Bovine Tuberculosis

Debate between Lord Winston and Baroness Northover

Wednesday 25th June 2014 Lords Chamber

[Baroness Northover]

All areas are being looked at. There has been research into gassing but at the moment we are finding that this method has significant practical challenges. The noble Lord can be assured that further research is being taken forward in this area, although as yet it does not involve live badgers or active setts.

[Lord Winston (Lab)]

My Lords, given that Professor Rosie Woodroffe has said that badger culling is unequivocally ineffective and extremely inhumane, can we have clarity from the Government that culling will not continue under any future circumstances? Can we also have an assurance that, wherever possible, scientific advice will be followed? For example, the noble Lord, Lord Krebs, has shown that the mathematics relating to this issue are absolutely plain.

Air Pollution

Debate between Lord Winston and Baroness Northover

Monday 22nd July 2013 Lords Chamber

[Lord Winston]

To ask Her Majesty’s Government what measures they are taking to mitigate the health risk caused by air pollution in London.

[Baroness Northover]

The Government have invested more than £1 billion in measures that will help to improve air quality, including incentives for low-emission vehicles and sustainable transport. In London, the mayor is responsible for working towards national air quality objectives. The Government work with the mayor and London boroughs to improve air quality and help support the health needs of people across the capital.

[Lord Winston]

My Lords, I am sure we are grateful to the Mayor of London for the initiatives he has taken, even though their implementation seems to be rather slow. However, is the noble Baroness aware that the WHO has calculated that there have been something like 29,000 premature deaths due to air pollution in the United Kingdom? Will she be kind enough to let me have details of the like-for-like figures, by region, for people dying as a result of air pollution compared with those dying as a result of obesity, alcohol or smoking?

[Baroness Northover]

The noble Lord is quite right to give the figure of 29,000 premature deaths per year because of pollution. I will get him the information that he requires from the department.

Health and Social Care Bill

Debate between Lord Winston and Baroness Northover

Monday 27th February 2012 Lords Chamber

[Baroness Northover]

My Lords, the Minister has sat down, so it is for the mover of the amendment to respond.

[Lord Winston]

I am sure that the Minister will want to answer my question because it is not aggressive or political; it is really to find out how this Bill will work. When somebody goes to casualty after a month with a broken nose and complains, “Look, my main problem is the pain in my sinuses which I have had for a long time”, and is told by the doctor when they had already waited six hours, “I’m afraid the sinuses are a different department. You’ll have to make another appointment”, that is a problem with integration. How does the Minister think we might accomplish better integration with this Bill?

Health: Cancer

Debate between Lord Winston and Baroness Northover

Tuesday 13th December 2011 Lords Chamber

[Baroness Northover]

My noble friend is absolutely right. We owe a huge amount to the organisations in the United Kingdom, not least Cancer Research UK, which is a major player internationally. She is also right about early diagnosis. That is how you start to bring deaths down; you make sure that you diagnose early enough so that you can intervene in a way that is going to be much more effective. Noble Lords might like to know that there will be a first ever national cancer campaign on bowel cancer to flag up the symptoms to people in the hope that they seek diagnosis at a much earlier stage, because if it is caught early it is completely curable.

[Lord Winston]

My Lords, the complex paper by Professor Pritchard also looks at the costs of delivering cancer care. One of the points made very clearly in that paper is that the cost of drugs delivered under the NHS is considerably less. We pay far less for the excellent results that we get than Germany, Spain, Italy and France do—as much as 40 per cent less, in some cases. Given that, and given that independent assessments of the health service show that the British health service has some of the best value for money in the world, why did the Prime Minister say that we cannot go on as we are and introduce the current Health and Social Care Bill?

