Terminally Ill Adults (End of Life) Bill

Baroness Wheeler Excerpts

Committee stage
Friday 5th December 2025 Lords Chamber

[Lord Lansley (Con)]

My Lords, my amendments would remove the 12 months, because that would enable greater alignment with practice in the NHS. I make a plea to noble Lords that we might hear from those who have tabled amendments so that we complete the group more quickly. I think it is a discourtesy to those who have tabled amendments not to hear their explanation for them.

[Captain of the King’s Bodyguard of the Yeomen of the Guard and Deputy Chief Whip (Baroness Wheeler) (Lab)]

My Lords, while we are on the subject of interventions, I remind the Committee that a Member who is speaking may be interrupted with a brief question of clarification. A Member may justifiably refuse to give way. Let us try to stick to the people who have their names on the amendments and make progress.

[Baroness Grey-Thompson (CB)]

My Lords, my Amendments 13 and 309 are probing amendments. I recognise that the 60 months and the 12 months in my two amendments do not quite tally, but they were tabled at quite different times.

Amendment 309 is quite simple. It looks to open a discussion and seeks to protect asylum seekers, immigrants without indefinite leave to remain, and anyone in the asylum system.

On Amendment 13, it was very interesting to listen to the noble Lord, Lord Lansley. I recognise that 60 months will have raised some eyebrows. It was my clumsy attempt to talk about death tourism and look at how we can provide consistency within the Bill. One of the reasons that we are consistently given for needing the Bill is that those who can afford it can go to Dignitas, which promotes inequality. However, if we do not get this section of the Bill right, that inequality will still exist.

My noble friend Lady Finlay raised some important points on where someone is able to die, and I have other amendments on certification of those areas. This needs more thought because, in many of the letters I receive, individuals who want the law to change talk about wanting to end their lives at a time and place of their choosing. They may get roughly the time that they want, but they may not get the place.

We have been talking about people living in different countries. The latest statistic that I can find online is that at any one point there are between 4.5 million and 5.5 million British people living abroad, and they need clarification about how the Bill could affect them.

I am concerned about the possibility of different processes existing in different parts of the UK and the Crown dependencies, because it could be possible that, if you have money, you could purchase or rent a small property in another jurisdiction to enable you to access this. That might be totally fine, but people need to understand what this is going to bring, and that inequality could still exist.

The phenomenon of death tourism represents a documented concern internationally. The Isle of Man explicitly incorporated a five-year residency requirement into its assisted dying legislation, following recommendations from scrutiny committees examining the Bill’s clauses. That is why I picked 60 months. However, we have to be careful that we are not turning jurisdictions into destinations for accessing end-of-life services. Such relocation could create several problems. It might indicate that the person’s wish to die is not deeply rooted in their established community context. It could create practical and ethical difficulties for healthcare systems, which are unprepared to provide end of life to transient populations. It also raises questions about whether individuals are making decisions in isolation from their established support networks.

Whatever we end up with in terms of what residency looks like, we have to take into account what has happened in other jurisdictions. I was pleased that the noble and learned Lord said in the previous debate that in the Bill the age will not drop below 18. It is important that we get the residency right, because in other jurisdictions over time it has changed. In 2014, Belgium removed any age restriction and Vermont lifted its residency requirements in May 2023. At least 26 people have travelled to Vermont to die who were not resident there. Vermont is a tiny US state, but that represented nearly 25% of reported assisted deaths in the state from May 2023 through to June 2024, as listed in Vermont Department of Health data.

In Oregon, the same thing has happened: the residency requirement has been lifted, and around 6% of those choosing to end their lives in Oregon have been from out of state, according to official Oregon Health Authority reports. The oncologist Charles Blanke, whose clinic in Portland is devoted to end-of-life care, has said Oregon’s total is likely an undercount and he expects the numbers to grow.

Adequate residency duration enables meaningful healthcare relationships to develop, and I have amendments on relationships with GPs in a later group. For me, it is about providing appropriate healthcare and the right information. It is about being able to look at patterns of depression, changing wishes, family dynamics and coercion, which we have already debated. It is about providing stability and the authenticity of the person’s desire for assisted dying. It is also about whether the correct palliative and psychosocial support is there.

