NHS: Long-term Sustainability

Lord St John of Bletso Excerpts

Thursday 18th April 2024 Lords Chamber

[Lord St John of Bletso (CB)]

My Lords, I join others in thanking and congratulating my noble friend Lord Patel on introducing this topical debate, and in congratulating the noble Baroness, Lady Ramsey, on her very moving maiden speech.

As the last to come to the crease before the closing speeches, I shall be very brief, and just make a few observations. I come to this debate not as a medical expert, though like my noble friend I suffer from peripheral neuropathy, but for the past 20 years I have been a company doctor, fixing companies large and small, though not on all occasions helping them to become more efficient and profitable. My first observation on the NHS is the apparent failure of effective leadership. I know many GPs, specialists and junior doctors, and one junior doctor I spoke to yesterday commented that he had been on strike not just because of the money but because he and others felt disfranchised.

We live in an exciting time of digital transformation and artificial intelligence, and we are seeing huge advances in quantum computing. By analysing vast amounts of medical data, including electronic health records and genetic information, we can uncover patterns, predict outcomes and improve diagnosis and treatment. Ultimately, however, the focus must be on effective, adaptable and accountable leadership. There is a danger that many in the medical fraternity are too focused on following protocols rather than guidelines and get bogged down in red tape.

I recently read the book, 2030: The Future of Medicine by Professor Richard Barker, a specialist in longevity research. I mention as an aside that it is my noble friend Lady D’Souza’s 80th birthday today—happy birthday. At 80 in your Lordships’ House, she is but a youngster. The observations that Professor Barker made when he wrote this book in February 2011 pertain as much today as they did then. In essence, he called attention to the need to re-architect the NHS and provide more effective time management to NHS GPs. Many GPs complain that they spend far too much time on administration and far too little time using their medical skills to diagnose and treat acute conditions. In this regard, a lot of elderly patients are not getting the treatments that they need and deserve. One of his observations was the need to focus on preventative medicine. We have seen huge advances in oncology and cardiology, but a lot more can and should be done on preventive medicine, including more focus on tackling obesity, on gut health and on lowering cholesterol.

The noble Baroness, Lady Blackwood, spoke very eloquently on the profound impact of genomics on personalised medicine. With the ability to sequence entire genomes rapidly and affordably, we are entering an era where treatments can be tailored to an individual’s genetic make-up, leading to far more effective, targeted therapies.

Time precludes me from debating the need for more effective procurement within the NHS. A huge amount could and should be done to save costs through shared services. I agree with my noble friend Lord Kakkar that the long-term sustainability of the NHS is a joint effort and requires commitment from all stakeholders—the Government, healthcare professionals, patients and the public sector. Will the Minister, in winding up, advise us as to what measures have been taken to conduct a global best-practice study on the long-term sustainability of public healthcare? I agree with the excellent suggestion of my noble friend Lord Warner of assimilating the Singapore healthcare system.

In conclusion, there are a lot of positive developments in the NHS and people should be congratulated and appreciated for their hard work, but my call is a simple one: we need to focus on effective and adaptable leadership, on effective procurement and on patient care; and to continue to focus on prevention. More funding in the NHS does not necessarily solve the problem. We need to get smarter.

Plastics: Health Research

Lord St John of Bletso Excerpts

Monday 19th December 2022 Lords Chamber

[Lord Markham (Con)]

Again, the research bodies are very happy to look at any good proposals. The only place I would disagree with this is on whether you would want to ring-fence a certain amount to a space when you do not know whether there is a health risk there. Therefore, if there are good research proposals, we are definitely ready to take that forward. I will caution against some of the quotes where they are based on a sample size of 22 people, in terms of the common-sense study. That is why we place caution on this, but if there are good research proposals, I say: absolutely, please bring them forward.

[Lord St John of Bletso (CB)]

My Lords, while welcoming the plastic packaging tax in April this year, I noted an alarming OECD report recently that plastic waste entering the oceans is set to treble in the next 40 years. What are our Government doing to fund credible plastic alternatives so as to mitigate the problems at source?

