National Health Service

Baroness Masham of Ilton Excerpts

Thursday 8th January 2015 Lords Chamber

[Baroness Masham of Ilton (CB)]

My Lords, I thank the noble Lord, Lord Turnberg, for securing this very timely debate. The National Health Service is so important that it should not become a political football. Patients need accurate, safe healthcare to enable them to get better quickly. If that is not possible, they should have compassionate care. All services need to co-operate and communicate with patients. Integration should be the aim, not working in silos.

I give myself as an example. I had been coughing for months and had an X-ray on 21 November but have never had the result. Having had three antibiotics, I decided to come off the statin that I was taking as I became frustrated with the cough. It seems to have worked. So much of patient care seems to be trial and error.

I take this opportunity to stress some of the difficulties surrounding rural health. Our surgery at Masham is open only every other Saturday for half an hour, for a half day on Thursday and is closed every day between 12.30 pm and 2 pm. The surgery needs to be improved but no one will pay, so my doctor went to Canada.

Next door to the surgery is the Marsden pharmacy, which has a four-inch step with no handrail or ramp, making it inaccessible for people using wheelchairs unless they are super-fit, and for those using walking frames. It is frustrating that this building has just been renovated and disabled peopled, who perhaps need the pharmacy more than most, have not been considered.

On Sunday, I spoke with a member of the Army from Catterick, which has the largest military camp in Europe. I was told that the Catterick Medical Centre has been given a bad report and has to close every day at 3.30 pm, leaving the A&E department at the Friarage Hospital as the only alternative. More military personnel are coming back from Afghanistan and Germany. Therefore, urgent improvements are needed if the future of the NHS is to improve.

I was very pleased to be invited to give the awards to the Yorkshire Ambulance Service last autumn. I found the staff to be dedicated and enthusiastic. In rural areas, where the countryside can be challenging and public transport in some areas is non-existent, the ambulance service can be vital. Without doubt, the Air Ambulance is the most popular charity in north Yorkshire. The impact on the ambulance services in England is very great. There continues to be a year-on-year increase in demand. The major increase has been seen in top-level emergency calls.

There is a worrying situation in that there is a shortage of district nurses, with many having retired or gone off sick. They are so important in helping with ill and disabled people in the community. What plans are there to increase the numbers in the future? I have a cousin married to a registrar surgeon. The surgeon tells me that there is concern about the modern shape of training for surgeons. She tells me that hospitals with poor records should not be training and that sometimes deaneries come round and find poor standards but do nothing about it. She also tells me that the European working time directive has not helped with the training of surgeons. Surgical training should be a priority. I ask the Minister: should we not be aiming for the highest standards of surgery and safety, and stop the worrying increase in negligence claims that is draining the NHS?

I am so pleased to see my colleague, the noble Baroness, Lady Wilkins, back in her place. As president of the Spinal Injuries Association, I ask the Minister to look into the worrying situation where so many excellent doctors and surgeons working in spinal injuries have retired and new young doctors are not coming forward to take their place. Also, the cutting of physiotherapists and occupational therapists is detrimental to rehabilitation. High-lesion tetraplegics on respirators are often kept in intensive care beds in general hospitals because of the lack of beds in spinal units. Therefore, there is a blockage in intensive beds in general hospitals, causing huge problems.

Because of paralysis, the “three Bs”—bowels, bladders and bedsores—become very important to these patients. One of the distressing problems for spinal patients being in general hospitals is the difficulty of having their bowels evacuated, as nurses seem to shun this essential part of care. I hope that in future the NHS will recognise the importance of specialised spinal units with trained specialist staff.

I end by saying that there are many complicated conditions that need to be researched, but of concern is the increase in people with liver disease and hepatitis C. I hope that in future they will get the new, crucial drugs that are available but not yet approved by NICE.