Children’s and Young People’s Mental Health Services
Baroness Pidgeon Excerpts(2 months, 3 weeks ago)
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Baroness Merron (Lab)
I agree with the noble Baroness’s observations. Early intervention is key. That is what our entire focus is on, in the ways we have already discussed, and also on developing a children and young people’s modern service framework because we want to reduce variation and ensure that children get the right support at the right time.
Baroness Pidgeon (LD)
My Lord, recent analysis from the charity Young Minds shows that, for the eighth month in a row, the average waiting time from referral to specialist support for young people was more than 300 days, and in the worst case it was two and a half years. Will the Government commit to using the forthcoming cross-government strategy to deliver open-access mental health support in every community for young people up to the age of 25?
Baroness Merron (Lab)
The point about age is important and one that we will be considering as we go forward with the mental health strategy. Waiting times are way too long, but there is a particular challenge that we have to meet, which is that some 10% of young people are waiting for an inordinate amount of time, as the noble Baroness said. I was very glad that the report does recognise that increased prevalence is a driver. One in 10 17 to 19 year-olds was in need in 2017 and now it is 1.4. I think that gives some idea of the scale and of why we have to make such a systematic change.
IVF Treatment
Baroness Pidgeon Excerpts(2 months, 3 weeks ago)
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Baroness Merron (Lab)
I recognise the situation that my noble friend describes and note that, while the relevant Act has provided a strong framework for over three decades, the fact is that treatment, science and societal expectations have all evolved very significantly since the last major reform in 2008. It is the case that the Act does not currently provide powers to ban add-ons. We are constantly looking at what we can do while we await and consider legislative change, but that really is the best way forward to tackle this.
Baroness Pidgeon (LD)
My Lords, the reality is that patients in England are struggling to access publicly funded IVF, with only two out of the 42 integrated care boards in England complying with NICE fertility guidelines. Can the Minister advise whether the Government are considering following Wales and Scotland in centralising commissioning for IVF rather than the current postcode lottery?
Baroness Merron (Lab)
We are not doing that, not least because, as the noble Baroness is aware, we believe that the needs of the local population are best served through local decision-making and through the integrated care boards. That said, I absolutely recognise that access to NHS-funded fertility services is variable, and we are reviewing the situation so that we can determine the next steps. I should emphasise that NHS commissioning organisations are expected to commission fertility services. They do have NICE guidance, which we are supporting them in following.
Extreme Heat: Resilience of NHS Infrastructure
Baroness Pidgeon Excerpts(2 months, 3 weeks ago)
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Baroness Merron (Lab)
We are already investing some £30 billion of capital across the NHS estate. I have mentioned the most serious infrastructure risks, which the noble Lord rightly refers to. While we accept the age of the estate and its size—I noted in preparing for this Question that we are talking about the equivalent of 4,000 football pitches—we also have a backlog of maintenance issues, which have grown and grown. We estimate that some £15.9 billion is needed. While there are no easy solutions, we do have a resilience plan not just for overheating but for all threats to resilience arising from temperature. We are also providing the funding—although, to the point the noble Lord makes, it is down to local decision-making—and ensuring that we are assisting the estate across the country to meet the challenges, the priority being those areas that need it most.
Baroness Pidgeon (LD)
My Lords, aside from the estate, patients on medications known to cause issues in extreme heat are not always being given specific advice on adjusting use of these during extreme weather and, as a result, have been admitted to hospital. What work is the department doing, particularly given that we have further hot weather coming, to ensure that patients receive the right advice and support to avoid hospital admissions as a result of such hot weather?
Baroness Merron (Lab)
The recent heat health alert was the first alert since July 2022. Importantly, the UK Health Security Agency has updated its weather health alert system in order that action can be taken and preparations put in place. It has also expanded its guidance, communications and the training of staff across the health and social care sector, so they can better deal with the challenges.
