Edenfield Centre: Treatment of Patients

Baroness Blackwood of North Oxford Excerpts

Thursday 13th October 2022 Lords Chamber

[Lord Markham (Con)]

I agree with the points that my noble friend makes. I have some personal experience of people with learning difficulties, and I completely agree that the right setting for them should actually be in the community. I know that is the direction of travel of this Government, and I know that there is an objective to make sure that that is the major place where they are cared for. I have some further details on that, which I would be happy to share, and to meet with my noble friend.

[Baroness Blackwood of North Oxford (Con)]

My Lords, I have been in the Minister’s place, answering on similar scandals, and I think that the whole House shares the dismay of my noble friend that we are in this place once again. I hope that the Minister will take back the condemnation of this House that such a thing should happen in this country. We want to say that it will never happen again, but I think that we feel as though we will be back here once more.

If I could raise one single point, it is that the CQC, the police, the Government and all those involved in the investigations that go forward should take particular care with the patients and families as they go forward, to have the utmost respect and transparency in the way in which they communicate. Too often in these cases, information is leaked to the media or there are failures in communication, which leads to even more distress over and above what has already happened. Please can that not happen in this case, and can those who have already been so grievously affected be protected going forward?

[Lord Markham (Con)]

I am grateful for my noble friend’s comments. She is absolutely correct that, although we are grateful to the likes of the BBC for highlighting these issues—and I speak here as a former director of ITV—and for the undercover work they do, I believe that there is a responsibility there as well, when they have found these sorts of cases, to allow the patients and the people affected some sort of early indication, because the impact on them is central to all of this. I do not know what the BBC did in terms of an early warning on this, to make sure that there were no surprises. I think it is a very good point. We need to make sure that, although independent journalists are correctly doing their job and highlighting important issues, for which we are grateful, we first and foremost need to make sure that when this happens, patients and their family are made aware first and that their concerns are foremost in any action that is taken.

NHS: Access to Treatments

Baroness Blackwood of North Oxford Excerpts

Wednesday 7th September 2022 Lords Chamber

[Lord Kamall (Con)]

We are looking at a number of different things when it comes to doctors across the service. One is clearly opening new medical schools in areas which are underserved: sometimes we have doctors, but not in the right areas. We are also looking at overseas recruitment but, on the specific issues, we are having discussions—let us put it that way—on the cap. That is constantly being debated and I will take that back to the department.

[Baroness Blackwood of North Oxford (Con)]

My Lords, NHS leaders have warned of a life-threatening situation in which clinically vulnerable people are being admitted to hospital after having their energy supplies cut off. This is obviously horrendous for the patients involved, but also risks putting tremendous pressure on NHS systems, which cannot bear that pressure at the moment. I urge the Minister to advise the incoming Health Secretary to take action to prevent the cost of living crisis becoming a health crisis when we can least afford it.

Paramedic Services

Baroness Blackwood of North Oxford Excerpts

Monday 4th July 2022 Lords Chamber

[Lord Kamall (Con)]

I begin by thanking the noble Lord for his engagement with me and the department on this issue. When the noble Lord has sent me details or suggestions, I have passed them to the relevant officials within the department. I hope I can assure that noble Lord that I have done that. As the noble Lord will know, within departments we have particular portfolios and I have to hand it on to the person responsible. In terms of the recovery plan, the NHS has published a 10-point action plan for urgent and emergency care. I will not go through the whole action plan, but it includes dealing with paramedics, recruitment and retention, and more space in A&E departments. At the same time, can requests be handled by telephone by clinicians and patients diverted to a more appropriate resource? All these have been looked at. I understand that the noble Lord thinks it is unsatisfactory, but we have been hit by the pandemic, we are trying to recover and there is a plan.

[Baroness Blackwood of North Oxford (Con)]

My Lords, the noble Lord, Lord Young, is right that handover times have a particular impact on ambulance services. I was pleased to hear the Minister mention recruitment and retention in A&E departments. This is a long-standing problem in emergency services. The Royal College of Emergency Medicine states that emergency medicine has a high attrition rate. I know that a number of steps have been set out. Can the Minister state what success they are having and, if they are not succeeding yet, what further steps the Government plan to set out? We need a change in direction as soon as possible.

