Prostate Cancer: National Screening Programme

Debate between Baroness Merron and Baroness Finlay of Llandaff

Thursday 27th February 2025 Lords Chamber

[Baroness Merron (Lab)]

Again, I am sure that the noble Baroness would agree that the important thing is that people ensure that they do not ignore the situation. I agree that the situation that we inherited was hugely difficult, particularly in some areas, around GPs. In the 10-year plan, which will be published in the coming months, there will be a big focus on the move from sickness to prevention, from analogue to digital, and from hospital to community. In all three pillars, greater access to GP appointments will be included.

[Baroness Finlay of Llandaff (CB)]

My Lords, as the Minister rightly highlighted, there are detection gaps, and one in 50 people have aggressive disease at the time of diagnosis. When this proves to be hormone-therapy or chemotherapy resistant, how many centres can offer strontium, which can be very effective for metastatic bone pain, as that is how some people present?

[Baroness Merron (Lab)]

I was glad to have the opportunity to discuss this with the noble Baroness. Having looked into it, we do not currently hold this data. However, where strontium therapy is appropriate and preferred to improve patient outcomes, it will be offered. This is, of course, a clinical decision.

NHS: Electronic Patient Record Systems

Debate between Baroness Merron and Baroness Finlay of Llandaff

Wednesday 12th February 2025 Lords Chamber

[Baroness Merron (Lab)]

The noble Lord is an exemplar when he describes the quality of care and the joined-up approach of the data and information relating to him. I am delighted to hear that Bedford Hospital was so good to him. I am sure it will appreciate him sharing that with your Lordships’ House, and I add my thanks too.

[Baroness Finlay of Llandaff (CB)]

My Lords, as part of the tailored support that the Minister spoke about earlier, can she explain about the cybersecurity provisions? The ransomware attack on Synnovis last June meant patients’ blood groups were unable to be matched, so there was a call-out for O-negative blood. Patients transfer between the devolved nations of the UK, between Wales and England, and across the border, to a lesser extent, between Scotland and England. Is she having discussions about United Kingdom-tailored cybersecurity support for these rollout systems?

[Baroness Merron (Lab)]

We regularly liaise and work closely with the devolved Governments. More than £338 million has been invested in cyber resilience to date. In March 2023, the department published the cybersecurity strategy for health and social care, which runs until 2030. This is an area of huge importance, as the noble Baroness identifies, and one we continue to press.

Community Pharmacy Closures

Debate between Baroness Merron and Baroness Finlay of Llandaff

Tuesday 28th January 2025 Lords Chamber

[Baroness Merron (Lab)]

That point is understood, which is why I thought it important to bring to your Lordships’ House the announcement in the media release from my ministerial colleague Stephen Kinnock. As I mentioned in answer to an earlier question, integrated care boards have a role to play. They should—in fact, they are required to—have regard to the pharmaceutical needs assessment conducted every three years by local authorities. That ought to identify where there are gaps and allow consideration of how to fill any such gaps.

[Baroness Finlay of Llandaff (CB)]

My Lords, given the estimate that community pharmacies save some 38 million consultations that would otherwise have been in general practice each year, and the fact that 97% of pharmacy staff report shortages in accessing different medicines as prescribed, how are the Government planning to allow community pharmacies to adjust medicines—as has been recommended by Community Pharmacy England—so that they can modify prescriptions, rather than spend time recontacting the GP when they are themselves familiar with the items?

[Baroness Merron (Lab)]

The noble Baroness raises a good point and work is continuing to resolve that. It might also be helpful to say that NHS England has commissioned an economic analysis of the cost of providing pharmaceutical services and that will inform future funding arrangements. I say that in answer to the point the noble Baroness made about the potential savings that can accrue if we maximise the role of pharmacies.

Prisons: Health Services

Debate between Baroness Merron and Baroness Finlay of Llandaff

Tuesday 14th January 2025 Lords Chamber

[Baroness Merron (Lab)]

I certainly agree with my noble friend that there are huge opportunities to improve healthcare for prisoners. On new prison design, I reassure her that all prison design will be fit for purpose because medical architects will be commissioned. That new design includes, for example, medical cells so that as many healthcare needs as possible can be met in prison. On my noble friend’s point about ICBs, it is a retained service, so it is not currently delegated to ICBs. It is the responsibility of health and justice commissioners to collaborate closely with ICBs to ensure continuity of care. The electronic referral service means that patients in prison can have access to the developments to which others in the community have access.

