Inflammatory Bowel Disease
Debate between Lord Markham and Baroness Manzoor(6 months ago)
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Lord Markham (Con)
The noble Lord is correct. This is an area where we still need more knowledge. We have spent about £34 million in research in this space over the last few years, but there is still a lot that we are learning. I can say freely that if there are good research projects there, the resources are available to make sure that they are funded, because we need to learn more in this space.
Baroness Manzoor (Con)
My Lords, many health authorities are sending out these tests to people. What percentage of these tests—“poo collections”, to use my noble friend’s words—are not being returned? It could be relatively high, particularly if we are not explaining the difference between the two types of illness.
Lord Markham (Con)
As described by the clinical lead in this, these really are game changers, so getting them back is key. I do not have the figures to hand as to the amount that they get a response from but, in the case of the bowel cancer screening, many of us will be aware that there has been a whole programme which has been very successful in getting those poo tests measured and responded to. We need to learn the same lessons in this area.
Immunisation: Children
Debate between Lord Markham and Baroness Manzoor(6 months, 2 weeks ago)
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Lord Markham (Con)
That is an important point. We must try to make sure that vaccination clinics are widespread. We have used pop-up clinics successfully in many locations, particularly around London, and that has helped get 25,000 more jabs into unvaccinated people’s arms in the last few months.
Baroness Manzoor (Con)
My Lords, I welcome the action that the Government are taking to ensure that MMR vaccinations are going up in underrepresented groups. Can my noble friend the Minister say what action the Government are taking for people seeking asylum? What kind of service are they being offered, and what access do they have to vaccination?
Lord Markham (Con)
I thank my noble friend for the question. Actually, it is not just asylum seekers; it is often migrant groups full stop. Their communities or the countries they have come from often do not have the same level of vaccination programmes. It is part of the check we try to give people as they come into the country, and something we ask GPs to look out for, so that we can get them in a catch-up programme. A lot of the work we are doing on outreach is also particularly focused on those communities.
Mental Health Patients: Discharge
Debate between Lord Markham and Baroness Manzoor(8 months, 3 weeks ago)
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Lord Markham (Con)
The noble Baroness is correct; the question is of the utmost importance. It is about putting more care into the community—that is why we have put £1 billion of extra spend into community support for mental health. Some 160 local mental health infrastructure schemes are being set up, with 19 in place already, and they are starting to work. The crisis cafés have resulted in an 8% decrease in admissions, while the telephone helpline has resulted in a 12% decrease.
Baroness Manzoor (Con)
My Lords, my noble friend will be aware of the link between mental health and homelessness. He will also be aware that 50% and more of those who suffer from mental health illness have been homeless for over a year. What action are the Government taking to work with other government departments to ensure that this issue can be alleviated as soon as possible, and what help and mental health services are these homeless people entitled to?
Lord Markham (Con)
My noble friend is correct. In fact, 48% of the reasons for the delayed discharge of mental health patients is because of a lack of suitable housing. That is why we have introduced the specialist housing fund; we are working with Homes England and DHLUC so that supported housing runs alongside more support in the community from the extra mental health services.
NHS: Dementia Commission Report
Debate between Lord Markham and Baroness Manzoor(9 months ago)
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Lord Markham
I thank the noble Baroness for this Question. As ever, I have found that one of the real strengths of being in this position is that the questioning here makes me explore an area. This has been another area which I have enjoyed and found fascinating. Early detection is absolutely key, and what I have been learning from that is that, yes, we need to arm primary care staff and a potentially vital front line in terms of primary care staff are opticians, because retinal scans are a really good way to early diagnose. Apparently, people more than ever will have a frequent eye check. I have pulled together a panel to understand this more, and I invite the noble Baroness and others so that we can look at the latest research and really understand this more.
Baroness Manzoor (Con)
My Lords, I welcome the additional sums of money that the Government are putting into this service, which is very important, but, as the Minister will be aware, and as he indicated in his response to the noble Baroness, Lady Wheeler, around 36% of those with this condition are undiagnosed, and that rises to around 50% in some authorities. The Minister will be aware that some exciting new drugs are coming on to the market that help to delay the onset of this terrible condition. What are the Government doing to raise awareness so that there is early diagnosis and those with the condition can access those services much sooner?
