Hospices: Impact of NHS Pay Increases

Debate between Lord Judd and Lord O'Shaughnessy

Monday 18th June 2018 Lords Chamber

[Lord O'Shaughnessy]

I am sorry that that meeting has not taken place, and of course I am always glad to meet the noble Lord to discuss this issue. I am glad that the threat of a meeting has had the desired result, and clearly, I agree with him that we have to make sure that hospices are equally attractive places to work as is the NHS more broadly.

[Lord Judd (Lab)]

My Lords, I declare an interest as a vice-president of Hospice at Home in west Cumbria, where I live. This Question is very important. Does the Minister not agree that hospices work best when they work very closely with the health service? That is certainly the case in west Cumbria. We have become part of the co-operative provision of services and care to the community as a whole, but raising the necessary funds is a tremendous task. I hope that the Government will look very seriously at how hospices can be supported in ensuring that the nurses working for them with so much devotion are able to enjoy any improvements in the remuneration of nurses across the country.

[Lord O'Shaughnessy]

I can reassure the noble Lord that we are looking at that. Hospices work closely with local CCGs, which provide around 30% of their funding. We estimate that around 9,000 nurses work in hospices, and clearly we want to make sure that that number not only stays level but increases so that we can start to deliver the choice that we have committed to in palliative care for people.

Breast Cancer Screening

Debate between Lord Judd and Lord O'Shaughnessy

Thursday 3rd May 2018 Lords Chamber

[Lord O'Shaughnessy]

I know that the whole House will join me in saying that the noble Baroness is definitely worth it. Indeed, I am pleased to hear that her care was successful and that she is with us today. It is a very interesting question about age discrimination. We have again to separate it from the clinical advice, which I am reassured, having spent time with those involved in putting it together, is based on a proper weighing of costs and benefits—of course, that is inevitably in aggregate because we are talking about whole populations. Clinicians have autonomy to do things differently. Indeed, the offer we have given to women aged over 72 is that they can refer themselves and they will have an appointment if they want one. I can provide that reassurance to the noble Baroness.

There is perhaps a separate issue. There are sometimes problems of age discrimination in society and in the national health system itself. Could that be an issue regarding why signs were missed? We know that in some instances, the National Health Service has not been very good at listening to women on some of the issues we have debated in this House and that my noble friend Baroness Cumberlege is looking at in her review. This is a very good point that needs to be investigated properly: are there cultural reasons why signs that might otherwise have been picked up during these nine years were not? I can reassure her that the inquiry will look at this.

[Lord Judd (Lab)]

My Lords, reverting to the point about the role of the GP, does the Minister agree that it raises wider questions about the operation of the health service? Surely, if we are taking a holistic approach to the well-being of patients and people, the GP has a vital role which increases in importance the more technology comes into play. There should be a proactive role for the GP in helping people to meet the challenges that arise from the inevitably rather more impersonal operation of more technological services. There is a significant issue. Frankly, I sometimes wonder what the role of the GP really is. In a lot of surgeries, it is a pretty meaningless term, because one goes not to a general practitioner but to a surgery. This issue needs attention as we consider the future of the health service.

[Lord O'Shaughnessy]

The noble Lord makes a good point, in the sense that technology is an enabler and supporter of clinical practice done by highly skilled professionals, not a replacement for it. That interaction between reliance on technology and the human face of the service is an issue that the inquiry should investigate.