The NHS

Lord Selsdon Excerpts

Thursday 5th July 2018 Lords Chamber

[Lord Selsdon (Con)]

My Lords, I apologise for my delay in speaking but my mobility is not as great as I would have hoped. I made the mistake of being a wicket keeper for many years and was suddenly told that I needed a new knee, having found that I could not walk.

One thing about the NHS is that, when you do not know it, you do not know what to expect. The NHS gave me a new knee. Attractive girls came to drip-feed me every evening, and then I found that I could walk and almost run. Against that background, I find it quite intriguing that we now have the technology to deal with all forms of sports activities. I found that the first thing the NHS needed to get was a new knee, which had to be ordered from the United States. I wondered why we did not do new knees. The surgeon was American and the operation was done by the NHS in London, then I was told, “You can go home shortly”, but they were not sure that they could trust me. When I got home, I found that every day at six o’clock two ladies turned up to give me injections in my arms and so on in case anything went wrong. Then—lo and behold!—I found, with joy, that I could walk properly, and I have been able to do so almost ever since.

With that thought in mind, I turn to the difficulty of dealing with the authorities. You make a telephone call and, before you know it, you get into the bureaucracy of receiving pieces of paper requiring you to attend another hospital appointment. I have had nearly 10 hospital visits with people wanting to check me out—they found that I had lost weight. It was the care that I received from the NHS that impressed me, as well as the fact that I can walk again. I am extremely grateful to it for what it has done for me.

NHS: Medical Competence and Skill

Lord Selsdon Excerpts

Wednesday 7th January 2015 Lords Chamber

[Lord Selsdon (Con)]

My Lords, I am most grateful to the noble Lord, Lord Parekh, for giving me an opportunity to say things that I never thought I would say. In my family, we have had many doctors but we did not do being ill. We were brought up to believe that you suffered and you lived. However, one day, we had an incident at home when I learnt about NHS 111. I dialled 111 and, in no time at all, a member of the family was advised. I went off to my first experience of A&E, which lasted for only four and half hours, and I learnt quite a lot.

Another day, to my horror, I was standing here speaking when I suddenly felt rather faint. When I went out, I nearly passed out, and when I got to my office in Millbank, the word was out and a paramedic was there. He found that he was not competent to look after me properly and, before I knew it, an ambulance arrived and then another. I was tested and overwhelmed with the overcompetence of the issue.

After that I thought that perhaps I had better register with the NHS, which was rather a pleasant exercise. The local operation was rather busy, but it thought that it might be able to fit me in because my wife was there. Since then, I have been extraordinarily impressed. You ring up and ask for an appointment. Usually you can get one within a day or, if it is urgent, more quickly. You walk there and wait for 10 minutes. You are seen for 10 minutes, and a diagnosis takes place. The e-mails go off and you are told which clinic or wherever you should go for the next stage. Then you walk down the road to the pharmacy to get your prescription, with the dog in tow.

I had not realised the significance of pharmacists, who are, in a way, linked to the NHS. I interviewed a few and found to my surprise that there are 12,000 pharmacies in the United Kingdom and that a trained pharmacist spends more time in training than a doctor. Then you realise that there is a link: almost every time you consult a doctor, you end up with a prescription that you take to a pharmacist. I have spoken to several pharmacists and to their association and have realised that there could be a much closer link between them and the medical profession.

My interest in this sector is that when I was in the financial world, I dealt with some of the newer technologies, which I have mentioned on other occasions, not least the developments in the stem cell field. I did some research into the burdens of disease in Europe. To my surprise, cardio came top at 21%, followed by mental at 20%. Down the line was cancer at only 11%. Looking at the afflictions, as one would call them, you found that heart and cancer were almost equal. One of the biggest afflictions was Alzheimer’s, which I would not know how to treat.

I thought about what can be done in the high-tech or the technological field to use the latest technology. At that time, I got involved with the Germans in working with adult stem cells. We looked at the areas of operation. I did not realise that bits out people’s hips were taken out and were injected here and there. There were problems of morality. In Germany, I spoke to Professor Strauer, who had developed some of these technologies and found that there were some religious factors against it. A meeting was held, surprisingly, with the Pope, who approved that this sort of invasive surgery was reasonable.

