluent end of society? Is it not time that the Government took a firm grip on local authority budgets for public health? I know that the Minister has talked about this issue but at the moment, people are still being deprived.

[Baroness Manzoor]

My Lords, of course it is not right that there are health inequalities between people who are poor and those who are not. The Government are endeavouring to do everything they can to reduce those inequalities. I have talked about the obesity plan; we are also looking at diet, information and working with local authorities to improve the wider detriments of ill health. We have a world-leading strategy on obesity and salt intake. In this House we have discussed issues such as fluoride and folic acid, on which the Government continue to work.

NHS Long-term Plan

Debate between Baroness Manzoor and Lord Turnberg

Monday 7th January 2019 Lords Chamber

[Baroness Manzoor]

I thank my noble friend; as he says, there is a challenge. For the record, since everyone around the House, quite rightly, has praised my noble friend Lord O’Shaughnessy, I am not his replacement; I am standing in for him.

It is an interesting question; we know that publishing this document alone will not translate all the plans and objectives into reality. As I have already said, that is why we have asked the NHS to develop a clear implementation framework by April, to set out the commitments that should be delivered by local systems to ensure that there is transparency for patients and the public. This is not something that has come out of the ether from nowhere; we are building on success. It is not a radically different plan; we are picking out the best of what we need to achieve. The plan builds on what has been achieved in recent years and the learning from previous reform programmes. It has already benefited from widespread engagement during its development, working with organisations that represent over 3.5 million people to ensure that its vision and aims are the right ones.

[Lord Turnberg (Lab)]

My Lords, I bow to no one in my admiration of the NHS, having worked in it for many years—and of course I have, with the merry band of admirers, strong admiration for the noble Lord, Lord O’Shaughnessy. The document is extremely strong on aspiration and it identifies many of the problems but, as always, the big problem is implementation: how it is carried out, and whether we will achieve it. As always, implementation is dependent on the workforce.

I was going to ask about what we are doing in public health but that has been asked already, so I will ask about general practice. The Government have made many valiant attempts to improve general practice, but the fact is that general practitioners are unhappy, dissatisfied and under a lot of stress. Many are retiring early; many are not able to get recruits into their practices to succeed those who are leaving. Can the Minister explain what is happening to a friend of mine, who is a general practitioner and tearing her hair out because she cannot get a successor to a partner who has left? She is increasing her workload and is on so many committees that she can hardly spare the time to go to her clinical practice. General practice is in a sorry state. If we cannot improve it, none of this can happen.

[Baroness Manzoor]

The noble Lord is absolutely right that implementation is key. We can have great aspirations, but we must have a proper plan in place to ensure that we can deliver. The implementation plan that I have spoken about previously will flesh this out in much greater detail so that we can look at what the IT systems will be, what the genomics will be, what clinical issues we want to tackle and what performance areas we want to highlight. On primary care, I have already indicated the amount of money that we are putting in place for preventative measures. GPs are the gatekeepers to secondary care, so it is important that we have a healthy and viable workforce in primary care.

Primary care is of course very important. We are committed to delivering 5,000 more GPs; we recognise that this might take longer than we had hoped, but there has been a bit of improvement in the numbers from last year to this year. NHSE and HEE have a number of schemes in place: to recruit more GPs, including increasing the number of doctors entering GP training; to boost retention through the GP retention scheme and the GP retention fund; and to support doctors through the GP Health Service and the releasing time for care programme. Last year, to put it in perspective, we recruited 3,473 GP trainees against a target of 3,250. That was a 10% increase on 2017, but I recognise that we need to do better.

Occupied Palestinian Territories

Debate between Baroness Manzoor and Lord Turnberg

Monday 17th December 2018 Lords Chamber

[Baroness Manzoor]

I thank my noble friend for that question. We understand the concerns of people who do not wish to purchase goods exported from Israeli settlements in the Occupied Palestinian Territories. We also welcome the European Commission’s decision in November 2015 to issue indication of origin guidelines for products produced in the Israeli settlements. It is up to British retailers who stock settlement produce to voluntarily adopt the labelling policy recommended by Defra.

[Lord Turnberg (Lab)]

Is the Minister aware that some 50,000 Palestinians work for Israeli companies in the West Bank and that Israeli trade unions ensure that the Palestinians are paid at exactly the same rate as the Israelis for the same jobs and receive the same benefits? I can do no better than quote Nabil Basherat, a Palestinian who said:

“The BDS movement has threatened my job security and livelihood … and damaged the livelihoods of hundreds … of factory workers”.


Does the Minister agree that the BDS movement damages Palestinians much more than it does Israel?