[Lord Kamall (Con)]

I thank my noble friend for the question and also for the point that this happens at number of different points in the system. Clearly, there are recruitment campaigns for doctors and nurses. In addition, the number of ambulance and support staff has increased by almost 40% since 2010. Call handler numbers have also increased since the start of May 2022; we have 400 more. In addition, there are pledges to increase the training of paramedic graduates nationally by 3,000 per annum. All these will take time to get into the system, which is still recovering from the pandemic.

Vaccinations

Baroness Blackwood of North Oxford Excerpts

Wednesday 15th June 2022 Lords Chamber

[Lord Kamall (Con)]

The noble Lord is absolutely right; we have received advice on the flu vaccine and at the moment it is free to those aged 65 and over. The issue, frankly, is balancing resources. A number of people in the system are saying that if you keep mandating vaccines, it means they cannot get on with tackling the elective backlog. On balance, at the moment it seems better to focus on the elective backlog, but UKHSA and others are monitoring the situation very closely.

[Baroness Blackwood of North Oxford (Con)]

My Lords, the whole House will know that the great success of the Covid vaccine’s development was not built during the pandemic but over many years of visionary research and investment. What steps are the Government taking to invest in a similar amount of research in next-generation vaccines for things such as cancer and universal flu?

[Lord Kamall (Con)]

My Lords, I thank my noble friend for that question. She will know that we are investing in a number of different areas via NIHR and other research bodies. Those research bodies also welcome applications for research funds in specific areas. We do not necessarily ring-fence that funding, but we ask for applications. One issue we learned about is that there is the potential for future vaccines to cure, or be used as therapeutics for, a wider range of issues. In addition, we are looking at blood tests which can identify far more conditions.

GP Access

Baroness Blackwood of North Oxford Excerpts

Tuesday 7th June 2022 Lords Chamber

[Lord Kamall (Con)]

I apologise, I did not exactly get the nature of the noble Baroness’s question, but I understand about some issues in Devon. Clearly, there are areas of the country where there is more of a challenge. One solution being looked at is how we make sure that doctors are trained close to areas where there are shortages. Research has shown in some cases that people tend to stay in the area in which they were trained, and we have opened new medical schools. However, that will not be an overnight solution as we have to wait for doctors to be trained. Some solutions will be short-term and some will be long-term.

[Baroness Blackwood of North Oxford (Con)]

My Lords, I am pleased to see that since last July there have already been 1 million scans, tests and checks delivered by the new community diagnostic centres. Can the Minister give us some idea of how these centres are going to improve capacity and the quality of care in our GP services, which we have already heard are under so much pressure?

[Lord Kamall (Con)]

I thank my noble friend for that question and for highlighting the role of community diagnostic centres. When we look at the backlog and the waiting lists, about 80% of the waiting list is for diagnosis, not necessarily surgery. Of course, once they have been diagnosed, some of those people will require surgery. After that, about 80% of those who require surgery will not require an overnight stay. They can be daily in-patients, as it were. The role that CDCs will play in trying to tackle that backlog is to encourage more diagnosis in the community, so rather than people having to go to NHS settings, diagnosis will go to the people in shopping centres and football stadiums.

Children: Cancer

Baroness Blackwood of North Oxford Excerpts

Thursday 26th May 2022 Lords Chamber

[Lord Kamall (Con)]

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.

[Baroness Blackwood of North Oxford (Con)]

My Lords, I declare my interest as chair of Genomics England. I am pleased to report to the House that whole-genome sequencing is now improving care for children with cancer as part of the NHS Genomic Medicine Service. In fact, Great Ormond Street recently found that WGS has reclassified diagnosis in 14% of cases, changed management of the condition in 24% of cases and improved diagnosis in 81% of cases. Will the Minister join me in thanking those at Genomics England and in the NHS who worked so hard during the pandemic to get this service up and running? Will he also pledge today to do whatever he can to scale this service so that we can play our full part in tackling this pernicious disease head-on?

