Social Care: Person-centred Dementia Care

Lord Jones of Cheltenham Excerpts

Monday 17th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the Prime Minister has made it very clear that he is committed to bringing forward proposals to address this issue before the end of the year. He stands by that commitment. I look forward to the kind of cross-party and cross-society collaboration that will be necessary to address that massive generational challenge.

[Lord Jones of Cheltenham (LD) [V]]

My Lords, as someone who knows the demands of caring for a close relative with dementia, I ask the Government to ensure that there are enough high-quality short-term placements for person-centred dementia care to give carers the chance of an occasional break. Given that person-centred care is at the very heart of the care provided by our hospices, do the Government have any plans to review the sector’s long-term financial situation and move it on to a more sustainable footing?

[Lord Bethell (Con)]

I pay tribute to those who deliver person-centred care. The noble Lord referred to hospices, and I am extraordinarily touched and impressed by the way in which they delivered on an enormously difficult task during the pandemic. We debated earlier the financial arrangements around hospices and the delicate state of their finances. We continue to be in touch with the industry and will take whatever measures necessary to ensure its financial stability.

Independent Medicines and Medical Devices Safety Review: Sodium Valproate

Lord Jones of Cheltenham Excerpts

Tuesday 2nd March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I welcome the noble Baroness’s point on the proportion of those who say they have filled in the form. Phase 1 of the registry is a helpful collection of statistics, but we are putting in place phase 2, which will help us to understand exactly how many patients who are taking sodium valproate have actually filled in the form. That will give us the concrete reassurance that we seek on this matter. I recognise that there are redress payments for thalidomide and contaminated blood, but redress payments are not necessarily suitable for every single misfortune that happens in the medical world. However, we will look very carefully at the case for sodium valproate and I take the noble Baroness’s comments on board.

[Lord Jones of Cheltenham (LD) [V]]

Research from Konkuk University in South Korea has suggested that disabilities caused by the compound could cause autism spectrum disorder transgenerationally—in other words, afflict successive generations within families. What is the Government’s view?

[Lord Bethell (Con)]

I am grateful to the noble Lord for raising that study. It is not one that I am aware of, and I am keen to go back to the department to find out whether it has done any analysis of it. I will write to the noble Lord with a response.

Covid-19 Update

Lord Jones of Cheltenham Excerpts

Thursday 12th November 2020 Lords Chamber

[Lord Bethell (Con)]

I thank the noble Lord for his championing of nurse practitioners, because we are going to rely on all qualified healthcare workers to administer an injection to support this huge project—one of the largest of its kind in recent national history. I also emphasise the role of pharmacists who will, where appropriate, deliver the vaccine as well. We need a massive, mass-scale effort to deliver this vaccine. We will be empowering all those qualified to deliver the injection to do so and we are extremely grateful to them, including nurse practitioners, for their help in this matter.

[Lord Jones of Cheltenham (LD) [V]]

My Lords, President-elect Biden has shown refreshing leadership by setting up a panel of scientific experts to deal with Covid-19. Why, then, do the Government think that a venture capitalist married to a government Minister is best placed to chair the Vaccine Taskforce rather than an expert in vaccines?

[Lord Bethell (Con)]

The role of Kate Bingham, the head of the Vaccine Taskforce, has been to acquire vaccines—and that is what she has done. She has served the nation brilliantly by acquiring six of the vaccines on four of the platforms. We should be extremely grateful for the work that she has done. It was not remunerated, and it was extremely effective. To knock those who have contributed voluntarily to our fight against Covid is not appropriate at this stage.

Covid-19: Charitably Funded Hospices

Lord Jones of Cheltenham Excerpts

Wednesday 28th October 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness will know through her work as a lay member of the NHS Camden Clinical Commissioning Group that hospices are much valued by the healthcare system. I assure her that the agenda for 4 November will include an assessment of the ongoing support that hospices will need through the winter.

[Lord Jones of Cheltenham (LD) [V]]

Today the director of my local Sue Ryder, told me that she faces a budget shortfall of 43%—almost half—in this financial year because fundraising from shops and other means has fallen. She has already had to make redundancies. However, demand is increasing and she is expecting a tsunami of new patients who missed an early diagnosis of their condition because of the Covid crisis. What are the Government going to do about this both now and in the long term?