[Baroness Finlay of Llandaff (CB)]

My Lords, a quarter of a century ago, I worked with the then Minister for Prisons following the difficulty we had releasing a shackled remand prisoner. The recommendation was that every prison should have a link with a hospice service in their area to ensure appropriate care, particularly for prisoners who cannot be transferred out of prison and who may wish to die in their cell, with their cellmate providing some of the support for them as they are dying. Can the Minister tell us how many prisons actually have such links?

[Baroness Merron (Lab)]

I thank the noble Baroness for raising such an important point and for having worked on this in the past. I will need to write her with the exact figures, but we do know that more needs to be done to address health issues. However, we are keen to ensure, and are working towards making sure, that healthcare for prisoners, whether at the end of their lives or earlier, is appropriate and meets their needs, whichever is the right way to do it. Great strides have been made in that regard.

Hospice Funding

Debate between Baroness Merron and Baroness Finlay of Llandaff

Monday 6th January 2025 Lords Chamber

[Baroness Merron (Lab)]

The noble Lord makes a very interesting point. Of course, the introduction of gift aid supported charitable funding, including to hospices, and I know was very warmly welcomed. These are all important ways of looking at funding and we will consider the best way forward, but I note from discussions with the hospice movement that hospices very much value their autonomy in terms of funding; the more linked it is to government funding, the less autonomy they have. We want dignified and appropriate care for patients and families, and to find the best way to deliver that.

[Baroness Finlay of Llandaff (CB)]

My Lords, I pay tribute to Lady Randerson, who was a great supporter of hospice and palliative care services in Wales, as well as a dear friend. I declare that I am vice-president of Hospice UK and have been involved in setting up the palliative care commission, which will be chaired by Professor Sir Mike Richards and will start to take evidence this week. Can the Minister inform us of the department’s work to look at different funding formulae, such as the one we developed in Wales, which respects the individual autonomy of the voluntary sector while ensuring that some of the black holes of provision can be filled? Will the Government collaborate with the commission by providing as much evidence as possible so that Professor Sir Mike can come up with some really firm recommendations for the future?

[Baroness Merron (Lab)]

I associate myself with the tributes paid to the great contribution that the late Lady Randerson made to this House. She will be sorely missed. In addition to Minister Kinnock meeting major stakeholders, including Macmillan, Together for Short Lives and a number of other organisations and charities to discuss sustainability of funding, Ministers will continue to have discussions with NHS England, because the other area is about getting the money promptly, which has not happened to date. Again, that has caused huge difficulties. We very much look forward to seeing the commission’s findings and recommendations and will look at how we can work to support it.

Health: Quad-demic

Debate between Baroness Merron and Baroness Finlay of Llandaff

Tuesday 10th December 2024 Lords Chamber

[Baroness Merron (Lab)]

The noble Lord will be aware that being prepared for winter is crucial. It has felt for too long as though winter crises have almost become normalised. Certainly, our move towards a 10-year plan will ensure that we have an NHS that can provide all year round. To give one statistic on Covid, in the week beginning 1 December there were 1,390 hospital beds occupied by confirmed Covid-19 patients per day, which was 41% lower than in the same week last winter. However, we are absolutely aware of this issue and we are not expecting a difficulty in respect of beds.

[Baroness Finlay of Llandaff (CB)]

My Lords, in her original Answer the Minister spoke about hygiene measures. I wonder whether she could expand on the advice that will be given to the public about considering washable face masks that can be recycled; about improving handwashing because of norovirus; and, particularly as we go into the Christmas season, about not washing poultry, which causes the droplet spread of campylobacter in kitchens and can lead to severe gastrointestinal infections. These will all increase the workload on the NHS if combined with the other infections that we have spoken about.

[Baroness Merron (Lab)]

Prevention is key, rather than just focusing on cure. Communications thus far are focusing on handwashing; I will discuss the other points the noble Baroness raises with the department.

