Ultra-processed Food

Baroness McIntosh of Hudnall Excerpts

Tuesday 18th July 2023 Lords Chamber

[Lord Markham (Con)]

On any advisory body you clearly want to get experts in the field. Necessarily, they will often be experts from companies as well. It is vital that they abide by the principles of conduct in public life and make sure they declare any conflicts. As such, we are content that we have a proper expert panel.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, may I take the Minister back to the question from my noble friend Lord Brooke, who asked about the content of school meals? The Minister replied that school meals are a good thing and more people should have them, with which I do not suppose anybody would want to disagree. However, I did not hear him say in what way the Government are ensuring that the content of those school meals is appropriate and free from salt, sugar and fat in the way that my noble friend Lord Brooke was asking for.

[Lord Markham (Con)]

My understanding is that those guidelines are there; it is absolutely the right question. The Department for Education, working with the Department of Health, makes sure that a nutritionally balanced diet is there. There is also a joint DfE/DHSE programme in respect of nursery milk and fresh fruit and vegetables for young children, to give them a good start in life.

NHS Long-term Workforce Plan

Baroness McIntosh of Hudnall Excerpts

Tuesday 4th July 2023 Lords Chamber

[Lord Markham (Con)]

I would like to think, as I mentioned before, that increasing the supply and training of the whole medical profession would help the whole sector. This is quite close to my heart; as I have mentioned before, my mum became a nurse later on in life and went through an apprentice-type route, for want of a better phrase. Having different entry points is a very positive thing. I sincerely hope that people going into a social care environment will see that as a building block to onward career progression and that it will set them up to take further qualifications later on in life, if they wish, in the nursing profession. We are looking to expand the whole sector, and the general belief is that that will benefit both social care and the NHS.

[The Deputy Speaker (Baroness McIntosh of Hudnall) (Lab)]

My Lords, the noble Baroness, Lady Brinton, is contributing remotely.

[Baroness Brinton (LD) [V]]

My Lords, while this NHS plan is welcome, can the Minister say whether this Government will undertake to commit to the plan and, crucially, to its funding and not change the number of education and training places, as happened last year and in too many previous years, causing chaos in planning for doctors, nurses and allied healthcare professionals? On hospital training places for junior doctors after they have finished their medical school courses, last year 790 medical graduates could not begin their junior doctor in-hospital training because the NHS did not have enough placements. Given that university medical school places are already capped and highly competitive, this is a complete waste of newly qualified medical graduates.

Mental Health In-patient Services: Improving Safety

Baroness McIntosh of Hudnall Excerpts

Monday 3rd July 2023 Lords Chamber

[Baroness McIntosh of Hudnall (Lab)]

My Lords, on the Minister’s last observation, I think there are a number of noble Lords here who would say that the quality of the output has not been that great from some private providers. It is just an observation.

However, the question I want to ask will take us back to the original observations by the noble Baroness, Lady Buscombe—I was also a member of the Joint Committee. The Minister gave a very brief reply to her questions about what has happened to the many recommendations, the vast amount of evidence and a great deal of hard work that went into producing that report. He even mentioned that it was going to be responded to in a “timely” manner. I think the moment for that has passed. Will the Minister have another go at explaining what has happened to the report and when there will be a response to it?

[Lord Markham (Con)]

I am afraid I do not have the timing of a response on that. Minister Caulfield is very engaged in this area. A number of things have been mentioned. I mentioned the community treatment orders, where we are very mindful of the point made earlier by the noble Baroness, Lady Uddin, about black males being eight times more likely to be given one, and the recommendation that they should be abolished altogether. Those recommendations are very much in our thinking and our knowledge base. I know that Maria Caulfield is working on them, but I am afraid I cannot give the noble Baroness an exact time yet.

Cancer Referral Targets

Baroness McIntosh of Hudnall Excerpts

Monday 5th June 2023 Lords Chamber

[Lord Markham (Con)]

I did not know whether the noble Lord was referring to GRAIL and the comment from the noble Lord, Lord Patel, about false positives. This question probably deserves a detailed reply but, as with any test, it is not about just specificity but sensitivity, which is key, so that the number of false positives is minimised. I will provide a detailed reply.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, the noble Lord has referred at several points in this discussion to early diagnosis. He will be aware that cancer very often develops later in life and that the older you are the greater the risk is. Yet older people are excluded from routine screening tests past a certain age. Can he explain the thinking behind that?

[Lord Markham (Con)]

It is about trying to make sure that we are screening those of highest risk, given the impact on quality of life, and catching it early. I know that is very specifically the thinking around it. Beyond this, while we know the challenge around waiting lists, we have increased the supply through a 15% increase in activity. We are supplying more than ever, but we know that a lot more needs to be done to meet the demand.

NHS National Health Inequalities Improvement Programme

Baroness McIntosh of Hudnall Excerpts

Thursday 25th May 2023 Lords Chamber

[Lord Markham (Con)]

I would be happy to. I need to find out more first, and I would be delighted if there was some information or if we could meet on this, but I would be happy to take it up.

[Baroness McIntosh of Hudnall (Lab)]

The Minister has twice cited the figure of 37.5% of children now receiving free school meals, which, as he rightly says, is an achievement of a sort. However, if the standard of food those children are receiving is insufficiently good—and there appears to be some evidence of that from the information that has been going around the House this morning—adding to the number on the list of those receiving free school meals, although admirable in terms of the numbers, may be contributing to the problem. Does the Minister agree?

