Health: Maternity Care Provisions in East Kent

Debate between Baroness Brinton and Baroness Blackwood of North Oxford

Thursday 13th February 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

As I said, there has been an unannounced CQC inspection; there is also further engagement with the CQC and we await the findings of its report, which will come forward in due course. In addition, specialist teams have been sent in to ensure that there is robust leadership so that ongoing care is assured and patients can be reassured on that point. NHS England has announced that it will commission an independent review into East Kent so that there is a belt-and-braces approach to ensure the highest possible standards of care there. We can be reassured that the issues raised by the noble Baroness will be addressed and that no stone will be left unturned.

[Baroness Brinton (LD)]

I also thank the Minister for the detailed Statement, which is much appreciated, and echo the sentiments of sympathy and support to the parents of Harry Richford and the other children who have died or had their health severely impaired by the trust. It does not start just two years ago. In 2010 there was a review by NHS Eastern and Coastal Kent on maternity care; safety and quality are mentioned three times in the statement of that review. In 2012 the services were reconfigured despite many concerns of local people. In 2014 the trust was rated inadequate and put in special measures by the CQC—it left special measures in 2017. In 2015 there was an expert report by the Royal College of Obstetricians and Gynaecologists warning about many of the problems that emerged in the subsequent tragic deaths of Harry Richford and at least six other babies. And so on and so on.

The expert review said that action needed to be taken quickly. This report was not passed to the CQC. Why, given that the hospital was in special measures, was the report not handed to the CQC and why on earth was the hospital allowed to continue out of special measures after that when there were clearly still major problems? Following on from the comments of the noble Baroness, Lady Thornton, why did the chief exec and, I presume, the board not read, implement and monitor this expert review?

[Baroness Blackwood of North Oxford]

The noble Baroness raises an important question, which I am sure will be considered as part of NHS England’s independent review and the CQC’s questions around quality of leadership, but I will make a wider point for those who may be listening about the safety of maternity care in the UK. We are rightly focusing on the questions of East Kent, but for those who may be considering giving birth at the moment it is important to state that the NHS is one of the safest places in the world to give birth. Some 0.7% of births result in a stillbirth or neonatal birth. We have stated that our ambition is to halve this rate of stillbirths, neonatal and maternal deaths, and brain injuries by 2025. We have already achieved our ambition of a 20% reduction by 2020. A message of reassurance, alongside the firm actions we are taking to address the concerns raised by the noble Baroness, is appropriate and important.

Wuhan Coronavirus

Debate between Baroness Brinton and Baroness Blackwood of North Oxford

Tuesday 11th February 2020 Lords Chamber

[Baroness Brinton (LD)]

My Lords, I begin my remarks from the Liberal Democrat Benches by echoing those thanks to all staff who are involved, not just on the front line but in the large amount of planning that is going on. We would also like to thank the patients who have self-isolated in calmness, accepting what has happened and moving a long way from home, and those who after flying back from abroad have quite contentedly gone on elsewhere. The advantage of social media, television and radio is that we can hear how they are managing.

I note that the Secretary of State has declared that transmission of coronavirus is a serious and imminent threat to public health, despite the fact that the current situation remains moderate. The regulations for England only—to isolate and hold those at risk of spreading the virus—is, I hope, a last resort. So far, that has not been necessary, but we on these Benches understand that there may be occasions when it is. Will the Minister confirm that the devolved states will follow suit? We would not want Gretna Green suddenly to have a reputation for the wrong reasons, with people trying to remove themselves to somewhere that the regulations do not apply. It seems sensible in the United Kingdom to make sure that there is consistency among the four states.

What safeguards are in place for those conducting the quarantines and isolation to ensure that they are kept safe, along with the patients, and to prevent them contracting the virus?

I note also the regulation that came into force at the end of January, ensuring that no charge is to be made or recovered from overseas visitors who may have to be diagnosed with, or treated for, coronavirus. We believe that that is right, but how is this information being disseminated to healthcare bodies? I see nothing at all about it on the department’s website. The regulation appears for parliamentarians via Hansard, but I can see nothing else anywhere that might help inform hospitals and other bodies.