I do not think 60 months is the right number, but we have to be careful and clear about what will happen in terms of people being able to access this service. Finally, longitudinal research on end-of-life preferences demonstrates significant variability in expressed wishes over time. That is why we have to be really clear that we get this right.

Terminally Ill Adults (End of Life) Bill

Baroness Wheeler Excerpts

Committee stage
Friday 21st November 2025 Lords Chamber

[Noble Lords]

Shinkwin!

[Captain of the King’s Bodyguard of the Yeomen of the Guard and Deputy Chief Whip (Baroness Wheeler) (Lab)]

My Lords, we will hear from the noble Lord, Lord Shinkwin, and then the noble Baroness, Lady Cass.

[Lord Shinkwin (Con)]

My Lords, an enormous amount of time was given in the other place to blocking safeguards. I support the vital amendments in this group and thank all those who tabled them. It is a pleasure to follow the noble Lord, Lord Dodds of Duncairn, who made some incredibly important points about vulnerability. Some of us have been there. This is proper scrutiny; it is the House of Lords at its best. On whichever side of the divide we find ourselves on this Bill, we should all be very proud of that.

As someone who speaks from one patient’s perspective, I would never presume to know exactly how the pain another person experiences might feel to them as an individual. But I think that the sense of incredible loneliness, compounded by a sense of disorientation, are both parts of total pain, as defined by the pioneer of specialist palliative care, whom the noble Baroness, Lady Finlay of Llandaff, mentioned—Dame Cicely Saunders. That makes these amendments dealing with coercion and pressure crucial.

When I have been drowning in a pool of pain, the sides of which, in that moment, seemed so steep and slippery, I would have clutched at almost anything in an attempt to pull myself out. I appreciate how coercion and pressure are so nuanced and subtle and how much each of us in this House, at some point in our lives, may need to be protected from them. My noble friend Lady Coffey is absolutely right, in speaking to her Amendment 47, to mention the Royal College of Psychiatrists and, in her explanatory notes, its reference to the sense of being a burden as an internal coercion. I can testify from personal experience that in some cases the sense of being a burden, or the burden of pain, whether physical and or emotional, can be simply too great to bear on your own. This can be the most powerful and damaging form of coercion and perhaps the one from which we most need protection. We need to recognise that in the Bill.

I note that the Bill does not require any questions to be asked about why a person may wish to die. It is because Rebecca Paul’s Amendment 468 on precisely this issue was rejected in Committee in the other place that Amendment 3, moved by the noble Baroness, Lady Finlay of Llandaff, and Amendment 181, in the names of the noble Baronesses, Lady Grey-Thompson and Lady O’Loan, are so important. As the noble Baroness, Lady Ritchie, and the other sponsors of Amendment 48 have argued, we cannot divorce this internal coercion from the circumstances in which, for example, a disabled or older person might find themselves. We have to factor those in. It is not just coercion or pressure by any other person that may prove the tipping point.

I hope that your Lordships’ House will give very careful consideration to the amendments on financial pressures, such as Amendment 462, which I thank the noble Lord, Lord Hunt of Kings Heath, for tabling so ably. As we know, these pressures are exacerbated when a person is living with a disability.

In closing, I particularly welcome Amendment 846, tabled by my noble friend Lady Berridge, and Amendment 58, tabled by the noble Baroness, Lady Grey-Thompson, because the subtlety of pressure, particularly as it relates to disability, can definitely stem from cultural attitudes, whether institutional—for example, in terms of access to appropriate care—or societal. I give one example. I was laughed at in the street outside my home as recently as last weekend because of how I look as a result of my disability. That is not good for morale, to put it mildly.

It could be argued that mockery goes with the territory of being disabled, particularly when the anonymised vitriol on social media encourages teenagers, for example, to view disabled people as fair game. My question in relation to the Bill, and specifically Amendment 58, is, how can being subject to such prejudice not affect a person’s mental well-being or their sense of self-worth? How could such a structural disadvantage, in terms of the cumulative effect of being constantly exposed to such negative and discriminatory attitudes, not affect a person in a vulnerable situation who is considering assisted dying? It is inevitable, but how many non-disabled people factor that in?