[Lord Markham (Con)]

I understand that this is part of the £500 million Blue Planet Fund that we put in place to help developing countries support the marine environment, and we are a contracting party to the OSPAR convention to participate in marine-limited monitoring programmes.

Health and Social Care Update

Lord St John of Bletso Excerpts

Monday 22nd March 2021 Lords Chamber

[The Deputy Speaker (Lord Haskel) (Lab)]

The noble Baroness, Lady Blackstone, and the noble Lord, Lord Lucas, have both withdrawn, so I call the noble Lord, Lord St John of Bletso.

[Lord St John of Bletso (CB)]

My Lords, I would like to probe the Minister outside the question of the vaccine supply and its admirable rollout. While welcoming the Government’s workplace testing scheme, in which lateral flow tests will be given to businesses until the end of June, what established workplace testing infrastructure is in place? What measures are being taken to ensure the high uptake of this strategy and that it is as safe and accurate as possible?

[Lord Bethell (Con)]

The noble Lord is entirely right to emphasise this incredibly important aspect of our toolkit to manage infection rates down. The workplace is an area of infection threat and asymptomatic testing is a way to keep workplaces safe. We have put in place until the summer the free provision of lateral flow tests for those who wish to do workplace testing, and we are looking at ways in which we could potentially extend that, particularly in circumstances where the infection rate crept up again. We are working very closely with BEIS colleagues to look at the kind of regime that would be necessary. I pay tribute to DfT colleagues who have trail-blazed this area with the test to release programme, which uses private testing capacity for that important transport corridor, and to colleagues at UKAS who have put in place the accreditation necessary to create an independent, private ecology of the kind that the noble Lord refers to.

Health Protection (Coronavirus) (Restrictions) (England) (No. 4) Regulations 2020

Lord St John of Bletso Excerpts

Wednesday 4th November 2020 Lords Chamber

[Lord St John of Bletso (CB)]

My Lords, I am in favour of the amendment moved by the noble Lord, Lord Robathan. I seriously question why it is necessary to have a nationwide lockdown when the three-tier system was working well in many regions. Clearly, the Government were put into an impossible predicament by the dire warnings from SAGE and several scientific institutions that base their conclusions on worst-case scenarios. As the noble Lord rightly mentioned, there have been many disagreements among the scientific community. The fear and hysteria were hyped up by many in the media. Why, as the noble Lord, Lord Forsyth, has asked, was there not a cost-benefit and risk analysis?

As several noble Lords have mentioned, the King’s College Covid symptoms app, based on 4.3 million contributions, shows clearly that while cases are still rising across the UK, they have not spiralled out of control and the R value is just above one. There is clear evidence that the tier 3 restrictions in Liverpool and in the north-east have had a positive impact. Why did we not have tier 4 restrictions and regional lockdowns, which have been highly effective in other parts of the world such as Australia?

Businesses both large and small have acted responsibly in respecting social distancing, the wearing of face masks and strict hand-washing measures. This second lockdown will devastate many businesses and, inevitably, take us into a double-dip recession, destroying jobs and adding to the problems of anxiety, depression and domestic abuse.

I dread the long-term repercussions of the huge debt that will have to be repaid, predominantly by the younger generation. What will this lockdown cost? We seem to be reacting purely to bad news. In most cases, except long Covid, the recovery period is a matter of a week. I say this having had Covid. Apart from a dry cough for a few days, I recovered in no time at all. My 93-year-old mother-in-law has just recovered from Covid within two weeks. The treatment of Covid patients has hugely improved. We have over 250 vaccines under development globally.

While death rates are running at 10% above the seasonal average, death rates from Covid compared with earlier in the year have come down considerably. We all knew there would be a second wave. The NHS had seven months to prepare for it. What evidence does the Government have that the NHS cannot cope? The Government are using a sledgehammer to crack a nut and allowing the tail to wag the dog.