Inflammatory Bowel Disease

Debate between Lord Watts and Lord Markham

Monday 20th May 2024 Lords Chamber

[Lord Markham (Con)]

We had a very good debate on this a couple of weeks ago. All noble Lords accepted that it was a bit of a Cinderella service at the moment, but vitally important to a lot of people’s everyday well-being, so I am happy to do that.

[Lord Watts (Lab)]

My Lords, is the Minister monitoring what is happening in Europe and the US to see whether we can learn any new lessons from the research programmes that are being carried out there?

[Lord Markham (Con)]

The Getting It Right pathway was very much informed from that best practice around the world and, in the last year, NICE has approved four new drug treatments. We are trying to look at the best medicines around the world. One of them, risankizumab, has resulted in a 44% reduction in the disease—so, yes, we are trying to learn from the best in the world.

Immunisation: Children

Debate between Lord Watts and Lord Markham

Wednesday 8th May 2024 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend for the question. Actually, it is not just asylum seekers; it is often migrant groups full stop. Their communities or the countries they have come from often do not have the same level of vaccination programmes. It is part of the check we try to give people as they come into the country, and something we ask GPs to look out for, so that we can get them in a catch-up programme. A lot of the work we are doing on outreach is also particularly focused on those communities.

[Lord Watts (Lab)]

My Lords, is it not the case that we need to make the case for public health, and that our public health policy is determined by parents getting their children vaccinated? Do we not need to make the case that they put their own and other people’s children in danger unless they comply with vaccination?

[Lord Markham (Con)]

Yes, absolutely. Unfortunately, we are all aware of the Wakefield effect on the MMR vaccine. That knock of confidence was completely unjustified and irresponsible, but we know the impact it had. Clearly, a lot of the anti-vax sentiment around Covid has not helped either. We need to overcome all these messages.

International Health Regulations: Amendments

Debate between Lord Watts and Lord Markham

Tuesday 7th May 2024 Lords Chamber

[Lord Markham (Con)]

I am not sure in what year that policy was published. However, I can talk about how, when we were president of the G7 in 2021, we led the calls to donate vaccines on a worldwide basis, which led to 1.2 billion doses being donated to countries all around the world, led by Britain’s initiative with AstraZeneca. That was great global co-operation and we can feel very proud of it.

[Lord Watts (Lab)]

My Lords, the Government said that they would learn the lessons from the Covid problems. How have they tackled the issue of production of equipment that was needed for Covid but which we did not have? The Government promised to make sure that we will have it next time. Can he give us an update on that?

[Lord Markham (Con)]

Of course, we covered much of this when we had a Question on 15 April around this. This is about making sure that we have the diagnostic capability—which we have—and the ability to scale up. We have made a £125 million-fund available for precisely the issue that the noble Lord mentions, so we have the mothballed capacity ready to operate at quick notice.

Covid-19 Vaccination: Coronary Disease

Debate between Lord Watts and Lord Markham

Tuesday 23rd April 2024 Lords Chamber

[Lord Markham (Con)]

The noble Lord is absolutely correct. The MHRA study on heart inflammation, which he mentioned, said that there is that side-effect for one to two people per 100,000—unfortunately, the noble Lord seems to have been one of them. However, if you get Covid it affects 150 people per 100,000. On balance, if you have not had the vaccination, your risk is 22 per 100,000. The statistics are very clear.

[Lord Watts (Lab)]

My Lords, does the Minister think that we need to do far more on public awareness of vaccines and their benefits? All sorts of people out there are spreading malicious tales about the implications of taking them, whether for mumps or Covid.

[Lord Markham (Con)]

Absolutely. We are all very aware of the damage done by all the myths around the MMR vaccine 20 to 30 years ago and the impact that has had on people. The more we can get the message out, the better. As the noble Baroness, Lady Merron, asked me yesterday, we have learned that it is about making sure that we communicate to all groups so that we can make sure that ethnic minorities and other minority groups get that information.

Care of Critically Ill Children

Debate between Lord Watts and Lord Markham

Monday 29th January 2024 Lords Chamber

[Lord Markham (Con)]

Yes, the noble Lord is quite correct. We know that, in many walks of life, so to speak, there are certain sectors of society that do not get the same level of provision and sometimes miss out. We had the debate last week on maternity provision and saw instances in relation to ethnic minorities as well as people with learning difficulties. We need to make sure that all the communications are there and that everyone is armed to provide the right levels of interface and communication in what are some really difficult cases.

[Lord Watts (Lab)]

My Lords, many families with critically ill children find it very difficult to access treatment because often specialist treatment is only available hundreds of miles away from where they live. That puts tremendous pressure on the family financially. Do the Government intend to do any more to help those families?

[Lord Markham (Con)]

Clearly, we would all agree that the families need to be the priority in these terrible cases. What we have tried to do—and I have also done my own research into this—is make available what I call independent funding requests for when there is a new course of treatment which might not be allowed generally by NICE to give opportunities in those instances as well. I will come back to the noble Lord on things such as travel support and other expenses.