Lord Markham (Con)
My Lords, I thank my noble friend, who is absolutely right. This is where things such as the Barbara Windsor Dementia Mission have been successful in raising awareness, as she states. The challenge in all this, as I have learned, is that because it is such a slow-moving disease it is difficult to see how it progresses. Apparently, it has one of the lowest failure rates in terms of drugs because it is really hard to monitor the progress behind it. That is why work is being done, such as retina scans, where you can measure data objectively. There is real hope in all this, and it means that we need to make all primary care workers aware of the situation.
Care Home Staffing
Debate between Lord Markham and Baroness Manzoor(10 months, 1 week ago)
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Lord Markham (Con)
The Home Office has made an impact assessment of that. It thinks it will impact about 20,000 staff; we recruited about 100,000 last year. The main thing is that, by making sure that only CQC-registered bodies are able to recruit in this way, we are trying to make sure it is done in the correct, ethical manner by high-quality providers, which I think we would all agree is the right approach.
Baroness Manzoor (Con)
I welcome the additional care staff that my noble friend mentioned, but there are some real pressures in rural areas where people cannot get carers to come and work. Can he say what is being done about that? Also, because he mentioned it previously, can he give an indication of whether there is a greater number of community hospitals that patients could be discharged into?
Lord Markham (Con)
I thank my noble friend for the question. The whole point of trying to develop the career structure that we talk about is to make sure that it is a career that people want to go into across the board, be it in urban or rural areas. Part of that is putting in place about 100,000 training places—this is the first place in the world that has been set up—to try to set up a real career structure. We are starting to see early signs of it working. The number of beds blocked has decreased by 10% in the last few months. It is early days, but it is beginning to work.
NHS: Drug Shortages
Debate between Lord Markham and Baroness Manzoor(10 months, 1 week ago)
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Lord Markham (Con)
I quizzed the team on exactly that Times newspaper report today, because like the noble Lord, they were saying that they did not recognise the numbers that the British Generic Manufacturers Association had produced. I wanted to understand why, and asked the team to sit down with them, and understand the differences, because one side or the other must be right. They are absolutely doing that, and will report back; I will be happy to update the House on the results of that.
Baroness Manzoor (Con)
My Lords, the drug Ozempic has been described as a super-drug for the use of diabetic patients, in order to help them reduce weight. My noble friend the Minister will be aware that diabetes costs the NHS 10% of the budget—approximately £25,000 to £30,000 a minute—with 80% of that money spent on treating diabetic complications. Therefore, can my noble friend the Minister say why Ozempic can be prescribed privately but is not available easily to NHS patients as a result of demand and constraints in manufacturing? How can the Government address this?
Lord Markham (Con)
My noble friend is correct that this so-called off-label use of these diabetes drugs for weight-loss-type treatments is causing some of the shortages she mentions. That is exactly what we have been tackling, and we have been making sure that the only way you can get the Wegovy weight-loss drug is actually on a very tightly controlled weight management programme normally run through hospitals, and not through normal GPs, exactly to get on top of that issue.
Health: RSV Immunisation
Debate between Lord Markham and Baroness Manzoor(10 months, 1 week ago)
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Lord Markham (Con)
First, I thank the noble Baroness. She has been a tireless campaigner on this issue and very good—quite rightly—at holding our feet to the fire. The exciting news is that the new vaccines that are coming along for both mothers and infants, as well as the over-75s, are now cost effective; that was recognised in the JCVI’s analysis. As part of that, we have plans to fund the programme, as mentioned. I would rather not go into the details of the actual budgets, because they depend on the tender and I do not want to give that information out to the market—but I can reassure the noble Baroness that plans are in place.
Baroness Manzoor (Con)
My Lords, RSV is a leading cause of infant mortality globally. Sadly, as my noble friend the Minister will know, 20 to 30 such deaths occur in the UK. I am pleased to hear about the progress that the Government are making to roll out the programme in the UK, but my noble friend will know that rolling out this programme will significantly reduce costs to the NHS by reducing GP visits, reducing attendance at A&E and reducing the 20,000 hospitalisations of infants aged under one year. Can my noble friend the Minister say, as we move towards autumn 2024 and the rollout of the vaccination programme, what the Government are doing to ensure that mothers and families know about the programme so that they can take up this vaccination when it is available?
