Emergency Hospital Admissions

Lord McColl of Dulwich Excerpts

Wednesday 7th March 2018 Lords Chamber

[Lord O’Shaughnessy]

It is now the case that thousands of GPs and hospital staff have been trained to screen for the signs of alcohol abuse and to provide intervention. So not only are there dedicated staff and dedicated public health programmes, but hospital and primary care staff have now been specifically trained to look for the signs and to signpost people to care when they need it.

[Lord McColl of Dulwich (Con)]

Does the Minister agree that one of the causes of the recent pressure on acute hospital beds is that young people and children who are waiting for scarce specialist mental health beds are frequently put into inappropriate adult wards because there is no room for them anywhere else? Would the Minister look into that again?

[Lord O’Shaughnessy]

I thank my noble friend for making that point. Unfortunately, we have a growing prevalence of the kind of mental illness he is describing. We are in the process of increasing the number of in-patient beds available for young people going through those kinds of episodes. That is the right thing to do. It means that they will not have to travel so far from their homes and has the benefit of relieving the impact on adult acute beds.

National Health Service

Lord McColl of Dulwich Excerpts

Tuesday 10th October 2017 Lords Chamber

[Lord McColl of Dulwich (Con)]

Does the Minister agree that the major problem in the NHS today is the enormous increase in demand? It is not old people getting older; it is not young people being couch potatoes, because inactivity does not cause obesity. The obesity epidemic is what is wrecking the NHS.

[Lord O'Shaughnessy]

The NHS is seeing more people than ever—I think that some 1,500 more people a day are being seen in A&E. A lot more people are going through the service. The truth is that there are a number of factors: there are factors around lifestyle and around ageing. The point is that we have to change. At the heart of this Question is the comment made by the chief inspector about our not having new models of care. We need to change the way in which we provide care. That means integrated care, with much more of it based in the community. That means us all taking difficult political decisions about how care is configured so that it meets changing needs related to obesity and ageing.

National Stroke Strategy

Lord McColl of Dulwich Excerpts

Wednesday 5th July 2017 Lords Chamber

[Lord O’Shaughnessy]

I know that the noble Baroness has a deep commitment to ensuring the best possible stroke care. She is quite right to highlight the economic and personal costs of stroke. There is a good picture in this country in so much as mortality from stroke and the incidence of stroke have halved over recent years—so the picture is improving. The stroke strategy the noble Baroness mentioned was superseded in 2013 by a cardiovascular disease outcome strategy that is obviously broader but includes stroke. That builds on the work that has already happened. I am realistic about the fact that there is obviously more to do, but we now have a number of hyperacute centres that are rolling out new treatments, such as thrombectomy, which will help treat stroke and make sure that we bring mortality down even further.

[Lord McColl of Dulwich (Con)]

My Lords, is the Minister aware that the incidence of stroke in the Scotland is 40% greater than in England? That is surprising in view of the fact that Scotland spends 25% more on its health service. Could this have something to do with the obesity epidemic?

[Lord O’Shaughnessy]

Well, in order not to fall out with Scottish noble Lords, I shall not comment on that. Under successive Governments there have been improvements in stroke outcomes, which have come about through the centralisation and specialisation of care. That is not always popular because of what it does with reorganisations, but it is definitely paying dividends in England.

Alcohol: Children’s Health

Lord McColl of Dulwich Excerpts

Monday 3rd April 2017 Lords Chamber

[Lord O’Shaughnessy]

Action is being taken. There are clear rules and mandatory guidelines around the promotion of alcohol. It is important to point out that alcohol is different from smoking, where there are extremely strict rules on promotion. Most people enjoy alcohol in moderation as part of their healthy, pleasurable, normal social life, so there is a difference. However, there are clear and strict rules around promoting, advertising or selling to children.

[Lord McColl of Dulwich (Con)]

Does the Minister agree that whereas the commonest cause of cirrhosis of the liver used to be alcohol, it is now the obesity epidemic, which could be cured by eating less?

[Lord O’Shaughnessy]

My noble friend is right. Of all the things we should do in our lives, we should eat less and drink less—as I am sure every Member of this House does.

National Health Service: Nurses

Lord McColl of Dulwich Excerpts

Wednesday 22nd February 2017 Lords Chamber

[Lord O'Shaughnessy]

In answer to the noble Lord’s first question, I think the figure is 22,227 EU nationals, so I hope that satisfies him on that point. Of course, they do a fantastic job, as do all NHS and care staff, and they deserve the highest praise. The noble Lord will also know that we are keen to reassure them of their status as part of the EU negotiations, but, of necessity, that has to be a reciprocal arrangement.

[Lord McColl of Dulwich (Con)]

Will the Minister support my attempt to find out what makes so many young nurses leave the profession?

