Cancer: Staffing
Baroness McIntosh of Pickering Excerpts(1 month, 2 weeks ago)
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Baroness McIntosh of Pickering (Con)
My Lords, I remind the House of my interest with the Dispensing Doctors’ Association. Does my noble friend share my concern about the number of GPs, particularly those under 55, who are considering retirement in the next five years? How do the Government plan to fill the vacancies that will be created, to ensure that, particularly in rural areas, a fast track will exist for patients who are suffering from cancer for the earliest possible referral to hospital? I refer to the letter I wrote to our noble friend Lord Evans on this.
Lord Markham (Con)
I thank my noble friend and totally agree that GPs are the front line of our medical services. We are trying to do everything we can to make sure that they feel valued and are retained. The recent change to the pension law was all about addressing that very point, answering GPs’ number 1 concern in order to keep them. Their hard work has seen a 25% increase in the cancer referral rate: we treated 3 million people, up 600,000, over the last year, thanks to their work and the expansion in the diagnostic centres we have set up.
NHS App: Medical Records
Baroness McIntosh of Pickering Excerpts(4 months, 1 week ago)
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Lord Markham (Con)
The fundamental principle underlying all this is that none of the data leaves the control. The data controllers today—be it GPs, the NHS or the hospital—stay as they are, and any use of that data has to be approved outside of that. The noble Baroness is absolutely correct. We want to make sure that it is not used for any purposes that are not going to improve health outcomes, such as the ones we have talked about.
Baroness McIntosh of Pickering (Con)
My Lords, could my noble friend update the House on where we are with sharing data—in particular, the outcomes of clinical trials—with our European partners?
Lord Markham (Con)
Clinical trials are among the key areas that are vital to the life sciences industry. We are all aware that, post-Covid, we were falling a bit behind. I am glad to say that now we have improved, so that 80% of the time we are doing the clinical responses in time. We can still do better; that should be 100% but 80% is good. Most importantly, our data is the envy of the world. Just to give noble Lords an example, about 90% of our hospital records are digitised. In Germany, it is less than 1%.
Healthcare (International Arrangements) (EU Exit) Regulations 2023
Baroness McIntosh of Pickering Excerpts(9 months, 3 weeks ago)
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Baroness McIntosh of Pickering (Con)
My Lords, I congratulate my noble friend on bringing forward what I view as very welcome regulations for us this afternoon. I have to declare an interest, as I currently have an EHIC, which I assume will expire at the end of this year, and visit a very small number of the countries on this list. Given that the list on page 5 in the Schedule seems very full, I take this opportunity for my noble friend to put my mind at rest, because originally—it was a year ago, 2022—it was pointed out that the GHIC, which my noble friend explained will replace the EHIC in the regulations, originally did not cover countries such as Norway, Iceland or Liechtenstein, but they appear on the list. Is that because the original primary legislation did not cover them, or were we just waiting for the regulations before us this afternoon? Can he confirm that the EHIC covers those three countries and that the GHIC will also cover them?
From a practical point of view, I have never yet had to make a claim. I once, rather unfortunately, contracted salmonella poisoning as a Conservative candidate at a hotel which will remain nameless in north London, which rather sorrowfully served chicken drumsticks but did not have the foresight to defrost them. Unwittingly, I was so hungry I ate the chicken drumsticks, and within 36 hours I was in a very sorry way, but not as bad as some of my older colleagues at the time, who had to be hospitalised because of salmonella poisoning. I was then fortunate enough to be injected, not in my arm but in another part of my anatomy by a French doctor and had to have a course of whatever tablets they were.
Are we under these arrangements required to pay similar costs to those in that scenario up front, keep receipts and claim them back when we are back in the UK? Is that how it works? I think most of us are covered, and I know the department and the Foreign Office encourage all of us who travel outside the UK to have the fullest possible medical insurance that we can. Is it reciprocal? Does, say, a Norwegian, a Dane, a Liechtensteiner or someone from whatever third country pay here and is then reimbursed by their medical authorities—just to be absolutely clear on the reciprocity of the situation?
