Musculoskeletal Health
Baroness Burt of Solihull Excerpts(1 day, 7 hours ago)
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Baroness Merron (Lab)
I thank the noble Lord for allowing me to reiterate that the department is working closely with NHS England to look at a whole range of options to provide better-quality care and access to those important preventive services. I emphasise that this is part of ending the postcode lottery. I remind your Lordships’ House that integrated care boards are responsible for the delivery of these services. We will continue with the further actions that we are taking, some of which I have already referred to, which will ensure that patients are getting the service they need.
Baroness Burt of Solihull (LD)
Integrated Care Journal has indicated the potential to improve access pathways, giving an example of an AI physiotherapist service at home and covered by CQC. Will the Government develop and adapt something like this?
Baroness Merron (Lab)
The noble Baroness raises an interesting point and I will be happy to look into what she suggests. I know she is aware that one of the main pillars of change will be about analogue to digital, and in that I put the contribution of AI. Just this afternoon I will speak to a conference about the role of AI in respect of women’s health, and osteoporosis will be very much part of that.
Prisons: Health Services
Baroness Burt of Solihull Excerpts(2 weeks, 3 days ago)
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Baroness Merron (Lab)
Substance misuse in prison, to which the noble Baroness refers, is of course a major issue, and prison security has a crucial role to play in reducing it. I should also say that the use of illegal drugs can impact on routine healthcare for all prisoners, as resources have to be directed to the more immediate cases. Noble Lords may remember that we recently had delegated legislation to ensure that nasal Naloxone could be administered, including by prison staff, to prevent opioid-induced emergencies. All these things will help, and substance misuse support is available in all prisons in line with the national service specifications, but we are working across government to see what more we can do. It is a big issue.
Baroness Burt of Solihull (LD)
My Lords, many of the issues preventing prisoners getting equivalence of care with non-prisoners clearly relate to access to hospitals and health specialists. As we know, delays can exacerbate conditions. Will the Government ensure that the Nuffield Trust recommendations on improving transparency, prisoner escort numbers, reviewing the supply of prison escorts and increasing access to out-patient services via telemedical services are implemented as fully as possible?
Baroness Merron (Lab)
The use of technology is hugely important in all areas, particularly in respect of prison services, as the noble Baroness says. There is a policy specifying that escorts must consist of at least two prison officers, with at least one being of the same gender as the prisoner unless there are exceptional circumstances. I take this opportunity to say that every effort is made to ensure that female staff support women, particularly where appointments are specifically related to services such as gynaecology. It is very important that we are aware of the possibility of retraumatising women prisoners, and we have been particularly mindful of that in relation to escorts.
NHS: Single-sex Provision for Staff and Patients
Baroness Burt of Solihull Excerpts(3 weeks, 2 days ago)
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Baroness Merron (Lab)
The noble Lord raises an interesting point. In all cases with guidance, that is always the balance we seek to reach. I am also interested in the history of this, and I am sure the noble Lord will remember that the 2019 guidance on trans patients in single-sex spaces proved somewhat controversial, if I might put it that way. The guidance was meant to be updated under the last Government, but this did not happen. I am advised that it was delayed by a dispute between the previous Government and NHS England, which also delayed proposed updates to the NHS constitution. These again were consulted on under the last Government—which was a good thing—but nothing actually happened. So all these come to us as a new Government and will be given full consideration to get us into the right place.
Baroness Burt of Solihull (LD)
In the last few weeks alone, we have heard about the range of challenges facing our NHS: physically collapsing hospitals, extensive waiting lists and a social care review, to name but a few. More guidance in areas of uncertainty is to be encouraged. However, given that only 0.55% of the English population is trans, where does the Minister think that this should come in the order of priorities?
Baroness Merron (Lab)
I know that everybody in your Lordships’ House will take the view that the NHS is there both as an employer—as all employers are; this is not specific to the NHS—and in its service to patients. It is there to treat all with the right dignity and respect. We have a legislative framework to which reference can always be made. We will see what further guidance is needed—and that may be to all employers, not just the NHS. Again, I cannot emphasise enough the need for careful consideration and the involvement of all staff, on what has to be a trust-wide basis, because everybody is different in terms of their estate and what their challenges may be. It is not as simple as numbers: it is about fairness and dignity for all.
NHS: Patients with Allergies
Baroness Burt of Solihull Excerpts(1 month, 2 weeks ago)
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Baroness Burt of Solihull (LD)
My Lords, I congratulate—with my horrible squeaky voice—the noble Baroness, Lady Ramsey, on securing this debate today. My concern is not so much adolescents as children.
