NHS: Accident and Emergency Services

Baroness McIntosh of Hudnall Excerpts

Wednesday 7th January 2015 Lords Chamber

[Earl Howe]

I am grateful to the noble Baroness. It is worth observing that while the standard is that 95% of people arriving at A&E should be seen and treated within four hours, that standard has not been met in recent weeks. Nevertheless, on average, hospitals are seeing and treating around 90% of patients. The department is working closely with the College of Emergency Medicine. Indeed, I have the college’s paper in front of me. I am well aware of the issues that it has identified, but it is worth noting that the college says that the latest figures show that in England hospitals and their staff have coped extraordinarily well.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, can the Minister confirm that staffing, particularly of emergency medicine doctors, is acute in the sense that probably enough are being recruited but not enough are being retained in emergency medicine and that there is a significant loss of those qualified practitioners overseas? What is being done to address that?

HIV: Stigma

Baroness McIntosh of Hudnall Excerpts

Monday 1st December 2014 Lords Chamber

[Earl Howe]

My Lords, sex and relationship education plays an important part in exposing young people to the whole subject. Guidelines are available that schools must follow. They include sections on HIV and sexually transmitted diseases generally. As I say, secondary schools must follow those guidelines.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, building on the question from the noble Baroness, Lady Brinton, does the noble Earl agree that stigma starts very young? It builds on attitudes that are adopted by young people. The importance of PHSE programmes in schools is therefore very great. In what ways are his department and the Department for Education working together to ensure that these programmes are delivered—not just that they are recommended, but that they are delivered? Does he further agree that it would be a good thing if they were a regular and statutory part of the curriculum?

[Earl Howe]

I shall expand on my previous answer. Sex and relationship education is compulsory in maintained secondary schools, although not in academies. All maintained schools and academies have a statutory requirement to have due regard to the Secretary of State’s sex and relationship education guidance, which dates from 2000, when teaching sex and relationship education. The guidance makes it clear that all such education should be age-appropriate and makes the following points about HIV and sexually transmitted infections:

“information and knowledge about HIV/AIDS is vital; young people need to understand what is risky behaviour and what is not; young people need factual information about safer sex and skills to enable them to negotiate safer sex … Young people need to be aware of the risks of contracting a STI and how to prevent it”.

They also need to know about the diagnosis and treatment of HIV and STIs.

Medical Innovation Bill [HL]

Baroness McIntosh of Hudnall Excerpts

Friday 24th October 2014 Lords Chamber

Amendment 10 not moved.

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

I must inform your Lordships that if Amendments 11 and 12 are agreed to, I cannot call Amendment 13 on grounds of pre-emption.

Amendments 11 and 12

Moved by

NHS: Hospital Waiting Times

Baroness McIntosh of Hudnall Excerpts

Thursday 10th July 2014 Lords Chamber

[Earl Howe]

A handful of trusts are unable to report the full range of figures on their waiting times. They are given support to enable them to do so either by Monitor if they are foundation trusts or by the NHS Trust Development Authority.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, I do not believe that the House heard the noble Earl address the issue raised by my noble friend Lord Turnberg. It was not about cash but about share. Can he expand a little on why the share of GDP allocated to the National Health Service is set to go down?

[Earl Howe]

The share of GDP is only one measure. We have to take into account the state of the economy. If the party opposite had been elected to office, it had in fact decided that the share of the cake should be less than the one we have allocated. We have had to strike a balance and I believe that we have done so in a responsible way.

Health: Talking Therapy

Baroness McIntosh of Hudnall Excerpts

Tuesday 3rd December 2013 Lords Chamber

[Earl Howe]

My Lords, the noble Lord’s perception would be shared by many, which is why we have been very clear in our mandate to NHS England that parity of esteem is of the essence, and we will hold the service to account for that. I do not have the specific statistics that the noble Lord seeks but we know that more people are being treated in secondary mental health services now than two or three years ago. However, the proportion who needed to be admitted to in-patient psychiatric care fell over that period, and that reflects increasing emphasis on care in the community.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, as someone who has benefited from CBT on a number of occasions, may I ask whether the noble Earl agrees that it is not just a question of whether people need the therapy but rather that they receive enough of it? Following the question of the noble Lord, Lord Alderdice, about the number of people who could benefit from this, what is the average number of sessions of talking therapy that a National Health Service mental health patient will receive and is it, generally speaking, enough?

[Earl Howe]

My Lords, I apologise to the noble Baroness as I do not have that information in my brief. If it is available, I will write to her with the answer.

NHS: Accident and Emergency Services

Baroness McIntosh of Hudnall Excerpts

Thursday 25th July 2013 Lords Chamber

[Earl Howe]

The answer to the noble Baroness’s question is yes. We are looking very carefully at workforce issues and the mix of skills needed in those A&E departments that have been struggling. I refer not simply to A&E consultants but also specialists in their field—perhaps alcohol is a good example—who can deflect the pressure away from staff looking after acutely ill patients.

[Baroness McIntosh of Hudnall]

My Lords, building on the question from the noble Baroness, Lady Finlay, is there evidence that current difficulties in the administration of A&E departments are discouraging young doctors from regarding emergency medicine as an attractive specialism? Are the Government doing anything to encourage them to look at emergency medicine more favourably and to ensure that, if they do so, there will be jobs for them in the departments?

