(9 months ago)
Lords ChamberThe noble Baroness is correct that the science is unfortunately not there yet. That is why we are investing £160 million a year in research, because more needs to be done. In the meantime, and I suspect for ever, we will need to make sure that support networks are around this space, and the voluntary care sector, for want of a better phrase, is a vital part of that. We are making moves towards it; we are giving respite care and making some payments. I freely admit that there is more we could be doing in this space, but we have done quite a bit as well.
My Lords, my husband, having had two strokes, was part of a project called OPTIMA, so he left his brain to that project. When the report was sent to me, OPTIMA assured me that my husband had had vascular dementia, not Alzheimer’s.
Again, everything that can add to our knowledge has to be a good thing.
(5 years, 4 months ago)
Lords ChamberTo ask Her Majesty’s Government what steps they are taking to increase the use of automation in the National Health Service.
My Lords, the Topol review, published earlier this year, outlines recommendations for preparing the health and care workforce, through education and training, to adopt new technologies such as artificial intelligence and robotics. It is clear that the use of AI will not replace clinical staff but instead allow them to be more human. The use of new technologies will ensure that patients receive safer, more productive, more effective and more personalised care. The recommendations of the Topol review have informed the interim NHS people plan, which sets out how we prepare the workforce to build an NHS that is fit for the future.
My Lords, the success of any organisation is dependent on the people within it. I believe that the most precious asset that the NHS has is its human resource of dedicated staff, but in these days of sophisticated IT, and now artificial intelligence, can my noble friend tell the House what developments can be safely and securely harnessed by the NHS?
Tremendous innovations are being introduced, including in robotics and AI-based automation, particularly in diagnostics, which have the potential to transform how healthcare is delivered in the NHS, but the role of automation to carry out basic administrative and repetitive functions, and of robotics in surgical operations in particular, is due to increase over the next decade. The main purpose of this automation in health is not to replace staff with machines or to reduce the role played by humans in providing care but, rather, to enable staff to spend more time delivering personalised care. But it is also to improve the productivity of health services and systems so that we can ensure that the NHS becomes more sustainable in future.
(6 years, 5 months ago)
Lords ChamberI am afraid I do not know—it is a slight handbrake turn on the topic. I would of course be happy to meet the noble Baroness to discuss this issue; I was not aware of it, but I will happy to investigate it for her.
My Lords, can my noble friend the Minister explain why this NICE recommendation was rejected for the treatment for chronic lymphocytic leukaemia? NHSE operates a closed system whereas NICE is in direct contrast. There is no input in NHSE from patients or experts on this dreadful condition. If it is not reversed, will we not see poorer results for patients and, ultimately, higher costs for the NHS?
I thank my noble friend for that question. This debate has highlighted just how passionately people care about this issue and making sure that we have good and quick access to the most effective cancer drugs. It is important to point out that, for this particular disease, Ibrutinib is available for many groups. There is clearly a concern about a potential discrepancy between the NICE guideline and the NHS commissioning guidelines. That is what I will try to get to the bottom of next week. I have to restate, however, that NHS England’s view is that its guidelines are based on the full guidance that came from NICE, not just the summary; it is that that I need to explore.
(7 years, 1 month ago)
Lords ChamberMy Lords, I am fortunate to live in a lively Warwickshire village. There are two doctors with their own pharmacies, but every time I want something as simple as paracetamol I have to get the car out and drive eight miles to the nearest pharmacy. Last week, I was thrilled to see that the closed HSBC bank had a sign above it saying “pharmacy”.
I understand that in an NHS with increasing demands for funds it is not sensible to have pharmacies—each of which costs the NHS, on average, £220,000 a year—in abundance every few yards in urban areas. However, in rural areas it can be more than difficult to buy those essentials we rely on, especially if you do not have a car and there is an infrequent bus service. I congratulate the Government on being selective in supporting pharmacies that make life easier for country people while encouraging those small businesses to expand their basic service. In another village, I recently saw a sign in the window saying, “Opening hours: 6am to 9pm Monday to Saturday, and 9am to 5pm on Sunday”. What a service.
Last Saturday, I went inside the empty pharmacy and met Steve, the new pharmacist who is planning to open next week. He is enthusiastic to get going. So to him and all independent pharmacists who are free to flourish and to respond to the needs of the community, I say good luck, as they provide a really worthwhile service to the community. I am sure noble Lords will understand why I am not able to support this Motion.
My Lords, I declare an interest as chairman of the Climate Change Committee. I intervene only because one of the largest uses of vehicles is for health reasons. I hope my noble friend will not mind if I say that the Department of Health has perhaps not shown itself to be quite as central to the solution of our problems with climate change as other departments have. I hope this is going to change, and I am intending to bang on his door quite a lot until it does because this is a central issue.
This debate has shown that it is a useful one to have. I am not sure I want to enter into the party politics of it but there are quite good arguments about how many extra community pharmacies there have been, and there is certainly no doubt that the Government have shown themselves to understand this. No doubt there are other arguments, but the issue for me is proximity and propinquity. I am thinking not just about rural areas, although I live in a rural area and I understand the point very strongly; for many people in urban areas who do not have access to motor cars and where bus services are exiguous, the fact that they can walk to a pharmacy or ask others to do so if they themselves are unable to, is an important part of the kind of service that we need. It is disappointing that in the various collections of data we have not spent a bit more time looking at how many journeys are made and how many hours’ worth of diesel are used by people in accessing the health service. We know exactly how many journeys by lorry carry food—it is about 42% of all the lorry journeys in Britain—so we know a lot about these things, but I am not sure we know enough about what happens in the health service. When we are making these judgments, we have to make them in a holistic way.
