Allied Health Professionals: Prescribing Responsibilities

Lord Grade of Yarmouth Excerpts

Tuesday 6th February 2024 Lords Chamber

[Lord Markham (Con)]

Yes, because the noble Lord is correct: it should not take so long. We all agree with the approach. So noble Lords understand, there is a two-step process. First, the body to which we are trying to extend this needs to be agreed by a review of the Commission on Human Medicines; then, the Advisory Council on the Misuse of Drugs need to take a look at it. We are all aware of the dangers of anti-microbial resistance, which is why we need to be careful about things such as antibiotic prescribing. But in general, we want to do this as fast as possible.

[Lord Grade of Yarmouth (Non-Afl)]

My Lords, I am sure that most people will welcome the extension of prescribing facilities to pharmacies. Does the Minister understand that the rate of closure of independent pharmacies in the UK—these vital community facilities —is absolutely accelerating? Will he undertake to look at the rate of closure and understand why these small, independent businesses, which are the pillars of communities, are closing at such a rate? They are just financially unsustainable.

[Lord Markham (Con)]

I agree with my noble friend that not only are they the pillar of communities, but they are the front line in a lot of health services. This is about trying to put more business and activity their way to increase their viability, both in terms of paying for treatments such as these and increasing footfall generally. I completely agree with my noble friend that we want as many of these small businesses thriving in their own right, but also as a vital part of the health ecosystem.

NHS Winter Pressures

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Tuesday 10th January 2023 Lords Chamber

[Lord Markham (Con)]

I absolutely think these measures will improve the situation; I would not be putting them forward if I did not believe that. At the same time, just as we put out plans in October and are amending them now, I will continue to amend our plans. I think that is a flexible, responsible approach: you have a plan, you adapt that plan, you invest and you continue to improve. That is what we will continue to see and do; we will see those improvements go through this year and into the next.

[Lord Grade of Yarmouth (Non-Afl)]

My Lords, my noble friend the Minister mentioned pharmacies in his response, which clearly demonstrated a complete lack of understanding of the crisis that is going on in the independent pharmacy sector. They are closing at an alarming rate, yet they are the front line of the NHS, with record numbers of people coming to see them for free medical advice because they cannot get in to see their GP. There is a very serious crisis in the independent pharmacy sector, which is vital for healthcare. I have had many meetings, I have had letters, and I have got a campaign going in the media. It is clear from the responses that the department does not have a clue about the extent of the crisis and the closure of these independent pharmacies. Something needs to be done before they all close.

[Lord Markham (Con)]

I wholeheartedly agree with my noble friend that the pharmacies are the front line. We realise that they have been underutilised in the past. Actually, the plan of using them more for patients will put more funding their way, which I hope will support them, just as allocating Covid vaccinations to many pharmacies provided support. I hope my noble friend will see that this plan should add to the viability of a number of pharmacies by putting more business their way. They are a crucial part of the front line.

Pharmacy (Responsible Pharmacists, Superintendent Pharmacists etc.) Order 2022

Lord Grade of Yarmouth Excerpts

Tuesday 28th June 2022 Lords Chamber

[Baroness McIntosh of Pickering (Con)]

My Lords, I congratulate my noble friend on bringing forward the order before us today. I am interested to understand the background to why we are moving from ministerial discretion to regulated control. I think my noble friend will assure the House this afternoon that the concerns raised by the Secondary Legislation Scrutiny Committee have been addressed and that any changes will be brought forward by statutory instrument, in which case the committee and the House will have the opportunity to look at them.

I join the noble Lord, Lord Hunt, and my noble friend, in paying tribute to community pharmacies for the work that they have done throughout the years, and particularly during the Covid pandemic.

