Junior Doctors: Industrial Action

Debate between Lord Beecham and Lord Prior of Brampton

Monday 25th April 2016 Lords Chamber

[Lord Prior of Brampton]

I can confirm both those points. If the Secretary of State for Health was to fall under a bus tomorrow and somebody was writing his obituary, it is “patient safety” that would be written on his tombstone. That is the one big issue that he has consistently fought for ever since the problems at Mid Staffordshire were uncovered three years ago. Patient safety is his guiding star as Secretary of State for Health. I agree with my noble friend that it is tragic to see thousands of highly committed, highly intelligent and otherwise sensible young people going out on strike.

[Lord Beecham (Lab)]

My Lords, I am sure that there are many in your Lordships’ House, and perhaps people outside it, who rather regret that the noble Lord himself is not Secretary of State for Health as opposed to the present incumbent of the office. He has shown great sensitivity about this issue and, indeed, all others, and is widely respected here. However, is it not unfortunate that the Statement made this afternoon is somewhat disingenuous? It refers, for example, to the high mortality rates for people admitted to hospital at weekends—something which has been disputed in the sense that, to the extent that it exists, it is not necessarily connected to the issue of a seven-day service but rather a function of the emergency situation that many people face which is why they are admitted to hospital at that time.

Is it not equally somewhat disingenuous to refer to the recently announced further investment in the NHS as something that is directed at the issue which is the cause of the dispute? As has already been pointed out, the service has been denied comparable funding to that in previous years and is in a very serious condition up and down the country. I hope that the Minister can persuade the Secretary of State that it would not be a futile exercise, as he has perhaps suggested today, to accept the suggestion made by the group of four people from different backgrounds, including a former Conservative Health Minister who was also a doctor, to have a discussion about trialling the new scheme? As is so often the case in this House in other contexts, decisions appear to have been made without any proper assessment of the potential outcome. In this case, there is a very serious potential outcome both for the service and for patients. Will the Minister speak again to the Secretary of State to reflect the view, which I suspect is fairly widely shared, that the Secretary of State is making a mistake in not acting on the suggestion that has been made?

[Lord Prior of Brampton]

On mortality rates at weekends, the noble Lord is absolutely right that there has been confusion about the difference between the terms “excess mortality” and “avoidable mortality”—the two are clearly very different. However, having said that, I think it is widely recognised that the lack of senior cover and diagnostic support, particularly at weekends, is not at all satisfactory. Certainly Bruce Keogh and others have looked at this—I think that there have been six very detailed studies looking at mortality at weekends. The fact that there is a higher level of mortality than you would expect is ground for providing greater support at weekends. As for the suggestion that there should be a pilot scheme to study the contract, I tried to answer that in my response to his noble friend and I have nothing else to add to that.

Cities and Local Government Devolution Bill [HL]

Debate between Lord Beecham and Lord Prior of Brampton

Tuesday 12th January 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, first, I thank the noble Lord, Lord Warner, for his very friendly comments—long may they continue. As he and other noble Lords have mentioned, this is a good example of the scrutiny provided by this House in ensuring that we have, as my noble and learned friend Lord Mackay mentioned, a truly National Health Service, and that this legislation preserves, rather than undermines, the integrity of the National Health Service, with accountability, after devolution, still clearly with the Secretary of State for Health and to Parliament.

The noble Lord, Lord Beecham, asked what will happen in the event that things do not work out—I think that was the issue that he raised. The answer is, I think, that it will depend on the negotiations in each individual case. There need to be sensible arrangements from the outset as to what will happen in the event that things do not work out, which the Secretary of State will need to take a view on when agreeing to the deal at the beginning. In a sense, the end game needs to be considered early on in the proceedings. However, I may have missed the point that the noble Lord was making.

[Lord Beecham]

That may be partly my fault. My point was not that things might not work out in, for example, the Greater Manchester context; the problem that I raise is the situation that might arise where a district comes out of a county and into a combined authority for certain purposes and that combined authority decides that it wants to deal with health, but the social services provision, unless there is another change, remains with the county within which that district exists. That seems to me the area that has not yet been resolved; it is certainly not clear in my mind and, looking around, I think that there are others whose minds may also be confused by the situation. It is not an easy question for the Minister to answer, and if he is not able to do so, I will understand, but I think that it is a matter that needs to be addressed between the two departments and, if I may say so, in consultation with the local government world as well as the health world, before we get to the point where the situation becomes one where such a risk develops. It is not the case in Greater Manchester, but it may occur elsewhere if we have that movement by county districts into combined authorities for some purposes.

