Paramedic Services

Lord Tugendhat Excerpts

Monday 4th July 2022 Lords Chamber

[Lord Kamall (Con)]

The noble Baroness will know from the debates that we had during the passage of the Health and Care Bill that there is a 15-year plan; Health Education England has been tasked with that. In addition, significant amounts of things are being done at the local trust level, so it is not just a sort of five-year, top-down Soviet-type plan but is looking at recruitment at a local level. There is also a national discharge task force that works with national and local government and the NHS to identify long-term sustainable changes which could reduce delayed discharges and ensure that patients are in hospital only for as long as they need to be.

[Lord Tugendhat (Con)]

My Lords, what role does the Minister think the police might have to play in this? Last Wednesday I was knocked down in Great George Street by a bicycle and rendered unconscious. Although a paramedic arrived from St Thomas’ by bicycle quite quickly, there was no ambulance. I was very grateful to the police for taking me into St Thomas’ and depositing me at the A&E. That was very helpful, and I wonder whether the Minister thinks that might happen more often.

[Lord Kamall (Con)]

I thank my noble friend for sharing that experience, and it is good to see that he has recovered and is able to ask the question. One interesting thing that is being looked at as part of the overall review—again, we have to be very careful about unintended consequences—is how many of these cases can be treated at the scene without requiring the patient to be taken to hospital. That will need careful thought as it is a difficult trade-off. In this case, clearly, they were looking at the possibility of someone else taking my noble friend to hospital, and he was fortunate that there was a police officer nearby who was able to do that. However, with any of these interventions we have to be careful and make sure that we are fully aware of unintended consequences that could make things worse.

Covid-19: Restrictions

Lord Tugendhat Excerpts

Monday 14th March 2022 Lords Chamber

[Lord Kamall (Con)]

It is interesting that, when I was talking to some of the modellers and scientists about this, they said that whenever they look at models of changes in behaviour, they count in or consider that there will be some uptick because of people relaxing measures. Even though we are moving from a position where it was legal to where it is guidance, they reckon that number in, but they still felt that it was not significant enough not to go forward with the change in strategy.

[Lord Tugendhat (Con)]

My Lords, further to the question of my noble friend Lord Cormack, I have already received a summons for my fourth jab. My impression is that, in west London, the programme has been set up and will be working quite satisfactorily. I will be having my fourth jab tomorrow week.

[Lord Kamall (Con)]

Well, there we are: there is a result already—please never accuse me of working too slowly. In that case, it is quite clear that there is a programme, and I shall find out more details.

Queen’s Speech

Lord Tugendhat Excerpts

Thursday 9th January 2020 Lords Chamber

[Lord Tugendhat (Con)]

My Lords, the noble Lord, Lord Bichard, speaks very wisely with the voice of experience, and I hope very much that Ministers will pay attention to what he has just said. Notwithstanding the note of realism that he has injected into our debate, at the moment we are in a time of hope. The Government have a large majority and they can plan ahead in a way that has been impossible for Administrations in recent years. In that context, the role of the House of Lords is clear. We must accept that the Government have a mandate and we must offer our revisions, criticisms and advice not only in a constructive spirit but in a way that is designed on the one hand to improve legislation and on the other to enable the Government to avoid mistakes. I hope that Ministers will accept the revisions, criticisms and advice that we offer in that spirit.

I will deal with just one particular point in the Government’s programme: their aim of improving competitivity, productivity and prosperity in the north of England. In that connection, I welcome what I read in the press of the Treasury’s plans to reassess criteria for calculating the value for money of government investment in transport and infrastructure, away from focusing on overall national economic growth and towards improving the well-being of people in the north of England and, I hope, other regions as well. This follows a recommendation of your Lordships’ Economic Affairs Committee, chaired by my noble friend Lord Forsyth, of which I am a member.