What will the position of dispensing doctors be, who fulfil a role where community pharmacies do not reach? Quite a large network of rural areas is served by dispensing doctors. As the daughter and the sister of dispensing doctors, and as someone doing outside work with dispensing doctors, I think it is appropriate that we look at how they are potentially being asked, for example, to deliver a booster jab this autumn at the same time as the flu jab. That will pose enormous logistical challenges for community pharmacies, dispensing doctors and others. How do my noble friend and his department expect to address those challenges so that the rollout will go as smoothly in the autumn—particularly if it is combined with a flu jab—as it did in the previous three or four rounds?

[Lord Grade of Yarmouth (Con)]

My Lords, the health or otherwise of independent community pharmacies can be judged by the rate of closures, which has been increasing over the last few years for a number of reasons, not least the overall deal with the NHS. That deal requires, for example, an individually owned community pharmacy to be deemed to have received the same discount on the purchase of drugs that Boots and the other big chains get on volume discounts. There is a serious crisis in this sector. Can my noble friend the Minister give us some idea of the rate of closure? If he does not have the statistics today, perhaps he could place them in the Library. Closure is an upward trend.

[The Deputy Speaker (Lord Brougham and Vaux) (Con)]

The noble Baroness, Lady Brinton, will be taking part remotely and I call her now.

Future of Health and Care

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Tuesday 23rd February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Lord is entirely right that the regulation of both clinical care and social care is critical and key not only to good performance by both sectors but to the way in which they work together. That is why we will look at the CQC and its role in social care regulation. We will seek to enhance the way in which the CQC can look deeply into social care to set higher standards and to ensure that, when it comes to integrated care, social care is stepping up to the challenge as best it can.

[Lord Grade of Yarmouth (Con) [V]]

My Lords, the front line of social and community care—indeed the whole of the NHS—begins with local pharmacies, which, as the Government well know, are in dire financial straits, closing down at a rate of four or five every week. I ask my noble friend the Minister: is it the Government’s policy to wait until these vital community services have all gone bankrupt before they act?

[Lord Bethell (Con)]

My Lords, I start by paying an enormous tribute to the 11,251 community pharmacies for the work they do day in, day out, and in particular their contribution to the vaccine rollout. I remind my noble friend that £370 million has been made available by the Government in increased advance payments to support community pharmacies with cash-flow pressures caused by the pandemic. The community pharmacy contractual framework—the five-year deal—commits £2.5 billion annually to the sector. Non-monetary support has also been provided in recent months, such as the removal of some administrative tasks, flexibility in opening hours, support through the pharmacy quality scheme, and the delayed introduction of new services. I am afraid I do not quite recognise the figures my noble friend cited on the closure of pharmacies, but if he would like to write to me, I would be very glad to look into them more closely.

Pharmacies

Lord Grade of Yarmouth Excerpts

Monday 20th July 2020 Lords Chamber

Asked by

[Lord Grade of Yarmouth]

To ask Her Majesty’s Government what steps they are taking to ensure that independent pharmacies are able to continue to support the communities in which they are based.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con) [V]]

My Lords, I pay tribute to the immense contribution being made by community pharmacies in the epidemic. We are hugely grateful for the unequivocal commitment that the sector has shown and we want to make sure that the sector is treated correctly. We have made available £370 million in advance payments to aid cash flow, providing funding for the medicine delivery service for shielded patients and increased drug reimbursement prices. We are talking to the sector about additional funding for Covid-19 costs.

[Lord Grade of Yarmouth (Con) [V]]

I am grateful to my noble friend the Minister for that response but, as I am sure the whole House will agree, independent pharmacies in so many small towns such as Yarmouth and places such as the Isle of Wight are now the heroic first line of defence for GPs and the NHS. The most vulnerable in these communities depend on them for medical advice and deliveries of vital prescriptions, which they offer for free. In my view, it is totally unrealistic for the department to point to some recent funding help as if that has solved the problem. It is nowhere near enough to keep the pharmacies in business, let alone to allow the pharmacists to have a day off or even earn a living. It just demonstrates that the department fails to understand why independent pharmacists are still in such grave peril. May I please urge my noble friend to meet a delegation of these front-line heroes, to hear directly why their businesses continue to hang by a thread? When they fold, they will not be replaced.

