(2 years ago)
Lords ChamberMy noble friend is correct, of course. GPs have always been independent businesses, and that is the backbone of the service. We have managed to increase the number of GPs by 2000 since 2019, but we all accept that more needs to be done to attract them, especially to the key areas that my noble friend mentions. We have a £20,000 bonus in place to recruit GPs to those difficult areas and, most importantly, we have a record 4,000 GPs in training.
My Lords, is it not a national scandal that someone can purchase a building for £1 million, they can locate health services in there, they can get the NHS to pay the mortgage on that building and at the end of that period, that person owns that building? In other words, we have transferred £1 million from the taxpayer to an individual.
I think it was the noble Lord opposite who introduced patient choice. That looked to the independent sector to increase supply, which is what we care most about. I do not believe that anyone should be fundamentally against who owns a business. What they should care most about is the supply of good-quality services.
(2 years, 2 months ago)
Lords ChamberClearly, I am always going to support good dialogue—that is common sense, and we should do that. The proof of the pudding is in the eating, and 88% is a very good result. That notwithstanding, clearly it makes sense that they should work closely with local officials as well.
As I say, compared with 93% in the UK population—who have many bites of the cherry, for want of a better term, because there are many opportunities for them through schools and everything—88% is very good. Is it perfect? No, but it is very good and definitely better than anywhere else in Europe.
(2 years, 3 months ago)
Lords ChamberI thank the noble Lord for his contribution, as ever. Yes, absolutely; these things always have to be resolved around the table. As I say, I am pleased that we are making good progress with nurses and ambulance workers, and I hope we can get around the table and make more good progress with GPs as well.
My Lords, there is a shortage of nurses, a shortage of doctors and a shortage of ambulances. What have the Government been doing for 13 years to let this crisis happen?
Noble Lords will be aware that this is a situation facing people all around the world. Just today I was being grilled by a Select Committee talking about the problems in Stanford in California, where people were having to wait 48 hours to go from A&E to get to a bed. It is a worldwide issue.
(2 years, 4 months ago)
Lords ChamberAs has been mentioned many times, the workforce strategy is key; being able to recruit and retain staff, and pay, are vital elements of it, so I accept the challenges in this space. At the same time, I am mindful that we have sought to protect the lowest paid through these increases, as I mentioned. I am confident that the new pay review body, which is coming up, will seek to take the inflationary pressures into account to make sure that there is a fair settlement for everyone.
My Lords, why are the Government hiding behind the pay review body? When it looked at wages for the health service, inflation was running at 4% or 5%. We have just heard that food inflation is now running at 16%. Will the Government think about this again and ask the pay review body to look at the facts now?
Again, April is very close; the pay review body will be looking at the facts then. The noble Lord is quite correct that the real change is inflation, and that is why the priority for all of us has to be to reduce inflation. It is pernicious in its impact on every single one of our pockets, and most of all on those people with the least money. That has to be the priority, but we will continue to support these people.
(2 years, 5 months ago)
Lords ChamberYes, this is absolutely something that we talk to our Home Office colleagues about all the time. I believe that 15,000 people have already come through on this route in the last nine months or so; we are seeing a rate of about 1,500 a month. It is very important and something on which we are focused.
My Lords, rather than bringing in people from abroad, would it not be more effective to pay our own people proper wages with proper conditions, so that they want to work in this sector?
(2 years, 5 months ago)
Lords ChamberI thank my noble friend. The best ICBs that I have seen have the local authority as part of their board and their decision-making on a day in, day out basis. One of the best control systems that I saw in an ICB actually had the local authority social care people in the room making the decisions with them, so they are a key element in all of this. On purchasing and funding, they are very much a strong player.
The Government have spent 13 years cutting the number of beds and they are now reversing that and starting to increase it, which is welcome. The other thing that they have done is to constrain pay in the NHS and social care. They have an opportunity to do something about that. Why are they not taking the opportunity to boost pay in both those sectors to address some of the problems that we face?
