NHS: Five Year Forward View

Debate between Earl Howe and Baroness Hanham

Thursday 23rd October 2014 Lords Chamber

[Earl Howe]

My noble friend has alighted on an area to which the whole Government will have to give very careful thought. It is not simply a matter for my department. This will entail cross-departmental scrutiny and agreement. However, on the strength of the performance of local authorities in grasping the public health agenda, as they have very enthusiastically, I am sure that we should look at that particular proposal very constructively.

[Baroness Hanham (Con)]

My Lords, as chairman of Monitor, which is one of the signatories and contributors to this document, may I ask the Minister to confirm further that the Government will not see any wholesale managerial reorganisation in the health service, which is not what the document is looking for, but that they will see change coming about in the way that services are developed? Will they ensure that services will not all be developed in the same way, but that there will be local elements? Will they also support initiatives to help the organisations make this a realisable objective within five years?

[Earl Howe]

I agree with my noble friend. We neither want nor need further structural reorganisation; but we do need cultural reorganisation. I also agree that a one-size-fits-all model will not work: indeed, the Forward View expressly states that. We need to allow local areas to work through the solutions that are best for them. That can be done on a collaborative basis, with the benefit of health and well-being boards, which are now working so well in many areas.

G8 Summit on Dementia

Debate between Earl Howe and Baroness Hanham

Tuesday 17th December 2013 Lords Chamber

[Earl Howe]

My Lords, we certainly hope that the private and charitable sectors will respond to the call, but at the same time the Government are not dictating to the research funding bodies which projects they should support. The Haldane principle is very important. The noble Lord makes an extremely powerful point, and we would hope that the pharmaceutical companies will wish to step up to the plate.

[Baroness Hanham (Con)]

My Lords, will the Minister be kind enough to explain exactly what is going to be achieved by training public servants such as bus drivers in dementia, what is the purpose behind it and what we hope those public servants will be able to do?

NHS: London

Debate between Earl Howe and Baroness Hanham

Wednesday 30th October 2013 Lords Chamber

[Baroness Hanham (Con)]

My Lords, may I say how glad I am to hear that the proposals have support from all the clinicians and the CCGs? The noble Lord will know that I was chairman at St Mary’s Hospital when the Imperial College Healthcare NHS Trust was formed —and it was formed on the basis of full support from clinicians and the local community. The local community is not always at one with change, so I shall ask the noble Lord a couple of questions. First, this is not a short programme. These proposals will not take five minutes to implement. Most of the changes in the health service over recent years have taken an enormous amount of time, and it would be fair to say that the Imperial Trust, which includes Charing Cross, has probably only just completed its previous reorganisation, and now it is being reorganised again. The first question is: what is the proposed timescale?

Secondly, the noble Lord mentioned consultation, and may I say that it is absolutely vital that the local community be brought along with this? Otherwise, it will take even longer. Thirdly, there is an expectation that there will be a lot of new consultant and other medical posts. I am aware that A&E is not flush with clinicians taking up the specialty, so may I ask what encouragement is being given, by the colleges in particular, to ensure that there will be enough staff available to deal with the new services? Finally, may I say how glad I am that St Mary’s has figured again in trauma services?

[Earl Howe]

My noble friend, with her experience, asks some very pertinent questions. On the question of timescale, we believe that it will take between three and five years for the proposals to be actioned to their fullest extent. It will be necessary to take that kind of time. Some elements can happen relatively quickly, but my noble friend is absolutely right that there are important workforce issues to be taken into account. Indeed, one of the IRP recommendations was that the NHS should review its workforce programme and ensure that it has the means in place to deliver what is required. I am sure that in working through the proposals, local commissioners, as well as NHS England, will need to satisfy themselves on that point—not least with regard to the new posts to be created in the community, but also in terms of accident and emergency consultants in the A&E departments of the relevant trusts. On local communities, again I agree with my noble friend. As the Shaping a Healthier Future proposals are developed by the clinical commissioners, it will be vital that any further proposals are consulted on locally, and that there is real buy-in from patient groups and the public generally.