[Lord Bethell [V]]

My Lords, I agree with every word of the tribute of the noble Lord, Lord Grade, to the role of community pharmacies, particularly during the epidemic. They have played an absolutely pivotal role in communities, with advice, medicines and support, and I pay tribute to their hard work and commitment. I would be very pleased to meet a delegation to discuss the challenges that they face.

Health: Sepsis

Lord Grade of Yarmouth Excerpts

Wednesday 22nd January 2020 Lords Chamber

Asked by

[Lord Grade of Yarmouth]

To ask Her Majesty’s Government, further to the University of Washington’s Global Burden of Disease Report, published on 16 January, what steps they are taking to address incidents of sepsis in the United Kingdom which is ranked 132 out of 195 countries for deaths caused by sepsis.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)]

My Lords, over recent years the NHS has become much better at spotting and treating sepsis quickly. This means that more people are being identified as at risk of sepsis and mortality rates are falling. While we welcome this report’s attempt to advance knowledge of worldwide deaths from infection and sepsis, we are confident in our own data, which puts UK deaths from sepsis as significantly lower than reported in the study.

[Lord Grade of Yarmouth (Con)]

I thank my noble friend for that Answer. The House will not need reminding that some 50,000 people a year die in this country from sepsis, far too many of them unnecessarily. I declare my interest as an unpaid adviser to the UK Sepsis Trust, which has done remarkable work to improve awareness. Members of the trust, including clinicians and so on, have had many meetings at different levels within the department, begging for a registry of all sepsis cases in the UK. We have had a very sympathetic hearing but it is a bit like dealing with the laundry— nothing ever comes back. Can the Government make a commitment to introduce a registry which will help greatly to improve the targeting of the right antibiotics for the right cases?

[Baroness Blackwood of North Oxford]

I thank my noble friend for this Question and I pay tribute to his work on it, and the work of the UK Sepsis Trust. I am aware of the calls for a national sepsis registry for patients. It is important that we understand the data; we are confident that it provides an accurate indication. We think that UK data is as good as it can be at the moment but that there is a clear need for better data on sepsis. The problem with the registry as proposed is that it would use retrospective data collection. We want to go beyond this with the UK’s five-year national action plan for AMR, which includes a commitment to develop the real-time patient-level data of individual patients for infection, treatment and resistance history. Work is already under way by NHS England and NHS Improvement. I hope that is the kind of answer my noble friend was looking for.

Health: Sepsis

Lord Grade of Yarmouth Excerpts

Thursday 14th September 2017 Lords Chamber

Asked by

[Lord Grade of Yarmouth]

To ask Her Majesty’s Government what new efforts they will be making in the coming year to improve public awareness, and clinical management, of sepsis.

[The Parliamentary Under-Secretary of State, Department of Health (Lord O’Shaughnessy) (Con)]

My Lords, yesterday was World Sepsis Day, a timely reminder that patients rightly expect the NHS to recognise and treat this devastating condition. To continue making progress in tackling sepsis, NHS England yesterday published its Second Sepsis Action Plan. At the same time, NICE published a new quality standard for sepsis, building on the guidance it published in July 2016.

[Lord Grade of Yarmouth (Con)]

I thank my noble friend for that constructive response. The House may or may not know that sepsis kills 44,000 in the UK every year. It can develop from a simple scratch on the skin, but it is easily cured with antibiotics. The problem is ignorance of the symptoms on the part of both patients and clinicians. Will the department undertake to explore, with the UK Sepsis Trust, an urgent and impactful awareness campaign that will save both lives and money?

