(2 years, 6 months ago)
Lords ChamberWe are very concerned about the potential inequalities. NHS England and NHS Improvement are very mindful of the risks of widening health inequalities. That is why, in their guidance, they specifically ask dentists to focus on providing urgent treatment for vulnerable groups and children and to delay planned care. NHS England has provided a flexible commissioning toolkit to local commissioners to help focus the available capacity on those who need it most and to reduce oral health inequalities.
My Lords, an important point arising today is the absence of dental care for children. This problem has worsened. What specific measures have the Government got in mind to accelerate dental care for children?
(2 years, 7 months ago)
Lords ChamberThe CQC has a role in making sure that the care provided to care home residents is of satisfactory quality. As I said, 84% of care providers are rated good or outstanding. The market oversight scheme examines companies that could potentially be in trouble and keeps a close eye on them. There are six stages in the market oversight scheme to make sure that we manage that.
My Lords, I am sure that the noble Lord, Lord Sikka, is aware of the major benefits to our economy and the provision of social care contributed by the UK’s successful private equity sector. Private capital is driving the development of the UK’s world-leading technology sector and powers the growth of the UK’s dynamic new businesses. I have been chairman of the EIS Association for some 10 years. EIS has been a significant source of risk finance for new and small businesses. Is the noble Lord, Lord Sikka, aware that 32,965 companies have received £24 billion of EIS funds since EIS was introduced?
I correct my noble friend: his question should be directed towards me. I am not sure whether the procedure allows me to delegate the noble Lord, Lord Sikka, to answer the question—I will have to find out.
The private sector, the third sector and private equity play an important role. The most important thing is the quality of care that patients get and making sure that we have a market oversight scheme, so that if any companies are potentially in trouble, we can manage that, if they go under.
(2 years, 7 months ago)
Lords ChamberMy Lords, I support the amendment of the noble Lord, Lord Forsyth, but was asked at short notice by my noble friend Lord Suri to present his contribution. He makes the point that we humans look after animals and other living creatures with the highest levels of care—
The normal convention in this House is that if a Member is not present at the beginning and end of a debate, they should not speak. It is not right to read out someone else’s speech.
(2 years, 7 months ago)
Lords ChamberThe noble Lord makes a really important point: it cannot just be about fiscal policy; it has to be across a whole range of different areas, including education and prevention. Indeed, one of the things that the NHS is looking at for the future is making sure that we focus more on prevention rather than cure—not to put cure aside; clearly, we have to deal with people who are ill. At the request of the Government, the Scientific Advisory Committee on Nutrition has undertaken an extensive evaluation of the evidence, looking at all the measures that we could possibly take to reduce sugar consumption.
My Lords, the noble Lord, Lord Brooke, raises an important issue. Obesity is now a major UK health problem, and excess sugar consumption is a major cause, with significant sugar content in too much of our food. I confess to being somewhat of a sugar addict myself—corrected by my wife, but I still love chocolates and three spoonfuls of sugar in my coffee.
I am not sure that I heard the last word. Was it substitutes?
(2 years, 7 months ago)
Lords ChamberI am sure the noble Baroness will acknowledge that a number of people have been calling for ways to address this. The Government announced the Urgent and Emergency Care Recovery 10 Point Action Plan last year, which includes supporting 999 and 111 services, looking at primary care and community health services, greater use of urgent treatment centres, increased support for children and young people, better communications and call handling, improving inflow and hospital discharge, looking at mental health needs and a number of other issues. In each of those 10 points we have drilled down on working with trusts and the ambulance service to make sure we can address the issues that are currently being raised.
My Lords, could the Government look at how many lives have been lost as a result of delays? I suggest this might be more of an issue than the Government are aware of.
We regularly talk to the NHS—every day, in fact. We have, for example, daily omicron calls. Looking at some of the data, over 925,000 calls to 999 were answered by the ambulance service in December 2021, which is nearly 30,000 calls a day. That is 2% more than in November 2021, 22% more than in November 2020 and 9% more than in December 2019. We have invested in more people in the call rooms, working with BT to better handle the calls, and ensuring we have more staff where we need them to handle the whole system and ensure we can respond quicker.