Today’s Statement from the Secretary of State, the department’s daily 2 pm statement, and the report from the Chief Medical Officer all talk only about those travelling from a number of Asian countries—which the Minister read out in her repeat of the Statement—and who have come from those countries in the last 14 days. This is echoed in the department’s advice to healthcare professionals. So, despite being updated daily—and the number of patients was up to date as at 2 pm today—these Statements do not reflect the fact that some of the eight UK-based cases contracted coronavirus in France, or possibly even in the UK.

Today on radio and television, we have heard a number of experts from China, from John Hopkins University and from UK universities all talking about the possibility of substantial transmission. Indeed, the department has confirmed that this is a high-consequence infectious disease, with all the concerns and constraints that go with it, which include being

“often difficult to recognise and detect rapidly … ability to spread in the community and within healthcare settings … requires an enhanced individual, population and system response to ensure it is managed effectively, efficiently and safely”.

We now have cases in York, in Brighton and its area, and in the specialist receiving hospitals in London and Newcastle, in addition to two GP surgeries in Brighton that have been closed for cleaning. There are local concerns in Brighton about a community centre, and some schools appear to be making the decision to allow children not to come in, after two people were told to self-isolate. But there does not appear to be any formal advice being offered to councils, councillors, schools, prisons and other public bodies. Can the Minister explain why the Statement seems to take no account of what is happening in the UK at the moment? What advice is being given to local councillors, schools and other bodies about early planning for their area, what they should do if a person may have coronavirus, and what happens once they are diagnosed, so that they are ready in the event that there are cases in their area?

I specifically want to mention the role of councillors here. Elected members are often at the heart of their communities, and an informed councillor can calm worries, particularly at the school gate, if they can say that they have been briefed. These days, briefings do not have to happen face to face; there are mechanisms through technology for people to be brought up to date.

Finally, in Brighton, it has been reported in the local media that a number of people with cancer and other long-term conditions are understandably worried about what they should do. They are asked to make sure that they have their annual flu jab, but at the moment there seems to be no specific advice for people regarded as vulnerable patients. Public Health England’s very helpful flow chart on the management of a suspected case runs through very sensibly what to do with the patient, but nowhere does it suggest to ask the patient whether they have any vulnerable people in their family or their contact, nor can I find any advice, anywhere at all, about what primary care doctors should be saying to vulnerable patients in their area—I am thinking particularly of Brighton, at the moment—to make sure that they feel comfortable about this.

These are concerns that could, I suspect, be resolved with effective planning. However, it seems that, at the moment, there is a bit of a lacuna, and I hope that the Minister will be able to help fill the space.

[Baroness Blackwood of North Oxford]

I thank the noble Baronesses for those important questions and, like them, I thank NHS and PHE staff for their extraordinary work over recent days, and those patients who have acted so responsibly in self-isolating. In doing so, they have slowed the transmission of coronavirus in the UK and protected many, including those who are particularly vulnerable. I also thank both Benches for their support of these regulations, which hopefully will not be needed, but should they be needed, could play a crucial role going forward.

I wish to clarify that these regulations will apply only to coronavirus. They will be in force for two years and will be triggered only in the instance of a serious or imminent threat to public health by a person not complying with public heath advice and therefore putting themselves and/or others at risk.

The noble Baroness, Lady Brinton, asked about the devolved Administrations. These regulations apply only to England, but we are in touch with the devolved Administrations, and they will consider this. Obviously, CMOs are acting in concert, and we think that the devolved Administrations will want to take this forward. The question of the scrutiny by Parliament is one for duty managers, but we have come back to the House with this issue on a number of occasions and we are very committed to keeping the House updated on this and will continue to do so.

