NHS: Diabetes

Debate between Lord Prior of Brampton and Baroness Ludford

Thursday 26th May 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, diabetes is a key priority of the Government and part of the mandate that was given to NHS England for this year. The noble Lord is right—the direct cost to the NHS of treating diabetes is actually about £5 billion every year. Variation is the critical aspect that we should focus on. Whether it is foot care or the incidence and treatment of diabetes, across the country there is a huge degree of variation. The work being done with Diabetes UK on a national audit for diabetes will play a big part in reducing that variation.

[Baroness Ludford (LD)]

My Lords, are the Government satisfied with the overall cost-benefit analysis of the provision of insulin pumps and continuous glucose monitors? I should mention that my own husband has those. NICE guidelines are quite restrictive, and only a fraction of those who qualify get them. Many people self-fund, yet the long-term cost savings to the NHS of good blood glucose control and avoiding organ damage are enormous. Will the Department of Health look again at whether the benefits outweigh the relatively small costs?

[Lord Prior of Brampton]

My Lords, there are clear NICE guidelines on the use of insulin pumps and blood glucose monitoring equipment. For type 1 diabetes, NICE does not recommend their use unless there is clear evidence that the patient will comply with such use at least 70% of the time. The advice from NICE is clear on the use of both.

Health: Detection Dogs

Debate between Lord Prior of Brampton and Baroness Ludford

Thursday 17th September 2015 Lords Chamber

[Lord Prior of Brampton]

My Lords, interestingly, the human nose contains some 5 million scent glands but a dog’s nose contains many more. In fact, the sniffing ability of a dog can be up to 10 million times that of the ability of a human being. Therefore we should not underestimate the contribution that dogs can make in this field. The trial being conducted at Milton Keynes University Hospital, which involves 3,000 patients giving urine samples, with nine dogs in a controlled environment over the three years, could indeed make a huge a contribution to the early detection of certain cancers. Therefore we will follow that trial with keen interest.

[Baroness Ludford (LD)]

My Lords, I thank the noble Lord, Lord Astor of Hever, for asking this Question, and also Claire, a young diabetes nurse with type 1 diabetes, who told me about her dog, Magic, which helps her avoid hypos—hypoglycaemic incidents. I declare an interest in that I have been married to someone who has had type 1 diabetes for nearly 45 years. Is the Minister aware that if the NHS did a serious cost-benefit exercise on type 1 diabetes, its investment in measures to assist strict blood glucose control and prevent hypos would be transformed? However, it seems to have a blind spot. Type 1 diabetes accounts for a large chunk of the 10% of NHS spending on diabetes but is not even mentioned in the NHS Five Year Forward View. Will the Government seriously look at extending access to technologies and, for people whom they would assist, access to detection dogs?

[Lord Prior of Brampton]

It is interesting that the cost of training a dog is some £11,200—considerably less than the cost of training a doctor, I might add. Unquestionably there is considerable evidence to suggest that dogs can make a real contribution as regards people suffering from diabetes and low-sugar problems, whom the noble Baroness mentioned. Decisions in this area are for local CCGs to make, but it is something that we will certainly encourage.