--- Later in debate ---

[Lord Goddard of Stockport (LD)]

I have moved my seat. I wish to speak briefly as a member of the Select Committee who has not spoken.

[Baroness Wheeler (Lab)]

We will hear from the noble Lord, Lord Goddard.

[Lord Goddard of Stockport (LD)]

I moved from my position at the front, because there was a presumption that I was the Front-Bench spokesman trying to force something. I apologise; I was not. This House has a free vote, and nobody is whipped. I happened to be sitting on the Front Bench, and I have moved back; I understand the alarm I may have caused by standing up then, but I was not trying to derail the debate. I was just trying to be helpful, because lots of people have spoken, and I respect every single person who is doing so in the House—for and against. Within my own party we have the same difficulties.

It is about evidence. I want to help the House today, on the specific premise of coercion. Sir Max Hill, the former Director of Public Prosecution, said that

“throughout the time that I served as DPP … we did not have the coercion offences created by the Bill, which I suggest would be a significant advance, and nor did we have a legal system in which the investigation was taking place before the death. … The major advantage of the Bill, if I can put it that way, is that … scrutiny will be before death”.—[Official Report, Commons, Terminally Ill Adults (End of Life) Bill Committee, 28/1/25; col. 86.]

That comes to one of the points the noble Baroness, Lady Grey-Thompson, made—that when you are dead, it is too late to find out what has gone on.

In the other place, mandatory specific training on domestic violence, including coercive control and financial abuse, was introduced into the Bill and agreed through an amendment tabled by Jess Asato MP. Participating doctors and members of the multidisciplinary panel will have to undergo specific training in this area, as well as in assessing mental capacity. I believe there are now safeguards in the Bill—I think that was what the noble Lord, Lord Pannick, was alluding to.

It seems to me that we in the House think this is the first time this has ever happened, but the fact is that 300 million people across five continents have some form of assisted dying legislation. Not one of those countries has ever repealed it. It is right that we make it the safest and the best, and that the amendments be debated at length.

Noble Lords should forgive the cynicism of those who support the Bill—one Member said last week, causing some humour in the House, that they were sorry they came second to another Member in getting amendments down. This is not a competition; this is about getting the Bill right and fit for purpose.

I find it quite amusing when I see the noble Lords, Lord Pannick and Lord Carlile— it is worth the admission fee just to see the interaction. The points from the noble Lord, Lord Carlile, were right about trying to come to a conclusion and move forward. It is right that everybody speak, but that we speak to the amendments and try to get to a conclusion.

The noble Lord, Lord Dodds, is right: we should give it time. But we do not have time. We have four Fridays and no more. The Government have said they are not going to give way. If we do not finish the debate on these amendments, which are increasing every day—I believe we are up to 1,500 now—the Bill falls. Somebody—not me but someone else—might say, “Well, it is somebody’s objective that we run out of time; then we can stand here wringing our hands and say that we were just trying to make it the best Bill we could but we ran out of time and are very sorry”. That is not acceptable. Our role here is to ensure that legislation goes back to the other place, fit for purpose and the best we can make it. Somehow, we have to distil these amendments into something understandable.

Social Care Reform

Baroness Wheeler Excerpts

Thursday 22nd May 2025 Lords Chamber

[Baroness Andrews (Lab)]

My Lords—

[Captain of the King’s Bodyguard of the Yeomen of the Guard and Deputy Chief Whip (Baroness Wheeler) (Lab)]

My Lords, it is the turn of the Labour Party.

[Baroness Andrews (Lab)]

My Lords, can the Minister tell us what progress has been made on addressing the problem faced by many unpaid carers who have been penalised, through no fault of their own, for having been paid too much because of technical failures in DWP? Are we making progress on addressing those very serious issues?

Musculoskeletal Health

Baroness Wheeler Excerpts

Thursday 30th January 2025 Lords Chamber

[Lord Pannick (CB)]

My Lords—

[Captain of the King’s Bodyguard of the Yeomen of the Guard and Deputy Chief Whip (Baroness Wheeler) (Lab)]

We will hear from the noble Baroness, Lady Donaghy.

