Health: Tinnitus

Lord Elton Excerpts

Wednesday 5th February 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

We are working hard to bring down waiting times across mental health, and the noble Baroness will know that we are bringing in waiting time standards. On mental health provision for those with tinnitus, she will know that we are working to bring in improved access to psychological therapies. Ninety-five per cent of those accessing such treatments and therapies are doing so within the time available. The most important issue is making sure that those therapies are available in an accessible way. Local commissioners have to pay due regard to equality legislation and make sure they provide those services either through BSL-trained therapists or interpreters locally, if necessary.

[Lord Elton (Con)]

My Lords, having suffered from tinnitus for some 30 years, I do not share the Minister’s enthusiasm for reminding people that they have it. The most effective survival technique is learning to ignore it. Mine is a mild case. If fellow sufferers turn their mind away from it regularly and as hard as they can at the beginning, it tends to become less of a curse. As to whether it affects one’s mental abilities, I leave your Lordships to form your own conclusions.

[Baroness Blackwood of North Oxford]

My noble friend has put it rather accurately. As he said, a lot of the talking therapies available for tinnitus, which has no known cause, are ways of coping with it, some of which have proven effective. On research, we need a better understanding of causes so that we can provide better treatments for a condition that, for some, can be pervasive, pernicious and hard to ignore.

Health and Social Care Act 2012

Lord Elton Excerpts

Thursday 5th July 2018 Lords Chamber

[Lord O'Shaughnessy]

I absolutely agree with the noble Baroness that they have to go hand in glove. That is why the Green Paper has been delayed, so that it can co-ordinate properly with the NHS plan. It is also important to point out that the Prime Minister was very clear in her announcement that, as a result of the settlement on social care, there would be no further pressures on the NHS.

[Lord Elton (Con)]

As we are looking for savings in the National Health Service, perhaps my noble friend can explain why the National Health Service does not reclaim crutches, Zimmer frames, moon boots, et cetera. Even wheelchairs are found in the attics of deceased former patients. There must be quite a reserve in your Lordships’ attics, which would be very helpful.

[Noble Lords]

Oh!

Children: Obesity

Lord Elton Excerpts

Thursday 19th April 2018 Lords Chamber

[Lord O'Shaughnessy]

That is rather an interesting idea and suggestion from the noble Lord. We would need to speak to colleagues in the DCMS—which I would be delighted to do. I think that broadcasters such as the BBC have traditionally played a very important and positive role in public health issues and continue to do so, and I am happy to encourage them to do so in this area, too.

[Lord Elton (Con)]

My Lords, while recognising the essential nature of sufficient exercise at all ages, in the absence of my noble friend Lord McColl of Dulwich, I again remind the House that the more you exercise, the more you eat.

[Noble Lords]

He is here.

[Lord Elton]

I understood that he was in China; I do not understand his silence.

NHS: Charitable Donations

Lord Elton Excerpts

Thursday 22nd February 2018 Lords Chamber

[Lord O’Shaughnessy]

I think we are getting to a sensible position here: we want that transparency about what things cost in general, but not specific to each patient because of the concern that it might put people off. There is a lot more information available now than there ever has been about what items cost. What is critical—what we have learned—is that when people miss appointments, for example, which costs about £1 billion per year, there is a good opportunity to demonstrate what that cost is. But as regards what they incur as they go through the experience of healthcare, we worry about the deterrence.

[Lord Elton (Con)]

In his Answer to the noble Lord, Lord Brooke, my noble friend said that older people might be put off. Speaking as an older person, from what might I be put off by information after I have had a procedure or treatment as to what it cost? In the same supplementary, may I ask that when my noble friend comes to remind younger people about not turning up for their appointments, he should send them a note of the cost of that as well?

[Lord O’Shaughnessy]

I reassure my noble friend that I am not trying to make an ageist point. The point I was trying to make is that the majority of healthcare costs in a lifetime occur at two points in life: in younger children and in older age. We effectively have an insurance system where we pay through our tax and use the care when it is needed. The concern is that at a point in life when people might be vulnerable and not have support around them, and not necessarily know what is required in complex care, having had the facts about one piece of care they may feel that they should not be creating a burden on society by asking for more care. I do not think that is the right approach.

