NHS: Junior Doctors’ Pay

Debate between Lord Walton of Detchant and Lord Prior of Brampton

Wednesday 27th January 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, yes; the Secretary of State takes this matter incredibly seriously, and as part of the contract that is under negotiation with the BMA at the moment we are looking very much at the number of hours that junior doctors have to work. Many have worked for too many hours in the past and we want to put a cap on the number of hours they will work in future.

[Lord Walton of Detchant (CB)]

My Lords, I declare an interest as in 1950 I was elected chairman of the BMA’s Registrars Group, the predecessor of the present Junior Doctors Committee. I express the fervent hope that the current negotiations between the BMA and the Government will quickly be concluded to the satisfaction of both parties. In my view and in the view of many doctors it is a matter of considerable concern that there is a suggestion of further industrial action, which is inimical to the ethos of a caring profession. Will the Minister accept my view that the alleged threat by the Secretary of State to impose a new contract of employment on all junior doctors without agreement is outrageous?

[Lord Prior of Brampton]

My Lords, I think the whole House will agree with the noble Lord that we all very much hope to avoid another strike. The Secretary of State has asked David Dalton, the very distinguished chief executive of Salford Royal—the noble Lord, Lord Turnberg, will know him extremely well—to head up those negotiations with the BMA, and we are very hopeful that a conclusion to this dispute will be reached before there is any more strike action.

Health: Liver Disease

Debate between Lord Walton of Detchant and Lord Prior of Brampton

Wednesday 9th December 2015 Lords Chamber

[Lord Prior of Brampton]

My Lords, there was quite a lot in that question. Some 6,000 babies suffer from foetal alcohol syndrome and it is a shocking and appalling by-product of alcohol. Canada has increased the floor price of alcohol and I understand it has seen some reduction in alcohol-driven disease as a result of that. We are watching what happens in Canada carefully. Of course, Scotland is considering a similar move although it is awaiting the outcome of a court case in the European Union. I gather that Wales will possibly follow suit if that court case goes accordingly. We will watch what happens in those other countries, study it and then make up our minds accordingly.

[Lord Walton of Detchant (CB)]

My Lords, my former medical colleagues in Newcastle upon Tyne, including several distinguished hepatologists are gravely concerned by the increasing incidence of alcohol- induced liver disease in young people. The problem is that in Newcastle—in the centre of the city and on the quayside—many organisations sell what are called, “cheap shots” with a very high alcohol content. Surely the time has come, yet again for the Government to give urgent consideration to the introduction of a statutory minimum price per unit of alcohol.

[Lord Prior of Brampton]

My Lords, there are strong arguments for minimum unit pricing. However, other consequences might flow from minimum unit pricing to do with illicit alcohol sales and the fact that the cost of that would fall very heavily on those least able to afford it. As I said earlier, it will continue to be kept under consideration by this Government and we will study with great interest what happens in other countries which are introducing minimum unit pricing.

Health: Adult Pneumococcal Vaccination

Debate between Lord Walton of Detchant and Lord Prior of Brampton

Tuesday 8th December 2015 Lords Chamber

[Lord Prior of Brampton]

My Lords, the principal role for pneumococcal vaccination—the subject of the Question—lies with GPs. Take-up of the PPV for those aged over 65 is 70%; for those aged over 75, it is 80%. For young children, the rate is more than 95%.

[Lord Walton of Detchant (CB)]

My Lords, one of the great advantages of the pneumococcal vaccination programme is that it is widely believed that a single injection gives lifelong protection—or at least substantially lifelong protection—against pneumococcal pneumonia and pneumococcal meningitis. Is the Minister satisfied that that is still sufficient?

[Lord Prior of Brampton]

My Lords, the noble Lord knows far more about this than I do. I can tell him that the PCV 13 vaccination for young children provides long-term protection and, as importantly, prevents the disease spreading. The PPV—the polysaccharide vaccination provided to older people—does not have the longevity of PCV 13, but it provides wider protection against 23 of the serotypes, rather than 13. It does not provide the length of protection that PCV 13 does, but it still provides some protection.

