Hospital Waiting Lists

Debate between Lord Bethell and Baroness Stuart of Edgbaston

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

I completely agree with the noble Lord that the pandemic has illustrated the severe health inequalities that exist across the country as well as the need to address them. The resilience of our health system depends on addressing those who can create the biggest demands on it. There is both a preventive agenda and an agenda for getting through to the communities, to communicate effectively that they can find the treatment they need in their local authority. The Help Us Help You advertising campaign is particularly targeted at the disadvantaged to encourage them to come forward for diagnosis and treatment.

[Baroness Stuart of Edgbaston (Non-Afl)]

My Lords, the original Question requested a breakdown of geographical regions for waiting lists. Workforce shortages will be a continuing problem, and not just for catching up on the waiting lists. Will the Minister recognise the link between training facilities in regions where there are shortages and the ability to fill those vacancies? He will be much more successful in catching up with waiting lists if he pays greater attention to training places, regions and availability.

Covid-19: Poverty

Debate between Lord Bethell and Baroness Stuart of Edgbaston

Thursday 27th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I can speak for the health dimension. I should emphasise the work of the office for health promotion. Under the Chief Medical Officer, the OHP will deliver proactive, predictive and personalised preventive strategies. We believe that there is a huge opportunity off the back of Covid to really change the health inequalities of the country, and that is what the OHP will be devoted to doing.

[Baroness Stuart of Edgbaston (Non-Afl) [V]]

My Lords, levelling up is a UK-wide ambition and priority; health and public health are devolved responsibilities. Will the Minister undertake to take a good look at how the various parts of the United Kingdom have dealt with problems that they have faced? For example, Wales appears at the moment to be far more successful in rolling out vaccination than England, Scotland and Northern Ireland. We should not be too proud to learn from each other in order to overcome some of the deep inequalities that have developed over the past years.

[Lord Bethell (Con)]

My Lords, the vaccine race is being contested right across the country, and I take my hats off to all those who are delivering the programme so effectively. We are not too proud to learn from each other. In fact, I pay tribute to, for instance, those in Scotland who have programmes around alcohol and drug use, which are pioneering on a worldwide level. We have to work on this all together, and we will absolutely use the best case studies to apply the best programmes on a countrywide basis.

Women’s Health Strategy

Debate between Lord Bethell and Baroness Stuart of Edgbaston

Tuesday 9th March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, we are largely inviting written submissions from individuals and organisations with expertise in women’s health. It is envisaged that this could largely be done either by individual researchers, royal colleges, think tanks and third sector organisations, as well as the general public. There is an online platform and the online survey accommodates screen reader support, allowing for questions and answers be rendered in other formats, such as spoken language or Braille output. I accept the thrust of my noble friend’s point that we need to do enough to reach ethnic minorities and those from hard-to-reach populations, who should have a voice in this kind of exercise. Let me take that point back to the department and I will write to her accordingly.

[Baroness Stuart of Edgbaston (Non-Afl) [V]]

My Lords, I welcome the Statement and I welcome what the Minister said earlier in response to a question about FGM. I know from the work done in Birmingham hospitals that the problem is probably much wider than any of us appreciate. At the end of this consultation, if the Minister finds that, in some areas where we asked for data, the data was not forthcoming, but we know we ought to seek more data and more information, will he undertake to do so to identify problems where part of the problem is that they are still very much hidden?

[Lord Bethell (Con)]

This debate is, unfortunately, not the place for me to be able to make that sort of commitment, but I completely take on board the point that the noble Baroness makes. There are hidden crimes in our communities and we cannot sit back and wait for them to present themselves; we have to go and find the evidence in order to meet the challenge. I am sorry to repeat this point, but I invite the noble Baroness to make this point in her evidence to the consultation. It is exactly that kind of insight that we are seeking to elicit, and the strategy is exactly the right platform for us to be able to make those kinds of points.