[Baroness Donaghy (Lab)]

I am a member of the APPG on osteoporosis, and we are very worried that fracture liaison services have been deprioritised in the recent NHS planning guidance. We know that the pump-priming transformation fund works because we have seen it working in Wales. It saves lives, as the noble Lord, Lord Black, said, releases people into the labour market, releases beds in hospitals and improves quality of life for thousands of people. Can the Minister give us an assurance? If this milestone has been missed in the planning guidance, we need urgent clarity on how the 2030 target will be reached.

Hospices: Funding

Baroness Wheeler Excerpts

Thursday 24th October 2024 Lords Chamber

[Lord McColl of Dulwich (Con)]

My Lords, I, too, thank my noble friend Lord Farmer for initiating this important debate. For most of my professional life, I have been associated with hospices such as St Christopher’s, the Mildmay in the East End of London, the Mildmay in Uganda and the Phyllis Tuckwell Hospice in Surrey. I have learned a lot working in these places.

I remember, for instance, a lady of 28 with an inoperable cancer of the throat. She was in pain and a lot of respiratory distress and needed relief from these symptoms. I explained to her that I could put a needle into her vein and titrate her with analgesics until all her symptoms had gone. She agreed to this. I gave her a surprisingly large dose of heroin, which not only did not kill her but relieved all her symptoms and gave her three weeks of symptom-free life. During that time, she was able with a clear mind to say goodbye to her friends and to tidy up all those loose ends. Some people accused me of hypocrisy, saying, “You’re really killing them and just saying that you’re relieving their pain”. Well, anyone who thinks they know what is in my mind has delusions of grandeur.

Cicely Saunders and I were contemporaries as medical students. Her work on relieving symptoms in hospices was very important indeed. She established without any doubt that the right way was to keep a constant level of analgesia in the blood rather than give patients doses only when they had the pain. If you do this, you require less of the analgesics overall and so the patients are more awake and able to enjoy life. That was a very important contribution. The present laws against euthanasia and assisted dying are like a huge dam preventing great enthusiasm for euthanasia and assisted dying. That dam can sometimes develop a crack for those who want to legalise euthanasia. Once you have a little crack in the dam, the whole thing can give way. Cicely Saunders’s work was an extremely important aspect of this.

As far as the funding of hospices is concerned—

[Baroness Wheeler (Lab)]

Can the noble Lord wind up, please? His three minutes are over.

[Lord McColl of Dulwich (Con)]

There is an urgent need for more funding, as has been said many times, and a partnership between government, charities and local authorities is required.

Homecare Medicines Services (Public Services Committee Report)

Baroness Wheeler Excerpts

Thursday 2nd May 2024 Lords Chamber

[Baroness Wheeler (Lab)]

I too congratulate my noble friend Lady Morris on her usual thoughtful, thorough and robust introduction to this excellent report. I commend the whole committee for shining a laser-like spotlight on such a vital service, upon which half a million people with chronic health conditions living at home depend. Homecare medicines services are some of many services provided to NHS patients that are not publicly well known or understood by the majority of people accessing the NHS, but, as we have heard, they provide and utilise huge NHS expertise and physical and financial resources—over £3 billion per year, as the Government now estimate.

The forensic, in-depth reviews that Lords and Commons committees undertake of such services—which range across NHS provision and underpin the importance of providing quality patient care and safety across the NHS as a whole—are an essential part of parliamentary scrutiny. Today, we have heard support and insight from other committee members across the House—I note my noble friend Lord Carter and the noble Lords, Lord Blencathra and Lord Shipley—and I welcome their perspectives and reinforcement of the committee’s work. I particularly thank the noble Lord, Lord Blencathra, for suggesting the topic in the first place.

The report provides a very thorough analysis of what homecare medicines services cover, their strengths and the significant problems encountered by service users, as well as the recommended ways forward to improve the provision of high-quality care to patients in their homes, which can reduce pressure on hospitals and other NHS services that have to pick up the pieces when delivery services fail.

Since the committee members have stressed that they are open to suggestions, I say that I personally hope that the committee can in the future undertake similar important work on other vital services that are often out of the spotlight. One such service is the continence service, which impacts across major conditions such as heart failure, stroke and dementia, costs the NHS similar sums of billions of pounds a year and involves home delivery of medicines and supplies to patients and hospitals. I realise that this is an issue for another day, so I will leave these thoughts with the committee.