[Lord O’Shaughnessy]

I am grateful to my noble friend for raising this important issue and I should like to pay tribute both to the UK Sepsis Trust and to the campaigner, the parent Melissa Mead. I do not know if noble Lords saw the moving “Panorama” programme broadcast earlier this week about the work that she has done to raise awareness of this issue. She is truly inspiring given that she lost her child.

A major campaign was launched at the end of last year to raise public awareness. It was fronted by the Secretary of State, and, indeed, Public Health England is building messages about sepsis into its Start4Life campaign. I believe that the particular proposal is that there should be a campaign of advertising on the sides of ambulances. The Secretary of State is sympathetic to the idea and is raising the issue with the chief executives of ambulance trusts to see whether this is something that we can take forward.

Queen’s Speech

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Thursday 29th June 2017 Lords Chamber

[Lord Grade of Yarmouth (Con)]

My Lords, I draw your Lordships’ attention to my long register of interests, most particularly my connection with Pinewood film studios and my position as a trustee of the Science Museum Group.

I make no apologies for introducing a note of optimism into what has been a somewhat depressing debate with a list of worries and concerns, all of them legitimate and certainly well worth listening to. I will talk about social mobility. A year or two ago, Alan Milburn asked whether I would join his Social Mobility Commission, looking at that issue, and I came away as depressed as the noble Lord, Lord Whitty, about the general picture. However, I came away utterly thrilled, delighted and excited by the fact that the sector I represented—namely, the creative sector—is an absolute beacon of social mobility. It is open to anyone and everyone; geography sometimes plays a part as an inhibition to people joining, because so much of the money is in London—more on that in a moment.

I will give your Lordships one example of social mobility. There is an A-list Hollywood director from the north-east of England called Ridley Scott, who commands hundreds of millions of pounds-worth of Hollywood budgets to make movies that people want to see. He is a massive success story. He comes from very humble origins in the north-east; he started his career working in the scenic department of the BBC and ended up directing “Z Cars” and other things. He has made a huge success, together with his late and much lamented brother, Tony. I asked him what his father did for a living and he said, “If you ask my mother, she will say that he was in shipping, but I will tell you that he was actually a riveter in the shipyards of the north-east”. He is only one of many tens of thousands of young, hopeful kids with a bit of talent, who have made their way into the creative sector and made very good livings and contributions, training as technicians, with no training at all, as writers, actors, make-up people and so on. It is great that the sector is advancing.

Unusually from this side of the House, I pay tribute to Gordon Brown, who had the vision to realise the importance of fiscal incentives in the creative industries for us to be competitive internationally. He introduced the fiscal incentives, which successive Governments have increased. Through an era of austerity, the Treasury must finally be convinced that the taxpayers are getting a very good return indeed for the investment they make in the creative industries. Some figures say that taxpayers get eight times their money back and others say 12 times, so somewhere in that range is the result. This is therefore a tribute to Gordon for his vision.

We are an expanding sector and we are internationally successful. I was pleased yesterday that the British Film Institute announced a new industry-led skills strategy backed by an investment of £20 million of National Lottery funding—a huge boost to our skills shortage, which is up and coming because of the expansion. UK film production contributes about £4.3 billion to the UK economy.

Our museums and arts institutions contribute greatly to civilising and, most importantly, inspiring kids. I go around our museums in our group, four which are north of Liverpool, I am happy to say, including the National Science and Media Museum in Bradford, the advisory board of which I chair. Watching the results of the investment that has gone into those institutions, seeing the school parties going round getting inspired and plugged in—incidentally, to the STEM agenda—is incredibly exciting. I was pleased to see in the Conservative manifesto a recognition that this sector is so incredibly important to us.

One of the key themes that government has finally grasped is that money has to move out of London. I was thrilled to see the Arts Council for England moving money out of London into the English regions recently. There is beginning to be a real recognition that there is talent out there that cannot afford to come to London. We must move the talent out. It is one of the reasons I would support moving Channel 4 out of London. If you move the money and the air time out of London, the talent will follow. Decentralisation is terribly important. Recognising skills and talent in the regions will help social mobility. I have only one caveat to this optimism: contrary to the forecast of the President of the European Commission, this is all dependent on the English language surviving.

