Health: Online Services

Baroness McIntosh of Hudnall Excerpts

Monday 23rd April 2018 Lords Chamber

[Lord O'Shaughnessy]

On that specific point, NHS England is providing £45 million through the general practice forward view to promote online consultations. That is to ensure that they are available in general practice across the country. The noble Baroness will be aware of the GP at Hand practice, which is one practice in west London offering these services, but we are seeking to expand them, and NHS England, the CQC and others are providing regulatory support during that process.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, can the Minister explain the process? If someone chooses to access an online GP service, what happens to their registration with the GP with whom they are already registered—if they are registered? Is the process clear to each patient?

[Lord O'Shaughnessy]

That is an excellent question. It is important to distinguish between the independent sector and the NHS. The CQC report was about the independent sector, so a patient would continue to be registered with their NHS GP practice and have an augmenting consultation, if you like. With GP at Hand, as it is an NHS practice, they would switch their registration. One issue that has come up is whether people have full enough information about that switching, which is one thing that NHS England is reviewing in the independent review that it has commissioned about the success or otherwise of that service.

Children and Young People: Mental Health

Baroness McIntosh of Hudnall Excerpts

Wednesday 28th March 2018 Lords Chamber

[Lord O'Shaughnessy]

There has undoubtedly been an impact on mental health nursing. In fact, the widest definition of the mental health and learning disability workforce according to the latest workforce stats is up by around 3,000 full-time equivalent posts. But we agree that more needs to be done. That is why there is an ambition to bring in 4,400 more mental health staff to support children and young people over the next few years. It is also reassuring to know that there are 8,000 mental health nurses in training at the moment.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, the Minister will be aware that the incidence of mental health issues in children of primary school age is growing. Whatever the causes, they are almost always amplified and exacerbated by the onset of puberty and the transition to secondary schooling. What emphasis is being put on identifying and helping to meet the unmet need in primary schools, and who is undertaking that work?

[Lord O'Shaughnessy]

That is an excellent question. A terrifying statistic is that 8,000 of those under 10 years old are suffering from severe depression. The designated leaders will be in every school; that is the ambition. We are also rolling out mental health support teams to support all schools, both primary and secondary, so I can reassure the noble Baroness that primary schools are within the scope of the plans.

NHS: Charitable Donations

Baroness McIntosh of Hudnall Excerpts

Thursday 22nd February 2018 Lords Chamber

[Lord O’Shaughnessy]

That is an important point. We are not yet in a position where we have mandatory collection of all that unit pricing data. That will happen from the next financial year onwards, so we will be able to publish that data. It is important, though, to resist the urge to send out to people information itemising costs, precisely for the deterrence reasons that I mentioned.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, we can all agree that the National Health Service being free at the point of use is probably the single most valued thing about it for everybody. Personally, I would not want to see that changed or compromised in any way. However, despite the Minister’s reasonable point about putting people off, does he not think that it would help people to value the health service more if they better understood the real cost of what it takes to treat what are in some cases quite minor ailments? Further, could it not help with the pressure on GPs to overprescribe certain drugs, the use of which we would really do well to reduce?

[Lord O’Shaughnessy]

I think we are getting to a sensible position here: we want that transparency about what things cost in general, but not specific to each patient because of the concern that it might put people off. There is a lot more information available now than there ever has been about what items cost. What is critical—what we have learned—is that when people miss appointments, for example, which costs about £1 billion per year, there is a good opportunity to demonstrate what that cost is. But as regards what they incur as they go through the experience of healthcare, we worry about the deterrence.

Agency Nurses

Baroness McIntosh of Hudnall Excerpts

Wednesday 10th January 2018 Lords Chamber

[Lord O'Shaughnessy]

The number of uses of the “break glass” clause has actually fallen since April 2016, which was the peak. This shows that there has been a much more planned use of bringing in extra staff as they are needed, rather than an ad hoc response, which was what it was designed to address.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, further to the question from my noble friend Lady Pitkeathley, now that the noble Lord’s department has had “Social Care” appended to its title, does he agree that community and district nurses must be a vital part of the interface between healthcare and social care? As he has indicated that he accepts that there are fewer of them, what is being done to ensure that there are more in the future?

[Lord O'Shaughnessy]

That is an incredibly important point. We know the role that district and community nurses have, particularly in the interface between hospitals and social care. I have pointed out that more nurses will be trained. That will provide an opportunity to recruit to those areas which have not seen the increases that other areas of nursing have done, including district and community.

Young Women: Self-Harm

Baroness McIntosh of Hudnall Excerpts

Thursday 16th November 2017 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness is absolutely right to highlight the importance of schools in dealing with this. It is not just a health issue. Indeed it is not just about education either, but involves a cross-government approach. I would be very keen for her to write to me with the specific details of what she is describing—it does not sound like a positive development. Much more positively, more than 1,000 secondary schools have now had mental health first aid training for at least one teacher in the school, and the ambition is to extend that to all secondary schools. She will also know that there will very shortly be a children and young people mental health Green Paper, which I think will have quite ambitious actions for both schools and the health service to support young people with mental health problems.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, building on the Question from the noble Baroness, Lady Walmsley, does the noble Lord agree with me that bullying in schools can start very early, well before secondary school, and can give rise to very severe mental health issues among those who are bullied? Does he also agree with me that schools struggle to deal with this issue, partly because they are unclear about how to balance their duties of care to victims and to perpetrators, who often have issues of their own? Can he say in what way he is working with his colleagues in the Department for Education to make sure that primary schools have access to good resources to meet this, including programmes such as Place2Be?

