Safe Housing and Hospital Discharge
Debate between Baroness Merron and Lord Bishop of London(2 weeks, 1 day ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Merron (Lab)
I am glad that the noble Lord shares my enthusiasm for virtual wards. I shall expand on what they are: they allow people to be not in hospital but in their own home, whether it is their personal home or whether their home happens to be in a care home or some other setting, by the use of technology that allows them to be monitored. I recently saw an excellent example of that, and the liberation that it provides for individuals who would much rather not be in hospital is key. The noble Lord will know that, in the 10-year plan, the move from hospital to community is a key pillar, and we will soon be reporting on that. I certainly share his enthusiasm.
The Lord Bishop of London
My Lords, the VCSE sector plays a critical role in discharge planning. The Minister may know of a project in Warrington, where a social prescribing link worker and the VCSE team are integrated into the discharge team, and are therefore able to support people on discharge. The pilot has been positive, not least in that it has reduced readmission into hospital. Could the Minister say what support the Government are giving to integrated care boards so that they can enable this type of innovative provision? Can she reassure us that the aspiration to cut the ICBs by 50% will not impact on that potential?
Baroness Merron (Lab)
I very much commend the innovation and the commitment of people locally in the way that the right reverend Prelate describes. ICBs would be wise to work closely with the third sector in order to provide support and to tackle the very real challenges. With regard to decisions on how they use their funding, it is for ICBs to take into account the needs of the population and provide accordingly. As I say, it would be a wise ICB that took advantage of the innovation and the commitment in its local area.
NHS England Update
Debate between Baroness Merron and Lord Bishop of London(2 weeks, 1 day ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Merron (Lab)
The noble Lord is right to talk about NHS England in all its functions. Bringing it together with the department will not diminish those functions but will allow them to be delivered rather more effectively than they are currently. At the head of the transformation team is Sir James Mackey, the new chief executive of NHS England, working with Dr Penny Dash as chair. Both individuals are well respected across the sector for their outstanding track records, not least on turning round NHS organisations, in Jim’s case, but also on balancing the books, driving up productivity and driving down waiting times—exactly what is needed. But I agree totally with the noble Lord, and we are going to ensure that the necessary functions are continued; it is the way they are delivered that we are changing.
The Lord Bishop of London
My Lords, I declare my interest as indicated by the noble Baroness, in that I am a former government Chief Nursing Officer. Following on from the noble Lord’s point, this is a very significant change not just to the NHS but to its workforce. We know from looking back that when there is a reorganisation of the NHS, attention and funds are distracted away from the front line and patient care. The announcement came on the same day as the publication of the NHS staff survey results, which highlighted that only 31% felt that there were enough staff to enable them to do their job, and that 45% felt unwell due to work-related stress. What action will the Government take to make sure that there is not a management distraction, through this reorganisation, away from the front line and patient care in particular? How will staff be supported during this transition, not least those who, I suspect, fear that their jobs are now under threat?
Baroness Merron (Lab)
I recognise what the right reverend Prelate is saying. I myself have experienced change in large organisations, and change is never easy. We are talking about job losses; we cannot shy away from that. But it is appropriate that I re-emphasise the reassurance of our respect for and thanks to all those talented and hard-working staff in both the department and NHSE. We will, as I said, work with trade unions on this change in order to be fair and transparent and to deal with it properly. Of course it is uncomfortable, and people naturally find it difficult.
It is also important to look at the benefits. Currently, we have rather too much micromanagement, which frustrates progress and staff. Reducing that is one of the liberations that this will provide, so we can innovate and get on with caring for patients.
On maintaining people’s morale, this is a big challenge for us because morale has not been good at all, so we will pay particular attention to this as we publish the workforce plan later in the summer. This work continues. Senior managers and transformation team are very alive to the points the right reverend Prelate has made, and they will continue in that regard.
Soft Drinks Industry Levy
Debate between Baroness Merron and Lord Bishop of London(2 weeks, 2 days ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Merron (Lab)
I would be very pleased to write further to the noble Lord on this matter. I pay tribute to all of those community third sector organisations that work in line with government direction to reduce obesity. There are many aspects to this: it is not just about what community organisations can do but, for example, about implementing TV and online advertising restrictions for less healthy food. In all these ways, we will be able to make progress to reduce obesity.
The Lord Bishop of London
My Lords, we know well that diet and nutrition, and the infrastructure from which we can access the food that we eat, determine our health. These things continue to be unequal. The proportion of household income required to afford to follow the Eatwell Guide is 11% in the least deprived areas and 45% in the most deprived areas. What consideration will be given in the NHS plan to these wider issues—including the merits of reformulation policies—to improve the critical determinants of health?
Baroness Merron (Lab)
The right reverend Prelate is right to speak about the additional levels of ill health and obesity; a child of 11 in the most deprived areas is twice as likely to be obese as those in the least deprived areas. I can certainly assure her that the 10-year plan, which is soon to be made available, will take account of inequalities in all their aspects, including nutrition and food.
Musculoskeletal Health: Chiropractors
Debate between Baroness Merron and Lord Bishop of London(1 month, 1 week ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Merron (Lab)
I am certainly happy to have such discussions. Perhaps I could use this opportunity to say to noble Lords that part of the recently published elective reform plan sets out funding to boost bone density scanning—or DEXA—capacity, to provide an estimated 29,000 extra scans per year. The work goes on also to support workforce health. For example, we are commencing training so that over 200 doctors and nurses can undertake occupational health training and qualifications. The numbers of physios and OTs are increasing. This is very much work in progress. I certainly agree with what the noble Lord said about the impact and extent of this; it really does affect so many.