In giving my support wholeheartedly to that programme, I raise a few issues. One is that if the Government’s ambitions for the north—and, I hope, other regions—are to be effective in the long run, they cannot all be controlled from London. There will have to be more devolution of decision-making. That may well pose difficulties.

Secondly, where possible, efforts must be made to ensure that locally based SMEs are allocated contracts in the procurement process. When one looks at the record of government in this respect, it is striking that, on the whole, locally based SMEs do not share substantially in some of the plans introduced and executed so far.

Thirdly—I speak under the surveillance of my noble friend Lord Forsyth from Scotland—I wonder whether there is not more we might be able to do for Scotland. Under the SNP Government, Scotland is falling behind England in a number of respects. It will also lose the funding it enjoys at present from the various European funds, in particular the regional fund. I wonder whether there might not be scope for the UK Government to step in and provide further assistance on public expenditure in a way that the European funds have hitherto done.

Finally, I regret the Prime Minister’s election pledge not to raise income tax, VAT or national insurance—not because I want to see them go up, but because I believe that if the Government are to achieve their wider economic and social aims and to deliver to those who, as the Prime Minister has put it, have lent the Conservative Party their votes, higher taxes may well be required. I believe the public are ready for that; they want better public services and better infrastructure. If higher taxes are the price, they are willing to pay. As the old saying goes: “To govern is to choose.” I hope that if the Government have to choose between their broader social and economic aims on the one hand and higher taxes on the other, the former will win out. I believe that is what the country wants.

Nurses: Tuition Fees

Lord Tugendhat Excerpts

Wednesday 29th November 2017 Lords Chamber

[Lord O'Shaughnessy]

I obviously have not been clear enough; I thought that I had. The answer to that is that we are not considering that at the moment.

[Lord Tugendhat (Con)]

My noble friend is explaining the policy very eloquently, but surely he ought to take into account the point raised by my noble friend Lord Forsyth. The problem is that the way the scheme works disincentivises people from entering occupations that are extremely socially desirable and much needed by the country precisely because they are going to be loaded with debt. Although they do not in the end pay it off, it bears very heavily on them during their working lives.

[Lord O'Shaughnessy]

The system that we have means that the people who benefit most from higher education are those who pay for their higher education and, in doing so, they subsidise those who go into the professions that my noble friend has mentioned, which are extremely worth while but might not be that well paid.

NHS: Shared Business Services

Lord Tugendhat Excerpts

Tuesday 27th June 2017 Lords Chamber

[Lord O'Shaughnessy]

I take the noble Lord’s advice very seriously. Indeed, I note that he, as a former Secretary of State for Health, understands what is going on and the dynamics within the department. I would say only that the NAO report has described a set of actions that have taken place and why they have taken place. It has described the decision-making process, which is why the Statement responds to the content of the NAO report as it was set out today.

[Lord Tugendhat (Con)]

Could I press the Minister further on shared costs? Why is the company paying only some of the costs? Is the NHS paying the rest of the costs or is there some other body, public or private, that is going to put up some of the money? It is difficult to understand why the company is not paying the whole of the costs.

NHS: Junior Doctors’ Contract

Lord Tugendhat Excerpts

Wednesday 6th July 2016 Lords Chamber

[Lord Prior of Brampton]

It is worth noting that the Royal College of Surgeons and the Royal College of Physicians, and I think most of the other royal colleges, have supported this contract. Many of the leaders of the BMA supported this contract. As I said, the Secretary of State has specifically said in a statement today that his door is always open when it comes to issues around implementation. The plan is to implement this contract after the first foundation year 1, when doctors complete their first four-month rotation in October and November.

[Lord Tugendhat (Con)]

My Lords, is it not worth pointing out at this time of great economic uncertainty that there are many people in this country whose jobs are at risk, and there are other people whose pensions are uncertain, as we have seen particularly in the case of BHS? Is it not, therefore, the case that junior doctors should reflect on the fact that they have no fear of redundancy and that their pensions are safe?