Nottingham Maternity and Neonatal Services
Baroness Pidgeon Excerpts(2 months, 3 weeks ago)
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Lord Kamall (Con)
My Lords, I thank the Minister for the opportunity to ask questions on this Statement on the report, which raises many troubling issues. I add my thanks to Donna Ockenden and her team for their extraordinary work in conducting what has been the largest review of maternity services in the history of our NHS. Our thoughts are with the thousands of mothers, babies, fathers, partners and families whose experience lies behind this report. It is only because of their courage and determination that these failures have finally been brought to light.
When, in the past, I have spoken to families who feel that they have lost a relative or friend due to medical negligence, they often say to me that they are reluctant to pursue justice, since it adds to their grief. They also point out that they often face hostility for raising concerns, as they are seen to be criticising the NHS. This is a terrible indictment. No organisation, including the NHS—perhaps especially the NHS—should be above criticism. The findings expose years of failures in leadership, governance and culture, not just a few isolated cases of clinical failure. Women were not listened to, families were dismissed, and staff were unable to raise concerns in an environment where bullying and intimidation were embedded. Most disturbing of all, the report noted that evidence of these failings already existed, yet action was repeatedly delayed or avoided.
However, we on these Benches wish to be constructive in our response, since maternity safety has challenged Governments of all political persuasions. Will the Government and the healthcare system introduce measures that genuinely improve safety and strengthen accountability, and will they listen to women and families? If so, they will have our support. But the real test will be whether the report leads to meaningful and lasting change across every maternity service in England, because, regrettably, many of the report’s conclusions are not new. Previous inquiries in Morecambe Bay, Shrewsbury, Telford and East Kent identified many of the same underlying themes: women not being listened to, poor communication, inadequate staffing and weak governance. This report must become the point at which recommendations are accepted and demonstrably delivered.
I have four questions for the Minister. First, can she outline whether the national implementation plan will include clear milestones and regular public reporting, so that Parliament, families and clinicians can judge whether progress is being made? Secondly, how will boards be held accountable for creating an environment and a culture in which openness and patient safety genuinely come first? Thirdly, what steps are the Government taking to ensure that maternity services have the workforce training and leadership they need to provide safe care? I understand that the former Secretary of State felt that there should be more of a focus on technology than recruitment. That is not necessarily a bad thing, but can the Minister explain how this would work in maternity care?
I also welcome the Government’s recognition of the distressing findings on mortuary services. The treatment described in the report represents a lack of dignity and compassion towards bereaved families. The actions announced are important and I look forward to the Minister reassuring the House that the lessons from these failings will be embedded across the NHS and not just confined to Nottingham.
Fourthly, the Minister will be aware that Henrietta Hughes, the Patient Safety Commissioner, is increasingly frustrated that, having proposed a system for redress and compensation for those poor victims of valproate and pelvic mesh, there has still been no movement from the Government. Can the Minister update us on that?
No woman’s experience of pregnancy or childbirth should be determined by their ethnicity, background, language or confidence in navigating the healthcare system. This report highlights clear disparities. The evidence of racism and discrimination identified in the review is deeply concerning and underlines the importance of ensuring that every woman receives safe, personalised and compassionate care. This is not asking for special treatment for anyone; it is about making sure that patients of all backgrounds are treated equally.
Trust in our maternity services will not be rebuilt through apologies alone. It will be rebuilt when women know that they will be listened to, when families see concerns acted upon rather than dismissed, when staff are empowered to speak up without fear, when boards are judged by the safety they deliver and when Parliament sees clear evidence that today’s commitments have become tomorrow’s reality.
The families of Nottingham and other maternity scandals have carried this burden for far too long. They should never have had to fight so hard simply to be heard over many years. They now deserve our determination that this report marks a genuine turning point, and, if the Government achieve that, they will have the support of all Benches. I look forward to the Minister’s response.
Baroness Pidgeon (LD)
My Lords, the Statement before us today from the Secretary of State in the other place is distressing reading, as is the report by Donna Ockenden. This review shocks us all to the core and must shake the Government into real action at every level of our health service and its regulation. Staff concerns were dismissed, a board did nothing and regulators failed in their duties. There was a simple refusal to listen to women and their families, causing such loss, trauma, negligence and damage, alongside bullying, organisational failures and the horrendous misplacing of bodies. Words just cannot express this horror. What brave and resilient families to keep fighting for justice; I thank them all.
