Healthcare Sector: Clinicians
Debate between Baroness Pidgeon and Baroness Merron(1 week, 5 days ago)
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Baroness Merron (Lab)
That is exactly the reason why we need to encourage innovation and take advantage of all the improvements now available to us, including AI. It is by modernising our approach that we will move forward greatly. That is why we are building the practicalities, as I described in my Answer just now, as well as a culture of innovation. We are also providing the ability to see adoption, because people are rightly concerned if time is spent on innovation but the product or service never comes forward. We are changing a number of points to improve that.
Baroness Pidgeon (LD)
My Lords, in a growing number of hospitals, clinicians are using at-home bladder cancer testing to reduce the number of cystoscopies and speed up diagnosis. Can the Minister expand on how the Government will help clinician-led innovations such as this to spread across the NHS, so that access does not depend on where a patient lives?
Baroness Merron (Lab)
Yes, I am very pleased to do that. I point to the National Healthtech Access Programme, which is exactly what the noble Baroness is seeking. It is a route for cost-effective and clinically effective technologies, such as the one the noble Baroness describes, so that we can see the best benefit to patients and the best value, and that supports more equitable access. NICE is currently assessing three projects, including using AI in histopathology for the diagnosis of prostate cancer and breast cancer, to give two examples, and we will shortly see the publication of those results.
People with Learning Disabilities: Acute Illness
Debate between Baroness Pidgeon and Baroness Merron(2 weeks ago)
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Baroness Pidgeon (LD)
My Lords, specialist training in the care of people with a learning disability is critical to reducing avoidable mortality. Will the Government fund dedicated senior clinician roles in learning disability medicine across community, acute and mental health settings to provide the leadership that is necessary to improve healthcare outcomes for this population?
Baroness Merron (Lab)
There are a number of aspects to that area. We have greatly increased the mandatory training requirement and the numbers who have been trained. The noble Baroness also points to the importance of a multidisciplinary approach. We have seen an increase in nursing staff in that regard. It is a matter for the local provider to decide, but the workforce plan, which we will be seeing soon, will be very helpful in this regard.
National Maternity and Neonatal Investigation
Debate between Baroness Pidgeon and Baroness Merron(4 weeks ago)
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Baroness Pidgeon (LD)
My Lords, this is another week and another traumatic and difficult-to-read report about the state of maternity services. Behind it are thousands and thousands of women and families deeply affected by these service failures. I thank them all for their contributions to this report, as well as the noble Baroness, Lady Amos.
Women are not being listened to, heard or believed, with serious consequences for safety and quality of care. Racism and discrimination are embedded throughout the maternity and neonatal system. Services are not responsive to the changing profile of women giving birth and the increase in medical interventions during birth. Antenatal, birth and labour, neonatal and postnatal services are just not joined up. From Somerset to Blackpool, the safety of having a baby has become a lottery. Women are silenced and staff who raise the alarm on unsafe care or systemic discrimination are crushed by a culture of fear. We need to see genuine accountability throughout the NHS and the investment necessary to make Britain the safest country in the world to have a baby.
I have a number of questions for the Minister. I welcome the Government’s commitment to a national maternity commissioner, but can the Minister confirm that this post will go to an independent expert and not a political appointee? Will the Minister reassure us that action will be taken before December, rather than waiting for the taskforce to report on its plans? Will the Government guarantee safe staffing at all hours in every maternity ward in the country, so that no woman has to give birth in an unsafe unit?
This inquiry has, once again, raised the issue of poor bereavement support across the NHS after pregnancy or baby loss. The national bereavement care pathway seeks to resolve this by ensuring high-quality and consistent bereavement care across the UK. The trauma of baby death and pregnancy loss can last a lifetime. Parents’ memories of the care they receive at that moment will stay with them for ever. Good bereavement care can help parents and families navigate their bereavement journey, while poor care can just add to the trauma of loss.
