Health: Atrial Fibrillation and Stroke

Lord Cormack Excerpts

Tuesday 12th December 2017 Lords Chamber

[Lord O’Shaughnessy]

As the noble Lord will know better than anyone, making them mandatory is a challenge because of the importance of clinical autonomy. What we can make mandatory is an understanding of those guidelines and that they inform every treatment pathway. That is part of what the NHS RightCare programme, which is now rolled out across the country, is doing. It is introducing new things such as stroke pathways so that there is clarity about the options available. Patient choice is at the centre of that decision.

[Lord Cormack (Con)]

My Lords, I have this condition but I had never heard of it until I was diagnosed about seven years ago. I urge my noble friend to try to ensure that greater publicity is given to it. Could we start by making sure that every Member of your Lordships’ House has the opportunity to be tested for it?

[Lord O'Shaughnessy]

I like my noble friend’s idea of putting on a special clinic. I hope he is getting excellent care with his own AF. The idea of publicity is an important one, and I draw attention again to the role that the Stroke Association is playing within the development of the new plan, because clearly it has fantastic reach to patients and is a trusted voice. It has a key role in making sure that there is that understanding among both patients and the clinical community.

Brexit: Risks to NHS Sustainability

Lord Cormack Excerpts

Wednesday 12th July 2017 Lords Chamber

[Lord Cormack (Con)]

My Lords, the noble Lord, Lord Warner, has performed a very signal service in introducing this debate and I congratulate him most warmly on the way that he did so. We desperately need clarity from the Government—we have not had it, but I hope that tonight we might begin to see it. It could all have been so much more simple. The noble Lord, Lord Warner, referred to the pledge to EU nationals in this country. Would the number of nurses have declined in the way that he illustrated, with that figure of 90%, if we had in fact used our sovereign power, taken control, and said from the onset, as the leave campaign did say from many a platform, “Your position, for those of you who came here in good faith, who have paid your taxes, who have become part of our communities, is not at risk”? It is still not too late for Ministers, led by the Prime Minister, to say this.

The Prime Minister has appealed recently for cross-party work and consensus. When I spoke in the Queen’s Speech debate, I suggested that one way of dealing with these matters was to have a joint Grand Committee of both Houses, which could look at these things. I did not get any answer to that; I hope that I will. The previous week, I was sacked from the Home Affairs Sub-Committee of the European Union Select Committee of your Lordships’ House, on which I enjoyed serving, for my vote on the Article 50 amendments. That is hardly consistent with the principle of appealing for cross-party accord. When we have a Government who do not have a majority and who lost their majority in a thoroughly needless general election, we need a new start and to call upon the talents sitting on all the Benches in your Lordships’ House.

This afternoon, I had the pleasure—I think that others in the Chamber probably also had this pleasure—of hearing in the Royal Gallery a very moving and inspiring speech from the King of Spain, who expressed his wish and determination that relations between our two countries should continue to thrive and prosper. We would all say amen to that. However, he made equally plain his sadness at our leaving the European Union, where we and Spain have, as constitutional monarchies, played a constructive part. We must not be hamstrung by doctrine, particularly the doctrine of those behind the £350 million pledge pasted on buses, to which the noble Lord, Lord Warner, has already referred. We need a real route map; we need to know where we are going and how we are going to get there.

The speech of the noble Lord, Lord Warner, illustrated very graphically that the greatest of our national services—our National Health Service—is teetering on the brink of collapse. We desperately need plurality of funding and to look at some of the proposals of the committee so ably chaired by the noble Lord, Lord Patel, at the end of the last Parliament, which I think reported on 5 April. We have all the pointers. We have diagnosed the disease. The Government seem unable to accept that there is a remedy and it is in their hands. We need to work together across this House and the other place to address matters of enduring importance and continuing worth, of which the National Health Service is perhaps the greatest and most important example as it touches all our citizens at unpredictable as well as predictable points in their lives.

I just hope that my noble friend, for whom I have a high regard—he has competently mastered his brief since he took on his responsibilities—will be able to give us some hope this evening. I hope that he will also talk to the Secretary of State and others because we desperately need a leadership that is not hamstrung by doctrine. Brexit will dominate all our debates for the foreseeable future, but let it not dominate them in a totally negative way.

I accept, with great reluctance, the result of the referendum—of course I do, like others in your Lordships’ House. But we have to start talking in detail about transitional periods. All this cannot be accomplished in under two years, especially as the real negotiations will not begin until after the German election later this year. That gives a period of a little over 12 months. Therefore, if we are to avoid what the Prime Minister has called the cliff edge, we have to have proper transitional arrangements, in particular when we are considering the invaluable, and in the short term irreplaceable, contribution of EU nationals to our National Health Service. That 90% figure is alarming, and if it is replicated across the National Health Service, it will place countless British citizens at risk.

