NHS: Public Information and Advice

Debate between Lord Bishop of Blackburn and Earl Howe

Tuesday 12th June 2012 Lords Chamber

[Earl Howe]

My noble friend is right. Many dentists are good at conforming to the terms of their contract, which means making it clear to patients what it will cost them to have a particular course of NHS treatment. Other dentists, I am afraid to say, are less scrupulous. It is part of the contractual arrangement that dentists should be open on that score and it is an area to which we are currently devoting a good deal of attention.

[The Lord Bishop of Blackburn]

My Lords, one of the most startling ways that deprivation is measured is by health inequalities. We are all aware that, under the Act, the responsibility for public health passes to local authorities. As I understand it, local authorities do not have a duty under the Act to prioritise the reduction of health inequalities. How will the Government use the non-legislative processes open to them to reduce inequalities, especially with regard to local authorities?

[Earl Howe]

The answer to the right reverend Prelate, who makes a good point, is that clinical commissioning groups do have and will have a duty to bear down upon health inequalities and to ensure that they look after not only the patients on GP lists but the unregistered patients in their catchment areas as well. What we expect to see emerging from the joint health and well-being strategies coming out of the health and well-being boards is account being taken of those hard-to-reach groups in society who may not be on the immediate radar of GPs, but whose needs are nevertheless extremely acute and will have to be factored into commissioning plans.

Health: Children and Young People

Debate between Lord Bishop of Blackburn and Earl Howe

Monday 6th February 2012 Lords Chamber

[Earl Howe]

The role of local authorities will be pivotal in this because it is at local-authority level that public health, social care, and indeed the discussions that will go on in the health and well-being board context will bring together policy in a way that informs NHS commissioning. I think that the approach we have taken has been widely welcomed, and we are absolutely determined that all sectors of society, including children, are included in these processes.

[The Lord Bishop of Blackburn]

My Lords, my northern diocese of Blackburn scores heavily on the deprivation indices for children’s health outcomes. Does the Minister share my concern that if phase 3 children’s centres become self-financing—as I understand they are to—and a children’s centre is deemed not viable, surely the health impact on the community and of course on the health services will be immense?

[Earl Howe]

The right reverend Prelate is right to draw attention to this issue. I simply say to him that the process that I have described at health and well-being board level is specifically designed to enable local people to determine the priorities that they see as most important for their area. It is right that these decisions are taken locally. I do not argue in the slightest with his analysis of the importance of these centres; I think they do a tremendous amount of good. I am sorry to hear that there may be some threat to the one that he mentioned, but I hope he will also tell me that discussions are going on at a local level to try to find a way forward that will suit the needs of local children.

Health: Stroke Care

Debate between Lord Bishop of Blackburn and Earl Howe

Monday 4th July 2011 Lords Chamber

[Earl Howe]

The noble Lord is absolutely right. I am sure that he will know of the FAST campaign, which stands for face, arm, speech and time to call 999, as the noble Baroness, Lady Thornton, used to tell us. We conducted a renewal of that campaign in March. We believe that it is an extremely important way of raising public awareness of the urgency of the situation. We will keep that programme firmly under our eye and renew it as we feel necessary.

[The Lord Bishop of Blackburn]

My Lords, it is well reported that the incidence of stroke and TIA in the north-west is higher than the national average. It is sad to note that, in my diocese of Blackburn, none of the hospitals in Lancashire manages to come into the best 25 per cent. I am very satisfied with the noble Earl’s Answer about the improvement that has taken place, but can he ensure that there are suitable specialists in place to provide a comprehensive stroke service throughout the country?

[Earl Howe]

The right reverend Prelate is quite correct to point out that there is variation in the country, as one would expect, not least in the area of rehabilitation after a stroke. The most encouraging progress we have seen throughout the country has been on acute stroke care, but we now have work to do on the rehabilitation side. As it happens, I was in the north-west some weeks ago and saw some encouraging work going on in the area of telecare, whereby stroke physicians can assess and diagnose a patient remotely, sometimes from their own living room. This will make an enormous difference, particularly where there are distances to travel for stroke specialists. I believe we should encourage those initiatives where we can.

Mental Health: Children in Local Authority Care

Debate between Lord Bishop of Blackburn and Earl Howe

Monday 23rd May 2011 Lords Chamber

[Earl Howe]

My Lords, the noble Baroness may know that NICE and the Social Care Institute for Excellence prepared guidance recently on promoting the quality of life of looked-after children and young people. In doing so, they considered evidence including research reviews, a practice survey, a consultation with young people who have been in care, field work with practitioners and the testimony of expert witnesses. The evidence demonstrated that the health and well-being of looked-after children and young people are affected by nearly all aspects of their lives and care. The noble Baroness may like to know that a detailed list of that evidence is contained in appendix C to the guidance.

[The Lord Bishop of Blackburn]

My Lords, some local authorities are experiencing a very large number of looked-after children moving from other local authorities. I believe that in Medway there has been an increase of some 21 per cent. What action are Her Majesty's Government taking to ensure that local authorities that accept children from other local authorities are able to provide the specialist care that this vulnerable group needs in the field of mental health?

[Earl Howe]

The right reverend Prelate is quite right that the numbers of children going into care have been rising and some local authorities have been under particular pressure. But local authorities generally should be in no doubt that they have legal obligations in this area that they cannot obviate. The Department for Education has produced revised regulations and statutory guidance on care planning for looked-after children and care leavers, which came into force on 1 April. I have already mentioned the NICE and Social Care Institute for Excellence guidance, which should be followed alongside those regulations.

All local authorities in England must provide information on the emotional and behavioural health of children in their care and there are established screening tools to enable them to do that effectively. A recent study published by the Local Government Association found that more than 60 per cent of councils are seeking to protect children’s social care from any cuts.