[Lord Markham (Con)]

I do not think anyone would say that the current school food standards are insufficient. I think the feeling is that it has been a while since they were changed because of Covid, and it is time to ask whether improvements can be made, because this is an ever-evolving situation. So I would not agree with that categorisation, but we should indeed always be looking to see whether we can make better choices.

Pharmacies: Medicines at Home

Baroness McIntosh of Hudnall Excerpts

Wednesday 17th May 2023 Lords Chamber

[Lord Markham (Con)]

I am sorry: I will try to be clear to make sure that I am fully understood. There are many, many people for whom a blister pack is absolutely the right solution. Basically, what has been put in place here is a structured medicine review, so that, in each case, it will be the responsibility of the pharmacist to make sure that they have the right solution for the patient. What I am saying equally is that blister packs are not a blanket solution, and it needs to be done on a case-by-case basis.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, I cannot claim any expertise in this matter; I have just been listening to the conversation that has been going on. My noble friend’s original Question referred to the burden on carers. I have not heard the Minister say much about that, particularly when the negotiation over what is the right way of dispensing certain kinds of medicine presumably has to go on between a patient, a pharmacist and, presumably, a doctor somewhere in it, or somebody representing the patient who would, in many cases, be the carer. In what way are carers being helped to engage in that negotiation, with all the knowledge and expertise that they bring about what actually works in the circumstances?

Autism: Diagnosis Targets

Baroness McIntosh of Hudnall Excerpts

Tuesday 16th May 2023 Lords Chamber

[Lord Markham (Con)]

We are working closely with the Department for Education. The Bradford pilot scheme I mentioned takes the early years foundation stage profile scores of children. It knows that if you have a low score, you are far more likely to have autism. That triggers a multidisciplinary team to come in and inspect. That is a way that we can use that as an early warning indicator and then follow it up with volume. I hope that working very closely with the DfE in this space will be a real way forward.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, the Minister has already anticipated receiving this question—I would not want to disappoint him. He is clearly aware that there is some question over the reliability of some diagnoses that are being offered, particularly in the private sector, for ADHD, which is another neurodevelopmental disorder. Is he confident that, in trying to scale up the availability of diagnosis, which is obviously an admirable aspiration, the quality of those diagnoses will be maintained? Are the NICE guidelines sufficiently robust to ensure that?

[Lord Markham (Con)]

As we all know, it is a complex area, and there is no black and white diagnosis of autism. The noble Baroness’s point is absolutely correct: we need to make sure that the quality is there. The Bradford pilot has now been running in 100 locations. Every child has to get an early years profile score. If we can show the linkages and follow that up with the screening programme, that will be very promising; but, absolutely, we have to make sure that the right assessment is made.

Childbirth: Black Women

Baroness McIntosh of Hudnall Excerpts

Wednesday 3rd May 2023 Lords Chamber

[Lord Markham (Con)]

The point I was trying to make is that I think all noble Lords would agree that the NHS does a fantastic job in addressing and reaching people of all ethnic minorities. That is something we can all support.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, the Minister omitted to answer the first question put to him by my noble friend Lord Hunt of Kings Heath about the frequency with which the task force met and the gap between its last meeting and the moment at which its report was put forward, if I understood the question correctly. Can he answer that now?

[Lord Markham (Con)]

My understanding is that since the task force was set up, which was little more than a year ago, it has had as many as four or five meetings. If that is incorrect, I will correct it. The latest meeting was on 18 April. Again, if noble Lords look at the actions that have come out of it, they will all agree that it is actions that count the most. The task force has been very thorough, and Minister Caulfield is very committed.

Adult Social Care: Challenge Procedures

Baroness McIntosh of Hudnall Excerpts

Wednesday 19th April 2023 Lords Chamber

[Lord Markham (Con)]

Yes, we are taking them very seriously. The House has heard me talk many times about the 13% of beds that are blocked. This is a key issue for the whole flow of the system, which is backed up right the way through. That is why we introduced the discharge fund. Again, Minister Whately is very focused on this issue.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, further to the question asked by the noble Lord, Lord Laming, in response to my noble friend Lady Pitkeathley, the Minister referred to an 89% satisfaction rate among people in receipt of social care. However, as the noble Lord, Lord Laming, has just pointed out, the issue is not the people in receipt of social care but those who are not, of whom there are far too many. That is exactly what is causing some of the problems the noble Lord referred to. Does the Minister agree?

[Lord Markham (Con)]

Again, this goes to the point about the massive increase we have put in place of £7.5 billion. I have not heard of but would be pleased to hear about any plans on the other side of the House to increase that funding, since £7.5 billion is a very large figure—a 20% increase. Clearly, we will continue to review whether more is needed; we have put in increases each year. The importance of ensuring social care provision is completely understood.

Mental Health Act Reform

Baroness McIntosh of Hudnall Excerpts

Thursday 26th January 2023 Lords Chamber

[Lord Markham (Con)]

Yes, and understanding starts in schools. Again, I am very aware of that, and of the fact that training in schools is vital. We have increased the proportion of schools with trained mental health assessors from 25% last year; it will shortly be about 35%. The target is 50% next year. It is not 100%—we need to do more—but it is rapid progress.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, like other noble Lords who have spoken, I was a member of the scrutiny Joint Committee. I should say in parentheses that I entirely support the legislation being brought forward, but one of the things that came through very strongly from all the evidence we took was quite serious anxiety about resourcing for the kinds of reforms that are required. That is about not just money but, to go to the point made by the noble Baroness, Lady Barker, the recruitment of appropriate people to deliver the services that are needed, and the retention and training of those people. Can the Minister tell the House whether the Government will review the resource allocation for the proposed changes to the Mental Health Act, to ensure that these workforce issues are addressed?