--- Later in debate ---

[Lord Beecham]

I am sorry to intervene again, but from what my noble friend just said it occurs to me that it is not just social care; one has to think about education and children’s services, where there is also a potential dimension. So far, nobody has mentioned that. That is another department that ought to be involved. Of course, we cannot resolve this today, but I urge that the kind of discussions I have mentioned should take place, and I now add the education department to that.

[Lord Prior of Brampton]

My Lords, life is untidy, unfortunately. It is never clear and you cannot foresee all eventualities. The only response I can give noble Lords today is that the Secretary of State will deal with each matter on a case-by-case basis. I do not think that anyone can lay down a blueprint for dealing with that now, but I am happy to discuss it with the noble Lord and the noble Baroness if they want to do so. Maybe this is not the right place to go into all of that. I hope that that will be acceptable to them.

The noble Lord, Lord Shipley, raised the report on the success of devolution. I think I can speak for the Secretary of State for Health in saying that he would want to involve all relevant stakeholders in that report, not least patients, frankly, for obvious reasons. I am happy to put that on the record.

I conclude by thanking the noble Lord, Lord Smith, for updating us all on what is happening in Manchester. We on both sides of the House wish Greater Manchester well. It is a trailblazer and a very important development. We hope that we will see more devolution across England while still retaining the central accountability and integrity of the National Health Service.

NHS: Food Banks

Debate between Lord Beecham and Lord Prior of Brampton

Thursday 26th November 2015 Lords Chamber

[Lord Beecham]

To ask Her Majesty’s Government what assessment they have made of the provision of food banks at, and the distribution of food to people in need by, NHS hospitals.

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, decisions about such schemes are rightly made locally. The Government’s policy approach is that economic growth, productivity and employment offer the best route to give people a better future and reduce poverty. We implemented a long-term economic plan which is working. The employment rate is at a new record high and earnings are growing. We also announced that a new national living wage will be introduced from April 2016 for those aged 25 and above.

[Lord Beecham (Lab)]

My Lords, four weeks ago the Guardian reported that hospitals in Tameside in Greater Manchester and in Birmingham were opening food banks on their premises. In the ward I represent in Newcastle, all six primary schools and the local secondary school run a breakfast club for their pupils. These stark facts are reflective not of lifestyle choices, as some would have it, but of real need. When will the Departments of Health, Education, Work and Pensions and the Treasury come together to develop and implement policies to address the scandal of food poverty in what is still one of the richest countries in the world?

[Lord Prior of Brampton]

My Lords, the people running the schemes in the two hospitals in Birmingham and in Tameside are to be congratulated. I am not sure that there is a similar scheme in Newcastle. I know from experience of homelessness how difficult it is, for example, to discharge patients when they have nowhere to go, with the risk of discharging people onto the street who will then come back into hospital. The work they are doing in those two hospitals is to be applauded. We have a welfare safety net in this country. Tragically, anywhere around the world there will be some people who fall through that net. The fact that there are voluntary groups and charities prepared to help pick those people up is a cause for celebration. It is that combination of a state welfare net with an active civic society which makes this country as good as it is.

Health: Children

Debate between Lord Beecham and Lord Prior of Brampton

Thursday 10th September 2015 Lords Chamber

[Lord Prior of Brampton]

I am not sure that I can give that question a full answer. I am aware of the early years programme and I think that it is largely up to schools to monitor the development performance of children when they come into reception classes, which they are doing. I have seen the figures that the noble Baroness refers to—the 40% figure of children who have not reached the right development age by the time they come into reception class. It is a serious issue and I will take her words on board.

[Lord Beecham (Lab)]

My Lords, what is the Government’s response to the recent concerns expressed by the Royal College of Nursing about the reduction in the number of school nurses in recent years, and what assurance can the Minister give that the reduction in the public health budget will not lead to a still further reduction in the number of school nurses?

[Lord Prior of Brampton]

I have not seen the figures that the noble Lord refers to on school nurses but I will take that away and look into it.