On the point about how the NHS is being kept updated and prepared, we have announced the capital arrangements today to ensure that the NHS can be prepared for different isolation measures, but the NHS is always ready to provide world-class care, with expert teams in every ambulance service and a number of specialist hospital units that can respond to this. I am pleased to report that the latest data from PHE indicates that, in the past week, flu activity has once again decreased, against all indicators, the rate of GP consultations remains below baseline levels and the rate of ICU and HDU admissions and hospitalisations remains low, which is an encouraging background for us.

The noble Baroness, Lady Brinton, also asked about those who are vulnerable. This is factored into the NHS 111 algorithm, where we advise individuals to call should they have any concerns, as part of the public health advice. I take on board her point about those individuals who may be useful for community communications with councils, schools and others. Obviously, the first place for advice is Public Health England, but there may be activity which I do not have in my brief, so I will come back to her on this.

We have cascaded very detailed information through the NHS about coronavirus—what to look out and what actions to take—which has come from the Chief Medical Officer and those leading the response, to ensure not only immediate response and preparedness, but also on what actions can be taken by healthcare professionals to protect themselves.

The noble Baroness, Lady Thornton, asked about vaccines. She will know that we have pledged £20 million for the new vaccines to combat this. Every day that we slow down sustained transmission is a day closer to development of that vaccine. Developing a new vaccine is not necessarily a quick process; I think it will be in months rather than weeks, but we will put every effort into making sure that we can take part in that.

Finally, the noble Baroness, Lady Brinton, asked about the differential advice regarding travel from Wuhan and travel from other Asian states and about where that stands at present. The Scientific Advisory Group for Emergencies and UK Chief Medical Officers have given that advice, on those who have travelled from mainland China and the other nations that I stated versus those who have travelled from Wuhan, based on evidence now available on sustainable transmission. Should there be person-to-person transmission at a different rate, it would be kept under review and the advice would change.

I hope that I have responded to most of the questions. Should there be further questions, I am happy to respond in writing.

Health: Tinnitus

Debate between Baroness Brinton and Baroness Blackwood of North Oxford

Wednesday 5th February 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

The noble Lord is absolutely right that contact should be made with a GP regarding hearing loss as soon as possible, that links between hearing loss and dementia have been found and that it is extremely important that we increase research in this area. That is exactly why I have asked officials to get together a round table regarding hearing loss and dementia to drive up research in this area as soon as possible.

[Baroness Brinton (LD)]

My Lords, one in 30 children suffers from tinnitus. That is one child in every average-sized class, so there are a number of such children in every school. These children often say that their tinnitus sounds like a rushing train. They find it difficult to concentrate in school and often end up with problems. Some of these children will require mental health support. Can the Minister say what the current waiting time is for a CAMHS appointment for a child or young person suffering from life-changing tinnitus? It is a chronic condition. There is already a problem with the waiting list for children and young people with acute and life-threatening conditions, but what is the waiting time for these children to get in front of a doctor?

[Baroness Blackwood of North Oxford]

We are working hard to bring down waiting times across mental health, and the noble Baroness will know that we are bringing in waiting time standards. On mental health provision for those with tinnitus, she will know that we are working to bring in improved access to psychological therapies. Ninety-five per cent of those accessing such treatments and therapies are doing so within the time available. The most important issue is making sure that those therapies are available in an accessible way. Local commissioners have to pay due regard to equality legislation and make sure they provide those services either through BSL-trained therapists or interpreters locally, if necessary.

Paterson Inquiry

Debate between Baroness Brinton and Baroness Blackwood of North Oxford

Tuesday 4th February 2020 Lords Chamber

[Baroness Brinton (LD)]

My Lords, I echo the points just made about the speed of the Government’s reporting. It is extremely helpful that the Minister in another place apologised clearly for the failures in the system and paid tribute to the victims. I too pay tribute to them and their families for their tenacity over many years, when it was clear that something was going wrong but the people who were in a position to gather information and do something chose not to.

The Statement says:

“I can promise the House a full response in a few months’ time.”