I heard the deeply moving testimony at the press conference last week about the mental health legacy for bereaved parents. One explained how she had lost all trust in the NHS and had the constant, triggering experience of having to engage in her daily life with the organisation she holds responsible for the loss of her baby. It is hard to imagine.
This review, and the upcoming wider review from the noble Baroness, Lady Amos, must draw the line. This has to stop. Mothers, babies, children and families must have confidence that they will be provided with first-class maternity services, wherever they live in our country. There must be quality services that meet their needs whatever their age or background, with respect and dignity at the heart.
I welcome the taskforce, chaired by the Secretary of State. It will be crucial to ensuring the implementation of recommendations at every trust and to ensure that whistleblowing throughout the NHS works. An independent patient voice must remain part of our health service to help hold NHS trusts to account. We will revisit this point with the NHS Bill later this year.
I understand that, in 2018, over 50 members of staff wrote to the chair of Nottingham’s board, stating plainly that there were significant safety concerns. The letter was not even discussed by the board—it went to a sub-committee and was buried. In 2023, the chief executive found that the trust had never formally investigated staff shortages. I cannot get my head around this, as someone who has sat on many different boards over the years. This is not good practice. I therefore ask the Minister what urgent work the Government are undertaking to assess the competence of NHS trust boards. What changes may take place to strengthen them and to ensure that they carry out their serious role and responsibilities thoroughly and robustly?
The Government must also take action to strengthen whistleblowing powers in the NHS. My Liberal Democrat colleagues in the other place have tabled amendments to the Health Bill which would provide new powers for coroners and medical examiners to report suspected health failings. Will the Government look to support those amendments to strengthen whistleblowing in the NHS?
Finally, families need to have confidence in their local maternity services, and those services need to all be at the highest standard. Will the Government commit to a maternity rescue package to deliver this, including one-to-one midwifery care for every woman in labour and consultant obstetricians present 24/7 on every labour ward?
A big step change is needed to transform maternity services across the country that every family and every individual can have confidence in. I look forward to the Minister's response.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, we find ourselves deeply affected, as we have heard from both Front Benches. I am grateful for the tone and for the acknowledgement of the experiences of bereaved and harmed families who are at the absolute centre of this. The noble Baroness, Lady Pidgeon, said that she could not get her head around many of these things; I am sure we are all in agreement on that. I share the views of both Front Benches. I am grateful for the support for action. I absolutely agree with the noble Lord, Lord Kamall, that there is only one test: action. As the noble Baroness, Lady Pidgeon, said, it is also about confidence and step change. We all want to get this right. It is not recent; it is not isolated—as both Front Benches identified. It should not be the case that those who are bereaved and harmed have had to show such courage and determination. This is an impossible circumstance that people are in. The noble Lord, Lord Kamall, said that people understandably often do not wish to add to their distress. The fact is that women, babies and families have all been terribly let down, not as a one-off but by a system—a system that failed to listen, failed to be transparent and, to make it even worse, failed to provide the truth when things went wrong. We are looking at 13 years, since 2012. This is a sustained approach that was totally unacceptable.
On behalf of the Government, I want to say how deeply sorry I am, and the Government are, for what every family has suffered and for those who have been affected. I also want to thank parents and families for their courage and determination for sharing their experiences. Without that, Donna Ockenden and her team—to whom I express great gratitude—could not have done the work that they did. They have been diligent; they have shown compassion and great detail, and it will make a difference.