[Lord Kamall (Con)]

I thank my noble friend for that. It is really important that we look at the huge potential of genomic research and the information it can give us. It is also important that, as we move towards the newly born programme, we do genomic sequencing of newly born babies so we have that data and are aware of the issues that could arise in their lifetime. In addition, we are looking at technology on testing—some research trials show that there are blood tests that could identify up to 50 different types of cancer early—so there is a lot of work going on in this area.

Health and Care Bill

Baroness Blackwood of North Oxford Excerpts

2nd reading
Tuesday 7th December 2021 Lords Chamber

[Baroness Blackwood of North Oxford (Con)]

My Lords, it is a pleasure to follow the noble Lord, who was chief executive at my father’s hospital. I refer to my role as chair of Genomics England, as declared in the register.

The future of health and care must be collaboration, increased productivity and innovation. To that end, there is much to welcome in the Bill. As the noble Lord, Lord Stevens, put it so clearly in his outstanding maiden speech, the Bill is based on recommendations from NHSEI and local health and care leaders, so it is no surprise that it removes statutory barriers that are preventing front-line NHS leaders responding to current challenges. The NHS Confederation agrees. It says that it is not a top-down reorganisation; it is providing a legislative framework for what is already happening on the ground. The King’s Fund says that it has nothing to do with privatisation.

Moreover, I cannot count the number of times we in this place have agreed that integration of services is absolutely critical for delivering higher quality care, and this Bill enables that through health and care partnerships. We have also frequently violently agreed on the unintended consequences of the internal market, so I am looking forward to an outbreak of consensus on the abolition of mandatory tendering, as well as the many public health measures for which I have heard many in this place campaign. It is a move away from competition to collaboration, which can be only beneficial, particularly when the NHS is facing so much pressure.

Having said that, I also say that there are many genuine issues for debate. Others have raised workforce planning, social care and the Secretary of State’s powers very eloquently, so I will not speak to them now—there will be time for debate—but I strongly associate myself with the eloquent contribution of my noble friend Lady Harding. Instead, I add my voice to those who have called for the Bill to go further on clinical research. Evidence shows that research-active hospitals have better patient outcomes, more satisfied staff and higher CQC ratings. For patients such as me with rare diseases, participation in clinical research may be the only way to access effective treatment. We have all seen the impact of the pandemic on the landscape of research. On the one hand, the response to Covid-19 has been phenomenal. RECOVERY, PRINCIPLE and the vaccine trials have all demonstrated our capacity to deliver clinical research with global impact at unprecedented pace and scale. We should be incredibly proud of that.

On the other hand, non-Covid clinical research has faced enormous disruption. Many studies have been paused or cancelled altogether, as those research staff were redeployed either to front-line activity or to Covid studies. Data from the ABPI shows that the number of participants enrolled in commercial clinical trials was 15% lower in June 2021 compared to June 2019, while in Spain and Italy enrolment rose by more than a third during the same period. As a result, the UK has now fallen to fifth in Europe in phase 3 trials initiated per year. As we restart care, we must ensure that non-Covid research is also reprioritised. Of course, that will require the staff and resources to ensure capacity to deliver research at the same time as NHS recovery. I believe that this is exactly what the Minister wants. The Government have set an ambition for the UK to be the destination of choice for clinical research, but we have to ensure that we have the capacity within the health and care system to deliver that research and prioritise it while delivering that recovery. We can start with that today.

Like the 2012 Act, the Bill only includes a duty “to promote research” in Clause 19. While welcome, that has too often allowed clinical research to fall down the agenda. We can do more. The Bill provides a once-in-a-decade opportunity for us to embed research right at the heart of the NHS by putting that ambition on a statutory footing.

The Bill would be stronger if we mandated integrated care boards to ensure that the NHS organisations for which they are responsible are conducting clinical research. They should publish and transparently track that research in their annual reports and joint forward plans to understand exactly how that clinical research is being delivered in a way that meets the needs of local communities and ensures that they are increasing the diversity of participation.