This public inquiry has rightly taken two years—it was slightly delayed by the general election and purdah—but it was clear in 2017 what many of the issues were. The excellent report from the Centre for Health and the Public Interest published in November 2017 entitled No Safety Without Liability: Reforming Private Hospitals in England after the Ian Paterson Scandal set out in a slightly different format many of the recommendations in front of us. I am sure that the Department of Health, the NHS and the independent hospitals will have looked at those recommendations.

I ask the Minister right up front: how long will it take before recommendations come back to the House from the Government on where they want to take things? After all, we have a Bill that is almost ready to go—or perhaps, as I said yesterday on the Second Reading of the Birmingham Commonwealth Games Bill, Groundhog Day is coming around again for us. Let us use that opportunity, at the very least, to remedy the obvious shortfalls in the system.

One of our major concerns is regulation of indemnity procedures for healthcare. There are serious shortcomings that must be dealt with as soon as possible. I was extremely concerned to read in the recommendations about the arrangements private hospitals have with clinicians to carry out their own activities that are rather like self-employed contractors almost renting an out-patient desk and in-patient beds. That is similar to renting a barber’s seat but without the overseeing regulations you need when people’s lives and health are absolutely at risk. That must be managed immediately.

Independent hospitals must take responsibility for their actions, so it is good that one of the key recommendations tries to focus minds on filling the gap between responsibility and liability. The report from CHPI two years ago said that this was vital and that independent hospitals must employ doctors and healthcare professionals, because without that responsibility on their behalf they will continue to wriggle out of liabilities and choose not to monitor clinical practice, missing either ill-meaning or incompetent surgeons. That cannot happen in the NHS and trusts have to take responsibility, as they do when things come to light. This hole in the current system needs to be remedied swiftly.

The inquiry also makes the important point that boards must apologise meaningfully and as early as possible. The UK health system, whether NHS or independent, has an extremely poor record of apologising, or of even commenting at all. Worse, it often tries to bury problems, denying whistleblowers any access. I am afraid that this is part of the systematic culture exposed in this very important inquiry—one that fears liability above apology and, equally importantly, does not learn well from mistakes, especially if through malpractice.

It is shocking that patients were often not guided to the Parliamentary and Health Service Ombudsman or the Independent Sector Complaints Adjudication Service. Compare that with the Financial Ombudsman Service: financial services companies must signpost access to the ombudsman at every step of the way when people buy financial products. A financial service problem could result in a loss of money, but a medical problem could end up changing lives for ever, as in the Paterson cases, so when will the Government deal with this issue? Will there be compulsory signposting for patients and clarity over whether all independent hospitals have to sign up to an independent complaints adjudicator—preferably just one, but I understood from what the Minister said in another place that they cannot regulate the independent sector completely? Frankly, as far as healthcare is concerned, my party believes we should.

Once again, the Paterson case demonstrates the need for effective whistleblowing processes. Will the Government commit to an office of the whistleblower to, through legislation, give more protection to patients, whether they are in the NHS or the independent sector? Spire Healthcare has said that it has put more measures in place to encourage staff and patients to speak out since the Paterson case, but even the Statement refers to there still being problems in Spire Healthcare. This just demonstrates that this is not working. Paterson’s victims are very clear: we need a system within the NHS that protects patients and staff. That is equally true of the independent sector.

I end by repeating my initial question: can we please have a timetable for the Government to come back to Parliament with proposed changes, given that a Bill is waiting that could easily be amended for both Houses to attend to speedily?

[Baroness Blackwood of North Oxford]

My Lords, I thank the noble Baronesses for those very important questions on this very serious inquiry. I will try to respond to as many as I can in detail, bearing in mind that the Government are carefully considering the recommendations on an issue that deserves serious consideration.