The first moments after a baby dies can be the only opportunity parents have to make memories with their baby, and there is only once chance to get this right. After a baby dies, parents often face really tough decisions, and they cannot make informed decisions about their baby without clear and compassionate communication from healthcare professionals. I therefore ask: will the Government roll out all five national bereavement care pathways, including for miscarriage, and actively monitor implementation across the health system? Will they ensure that suitable bereavement rooms are available in all trusts, not as a “nice to have” but as part of dignified trauma-informed care? This would be a step change for so many families.
There is so much more I could say on a topic that has shocked us all. All families, wherever they live and whatever their ethnicity, must be supported to have their babies safely. This has clearly not been the case for too many years. This is the point where things must change, and I really 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 know—and we can never acknowledge it enough—that women, babies and families across the country are being harmed, traumatised and let down by a broken system. I am grateful to both Front Benches for the way in which they have received this report and for their support, and their acknowledgement of the role we have taken in government.
The noble Baroness, Lady Pidgeon, talked about trauma lasting a lifetime, and that is indeed the case. When I have met women and families who have been affected, that is what has stuck with me: the trauma never goes away. I also accept the correct challenge from the noble Lord, Lord Kamall, that the judgment will be on what has changed, not on what is written. We are very conscious of that, and I am grateful to him for reminding me of it.
Before turning to the helpful questions from the noble Baroness and the noble Lord, I will make a few comments. I too want to express my gratitude to every woman, family member and member of staff who came forward to give evidence to the noble Baroness, Lady Amos, and her team, who heard from thousands of people who showed great courage and determination to share their experiences, painful though they were, and conducted their investigation with immense sensitivity and care. The noble Baroness, Lady Amos, diligently brought together evidence from families, staff, 12 local investigations and all the past reviews, and her review shows systemic, repeated failures by our maternity and neonatal system. It has also given us the opportunity and determination to break that cycle.
As I know your Lordships’ House will agree, it is also important that we acknowledge the very positive role that so many staff and families have played in providing the necessary care.
It was most helpful that some of our immediate actions were acknowledged. But, on top of those immediate actions, some of which have been mentioned today, we have ongoing actions. We have been tackling avoidable brain injuries and maternal deaths through dedicated programmes and packages. We have already begun the expansion of Martha’s rule to all maternity and neonatal units, to give families and patients the right to request a second opinion where there are concerns.
Among other things, we have also introduced a perinatal culture and leadership programme, which is important to develop a safety culture and a learning and support culture for the leadership across all units, and an early warning system to better identify safety concerns. Importantly, because continuity of care is something that has been highlighted a lot, we are providing £10 million of recurrent funding to ICBs for this very purpose, in particular to provide midwifery continuity of care for those women who live in the most deprived neighbourhoods and who are at risk of poor outcomes.
I will do my best to answer the questions asked by noble Lords. The noble Lord, Lord Kamall, asked about the timeline for Leeds and Sussex. Donna Ockenden, who will be chairing those reviews, is currently engaging with the families on terms of reference, which will include timelines. We will not be waiting for the publication of the findings to make changes. As they emerge, those issues will be shared with us, so that we can act.
In answer to the question from the noble Lord, Lord Kamall, the new maternity triage standards will be implemented by June 2027. There must be clear board oversight in place of the operation of the triage system, including regular reviews of waiting times and actions to improve the necessary services. The role and remit of the maternity commission is being urgently considered by the National Maternity and Neonatal Taskforce. The commissioner will co-chair the taskforce, which will drive all the change as well as setting it out.
On workforce pressures, we are not waiting. There is £10.6 million investment funding in an additional 1,000 temporary roles to help newly qualified midwives to join the NHS, which is extremely important. So, we are not waiting for the 10-year workforce plan. However, the taskforce will take into consideration wider work, including the 10-year workforce plan.
With regard to concerns raised by Bill Kirkup about what is referred to as “normal birth ideology”, women have to be able to make the right decision about what is safest and best for them. No woman should ever feel pushed into a particular type of care. The words “normal” and “natural” are perhaps not particularly helpful in this setting. We are talking about vaginal births; what matters is what is best and what is safest, and I am certainly very grateful to Bill Kirkup for all this work.