The important starting point on homecare medicines services, heavily underlined by speakers today, is addressing accountability and who is responsible for the whole service. I welcome the DHSC’s and NHS England’s willingness, in the Government’s response to the committee, to recognise the disjointed complexity of the current system, which has largely evolved over the years without a coherent overview and strategy. I also welcome their recognition of the need to come to grips with how HMS operate today and move forward in the future.

Appointing the NHS England senior responsible officer responsible for HMS nationally is just the first step—a crucial point well reinforced today. When appointed, that senior officer, working with the national HMS committee, will face huge challenges identified by the committee and acknowledged in the Government’s response. These include developing consistent performance metrics and updating and rolling out new KPIs, with regular publication of performance data in standardised form to ensure that comparisons can be made and lead to better scrutiny, transparency and improved patient care. All these are promised for a report back to the committee in the summer.

The committee also underlined the importance of ensuring that homecare medicines services are part of, and included in, the NHS long-term workforce plan, or the social care equivalents when they are finally developed. It is astonishing that these two strategies do not include HMS. I look forward to the Minister telling us how this happened and the steps now being taken to address this significant oversight. How is the work on the vital information and data—so essential, as we heard, to assessing the patient experience and identifying the harm that delays, errors and misdeliveries cause patients—progressing under the desktop exercise, in advance of the promised summer report back to the committee on what data is available to assess patient harm?

The Government’s response also accepts that significant improvements must be made in the HMS procurement process to achieve value for money, in developing experts who understand the service and in the support offered to NHS trusts on drawing up and managing procurement contracts. My noble friend Lord Carter, as we know, has huge expertise in this area, working with NHS trusts on productivity, contract development and operational management across NHS trust operations. He has raised a number of key areas on this important aspect of the report, and I look forward to the Minister’s response, particularly on how we move forward towards operational excellence and integrated care records. The committee’s recommendation for government to start work now with the National Audit Office and the CMA to identify barriers to effective procurement makes sense in the light of the current disjointed and impossible-to-navigate system—another summer report-back item. Perhaps the Minister can explain why this work cannot begin now to help NHS England assess future options.

Today’s contributions have all drawn heavily on the crucial evidence of service failures from key patient groups. I join noble Lords in paying tribute to them and to the British Society for Rheumatology for its leading, co-ordinating role in gathering and presenting patients’ first-hand evidence to the committee. We have heard many examples today. The comments from two Cystic Fibrosis Trust respondents sum up what patients can experience. One says:

“It’s terrible … the times are a nightmare and missed deliveries can take ages to rearrange … it’s a horrible system”.


The other says that

“it is a massive burden and on top of everything else we need to do and have to deal with”.

The latter is a familiar sentiment from patients and their carers across many health and social care services.

As my noble friend Lady Morris underlined today, the committee fully acknowledges the “irreconcilable gulf” between the views of clinicians and service users and the leadership and governing bodies of the homecare sector on how well the service is performing. But it rightly underlines that it is

“persuaded by the weight of evidence from service users that there are real and serious problems in the sector”,

despite HMS being a complicated system with multiple variables. The example from the noble Lord, Lord Blencathra, regarding the delivery of his medicines and the testimony of the noble Lord, Lord Willis, clearly demonstrate this. Indeed, one of the most stark conclusions from the committee—the noble Lord, Lord Blencathra, referred to it, but it is worth repeating—is that:

“No one—not the Government, not NHS England, not patient groups, not regulators—knows how often, nor how seriously patients suffer harm from service failures in homecare”.


It is this and the complexity of the system that need to be urgently addressed. It is so important to have accurate and consistent performance data across providers and the services involved to measure the impact of poor performance on patients in the public domain. What are the expected timescales for the newly appointed senior HMS officer and the National Homecare Medicines Committee to develop a strategy and implementation plan for HMS, and how will service users be consulted and involved?

The failure of the regulatory model for homecare comes in for equally heavy criticism from the committee, which describes it as

“failing to ensure the safety and quality of patient care”;

having

“a limited understanding of the sector”

and “no appetite” to find out more; and having only “feeble”—indeed, “toothless”—enforcement action against providers, even where avoidable harm has occurred. The Government recognise that more work has to be done before deciding on undertaking the thematic review called for by the committee—that will be one more summer update to the committee.