I welcome what I hope, over the past few days, has been better mood music—let me put it that way—in this space. I hope from the different things that we see that we will get closer towards a landing zone where we can reach agreement going forward. We know from both sides that neither side wants to be in this dispute. My hope very much is that constructively—with good will on both sides, which we are seeing—we will find a way forward.
(2 years, 7 months ago)
Lords ChamberI thank the noble Baroness. If I have used a poor choice of words, I apologise. What we are looking at is identifying the areas where we most need to focus resources to solve wait times. That might be because it is a rural area or it might be, candidly, because it is not performing so well. The point that I was trying to make is that there is targeted support. We spent £150 million on ambulance performance and new facilities last year, and it is something that we will continue to do if those rural areas and other areas need the spend.
My Lords, will the Minister deal with the issue of 18 weeks? Are the Government still committed to that policy? If they are, when does he think it will be achieved?
We are committed to timely appointments. The whole point about the community diagnostic centres that were set up—and we have set up more than 90—is so that patients can be referred straight to those centres and get their screening and tests straightaway, getting them more quickly and, I hope, getting peace of mind more quickly as well.
(2 years, 11 months ago)
Lords ChamberThe department has been reviewing the Hodges review and has been looking at the method of data collection. At the moment, I cannot comment on the significance of the statistics in the report, but the important thing here, I think, is that once again we are asking the industry to come forward. It can fund the trials—it can afford this—but for some reason it prefers to sell it unlicensed.
My Lords, just to clarify the point that the Minister made, that it is not for him to tell doctors what medicines to prescribe, is he really saying that if doctors are failing to give their patients the proper and adequate medicines—the only medicines that work—there is nothing he can do?
These are left to clinical decisions, and it is up to individual doctors. Some doctors believe that the evidence is not there to prescribe it; other doctors believe that it is there and they would like to prescribe but they go to their local CCG or elsewhere and they are not given permission or access. What we are trying to do is make sure that there is sufficient evidence, but we really need the companies to come forward. If I can make one appeal to noble Lords, if anyone contacts them from the industry, ask them to come forward and go through the trials.
(3 years ago)
Lords ChamberThe noble Lord makes an important point, and the fact is that if some patients do stay in hospital too long, they can lose control of certain faculties and see muscular deterioration. So it is our priority to ensure that people discharge safely, as quickly as possible, to the most appropriate place. Local areas should work together to plan and deliver hospital discharge, and the department is working with NHS England, NHS Improvement, local government and social care providers to monitor and understand the underlying causes and do something about them.
My Lords, the Government say this is a long-term problem, but they have been in power now for 10 years. What have the Government been doing to address this issue, bearing in mind that Andy Burnham identified this as a problem and was attacked by the Front Benches when he put forward some suggestions on how they could deal with it? This is a crisis made by this Government.
I am afraid I will have to humbly disagree with the noble Lord, because this has been a problem for subsequent Governments, as we discussed during the passage of the Health and Care Bill. In some cases we can see reports going back 50 years. What has happened over the years is that Labour, Conservative and coalition Governments have put those reports on shelves to gather dust. We were the first Government to introduce an integrated health and care system and to grasp the nettle.
(3 years, 1 month ago)
Lords ChamberI thank the noble Lord for the question, which cuts across three of the priority areas in my ministerial portfolio: data sharing, the life sciences industry—in which clinical trials and research play a huge part—and international collaboration. It is really important that we continue international collaboration. However, one of the challenges we face is that we have to make sure that patients are comfortable with researchers having access to their data. As part of that work, we have called in civil liberties organisations to help us along that journey. So, while we encourage more people to share data, we have to make sure that they have those protections. We can have the best systems in the world, but, if people opt out, they are useless.
My Lords, many families of children with cancer have to travel a long distance to get treatment for their child. Those families face financial problems. Will the Government do more to help families who have children with cancer and who are feeling financial pressures because they need to travel and cannot continue to work because of the pressure the family is under?
The noble Lord makes an incredibly important point about support. One of the things we are looking at in the research is how to help not just the patient but their family and their wider support network. I will take his specific question about assistance back to my department and write to the noble Lord.