NHS and Adult Social Care

Baroness Blackstone Excerpts

Wednesday 5th April 2017 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness makes an incredibly important point. Despite the ageing population, the fastest-growing part of the adult social care budget is, I think, for adults with learning difficulties. She is quite right that there needs to be a comprehensive approach. That is why additional funding is going in to support not just older people but working-age adults too.

[Baroness Blackstone (Lab)]

My Lords, I declare an interest as the chair of the board of Great Ormond Street Hospital. I was also a member of the Select Committee. I want to pick up on what the Minister said just now about public health—which, if I may say so, I thought was rather complacent. The public health budget has been cut year after year over the past decade. Will he give the House an assurance that this budget will not only be protected but enhanced? Unless that is done, the terrible crisis we have in obesity will not be prevented, and many other areas of public health such as smoking, drugs and alcohol will not be addressed properly.

[Lord O'Shaughnessy]

The budget for all health services has been set out now for the spending review period until 2021. I completely agree with the noble Baroness about the importance of these kinds of activities. We are, of course, moving to a system where local authorities are able to retain their business rates. They have primary responsibility for the delivery of much of the public health services and we are trying to put them on a long-term financial basis so that they will be able to continue with the kind of work she has highlighted.

NHS (Charitable Trusts Etc) Bill

Baroness Blackstone Excerpts

Friday 26th February 2016 Lords Chamber

[Baroness Blackstone (Lab)]

My Lords, I declare an interest as the chairman of the Great Ormond Street Hospital board, and I want to give the reassurance that I am not Captain Hook in disguise.

I thank my noble friend Lady Massey of Darwen for taking forward this Private Member’s Bill in this House. I especially thank Wendy Morton, the Member of Parliament for Aldridge-Brownhills, for introducing the Bill in the House of Commons and for her very hard work in helping the passage of the Bill through the other place.

In advance of what the Minister is to say, I also thank him and the Government for their support for the Bill. I say that in particular since, as my noble friend Lady Massey of Darwen has already said, back in 2014 I attempted to make an amendment to the Copyright, Designs and Patents Act 1988, but without success. So it is a great pleasure that it looks as though as we are going to be successful today.

I want to say a little bit—I feel that I am obliged to do so and I want to do so—about the enormous value of the charity to the hospital’s work. It cannot be overstated. I thank the charity and its special trustees for the enormous amount of hard work that they put in to raise funds. Its current strategy is to try to raise £500 million over the next five years, and I want to say a bit about how vital this is by giving a few examples of the support that the charity gives the hospital.

We are now working to complete what will be called the Premier Inn Clinical Building. It will fit seamlessly with the Morgan Stanley Clinical Building, which was opened in June 2012, to complete what we call our Mittal Children’s Medical Centre. It is truly state of the art. It houses a new surgery centre, a high-specification respiratory ward and a high-dependency area, where the most unwell children can be carefully helped back to better health. The cost to deliver this is scheduled to be around £300 million, and the charity is still working to raise the final amount to make that happen.

Research is absolutely fundamental to everything that a hospital like Great Ormond Street does. If we have to be innovative, we have to be not just the hospital that does research but a research hospital. I shall give one example, which had some publicity last year, of a world first. One year-old Layla was cured of her leukaemia thanks to a gene editing technique developed and used by Professor Waseem Qasim. He designed a new treatment that uses what are called molecular scissors to edit genes and create designer immune cells programmed to hunt out and kill drug-resistant leukaemia. Research like this is made possible only thanks to charity-funded specialist laboratories dedicated to gene therapy research. Our new centre for research into rare diseases, which will be completed in 2018, will take forward a lot of that really innovative, life-changing research. Again, the money for that is being raised through the charity.

The charity also helps the hospital by securing extremely expensive equipment, such as a 3T magnetic resonance imaging machine and scanners that allow us to take much clearer and more detailed pictures of children’s bodies than was ever possible before. That allows faster and more accurate diagnosis, followed by better treatments for the children.