I am talking about myself, a complete amateur. Amateur means someone who loves his subject but probably knows nothing about it. When I introduced people for stem cell treatment, I found that it was very simple: you take something out of one part of the body and inject it into another. Before you know it, you may have cured the problem of diabetic foot. I had a great friend whose wife was suffering very badly and I asked him why he did not look at the application of adult stem cell treatment, which he did. I did not see him for a while, but when I did he said that his wife was much better. Then you get one of those moving moments in life: his wife lived for another four years. I was invited to the funeral at a church in France, at which my friend thanked me for giving them a further few years together.

When you look at some of the new technologies in health, you have to say that some are to help to cure people and some are to help to keep people alive. Health is part of the social scene. It is the interrelationship between the professions, the nurses and others. The Minister has spoken today about A&E centres. I am a leading expert on them as I have spent many hours in them waiting to collect people, looking at the nationalities of people and wondering why you need four ambulances stationed outside. The A&E situation has come to dominate the British health situation overall. Can the Minister give us an idea of how many A&E patients are now being served? What are their nationalities and what are the costs? I accept that my experience with a local health operation has been very thorough. I have a code name that I can ring. I am told that I must receive an e-mail every five minutes. I am very impressed indeed, and I thank the Minister for what he has done.

NHS: Health Improvements

Lord Selsdon Excerpts

Wednesday 26th November 2014 Grand Committee

[Lord Selsdon (Con)]

My Lords, I am most grateful to my noble friend for introducing this debate. I suppose that I am the only person here who can declare to be an unqualified amateur, but the word “amateur” means someone who loves his subject. When I was brought up, I was surrounded by four doctors in various parts of the family. I took the view that I could never be ill, because you were not allowed to be ill at that time, and that one should get on with life, but I learnt about the problem of the co-operation between the public sector, as it is called, and the private sector.

I go back to when I was quite a small chap in the 1950s. My father said, “You must learn to play golf. There’s some golf going on at the Liphook golf course”. I went down there, and there was a chap called Douglas Bader, who did not have any legs. Bobby Locke from South Africa was there, and I had never picked up a golf club at all, but Douglas was very kind to me—he showed me his legs. He took one off and waved it at me.

I forgot that partnership is what one looks at, and perhaps the greatest prosthetic partnership between medicine and commerce was Professor John Charnley back in the early 1980s. He was an orthopaedic surgeon who, together with Charles Thackray of Leeds, set up the first artificial hip replacement. In parallel, there was Uncle Archie, as I call him—Archie McIndoe, who had a very attractive wife. He was a New Zealander who came to London in 1930, could not get any work and so worked as a clinical assistant for plastic surgery at Barts. Then he was appointed as consultant to the RAF in plastic surgery, leading to the Blond MacIndoe Research Foundation at East Grinstead. As your Lordships will recall, the patients there were Hurricane and Spitfire pilots who were badly burnt. That was the start, a long time ago, of the co-operation in technology that led to the experience in skin grafts on patients who were known as “guinea pigs”. I believe that there was a smart club you could join if you had suffered, that was called the Guinea Pig Club.

I move forward now to Camp Bastion and the technology that has been developed over that period of time. There have been some very interesting developments. In the research world, we must accept that the Government and the NHS have to co-operate with the private sector. Out there, there is a private sector that is very willing to co-operate on all sorts of developments.

For many years I was a banker. Mainly because I had previously worked in a research company whose office was just above a pump in Broadwick Street that had polluted the whole of London, I got involved in water and sewage projects. In the context of hospital diseases, which were mentioned earlier, there was a company up in the north-east called Henry Cooke, which was on a river belonging to another company—I will not name it—which it did not really want. It made paper that was particularly suitable for the health service. It meant that you could put an instrument in a paper bag and then shove it in to be sterilised at a later date. It was steam-sterilisable paper, which was one form of technology. Over a long period there have been other developments in this field that make me think.