Care Home Staffing

Debate between Lord Watts and Lord Markham

Thursday 18th January 2024 Lords Chamber

[Lord Markham (Con)]

Yes. I have seen a number of really good examples of the kind of step-down care that my noble friend is talking about, or intermediate care that can be used as interim measures. We are trying to bring more of them on board, as well as the very good virtual wards. We have set up 11,000 virtual wards, and they are making a difference as well.

[Lord Watts (Lab)]

My Lords, the Government say that they have done an assessment on the effects of the visa changes. Can he tell us how that was done if the Government did not discuss it or consult with the sector?

[Lord Markham (Con)]

It was a Home Office impact assessment, so I freely admit that I do not know exactly who was consulted; I will happily get back to the noble Lord on that. I know that the assessment looked at all the different parts, including the salary cap and the impact on dependants. For instance, it was not thought that the restriction would have much impact on dependants because not many people come with dependants in the care sector. It looked into each bit, but I will happily let the noble Lord know more in writing.

Adult Social Care

Debate between Lord Watts and Lord Markham

Wednesday 22nd November 2023 Lords Chamber

[Lord Markham (Con)]

As I say, we are seeing staff increases. I accept that there is a lot to do in this space, but there has been a 1% increase this year, so we have turned things round quite substantially. Overall, the number of patients being cared for in this way went up by 15,000 in the last year. As the ADASS survey showed, there has been a decrease in the waiting lists, down 13% from the peak, so we have turned a corner and we will see further improvements.

[Lord Watts (Lab)]

My Lords, the Minister said that waiting lists have gone down by 13%. Can he tell us by how much they went up over the previous 12 years?

[Lord Markham (Con)]

I do not have the figures for those 12 years, but I will happily send them to the noble Lord.

NHS Long-term Workforce Plan

Debate between Lord Watts and Lord Markham

Tuesday 4th July 2023 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend. Dentists were pointed out in particular because so many of them go on to work not in the NHS but in private care settings. It is out for consultation, but I think that was the thinking behind it. For instance, even after five years, 93% of doctors are still registered and working in the health service; that is a lot lower in the dentist space. We are putting investment into that group and it is clearly perfectly reasonable to expect a return on that by a certain time.

[Lord Watts (Lab)]

My Lords, the Minister has set out the aims and objectives of the plan, which we all welcome, but does he understand that, unless we fix the care system at the same time, this plan is bound to fail? It could make it even worse, with staff moving from the NHS and away from care services. How will joined-up government address the problem of under- recruitment and low morale in the care service, which will make this plan either succeed or fail?

[Lord Markham (Con)]

I would like to think, as I mentioned before, that increasing the supply and training of the whole medical profession would help the whole sector. This is quite close to my heart; as I have mentioned before, my mum became a nurse later on in life and went through an apprentice-type route, for want of a better phrase. Having different entry points is a very positive thing. I sincerely hope that people going into a social care environment will see that as a building block to onward career progression and that it will set them up to take further qualifications later on in life, if they wish, in the nursing profession. We are looking to expand the whole sector, and the general belief is that that will benefit both social care and the NHS.

NHS GP Surgeries: Purchase by US Companies

Debate between Lord Watts and Lord Markham

Monday 5th June 2023 Lords Chamber

[Lord Markham (Con)]

My 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.

[Lord Watts (Lab)]

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.

[Lord Markham (Con)]

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.

Diphtheria

Debate between Lord Watts and Lord Markham

Tuesday 18th April 2023 Lords Chamber

[Lord Markham (Con)]

Clearly, 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.

[Lord Watts (Lab)]

My Lords, 88% is very good, but why is it not 100%?

[Lord Markham (Con)]

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.

Patient Deaths: Ambulance Waiting Times

Debate between Lord Watts and Lord Markham

Tuesday 14th March 2023 Lords Chamber

[Lord Markham (Con)]

I 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.

[Lord Watts (Lab)]

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?

[Lord Markham (Con)]

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.

NHS Staff: Food Banks

Debate between Lord Watts and Lord Markham

Tuesday 7th February 2023 Lords Chamber

[Lord Markham (Con)]

As 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.

[Lord Watts (Lab)]

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?

[Lord Markham (Con)]

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.

Care Homes: Staffing

Debate between Lord Watts and Lord Markham

Wednesday 11th January 2023 Lords Chamber

[Lord Markham (Con)]

Yes, 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.

[Lord Watts (Lab)]

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?

NHS Winter Pressures

Debate between Lord Watts and Lord Markham

Tuesday 10th January 2023 Lords Chamber

[Lord Markham (Con)]

I 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.

[Lord Watts (Lab)]

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?

[Lord Markham (Con)]

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.

NHS Waiting Times

Debate between Lord Watts and Lord Markham

Tuesday 22nd November 2022 Lords Chamber

[Lord Markham (Con)]

I 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.

[Lord Watts (Lab)]

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?

[Lord Markham (Con)]

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.