NHS: Drug Shortages

Debate between Lord Bellingham and Lord Markham

Wednesday 17th January 2024 Lords Chamber

[Lord Markham (Con)]

There are 78 medicines for ADHD, 10 of which are particularly affected. We have put export restrictions in place on that, and we are working it through so that we can hopefully get it resolved by April. It is something we are working very closely on, because we know the importance.

[Lord Bellingham (Con)]

My Lords, I understand the Minister’s department has a cap on total allowed sales of branded medicines to the NHS. I think it will be a 4% cap over the next five years. Is this making the problem worse? Is it exacerbating the problem? Is it something he could look at with his ministerial colleagues?

[Lord Markham (Con)]

I think the cap my noble friend is referring to is actually in terms of the price negotiations on the VPAG and how the rebates kick in. It is not my understanding that is something that is at issue here. We are talking about where there are specific ranges. A study was produced by the Pharmaceutical Research and Manufacturers of America looking at supply issues across lots of countries over the 10 years from 2012 to 2021. The UK was consistently in the top three. Yes, there are some issues that we are working through, but by and large we are consistently in the top three of supply.

Recovering Access to Primary Care

Debate between Lord Bellingham and Lord Markham

Tuesday 9th May 2023 Lords Chamber

[Lord Markham (Con)]

The noble Lord makes a very good point. It is really making sure that the independents can play a very important role. It is, where necessary, making sure that whole-estate planning takes that into account. A lot of the work I have been doing with Minister O’Brien—he heads the GP space while I look after the capital space—is looking at how we can create the sorts of models where you can put pharmacies alongside GP surgeries, in many cases, and make sure that that capability is there. I freely admit that capital is at a premium within the system, so we have to be creative in the ways we use it, but the noble Lord is absolutely correct that this is a key way to make sure we have a network of independent pharmacies that can really serve their local community.

[Lord Bellingham (Con)]

My Lords, I thank the Minister for the Statement and put on record my gratitude to him and other junior Ministers who played a very important part in making sure that this initiative has been brought to fruition. I pay tribute to the local surgery in my own community in Norfolk, the Great Massingham and Docking surgery, where the receptionists are invariably incredibly patient and polite to everyone and the doctors are quite outstanding—they have a lot of very satisfied people in the community because of their attitude to local people who may have ailments. But, obviously, they are under pressure, and that is why I welcome the Government’s announcement on Pharmacy First and on recruiting new GPs. Can my noble friend tell the House whether the Government’s commitment to recruit an extra 6,000 GPs by the end of this Parliament is on course? Has the number of GPs in training increased? Can he just clarify those two points?

As the noble Lord, Lord Boateng, pointed out a moment ago, pharmacies are often at the centre of communities. Apart from anything else, pharmacists often have a really strong relationship with patients because they see them on a regular basis, understand their needs and see them consistently—which, unfortunately, is not always the case with doctors. That is why I support the Pharmacy First initiative, which could be a lifeline to a lot of pharmacies that are under pressure. They will be able to prescribe many more medicines, but can my noble friend tell the House whether they will be able to prescribe antibiotics for some of the conditions he mentioned? If that is the case, that would be a very positive extension to the services that they provide.

[Lord Markham (Con)]

I thank my noble friend. As evidence of the good work that receptionists do under trying circumstances, in a recent survey 91% of patients said that their needs were met. On the target of having 6,000 extra GPs by the end of this Parliament, currently we have increased the number by 2,000 but, in all honesty, I think the feeling is that we will struggle to meet the 6,000 target—I believe that is something that Sajid Javid, as Minister, said before. But there is a 50% increase in the number of graduate trainees since 2014, with more than 4,000 currently in training. So we have made steps in the right direction, albeit not as far as we would hope.

On the supply of antibiotics, the idea behind this is that there will be certain agreed treatments that the pharmacist will be able to give. Clearly, UTIs is an example where you often need antibiotics to clear those up, and in those circumstances there will be agreed treatments that pharmacists can give: provided that, in the pharmacist’s judgment, the symptoms warrant it, the pharmacist will be able to enable the supply of antibiotics. On all those, this is a very positive way forward.

GP Appointments

Debate between Lord Bellingham and Lord Markham

Thursday 23rd February 2023 Lords Chamber

[Lord Markham (Con)]

Are you going to dare me?