[Lord Bethell (Con)]

The noble Lord is entirely right to cite the challenge being faced by Sue Ryder and other hospice charities that depend on retail income. They face a most difficult and challenging problem; it is one that we acknowledge and recognise. The question of misdiagnosis leading to a bump in arrivals in hospices is not one that I have been conscious or aware of, but I am grateful to the noble Lord for flagging it up for me. I will take that back to the department and, if it is something that we should be focused on, I will write to him accordingly.

NHS: Accident and Emergency Services

Lord Jones of Cheltenham Excerpts

Thursday 15th January 2015 Lords Chamber

[Lord Jones of Cheltenham (LD)]

My Lords, I, too, congratulate the right reverend Prelate on securing this timely and important debate. I should like to focus my remarks on the situation at the Gloucestershire Hospitals NHS Foundation Trust and the critical incidents at A&E at Gloucestershire Royal and Cheltenham General Hospitals. The latest critical incident lasted for more than a week and was lifted only yesterday. Presumably in that time, hundreds of routine operations and admissions were cancelled and have stacked up. This was the second such critical incident at GHT in a month and went on longer than those at other trusts in the country. We need to understand why.

It is complicated and not simply to do with money. We know that the coalition Government have increased NHS spending overall from £95 billion in 2010 to £115 billion this year, giving GHT £3.6 million for winter pressure this year; so what are the problems? Are too many 111 calls going into A&E? Anecdotal evidence from local doctors says that they are, and certainly the non-medical call-handlers have a naturally risk-averse system that will direct people to a doctor when in doubt. The Prime Minister, in response to a Question from my honourable friend Martin Horwood, said that only 7% of 111 calls ended in A&E. I believe that that was a statistic from October; it would be helpful if the Minister could tell us whether that is increasing and what it has been in the last month or two.

GHT has implemented what is called the UTOPIA system of routing all unplanned admissions through A&E. Has this made things worse? The theory is that people see a doctor sooner than in direct admission, when they have to wait for the next ward round, but in practice you need enough capacity in the emergency department to handle cases, which GHT pretty obviously does not have. I wonder whether the June 2013 decision to remove doctor cover from Cheltenham A&E at night and route blue-light admissions to Gloucestershire made matters worse. I understand that these decisions were made not due to a lack of money, but simply to the failure to recruit sufficient staff. Is there something wrong with the salary structure within the NHS that particularly affects Gloucestershire? At night, Cheltenham General Hospital is now really a minor injuries unit, although I understand that it still gets help from GPs in the out-of-hours service based at CGH .

I have spent more time than I care to remember as a patient in Cheltenham A&E. In January 2000, I was there following a sword attack in my constituency office which left my assistant dead and my hands in need of repair with 57 stitches. Then, in 2002, 2003 and 2006 I had three events of flash pulmonary oedema, all at night. This is a deeply unpleasant experience in which the heart goes into a ridiculous non-rhythm and stops pumping and one’s lungs quickly fill up with fluid. Fortunately, I was at home when these events occurred; I am grateful for the prompt response of the ambulance paramedics who rushed me to Cheltenham A&E. On two of these occasions my wife was called out of the family room and told to prepare herself for the worst; but thanks to the skill of the truly wonderful doctors and nurses—and, no doubt, a lot of praying in the family room—I survived. I do not know what the doctors did: I was out at the time, but I understand that a super-dose of frusemide was involved. If the recent downgrade of Cheltenham A&E had been in operation then, it would have taken an extra 15 minutes to get me to Gloucestershire Royal. I would probably not have survived and would not be here now addressing your Lordships’ House. Therefore, will the Minister ask the regulators and the Care Quality Commission to look into the difficulties in Gloucestershire to give answers as to why we have experienced these critical incident periods? Will he please ask the Gloucestershire Hospitals Trust to reinstate round-the-clock A&E services at Cheltenham General Hospital and ensure that it has the capability to recruit sufficient doctors, nurses and technicians?