To the noble Lord, Lord Kamall, I can say that, certainly, the Government are going to deliver a clear and deliverable plan by the end of the year. As the noble Lord and the noble Baroness have asked for, these will indeed be system-wide improvements, so that everyone can have full confidence across maternity and neonatal services—and, yes, it will have milestones and transparency. How will this be done? The noble Baroness, Lady Pidgeon, has spoken about the taskforce. That is important. It is personally chaired by the Secretary of State. There is a very good reason for that—to give the absolute authority of his office. I am the deputy chair of that taskforce. It brings together many groups, including through the expert reference groups, but, crucially, it includes affected families and Michelle Welsh, MP for Sherwood Forrest, who would describe herself as someone who has been harmed in this terrible catalogue of heartbreaking experiences. She is our first appointed maternity adviser to the Secretary of State.
How will we deliver through the taskforce a clear action plan that will make a difference? We will bring together the national recommendations from this review and the independent review from my noble friend Lady Amos, rightly established by the former Secretary of State, which will report this Wednesday. The work will also look at previous reviews. It is right to say that there have been many previous reviews and lessons clearly have not been learned, which is totally unacceptable. It will be our duty to deliver that lasting change through the National Maternity and Neonatal Taskforce.
I have some immediate responses to the points raised by noble Lords on the Front Benches. The Secretary of State announced last week that we are extending Martha’s rule straightaway to all maternity and neonatal services. That means that every parent or caring person supporting a birth can request a rapid review from an independent medical team if the condition of a baby or mother is deteriorating and they are concerned that it is not being responded to. This is a very important step on the point of real listening.
I was also absolutely shocked to read the findings on mortuaries. They are chilling and deeply distressing. It is hard to believe that these things could ever be allowed to happen. There is a live police investigation, and two people have recently been arrested—noble Lords will appreciate that I cannot say more. Two immediate actions are also being taken: the Human Tissue Authority is conducting an urgent national review of mortuary incident reporting and NHS England, on instruction from the Secretary of State, is writing to all trusts to ensure that they consider the findings on mortuary care in this report.
I will pick up some of the questions asked by the Front Benches. On the point about boards being accountable for an open culture and patient safety coming first, that is their job. Noble Lords will not be surprised to hear that there has been a change of leadership. This week, the Secretary of State is meeting the chief executive and interim chair to discuss this point. Boards are held accountable to ensure that there is a patient safety culture through strict duties, independent oversight and targeted regulatory assessments. Clearly, this was not the case here and in other areas, but I welcome the change in leadership and their commitment to delivering a change of culture. I am grateful to Donna Ockenden for recognising that there have been improvements, though she is right that more needs to happen. As I said earlier, this is not just one random situation in one area—it goes so much deeper than that.
The noble Lord, Lord Kamall, asked about workforce. One of the recommended actions from the Nottingham report is that a perinatal workforce tool be developed. This will be considered by the taskforce along with all the other recommendations, as we have discussed.
The noble Baroness, Lady Pidgeon, asked about the urgent work to assess the competence of NHS trust boards. For example, the Nottingham trust has a learning and improvement board to oversee the required improvements, chaired by Michelle Welsh MP. It is supported by a family board and a staff board, which is the model we need to see.
On strengthening whistleblowing as part of the taskforce’s work, we will be looking at all parts of the health system when things go wrong, including how accountability is established and, if necessary, strengthened. On a maternity rescue package, continuity of care, referred to by the noble Baroness, Lady Pidgeon, is an action in the report from Nottingham and will be considered closely by the taskforce.
The noble Lord, Lord Kamall, asked about sodium valproate compensation. The Patient Safety Commissioner rightly continues to press on that. I do not have a specific update for the noble Lord; as soon as I do, I will be very glad to write to him.
It is impossible not to be affected by this report, but I consider it a luxury that I am affected in how I feel rather than in what has happened to me. Again, I apologise for myself and on behalf of the Government for the harm, losses and trauma that continue to this day. I commit us to doing all we can to make sure this is not repeated, and I am grateful to have the support of the Front Benches in doing this.
