(5 years, 4 months ago)
Lords ChamberMy Lords, my understanding from the trust is that that is exactly its intention. The overwhelming majority of the 22,442 names on the memorial will be British, but troops of 38 different nationalities will be commemorated. Predominantly they were from Commonwealth countries and Europe, but there is also provision to record the contribution of the Merchant Navy, French agents who were parachuted in to observe German movements and the SOE, as well as war correspondents.
Does the Minister accept that as well as acknowledging and commemorating the valour of all those who died in the past, it is equally important that we safeguard the institutions of Europe which were devised to try to make sure that war like that never happens again? Will he therefore recommend to people who talk about recalling the valour of the past that they should not capriciously destroy the institutions of the European Union, which are there to prevent war happening again?
My Lords, I have sympathy with the spirit of the noble Lord’s question but of course we now have the NATO alliance, which represents the values of all western nations. Although we are leaving the European Union, we are not leaving Europe in terms of the values that we share with our European friends and the defence of the international rules-based order.
(5 years, 10 months ago)
Lords ChamberMy noble friend makes a very good point. The issue to stress in this context is that if we were to fight at divisional scale, we would likely be doing so as part of a multinational force, probably NATO. The Army therefore regularly exercises with allies and partners, and a good example of that was Exercise Trident Juncture held last November, which involved some 50,000 personnel from 31 allies and partners. That was a really good opportunity to test every element of our war-fighting capability on land.
My Lords, the proposal from the noble Earl, Lord Attlee, is to have troops ready for deployment training. However, it is important that in such an exercise we only deploy troops who are available for deployment. Will the Minister link that to the comments that were attributed to the Ministry of Defence this weekend about the fact that more than 20% of the total staff of the Army are medically unfit for deployment?
My Lords, the press coverage on this has been somewhat overdramatised. A person can be medically downgraded for a whole variety of reasons, most of which are minor and temporary and do not prevent them fulfilling their core duties. A good example would be a sports injury. Medically non-deployable, another category of personnel, can include more serious circumstances but also includes pregnancy, which—my brief says—is a self-limiting condition.
(11 years ago)
Lords ChamberThe noble Lord is absolutely right. These solutions should not be imposed from above. Indeed, the Shaping a Healthier Future proposals were designed by local clinicians in consultation with their patients. It was not a prescription dreamt up in Whitehall. We are very clear that the local NHS should continue to feel local ownership of these ideas as it takes them forward. I have no doubt that, if it feels it necessary, it will turn to the royal colleges for particular kinds of advice. It is free to do that as it wishes.
Is the noble Earl aware that on this side of the House he is very highly regarded as a model of clarity? However, in the second part of his answer to the noble Lord, Lord Hunt, today, he was somewhat equivocal in relation to the future of Lewisham Hospital. I hope that he will accept an invitation to visit Lewisham Hospital. I declare an interest as somebody who lives in that area and has opposed the closure. Does he also realise that such is the strength of feeling in Lewisham, he had better have read the whole judgment carefully and cleared all his lines before he goes there? The threatened closure created such community anger as I have never seen before and he would be most unwelcome unless he were able to give a clear and unequivocal response about its future.
My Lords, I certainly understand the noble Lord’s strength of feeling on this. It is certainly my intention to read the judgment when we receive it in full. Nothing is closing in Lewisham. The service remains as it has been. There is nothing that Ministers intend to do to change that situation. However, as I mentioned earlier, there is an issue to be addressed in Lewisham and indeed in Greenwich. It is a pressing financial issue that commissioners as well as the hospitals themselves have to face. I have no doubt that a visit to Lewisham would benefit me enormously and I shall await an invitation to that effect.
(11 years, 6 months ago)
Lords ChamberDoes the Minister accept that Sir Bruce looking at these questions is not necessarily a comfort? Sir Bruce looked at accident and emergency services in south London but, based on what the Minister has said today about the pressure on accident and emergency services, Sir Bruce came to the wrong conclusion about Lewisham accident and emergency.
