Perinatal Mental Health
Baroness McIntosh of Hudnall Excerpts(2 weeks, 4 days ago)
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Baroness Merron (Lab)
As the noble Baroness is aware, the long-awaited 10-year plan will be with us shortly. That will set out the parameters for change and the services that we need. Following that, there will a long-term workforce plan, which will deal with the kind of matters the noble Baroness referred to.
Baroness McIntosh of Hudnall (Lab)
My Lords, I had not intended to ask a question but, following on from the contribution from the noble Lord, Lord Patel, impacts other than the most undesirable one of suicide come from postnatal depression. Among those are an inability of new mothers to cope well with the demands on them and therefore provide the care that very young children need. Is the Minister confident that the way that the NHS now—I am struggling not to say “gets rid of”—moves mothers out of hospital very soon after birth provides the right start to the sort of care that particularly vulnerable women need immediately after giving birth?
Baroness Merron (Lab)
My noble friend raises a very useful consideration. Decisions about how long a new mother stays in hospital are a local matter and specific to that woman. The other point I want to raise is that the services we are talking about have actually been expanded to provide care to women for up to two years after birth. That is incredibly important, as is providing a mental health assessment and signposting support for partners, who we should also remember in all of this. The services we are talking about cross the entire span and go on for two years beyond it. That certainly underpins the kind of services we want to see, but I certainly agree with my noble friend that individual cases must be seen as individual cases.
Self-harm: Young People
Baroness McIntosh of Hudnall Excerpts(2 months, 2 weeks ago)
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Baroness Merron (Lab)
The role of civil society is crucial. I have had a number of very helpful meetings and visits, including most recently with the Samaritans. We very much believe that that sector supports the delivery of not just the national suicide prevention strategy, of which tackling self-harm is part, but tackling self-harm where it is not linked directly with suicide.
I refer the noble Lord to the work being undertaken by the multi-centre study of self-harm, which I know will be of interest. It has a long-standing research programme to keep an eye on—more than keep an eye on—and examine self-harm trends, and the findings also inform NICE clinical guidance. Recent research has looked at different ethnic minority groups, the characteristics and outcomes for children under 13 who self-harm, and patterns and risk factors for self-harm among university students—and that is just a snapshot.
Baroness McIntosh of Hudnall (Lab)
My Lords, those of us who are not experts but have some direct experience of this problem know that self-harm is not just one thing; it can come in a number of forms. One of the problems for families is that it is not always easy to spot, at least not initially. Can my noble friend say in what way families are being supported to identify and then help young people who are beginning to exhibit signs of self-harm?
Baroness Merron (Lab)
My noble friend is right: it is crucial that, where they are able to, friends, family and communities assist those at risk and those who are actually self-harming. The recommendation is that people should not hesitate to speak to a GP or access the free listening services that are available through not just the NHS but the Samaritans, for example.
Funerals: Death Certificate Delays
Baroness McIntosh of Hudnall Excerpts(3 months, 1 week ago)
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Baroness Merron (Lab)
I agree that those changes—the move from analogue to digital, which will be outlined in the 10-year plan—will indeed help in this area, as well as many others.
Baroness McIntosh of Hudnall (Lab)
My Lords, clearly, this is a complex and difficult issue, and there does not seem to be any one reason why these delays have started to extend. Can the Minister tell the House whether there are any financial implications for people who have to wait much longer for a funeral to be arranged, given that they are not cheap to begin with?
Baroness Merron (Lab)
I am not aware of the specifics around that point, but we will be very pleased to look into that because we do not want people to be inconvenienced and distressed even further.
Cancer: Older People
Baroness McIntosh of Hudnall Excerpts(7 months, 3 weeks ago)
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Baroness Merron (Lab)
I give my sincere condolences to the noble Baroness and her family. Yes, I will raise that. It is a good point to look at, and I thank her.
Baroness McIntosh of Hudnall (Lab)
My Lords, what plans do the Government have, if any, to include older people in routine screening programmes, particularly given all the statistics that we have heard in the course of this Question and others? I have asked this question before. I have never heard an answer that I found entirely convincing. I am confident my noble friend will be able to help on this occasion.
Baroness Merron (Lab)
I thank my noble friend for her confidence, and I will do my best. Decisions on screening, including the age ranges at which they operate, are made by the UK National Screening Committee. They have an upper and a lower age limit, which are based on evidence and kept under review. Current evidence does not support making changes to these ages. For breast screening, for example, self-referral is available for those over the age of 71 and for bowel screening it is available for those over 75. I confirm to her that this is all evidence-based, and we always keep an eye on the continuing evidence.
Inflammatory Bowel Disease
Baroness McIntosh of Hudnall Excerpts(1 year, 1 month ago)
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Baroness McIntosh of Hudnall (Lab)
My Lords, the Minister has twice mentioned the bowel cancer screening programme, which I think is universally accepted to be very successful, and is also very reassuring to those people who are part of it, whatever the outcome of the tests. He will also know that that screening programme and others drop people once they reach a certain age, which coincidentally is the age at which they become more likely to develop the cancers that the screening programme is intended to detect. Do the Government have any plans to increase the age up to which people can be routinely included in bowel cancer screening and other screening programmes?
Lord Markham (Con)
The noble Baroness makes an important point. In this and other areas, we are guided by the science; we have been guided by the science on the advice to date. I will go back and ask for the latest thinking on that, and get back in detail in writing to the noble Baroness, but, generally, being guided by the science will be the approach.