Suicide

Lord Grade of Yarmouth Excerpts

Tuesday 23rd April 2013 Grand Committee

[Lord Grade of Yarmouth]

My Lords, I declare an interest as another member of the Samaritans advisory group; I think we are quorate today, which is good news. I also declare another interest, as an independent lay commissioner of the Press Complaints Commission, since I want to talk a little bit about the media role in this subject.

About 28 years ago, my boss and mentor fell out of a window four or five stories high in a block of flats. The next morning, the Daily Mail’s front page had a photograph of a mansion block of flats, and a dotted line from the fifth floor to the pavement where he fell. His children had to look at that in the newspaper. The story of media coverage of suicide, and its imitative effects and so on, is actually a good story from that day because coverage is much more sensitive. It is much improved. Editors and journalists are much more aware of the damaging effect of the wrong kind of sensationalist and detailed coverage of the methods of suicide. This is particularly true in broadcasting, where the statutory guidelines for producers and coverage and so on deal in great detail with the coverage of suicide. The media have for once a good story to tell in the way they deal with this subject. There is a substantial body of evidence from around the world which indicates that certain types of media reporting of suicide can have a negative influence on the behaviour of people who are already vulnerable and put them at greater risk.

I am worried about the uncertainty, the lacuna that exists, as we move from the PCC to the Leveson-compliant new formula. There is considerable uncertainty about the nature of that, who is going to sign up to that regulation and so on, which has been well rehearsed in the Chamber. I am worried that the progress that the media has made—and it is a good story—should not get lost. The Government, and those charged with setting up the new body, will understand that the good work that has been undertaken should not be lost in the transition from the PCC to whatever the new body concerned is.

Others have spoken about the good work that the Samaritans and other organisations do, and that has to be true. The “116” phone line that my noble friend Lady Wheatcroft alluded to is a serious worry. We have to find the money to make this happen. I do not think it has to be government money—it is only £1 million. I know it is easy to say that but, somehow, through the lottery—I declare I was once chairman of Camelot—there has to be a way to find this money on a regular basis, because those calls may well, although I am sure not always, be life-saving.

One of the most worrying aspects concerns the causes of suicide. Sadly, throughout my professional and personal life, I have been very close to far too many suicides. In one or two cases you could look at them and say they had everything to live for. Lack of recognition of the symptoms is the most difficult aspect of this subject. I hope that the ease and availability of the Samaritans service and the “116” lines will permeate people’s consciousness, that they will make that last despairing call and that they will be able to afford to do so because the Samaritans can pay for it. That could, in time, save lives.

It is rare these days to pay tribute to the sensibilities and sensitivities of the media, but in this particular case I am very happy to put that on the record. I thank the noble Baroness, Lady Buscombe, for this debate, and all those who have taken part.

--- Later in debate ---

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, my noble friend Lady Buscombe is to be congratulated for bringing forward this emotive and important subject for a debate, which has generated some splendid speeches for which I, for one, am very grateful.

The loss of a loved one to suicide is a tragedy, and yet suicides are not inevitable. There are often opportunities to intervene, and those missed opportunities can highlight systemic failings. Timely access to high-quality mental health services is an essential foundation for suicide prevention. Although good progress has been made in reducing the suicide rate in England over the past 10 years, the recent rise in the number of people dying by suicide to around 4,500 in 2011 is worrying. Suicide continues to be a major public health issue, particularly at a time of economic and employment uncertainty. That is why we set out a new suicide prevention strategy for England in September 2012, which highlights the importance of targeting the groups most at risk by providing the right support at the right time.