Can the Minister confirm that meaningful discussions have begun between the CQC, the General Pharmaceutical Council and the MHRA? Are they just focused on identifying

“opportunities for strengthening collaboration, communication and transparency”,

as referred to in the Government’s response, or will they include more structural issues, including a leading regulator where providers are underperforming and overall responsibility for a patient complaints system? How will the role undertaken by the CQC for its—currently relatively few—HMS provider inspections be levelled up to the much tighter approach taken in inspecting small residential care homes?

With noble Lords’ indulgence, I refer lastly to a related but non-HMS issue: medicine blister packs for people living at home, which are assembled by pharmacies and either collected by patients and carers or delivered to their home. The Minister and I always seem to talk at cross-purposes about this. When I raise the issue, he stresses that they are not suitable for everyone, which I fully agree with, but I always emphasise how essential they are in the delivery of domiciliary personal and social care for people living in the community or in care homes. Care workers often administer these drugs to the client in their homes. This process ensures that the drugs are taken properly and safely and are not missed. Care staff can do this only using blister packs. They would not sort out the daily doses from multipacks, which I as a carer was recently offered. Our local Boots chemist, a large chemist, has stopped providing this essential service. Where it is not provided or where the chemist closes down, the task would again fall back to the carer. This is an important issue related to our discussions on HMS and it needs to be recognised as an essential part—where appropriate—of safe care in the community. I hope I have provided food for thought in the context of today’s debate.

Finally, this has been an excellent debate and I once again congratulate the committee on its searching report and very practical recommendations on ways forward. There has been a good start made on addressing the key problems, and optimism, in the Chamber at least. But, as the British Society for Rheumatology has stressed, both NHS England and the DHSC still have a long way to go to demonstrate that they understand the scale of the problems that need to be tackled if HMS is to achieve its full potential.

Pandemic Preparedness

Baroness Wheeler Excerpts

Monday 15th April 2024 Lords Chamber

[Lord Markham (Con)]

We definitely look to work closely with our colleagues, and I have spoken to my Health Minister counterparts on this. One of the lessons from the pandemic was that you also need to have your own capability. The work we have done on the100-day mission, and the strategic relationship we have entered into with Moderna—which can develop vaccines in as little as four to six weeks to answer some of those unknowns—is very powerful.

[Baroness Wheeler (Lab)]

My Lords, it is now two years since the UK Health Security Agency replaced Public Health England. As we await the Science and Technology Committee’s report on the threat caused by zoonotic diseases such as Covid, avian flu and Ebola, can the Minister update the House on the progress the agency is making in building resilience in these areas? It reported last year on global work on developing pandemic-fighting tools but not on the nitty-gritty needed to tackle underlying problems still hampering us, such as tackling widespread health inequalities, building systems for vaccine resistance and raising public awareness of the threats we all face.

[Lord Markham (Con)]

I thank the noble Baroness. The UKHSA has been working and there are four main areas we want to be responding on. First, there is the vaccine, and the 100-day mission is all about making sure that we have the vaccines quickly. We have 100 million vaccines prepositioned for flu and 250 million for other diseases. Secondly, there is the manufacturing scale-up. We have a fund in place so that we have UK domestic production capability to produce vaccines quickly. Thirdly, there is the stock of PPE, and, fourthly, there is the diagnostic capability. That is how the UK Health Security Agency is making sure we have all the bases covered.

Stroke Treatment

Baroness Wheeler Excerpts

Wednesday 27th March 2024 Lords Chamber

Asked by

[Baroness Wheeler]

To ask His Majesty’s Government what steps they are taking to improve treatment and care for those of working age who are affected by stroke.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

The Government are taking three major steps to improve treatment and care for strokes: first, a whole series of prevention measures to help avoid a person having a stroke in the first place; secondly, an updated and evidence-based stroke care pathway using AI, the latest technology in stroke rehabilitation, to maximise the chances of recovery; and, thirdly, post-stroke rehabilitation care and support to maximise the chances of recovery.