Public Health: Strength and Balance Programme

Lord Elton Excerpts

Thursday 18th January 2018 Lords Chamber

[Lord O'Shaughnessy]

I will write to the noble Baroness with specifics on the NICE guidelines, which are incredibly important because they establish best practice. Of course, it is then incumbent on professionals to follow that best practice. We know that public health budgets have been under pressure, but local authorities are still getting £16 billion over five years. That is a lot of money and they can use some of it to focus on such activities. Moreover, in the spring Budget last year, there were big increases in the social care budget, which I know we all welcomed. That money is particularly focused on older people and preventing falls, which is what we want to see as part of that programme too.

[Lord Elton (Con)]

My Lords, the noble Lord, Lord Jordan, has raised a matter that is of close interest to a large number of noble Lords. I wonder whether it would be worth considering having access to the programme to which he refers in the Palace of Westminster.

[Lord O'Shaughnessy]

My noble friend makes an extremely good suggestion and I look forward to talking to him about that. Perhaps he could lead such a class.

Care Homes: Hospital Discharges

Lord Elton Excerpts

Monday 16th October 2017 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness raises an excellent point. She may know that the better care fund—the route by which the additional money goes into social care—reviews and holds accountable local authorities and the NHS for interacting with one another to deal with delayed transfers of care. There is something called the high-impact change model, which is designed precisely to bring people together to ensure that the number of delayed transfers in care are reduced. That is compulsory as part of the funding provided.

[Lord Elton (Con)]

My Lords, the essential issue is pressure on hospital beds. Will my noble friend tell us what the effect is of the work of charitable—I am sorry, the name has gone, but which charitable institutions take people in their last days?

[Noble Lords]

Hospices.

[Lord Elton]

Thank you very much—retirement draws closer. What effect do charitable hospices have on the pressure on hospital beds? To what extent could a nationally efficient National Health Service palliative care service continue that effort?

[Lord O'Shaughnessy]

I hope that my noble friend’s retirement is still a long way off. I do not have specific numbers on the impact of hospices, but various changes are going on in the funding of palliative care to make sure there is much more consistency across the country for what is available. I hope that will be one of the ways we can ease the pressure.

Abortion (Disability Equality) Bill [HL]

Lord Elton Excerpts

Report stage (Hansard): House of Lords
Friday 24th February 2017 Lords Chamber

[Baroness Stroud (Con)]

My Lords, I thank the noble Lord, Lord Winston, for the time he has given me to understand fully his amendment, and I put on the record my deep admiration and respect for so much of the work he has done.

Of all people, the noble Lord, Lord Winston, will be only too aware of the extraordinary medical progress that is being made in perinatal and neonatal care. In this Bill we should be advocating for the best treatment of children with disabilities. The provision of holistic care, including perinatal and neonatal hospice care at the end of life, can help to ensure that these babies are treated with dignity, care and love. While the life expectancy of these babies may well be brief, they do have a life and are significant family members who will be valued, remembered and treasured.

The Northern Ireland Executive have recently set out a commitment to provide such hospice care in the Department of Health’s 10-year plan on palliative care for children. I hope that we will see such care being provided elsewhere in the UK. Perhaps the Minister can comment on that.

Amendment 1, aside from being antithetical to the spirit of the Bill, is fraught with difficulties, as we have heard in the debate. Taking the amendment in the order of its wording, what would be judged to be a “high probability?”. We have heard that question repeatedly in the debate. Is that more than 90%, more than 50%, or 65%? How would the decision about likely death be made? Would that be with or without treatment, since conditions may be classified as the same but manifest varying symptoms, from those which may be lethal to those which may in fact be treatable or not immediately lethal? In my meeting earlier with the noble Lord, Lord Winston, we discussed cleft palate, which can be very severe or quite minor and correctable. How long would “shortly after” need to be to qualify? Would it be a matter of hours or days or months? What would count as a “serious fetal anomaly”, since that is not even a medical term? Amendment 1 does not bring any certainty; rather, it raises more questions than answers.