Lord Markham (Con)
As I mentioned, the tender is in place with a view to rolling it out in the autumn. Whether we go for the maternal vaccination or the infant one will depend on the communication plan, but I can assure my noble friend that a communication plan will be part of this ground-breaking rollout. Only one other public health rollout like this has happened in the world—in Galicia, Spain—so I am proud to say that we will be top of the list.
Black and Minority Ethnic Babies: Mortality Rates
Debate between Lord Markham and Baroness Manzoor(1 year ago)
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Lord Markham (Con)
Yes. Obviously, we want to find every group and then understand the targeted action around them. Noble Lords will have often heard me say that one of the most effective bits of joined-up government I have ever seen was the Troubled Families initiative, led by the noble Baroness, Lady Casey, and I am interested in the 13 local authority pilots that are using wraparound services to identify community groups and troubled families in particular and provide them with cross-government help.
Baroness Manzoor (Con)
My Lords, my noble friend will know that over the last four years the NHS workforce has grown by over 14%, but in the workforce for midwives there is a shortage of 2,500, according to the Royal College of Midwives. Can the Minister say what the Government are doing to ensure that we have sufficient midwives on the wards and, more particularly, a diverse workforce from ethnic minorities who will become midwives and health visitors? The numbers do not look great and of course this plugs in to the prevention strategy the Government have in place.
Lord Markham (Con)
Yes, it absolutely does fit into it. We have increased the number of maternity staff by about 14% since 2010, and the long-term workforce plan is all about making spaces for 1,000 extra students and having many routes into it. Noble Lords have often heard me talk about how my mother got into nursing as an older mum—she got into maternity services. There are apprenticeships and later-life opportunities. You should not only be a graduate; you often know much more about life when you are that bit older, especially if you are a mum.
Domestic Violence and Brain Injury
Debate between Lord Markham and Baroness Manzoor(1 year, 1 month ago)
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Lord Markham (Con)
Yes. The main thing is that £9.5 million is being invested into research on traumatic brain injury, but this is a platform to allow spin-off research from there. When speaking to people on this, I am clear that this is not a cap: if we get good research proposals put forward in areas such as the one the noble Lord mentioned, the money is there to pursue that.
Baroness Manzoor (Con)
My Lords, it is good news that research is going to happen in this area. We all know that women suffer through domestic violence much more greatly. However, there is also research that shows that young girls in sports suffer more from concussion. Can we look at the preventative elements to ensure that girls are safe in sport, and by working closely with DCMS?
Lord Markham (Con)
The hope from this research is understanding all the different causes and some of the protocols. I know it is controversial sometimes, because, speaking as a centre half myself, heading the ball is a key part of the game. However, making sure that children under a certain age are not heading the ball a lot is one of the things that we should be looking at as prevention.
Nursing Courses: Reduction in Applications
Debate between Lord Markham and Baroness Manzoor(1 year, 2 months ago)
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Lord Markham (Con)
We are delivering on a number of routes to recruit nurses. Obviously, the graduate route is one route, which, as mentioned, is above pre-pandemic levels; apprenticeships is another route, which is proving very successful; and associates is another route again. So there are many routes in, and the result is that our applications are 20% up on pre-pandemic levels. We set ourselves a target of recruiting 50,000 more nurses by the end of this Parliament and we are currently on 45,000, so we are going to hit it.
Baroness Manzoor (Con)
My Lords, I welcome what my noble friend the Minister said regarding the number of nurses joining; nevertheless, the number of nurses leaving the NHS is higher than we would expect. Would my noble friend say exactly whether we are collating this information and understanding why those people are leaving, because they have a very valued skill?
Lord Markham (Con)
Yes, absolutely. Clearly, we want to recruit, but we also want to retain our workforce and again that is what the long-term workforce plan is all about—trying to look at a clear professional development path and other things we can help with, such as childcare support and the culture and leadership, and really make nursing a very successful and rewarding career structure. There is a lot to do on it, but I think there has been a lot of good progress as well.