The Lord Bishop of London
My Lords, according to the Arthritis and Musculoskeletal Alliance report on health inequalities and deprivation, an important way to reduce health inequalities in these conditions, particularly in those groups of people who are underserved, is to help them to manage their own conditions. Often it is much harder because they often have more than one complex condition; often they are much more complex and are picked up much later. One of the recommendations was around moving NHS care into the community. Could the Minister tell us what the Government are doing to encourage the NHS to build partnerships with community groups, including faith groups, to seek to reduce inequalities in these conditions and communities?
Baroness Merron (Lab)
Working with community-based organisations, including faith communities, has come up a number of times in the 10-year plan consultation, as I am sure the right reverend Prelate will find. I would certainly associate myself with the comments about the importance of getting healthcare provided in the community.
NHS Plan: Consultation
Debate between Baroness Merron and Lord Bishop of London(4 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Lord Bishop of London
To ask His Majesty’s Government what steps they are taking to ensure the consultation for the NHS 10 Year Plan reaches all communities, including those who have least interaction with the health service.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, we want to ensure that the voices and experiences of patients are at the heart of our plans to make the NHS fit for the future, especially those voices that often go unheard. We are working with charities, faith groups, health and care providers, local government and others to ensure that we hear from those that national government often fails to reach. We will monitor this closely and target underrepresented groups before the engagement exercise concludes in spring 2025.
The Lord Bishop of London
I thank the Minister for her reply, and I am encouraged by the Government’s consultation on the NHS 10-year plan. However, does she agree with me that, if we are to move from sickness to prevention, any engagement ICBs have with their communities has to be long term and systematic? If so, what are the Government doing to resource ICBs to make sure that their engagement with communities is long term and systematic?
Baroness Merron (Lab)
I agree with the right reverend Prelate. Integrated care systems, which are responsible for reflecting the needs of the community and its spending, must follow guidance, and it is important that we identify the seldom-heard groups. We have built into the consultation plans a “workshop in a box”—a toolkit to support discussion in local communities, which ICBs are rolling out. It is a good way of encouraging ICBs to talk directly to local communities.
Type 2 Diabetes: Continuous Glucose Monitors
Debate between Baroness Merron and Lord Bishop of London(4 months, 2 weeks ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Merron (Lab)
It is probably important to say at the outset that type 1 diabetes, as the noble Lord knows, is not related to lifestyle issues, and at this point cannot be prevented, so it is a case of management. The technology that is available now is quite remarkable— not just the CGMs that the noble Lord, Lord Rennard, inquired about, but also hybrid closed loop systems, where the CGM is paired with an insulin pump, so it is administered automatically without the person having to calculate. I think that is incredibly helpful. It is only available to those eligible, with type 1 diabetes, but the rollout began in April 2024. The noble Lord makes a good point, as did the noble Lord, Lord Rennard, about access and inequality in access. That is something we continue to work on, ensuring that everybody can fairly access these wonderful technology advancements.
The Lord Bishop of London
My Lords, women with type 2 diabetes face a higher risk of miscarriage, stillbirth, neonatal deaths and birth defects. As we have heard, women who live in areas of high deprivation as well as women who come from black and minority ethnic groups are more likely to be impacted by type 2 diabetes. This compounds the existing inequalities in the maternal mortality rate. What steps are the Government taking to support integrated care boards to build relationships with these women who are most likely to experience these impacts, to ensure that they have the best maternity care and diabetic care, including ensuring they have access to continuous glucose monitoring where necessary?
Baroness Merron (Lab)
The right reverend Prelate is quite right in what she says, including that responsibility for CGM implementation rests with integrated care boards. It is their responsibility to ensure that the technologies we are talking about can be accessed by all eligible patients regardless of their ethnicity or their indices of multiple deprivation. I assure the right reverend Prelate that achieving that equality of access in all diabetes technology is an absolute priority. We will continue to monitor progress and encourage ICBs to do that by the NDA quarterly dashboard in 2025-26. In other words, we will give ICBs the tools to do the job they need to do.
Palliative and End-of-life Care: Funding
Debate between Baroness Merron and Lord Bishop of London(6 months, 4 weeks ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Lord Bishop of London
To ask His Majesty’s Government what assessment they have made of the adequacy of funding arrangements for accessible and equitable palliative and end of life care.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, we want a society where every person receives high-quality, compassionate care, including at the end of their life. Integrated care boards are responsible for the commissioning of palliative and end-of-life care services to meet the needs of their local populations. This is to promote a more consistent national approach and supports commissioners in prioritising palliative and end-of-life care. We will be considering the next steps, including funding, more widely in the coming months.
The Lord Bishop of London
I thank the Minister for her reply. We know that the hospice sector depends on charitable giving because of the low level of statutory funding at present. This means that the wealth and resilience of a community define the level of hospice services. This entrenches inequalities of place and means that access to hospice services is extremely unequal. Can the Minister outline what the Government are doing to look at the funding settlement, and particularly the wider hospice funding model, to ensure that this is not just another service that has poorer access for those in more deprived areas?
Baroness Merron (Lab)
I certainly take on board the point that the right reverend Prelate makes. It is the case that the amount of funding that charitable hospices receive varies by ICB area. That, in part, is dependent on the breadth of a range of palliative and end-of-life care provision within the ICB area. I can assure your Lordships’ House that my colleague, Minister Kinnock, the Minister of State for Care, has recently met with NHS England, and discussions have started on how to reduce inequalities and variation in access to services and their quality.