Healthcare Services: Acute, Primary and Community
Baroness Pidgeon Excerpts(2 months, 4 weeks ago)
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Baroness Pidgeon (LD)
My Lords, I am delighted to follow the noble Baroness, Lady Gerada, with her first-hand expertise and experience as a GP, and her description of the service that we all would like to see. I am grateful to my noble friend Lady Janke for introducing this vital debate. The relationship between acute services and primary care goes to the heart of how the health service that we value can survive and function. The noble Baroness, Lady Lane-Fox, rightly highlighted the need for the patient to be the focus, not the organisation, and she described the needs of serious trauma patients and the opportunities for technology. My noble friend Lady Brinton highlighted the need for patient-centred services and the whole person being at the heart of this.
The consequences of the deep imbalance between acute, primary and community health services are starkly visible in the data. NHS England discharge data from 2025 shows that patients who were medically fit to leave hospital spent the equivalent of 4.34 million days stuck in beds. They were there not because they needed acute care but because the community and social care that was needed to support them simply did not exist. My noble friend Lord Scriven provided the clear financial reality of acute services being prioritised, community services being reduced and the hollowing out of services for people with learning disabilities.
Let us look at dentistry. NHS England statistics published in 2025 show that four in 10 children—over 5 million in total—had not seen an NHS dentist in over a year. The Darzi review in 2024 found that only around 30% to 40% of NHS dental practices were accepting new child or adult registrations respectively. As my noble friend Lady Walmsley mentioned, official data from NHS England and the Royal College of Surgeons confirms that tooth decay remains one of the most common reasons for hospital admissions among young children in this country. The reality is that preventable dental disease generates acute demand. A child admitted to hospital with rotting teeth is a child whose primary care failed, not their acute care.
The noble Baroness, Lady Cass, brought her expertise in children and young people and questioned how the Government’s plans will really serve families better and bring the change that is needed.
We should look at some other trends in primary care. As we have heard, general practice is under extraordinary and unsustainable strain. Our GPs are the front line of defence, positioned precisely where they need to be to detect health issues early. They are the front door through which the public interact with our health service, and they need investment. If accessing a GP feels impossible, then public faith in the wider health service collapses entirely. My noble friend Lady Walmsley highlighted that the funding of primary care is not keeping up with demand, population and key areas of prevention work. The noble Baroness, Lady Gerada, talked passionately and rightly about how GP services have been left to wither and now have less than 8% of the budget.
As we have heard, according to the Association of Optometrists, access to community eye care services varies significantly across England. As a result, one in four people cannot access these services locally. Patients with common eye conditions are frequently directed to GPs, A&E or hospital eye services, even though they could be safely managed by community optometrists. At the same time, more than 600,000 people are waiting for hospital ophthalmology appointments, adding extra pressure to acute services. This just makes no sense, and it is patients who suffer.
In mental health, the picture is equally distressing. Thousands of children and adults are waiting months, sometimes years, to receive the support that they need. The previous Government left mental health services in a state, but the consequences of mental health being underresourced, and only triaged at the point of crisis, flow directly into acute services. Psychiatric presentations in A&Es, lengthy detentions under the Mental Health Act and ambulance callouts could have been avoided with earlier community intervention. They are the heavy downstream costs of failing to invest upstream.
Emergency departments are already bearing that cost. Department of Health and Social Care figures show that the Government have announced an average of £376 million in emergency winter funding annually, over the past seven years. This is patching up the system, year after year. That is not a sustainable health policy; it has become a bad habit.
The Royal College of Emergency Medicine has long called for staffed hospital beds, social care capacity and community step-down services. The Liberal Democrats have proposed a £1.5 billion plan to deliver 6,000 more beds daily, boost step-down care and enshrine in law the right to be seen in A&E within 12 hours. But let me be clear: beds alone will not solve this. Beds will fill up again, unless what lies beyond the hospital in home care, community services and general practice is also fit for purpose.
Social care sits at the very heart of this problem. Local Government Association figures for 2025 show that total local authority spending on social care reached a record £29.3 billion in 2024-25, up by £12.4 billion since 2015-16. Social care now accounts for up to 80% of many council budgets, putting immense strain on other services, yet the commission tasked with recommending long-term reform is not scheduled to complete its work for a further two years, with implementation potentially delayed until 2036. Those waiting for care, and those stranded in hospital beds for want of it, simply cannot wait that long.