These questions demonstrate how the law would treat these children differently from those without disabilities. It would again enshrine the discrimination that my noble friend Lord Shinkwin is seeking to eliminate, and I encourage noble Lords not to support the amendment.

[Lord Elton (Con)]

My Lords, after that intervention I need say very little indeed. I share with everyone else my admiration for the noble Lord, Lord Winston, as I have for my noble friend Lord Shinkwin. However, while it would be helpful to have the noble Lord’s assurance as to what is meant by these terms, that is not sufficient. It has to be on the face of the Bill because that is what the law will be. Otherwise it will be decided by the courts, which would mean there is no certainty. The purpose of good legislation is bring certainty, not doubt.

[Baroness Gale (Lab)]

My Lords, we have had a thorough debate on this amendment and I thank my noble friend Lord Winston, who has such great expertise in this field, for his clarity in explaining why he wishes to move this amendment.

This is a sensitive matter with strongly held views on both sides. The noble Baroness, Lady Tonge, mentioned a woman’s right to choose: many people hold that view. My noble friend Lady Massey said that this was not a political issue. I agree that it is not a political issue. Whenever these matters are debated, in both Houses, Members have to make up their own mind; I think that that is the right thing to do. The term “back-street abortionist” has been used several times this afternoon. Many of us remember those days and absolutely no one wants to go back to a time when women were put at such great risk.

The noble Baroness, Lady O’Loan, mentioned Northern Ireland. We may be debating that later, on other amendments, but I take her point. The arguments have been well rehearsed on both sides of the debate today and from the Front Bench I can say only that the Opposition still fully support the Abortion Act 1967.

Dental Health: Children

Lord Elton Excerpts

Tuesday 7th June 2016 Lords Chamber

[Lord Prior of Brampton]

The best way of addressing social deprivation is to have a strong economy. As I am sure the noble Baroness will agree, the Government have the perfect economic strategy to address that issue.

[Lord Elton (Con)]

My Lords, my noble friend emphasised the fact that sugar is bad for teeth and that the Government are trying to reduce the intake of sugar by private individuals. What is the effect on teeth of the substitutes that will be introduced into many products to replace sugar?

[Lord Prior of Brampton]

I am afraid that I cannot answer that question as I simply do not have the knowledge. I will research it and write to my noble friend.

NHS: Bursaries

Lord Elton Excerpts

Wednesday 25th May 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, I think that the Royal College of Nursing, Unison and other unions have concerns about moving from bursaries to student loans; it would be idle to pretend otherwise. But we are convinced that the demand for young people to go into nursing is very strong and that the availability of more money through the loan system to nurses at university will therefore encourage more people to go into nursing.

[Lord Elton (Con)]

My Lords, I am sure that there is a simple answer to my question that everybody else knows. My noble friend said that there were 20,000 nursing places available for training and more than 50,000 people wishing to fill them. But we also read that there is a shortage of nurses such that there are very heavy demands made for agency nursing. What explains that discrepancy?

[Lord Prior of Brampton]

My Lords, the reason for the discrepancy is that at the moment the bursary system effectively caps the number of student places for nursing. One of the purposes of moving to the loan system is to remove that cap and our estimate is that by so doing an additional 10,000 places will be created between 2017 and 2020.

Sex-selective Abortion

Lord Elton Excerpts

Monday 7th December 2015 Lords Chamber

[Lord Prior of Brampton]

My Lords, my noble friend makes an important point. Gender-based abortion, female genital mutilation, honour crimes and various other issues still take place in some ethnic communities in England. Across the board, we have to be vigilant about all of these issues and make it clear that they are not acceptable. They are against the law and anyone aware of these practices going on should report them to the police.

[Lord Elton (Con)]

My Lords, my noble friend has twice referred to evidence on a population basis, which I take to mean that the evidence is taken without distinction of which part of the country it comes from. Has any effort been made to correlate the evidence with clusters of cases, which might point to some social activity that would be possible to countermand?

[Lord Prior of Brampton]

My Lords, the statistics are collected on the basis of birth across the population. They are then analysed in 500 different ways. In only one of those 500, which concerned the third or further child given birth to by women from Nepal, was there any variation from what one would expect. I can assure noble Lords that the statistical analysis is very robust.