Immunisation: Children
Baroness McIntosh of Hudnall Excerpts(1 year, 2 months ago)
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Baroness McIntosh of Hudnall (Lab)
My Lords, on the Wakefield effect, as the Minister called it, he will remember that the impact it had on a lot of people was very profound. In particular, some of that was associated with incidence of autism, which again was completely unjustified. Can he tell the House whether any work has been done, in the interests of public information, on what happened to the children who were not vaccinated at that time, and what the outcomes were for them? As a deterrent, it might be useful for people to know what the worst that can happen is if you do not get your children vaccinated.
Lord Markham (Con)
The noble Baroness is quite right. I had two young sons at around that time, and it was a concern. Of course, we did go ahead, but it was a consideration. It is an excellent question. I have not seen the study of those various cohort groups but I will go back, because it is something we need to bring out.
NHS App: Medical Records
Baroness McIntosh of Hudnall Excerpts(1 year, 6 months ago)
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Lord Markham (Con)
Patient records is what the federated data platform is very good at, in terms of drawing data and information from all sorts of sources into one place, so it is always in the ownership of the person, the GP or the individual place. You can make your data available to the private care providers, if you are having an operation with them, for instance, but the data always remains within the NHS and in the ownership of the person.
Baroness McIntosh of Hudnall (Lab)
My Lords, following the question from the noble Baroness, Lady Bull, is the Minister confident, in all the talk about advances in technology, that data-sharing within the NHS is fit for purpose? We frequently encounter an apparent disconnect between different departments in the NHS, or different levels of care, where information which should be available to everybody is palpably not or, if it is, it is not being taken any notice of.
Lord Markham (Con)
The noble Baroness is absolutely correct. While I think everybody would say that 90% digitisation is pretty good—it is not 100%, but it is pretty good—always making sure people are talking to each other is often the issue. I am sure we have all had examples of that. That is what the federated data platform helps to do, in terms of drawing it all in. For example, Chelsea and Westminster has put what was on 10 different spreadsheets and records into one place. We are getting a lot better at that, but is it perfect and seamless? No, there is still some work to be done.
Sexually Transmitted Infections
Baroness McIntosh of Hudnall Excerpts(1 year, 7 months ago)
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Lord Markham (Con)
My noble friend is absolutely right: young people—15 to 24 year-olds—represent one of the highest levels of this. In 2020 we made relationships, sex and health education classes available compulsorily in schools. We are currently reviewing that to see the effectiveness of it, with a view to expanding it further.
Baroness McIntosh of Hudnall (Lab)
My Lords, can the Minister tell the House what the current rate of take- up is for vaccination against HPV—human papillomavirus —and what efforts are being made to make sure that all those who should be vaccinated are?
Lord Markham (Con)
I will need to come back with the exact figure for the vaccination rate. I know that it is proving quite effective, which is important. On the measures we are taking, we are investing £25 million in women’s health hubs precisely to enable these sorts of vaccination programmes. I will happily follow up in writing with the detail.
Paediatric Care: Wating Times
Baroness McIntosh of Hudnall Excerpts(1 year, 8 months ago)
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Lord Markham (Con)
Unfortunately, industrial action is impacting on waiting times; we estimate that about a million appointments have been lost to date. Clearly, that is a matter of regret and not good news for anyone.
Baroness McIntosh of Hudnall (Lab)
My Lords, I take the Minister back to the question from the noble Lord, Lord Allan, who referred to the necessity for parents to do a lot of running around and following up for themselves. Does he agree that this is a particular problem with the management of long-term conditions in young people—for example, ADHD and other things relating to autism—where the challenge is not just to get the diagnosis but to then get a consistent level of treatment over the long term? Can he comment on what steps have been taken to improve that? Can he also comment on the reported limited availability of appropriate drugs for treating young people with ADHD?
Lord Markham (Con)
I am aware from personal experience that, when you have a child with neurodiversity or developmental needs, it is a long journey. We are seeing this manifest itself much more in recent years; I was talking to Minister Caulfield about this just this morning. One-to-one is always preferable but, where capacity is constrained, group education and help can sometimes lend themselves to this space. It is a long-term condition, and clearly it will not be solved by treatment over a few months but needs many years.
NHS: Staff Numbers
Baroness McIntosh of Hudnall Excerpts(1 year, 10 months ago)
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Lord Markham (Con)
In every area, anaesthetists being a very good example, we need to be looking at where the bottlenecks are and moving to free up those situations. I think we would all agree that with practitioners such as anaesthetists and in other areas, it is a very sensible approach to make sure that the most highly skilled are focused on the most highly skilled jobs and that they can have people underneath them who can be trained to work within that. So hearing that there is a certain amount of opposition from certain colleges and the BMA to those sorts of roles is quite disappointing. I hope they would accept that this is a key way of addressing the issue.
Baroness McIntosh of Hudnall (Lab)
My Lords, can I take the Minister back to the original Question from my noble friend Lord Clark? He put before the House some quite startling statistics about the number of medical staff—particularly but not exclusively doctors —who are leaving following or shortly after the completion of their training, either for other countries or for private practice? What view does he take of that drain away from the National Health Service and the effective loss of the investment that the country makes in the very expensive training of clinicians?
Lord Markham (Con)
My first point on that is to ask what the real facts are. Five years on from qualification, around 95% of doctors are still registered with the General Medical Council and still practising in the UK. So the fact is that retention is very high. That notwithstanding, we want to do everything that we can to retain people, and professional development is what the long-term workforce plan is all about. Also, we all know that pensions were a big reason for a lot of the brain drain and doctors leaving the profession, and that was something we were quite radical in supporting and changing. We are going through this bit by bit, asking what key things we need to do to retain our staff and resolve this.