I will reply first to the question on the Government’s responsibility for the independent sector. As I stated, patients in England have a right to safe and proper healthcare regardless of where it is provided and how it is funded. We are committed to ensuring that public and private sector providers adopt proper measures for protection of their patients, as was rightly raised by the noble Baroness, Lady Brinton. As she said, following a CQC report on acute care in the independent sector, my right honourable friend Jeremy Hunt wrote to the NHS Partners Network and chief executives, seeking their co-operation on a range of safety and quality issues, which will be followed up. Further, the independent sector has published a medical practitioner framework requiring consultants’ practising privilege to be reviewed regularly. Furthermore, the regulatory system has evolved since Paterson was practising, with fundamental standards of care, intelligence-led inspections and greater scrutiny of clinical governance as part of the well-led domain. However, this report is a rightful challenge to us to take a more strategic approach, and to regulate smarter and not harder when problems arise so that we can make sure these issues do not arise.

I would like in particular to pick up on the point made by the noble Baroness, Lady Brinton, that it is vital that the NHS has excellent directors to ensure that it can deliver the right standard of care. The Government have accepted in principle recommendations 1 and 2 of the Kark review,

“to develop specified standards of competence that all directors who sit on the board of any health-providing organisation should meet, and to create a central database of directors.”

The noble Baroness, Lady Harding, the chair of NHS Improvement, is taking this work forward as part of the people plan. This should also improve the standards available.

I must make the point that Paterson is in jail. This demonstrates that action has been taken. We have moved further from where we were. The GMC introduced revalidation in 2012 and the CQC started inspecting the independent sector in 2014. However, we will never be complacent because we recognise that there is much more to do, as the report makes clear. The staff and clinicians need to be more open, as has been stated. That is one reason why we introduced the 500 “freedom to speak up” guardians in 2015. When we speak to people, we know earlier where there are problems. As the inquiry says, we need better systems. I will go back to the national guardian, Henrietta Hughes, to ensure that she is as supported as possible in making these systems work effectively.

Regarding indemnity products, we understand how important it is, not only that patients are able to obtain compensation but that the process for assessing that compensation is easy to understand. We are considering this carefully as part of the response, and whether regulation is an appropriate means of addressing concerns about the indemnity cover of health professionals not covered by a state-backed scheme. This includes the consideration of clarity for patients seeking redress. I hope this reassures the noble Baroness.

There are widespread considerations about how cosmetic procedures not currently covered by the CQC are regulated. I hope I have answered most of the questions. We also recognise that while ISCAS is a second line of complaints system for independent patients, it may not be working for PPUs in the NHS. We will be considering that as part of our response. As for the timeframe for that response, we are looking at a three-month window, but want to ensure that we respond appropriately, carefully taking into account the points raised. As pointed out by the noble Baronesses, there are some quite knotty questions to take into account, which may require regulatory or even legislative responses. We must ensure that we get that right and respond in an appropriate timeframe.

The one further point to put into the mix is that it is still appropriate to take into account that there are many good-quality care providers in the private sector, so NHS commissioning through those providers is still appropriate. We must ensure that the regulatory system works in an appropriate manner and that, where there are concerns, people feel free to speak up and action is taken to protect any patients who may be at risk.

Coronavirus

Debate between Baroness Brinton and Baroness Blackwood of North Oxford

Monday 3rd February 2020 Lords Chamber

[Baroness Brinton (LD)]

I echo the thanks to medics, staff involved in logistics and especially the scientists working so rapidly to sequence the genome of the coronavirus. I support many of the points made by the noble Baroness, Lady Wheeler.

Our concerns are more about some of the very practical arrangements and the fact that the UK seems to be responding 24 or 48 hours behind some other countries. I note the Statement says that

“anyone who has travelled from Wuhan or Hubei province in the last 14 days should immediately contact NHS 111 to inform it of recent travel.”

It also says:

“Anyone who has travelled to the UK from mainland China in the past 14 days and is experiencing a cough, fever or shortness of breath should self-isolate”.