[Earl Howe]

That is very much in the focus of Health Education England, which oversees workforce issues in the health service. There has been a shortage of A&E consultants for some time and Health Education England is looking at that area very carefully. A&E is a discipline that has not traditionally proved attractive to trainee doctors for a number of reasons. It is very stressful and the remuneration is perhaps less than in other areas of medicine. That needs to be addressed and is very much an area of scrutiny.

Public Health England Advisory Board Membership

Baroness McIntosh of Hudnall Excerpts

Thursday 4th July 2013 Lords Chamber

[Earl Howe]

My Lords, yes.

[Baroness McIntosh of Hudnall]

In view of the answer that the Minister gave to my noble friend a few moments ago about not operating a positive discrimination policy, is it possible or even likely that the next round of advertisements will also result in the appointment only of men?

[Earl Howe]

I simply cannot tell because we do not know which candidates have come forward. It may be that no women come forward. I hope that that is not the case. We make a point of advertising our appointments on the website of Women on Boards UK Ltd—the noble Baroness may be aware of it—which is an open UK-wide organisation for women seeking to leverage their professional skills, if I can put it that way, on to leadership roles. We will see what happens, but I assure the noble Baroness that while there will not be positive discrimination, there certainly will not be negative discrimination either.

NHS: 111 Telephone Service

Baroness McIntosh of Hudnall Excerpts

Monday 13th May 2013 Lords Chamber

[Earl Howe]

I agree. NHS England and clinical commissioning groups are engaged in that publicity. I think it will be a while before the general public are fully aware of what NHS 111 has to offer, but I have in my brief a series of very complimentary testimonials about 111 that show that many members of the public are already enjoying its benefits.

[Baroness McIntosh of Hudnall]

My Lords, would the Minister accept that many people who are not directly involved in the health services find it quite hard to understand why NHS Direct was dismantled in favour of the 111 service, which has clearly not been working terribly well? Does he agree that the fact that this change has not succeeded tremendously well does not give one great confidence that other changes that appear to have been relatively unnecessary will go through successfully?

[Earl Howe]

I agree. It is unfortunate that the launch of this service was not nearly as satisfactory as was planned. The adverse performance in certain areas of the country has rather overshadowed the very good, if not excellent, performance in other areas, so while not belittling the issue the noble Baroness raises, I think we have to get it in proportion.

Health: Tuberculosis

Baroness McIntosh of Hudnall Excerpts

Wednesday 24th April 2013 Lords Chamber

[Baroness McIntosh of Hudnall]

My Lords, the Minister will be aware that the problem of multidrug resistance is not confined to TB; there are many other areas where we have every reason to be fearful about the development of drug resistance. Is the noble Earl satisfied that enough is being invested in research into the development of new drugs to be reasonably confident that we are making proper inroads into this problem?

[Earl Howe]

My Lords, the Government are supporting a range of research programmes to promote the development of new diagnostics, drugs and vaccines for TB. These include £6.5 million for the Foundation for Innovative New Diagnostics, £23.3 million for the Global Alliance for TB Drug Development and £10.5 million for the AERAS Global TB Vaccine Foundation. However, I will look into other areas of disease where there is drug resistance, and if I can supply the noble Baroness with further information I will be happy to do so.

Social Care Funding

Baroness McIntosh of Hudnall Excerpts

Monday 11th February 2013 Lords Chamber

[Earl Howe]

First, I completely agree with my noble friend that the leak to the media over the weekend was highly regrettable. I do not know how it occurred. It certainly was not of my making or that of my ministerial colleagues in the Department of Health. We wished to make this announcement to Parliament first of all, and I am sorry that that did not happen.

My noble friend’s second question relates to the national minimum eligibility threshold. We believe that that can be introduced in advance of the Dilnot package because what it is designed to do, as I explained earlier, is to give people greater certainty about their access to care wherever they live around the country, particularly for those who move from one place to another. That is a separate issue from those covered by Dilnot, although it was one of those which the commission considered. It is separate from the issue of the cap or the means test, which we believe can logically come in at a later date.

[Baroness McIntosh of Hudnall]

My Lords, as one of those in the Chamber today who is not an expert on social care matters, I ask the noble Earl whether he can reassure the great many people who are hearing about this for the first time as to what it means in practice for them when they have to start paying for social care—or, more particularly, when they become in need of social care. When we have a Budget, newspapers often produce ready reckoners, showing the impact of tax rises, reductions or whatever is being introduced on people in particular circumstances. Will the Minister encourage his department, and encourage his department to encourage local authorities, to produce the kind of information that ordinary people can understand, which will show them in easily understood, ready-reckoner terms what they will be in for if they need long-term care?

[Earl Howe]

My Lords, I absolutely agree with the noble Baroness on how important this is. It is quite complex to explain the whole system in words. The system will depend on the operation of a sliding scale which, by its nature, is difficult to describe other than pictorially. Nevertheless, the basics of the rules of these funding arrangements are straightforward and can be described. They are, as the Statement described, two essential elements, being the maximum level that people have to pay for their care—which we are setting at £61,000 in 2010 prices; £75,000 in 2017—and the means test, which is £100,000.

Of course, there are nuances around that, such as around couples and how the system will work for them. That is a question that the noble Lord, Lord Hunt, asked me which I did not answer. At present, a couple could potentially face two sets of unlimited care costs. By protecting them from these costs, the reforms offer them significant benefits which need to be spelt out. In most circumstances, even if a couple both had care costs at £75,000, the level of the cap, they would contribute less than this because housing assets do not count towards the means test if one of the partners remains resident in the home. All those sorts of things need to be made clear. We will do our very best to work with others to ensure that these messages have not only the greatest clarity but the greatest coverage.