Treating children at home is something that we are also trying to develop at the hospital. Every parent with a very sick child longs for that child to go home, and every very sick child longs to go home. If we can release them from hospital and get them home faster, that makes a huge difference to them. One example of this is that we are now able to allow home dialysis to take place—again, thanks to charity funding. We have been the first hospital in Europe to offer home dialysis for children with serious kidney conditions. Before that, children had to come into the hospital a minimum of three times a week, spending four hours having dialysis. Home dialysis allows them hugely greater freedom and has dramatically improved their quality of life. Those are just a few examples.

I want to finish by asking a question of the Minister. I wonder whether he can clarify the details of the commencement of the provisions of the Bill. As I understand it, a number of NHS charities are still in the process of converting to independent charities. How long will it take for these conversions to be completed, and is it or is it not correct that they have to be completed before Clauses 1 and 2 and Schedule 1 can come into force? I would be really grateful if he could clarify that.

I end by thanking the many supporters of the charity—some of whom, indeed, are probably in this House—from the corporate sponsors to the big celebrity donors, but, above all, the many, many members of the public who support us by giving regular donations over many years.

Last of all, in his absence, I should thank JM Barrie for his extraordinary legacy when he donated the copyright to the hospital in 1929. “Peter Pan” has raised large sums of money, which has been put to wonderful use. It is now important that this legacy is safeguarded by passing this Peter Pan and Wendy Bill.

NHS: Reform

Baroness Blackstone Excerpts

Thursday 16th July 2015 Lords Chamber

[Baroness Blackstone (Lab)]

My Lords, I declare an interest as the chairman of the Great Ormond Street Hospital Foundation Trust. Before I put my questions to the Minister, I will just make one brief comment on his remarks about the Opposition. I have no idea what the shadow Secretary of State for Health said in another place, but I will defend what my noble friend Lord Hunt has just said. He said that he agreed in principle with a great deal of the Statement, but it is legitimate for the Opposition to ask questions about how a Statement of this sort might be implemented, which is what he was doing.

I have two questions, the first about bureaucracy. The Minister said that he wished to see a reduction in bureaucracy. As a chairman of a trust, I entirely identify with that. However, some of the bureaucracy is in the regulators, and I hope that his attack on bureaucracy will cover the regulators. The Government are about to set up another outside agency, which will put further bureaucratic pressure on those who are delivering services upfront. Anything he can do to try to reduce that would be helpful.

My other question concerns seven-day services. Again, I entirely endorse what the Government wish to do with respect to seven-day services—if anything, they are overdue—but there are questions to be asked. What is the timetable for this, if it is only going to apply to new consultants? It will take a very long time to introduce seven-day services if only new consultants are going to go on to the new contract requiring them to work at weekends. I understand why the Government are doing that, but it will make for a very long delay. What steps will the Government take to try to encourage existing consultants, who will be far greater in number than the flow of new consultants, to adjust to a new approach where seven-day services are introduced in the interests of patients?

[Lord Prior of Brampton]

I can only agree with the noble Baroness on bureaucracy. The new body that we are setting up to look at incident reporting, as recommended by the PAC, will only look at big incidents so will not be an added bureaucracy for the day-to-day running of a trust. I am always struck by the figure that nurses spend only between 70% and 80% of their time dealing directly with patients because they are dealing with bureaucracy. The bureaucracy argument falls into two parts: it is partly about the way hospitals run their affairs and partly about external regulators. We believe fundamentally in intelligent transparency. I see the CQC, for example, as less a regulator and more a means of providing intelligent information to boards of hospitals and to patients. But I take on board what the noble Baroness says. We will do everything we can to reduce the level of bureaucracy.

As far as the timetable is concerned, junior doctors will switch over much more quickly than consultants, because they turn over much more quickly. It will take time for consultants to move over to the new contract, but we hope that we can make it more attractive to consultants and that it will be more of what I would call a professional contract, so that existing consultants will switch over to it as well as new consultants. We will have to watch that very carefully.