In my hotel room this week, I was interested to find a card explaining what to do in the case of anaphylactic shock. This suggests to me that the concern about, and the volume of cases of, serious reactions to allergies is on the up, as well as the seriousness with which the hotel group took its responsibility towards its guests. Indeed, that is borne out by the facts: an estimated 21 million people—just under one in three of us in the UK—live with one or more allergies. For most of us, this can be managed and is not severe, but for some it can be life-threatening, as the noble Baroness has said. In the UK, between 1998 and 2018, more than 100,000 people were admitted to hospital for anaphylaxis, a life-threatening allergic reaction. While the number of hospital admissions has increased in recent years, the number of deaths, I am glad to say, has decreased.
Allergy UK advocates three policies to improve NHS services for people who suffer from allergic reactions. The first is to have an allergy nurse and dietician at primary level for each UK health region. That does not seem a huge ask to me but, apparently, there is a postcode lottery for specialist allergy services. Secondly there should be a national register to consolidate patient data across the country and track allergy diagnoses. Clearly, this would enable the identifying of areas where additional services were needed. Thirdly, prescription costs should be removed for those living with allergies to address the additional costs people face when managing their allergies. The estimated total cost is £3,000 per year; I tried to quantify that but had to give up. Suffice it to say that removing at least the prescriptions costs would be a very reasonable thing, because people live with these conditions.
Earlier this week, there was a reception for people interested in allergies by the Benedict Blythe Foundation. Benedict, a little four year-old, collapsed at school and died from anaphylaxis. Helen, Benedict’s mum, whom I met this week, has been campaigning for all schools to have the recommended allergy safeguards in place. Teachers need to be able to manage the average one to two pupils with an allergy in each class, but many feel underprepared to be able to deal with a child experiencing an anaphylactic reaction. Every teacher should feel prepared. Every parent delivers their child to the care of the school every schoolday. Surely it is the duty of the school to take care of the health and well-being of that child above all else and to hand them back to the parent at the end of the day as fit and healthy as when they went in. After all, if an individual hotel room can have a notice explaining what to do in the case of an anaphylactic reaction, should not all teachers who care for the children of others have that basic knowledge too?
Cancer: Older People
Baroness Burt of Solihull Excerpts(2 months, 1 week ago)
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Baroness Merron (Lab)
It is important that we concentrate on the biggest ever NHS consultation, because that will lead us to the 10-year plan, and all that we are doing will sit within that. As the noble Lord will know, we are committed to getting the NHS to diagnose cancer earlier, treat it faster and improve waiting times. One of the announcements in the recent Budget, which also shifts the dial, is that we will deliver an extra 40,000 scan appointments and operations every week. The 10-year health plan will set out our approach for shifting healthcare from sickness to prevention, including reducing the incidence of cancer.
Baroness Burt of Solihull (LD)
My Lords, my mother-in-law died riddled with cancer that was not diagnosed until the very end of her life. We know that older people often suffer from several conditions and that frailty may minimise the treatment options available. The comprehensive geriatric assessment is the gold standard for the assessment of older patients and can make a real difference in outcome and cost, but cancer is not embedded in that assessment. Will the Minister find out from clinicians whether that might be possible?
Baroness Merron (Lab)
I give my sincere condolences to the noble Baroness and her family. Yes, I will raise that. It is a good point to look at, and I thank her.
National Carers Strategy
Baroness Burt of Solihull Excerpts(2 months, 1 week ago)
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Baroness Merron (Lab)
It is indeed the case that using technology and digital advance is key in all the areas where we are working, and the noble Lord will know that in the 10-year plan one of the three pillars will be, for example, going from analogue to digital. On that point, plans for going forward in dealing with social care, which is much needed in this country, will be set out in due course. I assure your Lordships’ House that it will be done through a cross-party approach, involving those with lived experience and the many voices and organisations that are part of the social care sector. We are keen that it is something that we can all get behind.
Baroness Burt of Solihull (LD)
As the Minister has said, the carer’s allowance was increased in the Budget by what can only be described as a modest amount, but it remains at one of the lowest levels for any benefit in the UK today. No help has been given to any carer who inadvertently overclaimed, even by £1. If the Government chose, they could stop collecting the overpayments while the independent review that they have commissioned takes place. Carers saddled with returning this money are struggling and suffering now. Why cannot the Government give them a break?
Baroness Merron (Lab)
I understand the point that the noble Baroness is making. Certainly we recognise that overpayments have caused people great anxiety. That is why it is important to review the circumstances independently, so we can find out exactly what went wrong and make things right, so it does not happen again. The main message I would give is to urge anyone in receipt of carer’s allowance to inform the DWP of any change in their circumstances in respect of the earnings limit, so that overpayments can be avoided. But we are seeking to work constructively to ensure that this is not an ongoing problem.