[Baroness Northover]

I fully agree that the National Health Service is very cost-effective and that it has been an extraordinary service. However, we have many challenges coming down the track, as the noble Lord will be acutely aware—not least our ageing population, which needs to be supported, particularly at home and in the community where appropriate, and not immediately taken into hospitals, where interventionist care may not be in the best interests of those patients. Therefore it is extremely important that there is more clinical judgment on the best interests of each patient and how these things are organised, and that they are not simply driven forward by the way in which provision is organised at the moment, which is very much focused on secondary institutions.

NHS: Joint Replacement Procedures

Debate between Lord Winston and Baroness Northover

Tuesday 5th April 2011 Lords Chamber

[Baroness Northover]

I thank the noble Lord for his Question and pay tribute to his long battle for patients in the NHS. I assure him that, if it is clinically appropriate for a patient to receive a joint replacement, they should do so. As noble Lords will no doubt know from their own experience and that of their relatives, people often find that their recovery is not as uneventful as they might have wished, and for some patients the joint replacement does not work as well as it might. There are other procedures. For some patients, the best road to go down may be that of other options, which may be a factor here. However, I assure the noble Lord that, if it is clinically advised that people should have a joint replacement, that is what is supposed to happen and, if there is any evidence that that is not being carried forward, we would certainly like to know.

[Lord Winston]

My Lords, joint replacement treatment of all sorts is a highly successful area of medicine but there are still failures and many joints give up. Improvements have been possible only with continued research. Can the noble Baroness tell the House how it is envisaged that such research will continue under the improved National Health Service that the Government are proposing when more and more private providers will be offering these services and there is no particular academic interest in this aspect of medicine?

[Baroness Northover]

I note what the noble Lord has to say. Of course, he will know that my right honourable friend in the other place, Vince Cable, has recently put a considerable amount of money into health research. Looking forward over the next few years, real-terms spending on health research will increase. The National Institute for Health Research will be co-ordinating this and it supports research in this area. As for the noble Lord’s question about new arrangements in the health service, it is of key importance that research is carried on within the NHS. The NHS has led in clinical research and we are very committed to ensuring that under the new arrangements that continues to be the case.

Healthcare

Debate between Lord Winston and Baroness Northover

Thursday 28th October 2010 Lords Chamber

[Lord Winston]

My Lords, I congratulate the Government on a wonderful, beautifully written document—the White Paper, Liberating the NHS. Finally, the NHS is to be freed. The document’s honeyed tones and warm aspirations are sweetness and light. Its expressions of good intentions will easily deceive less well informed readers. However, to leave aside the aspirations, to which I shall return, the one thing that the NHS does not need is another reform. That is why in opposition Mr Cameron promised to halt the merry-go-round of organisational change with which the NHS had been previously inflicted. This promise was countersigned by a pledge by Mr Clegg, the Deputy Prime Minister.

I have absolutely no desire to embarrass the noble Earl, Lord Howe, for whom I, like so many of us, have genuinely a huge regard, but we have already learnt how trustworthy this Government as a whole are. So this merely minor change—no merry-go-round—means a reorganisation in which all primary care trusts are to be liquidated, all hospitals will become foundation hospitals, strategic healthcare authorities are to be abolished and the responsibility for public health will become part of the remit of local authorities. This does not seem to be so minor after all—more of an amazing big dipper. In this battle for the NHS, more than three-quarters of the £100 billion NHS budget will be devolved to general practitioners for administration.

Over the past few months, we have heard a great deal about the legacy left by the previous Government. Forgive me if I feel angry at this; it is not often that I do and seldom have I felt as angry. The negative tones have been the cornerstone of an excuse for the severest cuts in public spending in living memory. This Government’s pronouncements, on the whole, are not to be trusted. If their pledges on the NHS reforms are void, so are their promises on the ring-fencing of NHS funding. If we want to consider a legacy, perhaps we might recognise that the Labour Government left the NHS in its healthiest state for decades—a position that this Administration have inherited.

