NHS: 111 Service

Lord Clark of Windermere Excerpts

Monday 21st March 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, 100% is clearly the only acceptable level but, realistically, it would be extremely difficult to get to that. Referring back to the charge of complacency, we recognise that significant improvements need to be made to the 111 service, but it can be a vital part of the way that we deliver urgent care in Britain.

[Lord Clark of Windermere (Lab)]

My Lords, we all accept the Minister’s commitment to the NHS. He has just stated that improvements to the service need to be made. When are they going to be made?

[Lord Prior of Brampton]

My Lords, it may sound trite, but we need to make continuous improvement in all aspects of the NHS. We can never be satisfied with where we have got to. Interestingly, the licensing arrangement which underpins the NHS Pathways—the algorithm developed by the Royal College of GPs—has within it an audit to ensure that continuous improvement is being made.

Accident and Emergency Services: Staffing

Lord Clark of Windermere Excerpts

Tuesday 23rd February 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, the noble Baroness calls for a national debate but sometimes I feel that, in this House, we talk of almost nothing else. However, I understand the serious point that she makes. The fact is that the Government are committed to investing £10 billion of new money into the NHS. It is a very significant investment and is no more and no less than her own party promised at the last general election.

[Lord Clark of Windermere (Lab)]

My Lords, the Minister has said that we have to train more of our own doctors, and on previous occasions he said that we have to train more of our own nurses. In training the nurses, we are taking a risk in abolishing the bursary system so that when those new nurses are qualified in 15 months’ or 18 months’ time they will have debts of about £40,000. What progress are the Government making in trying to reward those nurses who spend a considerable time in the health service—perhaps 10 or 15 years—so that those debts can possibly be written off?

[Lord Prior of Brampton]

The noble Lord will know that we are consulting on the proposals to remove bursaries and replace them with student loans. All the indications are that this will enable us to increase the number of nurses because the current system means that many young men and women who wish to become nurses are not able to do so. I think that three out of four people who apply are not able to get on the right courses. We hope that the new system will increase the number of nurses available to the NHS.

National Health Service: Nurses

Lord Clark of Windermere Excerpts

Tuesday 26th January 2016 Lords Chamber

Asked by

[Lord Clark of Windermere]

To ask Her Majesty’s Government what plans they have to ensure that there are a sufficient number of nurses in the National Health Service.

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

My Lords, Health Education England is responsible for workforce planning in the NHS. In 2016-17, the HEE commissioning and investment plan forecasts an additional supply by 2020 of 40,000 nurses as a result of undergraduate and postgraduate commissions placed with universities between 2012 and 2016. Moving new nursing students on to the student loans system from August 2017 allows universities to offer up to 10,000 extra nursing, midwifery and allied health degree places by 2020-21.

[Lord Clark of Windermere (Lab)]

I thank the Minister for his answer, and we all wish the Government well in trying to make up the shortfall of nurses which is bedevilling our National Health Service at the moment. I am dubious about the abolition of the bursary scheme and think that the Government’s proposals are highly risky, but I wish the Government well. I ask the Minister for an assurance that if they proceed with the abolition of the bursary scheme, they will recognise that the cost to nurses at the end of their training will probably be approaching £50,000. Will the Government give a commitment that they will fund a payback or reward scheme so that those nurses who have spent a number of years in the National Health Service will have some of those debts written off?

[Lord Prior of Brampton]

My Lords, I thank the noble Lord for wishing the scheme well. It is intended to increase the supply of young men and women going into the nursing profession, with which I think everyone in this House would agree. It is true at one level to say that people receiving loans rather than bursaries will have a debt of about £50,000 at the end, but the repayment of that is, as the noble Lord knows, graduated, and only 9% of the excess over £21,000 a year will be payable, not the full amount, as he suggests.

Health: Skin Cancer

Lord Clark of Windermere Excerpts

Wednesday 22nd July 2015 Lords Chamber

Asked by

[Lord Clark of Windermere]

To ask Her Majesty’s Government what has been the increase in diagnosed skin cancer over the past 10 years.

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

My Lords, over the past 10 years in England, there has been a 61% increase in new cases of melanoma, the most serious form of skin cancer, and an increase of 41% in non-melanoma skin cancers. In 2012 there were 11,281 new cases of melanoma and 79,743 new cases of non-melanoma skin cancer.