My noble friend helpfully set out the key strands of that strategy and I was grateful for her endorsement of them. She is right that success in suicide prevention depends on communities, individuals and organisations working together to tackle the issue. Much of the planning and work to prevent suicides needs to be carried out locally. The right reverend Prelate rightly referred to the role of the new health and well-being boards in planning and co-ordinating local services based on local needs. That role will clearly be a pivotal one in the future. These health and well-being boards will become the forums for determining local needs and priorities, bringing together local authorities, clinical commissioning groups, directors of public health, adult social services and children’s services. I am sure he is right that third sector and voluntary groups will pay a key part in the delivery of local plans in many parts of the country. The concerns expressed by the noble Baroness, Lady Royall, about fragmentation of services are not ones I share. She may recall that in the Health and Social Care Act we laid great emphasis on integration as a key driver of commissioning. The very existence of health and well-being boards acting as the hub for so many key players in the public health and health arena will itself be a driver for that kind of integration.

As well as targeting high-risk groups, improving the mental health of the population is another way to prevent suicide, as has been mentioned. Our mental health outcomes strategy, No Health Without Mental Health, sets out an ambitious vision for improving people’s mental health. The implementation of the measures set out in the strategy will build individual and community resilience, promote mental health and well-being and challenge health inequalities where they exist. Again, the Health and Social Care Act passed last year was the first one to contain an objective in all parts of the health service to drive out health inequalities.

The noble Baroness, Lady Royall, referred to the need for parity of esteem between mental and physical health. Of course, I subscribe wholly to that aim. The Government’s mandate to NHS England explicitly recognises the importance of putting mental health on a par with physical health, and closing the health gap between people with mental health problems and the population as a whole. We expect the NHS to have made measurable progress towards this goal by March 2015. This will include ensuring timely access to the best available treatment through extending and developing open access to the IAPT programme, Improving Access to Psychological Therapies, particularly for those out of work. I think that is an important part of the targeting philosophy.

Alongside the development of the suicide prevention strategy, Samaritans—to whose work I pay special tribute in their anniversary year—have been facilitating a Call to Action for Suicide Prevention in England, supported by a grant from the Department of Health. Over 50 national organisations have signed the Call to Action, committing to work together so fewer lives are lost to suicide and to support those bereaved or affected by suicide. Organisations include public and private sector bodies and a wide range of charities, including those set up specifically to reduce suicide such as Papyrus, a charity dedicated to the prevention of young suicide in the UK. This is the first time that so many organisations have come together to deliver real action to reduce suicide across England.

Most people who take their own lives have not been in touch with mental health services. We know that some people, particularly men, find it difficult to speak to their doctor if they are having mental health problems, and this is partly because of stigma and shame. By tackling the stigma associated with mental health problems, we can remove a barrier to people seeking and receiving the help they need before they get to crisis point.

The department is therefore supporting the anti-stigma campaign, Time to Change, with up to £16 million of funding over four years. The campaign is run by the charities Mind and Rethink Mental Illness, and is an ambitious programme to end mental health stigma and discrimination. It has the potential to reach 29 million members of the public with its vital messages on mental health.

We know that the media have a significant influence on behaviour and attitudes towards suicide. My noble friend Lord Grade was absolutely right to highlight this. A number of organisations have developed guidance for the media on the reporting of suicide and its portrayal. One of these is Samaritans, which plays a key role in supporting sensitive reporting of suicide.

As my noble friend said, the media have a significant influence on behaviour and attitudes. There is already compelling evidence that media reporting and portrayals of suicide can lead to copycat behaviour, especially among young people and those already at risk. The media is aware of its responsibility in the representation of suicide. In 2006 the Press Complaints Commission added a clause to the editors’ code of practice explicitly recommending that the media avoid excessively detailed reporting of suicide methods. The 2009 edition of the PCC Editors’ Codebook highlights, for example, the distress that can be caused by insensitive and inappropriate graphic illustrations accompanying media reports of suicide.