Stroke Care
Debate between Lord Markham and Baroness Manzoor(1 year, 4 months ago)
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Lord Markham (Con)
First, I thank the noble Baroness for the work that she does in this area; I know that it is very close to her heart. I have set up a meeting with the NHS COO David Sloman and with Sarah-Jane Marsh, and would be delighted if the noble Baroness would like to join me. The benefit of these sessions is always the shining of a light on areas.
It is vital that people are seen within the first hour; currently 59% of people are, which is an improvement on the last couple of years when the figure was 55%. However, we would all agree that we want that number to be as high as possible. The SQuIRe managers’ job is to make sure that all the different integrated care boards are delivering best practice in each area.
Baroness Manzoor (Con)
My Lords, what role will NHS England play in first collecting information, monitoring it, evaluating it and disseminating it across the UK to ensure best practice, and how often does it undertake to do this?
Lord Markham (Con)
I thank my noble friend. The NHS delivery plan set out in January 2023 was trying to set out the best practice in this area. It is then the job of the SQuIRe managers to make sure that that is implemented in each area. One example is that they are trialling having videos in ambulances in certain areas so that paramedics can speak to stroke experts. We all know that getting patients to the right place quickly is vital, so I hope that that is another example of best practice that we can roll out.
MMR Vaccine
Debate between Lord Markham and Baroness Manzoor(1 year, 4 months ago)
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Lord Markham (Con)
Yes. This whole campaign is looking particularly at hard-to-reach communities. The concern is particularly in London. Whereas we have about 85% take-up across England as a whole, in London it is around 75%, so that is where the particular outreach is. That also involves looking at children who are not able to go to school or who are home-schooled.
Baroness Manzoor (Con)
My Lords, I welcome the catch-up campaigns that the Government are running. They are very welcome. I particularly note the campaign in London. As the Minister will know, there is variation across the country. The WHO stipulates that 95% is the target reach, yet we are at 89%. So how are those hard-to-reach communities, particularly the ethnic-minority communities, being targeted? The uptake is slightly lower in those particular areas.
Lord Markham (Con)
There are two main approaches. If a child is under 11, we would prefer to have a parent present, for obvious reasons—because it involves a vaccination—so that is normally done through the primary care system, through nurses. Post 11, because you do not need the parent there, that is where schools really come into effect. In particular, there is a school-age assisted immunisation providers programme that goes into every school in a particular area, targets it and speaks to every child to see whether they have had their vaccination—and they can give it on the spot if they have not.
Ultra-processed Food
Debate between Lord Markham and Baroness Manzoor(1 year, 4 months ago)
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Lord Markham (Con)
First, I thank the noble Baroness for the work she does and has done in this space for a number of years. The problem is the definition of “ultra-processed food”. It includes things such as wholemeal bread, baked beans and cereal. It is not a helpful definition. There are certain ultra-processed foods which are high in fat, salt and sugar. We completely agree that those things are bad for us and that we should do everything we can to discourage people from eating them. The label “ultra-processed food” is not helpful.
Baroness Manzoor (Con)
My noble friend will know that one-third of baby and infant foods contain ultra-processed food which, in effect, is leading to obesity, and he will know that obesity can lead to cardiac problems and hypertension in later life, which costs the NHS significant sums of money. There is evidence in recent research that firms’ marketing is providing misleading information. What are the Government doing to ensure that this aspect, particularly with baby and infant food, is better regulated?
Lord Markham (Con)
I thank my noble friend. We are focused on the sugar, salt and saturated fat content. It is not the fact that food is called ultra-processed, per se. We would not discourage people from eating whole- meal bread, but wholemeal bread is considered to be a processed food. The action we are taking is for a reduction in sugar, salt and saturated fat.
Community Health Services: Waiting Lists
Debate between Lord Markham and Baroness Manzoor(1 year, 4 months ago)
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Lord Markham (Con)
The noble Baroness is correct about the urgency for young people; I have personal experience of this as well. We are taking steps by piloting nine early language and support services for all children focused on exactly what the noble Baroness mentioned. There is £70 million behind that pilot, with the intention being that we learn lessons from that and roll it out quickly.