I give the regulations before us this afternoon a very warm welcome.
Lord Naseby (Con)
As I understood it, the Schedule on page 5 covers overseas territories and dependent territories. I note that the Cayman Islands is not listed. I have not had time to check whether anywhere else is off the list, but I wondered whether my noble friend could find out and let me know. I ought to declare an interest: one member of my family is working in the Cayman Islands, and there may be others. I recently attended a conference of all the overseas territories and dependent territories, and there seemed to be rather more than appear here, but that may be me and my memory bank. I leave that question with my noble friend.
General Practitioners: Recruitment and Retention
Baroness McIntosh of Pickering Excerpts(10 months, 2 weeks ago)
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Baroness McIntosh of Pickering
To ask His Majesty’s Government what assessment they have made of the current state of recruitment and retention of general practitioners.
Baroness McIntosh of Pickering (Con)
My Lords, I beg leave to ask the Question standing in my name on the Order Paper and declare my interest with Dispensing Doctors.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)
We acknowledge that there are challenges in growing GP numbers. We are working with NHS England and the profession to explore measures to boost recruitment, address the reasons why doctors leave the profession and encourage them to return to practice. As of March 2023, there were 1,903 more full-time equivalent doctors working in general practice compared with March 2019, and we have a record 4,000 doctors in GP training.
Baroness McIntosh of Pickering (Con)
I have slightly different figures, although I thank my noble friend for his Answer. Since 2015, there has been an 18% increase in the number of patients per GP but a 7% reduction in GPs, with potentially 39% of the GP workforce considering leaving the profession in the next five years. Does my noble friend share my concern about the recruitment and retention of GPs? What urgent action is he going to take to address the workforce strategy for GPs to double the number of medical training places and to ensure that general practice once again becomes an attractive place for doctors to work?
Maternity Services
Baroness McIntosh of Pickering Excerpts(1 year, 2 months ago)
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Lord Markham (Con)
That question probably deserves a more detailed reply then I can give here in 30 seconds. In terms of the direction of travel, continuity of care, not just in the maternity service but in understanding that person and their needs, has to be the right thing to do to make sure that we have cradle-to-grave treatment with people who know your case. So I agree with that direction of travel and I will follow up with a more detailed response.
Baroness McIntosh of Pickering (Con)
My Lords, will my noble friend update the House on the number of midwives available? I understand that there is concern among expectant mothers about the availability of midwives.
Lord Markham (Con)
The figure for the number of midwives has been roughly constant over the last few years at about 23,000. We want to increase that, which is why we have made a commitment to increase the number of graduate places to more than 1,000 each year. This year, as I say, we have 1,200 places, so we are making good progress.
Urgent and Emergency Care Recovery Plan
Baroness McIntosh of Pickering Excerpts(1 year, 2 months ago)
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Baroness McIntosh of Pickering (Con)
My Lords, my noble friend will be aware that this problem is not unique to this country. I am ashamed to say that Denmark, my mother’s original country, is building new hospitals all over the place but people cannot be treated because there are not enough doctors to treat them. Is my noble friend aware of the report from the Health and Social Care Committee in the other place, which noted that there are almost 500 fewer full-time equivalent GPs in a three-year period and that the committee realised that that accounts for the fact that there is an increased challenge in accessing GPs and also a lack of continuing healthcare? Will my noble friend take this opportunity to explain to the House what proposals the Government have to retain GPs so that recently qualified GPs are not working as locums in preference to being salaried or partners in a practice? I declare my interest as an adviser to the Dispensing Doctors’ Association.
Lord Markham (Con)
I thank my noble friend and agree that the GP service is the backbone. As per the earlier comments, a lot of the issues and challenges we have with A&E are because people are not getting their appointments in the GP space, and fundamental to that is having enough doctors. I did not quite recognise the figures. I am aware of an increase of over 2,000 GPs since 2019. That is not to say that that is enough, and so, again, the workforce plan will be key to making sure that we are building for that long-term future. However, we are also looking to retain them. We had a very good debate in the House about pensions and what we need to do in that space, and we will make sure that everything we do—including, I hope, the primary care plan—will show that primary care is key to the solution.