--- Later in debate ---

[Lord Clark of Windermere (Lab)]

My Lords, I thank the Minister for that Answer, which shows an alarming increase in skin cancer. I understand that NICE is in the process of issuing new guidelines in this respect, due out this month. Will the Minister advise the House whether these guidelines are mandatory because they are so central to the Government’s campaign in fighting skin cancer, or are they merely “guidelines” and need not be followed? Secondly, is the Minister aware that there is concern among consultant dermatologists in hospitals that the clinical commissioning process may not be sufficiently robust to deal with this increased spate of skin cancers?

[Lord Prior of Brampton]

The NICE guidelines are due to come out at the end of July or in August. I believe that they are guidelines, not mandatory, although they should be read in the context of the report by Harpul Kumar, Achieving World-Class Cancer Outcomes. Cancer is a very high priority for this Government, and this may come out in further questions. In commissioning these services, we have to be very careful that we do not disaggregate dermatology services in hospitals; the provision of routine and complex emergency dermatology services and, of course, the training of dermatologists should be commissioned as a whole.

Care Quality Commission: Morecambe Bay Hospitals

Lord Clark of Windermere Excerpts

Thursday 20th June 2013 Lords Chamber

[Earl Howe]

My Lords, there has never been a right to tell lies, either professionally or in statute. My noble friend is right that we should be shocked that it is necessary to put in legislation that there has to be a statutory duty of candour. Candour has been part and parcel of the ethical framework for professionals in the health and care sector for many years. It is a sad reflection on those involved in the events at Mid Staffs and Morecombe Bay that we should be thinking in these terms at all, but we must, because unless we do we lay ourselves open to matters being brushed under the carpet, as they have been in these cases.

The inspections themselves have not been generic: it is the skills on the part of the inspectors that were considered to be adequate as those individuals were deployed generically. That decision was taken very early on when the CQC first came into being in 2009. We now think, as does the CQC, that that was wrong and that skills should be altogether more specialist.

[Lord Clark of Windermere]

As someone who lives in the catchment area of Barrow-in-Furness hospital, I have followed the story very closely. Does the Minister agree that, while we are discussing the cover-up by the CQC today, it in turn was investigating shortcomings by what was presumably the previous management of Morecambe Bay hospitals? Did he see the very pointed quote yesterday in the other place by the MP for Barrow-in-Furness, John Woodcock, who has done so much in this? He quoted the report as saying that there could be a “broader and ongoing cover-up”. Can he give the House an assurance that any investigation will not stop at the CQC but will look at the main cause of the disturbance and Mr Titcombe’s complaint initially?

[Earl Howe]

My Lords, I can give that assurance. In part, we have the answers in the Grant Thornton report commissioned by the CQC on the actions that the CQC took or did not take. As I said in answer to the question asked by the noble Lord, Lord Hunt, it is reassuring that the chief executive of the CQC has undertaken to produce for the department within the next two months a report to provide assurance that any cover-up has been fully exposed and that we will learn fully not only the facts but the lessons that we can draw from them.

Health: Clinical Commissioning Groups

Lord Clark of Windermere Excerpts

Thursday 26th April 2012 Lords Chamber

[Earl Howe]

My Lords, we are involving all relevant stakeholders in drawing up the precise rules that we expect the NHS Commissioning Board to follow. As I mentioned in my initial Answer, part of that has resulted in guidance that has already been issued and the rest will follow shortly. As regards the second part of my noble friend’s question, the key is for CCGs to make arrangements to make sure that actual and potential conflicts of interest do not affect the integrity of the group’s decision-making process and do not appear to do so. Therefore, the CCG must not only be fair and open and honest, it must also be seen to be all those things, because a perceived conflict of interest which is not managed appropriately would be as damaging to the reputation of a CCG as an actual conflict.

[Lord Clark of Windermere]

My Lords, would the CCG’s workings and operations be subject to the Freedom of Information Act?

[Earl Howe]

My Lords, CCGs will be statutory bodies and so the answer is yes.

NHS: Waiting Times

Lord Clark of Windermere Excerpts

Tuesday 22nd November 2011 Lords Chamber

[Baroness Jolly]

My Lords—

[Lord Clark of Windermere]

My Lords—

[The Chancellor of the Duchy of Lancaster (Lord Strathclyde)]

Perhaps we may hear from one noble Lord from the other side at a time, and then from my noble friend.