NHS: Equitable Access

Debate between Lord O'Shaughnessy and Lord McColl of Dulwich

Thursday 5th July 2018 Lords Chamber

[Lord O’Shaughnessy]

I thank the right reverend Prelate for asking two very good questions. We recently announced the first local health and care records, covering around 40% of the population. Sometimes, you can pitch up in one part of the NHS and they cannot access all your patient and care data; this measure will make sure that that does not happen. Patients want this; it is essential for good direct care.

The right reverend Prelate is quite right about the ethical considerations. We will publish a code of conduct on the proper use of AI in the NHS later this year. We are working with the new Centre for Data Ethics to make sure that this happens.

[Lord McColl of Dulwich (Con)]

My Lords, there are 4 million type 2 diabetics in this country. Does the Minister agree that they could be cured quite easily if they ate fewer calories?

[Lord O'Shaughnessy]

Changes in eating habits certainly help, as do changes in exercise. Our obesity strategy tries to make sure that those good habits are ingrained from an early age.

Childhood Obesity: Yoga

Debate between Lord O'Shaughnessy and Lord McColl of Dulwich

Thursday 21st June 2018 Lords Chamber

[Lord O’Shaughnessy]

I am not aware of the charity that the noble Lord mentioned, although after university I spent six months in India as a teacher. The school I taught in practised yoga with its children and it seemed to have a calming effect on them—which is just as well, because I am not sure my teaching skills had such an effect. I am sure many noble Lords know personally the benefits of yoga. It has not been proven to have any impact on obesity, although it has many other benefits, as the noble Lord pointed out. It is something that schools can and do use as part of their repertoire in the PE curriculum to provide exercise for children, although it does not count towards the moderate and higher levels of activity demanded by the PE curriculum.

[Lord McColl of Dulwich (Con)]

Does the Minister agree that exercise does not deal with the obesity problem at all? There is only one way of dealing with obesity: eating less. Does he also agree that pregnant women who are obese transfer that tendency of obesity to their offspring by a mechanism, which we do not understand, called epigenetics? While we are on the subject, I congratulate the Minister on being a shining example of controlling his measurements. I have noticed that his waist measurement is less than half his height.

[Lord O’Shaughnessy]

I am wondering how my noble friend has made such an accurate assessment. He did not see my weight on the scales this morning. He is quite right. Of course, it is a combination of exercise and healthy eating, which is why there has been a push for both those things in our schools. There are great risks to pregnant women from being obese, not only to themselves with diabetes in pregnancy, which tends to reappear in later life, but in the impact on their children. That is why it is so important that pregnant women get good advice about healthy eating.

Long-term Plan for the NHS

Debate between Lord O'Shaughnessy and Lord McColl of Dulwich

Tuesday 19th June 2018 Lords Chamber

[Lord O'Shaughnessy]

I would not agree with that because it is clearly the case that once we have left the European Union we will not be paying for membership of it—and it is those funds which will, in part, go towards helping us solve the funding challenge that we have set ourselves for the NHS.

[Lord McColl of Dulwich (Con)]

My Lords—

--- Later in debate ---

[Lord O'Shaughnessy]

No.

[Lord McColl of Dulwich]

Does the Minister agree that the obesity epidemic is costing well over £25 billion a year? Would he consider having an all-out campaign— including every man, woman and child, every institution, school and government department—not to tell people what to do but to tell them the truth? For instance, there are 4 million people with type 2 diabetes due to overeating. If they ate less the savings would be terrific and most of them would be cured of their diabetes.

[Lord O'Shaughnessy]

My noble friend sets a tremendous personal example in this case. He is a fearless and tireless campaigner on the causes of obesity. He knows that it is our hope and intention that we will return to this topic so that we can start to reduce this plague on children and adults.

Children: Obesity

Debate between Lord O'Shaughnessy and Lord McColl of Dulwich

Thursday 19th April 2018 Lords Chamber

[Lord O'Shaughnessy]

One thing I noticed at Easter was that Easter eggs seem to have got bigger. I was counting the calories on the Easter egg that my children had. There is a serious point there. It is about reformulation, it is not just about reduced sugar, salt and so on; it is also about smaller portion sizes, and that is a measure that we are tracking as well.

[Lord McColl of Dulwich (Con)]

My Lords, it is really me. Is the Minister aware that a recent report from Canada showed that children who were fed on whole milk for the first eight years of their life were much healthier than those not, and they were not obese? Why on earth did we ever start skimming milk when human breast milk has the same amount of fat as cows’ milk? As far as I know, we have not started skimming human breast milk yet.

[Lord O'Shaughnessy]

I am trying to imagine how that might work. The noble Lord makes an important point which he also made in a debate the other day, that our understanding of dietary needs is changing. In some ways, we are rediscovering old truths about the importance of fat and reduction of sugar. That is part of the approach that Public Health England is promoting.

Emergency Hospital Admissions

Debate between Lord O'Shaughnessy and Lord McColl of Dulwich

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

Debate between Lord O'Shaughnessy and Lord McColl of Dulwich

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

Debate between Lord O'Shaughnessy and Lord McColl of Dulwich

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

Debate between Lord O'Shaughnessy and Lord McColl of Dulwich

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

Debate between Lord O'Shaughnessy and Lord McColl of Dulwich

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

Debate between Lord O'Shaughnessy and Lord McColl of Dulwich

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—