Osteoporosis: Treatment

Debate between Lord Bethell and Baroness Stuart of Edgbaston

Tuesday 9th February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the Royal Osteoporosis Society estimates that there are 95 fracture liaison services across England and Wales. While it is true that many cover more than one hospital, it should be remembered that they are non-specialist services and therefore CCGs are able to refer patients to fracture liaison services beyond their area. As I mentioned, we have a RightCare programme publishing case studies and pathways to encourage the greater rollout of best practice, but we are conscious that gaps remain and are working hard to close them as soon as possible.

[Baroness Stuart of Edgbaston (Non-Afl)]

My Lords, if the Minister were to go to Birmingham, he would find acclaimed fracture liaison services in the south, but in the north and east of the city they are not available, yet they are all part of the same clinical commissioning group. Will he encourage that group to ensure that there is equality of access across its geographical area and not to create a postcode lottery within it?

[Lord Bethell (Con)]

The noble Baroness alludes to a point slightly beyond the reach of the junior Minister in the department; we have a degree of federalisation, as she knows. However, I completely agree with and applaud the sentiment. We need more comprehensive coverage of fracture liaison services. We believe in the principle of 100% coverage, to which the noble Baroness, Lady Bull, alluded. I will look into whether we can do more in Birmingham to get a wider service.

Cannabis Oil

Debate between Lord Bethell and Baroness Stuart of Edgbaston

Tuesday 12th January 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Lord alludes to an important, although frustrating, point. If I may gently push back, the truth is that there is a large amount of very persuasive anecdotal evidence, some of which we have heard today. It is completely compelling—it is just not scientific. Patient safety relies on extremely rigorous clinical trial regimes; that is why we have safe medicines in the UK. It is simply not possible to persuade front-line clinicians to make prescriptions on the basis of anecdote rather than clinical study.

[Baroness Stuart of Edgbaston (Non-Afl) [V]]

My Lords, I am delighted that the Minister is on the case and that we can make sure that this issue is resolved for this set of parents. On a wider note, however, would the Minister consider revisiting the NICE guidelines, last published in November 2019, which had a list of recommended research, to ensure that we potentially widen the base of research and bring more speed into the process?

[Lord Bethell (Con)]

The noble Baroness is right that research is the key. I reassure her that we are looking at ways to try to bring research forward. The issue is not with the NICE guidelines themselves; it is with getting the scientifically backed data to be able to justify the authorisations from the MHRA. We are working extremely closely with the NIHR. We are looking at the NHS, which, as the noble Baroness likely knows, does have manufacturing capability within itself for these kinds of drugs. As some noble Lords here will know, we are engaged in thoughts about how the NHS manufacturing capability can be used to mobilise clinical trials in this important area.

Obesity

Debate between Lord Bethell and Baroness Stuart of Edgbaston

Tuesday 5th January 2021 Lords Chamber

[Lord Bethell (Con)]

I thank the noble Baroness very much for the recommendations of her report. Implementation is key. We have 13 workstreams, which is too much for me to go through in detail, but yesterday evening I tweeted a full list of each of them for her interest. Her point about implementation on the front line is extremely well made. I reassure her that the NHS plan makes it very clear that front-line services should provide obesity support in all the right cases.

[Baroness Stuart of Edgbaston (Non-Afl)]

My Lords, the report quite rightly encourages the Government to continue their promotion of better health and to develop an obesity prevention strategy. Twenty years ago, food was moved largely out of the Ministry of Agriculture into the Department of Health. Obesity is a question of our relationship to food. Could I encourage the Minister, in the light of changes to the way we do agriculture, to focus also on health and how, locally, the relationship between health, agriculture and the provision of food can actually be deepened?

[Lord Bethell (Con)]

The noble Baroness puts her point extremely well indeed. Undoubtedly, there is a movement in the country as a whole to relate more closely the production of food in this country and the way in which healthy eating relies on good, locally produced food, and I take on board her points entirely. We very much take obesity more seriously as a result of Covid. That has given our plans a huge amount of energy, and the sponsorship of the Prime Minister has been very vocal.

