Integrated Care Boards

Debate between Lord Kamall and Lord Turnberg

Monday 5th September 2022 Lords Chamber

[Lord Kamall (Con)]

I hope the noble Baroness will remember that, during the debate on the Health and Care Bill, there were concerns about private sector bias, as it were, in giving contracts. We agreed to an amendment suggesting that there should be no conflict of interest. I am afraid I am not aware of the specific cases that the noble Baroness raises, but I will look into them and write to her.

[Lord Turnberg (Lab)]

Does the Minister agree that yet another reorganisation of the management structure of the NHS is irrelevant to the latest problem facing the NHS, which is the dramatic loss of staff? We are losing thousands every month. That is where we should be focusing our efforts—does he not agree?

[Lord Kamall (Con)]

One of the challenges that we all face, and that the system as a whole faces, is that, even though we have more doctors and nurses than ever before, demand is outstripping the supply of healthcare workers. One reason for that is that there are far more conditions that would not have been considered years ago. Therefore, the Government, in partnership with the NHS, are looking at particular issues—for example, retention of the workforce, where they are worried about their pensions, and making social care an attractive vocation, with training and skills, as well as looking to recruit people, as we did after the war. As I often remind noble Lords, it was people from the Commonwealth who saved our health service after the war, and when we do not have the skills locally we will look to recruit people from abroad.

National Institute for Health and Care Excellence

Debate between Lord Kamall and Lord Turnberg

Monday 23rd May 2022 Lords Chamber

[Lord Kamall (Con)]

I thank my noble friend for the question but also for highlighting the fact that NICE is trying to change the way it works to be more flexible and responsive. The new subscription-style payment model that the NHS is developing has been designed to try to address the lack of new antimicrobials being developed and the growing threat posed by antimicrobial resistance, or AMR. The recent guidance from NICE on the two new AMRs is a world first and an important step forward. What NHS England has now got to do is enter into negotiations with the manufacturer, with a view to making them available to NHS patients.

[Lord Turnberg (Lab)]

My Lords, NICE is a remarkably effective organisation, but is the Minister aware of the gross inefficiencies in the system which operates in order for health technology assessment approvals to occur? There is a huge number of committees through which this process has to go. Is there any way of reducing this nightmare?

[Lord Kamall (Con)]

I am aware of some of those issues, but I wonder whether the noble Lord could write to me with some more specific examples. In my meetings with various organisations, including the Health Technology Alliance and others, wherever they have raised these issues we have looked at them. The NHS, the department, NICE and others are trying to work with suppliers, manufacturers and providers to see how it can be more responsive. If we are going to realise the life sciences vision, we have to make sure that we make the best of the NHS as a global centre of excellence and show that we are at the forefront of research.

International Healthcare Outcomes

Debate between Lord Kamall and Lord Turnberg

Thursday 19th May 2022 Lords Chamber

[Lord Kamall (Con)]

When we looked at the statistics, which clearly included data from the OECD, some were repeated from the Civitas report, which ranked the UK as quite good in some places and as needing more work in others. In 2019, the UK was ranked as having the fifth highest mortality rate out of 21 countries. Given that, in a long-term plan published in January 2019, the Government outlined commitments to improving stroke services, including better stroke rehabilitation services. Because we have a better understanding of strokes, we also have new ways of tackling the issue.

[Lord Turnberg (Lab)]

My Lords, I think everyone agrees that primary care is in disarray. I met a young general practitioner, aged 51, who was about to retire because she could not stand the pressures being placed on her. It is not simply a matter of manpower or workforce planning; it is a matter of doing something urgent now. What are the Government’s plans?

[Lord Kamall (Con)]

I had a meeting only a few days ago with the person responsible for primary care—a doctor herself. One of the issues we discussed is how we make more effective use of different levels of primary care. What is interesting here is that primary care has, over time, taken on some of the services that used to be provided by secondary care. At the same time, some of those primary care services are now being contracted out or delegated out to, say, pharmacists or physiotherapists, et cetera. We are looking at a solution-focused way of tackling these issues, rather than focusing on who provides the care.

NHS Mental Health Patients in Private Hospitals

Debate between Lord Kamall and Lord Turnberg

Thursday 28th April 2022 Lords Chamber

[Lord Kamall (Con)]

I should remind noble Lords that the noble Baroness said that she was not against private provision out of principle. Private provision can be very helpful and has always worked with the NHS, ever since it was founded. If we think about responders—for example, the impact of lockdown on many people—we have seen an increase in mental health needs. What do you do to increase the provision of mental health services? Do you wait for a new NHS hospital to be built? No—if there is a private provider out there, or an independent provider that can provide those services, you engage them. That is why the NHS and the independent sector, working together, is a really important partnership.

[Lord Turnberg (Lab)]

My Lords, is the noble Lord aware of the Migration Advisory Committee’s report, which pointed out what we all know: poor pay is driving social care workers, including mental health workers, out of the service and into the private sector? For example, they are losing more through inflation than they can keep up with and their pay certainly runs behind private sector pay. I understand that a social care worker can earn more in an Amazon distribution centre than they can in the social care sector. Can the Minister bring to the notice of the Treasury the damage that this policy is doing?

[Lord Kamall (Con)]

The noble Lord clearly discusses an important point: we have to have the appropriate workforce. The Government have begun a register of social care to work out who is in the workforce, what qualifications they have and what improvements we have to make to social care. We should also remember that social care providers are a mixture of private homes and state provision. At the same time, we have to make sure that we have the right people, locally trained. For example, the visa system encourages people to come and work in our social care system as well.

Covid-19: Restrictions

Debate between Lord Kamall and Lord Turnberg

Monday 14th March 2022 Lords Chamber

[Lord Kamall (Con)]

I can see that that may well be a reasonable request, so why do I not discuss what is relevant and perhaps write to all noble Lords?

[Lord Turnberg (Lab)]

Does the Minister agree that there is a link between the recent upsurge in cases and the decision to stop wearing masks on 1 March?

[Lord Kamall (Con)]

It is interesting that, when I was talking to some of the modellers and scientists about this, they said that whenever they look at models of changes in behaviour, they count in or consider that there will be some uptick because of people relaxing measures. Even though we are moving from a position where it was legal to where it is guidance, they reckon that number in, but they still felt that it was not significant enough not to go forward with the change in strategy.

Medical Schools: Training Places

Debate between Lord Kamall and Lord Turnberg

Monday 13th December 2021 Lords Chamber

[Lord Kamall (Con)]

When it comes to workforce plans, particularly in local areas where there is understaffing, we are very much focused on specialisms that are understaffed.

[Lord Turnberg (Lab)]

My Lords, we are losing doctors more rapidly than we can train them, and it has been like that for a while. The average age at which a physician retires is now 58; it used to be 62. What are the Government doing to help doctors stay in post and to bring them back part-time after retirement to help the NHS?

[Lord Kamall (Con)]

As the noble Lord will be aware, there is a temporary measure to bring doctors back, without affecting their pensions, which lasts until 2024. We are looking into whether that should be continued, as well as increasing the number of training places.