Health: Stroke

Lord Smith of Clifton Excerpts

Wednesday 23rd July 2014 Grand Committee

[Lord Smith of Clifton (LD)]

My Lords, I thank the noble Baroness, Lady Wheeler, for introducing this short debate on stroke and young people. I shall concentrate on the young victims of sickle cell disease. It is, as other noble Lords have said, one of the major causes of stroke in young people.

Until I stood down last week, I was for some years vice-chair of the APPG on Sickle Cell and Thalassaemia. When my noble friend Lady Benjamin introduced me to His Excellency the Trinidadian High Commissioner and mentioned my involvement with the APPG, he looked somewhat quizzical. I explained that as I was susceptible to many modern diseases and had succumbed to many, both actually and hypochondriacally, the one I was unlikely to suffer from was sickle cell disease and therefore it was the disease I could speak about most objectively.

When the previous Labour Government announced the creation of a lead agent for adult stroke, I asked why they had not appointed one for children. Since sickle cell is the main cause of stroke in young people, was it because the Department of Health was unconsciously institutionally racist? Consequently, the Royal College of Physicians was swiftly announced as the lead agent for stroke in young people. Is this still the position? If so, what initiatives has the royal college taken since 2010 in relation to research into or treatment of the disease? Does the RCP make regular recommendations to the department and, if so, how many times has it done this since 2010? More generally, what initiatives has the Department of Health been involved with or know about?

This is a time of rapid advancement in both cell and gene therapy. It would seem opportune, therefore, to examine what likely improvements in the treatment of and research into sickle cell disease might be attempted, especially with regard to stroke in young people. I believe that there is a crying need, as other noble Lords have said, to develop a single centre of academic excellence to further both research and treatment. Accordingly, nearly two years ago, I enquired of all the London deans of medical colleges whether they would bid to host a dedicated chair in sickle cell disease in their institutions. They replied that they would all do so. Having got their assent, I next saw the Chief Medical Officer at the Department of Health and put the proposal for a dedicated professor and supporting staff to Dame Sally Davies, who, in her previous role as a consultant, had much experience of treating sickle cell patients. Her response was not encouraging. First, she could see no need for any special funding for research in the area. Secondly, no extra money would be made available. Thirdly, in her opinion there was too weak a gene pool of worthy professorial candidates in the UK who could fill such a chair.

That third reason is a damning indictment of successive Governments and agencies such as the MRC and other research foundations. Why has there been such a lack of concern and finance? In any case, why should the search for suitable candidates be confined to the UK? British universities attract many professors across disciplines from abroad, and I am sure that a visa would be awarded to a foreign expert to come and lead research into sickle cell if he or she could be found. At a meeting in November 2012, with Anna Soubry MP as the Minister responsible to Parliament for sickle cell disease, APPG officers put the idea of a chair to her and she responded enthusiastically. Unfortunately, her follow-up letter was written by the civil servants and did not reflect this but struck a depressing note as the official departmental line.

As an index of the trends at work, it is interesting to look at the role of the MRC and its increase in spending. What MRC funds were made available in 2012-13 for sickle cell disease? There has been a modest incremental increase, which is welcome, but the trend is still increasing. To what extent is the MRC adopting a strategic approach to sickle cell? Is it encouraging a centre of excellence or does it just respond to disparate bids? One way in which more money could be found perhaps is by greater co-operation within the Commonwealth. The MRC already gives money to the University of the West Indies centre for the treatment of sickle cell, which is commendable, but funds for pioneering research into the causes of the disease are lacking. Since the incidence of this disease is high in Africa and the Caribbean, as well as in the UK—and, for that matter, the USA—I urge Her Majesty’s Government to seek collaborative funding within the Commonwealth to secure adequate financing or research. Does the Minister agree?

Health: Stroke Care

Lord Smith of Clifton Excerpts

Monday 4th July 2011 Lords Chamber

[Lord Smith of Clifton]

My Lords, with regard to stroke in young people, what specific policies is the Minister’s department pursuing, particularly bearing in mind that most strokes in young people are caused by sickle cell disease?

[Earl Howe]

My noble friend makes an extremely important point about strokes in young people. It is of course true that, thankfully, fewer young people suffer these strokes, but he is right that sickle cell presents a warning sign. There are clear guidelines for ambulance crews and doctors more generally relating to those who have sickle cell disease. We had a debate a while ago on this topic in which the noble Baroness, Lady Benjamin, made some extremely important points which we continue to bear in mind.

Health: Isle of Man

Lord Smith of Clifton Excerpts

Monday 14th June 2010 Lords Chamber

Asked By

[Lord Smith of Clifton]

To ask Her Majesty’s Government when they will decide whether to continue or cancel their reciprocal healthcare agreement with the Isle of Man.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, the current reciprocal healthcare agreement between the United Kingdom and the Isle of Man is due to end on 30 September 2010. My right honourable friend the Secretary of State will consider this matter, in consultation with other relevant parties, in good time to reach a decision by September.

[Lord Smith of Clifton]

My Lords, I thank the Minister for that reply. At the British-Irish Parliamentary Assembly plenary last March, it was unanimously resolved that the Government should continue with the reciprocal healthcare agreement. It would be very ageist if that agreement were rescinded, because people such as me—I declare an interest—could not get the personal health insurance that would be needed to go to the Crown Dependencies. Is this not a form of discrimination which is totally unacceptable?

[Earl Howe]

My Lords, it might be helpful if I were to clarify the current position. If the noble Lord were to go the Isle of Man, the agreement in place at the moment would enable him to receive emergency healthcare there—that is, healthcare that is immediately necessary—free of charge should he need it. The only reason for requiring travel insurance in addition would be to cover the cost of, let us say, an air ambulance back to the mainland or any extra costs that were non-medical arising out of the emergency. In that sense, the Isle of Man is no different as a travel destination than, let us say, the United States.