(10 months ago)
Lords ChamberMy understanding, now that the task force composition has been set up, is that this will be arranged shortly. I completely agree with the noble Baroness that these are important, as well as often heart-wrenching, matters, so urgency is required. As I have said, good progress has been made in a number of areas. Already, the MoJ is setting up a round table on this. The regional conflict managers have been established. We have training courses online so that communication can improve. A lot is being done, and the task force will push that forward further.
My Lords, the Minister will know that there is currently an imbalance between the resources available to the parents and guardians of children involved in end-of-life care—particularly time, money and legal advice—and that of public bodies such as NHS trusts. Compounding that issue is the routine use of secret transparency orders, which prevent scrutiny and oversight of court proceedings, particularly in the family court. Does the Minister agree with me in that respect: that secret justice is no justice at all?
Clearly, the processes on these terrible cases have got to be as transparent as possible. As noble Lords probably know, legal aid is automatically available in all these types of cases to make sure that there is a level playing field. I also think we all believe that there is a case for seeing whether we can use mediation more as, obviously, courts should only ever be a last resort.
(10 months, 2 weeks ago)
Lords ChamberOne of the key learnings from last year, which goes back to the whole question about planning, was actually that if you put social care moneys in too late, you do not get nearly as effective spend. That is why we brought forward the £600 million discharge fund much earlier—actually, into the summer—so that local authorities and care providers could plan on that money. It is starting to make a difference. A key thing that noble Lords have heard me talk about is bed-blocking. Actually, we have seen a 10% reduction in bed-blocking since these measures have come into effect in the last few weeks. It is early days, but we are actually making progress.
My Lords, the number of over-85s is due to double over the next 30 years. Would my noble friend the Minister give some consideration to government funding for extra care facilities and at-home treatment, such as physiotherapy, in order that pressure be taken off acute district hospital beds in respect of older people?
Funnily enough, I had this conversation in terms of productivity just today. The virtual wards—the 11,000 extra beds we have put in—are actually making a real impact on that, because of course it is much better that people can be treated in their own home, knowing they have the comfort of these virtual displays and treatment to look after them. We have 11,000 extra beds, with 72% utilisation, and, yes, it is really working.
(1 year, 4 months ago)
Lords ChamberThe noble Lord is correct that it is essential. I emphasise that this is an NHS document, and the whole point is that it does not look to go “zoom” on recruitment. There is absolutely the understanding that this is a pipeline that has to be built brick by brick. There is no point front-loading the number of university places if, as the noble Lord mentions, there is no follow-up behind it in clinicians. The plan has been developed from the bottom up, including with clinicians and the trusts. There is an understanding that they need to build their own part of the pipeline towards this as well.
I welcome this ambitious and comprehensive workforce plan and I concur with other noble Lords on the issue of social care. On the specific issue of medical school places, while I strongly welcome and commend the Government for responding to the campaign of many people—including Policy Exchange and its excellent Double Vision report, published earlier this year—my concern is the waste of resources and the talents of those thousands of A-level students who do not get university places to study medicine. While I welcome the focus on degree apprenticeships and the regionalisation of medical education, is there any chance that we could speed up the process? Another eight years to double the number of medical places is an awfully long time—it is almost the equivalent of two Parliaments.
As for the A-level point and those people not being able to go on to universities, that is what the different routes are about. The different pathways that we are talking about include nursing associate training places, which we want to see increased to 10,000, and similarly with physician associates. While we all understand that having a university education is a fantastic medical grounding, there are many other ways to get there. I am sure we all have very good examples of fantastic clinicians who did not have a degree.
(1 year, 6 months ago)
Lords ChamberMy Lords, on the subject of support services, is my noble friend the Minister aware of, and does he deprecate, the widespread practice of catheterising very elderly people who are only temporarily immobile or infirm? In the long term, that reduces their independence and adds to the cumulative costs to the state of their care, particularly to primary care, the NHS and local authorities.
(1 year, 9 months ago)
Lords ChamberThe noble Baroness is correct. Key to all these things is awareness that the best advice is to take folic acid supplements, as suggested. I am happy to provide precise figures of how that has moved in recent years. I completely agree that, as ever, education and awareness are key to this.
My Lords, I welcome my noble friend the Minister’s very positive tone. I first campaigned on this issue as a constituency MP 18 years ago, but it is 32 years since the Medical Research Council established the causal link between the ingestion of folic acid and the reduction of neural tube defects such as spina bifida and hydrocephalus. Scores of countries have pursued this policy and it has had a significant impact on reducing the tragedy of lifetime disability that has affected many families. Can the Minister ensure that the review is concluded expeditiously so that we can erode these terrible medical conditions as soon as possible?
Yes, I am very happy to do so. It has been quite a process, as my noble friend says, but we are getting there. As I said, the good news is that the industry is seeing the direction of travel and is responding as well. That is always better when done voluntarily. We are seeing more foods with levels of fortification. We will get there in terms of it being mandated as well.