Therefore, in supporting the noble Lord, Lord Warner, I ask my noble friend to forget the lies on the bus and put aside the doctrine that Brexit means Brexit—which I think is the most meaningless slogan I have ever heard in my 50-odd years in politics. Let us now tackle the real issues with a real programme and bring parliamentarians of all parties and both Houses together to contribute their suggestions and their solutions.

I therefore end more or less where I began, by asking my noble friend to pass on to those in high authority—I do not want him to tell us that it is above his pay grade—the idea of something unique: a joint Grand Committee of both Houses of Parliament. A committee can put party political considerations to one side and concentrate on trying to ensure that, from what the noble Lord, Lord Warner, called the mess that we are in at the moment, a stronger nation can indeed emerge.

Social Care in England: Older People

Lord Cormack Excerpts

Monday 20th March 2017 Lords Chamber

[Lord O'Shaughnessy]

There are two distinct issues here: carers and care workers. To attract more care workers into the system we have introduced the national living wage, which will make a difference in pay for about 900,000 people. The noble Baroness is quite right about carers. There are millions of carers in the country, and we will be bringing forward a carers strategy this year, which will address some of the issues she talks about.

[Lord Cormack (Con)]

Will my noble friend first of all associate this side of the House with the warm tributes to Dame Vera Lynn? Will he also tell the House how many care workers are from other countries within the European Union? What are we doing to ensure that we do not have a haemorrhaging of those upon whom our old people depend?

[Lord O'Shaughnessy]

I of course associate myself with the comments made by the noble Baroness and apologise for not saying so before. However, I am not going to sing in tribute.

Around 17% of the care workforce comes from abroad and some 7% of the total are from the EU. The key is to make sure that we have, as far as possible, a care system that attracts workers domestically. We are doing that through improving the training packages available and through better pay under the national living wage, which I mentioned.

Junior Doctors: Industrial Action

Lord Cormack Excerpts

Monday 5th September 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, the contract that has been offered to the junior doctors is not confidential. It can be made available to the public. Indeed, I think the main terms of that contract have been made available to the public. My noble friend is absolutely right that members of his family—and, indeed, my family and others we know—enter the medical profession as a vocation or a calling. It is an awful shame that that seems to have been lost in the dispute that has been happening over the past few months.

[Lord Cormack (Con)]

My Lords, following on from that point, is there not a case for the presidents of the royal colleges to have a greater leadership role? Is there not a case for the Secretary of State and my noble friend, in whose negotiating skills I have very great confidence, calling in the presidents to discuss this and see whether there is not some opportunity of rebuilding trust between individuals at the head of the profession and those junior doctors who are clearly disenchanted, disaffected and, frankly, behaving in a way that is not compatible with a true vocation?

[Lord Prior of Brampton]

My Lords, I agree with my noble friend. I think there is a huge opportunity here—actually, a necessity—for senior leaders in the profession, in the royal colleges, to play a really serious leadership role. Rather than standing on the touchline, if you like, they need to get on the pitch. There is a role for them. To some extent, they were instrumental in getting the two sides back to work again back in May. They were successful in doing that. Certainly, I know the Secretary of State would be very happy to listen to any thoughts that they have.

NHS (Charitable Trusts Etc) Bill

Lord Cormack Excerpts

Friday 26th February 2016 Lords Chamber

[Lord Cormack (Con)]

My Lords, I would like briefly to pay my tribute in the gap—I have given notice—to the noble Baroness, Lady Massey, and to add my congratulations on what is clearly a double golden day for her. I said that I would like to speak in the gap because I noticed there was no voice from this side of the House on the speakers list other than the Minister’s. I thought it would be appropriate to underline what general support there is for this small but very important and far-reaching measure.

When I came to the House this morning, I thought I knew what being given the bird meant. A new meaning has been brought today by an extraordinary Member, who encapsulates the importance and worth of your Lordships’ House. It is highly unlikely that he would have gone to another place, but here he is, able to contribute from a unique perspective to our deliberations. He is warmly welcomed by us all and we look forward to more hilarious and pertinent speeches, for which I suppose there is only one exclamation, which is GOSH. When the noble Baroness spoke about the charity having that name—a sort of Wodehousian name, rather than a JM Barrie one—I thought, “Oh dear, not another abbreviation that we’ve all got to remember”. But it is a memorable word. I am delighted that the noble Baroness introduced the Bill with her usual quiet skill, and we all pay tribute to a real Wendy in another place for what she did. I am delighted to give my strong support to this small but important measure.