For a while, through an accident of no reason at all with a client, I became a director of Terme di Porretta, the oldest spa company in the world. Ovid wrote of our springs, “From these springs cometh forth life”. We had a problem in Bath: there was an amoeba in the water there, which meant that people could not bathe anymore. Needless to say, one word to the Italians and the whole team decided to come to London, explain that they had created the middle of Bath and put forward new proposals for drilling and things of that sort.

That led me to wonder about the impact of waterborne diseases—C. difficile and the others. I was director of a construction company. We built several hospitals. Suddenly, after having built one hospital and put in all the water systems so that people washed their hands, the NHS decided to change the rules and that you should use some form of chemicals or other things, so the water was not used. The water backed up, and we suddenly had one of the first examples of legionnaires’ disease. These are the sorts of problems that I have had in my life, but with waterborne diseases it becomes quite important. Because of the sewage thing, I ended up in the sewage business, building sewers. I got gippy tummy in Cairo and we then built sewers there, but that is another long story.

The point that I am trying to make is that co-operation with the private sector is very willingly there. In the research field, when you look at the amount of drugs that we are developing, we are a pretty successful nation. I congratulate my noble friend on what he has done.

I will not move on to the worrying business of adult stem cells, except for a brief moment. I found to my surprise that I was involved in this field with a professor from Germany who had looked at the application of stem cells for heart treatment. That was a worry. While he was a German, the Swiss were involved and they needed the support of the Vatican. So after a meeting with the Pope, the Pope shook hands and said that autologous stem cells could effectively be used for the regeneration of hearts. In this area, you look at what happens when people go out to try to buy hearts for regeneration where adult stem cells of different sorts, whether they be autologous or allogeneic, can do an awful lot of work. This is a development area that is very important.

The point is that the private sector can work very closely with government. My favourite exercise of all was when I first met the Da Vinci machine. That is a machine that I brought into the Library and everyone had a look and said, “What does it do?”, and I said, “You’d better find out from Lord Kakkar”.

NHS: Accident and Emergency Units

Lord Selsdon Excerpts

Tuesday 26th November 2013 Lords Chamber

[Lord Selsdon (Con)]

My Lords, I thank the noble Baroness for introducing this debate. I declare an interest as a director of the construction company that built St George’s. We had quite a lot of trouble with it.

I will use as my text the wonderful brief produced by the Library. I declare an interest as having been on the Information Committee. I want to draw attention to the need to separate the main A&E centres from the patient. I take the point of the noble Lord, Lord Patel, that we should look to people who have a long-term condition, and generally are aware that they have a long-term condition. We should also look at the intermediate situation of what can be done at the place of an incident.

I have used 111 three times. When I first used it, I was quite surprised that I was dealing with foreign doctors who had relatively little knowledge but terribly pleased with the enthusiasm of these people who had only been in the business for a short period of time. There was a tendency to refer someone to A&E immediately rather than to look at what care might be given closer to the place of the incident or to a person’s home. In my day we looked to the district nurse, who seems to have disappeared from real life, or the retired doctor whom we knew down the road or the pharmacist. Our pharmacists in the United Kingdom are among the best in the world. They are extremely well trained and a very good point of contact.

When calling 111, you usually receive an answer to a telephone call quite quickly, and you receive a bit of guidance and advice, but the irrevocable next step is to be taken to A&E. One or perhaps two ambulances may then arrive.

I have often worked abroad and have been privileged to benefit from A&Es in other places. I once suffered from an extremely bad upset stomach in Cairo, which ended in rebuilding the sewers, where the A&E man arrived on a moped with only one working cylinder and a flat tyre and cured me within a couple of hours. He was the doctor to the Egyptian swimming team. Egyptian doctors are really quite good and he explained to me that every one of them was trained to deal with situations on the spot.

When I was in Italy, not so long ago, there was no doctor available when someone was ill so a hotel rang the transport department. The transport department has doctors on motorbikes on call for car accidents. They turned up and sorted everything out. This seems to happen in many places. I live in France part of the time, and there we do not call the health service when there is a problem, we call the fire brigade. They like exercises and they send a small fire engine—if the patient is a woman, there will be a woman with them—and they get patients to hospitals more quickly than ambulances.

There must be further thought on this. I ask your Lordships to read the Library’s report, as that is what I would have said if I were competent to do so.