My noble friend Lady Janke described powerfully the role of community pharmacies, which are a key part of primary care, and my noble friend Lady Leaman described the real impact of medicine shortages on children and young people, continuing into acute services. She also referenced the excellent report on medicines security from the Public Services Committee, which I recommend to the House.
This debate has not even touched on ambulance services, the key role that paramedics can play and the potential that they have, with a shift in resources, to help ensure that people are treated in the right place and at the right time, rather than at the critical point we have today. I recommend that noble Lords also read the latest publication from the Public Services Committee on this very topic.
The noble Lord, Lord Darzi, commented in his review of the NHS:
“Since at least 2006, and arguably for much longer, successive governments have promised to shift care away from hospitals and into the community. In practice, the reverse has happened. Both hospital expenditure and hospital staffing numbers have grown faster than the other parts of the NHS, while numbers in some of the key out-of-hospital components have declined”.
The King’s Fund also commented:
“When trying to envision the future of the health and care system in England, the difficult question to answer is not ‘What do we do?’—the vision for care has been outlined by multiple governments in countless policy documents—but ‘How do we actually make it happen?’”
I welcomed the commitment in the Government’s 10-year health plan to shift from hospital to community. It is the pace of change and the resources needed to support the rhetoric that will actually make it happen. Rebalancing an entire national health service requires rewiring funding, stabilising the workforce and completely integrating local services. If we all agree on the diagnosis, we need to work together to implement the long-term, radical changes needed to fix this. I look forward to the Minister’s response to this timely debate.
Resistant Hypertension
Baroness Pidgeon Excerpts(3 months ago)
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Baroness Merron (Lab)
I can indeed give the commitment to my noble friend that NHS England is currently reviewing the clinical evidence for the commissioning of renal denervation treatment, and recommendations are expected next year.
Baroness Pidgeon (LD)
My Lords, while innovative treatments have an important role, uncontrolled high blood pressure remains one of the leading drivers of stroke, heart attacks and kidney failure. What work are the Government undertaking to improve prevention and management of high blood pressure, particularly in communities with the highest prevalence and the poorest outcomes?
Baroness Merron (Lab)
The noble Baroness is right in what she says. This is a largely preventable condition and requires much movement from treatment to prevention, as the noble Baroness said. That means bearing down on certain lifestyle factors and encouraging people to seek to give up smoking, or not to take it up in the first place; to tackle obesity and support people in that; and to reduce alcohol consumption. It is important to note that identifying it at an early stage is crucial, because it allows us not only to support lifestyle changes but, where necessary, to provide medical intervention.
NHS: Dementia Treatment Trials
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Baroness Merron (Lab)
We do indeed, and I certainly agree with the noble Baroness. A timely diagnosis is absolutely vital to make sure that people with dementia can access everything they need, live well and remain independent for as long as possible. We are committed to recovering the dementia diagnosis rate to the national figure of 66.7%, and as of 31 March the figure stood at 66.3%. That is an increase from the time before and we will continue, through developing the modern service framework, to drive that upwards.
Baroness Pidgeon (LD)
My Lords, dementia is projected to reach 1.4 million people by 2040, yet Alzheimer’s Research UK reports that up to 45% of dementia cases could be prevented or delayed. Will the Government commit to a national dementia public awareness campaign to support risk reduction and healthier ageing?
Baroness Merron (Lab)
Encouraging people to age well and healthily is indeed part of our whole drive in terms of prevention and moving away from sickness. As part of this, it is absolutely crucial that we have the NIHR and UKRI, which are the relevant arms of our health service where we are investing in that dementia research. Causes, diagnostics and prevention in order to get treatment, care and support, as the noble Baroness says, are absolutely crucial. I would include carers in that too.