The noble Baroness, Lady Pidgeon, asked further questions about the commissioner, which were helpful. The selection and appointment process will be considered as part of the process of establishing the role.
Questions were asked on action being taken before December, when the report of the taskforce will be available. As I mentioned, immediate actions are already being driven forward. These actions were already under way over the last two years and as part of the immediate response to the recommendations of the noble Baroness, Lady Amos. Where we can, we have already actioned work, and, where we need further work done, that will be developed over the next few months, at pace.
The noble Baroness raised a good point about the rollout of bereavement pathways, including for miscarriage. We are rolling out all five strands of the national bereavement care pathway. All trusts in England have signed up to implement the core standards of the national bereavement care pathway. That is relevant in this case and, across other areas of bereavement, is of particular concern.
As I draw my remarks in this section to a close, let me give noble Lords a sense of the urgency. The taskforce and its supporting expert reference groups are meeting tomorrow to discuss the findings of both the Donna Ockenden report, on which we had a Statement last week, and the report by the noble Baroness, Lady Amos. Next Tuesday, the taskforce—which is spearheading all this and chaired personally by the Secretary of State—will be meeting to discuss next steps for the action plan. To the questions from the noble Baroness, Lady Pidgeon, about the commissioner’s role, the Secretary of State has already said that he wishes that the maternity and neonatal commissioner will co-chair the taskforce with him. That would be a very welcome move.
I hope that I have dealt with the questions and, more than that, given a sense of the pace and seriousness, as well as the action that I know we all seek.
Fracture Liaison Services
Debate between Baroness Pidgeon and Baroness Merron(4 weeks ago)
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Baroness Merron (Lab)
The noble Lord does not need to apologise for raising this extremely important matter. I am grateful for his campaigning on this, as I am to other noble Lords. There has been a lot of progress. In answer to his first question, I believe that it is possible, not least because all but two ICBs in the new, reconfigured groups have fracture liaison services already, with some having more than one. With respect to his specific request, as with other policies, I cannot give him exactly what he asks for, but I have already referred to some of the Government’s actions. We are looking, through the UK National Screening Committee, at screening women for osteoporosis, and a public consultation is about to start. We are cutting waiting times, and we have expanded community diagnostic centres and DEXA scanners. These, along with a whole range of other measures, show real commitment to tackling the matter that the noble Lord rightly raises, which affects lives and costs lives.
Baroness Pidgeon (LD)
My Lords, people from deprived areas have a 25% higher risk of fractures, spend longer in hospital recovering and die in greater numbers after hip fractures. The rollout of fracture liaison services is important to help tackle health inequalities. The Minister mentioned 2030, but how can this be rolled out faster to make sure that we help all these communities?
Baroness Merron (Lab)
We have rolled this out further, as we inherited a more limited coverage of fracture liaison services than we have currently, and we are looking at how to improve access. As I said to the noble Lord, 23 out of 25 ICBs have at least one fracture liaison service. We will push this forward through various means, including the Best Practice Guide for NHS Frailty Pathways, which recommends comprehensive neighbourhood-level frailty plans, and the modern service framework, to mention a couple of ways. I have to emphasise that this is about a complete change in the delivery of NHS services, from which fracture liaison will greatly benefit.
Children’s and Young People’s Mental Health Services
Debate between Baroness Pidgeon and Baroness Merron(1 month 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
Debate between Baroness Pidgeon and Baroness Merron(1 month 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
Debate between Baroness Pidgeon and Baroness Merron(1 month 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
Debate between Baroness Pidgeon and Baroness Merron(1 month ago)
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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.
Resistant Hypertension
Debate between Baroness Pidgeon and Baroness Merron(1 month, 1 week 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
Debate between Baroness Pidgeon and Baroness Merron(1 month, 1 week ago)
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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
Debate between Baroness Pidgeon and Baroness Merron(1 month, 2 weeks 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
Debate between Baroness Pidgeon and Baroness Merron(1 month, 2 weeks 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.