Sorry, I think a diplomatic response is probably wise at this stage. I note that, under the Barnett formula, per person funding for the NHS is Scotland is higher than it is in England. So there is significant funding in place. How well it is administered north of the border is probably a matter for the Scottish Government.

[Lord Bellingham (Con)]

My Lords, is it not the case that many European countries charge patients who fail to turn up for appointments without due cause? Is this something we are going to look at in this country?

[Lord Markham (Con)]

I am clearly aware of that. At the same time, I am very aware that we want to make sure that people are able to see a doctor when they need to and are not deterred from that. So we would have to tread very carefully and it is definitely not in our plans at the moment.

Urgent and Emergency Care Recovery Plan

Debate between Lord Bellingham and Lord Markham

Thursday 2nd February 2023 Lords Chamber

[Lord Markham (Con)]

I thank the noble Baroness. Taking those questions in reverse order, yes, it is understood that virtual wards do not work for everyone. At the same time, I am constantly surprised by the data: for instance, the average age of an NHS app user is in the mid-60s—so it is not a particularly young demographic who use this. Obviously, the examples I have seen, particularly on COPD at Watford, show that an older population is using that. However, we absolutely need to make sure that there is not a digital divide from that.

On the noble Baroness’s points on the workforce, she is quite right. We live in a competitive market, and one of the benefits of full employment is that, again, most people who want to work have a job, but one of the downsides is that there is competition for jobs. We have to face up to those realities and be realistic in terms of workforce, in that if you are going to attract and retain the good people, which you need to have as the bedrock of your services, you need to make sure you have an attractive and rewarding place to work. Clearly, that has to be a feature.

[Lord Bellingham (Con)]

My Lords, the Minister mentioned new hospitals. Is he aware that the biggest obstacle to major health improvements in west Norfolk is the chronic state of King’s Lynn’s Queen Elizabeth Hospital, which I gather is the most internally propped-up hospital in the UK? He will be aware of an all-party campaign to secure the building of a new hospital. Can he tell the House where are we with that process?

[Lord Markham (Con)]

I am very familiar with the problems with the so-called RACC—reinforced, autoclaved aerated concrete—hospitals. King’s Lynn is one of those, and there are a handful of others. There is a recognition that everything we do in the new hospital programme has to ensure that those hospitals are rebuilt in time, because they have a useful life that is fast reaching its end. Our priority number one is making sure that they are replaced.

Care Homes: Staffing

Debate between Lord Bellingham and Lord Markham

Wednesday 11th January 2023 Lords Chamber

[Lord Markham (Con)]

Before we went ahead with this, we spoke to many care providers to make sure that there was capacity within the system to do it. It was understood that the capacity is there. In fact, there is potential underused capacity of as much as 40,000. We are confident that the staffing is in place and that the care packages are there to really make a difference.

[Lord Bellingham (Con)]

My Lords, is the Minister aware that a lot of homes across Norfolk are complaining that they cannot sponsor more overseas members of staff? At a time when there are not enough locally trained and motivated staff, surely there should be more flexibility for those quality homes that want to sponsor more overseas members of staff.

[Lord Markham (Con)]

Yes, this is absolutely something that we talk to our Home Office colleagues about all the time. I believe that 15,000 people have already come through on this route in the last nine months or so; we are seeing a rate of about 1,500 a month. It is very important and something on which we are focused.

Childhood Obesity

Debate between Lord Bellingham and Lord Markham

Thursday 17th November 2022 Lords Chamber

[Lord Markham (Con)]

I am afraid the noble Lord is testing my memory as to what that was. If he will excuse me, I will find out what it was and write to him.

[Lord Bellingham (Con)]

My Lords, obviously the situation in the UK is extremely concerning, but we should consider what is going on elsewhere in the OECD: some countries have a better record than us, and others have brought in extremely innovative initiatives. What can we learn from other countries?

[Lord Markham (Con)]

I thank my noble friend for his question. Absolutely, we always need to ensure that we are trying to learn from best examples, either in this country or from around the world. The OECD talks about four major strands: information and education; increasing healthy choices; modifying costs, such as a sugar tax; and restrictions on the placement of food and promotions. Noble Lords can see that we are taking much action in all those areas. Most of all, I am pleased to see that, influenced by a trailblazing initiative started in Amsterdam, we are now funding five local authorities to follow that across Birmingham, Bradford, Nottingham and Lewisham to see what we can learn from those initiatives.