Amputees: Limb Fitting
Debate between Lord Patel and Baroness Manzoor
Baroness Manzoor
I am very sorry to hear of the experience that the noble Baroness’s family has faced. Sepsis is an important issue, and we are dealing effectively with ensuring that we bring it under control. All amputations as a result of whatever issue are taken very seriously and we are offering the same kind of service so that we cut down the variations in the system. The current review will take into consideration all issues that patients have raised.
Lord Patel (CB)
My Lords, following on from the question asked by the noble Baroness, Lady Thornton, about the relationship between amputations and type 1 diabetes, the worrying aspect is the great variation in amputation rates across England. Does the Minister agree that areas that have high rates of amputation should be asked to look at how they can follow the guidelines issued by NICE to reduce the rates?
Baroness Manzoor
I agree that it is important that we reduce the variations and that NICE guidelines are followed. NHS England’s service specifications include a duty to reduce inequalities. They set out a number of issues to ensure that there is improved access, including flexible appointments, rehabilitation and reablement—but the noble Lord is quite right that we must address the variations.
Healthcare (International Arrangements) Bill
Debate between Lord Patel and Baroness ManzoorTuesday 19th February 2019
(5 years, 9 months ago)
Lords ChamberRead Full debate Healthcare (European Economic Area and Switzerland Arrangements) Act 2019 View all Healthcare (European Economic Area and Switzerland Arrangements) Act 2019 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: HL Bill 155-II Second marshalled list for Committee (PDF) - (19 Feb 2019)
Baroness Manzoor (Con)
My Lords, I thank the noble Lord, Lord Patel, for moving Amendment 11 and highlighting the importance of an appropriate definition of healthcare in the Bill.
We have adapted the definition set out in the Health and Social Care Act 2012 to include the additional element of ancillary care, as the noble Lord noted. This is to reflect where current arrangements provide for ancillary costs, such as travel costs, which do not strictly fall within the definition of healthcare. This would be for use in such circumstances as in France, where residents are reimbursed with a contribution to their travel costs when attending healthcare appointments. The definition of healthcare in Clause 3 ensures that we can implement arrangements that are based on the current EU arrangements, if negotiated in future.
The noble Lord indicated that this is a probing amendment and, as a former clinician, he will understand that limiting the definition to exclude certain conditions would be inappropriate, as it is not in the UK’s jurisdiction to determine what level of access to healthcare should be provided in another country. It is up to each country to determine what is available as part of its public healthcare system, as we do here in the NHS. The government definition would enable individuals to access healthcare on those terms under reciprocal healthcare agreements. The Government are committed to ensuring access to healthcare in line with current arrangements, and that UK nationals can continue to benefit from them, as they do now.
The Government have been clear during the passage of the Bill—this alights at the heart of the noble Lord’s question—that access to social care in England would not be provided through any reciprocal healthcare agreement. However, it is worth noting that some types of treatment related to dementia care can be medical in nature and may be provided by the NHS. As the noble Lord knows, in the UK, we treat all people with any physical or mental health condition. This demonstrates the complexity of the issues that narrowing the scope of such an important definition in the Bill may afford. I hope the noble Lord, Lord Patel, will therefore agree that the definition used in the Bill is the most sensible. However, I thank him—he is a noble friend—for raising this important issue. With the assurances I have given, I hope he will feel able to withdraw his amendment.
Lord Patel
My Lords, I thank the Minister for her comments. I raised this issue only to make sure that whenever such agreements are made, it is borne in mind that there may be implications for other conditions not directly regarded as mental or physical health conditions; for example, an increasing number of people have dementia. On that basis, I beg leave to withdraw the amendment.
Health: Medicines Shortage
Debate between Lord Patel and Baroness Manzoor
Baroness Manzoor
The Government are taking a number of steps. We have introduced the six-week stockpiling, which I have already mentioned. We are also looking at transportation issues and addressing whether there are shortages. We are working with supply chains and manufacturers to get an early indication of where these shortages may arise. I reassure the noble Lord that shortages of various drugs happen throughout the year. This is not a new phenomenon, and we are not clear that it is Brexit related.
Lord Patel (CB)
My Lords, I want to reinforce what the noble Lord, Lord O’Shaughnessy, said. In the past, we have experience in this country of wholesale providers of over-the-counter drugs hoarding medicines to demand higher prices later, and the NHS had to pay up. It is right that the NHS agrees to take powers if that is found to be the case, and I hope that the Minister will confirm that.
Baroness Manzoor
I can confirm that. We are talking about concessionary pricing as well. However, I restate that our primary concern is to ensure that patients continue to get their medication and that community pharmacies are reimbursed fairly for the products that they use. The answer is yes.
Breast Cancer: Women Over 73
Debate between Lord Patel and Baroness Manzoor
Baroness Manzoor
My Lords, the noble Baroness makes a very interesting point but the NHS breast screening policy is based on strong peer-reviewed evidence. The decision to offer routine screening to women between the ages of 50 and 70 followed support from the Marmot review, which estimated that inviting women between the ages of 50 and 70 reduces mortality from breast cancer in the population invited by 20% and saves an estimated 1,300 lives a year. It also stated that evidence to support screening outside the 50 to 70 age group was not strong enough to allow older women to be invited for screening routinely.
Lord Patel (CB)
My Lords, does the Minister agree that although the evidence from the study leading to the introduction of screening between the ages of 50 and 73 was strong, the evidence for screening beyond 73 exists only in observational studies carried out in the United States and Australia? Would it therefore not be wise to ask NICE to conduct the same type of study it carried out before and assess the cost-benefit analysis, which includes the health benefits, relating to women over 73 who are offered regular mammography?
Baroness Manzoor
On the NICE review, NHS England has asked Sir Mike Richards to lead a review of the current cancer screening programmes and diagnostic capacity. He will make initial recommendations by Easter this year and the review should be finalised in the summer of 2019. The review aims to further improve the delivery of the screening programmes, increase uptake and learn lessons from the review and recent issues. I cannot say any more until the review has completed its work.
NHS Workforce: Mental Health
Debate between Lord Patel and Baroness Manzoor
Baroness Manzoor
That is an interesting question. As I have alluded to, NHS Improvement already has a programme to incentivise employers to ensure that they have good workplace strategies in place for well-being and mental health. It is looking to roll that out even further.
Lord Patel (CB)
My Lords, I am sure the Minister recognises that there is good evidence to show that an efficient occupational health service, run by any major organisation, that is confidential and provides good counselling reduces stress and mental ill-health in its workforce. Does she agree that such a service should be available in every major hospital trust?
Baroness Manzoor
Absolutely. Staff survey evidence shows that improving staff health and well-being leads to higher staff engagement, better staff retention and better patient care. I totally agree with the noble Lord.