Those proposals are supported by a long list of medical research and patient charities, as I am sure would be expected, but also by a number of colleagues in the other place who tried to push forward such amendments. Sadly, so far, they have failed. I urge the Minister to think again as the Bill goes through the House, because we have the opportunity with it to encode clinical research—and the hope that it gives so many—directly into the DNA of the NHS. Please do not let this opportunity pass as we take the Bill through this House.

Covid-19 Update

Baroness Blackwood of North Oxford Excerpts

Thursday 21st October 2021 Lords Chamber

[Baroness Blackwood of North Oxford (Con)]

My Lords, I declare my interest as chair of Genomics England. Does the Minister agree that, as well as testing, sequencing is critical to tracing the pandemic as cases rise? In addition to delta, we are now observing the delta subtype, AY42, and we need to be constantly on our guard for vaccine escape. Can he say what steps are being taken to ensure that our so far really very good pathogen sequencing programme will be as responsive as it needs to be to the winter surge?

[Lord Kamall (Con)]

I thank my noble friend for that question. The UK is world leading in genomics, and it is something that we can all be proud of. COVID-19 Genomics UK has now sequenced 1 million genomes, and the UK is working with global partners to fill global sequencing capability gaps. This includes building the new variant assessment platform, which will offer UK expertise to assess and detect new Covid variants emerging globally.

Animal Diseases: Future Pandemics

Baroness Blackwood of North Oxford Excerpts

Wednesday 21st July 2021 Lords Chamber

[Lord Bethell (Con) [V]]

My Lords, there is a very large number of initiatives. I emphasise our international efforts to reverse the underlying causes of spillover infections from animals to humans, including biodiversity loss and the risk from the illegal wildlife trade. Using the UK’s G7 presidency, we have committed to doing more by establishing the International Zoonoses Community of Experts, by creating the centre for pandemic preparedness and conducting a one health intelligence scoping study to ensure that the systems work better together to identify future threats.

[Baroness Blackwood of North Oxford (Con)]

My Lords, in 2016 a woman in rural Thailand spotted a cow frothing at the mouth. She snapped a few photos, reported it on the “one health” disease detection app and local authorities stepped in. They limited the spread of foot and mouth to just three cows, averting millions in potential losses. This app is now expanding across Asia and Africa, supported by Dame Sally Davies’s Trinity Challenge. This demonstrates that ever more global health data by itself is just not enough; it is deriving actionable insights from that data that matters, and that needs dedicated analytics tech at scale. What steps is the Minister taking to find and scale the “one health” surveillance tech that we need to prevent future pathogenic risk?

[Lord Bethell (Con) [V]]

My Lords, my noble friend puts it extremely well. It is exactly that kind of intervention at the front line that can nip infections in the bud, but it is only through international collaboration that we can really tackle the threat of zoonotic infection. The concept of zoonotic tech is not one that I had previously come across, but I will take it away from this debate and have a good look at what more we could do to support it.

Health: Dementia

Baroness Blackwood of North Oxford Excerpts

Monday 5th July 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I take seriously the testimony of the noble Baroness. I am not aware of the specific concerns that she describes, nor am I completely up to speed on the precise arrangements of the training, but I would be glad to correspond with her on this matter.

[Baroness Blackwood of North Oxford (Con)]

My Lords, while virtual assessments were vital during the pandemic, without further diagnostics many led to a diagnosis of unspecified dementia. An accurate diagnosis of dementia subtype is critical to good management, especially in complex cases. Given the backlog, there will understandably be a temptation to deprioritise those who have a preliminary diagnosis from a virtual assessment, but this would be a false economy. How can the Minister ensure that those with a provisional diagnosis will be invited back for a comprehensive assessment after the pandemic has finished, and for imaging and other diagnostics where necessary?

[Lord Bethell (Con)]

Few people are as enthusiastic as I am about the benefits of digital medicine and virtual consultations, but I completely acknowledge my noble friend’s point: this is one area where we absolutely must have face-to-face assessment. The diagnostic tests and assessments she describes play a critical role, and those whose conditional assessment was done virtually must be cascaded into a face-to-face assessment, as she says. That is why we have put the funds in place to ensure that this backlog is caught up with.