Covid-19 Update

Debate between Lord Bethell and Baroness Stuart of Edgbaston

Tuesday 15th December 2020 Lords Chamber

[Lord Bethell (Con) [V]]

My Lords, the noble Lord, Lord Hunt, is right to be concerned. Some of the data we have on public attitudes is of extreme concern and the statistics he has referred to show exactly why we have focused on this area as much as we have. We have worked extremely closely with social media platforms to try to minimise the availability of this material, and we have a large communications programme to engage with those concerned about taking the vaccine. I reassure him that our experience to date has been that when those who are considering taking the vaccine reach the moment of decision, their confidence increases, and I am hopeful that that will continue.

[Baroness Stuart of Edgbaston (Non-Afl)]

My Lords, in the Statement made in the other place, reference was made to notification to the World Health Organization about the new variant. The Statement went on to say:

“Public Health England is working hard to continue its expert analysis at Porton Down.”—[Official Report, Commons, 14/12/20; col. 23.]


I invite the Minister to make it absolutely clear that the work done at Porton Down is on behalf of the whole United Kingdom, not only Public Health England, and that any of the vaccinations which have been procured are procured on behalf of the whole United Kingdom. He may also want to say how the vaccines are to be distributed.

[Lord Bethell (Con) [V]]

The noble Baroness is entirely right. The vaccine is a great success story for the union and for the United Kingdom. We have had a four-nation approach and the distribution of the vaccine shows the union at its best. She is right to say that the work done at Porton Down is on behalf of all the nations of the United Kingdom and that the communication to the WHO was on behalf of the whole country. That communication demonstrates that our approach to the vaccine is to put transparency first and that we have moved extremely quickly to share this insight with our colleagues overseas.

Ockenden Review

Debate between Lord Bethell and Baroness Stuart of Edgbaston

Monday 14th December 2020 Lords Chamber

[The Deputy Speaker (Baroness Fookes) (Con)]

Lord Mann? No? We will move on to the noble Baroness, Lady Stuart of Edgbaston.

[Baroness Stuart of Edgbaston (Non-Afl)]

My Lords, this is the second time in six months that this House has been exposed to quite harrowing tales of patients’ experiences in the NHS. I am glad that the Minister mentioned the report by the noble Baroness, Lady Cumberlege, and her call for a patient safety commissioner. Both the Ockenden and the Cumberlege report identified a problem with the culture in the NHS. We cannot go on having review after review. While it is important to listen to the patients’ experiences as part of putting things right, we must learn comprehensive lessons. Will the Minister therefore say just a little more as to how he intends to take the idea of the patient safety commissioner forward, and in particular how that patient safety commissioner will be independent of and not part of the NHS?

[Lord Bethell (Con) [V]]

My Lords, it would be premature of me to describe in too much detail how any patient commissioner may work, since we are half way through the Bill’s progress. But I would like to reflect on the very good arguments made by my noble friend Lady Cumberlege and her supporters during the Bill’s passage at Second Reading, in Committee and in the amendment-moving process. She has made very convincing arguments for how a patient safety commissioner can be an ultimate destination for those who have not found due process and a sympathetic ear elsewhere in the consideration of their grievances. It is entirely right that any commissioner, whether a victims’ commissioner or any other kind, should feel a strong sense of independence; that is a total benefit that we endorse in the provision of any commissioner. But commissioners are not enough; what we need is a change in culture. That is why Aidan Fowler, the DCMO looking at this, works so hard and why we have a patient safety agenda that works to address this at every level of hospital trusts.

Covid-19 Update

Debate between Lord Bethell and Baroness Stuart of Edgbaston

Monday 30th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I saw the press reports to which my noble friend refers. I remind him that their suggestion that we should be running our hospital system at 99% capacity during a pandemic is not reasonable. It would put our flexibility to deal with any increase in infections over the winter months in an incredibly precarious state. Running at around 88%, which is the current rate, is pragmatic. It would take very little for the 600,000-plus group of people who carry the Covid infection at the moment to have an impact on those bed numbers before the NHS was overwhelmed. That was the point that the Chancellor of the Duchy of Lancaster made, and I thought he made it very well.