It is interesting that the Philippines, New Zealand, the USA, Singapore and Australia are now barring all foreign nationals from mainland China from entering their countries at all. I know that the World Health Organization is not yet saying that we should follow that, but I noticed that a report at the weekend said that about 340-odd people had come in from Wuhan just before the arrangements were put in place and that the Department of Health was now trying to track these people. Given that we now know that the disease can infect people prior to symptoms emerging, has the Department of Health been able to identify those people who arrived prior to the Government’s arrangements being put in place? Do the Government now have absolutely clear procedures to identify people coming not just from Wuhan and Hubei province but from mainland China so that they can contact them urgently if there are issues? Is everyone travelling in from China getting specific advice about who to contact and what to do?

Finally, what are the numbers of cases in regions outside Hubei? The press is reporting that at least 24 provinces, municipalities and regions in China have now told businesses not to resume work before 10 February at the very earliest. These account for 90% of exports from China. Given that many of our businesses rely on just-in-time manufacturing, I wondered whether the Government were assessing what the impact on our businesses would be if there was a gap in production and exports from China.

[Baroness Blackwood of North Oxford]

I thank the noble Baronesses for their comments and very relevant questions. The UK is of course very well prepared for these types of outbreaks. We have responded extremely well on previous occasions, so we should have confidence not only in the capability of Public Health England and the NHS to respond, but in the ability of our chief medical officers to assess the level of risk, which speaks to the point the noble Baroness, Lady Brinton, made about the pace and types of responses being put in place. This is clear medical advice based on the evidence and data available.

The advice available for travellers is obviously being kept under constant review and it has changed. Currently, there is advice against all travel to Hubei province and all but essential travel to mainland China. Essential monitoring has been put in place for all incoming flights from Hubei province, and for wider travel too. Public health officials are meeting all those flights and advice is being given as outlined in the Statement.

Rightly, a question was raised about the risk to the health workers who respond, as this is a virus that is spread by contact. Obviously, this speaks to the capabilities of NHS expert teams, who are accustomed to responding to any risk. As well as the expertise they already have, advice is being communicated from the CMO and others. The NHS expert teams are with every ambulance service and are in a number of specialist hospital units, where equipment and highly trained staff are ready to receive and care for patients with any highly infectious diseases. We have also provided an extra service on NHS 111, for public health advisers to triage people with specific queries or symptoms who have travelled from the region, so that they get to the right point. I hope that answers the question.

On the question of information to NHS staff across the system, a tripartite letter has been issued by the CMO, the NHS medical director and the director for the National Infection Service and PHE to all front-line clinical staff, so that they are aware how to respond and what steps to take when encountering patients arrived from overseas with respiratory infections. This was updated on 31 January in the light of the WHO’s declaration of PHEIC. I think we can be reassured on that point.

It is absolutely right that the evidence shows that the mortality rate of between 2% and 3% is mostly for older patients and those with pre-existing conditions. That is part of the data and the evidence which has been given to the NHS so that it knows how to provide appropriate care.

I would like to respond to the questions raised regarding the care provided for the confirmed cases. Public Health England is making good progress in identifying and contacting anyone who has been in close contact with those two confirmed cases. Thorough investigations will continue, to ensure that we take all possible actions to identify anyone who has come into close contact with them. They will be given health advice about symptoms, and emergency contact details to use if they become unwell within the 14 days. This is based on the CMO’s advice about tried and tested methods. Additionally, we are pursuing wider contact tracing across the country for all who have come in from Wuhan. We are confident in the progress that we are making.

Finally, I turn to the questions regarding vaccines. As I noted in the Statement, the Government have pledged £20 million to develop new vaccines to help to combat the world’s deadliest diseases. This will support work developing new vaccines for epidemics and includes three new programmes to develop vaccines against novel coronavirus. The project aims to advance vaccine candidates into clinical testing as quickly as possible. I cannot give an exact timeline to the noble Baroness today, but I shall endeavour to get her as much information as possible. I am sure that we shall have more discussion on these issues as we go through this, but I hope that I have answered her main questions. If I have missed anything, I will be very happy to write.