[Lord O'Shaughnessy]

I thank my noble friend for that question. We should be looking at attrition rates in training and in the profession itself, and I would certainly be happy to work with him on that. I know he is particularly anxious about the turnover of nurses within certain training settings.

Hospital Beds: Availability

Lord McColl of Dulwich Excerpts

Thursday 9th February 2017 Lords Chamber

[Lord O'Shaughnessy]

A number of investigations and reviews into the future of health and social care are taking place. I quite agree with the noble Lord that a royal commission is not necessary. What we all need to do in government and through the arm’s-length bodies involved in healthcare is to make sure that we are providing the 2.7 million staff, who are doing a brilliant job every day in supporting our health and care services, with the money and assistance they need to continue to deliver world-class healthcare.

[Lord McColl of Dulwich (Con)]

My Lords, does the Minister agree that it is not so much a question of old people getting older, because old people have always got older; rather, the difference in the last 30 years is the grotesque increase in the number of young people getting fatter and fatter?

[Lord O'Shaughnessy]

There are some long-term public health challenges, involving not just obesity but alcohol. But there is also good news: fewer people are smoking. I think that sometimes, young people—I do not know if I count any more—

Pharmacies: Funding

Lord McColl of Dulwich Excerpts

Wednesday 2nd March 2016 Lords Chamber

[Lord Prior of Brampton]

The noble Lord raises an important point. There is no doubt that community pharmacies are vital to all people, but particularly to those living in isolated rural communities. There will be a pharmacy access fund based around isolation and local health needs of the population. We are consulting with the Pharmaceutical Services Negotiating Committee over that issue at the moment. I assure the noble Lord that we are fully aware of the issue he raises.

[Lord McColl of Dulwich (Con)]

My Lords, the Government’s plans will squeeze all pharmacies, resulting in the closure of the least-viable ones—which are often in the poorest districts where they cannot easily diversify. Why do the Government not undertake a means assessment to find out which pharmacies are essential? Closing pharmacies will put even greater pressure on overworked GPs.

[Lord Prior of Brampton]

I assure my noble friend that not all pharmacies will be squeezed equally, as he put it. A pharmacy access fund will ensure that greater resources go to those pharmacies which serve isolated communities in rural areas, and a pharmacy integration fund will ensure that we encourage pharmacies to work more closely with primary care.

Sugar Tax

Lord McColl of Dulwich Excerpts

Wednesday 3rd February 2016 Lords Chamber

[Lord McColl of Dulwich (Con)]

My Lords, will the Minister give us an assurance that when the new policy comes out to tackle obesity we will not fall into the trap of saying that the answer is exercise? You have to run for miles and miles to take off a single pound of fat.

[Lord Prior of Brampton]

My Lords, exercise may be a part of our strategy to tackle obesity, but certainly not the major part.

National Health Service: In-Patients with Learning Disabilities

Lord McColl of Dulwich Excerpts

Monday 18th January 2016 Lords Chamber

[Lord Prior of Brampton]

I tried to explain the difference between avoidable deaths and excess deaths earlier in my answers, without trying to make any political point about it. There is an important distinction to be made, and I hope that I made it. I agree with the noble Lord that this is a very serious issue, and the Government are approaching it in a very serious way.

[Lord McColl of Dulwich (Con)]

My Lords, is the Minister aware that clinicians meet regularly to discuss all their complications, and that these meetings are extremely valuable and relevant? Have politicians considered the possibility that they might meet every week to discuss their mistakes?

[Lord Prior of Brampton]

My Lords, I am sure that it would be a very long meeting. My noble friend is right that mortality and morbidity meetings are extremely important in hospitals. It would seem that practice is very variable across hospital trusts and I know that part of what Sir Bruce Keogh, the medical director of the NHS, is doing is trying to develop, along with Monitor and the CQC, a governance structure around mortality that all hospitals can learn from.

Child Health: Play

Lord McColl of Dulwich Excerpts

Monday 12th October 2015 Lords Chamber

[Lord Prior of Brampton]

I wonder whether Members of this House might like to set an example in that regard as well by running a mile a day. There is no doubt that exercise is good for you. Not only is it good for all the problems associated with weight but there is plenty of evidence to suggest that exercise helps with mental health problems. Whether you are running or on your bike, I am wholly in favour of it.

[Lord McColl of Dulwich (Con)]

My Lords, although exercise is very important in terms of the heart and so on, the real answer is to eat fewer calories. We may criticise politicians of one party, but does the Minister realise that politicians of all three parties kept on saying that the answer to the obesity epidemic was exercise when it was nothing of the kind? It was eating fewer calories.

[Lord Prior of Brampton]

Clearly, my noble friend is right: nutrition and diet are fundamental to the whole debate about obesity. That does not alter the fact that exercise is also very good for you.