(4 years, 9 months ago)
Lords ChamberI believe there are some legal specialists in the Chamber. I note the noble and learned Lord, Lord Judge, sitting at the front on his Bench, who may be able to answer more effectively than I can. However, I believe that the regulations as they have been drawn up are legally appropriate and proportionate. As I have said, they apply only to coronavirus, are in force for only two years and are triggered only by a serious and imminent threat to public health and where a person has not complied, or will not comply, with public health advice and is therefore putting themselves and others at risk. This is well in line with other legal measures.
My Lords, will the Minister give more information on people, including parliamentarians, attending conferences and functions in various parts of the world? Is there a risk of picking up coronavirus at airports and on long-haul flights? Many of your Lordships attend conferences and one noble Lord has asked me to relay this question.
(4 years, 9 months ago)
Lords ChamberTo ask Her Majesty’s Government whether they have any plans to establish a major trauma centre in the immediate vicinity of Westminster to treat casualties in the event of any terrorist attack in the area.
My Lords, the NHS has well-tested plans and capability for responding to a terrorist attack and treating casualties. The attacks in London and Manchester in 2017 tested our capability. London has four major trauma centres where casualties will be triaged and treated, and this will include casualties from an attack in the vicinity of Westminster.
My Lords, I thank the Minister for her reply. Is she aware that thousands of people come into Westminster, including tourists from all over the world, people coming to work here, the police, demonstrators and both Houses of Parliament? Are we not a special case? Would it not be very good to have a special trauma unit at St Thomas’ Hospital? When there is a lockdown, we cannot move in Westminster.
My Lords, I pay tribute to all the brave members of the public, the NHS and Members of this place who so often have responded incredibly bravely when terrorist attacks occur. We owe a great debt of gratitude to all those individuals who do not think of their own lives in responding to protect others.
On the noble Baroness’s specific question about our capabilities in responding to risks that occur, we have a specific arrangement that has been put forward with the trauma network. The decision about the location of the trauma centres allows full geographic coverage while ensuring that the full package of care is available for patients when they come forward, which includes treatment for burns, orthopaedic injuries and neurosurgery. I know the noble Baroness knows there are four major trauma centres located in London at St Mary’s Hospital, St George’s Hospital, the Royal London Hospital and King’s. They are all adult and children’s major trauma centres and are all approximately three miles from Westminster.
More importantly, we have specialist ambulance capability in responding wherever an attack may occur in London. We can be very proud of the response that we have seen not only from the hazardous area response teams but from the tactical response units. Those responses have been in very short order and have meant that, although these were appalling incidents, their impact was much reduced.
The noble Lord makes a very sensible suggestion to look at ways in which we can encourage individuals to save lives. It may be appropriate in situations other than terrorist attacks and I am happy to look into it.
My Lords, many people think that St Thomas’ has a trauma centre and are very surprised when they hear that it does not.
I thank the noble Baroness for her comment. I think I have made the point that there is a trauma network across London to ensure full coverage for trauma across the city and enable individuals to get the best trauma service, wherever they may be.
(4 years, 10 months ago)
Lords ChamberWe have indeed. First, three direct flights from Wuhan arrive into Heathrow and a team of public health experts, which will include the principal port medical inspector, the port health doctor, the administrative support and team leader and a translator, will meet every direct flight from Wuhan. We believe that this is a scalable solution, which could respond to a developing health challenge. In addition, before a flight lands a message will be broadcast to passengers in several languages to encourage them to report illnesses to flight staff and the captain will be required to provide an early warning of any illnesses on the aircraft one hour before arrival, which allows a much more appropriate response on landing. We believe that this is a manageable and effective response. The NHS has a very good record of responding to similar situations, whether with Ebola or monkeypox. We can be very proud of our public health record in these areas and can be confident in how bodies will respond to this incident.
My Lords, does the Minister agree that this has come at a very difficult time, because we are the middle of the flu season and this is difficult to diagnose? Does she realise that 15 health workers have been diagnosed in China? Therefore, will all health bodies be told to be aware?
The noble Baroness is absolutely right: there is great pressure on the NHS and we need to make sure that the appropriate information is given to the system so that there is no undue anxiety in that regard. As I said, the NHS has a tremendous record in responding to similar incidents. Clinicians in primary and secondary care have already received advice covering initial detection, investigation of possible cases, infection prevention and control and clinical diagnostics. NHS England and NHS Improvement have developed an algorithm to support NHS 111 to identify suspected cases and a central alerting system alert will be issued to the front line by the Chief Medical Officer, the medical director of Public Health England and the medical director of NHSE and NHSI to increase awareness of the situation and actions if potential cases present.
As I said to the noble Lord, Lord Patel, there are a number of infectious disease units around the country that can take suspected patients and are accustomed to responding in this way. Of course, the UK is one of the first countries outside China that has a prototype specific laboratory test for this novel disease. I want to emphasise, though, that there are no confirmed cases in the UK.
(5 years ago)
Lords ChamberWe will run tick awareness campaigns in the spring. Material for these campaigns will include information about Lyme disease and TBE. They will be run in all areas identified as at risk as part of the surveillance campaign.