Wuhan Novel Coronavirus: UK Citizens

Debate between Baroness Brinton and Baroness Blackwood of North Oxford

Thursday 30th January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

Public Health England is doing a superb job in providing very clear advice for all those who may be concerned—either those who have relatives in China or those who feel as though they have been exposed. I encourage anybody with concerns to look to Public Health England for the most accurate and up-to-date advice; it is updated on a very regular basis. That is the place to go for the most accurate and clinically validated advice.

[Baroness Brinton (LD)]

My Lords, the Question from the noble Viscount, Lord Waverley, asked about British citizens returning from China and other affected areas. The Minister has concentrated her replies on Wuhan and Hubei province. Yesterday, Dr Michael Ryan, the executive director of the World Health Organization Health Emergencies Programme, said:

“The whole world needs to be on alert now, the whole world needs to take action and be ready for any cases that come, either from the original epicentre or from other epicentres that become established.”


What advice is being given to people coming from other countries where there are already reported cases?

Nursing and Midwifery

Debate between Baroness Brinton and Baroness Blackwood of North Oxford

Thursday 30th January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

Yes, indeed. As the noble Baroness will know, Florence Nightingale was perhaps one of the earliest and most notable statisticians. She is a great role model for those young women who wish to go into STEM careers. One way in which we wish to mark this bicentenary is with the Nightingale Challenge, which calls for every employer of nurses globally to provide leadership and development training for young nurses and midwives in 2020. The aim is to have at least 20,000 nurses benefiting from it in 2020, with at least 100 employers taking part.

[Baroness Brinton (LD)]

My Lords, it is right that we have congratulated nurses and celebrate them but it is also the year of the midwife. It is important that we celebrate the progression in midwifery. Midwives are often much less publicised for the work they do within the community. What plans are there for celebrating midwifery specifically during this year?

[Baroness Blackwood of North Oxford]

We are of course conscious that we need to support midwives, especially as we look to raise standards in midwifery. Specific plans are being developed by the Chief Nursing Officer, Ruth May, which will ensure that all parts of the nursing profession, including midwives, will be focused on. These will be brought forward shortly.

Wuhan Novel Coronavirus: Threat to UK Citizens

Debate between Baroness Brinton and Baroness Blackwood of North Oxford

Wednesday 22nd January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

I thank the noble Lord for his important and timely Question. I am happy to update the House that, from today, enhanced monitoring is in place for all direct flights from Wuhan to the UK. Public health officials will meet every direct flight from Wuhan to the UK and will be on hand to provide information about symptoms. Mandarin and Cantonese speakers will be on hand and leaflets will be available in several languages. We will also roll out enhanced monitoring of all flights arriving in the UK from China. Leaflets and information will be available across all UK airports, advising travellers from China on what to do if they feel unwell. The enhanced monitoring of direct flights will obviously be kept under continuous review and expanded if necessary. The risk to the public is low and the NHS is well prepared but, to answer the noble Lord, any patients assessed for this new disease would be isolated under standard procedures if necessary. There are a number of infectious disease units around the country that would be able to respond appropriately.

[Baroness Brinton (LD)]

My Lords, it is good that the Chinese Government, and indeed our Government, are responding better than has perhaps happened in some past incidents, including over SARS. The BBC has reported today that a number of Chinese cities are now reporting that there are people with this condition. When will flights from those cities, and not just Wuhan, be monitored? Also, will there be specific traveller advice for UK citizens travelling into China who have chronic and underlying conditions that mean they may need to take more care?

NHS: A&E Waiting Time Target

Debate between Baroness Brinton and Baroness Blackwood of North Oxford

Tuesday 21st January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

My Lords, I know that the timetables are going to come forward in the people plan, so I cannot give you that in detail today. What I can tell you is that we have announced that we are investing an extra £4.5 billion in primary and community care by 2024 to fund a good amount of this. The five-year GP contract was agreed between NHS England and the BMA last January, which makes the job much more attractive. In addition, salaried GPs will receive at least a 2% increase and there are incentives to attract them into rural areas, which are struggling the most with recruitment. We have also announced that we want to recruit staff into support services around GPs so that GPs are not focusing on administrative tasks, which has been a disincentive to recruitment over the last period.