[Baroness Stuart of Edgbaston (Non-Afl)]

My Lords, it is a matter of regret that it was not possible to reach agreement on the tiering system with local authority leaders. However, local authorities will be crucial to its implementation, not just now but after Christmas. Birmingham City Council has succeeded in recruiting 468 Covid community champions and has regular meetings with faith leaders and public health. Can the Minister assure noble Lords that close co-operation with local communities, authorities and leaders, irrespective of their party allegiance, will continue, because otherwise we will not succeed?

[Lord Bethell (Con)]

I completely endorse the noble Baroness’s points. I know well the very good work that both Birmingham and the entire West Midlands are doing. Recruitment of champions and liaison with faith leaders are exactly the kinds of interventions that local authority leadership can provide. It is absolutely at the heart of our local and national approach. We are providing the kind of support that local authorities need to pursue these plans, which includes military personnel, testing facilities, data and analysis, and financial support, where necessary.

Covid-19 Regulations: Assisted Deaths Abroad

Debate between Lord Bethell and Baroness Stuart of Edgbaston

Tuesday 10th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the debate has not been scheduled, but evidence that would be of interest includes evidence from clinicians themselves, many of whom have seen some movement in their attitudes on this subject. There is also an enormous amount of values-based and faith-based evidence from those who have a particular view on this subject. There is also the evidence of the personal choices of those approaching death themselves. There are extremely moving testimonies by individuals faced with very daunting and challenging circumstances. All of these views have relevance and value, and they should all be part of this important and delicate debate.

[Baroness Stuart of Edgbaston (Non-Afl)]

My Lords, in response to the noble Baroness, Lady Grey-Thompson, the Minister stressed that this was travel advice, but surely it goes further than just travel advice. At a time of Covid, when many people in care homes would seek the companionship of members of their families but forgo it in the wider community interest, is it really the right decision to create a presumption that people at the end of life only have the option to travel abroad and to facilitate that? Surely more palliative care and more focus on helping people to a good death are more important during this Covid crisis than facilitating people to travel abroad.

[Lord Bethell (Con)]

I entirely agree with the noble Baroness that the contribution of hospices and the role of those involved in palliative care has been an incredibly important part of the Covid crisis, and it has given huge succour, compassion and care for those at the end of their life. We have sought to help with the financing of the hospice community with a substantial £150 million payment in the first wave, and there are currently talks in place on funding for hospice care through the second wave. Hospices’ work is enormously valued, and anything in this debate does nothing to underplay the value of the role that they play at the end of people’s lives.

Covid-19: Charitably Funded Hospices

Debate between Lord Bethell and Baroness Stuart of Edgbaston

Wednesday 28th October 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Lord is entirely right to cite the challenge being faced by Sue Ryder and other hospice charities that depend on retail income. They face a most difficult and challenging problem; it is one that we acknowledge and recognise. The question of misdiagnosis leading to a bump in arrivals in hospices is not one that I have been conscious or aware of, but I am grateful to the noble Lord for flagging it up for me. I will take that back to the department and, if it is something that we should be focused on, I will write to him accordingly.

[Baroness Stuart of Edgbaston (Non-Afl)]

My Lords, the manner of our going is as important to the human condition as the good life lived. Hospices have played an important role, in particular those hospices that care for children. The provision for children’s hospices is very patchy across the country, as is their need. At the meeting on 4 November, will the Minister pay particular attention to hospices caring for children and providing the necessary outreach work to families?

[Lord Bethell (Con)]

The issue raised by the noble Baroness is one that I am aware of. Who can think of a more moving cause than hospices for children? This will be definitely be on the agenda for 4 November and I will raise the issue with my honourable friend the Minister for Social Care.