(6 years, 1 month ago)
Lords ChamberMy Lords, since the 2012 Act was passed, there have been some significant improvements in NHS performance, not least in cancer outcomes, for example. There are also around 42,000 more staff since 2010. So improvements have clearly been able to happen within the legal framework set by Parliament in 2012. Nevertheless, we recognise that as the service is required to become more integrated and people across different care functions are required to work together, we need to look at the structure. There is already joint working, for example, between NHS England and NHS Improvement at the regional level. But if the NHS identifies any barriers, we will look at those.
My Lords, when we are looking at the structure, which is clearly important, can we also look at priorities within the National Health Service? I heard this morning that certain treatments and unnecessary medicines are to be ruled out. Can we have a comprehensive list of those? It is not right that dandruff shampoo should be on prescription. It is not right that we should be looking at funding the treatment of gaming machine addiction. Can we have a real look at the priorities?
My noble friend makes a very important point, which is that as we move ahead, even with the funding settlement, it is essential that the NHS becomes more productive. That means looking at whether there are medicines or treatments that are no longer producing the outcomes it was suggested that they would and taking those out of service. It is very important to state that this has to be a clinically led process. We have already begun that with certain low-value prescriptions. NHS England is now leading that process—as I say, it is clinically led—to look at whether there are other treatments that could be discontinued.
(6 years, 6 months ago)
Lords ChamberI am glad to be able to publish the response at last, and apologise again for how long it has taken. I am pleased to report that we have not just changed the name of the department but given the strategic direction for social care policy back to it. That also includes strategic direction of funding—but the actual funding settlement happens through the local government funding settlement. I have to disappoint the noble Lord on that because there are no current plans to change it.
My Lords, in his Answer to the noble Baroness, Lady Campbell of Surbiton, my noble friend referred to a forthcoming round table that will address some of the issues that provoked the Question. Can my noble friend assure me that the noble Baroness will be invited to participate in that round table?
My noble friend makes an excellent suggestion. It is not my round table, so the invitation is not mine to extend, but I shall certainly be seeing my colleague the Minister of State this evening and shall do everything that I can to encourage that invitation to come.
(6 years, 8 months ago)
Lords ChamberAs 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.
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?
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.
(7 years, 5 months ago)
Lords ChamberThere 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.
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?
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.