[Baroness Brinton (LD)]

My Lords, in addition to the importance of having more GPs to help relieve pressure on the service, there is still the continuing problem of social care, where many people are ending up in A&E or being returned to hospital after a brief stay back at home, or in a home. When will the Government publish their review on social care? We need to make sure that social care is absolutely understood and refunded properly in the future.

[Baroness Blackwood of North Oxford]

The noble Baroness, Lady Brinton, is right to hold the Government’s feet to the fire on this issue. I know the strength of feeling in the House on this matter. She will know that we have provided councils with an additional £1.5 billion to make sure there is short-term funding to address the challenges. Also, of course, the better care fund has provided some winter funding to address some of the challenges. But she is right that there needs to be sustainable funding for the long term. We look forward to the SR for that. Regarding the long-term solution, the Prime Minister has been clear that he wants to bring that forward within this year.

European Union (Withdrawal Agreement) Bill

Debate between Baroness Brinton and Baroness Blackwood of North Oxford

Committee: 2nd sitting (Hansard continued) & Committee stage & Committee: 2nd sitting (Hansard continued): House of Lords
Wednesday 15th January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

I apologise to the noble Baroness; I passed over that note in my response to the debate. Where the UK, a member state, an EEA or EFTA state or Switzerland is responsible for the healthcare of those in scope of the social security co-ordination part of the agreement, such individuals will be entitled to reciprocal healthcare cover from their competent country. This includes EHIC cover for people with full social security co-ordination rights under the agreements, and cover for people who have previously worked in the UK, another member state, an EEA or EFTA state or Switzerland before the end of the implementation period. Obviously, the specifics in future will be subject to the negotiations that will be forthcoming. I hope that that answers the noble Baroness’s question, and she will feel that she can withdraw her amendment.

[Baroness Brinton]

I am grateful to the Minister for her comments, and to other colleagues for their contributions. I am particularly grateful to the noble Lords, Lord Warner and Lord Davies, for their expertise, and especially for the intervention by the noble Lord, Lord Davies. The Minister is always courteous, and always gives us her best brief, but I am not reassured at all on the issue of the EMRN, partly because. although there was plenty of talk about trying to maintain the excellence in life sciences, there was no response to the question of how, with only 3% of the pharma market, we would be able to play the same role as we currently do in the EU, with 25%. There was also a complete failure to respond to the major concerns that everybody expressed about patients not being able to access drugs because we suddenly become a very minor player. On that basis, I will withdraw my amendment this evening, but I will consider whether to lay something for Report.

On the other matter, concerning reciprocal healthcare, again, I am not quite as positive as I think the Minister would like me to be. I remain concerned that the phrase “no-deal planning” was mentioned in the context of both parts of my speech. We on this side are concerned about the impact on UK citizens abroad, and on EU citizens here, of the loss of reciprocal healthcare arrangements. That is really worrying. But I am pleased to hear that there is some reliance, at least in the transition period, on the healthcare arrangements Act. I beg leave to withdraw the amendment.

Young Carers: Health and Well-being

Debate between Baroness Brinton and Baroness Blackwood of North Oxford

Monday 13th January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

We have now delivered all 12 of the commitments and recommendations in the Carers Action Plan to improve the situation for young carers, but the noble Baroness is absolutely right that the way we will improve on that is by improving identification. As I have said, with support from the Carers Trust and the Children’s Society, we are focusing on making sure that we embed not only early identification but also the right support throughout our work with young carers. We know that we have further to go but we are determined to do so.

[Baroness Brinton (LD)]

My Lords, the Children and Families Act 2014 made a very clear link between the Department for Health and Social Care working with other government departments to ensure that young carers got support, specifically the Department for Education. Also in that Act is a young carer’s assessment that every young carer is entitled to. What are the Government doing to ensure that every school identifies such young carers and makes sure that a referral is made to other support mechanisms elsewhere, including health?