My Lords, how much research is the UK doing with other European countries, which may know much more about these conditions?
(5 years ago)
Lords ChamberThe noble Baroness is right to raise the important issue of malnutrition in the community. We have put together a malnutrition task force, which has published a series of guides of expert advice on prevention and early identification of malnutrition in later life. These guides draw together principles of good practice and offer a framework for making sure that the situation which the noble Baroness has identified does not arise. We have also published a guide for care homes on integrating good nutrition into daily practice. This includes screening, initiating nutritional care plans and considering fortifying food and using oral nutritional supplements when appropriate.
My Lords, does the Minister realise that there is a huge problem of pressure ulcers due to bad nutrition? It costs the country millions, if not billions, of pounds. Could she do something about this? It is very difficult to encourage people who do not want to eat to do so.
The noble Baroness is absolutely right to identify some of the very significant health consequences of malnutrition. This is one of the reasons why it has been taken on board as a top priority by not only NHS England but the care system from top to bottom. The start is to have the right screening and to gather the right data so that we can identify where this needs to be improved. She is right that it needs to be integrated into nursing practice so that we not only prevent malnutrition in the first place but, where it does occur, provide the right support to put it right and the right care where there are health consequences for individuals due to clinical, social or economic problems.
(5 years, 2 months ago)
Lords ChamberWe will need to confirm the distribution of the grant in due course. I am sure that will be the subject of questions as we go forward. As for the guidance that comes from Public Health England, in developing its plans, local systems work in close partnership with directors of public health to respond to local health needs and deliver on the commitments for the long-term plan. Public Health England works very closely with those directors of public health.
My Lords, do the Government agree that drug resistance to some of these STIs is very serious and a strategy would help to make people more aware of the problem?
The noble Baroness is expert in this area and often raises this issue. She is absolutely right that antimicrobial resistance among some STIs is a growing concern. Public Health England has a world-class surveillance system to enable early detection and management of antimicrobial resistance. It is particularly an issue when it comes to gonorrhoea, and it uses that intelligence to advise the national gonorrhoea treatment guidelines. We will continue to keep on high alert when it comes to these matters.
(5 years, 4 months ago)
Lords ChamberI certainly agree that charging those who come from other countries and use the National Health Service is perfectly sensible and appropriate, and by no means racist. I also believe that, as the call for action on bullying says, it should be perfectly straightforward to get out messages on safety from senior leaders and staff voices. It should be a positive message about how it is a natural extension of the social contract between the NHS and those who use it.
My Lords, if a member of staff is being bullied by their senior, who should they go to for help?
The noble Baroness asks an important question. There are structures built into the NHS to enable those people to speak up. There is a “freedom to speak up” champion and a system of champions, so that it is perfectly clear to those experiencing bullying by senior managers who they can speak to.
(5 years, 4 months ago)
Lords ChamberThe noble Baroness has communicated an important message and it is one reason why we have prioritised perinatal mental healthcare. Specifically, services for young girls, who are particularly at risk of self-harm and suicide, recognise this risk. I would be interested to see the findings of the task force she mentions to ensure that those concerns are communicated.
My Lords, the Statement puts importance on technology. Will the Government speed up NICE in its assessments of technology? I hear that it is taking too long.
The noble Baroness, Lady Masham, is right to raise the importance of this. If we want to get innovative technologies and treatments to patients as soon as possible, we must ensure that we are one of the fastest in the world at regulating and assessing those technologies. However, it is also a matter of uptake. We have dramatically improved that process but we can and must always strive to do better. This is part of my job and I will make sure that I keep working harder at it.
(5 years, 5 months ago)
Lords ChamberI am afraid I was not here 21 years ago to hear the noble Lord’s maiden speech, but I shall look it up with utmost urgency upon leaving the Chamber and I thank him for his proposal. As the work moves from the interim people plan to the people plan, in which the work on bullying and the violence reduction strategy will be developed, I am sure that his proposal will be considered as a very sensible plan.
My Lords, how seriously does the CQC take bullying and what does it do about it?
The CQC takes this extremely seriously. One proposal in the people plan is for the CQC’s scorecard to include a proper measure of a sustainable workforce, so that the new staff engagement metrics for the NHS oversight framework can be taken into account in the CQC’s well-led assessments during inspections, and that includes questions about bullying.
(5 years, 6 months ago)
Lords ChamberI thank the noble Lord for his question. I can tell him that, while the accountability framework has not yet been published, it has been decided that it will be a high-level framework that will set two objectives: to ensure the effective delivery of the NHS long-term plan, and to support the Government in managing the effects of EU exit on health and care. Of course, the long-term plan includes improvements to a number of services and this will be followed by the national implementation programme for the long-term plan, which will have milestones for delivery of that plan up to 2023-24. I hope he will be reassured that eye health is included in that. If he would like to follow up specific points with me regarding the concerns his group has raised, I would be very happy to meet him later.
My Lords, can the Minister give an assurance that people who want to do so can come to work in the UK and be paid less than £30,000? Otherwise, this will stop many people coming: care homes and people who are disabled and living in their own homes cannot afford £30,000.