Health Service Medical Supplies (Costs) Bill

Baroness McIntosh of Hudnall Excerpts

Committee: 1st sitting (Hansard): House of Lords
Monday 23rd January 2017 Grand Committee

Relevant document: 12th Report from the Delegated Powers Committee

[The Deputy Chairman of Committees (Baroness McIntosh of Hudnall) (Lab)]

My Lords, in the event of a Division in the Chamber, the Committee will adjourn for 10 minutes from the sound of the Division Bell.

Amendment 1

Moved by

Mental Health: Children’s Services

Baroness McIntosh of Hudnall Excerpts

Thursday 19th January 2017 Lords Chamber

[Lord O'Shaughnessy]

I was not aware of that fact, but it is clearly an important one and I shall write to the noble Lord with the information about what we are doing to support those children who come to this country.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, the Minister will be aware that there is an issue around identifying people in need of treatment, but there is also an issue about the sustainability of the workforce to deliver that treatment. What are the Government doing to encourage more trainee professionals, both doctors and other kinds of mental health professionals, to pursue a career in relation to mental health, which as I understand it is still fairly unpopular as a specialisation?

[Lord O'Shaughnessy]

That is an extremely good point. The people need to be there in order to deliver. There are two parts to the answer—first, that within the additional £1.4 billion going into children and adolescent mental health services over the course of this Parliament, about £130 million is for workforce development. Secondly, because of our reforms to workforce training, there are another 1,500 doctor training places. By removing the cap on nurse, midwife and allied health professional training, universities will be able to offer up to 10,000 more places a year for those positions.

HIV Diagnosis: Clinical Guidance

Baroness McIntosh of Hudnall Excerpts

Thursday 1st December 2016 Lords Chamber

[Lord Prior of Brampton]

The black African community, male and female, is a group especially vulnerable to HIV, as identified in the work done by NICE. It is a part of the population where special efforts must be made to increase early testing. The work done by the Terrence Higgins Trust in the MARPs programme has also identified that community as extremely important. I think we will see greater targeting of the about 13,000 people in the population who are living with undiagnosed HIV.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, the Minister referred briefly in his opening Answer to the question of stigma. I do not know whether he will have heard some testimony from people living with AIDS on the “Today” programme this morning—probably not, as he may well have been working already. It showed that they were subjected to shocking levels of prejudice, most of which appears to come from ignorance. Can he expand a little on what the Government are doing to encourage the right kind of information, not just for people who have AIDS or might be vulnerable to getting it but to the wider population whose attitudes are, frankly, a little prehistoric in quite a lot of cases?

[Lord Prior of Brampton]

That is a very insightful question. If we look back over time it is a lot better than it was but, as the noble Baroness says, it is still far from good enough. The education programme needs to go beyond just the people who have AIDS to the wider population, to get a greater degree of understanding. Perhaps I could investigate that issue a little further and write to the noble Baroness.

NHS England: Pre-exposure Prophylaxis for People at Risk of HIV

Baroness McIntosh of Hudnall Excerpts

Tuesday 7th June 2016 Lords Chamber

[Lord Prior of Brampton]

I do not think that it is a fallout from the Health and Social Care Act. It is purely that the NHS specialist commissioning committee within NHS England has received clear independent legal advice, as I understand it, saying that it does not have the power to commission this product. That position may well be challenged legally, in which case it will be resolved one way or the other.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, I am sure that the Minister will be aware that for those of us who are not experts in this field but know a little about it, this is an extraordinarily puzzling thing to be confronted with. It just sounds plain daft, frankly. But will he confirm that there is very little prospect of vaccination or immunisation against HIV being developed any time in the foreseeable future and that PrEP is therefore a vital tool in preventing the spread of this infection for the next generation, and probably for subsequent generations? If this legal tangle has to be untangled, can he also say how long he anticipates that will take?

[Lord Prior of Brampton]

I do not know how long a judicial review will take. I guess that it will be months rather than years, but I simply cannot answer that question as I do not know the answer to it. Again, this is a legal issue, not an efficacy issue. This is a question not of the Government saying that we do not want to fund this prophylactic, but of NHS England simply saying that it has been advised it does not have the power to do so.

Mental Health Services

Baroness McIntosh of Hudnall Excerpts

Thursday 28th April 2016 Lords Chamber

[Lord Prior of Brampton]

I assure the House that, on the funding that the Government have agreed for children’s and young people’s mental health and adult mental health—in the light of the Prime Minister’s announcement in January, but particularly in the light of Paul Farmer’s report that came out six weeks ago —we are fully committed to meeting those obligations.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, I do not think that the House in any way doubts the Minister’s personal commitment to additional expenditure on mental health. However, he will be aware if he has been listening to questions in this House over the past few weeks that the issue of mental health provision has come up, for example, on the Question of children caught up in separation yesterday, and in relation to asylum seekers and the prison population. One of the key resources in short supply is mental health practitioners. What are the Government doing to encourage more people coming into the health professions to regard mental health practice as a priority for their careers, not just a government priority?

[Lord Prior of Brampton]

The noble Baroness makes an interesting point. There are no short-term fixes for workforce issues. It is generally recognised that there is a shortage of people choosing psychiatry when they come through their foundation year 2 as junior doctors. We are concerned about that. There has been a significant increase in the counsellors used for delivering IAPT courses, but we are cognisant of the fact that we have to keep a very close eye on that.