[Lord Prior of Brampton]

My Lords, I am sure that junior doctors will reflect on the new economic situation in which we find ourselves, and I hope very much that they will not resort to the strike action that has been taken in the past.

Sugar Tax

Lord Tugendhat Excerpts

Wednesday 3rd February 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, public procurement certainly has a role to play in tackling obesity. I am sure that that is one of the issues that will be addressed in the forthcoming strategy.

[Lord Tugendhat (Con)]

Does my noble friend agree that taxation, along with other measures, has played a significant role in diminishing the consumption of tobacco in this country over the years? Is it not therefore rather strange that the Government should be so reluctant to make more use of this weapon with regard to obesity?

[Lord Prior of Brampton]

My Lords, we have to be careful, or at least recognise, that if a sugar tax were imposed it would fall largely on those who are least able to afford it. There is of course a strong argument for a sugar tax, but there is also a case for making the argument against sugar consumption and making it easier for people not to consume sugar before we resort to taxation.

Junior Doctors Contract

Lord Tugendhat Excerpts

Monday 30th November 2015 Lords Chamber

[Lord Prior of Brampton]

I thank my noble friend for those comments. One of the issues often raised by junior doctors is that they do not always feel properly supported at weekends. I think that having more seniors available at weekends—and late at night, for that matter—will be welcomed by junior doctors. There is also sometimes a misunderstanding in the public mind, as junior doctors can actually be quite senior doctors. A medical registrar is, by most standards, a senior doctor so junior doctors are not just people who have recently finished their training.

[Lord Tugendhat (Con)]

My Lords, does the Minister agree that during the build-up to this strike, which has now happily been called off, a great burden was put on to the shoulders of the NHS management? It is often much maligned and compared unfavourably with the doctors and nurses and other medical staff but, once again, the management staff have shown their ability to rise to the challenge. I hope that the Minister might feel it appropriate to give them a word of praise.

[Lord Prior of Brampton]

I am delighted to do that, having been the chairman of an NHS trust for 12 years myself and knowing that my noble friend was chairman of the Imperial NHS trust and that the noble Lord, Lord Hunt, who is opposite, was chairman of the Heart of England NHS Foundation Trust. Given the pressure and stresses on management and the complexity of its day-to-day role, I think that no other organisation is as challenging as a large acute hospital. Managers have to do their work in the full glare of publicity as well and it is extremely difficult, so I certainly join my noble friend in paying tribute to the extraordinary work that many of them do in the NHS.

NHS: Cost-effectiveness

Lord Tugendhat Excerpts

Monday 12th September 2011 Lords Chamber

[Earl Howe]

I agree with the noble Baroness. One of the aims of our reforms is to integrate health and social care in a much more seamless way. There is another element to our reforms, which may have escaped noble Lords' notice. It is our wish to bear down on health inequalities in a much more systematic way than we have done hitherto. Both health and social care have a part to play in that.

[Lord Tugendhat]

My Lords, I declare an interest as chairman of the Imperial College Healthcare NHS Trust. Does my noble friend not agree that whenever an international organisation such as the OECD or the IMF has good words to say about the conduct of the British economy, the Chancellor of the Exchequer always welcomes them and uses them as an argument to support the Government’s economic policy? Would it not be helpful, when other organisations have good words to say about the NHS, for the Government to welcome them with equal fervour? Of course the NHS can improve and must modernise and move with the times; but when significant institutions such as the Commonwealth Fund in America, and the one that has just been quoted, have good words to say about the NHS, surely the Minister should be less carping.

[Earl Howe]

My Lords, in my opening words I said that we welcomed the report. I stressed that we fully acknowledge the improvements that have been made by the NHS over the past few years, which the report highlights. However, it is limited in its scope. The difficulty with all these reports is comparing like with like, particularly with different health systems. I am not decrying the work that went into the report, but I will say that perhaps some OECD reports take us closer to how well the UK's health system is performing in relation to those of other countries.