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
Debate between Baroness Pidgeon and Baroness Merron(1 month, 2 weeks ago)
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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.
Miscarriage Care
Debate between Baroness Pidgeon and Baroness Merron(2 months, 2 weeks ago)
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Baroness Pidgeon
To ask His Majesty’s Government what plans they have to improve miscarriage care and support.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, miscarriage can have a devastating impact on women and their families, and we are determined that they receive the support they need. We committed in the women’s health strategy to improve care for women, including carefully considering the graded model of care for repeated miscarriage. The National Maternity and Neonatal Taskforce will develop the national action plan to improve maternity and neonatal safety and experiences, and it will follow the pending recommendations of the independent investigation by the noble Baroness, Lady Amos.
Baroness Pidgeon (LD)
There are around 250,000 miscarriages in the UK every year. Following the recent Tommy’s Graded Model of Miscarriage Care report, will the Government now review the specific requirement for women to experience three miscarriages before being able to access the support that could help prevent another loss?
Baroness Merron (Lab)
This is an extremely important area, and I acknowledge very much that the current situation is not working for women or their families. To emphasise, we very much welcome the report from Tommy’s miscarriage centre at Birmingham Women’s and Children’s Hospital, which is about the effectiveness of its piloted model of sporadic or recurrent miscarriage care. I visited them when I first took office and was very taken by their work. I am glad they have reported, and, as confirmed in the women’s health strategy, we shall be looking very closely at this. It will deal with and refer to the point the noble Baroness makes.
Healthy Life Expectancy: England
Debate between Baroness Pidgeon and Baroness Merron(2 months, 2 weeks ago)
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Baroness Merron (Lab)
I recognise the noble Lord’s point. We are certainly seeking to give individuals the ability to grasp the opportunity to live well for longer and to support them in their choices. For example, in addition to the points I made to the noble Lord, Lord Krebs, we are working on restricting volume price promotions such as “buy three for the price of two” offers on less healthy food and drink.
Baroness Pidgeon (LD)
My Lords, given that the UK is an outlier compared to similar countries, what work are the Government doing to introduce proactive, preventive health measures, such as routine health MOTs for people, to try to reverse this trend?
Baroness Merron (Lab)
I welcome the noble Baroness to her Front Bench on the important matter of health and social care. I am most grateful for her question. We have to be ambitious, which is what the 10-year health plan is doing, in transforming how we tackle the biggest causes of ill health. We are going to take a whole-society approach and a whole-person approach, rather than dealing just with conditions. To the points made earlier, we will be working with individuals—as in the public—and in partnership with business and civil society.
Anti-depressants: Cost, Risks and Ramifications
Debate between Baroness Pidgeon and Baroness Merron(1 year, 7 months ago)
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Baroness Merron (Lab)
I assure the noble Lord that NICE keeps all its clinical guidance under active surveillance to ensure that it can respond to any new evidence that is relevant, including relevant clinically related literature, that could possibly impact on its recommendations. More broadly, guidance recommends that suicidal ideation should be monitored in people with depression who are receiving treatment, particularly in the early weeks of treatment. That includes specific recommendations on medication for people at risk of suicide.
Baroness Pidgeon (LD)
My Lords, a study in 2019 found that a third of women were prescribed anti-depressants by their GP to combat symptoms of the menopause. What are the Government’s current assessment of this situation and of adherence to NICE guidance in this area? If the Minister does not have full details to hand, perhaps she can write to me.
Baroness Merron (Lab)
I would be very pleased to write further to the noble Baroness. This is a very important point about support for women during the menopause. However, a prescription is made only after discussion with the patient about it and other alternatives, and the clinician has to follow and comply with the guidelines. Patient choice is absolutely key here. Every individual is an individual, and only what is appropriate should be prescribed—if needed.