(11 years, 9 months ago)
Lords ChamberMy Lords, I join in the thanks offered to the noble Earl for repeating the Statement. One has the feeling that, for someone so highly respected in this House, his heart was not really in the repetition.
Lewisham hospital is a local hospital which produces excellent local care—and I declare an interest as someone who uses its services. What the Minister has announced today is that he is not going to make the cuts quite as bad as they were—not quite as extensive. But, in effect, we are still having a very good service penalised in order to provide resources for the failures. Can I ask two specific questions arising from the Statement? At one point it states that,
“a non-admitting Urgent Care Centre at Lewisham may not lead, in all cases, to improved patient care”.
How does the Minister square that with some of the other statements made about the principles on which this reorganisation is based? With two further tranches of money—£36 million and £37 million—provided to the other sites which need to be improved, I ask him to comment on what the Secretary of State said at the end, namely that,
“there is a significant level of risk associated with achieving the identified savings. I recognise that the additional clinical safeguards I have put in place will marginally increase these financial risks but on balance”—
basically, “I think it might be all right”. Is this not another example of wishing being given a higher priority than factual decision-making?
My Lords, perhaps I may put on the record my own recognition that Lewisham hospital is an excellent hospital. There is no question about that and there has never been any question about it. The hospital provides good care for local people and it is highly valued. Only this afternoon I had one noble Lord from my own Benches telephoning me to tell me of his personal experience of Lewisham hospital and its excellent maternity care.
The noble Lord asked me two specific questions. He quoted the Statement where at one point it was made clear that a non-admitting urgent care unit at Lewisham would not improve patient care. That is the precise reason why Sir Bruce Keogh recommended something different; namely, an admitting A&E unit with 24/7 cover. He looked at the recommendation and was not satisfied with it in terms of risks to patients. I hope that that is helpful to the noble Lord because I think he misconstrued what I was saying.
On the question of risk, any set of assumptions that relies on hypotheses around patient flows in the future and clinical referral decisions has to be, by its very nature, uncertain. It is the view of the trust special administrator and the review of my right honourable friend that the assumptions underpinning these decisions are reasonable, and that was backed up by Sir Bruce Keogh. But the noble Lord has a point because the implementation of these recommendations is going to be key, and that is why the TSA has recommended a programme board to oversee the implementation of these recommendations over the next few years. It is absolutely essential that commissioners and the providers in that area buy in to these proposals. We believe that they will, but it is important that if the financial risk is to be minimised, we get as close as possible to the forecast and predictions that the TSA has set out.
(11 years, 11 months ago)
Lords ChamberMy Lords, it is questions of that kind that we expect the clinical commissioning groups to examine because they will become responsible for out-of-hours primary care. Therefore, it is incumbent on them to ensure that that service not only is a good one but does not lead to unwanted consequences in terms of unplanned admissions to hospital.
My Lords, does the Minister accept that his usual clarity has deserted him somewhat today as he has indicated that money which is underspent is returned to the Treasury but on the other hand he has said that it is not lost to the National Health Service? Does he agree that this gives a completely new meaning to double-entry bookkeeping?
I shall be happy to write to the noble Lord to explain why my answers have been absolutely correct and the situation that I have described is nothing new. However, we are in a new situation in the sense that it appears that the supplementary questions can be extended at will over any other Question on the Order Paper, but I am happy to take questions from the noble Lord at any time.
(12 years, 10 months ago)
Lords ChamberIs the Minister aware that his message about the imperatives of health service reform does not appear to have reached the Royal College of Nursing and the Royal College of Midwives, based on statements that they made yesterday? Does he share the view of his right honourable friend the Secretary of State in another place, who has stated that these are not disputes about the health service but politically motivated strikes?
I do think that the objections that the Royal College of Nursing has raised have very little to do with the Health and Social Care Bill. They are much more about what may or may not be happening in certain hospital trusts, which are matters that, in general, the Bill does not affect.