PPE Expenditure
Baroness McIntosh of Pickering Excerpts(1 year, 3 months ago)
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Lord Markham (Con)
Again, I would take issue with the words “useless material”. It was bought based on a projection of how the pandemic could progress and what would be required. The fact that it did not progress that far was thanks a lot to the work we did in being the quickest country to vaccinate in the world. So, we did not need that level of PPE; that was a good thing. We bought for a worst-case scenario and, thank goodness, we did not require it because of the action we took to get on top of it all. Now, we are dealing with the surpluses bought for that worst-case scenario and quickly disposing of them.
Baroness McIntosh of Pickering (Con)
My Lords, can my noble friend tell us the amount of this stuff in UK warehouses, and how much that costs daily?
Lord Markham (Con)
As I mentioned before, the daily cost is roughly £700,000.
Streptococcus A: Antibiotics
Baroness McIntosh of Pickering Excerpts(1 year, 4 months ago)
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Lord Markham (Con)
Absolutely—clearly, we always need to learn in such circumstances, so we will be happy to do that.
Baroness McIntosh of Pickering (Con)
My Lords, I remind the House of my interest with the Dispensing Doctors’ Association. Can my noble friend give reassurance that dispensing doctors, pharmacists and others will be reimbursed for the full cost of the increased price of antibiotics?
Lord Markham (Con)
My understanding is that there are measures in place to ensure that the people supplying in those circumstances are not losing out because of profiteering. The most essential message today is that that supply is available to anyone who needs it, so I will take that back.
Invasive Group A Streptococcus and Scarlet Fever
Baroness McIntosh of Pickering Excerpts(1 year, 4 months ago)
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Lord Markham (Con)
I thank the noble Lord. At this point, I put out the general message that, if parents are aware that their child is unwell, particularly drowsy or dehydrated, that is when they should look to seek medical advice. They should start by using paracetamol and ibuprofen. Clearly, if there is no response, they should be particularly concerned and absolutely making sure that they are getting access to the surgery—to a nurse, as well as a doctor, in this case. This is clearly a priority area. We need to make sure that there is access for those people.
Baroness McIntosh of Pickering (Con)
Following on from the question by the noble Lord, Lord Hunt, if the child presents symptoms after 6 o’clock at night or over a weekend, they will clearly be dependent on out-of-hours service. What is the department recommending that they do? Should they go to A&E in these circumstances? It is obviously absolutely vital that, if the child has meningitis or scarlet fever that may develop complications, they should be attended to and given medical assistance as soon as possible.
Lord Markham (Con)
I can probably draw on a personal illustration. In answer to a question a couple of weeks ago, I mentioned how I used 111, and in this case I think the advice would be to use 111. In that instance, I was able to get access to a doctor. On that basis, if the symptoms are there, to take that example, a doctor can arrange for a prescription to be sent to an out-of-hours pharmacy. The most important thing in these circumstances is to get antibiotics quickly. The first thing I would say is to use 111. Obviously, A&E is always there, but a more effective route would be through 111.
Covid-19: PPE Procurement
Baroness McIntosh of Pickering Excerpts(1 year, 4 months ago)
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Baroness McIntosh of Pickering (Con)
My Lords, will my noble friend pay tribute to Industrial Textiles & Plastics of Easingwold which, together with Barbour and Burberry, submitted an application to the Cabinet Office for a number of gowns, and are still waiting for a reply? They donated these gowns free at the point of use to local hospitals. I believe that they should have had a contract from the Government and am at a loss to understand why they did not. Is there any reason that the Cabinet Office failed to reply to them?
Lord Markham (Con)
I do not know why they did not reply. What I do know is that there were many companies like the ones mentioned who wanted to do their bit. They stepped up to the mark and provided all sorts of goods and services, sometimes at no cost and for no profit, because they all wanted to be part of the wartime effort. I will find out why they did not get a response.