NHS Hospitals: Apheresis

Debate between Baroness Merron and Baroness Finlay of Llandaff

Wednesday 9th October 2024 Lords Chamber

[Baroness Merron (Lab)]

I assure the noble Baroness that we are more than factoring it in. We are totally committed to working to support those with sickle cell, and thalassaemia. There is ongoing work to provide the very best possible care, including boosting the number of blood donors, which is vital in improving clinical pathways and delivering treatments. There is a treatment, as I am sure the noble Baroness is aware, called Casgevy, which requires apheresis as part of the process. It is being evaluated by NICE for the treatment of thalassaemia and it is also being evaluated for sickle cell. I hope all those things will bring great benefits.

[Baroness Finlay of Llandaff (CB)]

My Lords, I am grateful to the Minister for highlighting that we are a leader across Europe with our services, but only 50% of the country is covered. Can she assure us that in all reviews of the NHS, consideration will be given to centrally commissioned, highly specialised services such as this, rather than relying on local commissioning, that the workforce plan will recognise that highly skilled nurses are needed to undertake this treatment, and that that needs to be factored in? The numbers are small but the skills are enormous.

[Baroness Merron (Lab)]

What the noble Baroness says is very true and I certainly can give the assurances she seeks.

Bread and Flour Regulations 1998

Debate between Baroness Merron and Baroness Finlay of Llandaff

Wednesday 11th September 2024 Lords Chamber

[Baroness Merron (Lab)]

I certainly hear the very welcome points that the noble Lord makes. As we progress, this will make us the first European country to mandate folic acid fortification of non-wholemeal flour. While some European countries, including Ireland, have voluntary fortification, mandatory fortification is not the case. I and my ministerial colleagues are keen to be in this position.

[Baroness Finlay of Llandaff (CB)]

I am grateful to and congratulate the Minister on her perseverance on this issue and on decreasing neural tube defects. Can she also ensure that products are appropriately labelled with warnings that they are not fortified and that any woman who might become pregnant should take additional folic acid supplementation? Without that, we will not tackle the ongoing problem of neural tube defects. I do have a concern that there is inappropriate fear over toxicity, given that in 1991 there was a very good randomised controlled study. People were divided into groups, given fairly high doses, including with multiple vitamins, and compared with those on a placebo. There were no adverse neurological or other effects.

[Baroness Merron (Lab)]

I am grateful for the noble Baroness’s contribution and can reassure your Lordships’ House, and anyone else who may be concerned, that, as noble Lords have said, this has been gone through over many decades. Safety is paramount. On products that are non-fortified, I will have to look into this, but for those that are fortified, there will be a transition period for industry because the equivalent of some 11 million loaves of bread are sold in the UK every day but only 65% of the flour used in their manufacture is produced in the UK. We have to look at this huge diversity of food products, including biscuits and cakes, and where it is a food ingredient in ready meals and soups. It is quite an undertaking, but your Lordships’ House can be assured that we are on it.

Government Policy on Health

Debate between Baroness Merron and Baroness Finlay of Llandaff

Tuesday 10th September 2024 Lords Chamber

[Baroness Merron (Lab)]

My noble friend makes an important distinction, and I would certainly share that view. It is worth reminding your Lordships’ House that ministerial meetings that are attended by third parties are declared in a quarterly transparency publication in the established way. Of course, this will be done. I can tell your Lordships’ House that I had a meeting with the right honourable Alan Milburn, and it was very useful.

[Baroness Finlay of Llandaff (CB)]

My Lords, I should declare an interest because I was on the Times Health Commission. We took evidence from a wide range of people, including the person mentioned. Can the Minister provide assurances that, whenever people are consulted, they are routinely asked to declare their interests; that any declaration of interest is repeated not only at the first meeting but whenever other people are present so that it is well known; that the consultation goes widely; and that there is no overreliance on a small number of people? We at the Times Health Commission found that, by consulting widely, we were able to hear very conflicting views, which was helpful and formative.

[Baroness Merron (Lab)]

I thank the noble Baroness for sharing her experience of consulting widely. It is certainly entirely legitimate for government departments to do just that. However, those who do not have a formal role are not required to declare interests; it is different for those who have a formal role. Requiring them to do so would mean, for example, us sending forms in advance to Cancer Research UK before it comes in to talk to us about cancer and to assist us. Would we want that? We would not. Of course, where there is a formal role, we absolutely do that.

It is probably worth saying that a particularly high-profile invitation went from the Secretary of State to the noble Lord, Lord Darzi. He will report shortly on the true state of the National Health Service. He does not have a specific role in the department but he has been invited by the Secretary of State to assist; I believe that he will assist both your Lordships’ House and the other place.