Baroness Manzoor (Con)
My Lords, my noble friend will know that a number of surveys have identified that over half a million adults are waiting for adult care assessments. The normal waiting time is 28 days, but for some it is, sadly, significantly longer, which has a disproportionate effect on some of the most vulnerable. What action are the Government taking to reduce it?
Lord Markham (Con)
We are starting to see a blue- print which is beginning to work. The highest waiting list for adults is related to musculoskeletal issues. Since we put an improvement framework in place, 91% of people are now being seen within 12 weeks—a big improvement. We are moving to self-referral also, and digital therapeutics beyond that. There is a road map in place that we need to apply across other areas.
Dementia Palliative Care Teams
Debate between Lord Markham and Baroness Manzoor(1 year, 5 months ago)
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Lord Markham (Con)
First, we were very upfront about it; part of the Health and Care Act 2022 is that the ICBs commission palliative care. Secondly, it is part of the six major conditions strategy. It is a major cause of death; about 11.4% of all deaths are caused by dementia. It is fundamentally the responsibility of the ICBs but we at the centre are making sure that the ICBs are commissioning in the way they need to.
Baroness Manzoor (Con)
My Lords, I very much welcome the work that is being done in Derbyshire and, quite rightly, we want to see it commissioned elsewhere across the country. My question follows on from that of the noble Lord regarding the NHS board. What is it doing to evaluate where these kinds of proposals are being developed elsewhere? Unless it does this, and can demonstrate that it is doing this and providing guidance, we will not get the excellent service that residents in Derbyshire are receiving in more deprived areas, such as places in West Yorkshire and so forth.
Lord Markham (Con)
We have developed the dementia palliative care toolkit, which we are spreading around all the ICBs. Health Education England has developed an end-of-life care training programme, which is being taken up. Derbyshire has been a key part of the efforts as well, with its own programmes. It is very much our responsibility to make sure that the ICBs, which by law have to provide these services, are providing them to a high standard.
NHS GP Surgeries: Purchase by US Companies
Debate between Lord Markham and Baroness Manzoor(1 year, 5 months ago)
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Lord Markham (Con)
What the centre is most interested in is quality of the service; that is exactly what we do. As for Operose, which the noble Lord mentioned, 97% of its surgeries are rated by CQC as good or excellent. In the case of the one where there was a concern, CQC did a deep dive of the surgery and looked at the staff mixing, and that practice is now considered good. The key thing, I think all noble Lords will agree, is the quality of service, not ownership.
Baroness Manzoor (Con)
My Lords, as my noble friend said about ensuring the quality of services for users, since the inception of the NHS, GPs have been private practitioners and have invested money from their own pockets to improve their surgeries. What are the Government doing to ensure that there is equity and accessibility of good GP services to those who live in inner-city and deprived areas, and in rural areas?
Lord Markham (Con)
My noble friend is correct, of course. GPs have always been independent businesses, and that is the backbone of the service. We have managed to increase the number of GPs by 2000 since 2019, but we all accept that more needs to be done to attract them, especially to the key areas that my noble friend mentions. We have a £20,000 bonus in place to recruit GPs to those difficult areas and, most importantly, we have a record 4,000 GPs in training.
NHS National Health Inequalities Improvement Programme
Debate between Lord Markham and Baroness Manzoor(1 year, 6 months ago)
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Lord Markham (Con)
First, I thank the noble Lord for the work that he does in this space; I know it is something very close to his heart. It is the school foods standards that set and define the formulation in the food and drinks provided by schools. That is all through the school day: breakfast, lunch and afterwards. They were due to be reviewed around the time of Covid in 2019; clearly, that did not happen then, so we are looking again at whether we should be reviewing those. Precisely in that, we shall be looking at levels of calorific intake.
Baroness Manzoor (Con)
My Lords, as my noble friend will know, in the short term a poor diet can lead to stress, inability to concentrate and tiredness. In the longer term it can lead to obesity, diabetes, high blood pressure and indeed heart disease. Of course, my noble friend will be aware that there are great inequalities within ethnic minorities. Can he say what the Government are doing to reduce the inequalities and ensure that micronutrients play an important part in the promotion of the food strategy?