So I do not apologise for the fact that on this, as on many other issues, I shall try to dramatise the fact that we should not be making decisions without asking ourselves, “What is the issue here in trying to meet the requirements which are now statutory?”. By 2050 we have by law to cut our emissions by 80%. We have to meet by law the fourth and fifth carbon budgets, and we have just issued the clean growth plan which is designed to deliver that end. There is nothing in any of that on the contribution of the NHS. It is time we asked the NHS to recognise that part of its role is to ensure that people’s access is as convenient as possible, not just for their convenience or because it saves money for other bits of the NHS, but because we as a community have to look at our statutory requirements to meet our climate change targets.
I hope that my noble friend will accept this as a preliminary thrust on the subject of the health service’s contribution to what we need to do. Indeed, in doing it, it is of course a circular system. Many of the problems the NHS has to deal with result from the subsidiary effects of pollution. It is not a matter not just of changing our climate but of the pollution at a much lower level physically but very high-level in terms of air pollution, and the damage that that does to health. I do not think this is something the health service can avoid and I hope my noble friend will take it into account.
(8 years, 9 months ago)
Lords ChamberI understand that the common mosquito which we find in southern Europe could potentially carry Zika, which I think was reported in the Times today. There is as yet no evidence that it does carry Zika, but it is something that we need to watch very carefully.
My Lords, is the fever notifiable, so that a record is kept of this event?
My Lords, one of the problems of this illness is that four out of five people are asymptomatic—they have no symptoms. For many of the others, the symptoms are such that it is a very light cold or light flu. That is one of the problems with this illness.
(9 years, 8 months ago)
Lords ChamberMy Lords, the noble Baroness is right. It is with that thought in mind that Kate Lampard did not simply pigeonhole Savile as a one-off but has come forward with recommendations, most of which we have accepted, as to the wider lessons we should learn from this sorry saga. We know that, while the scale of Savile’s activities was probably unprecedented, there are others who have been found guilty of similar offences.
My Lords, my noble friend the Minister referred in the Statement to the review by Dame Janet Smith into Savile’s activities at the BBC. This review is ongoing. Of course, it was the BBC which gave Jimmy Savile this extraordinary platform in the first place. Will my noble friend confirm that this ongoing review is entirely independent of the BBC’s management and the BBC Trust? Can he also indicate when the review will be completed?
(10 years, 4 months ago)
Lords Chamber
To ask Her Majesty’s Government what steps they are taking to improve the early diagnosis, and to raise awareness, of dementia.
My Lords, in March 2012, the Prime Minister launched his Challenge on Dementia, to deliver major improvements in care and research. NHS England has set the first ever national ambition to improve dementia diagnosis. By March 2015, our aim is that two-thirds of the estimated people with dementia receive a diagnosis and appropriate post-diagnostic support. In May, Public Health England and the Alzheimer’s Society launched the Dementia Friends campaign, a major social movement to improve dementia awareness.
My Lords, all those who have lived with a loved one with dementia know only too well the heartache and unhappiness it brings to the whole family, without mentioning the financial implications for the family and, indeed, for the country. Does my noble friend agree that the Government must do everything in their power in this ageing society to support, wholeheartedly and urgently, research into this horrible condition? Does he also share my view that the probability of there being a test for early diagnosis around the corner does not mean that we all have to rush to the doctor if we have trouble remembering a few names or even, I understand, if one is losing one’s sense of smell?
My Lords, my noble friend is right on the last point. The advice I have received is that it is perfectly normal for memory to be affected by age, stress and tiredness, and that you should go to your GP only if you are worried. My noble friend is absolutely right about the importance of research because we need to make a step-change in the prevention of dementia and in its treatment and care. Research spending on dementia has increased by nearly 50% since 2010-11. We are on track to meet the target of increasing funding to £66.3 million by 2015 and our ambition is to further double spending over the decade following the end of the present Parliament. My noble friend will also be aware that research was a major focus of the G8 dementia summit last December and the World Dementia Envoy, Dr Dennis Gillings, is leading a World Dementia Council to stimulate innovation in this area.
(11 years, 5 months ago)
Lords ChamberMy Lords, we are clear that there needs to be a mechanism to assess the clinical and cost-effectiveness of new drugs, particularly those designed to treat rare and very rare conditions. NICE will indeed be the body charged with doing that. It is devising a process by which it can do so that is quite distinct from its normal technology assessment methodology. As the noble Lord will appreciate, the drugs concerned here are of a different kind and order of cost from those which NICE normally assesses. The noble Lord is quite right that that is the broad process which will be adopted.
My Lords, my husband did not have some rare disease but, following two strokes, he became involved with a research project called OPTIMA. He was then monitored. It gave my family—and me particularly—great satisfaction to know that he left his brain for research, which they found extremely useful.