We have made grants to charities directly involved in suicide prevention. In March 2010, Maytree Respite Centre was awarded a three-year grant totalling over £154,000 to support the continued implementation and development of its service. Maytree is a sanctuary for people in suicidal crisis, providing a non-medical alternative to hospitalisation or sectioning. The grant helped the organisation support over 4,000 people, with 300 being supported through a stay at the house. It also helped them to develop outcome-focused relationships with several NHS and private organisations. In March 2011 we awarded a £50,000 one-year grant to Survivors of Bereavement by Suicide, a charity that serves more than 8,000 clients each year. They provide a range of services from a national telephone line to local area support groups.

Early intervention is imperative to suicide prevention and various organisations, including charities, can help highlight and address problems such as bullying, poor body image and lack of self-esteem. The commitment to early intervention is borne out by the Department of Work and Pensions’ expectation that all Jobcentre Plus advisers are trained to enable them to identify and support people who are vulnerable and who may be at risk of suicide and self-harm. This is important, as we know that community locations, such as job centres and young people-friendly venues, are more successful in engaging with young men than more formal health settings such as GP surgeries.

The noble Lord, Lord Giddens, whose speech I listened to with great attention, spoke about statistics. I will certainly go away and reflect on his points on that score. He asked what the Government’s policy was on prevention at popular suicide spots. The suicide prevention strategy recognises that one of the most effective ways of preventing suicide is to reduce the means to access. Suicide risk can be reduced by limiting access to high-risk locations. Much of the planning and work to prevent suicides will, as I have said, be carried out locally; it will be for local agencies, working through health and well-being boards, to decide the best way to achieve the overall aim of reducing the suicide rate. I fully expect that the local agencies will work together to monitor those hotspots.

My noble friend Lord Roberts pointed to the effect of unemployment, a point made effectively by my noble friend Lady Wheatcroft. We know that previous periods of high unemployment or severe economic problems have had an adverse effect on the mental health and well-being of the population and have been associated with higher rates of suicide. Despite the good progress that has been made in reducing the suicide rate, we need to remain vigilant on that particular aspect of the risk.

Faith groups were mentioned by a number of noble Lords, including my noble friend Lord Roberts. I assure the Committee that the department recognises the comfort and support that people receive from their faith and would expect all medical practitioners to treat their patients holistically, taking into account their physical, cultural, social, mental and spiritual needs. The Government’s mental health strategy, No Health Without Mental Health, draws attention to the importance of ensuring that services meets the needs of diverse communities and faith groups. The right reverend Prelate will know that the former Archbishop of Canterbury, Rowan Williams, and Time to Change recently hosted an event for leaders from different faiths to look at ways of tackling the stigma and discrimination faced by people with mental health problems in their communities. That seminar was held at Lambeth Palace and was extremely well received.

The noble Earl, Lord Sandwich, spoke about the risk of prescribed anti-depressants. The suicide prevention strategy highlights the potential increase in suicide risk in the early stages of drug treatment and risks associated with withdrawal where people are dependent on prescribed drugs. The noble Earl has expressed his concerns forcefully in debate and privately to Ministers, and he knows that these messages have not gone unheeded—at least, I hope that he knows that. It is, as he said, for health and well-being boards to build into the joint strategic needs assessment suitable provision for this particular type of suicide risk.

Over the past 10 years, good progress has been made in reducing the suicide rate in England. Voluntary organisations, charities and community and faith groups have all played their part in this reduction. The messages are clear. We need individuals and organisations to support our continued efforts, to join us in our drive to sustain and reduce further the relatively low rates of suicide in England and to respond positively to the challenges that we face over the coming years.

[Lord Grade of Yarmouth]

Will my noble friend the Minister be kind enough to give us the benefit of his advice on how we might move forward an initiative to roll out the 116 line? I am much taken with the noble Baroness’s view that we might all write a letter, but I wonder if it is an initiative that the department might want to take up and try to co-ordinate to see if we can get a resolution.