Lord Markham (Con)
First, I wish my noble friend a happy birthday. I totally support her question. The most important thing with regard to inequalities—funnily enough, this was the answer to an earlier question—is the use of free school meals. I think we can all welcome the fact that 37.5% of children now receive free school meals and therefore a nutritious start to life. Clearly, that is the best way to make sure that children, particularly those with potential inequalities, are getting a healthy start in life, as well as the under-fours clubs to make sure that they get healthy food.
Pharmacies: Medicines at Home
Debate between Lord Markham and Baroness Manzoor(1 year, 6 months ago)
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Lord Markham (Con)
NICE and the Royal Pharmaceutical Society are clear that they do not recommend widespread adoption but prefer a case-by-case basis. There are many examples of where blister packs are not appropriate: some pills cannot be stored next to each other, some pills need to be stored in their original packaging and some blister packs cannot have more than four pills. So it is clear that you need a case-by-case review to make sure of what is right for the patient.
Baroness Manzoor (Con)
My Lords, the Government have the excellent Pharmacy First initiative. Can my noble friend the Minister say what the Government are doing to support community pharmacists with technology, and to advise those with chronic diseases, such as diabetes and heart disease, what their roles and responsibilities could be in relation to the technology that may be available to them?
NHS: Allocation of Financial Resources
Debate between Lord Markham and Baroness Manzoor(1 year, 6 months ago)
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Lord Markham (Con)
The budgets are in the allocations for each ICB and each hospital, and within them there are specific allocations to make sure that these fundings are rooted in the place where they have the most effect. As for making sure that really does happen, it is the responsibility of each ICB to make sure it is doing that. Ministers hold them to account by each having seven ICBs to take care of and make sure that they are hitting those targets.
Baroness Manzoor (Con)
My Lords, I very much welcome the significant sums of money that have been put into the NHS to date by the Government. It is not just increases in beds that we need in hospitals. We live in an age where we have made significant inroads and innovation in technology, diagnostics and so forth, including artificial intelligence. Will my noble friend the Minister say how new technologies are being used to ensure that patients are not needing the extra beds in hospitals and creating the old mistakes we know of?
Lord Markham (Con)
I shall answer quickly. As I said, there is already a 13% lower cost in a hospital which is digitally mature. We have virtual wards going in to make sure that we can treat as many as 50,000 patients every month to improve the flow and improve services.
Childbirth: Black Women
Debate between Lord Markham and Baroness Manzoor(1 year, 6 months ago)
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Lord Markham (Con)
I thank the noble Baroness; there were a number of questions there. I accept that there is a disparity, which is why the Maternity Disparities Taskforce was set up. I was speaking to Minister Caulfield just this morning, and I assure noble Lords that this is very high on her agenda. That is why, in providing continuity of maternity care, the focus is on making sure that people from ethnic minorities, particularly black women, get priority.
Baroness Manzoor (Con)
My Lords, this is not a new issue. I am pleased to hear that the disparities task force has been set up, but can it look not just at the issues of workforce planning—there is a shortage of midwives—but at the additional antenatal care that black and ethnic-minority women need because of underlying causes, and at the care they receive during labour?
Lord Markham (Con)
My noble friend is right. I was speaking to Minister Caulfield about this very subject this morning. She pointed out that a lot of the reasons for the differences are underlying health conditions and factors such as smoking, weight and alcohol consumption, as well as diabetes. Education is a key part of this, as is continuity of care, and making sure that there is prenatal and postnatal care is absolutely a focus.
Diphtheria
Debate between Lord Markham and Baroness Manzoor(1 year, 7 months ago)
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Lord Markham (Con)
All I can say is that the Department of Health co-operates very closely with the Home Office. We have a screening programme for all migrants coming in, as I mentioned, and an 88% vaccination rate for diphtheria among them, compared with 93% of UK children. It is a very high rate indeed; that record speaks for itself.