Health and Social Care: State Pension

Lord Cormack Excerpts

Thursday 21st January 2016 Lords Chamber

[Lord Prior of Brampton]

The Government believe that we have a plan—it is the NHS’s plan, which we fully support—and that to set up an alternative commission or other kind of look at the future would be a distraction at this time.

[Lord Cormack (Con)]

My Lords, it is over 70 years since Beveridge and almost 70 years since the foundation of the National Health Service. In the debate brilliantly introduced by my noble friend Lord Fowler last week, there were many calls for a commission or an inquiry from all parts of the House—from the Cross Benches and all the political parties. Cannot my noble friend give us some hope that he has a chink of an open mind?

[Lord Prior of Brampton]

My Lords, I am afraid that I cannot today give my noble friend that chink or that hope, because we are supporting the NHS’s plan, which was developed and produced by the NHS. We believe that it would be wrong to set up an alternative at this stage.

National Health Service

Lord Cormack Excerpts

Thursday 14th January 2016 Lords Chamber

[Lord Cormack (Con)]

My Lords, I will begin by making an appeal to those who arrange these matters in this House. A three-minute time limit in a debate such as this is absurd, and it is certainly absurd to allow a maiden speaker—we heard a very good one this morning—only three minutes. When times are allocated, a little could be taken off the Front-Benchers to give a little more for a maiden speech. I also endorse the plea made by my noble friend Lord Lansley for a proper annual debate—I do not refer to the Queen’s Speech—on the National Health Service.

Time allows me to make just two points. The National Health Service may indeed be the best in the world. If it is, that is because it is the creation of all political parties, and it is very wrong for any politician to seek to make a political football out of it. Your Lordships’ House sets a much better example than the other place when it comes to debating the NHS.

My second point is very simple. My noble friend Lord Fowler made an eloquent plea for a royal commission. I was privileged to take part in a debate that was instituted by the noble Lord, Lord Turnberg, just over a year ago, when I made for the third time a plea for a commission or an inquiry. I repeat that plea again today and endorse what my noble friend Lord Fowler said. It is important not only that we take the NHS out of the party political arena but, as the noble Baroness, Lady Williams, said in her excellent speech, we have to look to the future because the health service is in crisis. A sticking plaster is not the solution. To lurch from one financial crisis to another does not only the NHS but the whole nation a disservice in the process. As I have said before, we must have a plurality of funding. Whether that comes from taxation—hypothecated or not—compulsory insurance, extra charges such as penalties for those who do not keep appointments or from a combination of all three, we must have a plurality of funding and take away this continual crisis.

We are all beneficiaries of the National Health Service and we will all depend on it in the future. I therefore urge the Minister to give some indication that he has sympathy for the idea of a commission and, at the very least, I should like some sympathy for my noble friend Lord Mawhinney’s plea for a body to be set up in this House, where there is a greater accumulation of expertise on this subject than anywhere else in the country.

Southern Health NHS Foundation Trust

Lord Cormack Excerpts

Thursday 10th December 2015 Lords Chamber

[Lord Prior of Brampton]

My Lords, the noble Lord, Lord Hunt, gave two very important figures: 1% of these incidents involving people with learning difficulties were investigated and 0.3% involved people with learning difficulties who are older. We have not got it right in this country when it comes to people with learning difficulties. We have not fully learnt the lessons of Winterbourne View. However, NHS England has now published this new strategy for people with learning difficulties and mental health problems. We will hold it to account for delivering that. I think that represents a step change in trying to get as many of these people out of hospital settings—“from hospital to home” is the line in the report—which is so important. That is the fundamental issue that we should not lose sight of.

NHS England received the report in September. It has not yet been published because it had to give the trust a chance to comment on it, and the methodology has to be fully sorted before it is published. However, Jane Cummings has given a commitment to the Secretary of State that the report will be published before Christmas. So does NHS England have a grip? I think it does.

On the question of an independent investigation, which the noble Baroness, Lady Walmsley, raised, the trust has to be the first line in this. It is up to the trust to have the right culture within it so that these incidents come to the surface. We now have a much more empowered CQC providing independent inspection, and of course the Secretary of State has agreed to set up an independent investigation branch, on the recommendation of the PASC, which will be operable from March.

[Lord Cormack (Con)]

Will my noble friend institute an emergency review, through the CQC or wherever, to try to establish that this is an isolated incident and that there are not more horrors waiting to be discovered?

[Lord Prior of Brampton]

My Lords, I certainly cannot give a guarantee that this is an isolated incident. Often in the past we have taken these awful events when they happen and tried to say that they are isolated. The fact is that there are many trusts that the CQC has characterised as requiring improvement, so I cannot give my noble friend an assurance that this is an isolated incident. However, I can reassure him that our inspection procedures are much more robust than they used to be.