Health: Post-polio Syndrome

Debate between Lord Walton of Detchant and Lord Prior of Brampton

Tuesday 20th October 2015 Lords Chamber

[Lord Prior of Brampton]

The noble Lord is right that there is no specific pathway for people suffering from post-polio syndrome. NHS England will approach this on the basis of all long-term conditions rather than segmenting them by individual disease categories. I will be very happy to meet with him outside the House to discuss this.

[Lord Walton of Detchant (CB)]

My Lords, is the Minister aware that the poliomyelitis virus attacks the nerve cells in the brain stem and spinal cord which give origin to the nerves that control the movement of the muscles, and, hence, that if these cells are killed, the result is paralysis of the relevant muscles? Several authorities believe that in an acute attack of poliomyelitis, certain nerve cells are damaged but recover, only to die prematurely some years later, thus causing the post-polio syndrome of progressive muscular weakness. Would not one important strategy be to have a graded exercise programme to try to increase the power of those muscles that retain a viable nerve supply?

[Lord Prior of Brampton]

The noble Lord is much better informed about this than I am, and of course I agree with him 110%. However, there are other aspects to treating this pernicious illness; clearly pain relief is important. It raises the issue that GP practices having a multidisciplinary team—physios and people who are experts in mobility, orthotics, pain relief and exercise—is very important.

Local Authorities: Public Health Budget

Debate between Lord Walton of Detchant and Lord Prior of Brampton

Wednesday 15th July 2015 Lords Chamber

[Lord Prior of Brampton]

I shall give a short quote from the Prime Minister:

“when you look at the costs of obesity, smoking, alcohol and diabetes, we know we need a completely new approach to public health and preventable diseases. A real focus on healthy living. That’s why it’s at the heart of the plan”;

that is, the Five Year Forward View. We accept that prevention is extremely important. This reduction in spending is £200 million out of a grant for local authorities of £3.2 billion—a reduction of about 6%. Local authorities have demonstrated in many other areas an ability to extract savings. I am sure they will do the same in this case.

[Lord Walton of Detchant (CB)]

My Lords, I am not the only doctor to have expressed some reservations when the Health and Social Care Act decided to transfer funding for public health from the National Health Service to the local authorities. Do the Government now regret that decision in the light of the problems highlighted in the Question—particularly at a time when public health is facing enormous challenges, not least due to the obesity epidemic and the alarming increase in the incidence of type 2 diabetes?

Prisons: Mental Health

Debate between Lord Walton of Detchant and Lord Prior of Brampton

Wednesday 24th June 2015 Lords Chamber

[Lord Prior of Brampton]

I thank the noble Lord for his two questions. On the first, about coding, it is very important that we get the tariff right and that it does not become just another measure of activity but that outcome is built into that tariff. Paul Farmer, the chief executive of Mind, is preparing a report for NHS England, which will include proposals for the tariff and payment systems. That will include health in prisons as well as outside prisons.

The second question was about the standards issued recently by the Royal College of Psychiatrists. The noble Lord, Lord Bradley, in his foreword to The Bradley Report Five Years On, referred to the importance of having a national blueprint, which of course is now possible given that NHS England is the commissioner of specialist services throughout the country. I will also draw those standards to the attention of Paul Lelliott, the chief inspector of mental health within the CQC. I am sure that the CQC will wish to incorporate those standards into its inspection regime

[Lord Walton of Detchant (CB)]

Can the Minister say what qualifications are now required of doctors who are recruited to work in prisons? Can he further say what proportion of those who are now employed to work in prisons have had formal psychiatric training?

[Lord Prior of Brampton]

I thank the noble Lord for that question. I hope he will think it acceptable if I reply to him in writing after this session.