Baroness Manzoor (Con)
My Lords, as the Question implies, the UK has an excellent record on uptake of vaccinations, but my noble friend will know that the level has fallen among children for the MMR vaccine. What action are the Government taking to ensure that the most vulnerable are given this vaccination and that rates go back up to pre-Covid levels?
Lord Markham (Con)
We are all aware of the rumours and allegations about the safety of the MMR vaccine, which we are all delighted to know were totally unfounded. As my noble friend says, it has been quite a task to regain confidence in it, but we are doing so and vaccination rates have gone up. I will provide her with the exact details of those new take-up rates.
Patient Deaths: Ambulance Waiting Times
Debate between Lord Markham and Baroness Manzoor(1 year, 8 months ago)
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Lord Markham (Con)
The noble Baroness is absolutely correct. Some 50% of all wait times—I have used this statistic before and I will correct it if I have not got it exactly right—come from I think 20 trusts. Clearly, there is a focus on working on those areas. That is starting to bear fruit, with each of those trusts having specific plans to ensure that they use best practice. We have tried to pick the best practitioners in an area— I have done this on two occasions recently—and bring them into the centre to help us advise across the board. That really is making a difference.
Baroness Manzoor (Con)
My Lords, as well as disseminating good practice, there is the issue of accountability. The Government have put significant sums of money into the NHS, so what are the regulators —NHS England and others—doing to ensure that good practice is disseminated and, more importantly, that the chief executives and the boards are delivering on the commitments they have made?
Lord Markham (Con)
My noble friend is absolutely correct: with responsibility for these things comes accountability, and it is the job of us all to hold people to account where performance is not where it should be. I know each Minister has their own set of ICBs— I have a particularly close relationship with seven; other Ministers have the same—so that we can bear down on exactly these sorts of differences and hold people to account.
Physiotherapy: Rehabilitation Services
Debate between Lord Markham and Baroness Manzoor(1 year, 9 months ago)
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Lord Markham (Con)
Absolutely. That is why, as part of my research, I was pleased to read up on the national integrated community stroke service, which is designed to give personalised stroke rehabilitation in every person’s home. Its work is vital in achieving this. The House has heard me talk many times about the 13,000 beds that are blocked in our hospitals, and a lot of the way to free them is by having rehabilitation and getting people back into their home environment. I absolutely agree on the importance of this issue, and that is why noble Lords will see it as an important part of the workforce plan.
Baroness Manzoor (Con)
My Lords, I welcome the Answer my noble friend the Minister gave, but I will give him a real-life example, and declare my interest in doing so: somebody had two strokes, then had a third while waiting over an hour for an ambulance to arrive, has had no physiotherapy rehabilitation at home, and is still waiting a year on for that. This is a real example of people on the ground. Does the Minister agree that we must connect our policies with very clear outcomes?
Lord Markham (Con)
Totally. I am sorry to hear that case, and I think that we would all agree that that is not the sort of service we would want to see. As I said, we have put increases in staff in place—there have been 3,300 extra staff since 2017—but, clearly, we need to do more. That is why I was very pleased to read that this area is an important part of the workforce plan, which noble Lords will be happy to hear we are now seeing drafts of.
Maternity Services
Debate between Lord Markham and Baroness Manzoor(1 year, 9 months ago)
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Lord Markham (Con)
I welcome the noble Lord’s pursuit because that is absolutely the right thing to do. I think we all agree with that, and we would all say that what happened in East Kent and the other examples from the Ockenden report are clearly not something that we are happy with or that we should put up with. The Kirkup and Ockenden reports gave us a north star, a way forward. I am pleased to see that we are making progress on that, but I expect the noble Lord to hold us fully to account because I am holding the department to account on this.
Baroness Manzoor (Con)
My Lords, building on what the noble Lord, Lord Patel, has said, my noble friend will know that continuity of care is really important and has been recommended by the Better Births maternity review. That builds up with better medical understanding of the woman, the pregnancy and the issues related to it. However, only 37% of women are afforded this, and that drops down to 27% in antenatal care. What are the Government doing to take steps to address this so that the terrible examples that we have seen recently are averted?
