Health: Children's Heart Services

Lord Bishop of Ripon and Leeds Excerpts

Wednesday 12th June 2013 Lords Chamber

[Baroness Northover]

My Lords, I remind noble Lords that these should be brief interventions. We have only had two thus far and we are seven minutes in. I suggest we hear the Bishop, then from these Benches and we try to get around.

[The Lord Bishop of Ripon and Leeds]

My Lords, I am grateful to the Minister and I am also grateful to the Leeds group Save our Surgery for persisting with criticisms, at least some of which seem to have been justified, as they pursued this. I am particularly grateful for the affirmation that children and their families must always come first. Will the Minister also accept that nothing about us should be done without us? Therefore, will he ensure that families, local communities and, indeed, the case for keeping cardiac and other children’s services in our hospitals are heard, in addition to the clinical professionals?

[Earl Howe]

I can readily agree with the right reverend Prelate. I think it is illustrative of the IRP’s approach that in its press release it states:

“The critical factor to consider, in the Panel’s view, is that engagement of all interested parties is the key to achieving improvements for patients and families without unnecessary delay. There is now a real opportunity to involve patients, the public and other stakeholders in taking work forward as set out in the Panel’s recommendations”.

I endorse that view wholeheartedly, and it is a point that has been directly picked up by NHS England in its press release today.

Health: Midwives

Lord Bishop of Ripon and Leeds Excerpts

Monday 25th February 2013 Lords Chamber

[Earl Howe]

My noble friend raises a number of complex and important issues. My department provides approximately £1 million a year for health assessments of asylum seekers in UKBA initial accommodation in England. The aim of the health assessment is to identify and address immediate healthcare needs, including pregnancy, and to recognise ongoing and non-urgent care needs for attention in the dispersal areas. The use of experienced health teams and interpreting services to record medical history also avoids more expensive arrangements at GP-registration stage later on. My officials met Maternity Action on 19 February to discuss the report’s recommendations and were assured that the maternity care provided by NHS midwives was appropriate and in accordance with NICE guidelines. Following that meeting, officials have briefed the Home Office.

[The Lord Bishop of Ripon and Leeds]

My Lords, the fact that Edge Hill University, for example, had nearly 900 applications for 22 midwifery places shows considerable enthusiasm for acquiring this skill. However, experience shows that many midwives withdraw during training or the early years of practice. Has the Minister any statistics on such withdrawals and does he know any of the reasons for them?

[Earl Howe]

My Lords, as regards the statistics on trainees who drop out, I am advised that the average rate is around 22%, which is quite high, but that can be for a number of reasons. I am, however, encouraged by the statistics that I have on the number of commissions that are currently in train across the country. On conservative assumptions, this year and next, we should see about 1,900 midwives emerging from training.

Autism Act 2009

Lord Bishop of Ripon and Leeds Excerpts

Monday 26th March 2012 Grand Committee

[The Lord Bishop of Ripon and Leeds]

My Lords, I too am very grateful indeed to the noble Baroness, Lady Browning, for raising this issue; for continuing to put pressure on us to monitor the autism strategy following the 2009 Act; and for deepening our understanding of how autism develops and is regarded within our society. I look forward to hearing details of the 2013 review of the implementation of the Act.

I am grateful for the 2010 statutory guidance to local authorities and health bodies, but I remain alarmed at the slow progress being made on the provision of diagnostic services, especially for adults. I would be grateful if the Minister could tell us what guidance there will be for the health and well-being boards and the clinical commissioning groups as the NHS reforms are taken forward.

I look forward too to the self-assessments of local authorities, which are going to be published by the Learning Disabilities Public Health Observatory in July this year. I am aware of the very different levels of progress being made by different local authorities in how they respond to need and in how they use their own finances in this area. I would be very grateful for comment from the Minister on how the self-assessment project is progressing, and on what assurances he can give us as to the future of the learning disability observatory in the light of NHS reforms. It has a crucial role in the monitoring of learning disabilities in general and of autism in particular.

Successive Governments have worked hard to raise our awareness of autism and I pay tribute to both this Government and their predecessors in raising the issues and in getting us to think about just how autism exists in our society. It remains a disability which is not well understood and can be ignored or even despised by many people. I look for encouragement for a wider expression of the reality of autism. The National Autistic Society does an excellent job in alerting us to the needs of people with autism. It remains true that many people have a very limited concept of what autism is about. I, too, was going to ask about the relationship between the Welfare Reform Act and the Autism Act and how they are seen as working together.

That is not least because I am alarmed by the extent to which people with autism are regarded as unwilling to work or as trouble-makers. The National Autistic Society figures suggest that some 15 per cent of adults with autism are in work. Most people with autism are unable to find work. It is crucial that they are not criticised or rejected as a result of that inability to find the work which many of them would very much like to be part of. Physical disability is often respected by the general public. Social disability is much less easy to understand. The work of the National Autistic Society, which helps us to a deeper understanding of the effects of autism, is welcomed by us all. But we now need much better diagnostic opportunities and understanding of causes.

In my ministry, I have had the privilege of a series of contacts with people with autism and their carers. The noble Lord, Lord Addington, said that once you meet one person who has autism and their carers, you find yourself being introduced to a number of people with autism but they can have very different symptoms and ways in which that autism is expressed. That is one of the difficulties of this whole spectrum of issues. I have spent a good deal of time with people with autism—it is by no means unusual for more than one person in a family to have autism—and have watched the careful supervision provided by their carers. Such carers are among the unsung heroes of our society and we need to do all that we can to support and encourage them.

In the context of this debate, I want to pay tribute to the contributions made to society by those who have autism. There are many skills—specifically mathematical skills, for example—which people with autism are able to share with others. Many have an openness and friendliness which means that they give to society more than they receive. But that is dependent on there being carers around them who are able to encourage and help them to express those skills and qualities which are so deep within them.

In our right concern to protect and support them, we need also to be grateful for what they give. I am very grateful for the work of the National Autistic Society and for the 2009 Act, particularly the self-assessments of local authorities and the way in which those self-assessments are dealt with and responded to. I look forward to the Minister’s response to this debate.

Health: Cardiology

Lord Bishop of Ripon and Leeds Excerpts

Monday 24th October 2011 Lords Chamber

Asked by

[The Lord Bishop of Ripon and Leeds]

To ask Her Majesty’s Government what progress they are making in the development of paediatric cardiac services in England.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, the review of children’s congenital heart services is a clinically led NHS review, independent of government. The consultation ended on 1 July and an independent analysis of the responses and interim health impact assessment was published in August. The joint committee of primary care trusts expects to make a decision later this year. This will be based on an independent analysis of the consultation, reports from overview and scrutiny committees, a health impact assessment and other evidence from the consultation.

[The Lord Bishop of Ripon and Leeds]

My Lords, I am very grateful to the Minister for that Answer. Does he agree with me that, especially where children from deprived backgrounds are concerned, it is crucial that social and personal issues are considered alongside the clinical? Will he ensure that geographical proximity of services to children’s homes is taken into account when the time comes to make final decisions in this matter?

[Earl Howe]

I am grateful to the right reverend Prelate. All that he says is very pertinent. I am confident that the review will take those matters into account.