[Baroness Wheeler (Lab)]

I thank the Minister. We know that one in four strokes happen to working-age people, and that it is also a leading cause of disability. Speech and physiotherapy support after stroke is therefore vital, because it helps recover key skills such as motor functions and cognitive ability, and it can be the difference between returning to work and not returning, or giving up altogether. With serious delays across the country in getting people to hospital and scanned, and in providing the speech and physiotherapy that is needed, and with chronic staff shortages across the country in hospital and community settings, good care is just not the reality for thousands of stroke sufferers. Some 40,000 people missed out last year on essential six-month, post-stroke reviews. When will the up and coming major conditions strategy be published? How will it specifically support effective stroke rehabilitation and recovery, and what timescales will be set for that?

[Lord Markham (Con)]

I thank the noble Baroness for her tireless work in this area. As she quite rightly points out, aftercare and rehabilitation is the vital third leg of the three-step process I spoke about. In the major conditions strategy we talk about how we are basing it on a national model for an integrated stroke care service, based around personalised, wraparound care, for as long as is needed, with reviews every six months. I have seen some fantastic examples when I have been out and about, such as in Royal Berkshire and Leighton. The proof of the pudding is in the results; we have seen the number of people who are achieving a full recovery increase from 16% to 48%. That is the target we are going after.

Sodium Valproate and Pelvic Mesh

Baroness Wheeler Excerpts

Monday 25th March 2024 Lords Chamber

[Lord Markham (Con)]

Again, these are difficult areas. My understanding is that we are working from the conclusions of the expert working group in 2017, and its review of all the evidence was that it could not find a causal link between Primodos and the impact it had during pregnancy. This was again reviewed by the MHRA when more information was brought up in the last year. So I am afraid that, as we stand today, the evidence is not there that suggests that causal link.

[Baroness Wheeler (Lab)]

My Lords, the Patient Safety Commissioner’s report is all the more valuable because it is drawn from patients’ experiences, including physical, psychological and emotional impacts and their daily struggle with accessing health and other key services such as social security benefits and special educational needs support for the valproate-harmed children they are raising. What is being done to support mothers and families as they cope with the indecision and delay over the Government’s response to the commissioner and await the vital support they need?

[Lord Markham (Con)]

We have completed four of the initial recommendations in the report of my noble friend Lady Cumberlege, and another three are in process. The most important of those, to answer the noble Baroness’s question, is the setting up of these nine specialist centres which can provide the support needed, not just in terms of redress surgically or treatment-wise but in terms of the support that people need to help them cope with the issues.

NHS: Dementia Commission Report

Baroness Wheeler Excerpts

Thursday 22nd February 2024 Lords Chamber

Asked by

[Baroness Wheeler]

To ask His Majesty’s Government what actions they are taking in response to the NHS Innovation and Life Sciences Commission’s Dementia Commission: 2023 Report.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con) (Con)]

We welcome the Dementia Commission: 2023 Report and are taking steps to address each of the recommendations. The Government remain committed to improving dementia diagnosis rates and providing high-quality care and support following a diagnosis. The Government have committed to double funding for dementia research to £160 million per year by the end of 2024-25. We welcome all research that will help us to improve how we diagnose and care for people with living with dementia.

[Baroness Wheeler (Lab)]

My Lords, the commission’s wide-ranging and comprehensive report is very welcome, but it heavily reinforces the urgent need for radical change in the way we diagnose, treat and care for dementia patients and support their families and carers. To ensure timely, speeded-up diagnosis, the training of primary care practitioners in dementia-specific symptoms and diagnostic methods is crucial. What steps are the Government taking to strengthen general practice and community pharmacy in this regard so that individuals with dementia can receive appropriate care and support as early as possible?

[Lord Markham]

I thank the noble Baroness for this Question. As ever, I have found that one of the real strengths of being in this position is that the questioning here makes me explore an area. This has been another area which I have enjoyed and found fascinating. Early detection is absolutely key, and what I have been learning from that is that, yes, we need to arm primary care staff and a potentially vital front line in terms of primary care staff are opticians, because retinal scans are a really good way to early diagnose. Apparently, people more than ever will have a frequent eye check. I have pulled together a panel to understand this more, and I invite the noble Baroness and others so that we can look at the latest research and really understand this more.