Lord Markham (Con)
I agree with the work by my noble friends, including the noble Baroness, Lady Cumberlege, to put the importance of midwifery continuity of care at the centre of everything. The survey to which my noble friend’s question refers shows that that is coming through in terms of a consistent message that having that confidence in the person in treating them is vital to all of this. That remains important. Key to this is the workforce, so this is one of the things that is being built into the workforce plan. That is starting with ensuring that we have new people coming in. The 1,200 graduates that we now have going into training each year are a vital part of making sure that we can deliver.
Osteoporosis: Early Detection
Debate between Lord Markham and Baroness Manzoor(1 year, 10 months ago)
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Lord Markham (Con)
As previously mentioned, prevention is always better. Exercise, as I have learned from my noble friend Lord Sandhurst, is a good way of preventing osteoporosis. Where we can find cost-effective ways of getting that exercise, such as swimming pools, we should be promoting them.
Baroness Manzoor (Con)
My Lords, having identified the causes of osteoporosis, could my noble friend say how the message is being communicated? He mentioned vitamin D, which could be an issue, but the reality is that some vulnerable women in communities do not get some of the messages regarding exercise or indeed have access to those facilities. I know walking and so forth can help, but what are the Government doing to put that preventive message across in a very firm and consistent way?
Lord Markham (Con)
My noble friend is correct that education and awareness are always the start point on any of these health issues. It was a key part of the women’s health strategy that came out in 2022. Osteoporosis is a key part of that, and promotion and awareness are a key part if it as well.
Streptococcus A: Antibiotics
Debate between Lord Markham and Baroness Manzoor(1 year, 11 months ago)
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Lord Markham (Con)
The key mechanisms always involve broadening the supply chain. I have given exactly that instruction to the department, which is very much taking it on board. It is looking at supply across a number of sources, not just from the UK but worldwide, as well as the substitution of antibiotics. Penicillin is currently the advised one, but a number of others are being advised right now which will also work well, so that there is as much choice as possible.
Baroness Manzoor (Con)
My Lords, my noble friend will be aware that, while some people are making profits, 16 children under the age of 15 have died as a result of strep A. Exactly what advice is being given to GPs so that parents have direct access to them very quickly? Of course, there is also a concern about antibacterial resistance as a result of overprescribing antibiotics.
Lord Markham (Con)
I thank my noble friend and will take this opportunity to offer that public health advice. A rash, which is often the first sign of a bacterial infection in this case, or a child being floppy, drowsy or dehydrated are all key signs that they should urgently seek medical help. People can call 111 or 999 and be guided through the triaging process to make sure that they get help quickly. At the same time, medics have been told to lower the barrier for prescribing, so to speak, so that they can make sure that people get it early. Although every death is a tragedy, we are clearly now seeing some reduction in the death rate, which is welcome.
NHS: Backlogs
Debate between Lord Markham and Baroness Manzoor(2 years ago)
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Lord Markham (Con)
I agree on the importance of that; as the noble Lord says, often these are easy savings to make, but they are not the right ones. I assure the House that it is a key priority of mine that even such things as operational maintenance, which sounds very unsexy, are a key element in all this. As I say, that is why we have seen a 57% increase in the past year. At £10 billion a year, I hope we all agree that this is a good plan, albeit that there is a lot that needs to be done.
Baroness Manzoor (Con)
My Lords, the Public Accounts Committee has stated that £8.6 billion was lost by the DWP last year in overpayments to benefit claimants and fraud. That is £8.6 billion that could be used to maintain the NHS estates. Can my noble friend the Minister say what the Government are doing to ensure that not only are the inefficiencies cut in the NHS, but efficiencies are made within the wider government departments?
Lord Markham (Con)
Thank you. I am sure the whole House will agree the need for efficiencies to make sure every pound is well spent. I have a little knowledge in the DWP space. Although it falls outside my responsibilities now, I was the lead NED there and I know that the team worked very hard during the pandemic to make sure that universal credit reached people quickly, and as a result they did not proceed with as many checks as they would do normally. It was deliberate policy to make sure money was paid quickly to those who needed it. At the same time, they absolutely understand that they need now to get on top of it and it is key to their action because, as my noble friend says, the more money we can free up in other departments, the more we can focus it on the front line where we really need it.