In spite of the Government’s assurances, the NHS is already being cut. Managers have been told to find £20 billion in efficiency savings if widespread closures are to be avoided. To give just one other example, in London the deaneries are threatened. Perhaps the Minister can confirm that, where so much healthcare is needed and where the cream of our young professionals is trained, junior hospital posts are facing a cut of 14 per cent next year. As I understand it, 70 key training posts in general medicine out of a total of 300 are to go—perhaps the Minister can confirm this—and another 70 posts from the other specialities are to be cut by 2014.

If the King’s Fund has calculated correctly, the reorganisation will cost the NHS between £2 billion and £3 billion, which will be taken from patient services. Consider this for a moment: the pressure of population change, the incidence of chronic illness, the rising age of our population, inflation and the rising expectations of patients mean a real cut in resources. The biggest problem will almost certainly be in chronic care. The massive cuts proposed in social care and welfare services will inevitably result in increased pressure on what we can now see is becoming an already underfunded NHS.

What about research? Here is another unbelievable sleight of hand by the Government. Some of the so-called ring-fenced NHS research budget will almost certainly come from the other research councils. I declare an interest as a member of the Engineering and Physical Sciences Research Council. We already fund a huge amount of healthcare research, as does the BBSRC. We will be asked increasingly to contribute substantially, at the risk of other research. We will be heavily pressured on our own so-called ring-fenced budgets. Meanwhile, regarding NHS R&D carried out by the NIHR, if we are talking about assessing outcomes, how is its performance to be evaluated? That will certainly not, it appears, be anything like as rigorous as the superb work of international quality, funded by the research councils, in our top research universities. Here, surely, is a case for government scrutiny.

Front-line care is already threatened. The dulcet tones of the White Paper with its emphasis on patient choice and outcomes are a smokescreen. Of course patients would like choice, whatever that means, but what they really want is competent, efficient medical care. I recently went to a maternity ward in one of the most famous maternity hospitals in the country to visit a relative of mine in her 20s, an NHS patient, who had recently given birth to a premature baby at 35 weeks. Her GP had given her the choice of three different hospitals and she had chosen this hospital. She was four days post-delivery and she had not seen a doctor. Her blood pressure had been 200 millimetres of mercury—a situation in which she might even have had a stroke or a seizure—but she said that she had not been seen by a doctor. She was sitting there trembling with worry. She was scared stiff. What she wanted was a doctor to listen to her and to talk to. Even though it is some time since I left the health service or have done any medical practice, I felt obliged to examine her. I went to see the nursing staff and asked whether I could speak to the house surgeons. None was available, so I asked to speak to the registrar. They did not know the name of the registrar. I had to phone the central switchboard to find out who the on-call registrar for obstetrics and gynaecology was. It was only when I left the hospital that there was suddenly an outpouring of care and three doctors visited my relative in about five minutes.

What about outcomes? Outcomes depend so much on social circumstances. Equity and Excellence: Liberating the NHS mentions cancer, stroke, asthma and so on, but the outcomes of treatment depend on the circumstances of the patient. What we learn more and more, certainly with epigenetics, is that what happens to us in early age also plays a part. What happens in a child aged two or three can have far-reaching effects on whether that child is more prone to diseases such as stroke in 60 years’ time. How do you measure those kinds of outcomes with the possibility that this White Paper offers?

Finally, to leave the—

[Baroness Northover]

My Lords, I think that I need to remind noble Lords, as the noble Baroness, Lady Farrington, would always remind us, that this is a time-limited debate. When the clock reaches four, noble Lords’ time is finished.

[Lord Winston]

My noble friend Lady Thornton and I have agreed to split our time, which is why I went on for the extra time. I shall finish with one sentence. If we really want to improve the health service, we should make certain that doctors have enough time to listen to patients and that nurses are not involved with so much paperwork that they cannot speak to patients, we need to improve training by better investment, we need to renegotiate the EU working time directive and we need to make certain that hospital doctors work in teams so that there is proper continuity of patient care.