General Practitioners: Workforce

Lord Roberts of Llandudno Excerpts

Monday 5th March 2018 Lords Chamber

[Lord O'Shaughnessy]

That is an evolving model, as the noble Lord has pointed out, and I will write to him with the exact figures. The partnership model has an enduring popularity and importance, which is why the Secretary of State has asked for a review of it. However, as we see new models of care develop, I am sure that salaried GPs will become more of a feature of the system.

[Lord Roberts of Llandudno (LD)]

My Lords, many refugee medical trainees are coming over. Is there no way that we could help them finish their medical courses and then deploy their skills in this country before it is safe for them to return to their country of origin?

[Lord O'Shaughnessy]

The noble Lord has asked that question before. He will be pleased to know that there is specific help for refugees and others through waiving fees for language courses and other elements of the professional qualification process, and we can bring those into practice as soon as possible.

Mental Health: Children’s Services

Lord Roberts of Llandudno Excerpts

Thursday 19th January 2017 Lords Chamber

[Lord O'Shaughnessy]

The noble and learned Baroness may know that over the past five years I have been setting up primary free schools, with an explicit focus on developing character, well-being and resilience in young people, so I could not agree with her more—it has to start early. Indeed, it does not have to start in primary; it must start in early years and, of course, it must start with parenting and giving parents the skills that they need to teach resilience in their children.

[Lord Roberts of Llandudno (LD)]

Is the Minister aware that half the immigrant children in the Calais or Dunkirk camps were diagnosed with mental health problems? As we are supposed to accept 20,000 refugees in the next three years, is there sufficient funding and awareness of the need to add to our commitment?

[Lord O'Shaughnessy]

I was not aware of that fact, but it is clearly an important one and I shall write to the noble Lord with the information about what we are doing to support those children who come to this country.

Health: Diabetes and Obesity

Lord Roberts of Llandudno Excerpts

Thursday 30th June 2016 Lords Chamber

[Lord Prior of Brampton]

I think that the levy on sugary drinks has been universally welcomed as a start. That the proceeds of the levy will be put into the sport premium in primary schools and lengthening the school day in secondary schools is all for the good. If we are to address obesity, it has be across a very wide front.

[Lord Roberts of Llandudno (LD)]

My Lords, with the cuts in education budgets and consequent reduction in the number of nurses in schools, who are able to keep a special eye on diabetic pupils, will the Minister give an instruction that is helpful to education authorities and schools to replace somehow the specialised nursing staff who have done such a great job over the years?

[Lord Prior of Brampton]

My Lords, I cannot address the specific issue of the number of nursing staff in schools, but the Government are well aware that encouraging children to eat well and take exercise is a crucial part of any obesity strategy. As I said, our strategy will be revealed later in the year.

Primary Care: Targets

Lord Roberts of Llandudno Excerpts

Tuesday 13th October 2015 Lords Chamber

[Lord Prior of Brampton]

I completely agree with those comments. Over the next five years, we will see much greater integration of acute hospitals and primary care and community care.

[Lord Roberts of Llandudno (LD)]

My Lords, the suggestion has been made that nurses from overseas who are not earning £35,000 after five years will be deported. Does this mean that the Government are going to think again on this issue?

[Lord Prior of Brampton]

This raises an important point—that we ought to train our own nurses. Relying on recruitment from overseas is not a viable long-term strategy and we must increase the number of training places in the UK.

National Institute for Health and Care Excellence

Lord Roberts of Llandudno Excerpts

Monday 13th July 2015 Lords Chamber

[Lord Prior of Brampton]

I do not think that is a problem. In many ways, in acute hospitals we lack generalists. That is true of consultants as well of nurses. That is actually my noble friend’s point. Possibly there are too many specialists, but on a cardiac ward or a specialist acute ward you need specialist nurses who know how to operate the equipment as well as how to look after the patient. You need a good balance between the two but, if anything, I fear we have, as my noble friend said, become too specialist and insufficiently generalist.

[Lord Roberts of Llandudno (LD)]

My Lords, what is the Minister’s opinion of the Government’s decision to deport nurses from overseas who do not reach the £35,000 a year income level within five years?

[Lord Prior of Brampton]

The noble Lord raises a good point. We need to train as many of our own nurses as possible. There will be times when we get those calculations wrong and it will be necessary to bring in nurses from overseas. That is not a desirable outcome for many reasons, which there is not time to go into today. We need to train more ourselves.

Prisons: Mental Health

Lord Roberts of Llandudno Excerpts

Wednesday 24th June 2015 Lords Chamber

[Lord Prior of Brampton]

I am not aware of any current plans to conduct a survey similar to the one to which the noble Lord referred from 1998.

[Lord Roberts of Llandudno (LD)]

My Lords, what action will the Government take in Wales, where health is devolved to the Welsh Assembly but prisons are part of the Home Office remit? How will those two different aspects of government work together?

[Lord Prior of Brampton]

The noble Lord raises an issue to which, I confess, I have not given sufficient consideration to give a proper reply today. Perhaps I may take that away and come back to him. The simple answer to that question is: dialogue.

NHS: Clinical Negligence

Lord Roberts of Llandudno Excerpts

Tuesday 20th January 2015 Lords Chamber

[Earl Howe]

I agree with the noble Baroness. We view it as important that NHS organisations manage complaints in a positive manner and use the information obtained to improve service delivery. Saying sorry is important. People who complain often want an apology, an explanation and an assurance that the same thing will not happen to someone else.

