Paediatric Care: Wating Times

Debate between Lord Markham and Lord Addington

Monday 16th October 2023 Lords Chamber

[Lord Markham (Con)]

The role of the GP is clearly vital. That is what I was trying to get behind in the Start for Life initiative and clear early warning indicators. Clearly, that needs to go right through the development of a child at different key stages along the way. On digital treatments, I was at Boston children’s hospital last week, and it has early indicators for dyslexia—for example, looking at pattern recognition via an app, as it is not until children are older that they can see letters. Similarly, early signs of neurodiversity can be seen in the way that children play online on certain apps. I think we can add some of these digital support tools, but clearly the GP has a primary role.

[Lord Addington (LD)]

My Lords, following on from his last comment, can the Minister give us some idea of what contact there has been on this with the Department for Education? We are supposed to talk to each other, but it becomes increasingly apparent that we do not do so.

[Lord Markham (Con)]

I like to think that we have good contact on this, centred around, as I said, Start for Life, which is a £300 million joint programme between ourselves and the Department for Education. There are also other things; for example, noble Lords might remember me mentioning the Bradford pilot previously, where we are looking at children’s scores in test environments and using those where there may be early indicators of ADHD or other neurodiverse needs. There is quite a bit of work going on in this space. No doubt we could always work more closely, but there is some promising work being done.

Autism: Diagnosis Targets

Debate between Lord Markham and Lord Addington

Tuesday 16th May 2023 Lords Chamber

[Lord Markham (Con)]

Yes, absolutely, we need to look at all areas where we can increase and expand supply, including use of the private sector. I am sure I will be asked about ADHD later on and the “Panorama” programme, which shows that there are some pitfalls in all that, but provided they are assessing according to the NICE guidelines, it clearly has to be sensible to use as much supply as possible.

[Lord Addington (LD)]

My Lords, would the Minister agree that when you delay an assessment, you delay support from the entire structure of government, which we have said should be helping? What help is his department getting from the Department for Education and the Department for Work and Pensions to ensure people are getting to these assessments? If they cannot get the full assessment, can some intermediate steps be taken to ensure that people actually get the help they are entitled to?

[Lord Markham (Con)]

We are working closely with the Department for Education. The Bradford pilot scheme I mentioned takes the early years foundation stage profile scores of children. It knows that if you have a low score, you are far more likely to have autism. That triggers a multidisciplinary team to come in and inspect. That is a way that we can use that as an early warning indicator and then follow it up with volume. I hope that working very closely with the DfE in this space will be a real way forward.

Stroke Rehabilitation and Community Services

Debate between Lord Markham and Lord Addington

Wednesday 22nd March 2023 Lords Chamber

[Lord Markham (Con)]

We are very much believers in the importance of social prescribing. I was at a reception just yesterday given by the Alliance of Sport, talking about the importance of active lifestyles for people’s mental health and recovery, and in the criminal justice system. It is something that we agree on the importance of. I will come back in more detail on the arts.

[Lord Addington (LD)]

My Lords, can the Minister expand upon the encouragement that the Government are giving to people in secondary services, to encourage people to fulfil the exercise programmes that are given to them by the experts? Without that encouragement from GPs and practice nurses, such programmes may seem very difficult and may not happen.

[Lord Markham (Con)]

My Lords, that is a very important point. Two things have really struck me. When people are in hospital, they lose 10% of their muscle mass per week, which is clearly key in their ability to have an active lifestyle and look after themselves outside. At the same time, they need constant support and reminders to keep up that active lifestyle. It is very much at the front of our mind.

Physiotherapy: Rehabilitation Services

Debate between Lord Markham and Lord Addington

Thursday 23rd February 2023 Lords Chamber

[Lord Markham (Con)]

I thank the noble Baroness for bringing this to our attention; again, I believe that the advantage of these Questions is that they shine the spotlight on particular areas. As the survey pointed out, there are a lot of places which, for very understandable reasons, were swapped over to Covid uses during the pandemic and which now need to be brought back into physio use. That was one of the main recommendations from the society, and we will now write to all the NHS chief executives on the back of that. As the House will be aware, I am doing some work anyway to make more space available as part of the capital programme, so this is very much on my list to make sure that we expand that space and provision.

[Lord Addington (LD)]

My Lords, does the Minister agree that physiotherapists do very little of their work in the actual appointment, and that it is the supervised exercise patterns they give patients afterwards that are probably the most important for all forms of rehabilitative structure? Bearing that in mind, what is the Department of Health doing to make sure that local government has facilities such as swimming pools and gyms that remain open under the financial squeeze?

[Lord Markham (Con)]

I agree with the noble Lord’s point; our estimate is that over half of all physiotherapy takes place outside the hospital environment. Clearly, all sorts of settings, including swimming pools and gyms, are vital for that. The work we have done with the Energy Bill and the caps has been a vital help to those leisure centres, and, thankfully, we are now starting to see bills come done and so these places are on a better financial footing.

Childhood Obesity

Debate between Lord Markham and Lord Addington

Thursday 17th November 2022 Lords Chamber

[Lord Markham (Con)]

My Lords, I agree that we—both as the Government and in general—need to be clear about what our recommended calorific intake is each day. Whether you choose to change that by eating one less meal, or however else you distribute your eating across the day, it is our role to help educate people on healthy eating. I agree that it is an issue and a big cost to both the health service and the economy. Our latest estimates are that it could cost the economy as much as £58 billion a year, so it is a critical message to get across.

[Lord Addington (LD)]

My Lords, would the Minister enlighten us on the position of the BOGOF—buy one, get one free—deals? Are we going to remove the disincentive to people buying extra calories in the form of an extra portion? Or will the Government encourage people not to buy the first portion?

[Lord Markham (Con)]

As I think the noble Lord is aware, the position on BOGOF, so to speak, is that we have delayed those restrictions for a year. We have taken significant action in this space, most critically in supermarkets, by moving the promoted items away from tills and prominent aisle endings to remove this so-called pester power. We will very much keep this under review; when we see the impact, particularly of moving those items, we can look again at whether we will introduce more BOGOF restrictions.