(2 years, 7 months ago)
Lords ChamberAs my noble friend will appreciate, I cannot comment on the details of a specific case, but I would welcome a conversation with my noble friend. The general issue has to be that we make sure that patients are treated as well as possible but that staff and employers are treated with as much as dignity as they deserve.
Approximately what proportion of total working is represented by night working?
There are various surveys and debates, and it depends on whether you work purely at night-time or sometimes your shift might involve working at night-time. One estimate is that, at the moment, as many as one in nine workers works at night, but it depends on where you draw that definition.
(2 years, 10 months ago)
Lords ChamberIt is important that we listen to GPs and understand their needs and how we can support them. We have committed to growing and diversifying the workforce and boosting GP recruitment. We have also committed to recruiting an additional 26,000 primary care staff to be embedded in multidisciplinary teams. The details of the training will be left to the trainers themselves.
My Lords, it was appropriate for GPs to avoid physical contact with their patients when the Covid risk was significant. As this abates, it is surely equally correct for GPs to agree to returning to seeing patients when they so request and where their symptoms invite further investigation. Also, rewarding GPs at a lower rate for telephone appointments and for working three rather than five days a week might serve as an effective incentive to restoring physical appointments.
At the centre of what the department requires and expects is that GPs work with their patients to decide the most appropriate form of consultation. In some cases that will be telephone, in some cases that will be online, and in some cases it will be face to face. When the patient requests face to face and the GP refuses, they have to give a good medical reason why.
(2 years, 11 months ago)
Lords ChamberMy Lords, I question the wisdom of seeking to restore all visiting arrangements as soon as possible. For the time, surely visitor resource priority should go to those who are seriously ill, whether with Covid or other serious illness. Visiting should be limited, for the time being, both for the seriously ill and for limited slots of groups of limited size.
My Lords, it is a question of balance. We certainly have to be extremely careful about people visiting those with Covid because of the obvious contagiousness of that disease. As I said, the guidance is currently to limit the size of groups to one close family member, but we are mindful of the mental health impact of that, so trusts are trying to get the right balance between contagion control and the mental health implications of people being ill and alone in hospital.
(2 years, 11 months ago)
Lords ChamberThe points that the noble Baroness makes are entirely right, and we share exactly the same concerns. That is why we have put in place mental health support, enhanced occupational health support, expansion of the right to work flexibly across the NHS, and the promotion of equality. On the point about older nurses, two things particularly stand out: there is significant investment in leadership through the NHS Leadership Academy, and we have bespoke support for over-50s and newly qualified nurses, recognising that they are likely to be the biggest flight risk across the NHS.
My Lords, might the Government consider upping NHS nurses’ pay rates but, at the same time, ending the practice of employing agency nurses? Frequently nurses work three days a week directly and two days a week on an agency basis, costing the NHS significantly more than full-time employee nurses.
(3 years, 1 month ago)
Lords ChamberI assure the noble Baroness that it is a massive priority. The threats from both zoonotic transmission and antimicrobial resistance are areas in which Britain has previously shown great international leadership. Through our G7 chairmanship we will continue to take up that mantle. I pay particular tribute to the work of Dame Sally Davies on antimicrobial resistance. She has done an enormous amount, particularly through the Trinity Challenge, to raise awareness and bring together Governments, industry and academia on this matter. I do not have the precise budget to hand, but I will be glad to write to the noble Baroness with any details that are available.
What proportion of infectious diseases in people do the Government estimate to originate in animals? What should be the result of doctors and vets adopting a “one health” approach?
It is the case that 75% of all newly infectious diseases come from animals. Diseases such as HIV began when transmitted from an animal to a person. The Ebola, Zika, SARS, MERS and SARS-CoV-2 viruses are all examples of recent zoonoses. As the noble Baroness, Lady Brinton, pointed out, the changes in human behaviour are only going to accelerate this. That is why we are so committed to the zoonotic agenda and why vets and those who work with farm animals need to have raised awareness of this threat.