[Lord Roberts of Llandudno (LD)]

My Lords, do the figures we have been given today include Wales, Scotland and Northern Ireland? Are those claims included in the total figure?

[Earl Howe]

My advice is that the figure includes England only, but if I am incorrect in any respect, I will write to my noble friend.

HIV: Stigma

Lord Roberts of Llandudno Excerpts

Monday 1st December 2014 Lords Chamber

[Earl Howe]

I shall expand on my previous answer. Sex and relationship education is compulsory in maintained secondary schools, although not in academies. All maintained schools and academies have a statutory requirement to have due regard to the Secretary of State’s sex and relationship education guidance, which dates from 2000, when teaching sex and relationship education. The guidance makes it clear that all such education should be age-appropriate and makes the following points about HIV and sexually transmitted infections:

“information and knowledge about HIV/AIDS is vital; young people need to understand what is risky behaviour and what is not; young people need factual information about safer sex and skills to enable them to negotiate safer sex … Young people need to be aware of the risks of contracting a STI and how to prevent it”.

They also need to know about the diagnosis and treatment of HIV and STIs.

[Lord Roberts of Llandudno (LD)]

My Lords, is this not the direction in which we need the devolved health commitment in Scotland, Wales and Northern Ireland to go? What co-operation is there between them and the English set-up through television programmes, advertising and in other ways? Is this not one of the areas where it is essential to have effective co-operation?

[Earl Howe]

Yes, indeed, my Lords. I can tell my noble friend that there is such co-operation and constant communication between the public health authorities in England and the devolved Administrations on this, as on many other matters.

Health: Multiple Sclerosis

Lord Roberts of Llandudno Excerpts

Monday 30th June 2014 Lords Chamber

[Earl Howe]

The noble Baroness is right that care plans have to be tailored to each individual patient. For those with serious neurological conditions, that is as important as for anyone. I do not have up-to-date information about what work NHS England is doing at the moment on this, but I am happy to write to her on the subject.

[Lord Roberts of Llandudno (LD)]

My Lords, how widely shared are these new medications? For instance, I know that some cancer medications are available to patients in England but not to patients in Wales. How widely is this information shared so that everyone can benefit, even if we are under the devolved Administrations?

[Earl Howe]

My noble friend will know that I cannot speak for the devolved Administrations, who have complete autonomy in their healthcare policies. I can say that a number of drugs have been recommended for use on the NHS for MS patients, including Tysabri, Gilenya, Aubagio and Lemtrada. However, it is ultimately for the devolved Administrations to decide whether they wish to have the same set of rules in place as we do in England.

Suicide

Lord Roberts of Llandudno Excerpts

Tuesday 23rd April 2013 Grand Committee

[Lord Roberts of Llandudno]

My Lords, I, too, thank the noble Baroness, Lady Buscombe, for giving us this opportunity, and for bringing to our attention, as the noble Lord, Lord Giddens, said, the statistic that three times as many young men between the ages of 30 and 44 commit suicide than women in that age range, or perhaps a wider age range. Does that not somehow reflect the economic situation—jobs and so on? A University of Liverpool study suggested that 1,000 suicides in the general age range were because of the recession. How true that is I do not know, but that is the figure that the University of Liverpool gives us.

In Wales we had a different situation. In 2007, seven youngsters in Bridgend committed suicide, six of them by hanging. In that year, there was a terrible dilemma in Wales: why were these people doing it? They were saying, “It is such a boring place, what else can I do? What other job can I get? I want to get out of here”. The only way they could see to get out of there was by committing suicide.

The great contribution of the Samaritans has already been mentioned, as have Childline, the NSPCC, Chad Varah and Esther Rantzen. All these deserve our thanks for what they have done and the countless lives that they have saved.

The reasons for suicide vary tremendously. As a minister, I encountered it fairly often—not too often but often enough. Why did they try to do this? Sometimes you just shook your head and said, “No idea”. At other times you would say, “Ah yes”—there were problems that we were aware of. According to the statistics, 1 million people commit suicide every year worldwide. Of these, 100,000 are young people, 15 to 19 year-olds. I suggest that there are 100,000 different reasons why they would try to commit suicide—so many different countries, so many different situations.

A new scheme is being brought in in Indiana in July this year. Everyone seeking an initial teaching qualification will have to study education and training in the prevention of child suicide and recognising the danger signs. Somehow, because we are talking to machinery, computers or whatever, we are losing the personal touch—in communities and families.

I have discussed this with ministers of other denominations—the number of priests and ministers in communities and the number of lively, active, alert churches is far fewer than it used to be. When that happens, the community is weakened because there is not the person there to support the most vulnerable. The figures from my own church in Wales are startling: 100 years ago we had 137 Welsh-speaking ministers of our own home-grown variety; today we have two or three. It is a big difference. A Presbyterian minister told me, “In my church at the time of the great Welsh Revival 100 years ago we had 1,000 ministers. We now have 40”. So the people who would be in the community to support and listen are not there in the same way, and the families who would also get their support in the churches are not there.

However, it is not only churches. I have a list here: policemen, village-based teachers, local shop-owners, local football teams, bands and choirs, even well run pubs—and I might well be struck off for praising well run pubs. These are all part of the community and they are not there to the same extent any longer. The local community is the strongest and best friend of those who are most vulnerable. We must somehow give it new strength so that it can fulfil what it used to do in treating and responding to needs.