Mesothelioma (Amendment) Bill [HL]

Lord Cormack Excerpts

Friday 20th November 2015 Lords Chamber

[Lord Cormack (Con)]

My Lords, exactly what the relevance of that story is to the debate is unknown, but it is one that I have heard in the past and have much enjoyed hearing again. I will begin, as others have, by warmly congratulating the choirboy—not superannuated—because he has a wonderful and youthful enthusiasm, as the noble Lord, Lord McNally, said, and he is doughty campaigner. I am reminded when thinking of campaigners of Sir Walter Raleigh, who made the famous remark that it is not the beginning of a cause for which you should be praised, but for continuing with it to the end, until it is throughly, not thoroughly, finished. I do not think that the noble Lord, Lord Alton, is going to give up his campaign until it is indeed throughly finished.

The noble Lord outlined graphically the need for this modest measure to supplement the Act that is already on the statute book, and we have heard in the debate a number of moving testimonies, not least from the noble Lords, Lord Freyberg and Lord McNally, whose personal family lives have been tragically affected by this ghastly disease. We have also had something of a medical teach-in because the noble Lord, Lord Winston—I am sorry that he is not in his place; oh, he is in his place. I am so sorry. The trouble with the noble Lord is that he moves; he made his speech from the back and now he is sitting elsewhere. He gave us a treat of a lecture. Then the noble Lord, Lord Kakkar, and my noble friend Lord Ribeiro gave us supplements to that lecture. It has been a privilege and is indeed an illustration of the value of your Lordships’ House that we have such expertise in all parts of the Chamber. That has been demonstrated today in a splendid way.

I want to address most of my remarks to my noble friend the Minister. Quite rightly, complimentary things have been said about him. He made his mark before he came into the House when he was chairman of the Care Quality Commission. In a sense we are talking about quality care here, but we are not appealing to the Minister to come to the Dispatch Box and agree to large extra expenditure from public funds. What we are asking him to do is recognise that there is a very real problem that we cannot adequately quantify. In her splendid speech, the noble Baroness, Lady Finlay, talked about schools. How many five year-olds in this country today might already be stricken by this disease, which perhaps will not manifest itself for many years to come? We all know that in our youth—I am sure that I speak for most of your Lordships—asbestos was regarded as a good thing. It was a fire retardant material that brought great benefit. But now we know that it is one of the most lethal of killers. Of course the Minister knows that, but we are asking him to recognise that more must be done to combat this evil within our midst, the full and devastating results of which none of us knows.

That there should be a levy on insurances is a very sensible suggestion, but I would say to the Minister that that should be just the starting point. There are many substances from which we all benefit in some ways—some we regularly imbibe and others we eschew—that damage the health of the nation. Why should there not be a specific levy for medical research on alcohol, tobacco, petrol or diesel?

As my noble friend knows well, I have argued, as have many in your Lordships’ House in various debates on the health service, that we must have a plurality of funding if the National Health Service is going to be the service we need in the years ahead. We have to get away from the sticking-plaster approach that we have often referred to in this Chamber. Here is a wonderful opportunity to begin something by having a specific levy for a particular disease that could then be extended. I commend this to the Minister. When I talk to him about these funding issues, he always indicates the difficulty. Of course we all know there is a difficulty. We all know that there is a degree of cowardice in all political parties when we start talking about charges and compulsory insurance, for example. This is not one of those things the Minister has to fight shy of, because here, we are saying that those who have a degree of culpability should be made to acknowledge that by making a contribution.

Of course, that may not have helped the sisters of the noble Lords, Lord McNally and Lord Freyberg, but there will be others in the future whom it might help. We might be able to avoid some of the tragedies about which they movingly spoke, if only we could grasp this particular nettle. I do not want from the Minister the soft answer that turneth away wrath. I want a determined commitment on the part of the Government to recognise the overriding importance of medical scientific research, and to recognise that this is one way properly to meet the needs that we all acknowledge.

Social Care

Lord Cormack Excerpts

Thursday 15th October 2015 Lords Chamber

[Lord Prior of Brampton]

—any place! I look forward to that. We will be accompanied by officials. There is no doubt that the local authority-funded care sector is under considerable pressure at the moment and that the increase in the national living wage will add to that pressure. Those pressures are well recognised by the Government. To some extent they have been addressed by the better care fund. I think that pooling budgets between health and social care is a way forward but we have to await the out-turn of the spending round before we can be more definitive.

[Lord Cormack (Con)]

My Lords, might I express the hope that the meeting with the noble Baroness is not only productive but chaperoned properly? I ask my noble friend to take on board the very important point she made about travel time. It really is very wrong indeed that people should not be paid for travel time, especially in rural areas.

[Lord Prior of Brampton]

I thank my noble friend for that important observation, with which I agree completely.