Health: Lymphoedema

Lord Maginnis of Drumglass Excerpts

Wednesday 9th September 2015 Lords Chamber

[Lord Maginnis of Drumglass (Ind UU)]

My Lords, while I am not going to pretend to have any deep medical understanding of the problems arising from lymphoedema, I have, as a long-term sufferer from diabetes and a cancer survivor, a great deal of gratitude to our health service in Northern Ireland for having made me aware of the dangers. In fact, although it is not every day I can say so, I am rather proud that, for all the things that we tend to get wrong in my part of the United Kingdom, Northern Ireland leads the way in the diagnosis and treatment of what is an incurable but manageable condition.

This debate has a core issue—national equity. Wales and Northern Ireland have already received permanent, recurrent investment, and Scotland is finalising its work plan. Northern Ireland and Wales have utilised the managed clinical network model, building upon existing services and linking all healthcare trusts to enable partnerships and prevent duplication. This efficient model has facilitated both communication and education strategies, all necessary for a successful outcome. Both services are now award winning and have service users inherent in their advisory groups.

Another key component is that of leadership. I am pleased to say that Northern Ireland has an identified leader, who I am delighted to say was awarded an MBE for her services in this discipline. I welcome her here today. The strategy for England must include a leadership plan in recognition of the complexity of the clinical commissioning group areas of responsibility and the many other stakeholders, such as cancer networks and charitable bodies, that are contributors within this discipline. I am aware that some CCGs have been funded by Macmillan to complete council-wide lymphoedema needs assessments. While this is a great step forward and to be applauded, the project’s remit is for cancer-related lymphoedema only. We must ensure that new service delivery is equitable to all potential patient groups, both adults and children, and not restrict it to cancer-related lymphoedema, which is currently recognised to be the smaller referring lymphoedema group—probably about 25%. Equity at all levels and leadership need to be core to the strategy for England.

Encouraging figures show that in Northern Ireland in 2013-14, 642 patients were able to be discharged, meaning that they were able to self-manage their condition, freeing up important hospital resources. Only around 8% of those 642 needed to be re-referred in 2015—proof of the effect self-management can have on lymphoedema. But early identification would not have been possible without increased awareness of lymphoedema in Northern Ireland. In 2008 an undergraduate programme was developed and piloted in conjunction with Ulster University, where there are now dedicated modules on lymphoedema. This is complemented by regional study days to provide more in-depth learning for those acting as ward or clinic link staff.

It has been suggested that for every £1 invested in lymphoedema treatments in England, £100 would be saved in reduced admissions. The British Lymphology Society has estimated that the National Health Service could save at least £32 million a year by providing a national service. There is a great need for a national strategy in England and to sustain and increase provision of services in Northern Ireland, to create an equitable service across the whole United Kingdom. I do not want to end on a sour note but in the realisation that increasingly in the UK we are finance-driven before all else—so often moral justification seems to be dismissible —it is surely worth investing in a service that literally would show a profit.

Human Fertilisation and Embryology (Mitochondrial Donation) Regulations 2015

Lord Maginnis of Drumglass Excerpts

Tuesday 24th February 2015 Lords Chamber

[Lord Alton of Liverpool]

My Lords—

[Lord Maginnis of Drumglass (Ind UU)]

My Lords—

[Lord Singh of Wimbledon (CB)]

My Lords—

Health: Tuberculosis

Lord Maginnis of Drumglass Excerpts

Wednesday 24th April 2013 Lords Chamber

Asked By

[Lord Maginnis of Drumglass]

To ask Her Majesty’s Government, in the light of the recent findings reported in The Lancet, why the incidence of multidrug-resistant tuberculosis in the United Kingdom is higher than that in other European countries.

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

My Lords, the incidence of multidrug-resistant tuberculosis in the United Kingdom is not higher than in the rest of Europe. However, the proportion of TB cases in the UK that are multidrug-resistant has increased from 0.9% to 1.6% over a decade. Ninety-five per cent of multidrug-resistant cases diagnosed in the UK were not born in the UK.

[Lord Maginnis of Drumglass]

As always, I am grateful to the Minister for his frankness in his response. The reality is that compared with France and Germany, we have probably three times the rate of tuberculosis in the United Kingdom. In comparison with Italy, we have five times the incidence. The Minister made the point about immigration. Given that we are to have an influx of people from Romania, where the rate of tuberculosis is over seven times what it is in the United Kingdom, and is something like 22 times what it is in Germany and 36 times what it is in Italy, is it not important that his department is able to announce some measure that can be applied to ensure that we are not going to face an epidemic of tuberculosis? Is it not true that the cost of dealing with multidrug-resistant TB is about 14 times that of dealing with an ordinary case of TB?

[Earl Howe]

My Lords, as regards the very last point made by the noble Lord, he is absolutely right. To treat a multidrug-resistant case of TB typically costs between £50,000 and £100,000, and sometimes more if it is an even more complicated case, in comparison with about £5,000 for an ordinary case of TB.

In fact, to correct the noble Lord, if I may, the proportion of TB cases that were multidrug-resistant in the UK was not high compared with the rest of Europe. The only countries in western Europe with a lower proportion of cases that were multidrug-resistant in 2011 were Ireland, Iceland and Malta. However, I take his point about migrants from eastern Europe. Port health regulations give some powers at the port of entry but this involves knowing quite a lot about the individual, so we are left with what is open to us once the person is in the UK. Once here, health protection regulations can be used to provide local authorities with wider and more flexible powers to deal with incidents or emergencies where infection or contamination present a significant risk to human health, or could present such a risk. I could elaborate on those powers, if the House wished.

Autism

Lord Maginnis of Drumglass Excerpts

Wednesday 5th December 2012 Lords Chamber

[Earl Howe]

My noble friend is right, which is why the existing statutory guidance extends not only to local authorities but to the NHS; it is unique in that regard. The strategy is about integrating care across the NHS, social care and all other local authority services, and its focus must be on putting people with autism at the centre of any plans to improve their own lives.

[Lord Maginnis of Drumglass]

My Lords, I declare an interest as I chaired the independent review of autism services in Northern Ireland. Would it be inappropriate if I asked the Minister if he was aware that it does not matter how good one’s intentions are or whether you have an Act of Parliament; if you do not have the geographical structure that enables you to implement the measures that are required for early assessment and diagnosis, there is nothing that will naturally follow? Will he consider consulting the Northern Ireland authorities and those in Wales and Scotland, where possibly we have made more progress?

[Earl Howe]

My Lords, I shall gladly take that idea away with me. The noble Lord is right about the structures for delivery. Local authorities in England are responsible for the delivery of services and support for people with autism, and the NHS is the body that we are relying upon to identify those with autism and diagnose their needs. The two must work together.

NHS: Medical Records

Lord Maginnis of Drumglass Excerpts

Wednesday 7th September 2011 Lords Chamber

[The Countess of Mar]

My Lords—

[Lord Maginnis of Drumglass]

My Lords—