Prostate Cancer Screening: AI
Baroness Pidgeon Excerpts(3 months ago)
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Baroness Merron (Lab)
Yes, I agree with the noble Lord. While we are ambitious about the benefits of AI and wish to embrace them, we are equally clear that safety, fairness and public trust have to come first. That means that the National Commission into the Regulation of AI in Healthcare, which was established by the MHRA, will review the current regulations and provide the recommendations for a new regulatory framework. I assure your Lordships’ House that AI always will support professionals, not replace accountability.
Baroness Pidgeon (LD)
My Lords, AI has the potential to significantly improve options for patients, but this will be possible only if NHS staff have the right skills, time and infrastructure to be able to test and use such tools. How will the Government invest in staff to help drive this innovation and improve outcomes for patients?
Baroness Merron (Lab)
That is why we are publishing the workforce plan fairly soon, why we are building our cancer workforce and why we are creating new opportunities across multidisciplinary teams. Certainly, the use of AI is absolutely key, and we are, not least, working closely with the Royal College of Radiologists.
Integrated Care Boards: Budgets
Baroness Pidgeon Excerpts(3 months, 1 week ago)
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Baroness Merron (Lab)
The noble Lord actually outlines our entire focus. In March this year, we published the neighbourhood health framework that will empower local leaders to develop and scale neighbourhood health. It is important to recognise that this is not just more of the same; this is actually a change. It is a major shift, as outlined in the 10-year health plan on the back of the independent review by the noble Lord, Lord Darzi, that will mean that we can deliver what noble Lords rightly press me for: better patient-focused care, closer to home and with lower waiting times. That is the entire focus of the new arrangements. All the guidance and the targets that are set focus on that, which has not been the case previously.
Captain of the Honourable Corps of Gentlemen-at-Arms and Chief Whip (Lord Kennedy of Southwark) (Lab Co-op)
We will hear from the Lib Dem Benches.
Baroness Pidgeon (LD)
My Lords, since last year the number of patients waiting more than a year for basic community health services has shot up by a staggering 32%. What specific actions will the Government take to ensure that patients receive timely community health services?
Baroness Merron (Lab)
In February 2025 we published an overview of core community health services, Standardising Community Health Services, in order that ICBs should not just bear it in mind but act on it when planning for their local populations. I know that noble Lords are aware of this, but I often remind myself that ICBs are the best place to ensure that local health services meet the needs of local people. To assist the noble Baroness, we have also set very clear ambitions in our medium-term planning framework that mean that, by 2028-29, at least 80% of community health service activity should take place within 18 weeks, which would bring it in line with targets for elective care.
Compassionate Use Medicine Schemes: VAT
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
It is important to say, first, that this is not a new policy. There is recognition that while early access and compassionate use programmes are crucial, they are voluntary for pharma companies, which are aware, as I say, that VAT is applicable in these instances; it has been in place for decades. To be brief in answering the questions, first, I am not aware of the second issue that the noble Lord raised with regard to discussions—this is a totally different matter, in any case. Secondly, we are working closely with pharma companies, patients and anybody else who needs to be involved to find a sensible solution on this long-standing policy, which I understand was particularly discovered in 2023 by HMRC—so we are dealing with it from then. I have forgotten the third question, but I would be happy to write—oh, I know it. Yes, we always look at where revenue can be used, in a generic sense, but what matters here is that is not new. It was discovered in 2023, and it is entirely up to pharma companies—to which we are most grateful for the compassionate use of medicines, I should add—whether they wish to do it.
Baroness Pidgeon (LD)
My Lords, compassionate use and early access schemes are often the only way for patients with rare cancers to access life-extending medicines. What assurance can the Minister give that HMRC’s approach to VAT will not result in patients losing access to these vital treatments? What discussions about the impact has the department had with cancer charities?
Baroness Merron (Lab)
Cancer charities are important in this area, and we are certainly engaging with them; they are very invested partners. I understand why people are concerned. This is not instead of the NHS. NHS medicines are provided on the advice and guidance of NICE, and that absolutely continues. As I say, what we need to do, and what we will do, is work with everyone concerned to find a solution quickly, because we want to support the pharma companies that continue to donate what are very important medicines.