NHS: Primary and Community Services

Debate between Baroness Greengross and Lord Prior of Brampton

Monday 7th November 2016 Lords Chamber

[Lord Prior of Brampton]

I think the noble Baroness will agree with me that there are very difficult choices to be made when it comes to public spending. Sometimes, there is perhaps not always a high degree of consistency from our colleagues in the House of Commons.

[Baroness Greengross (CB)]

The Minister mentioned discharge procedures. Unfortunately, carers often do not know about plans for discharge early in the period during which the one they care for is in hospital. As has been said previously, surely the discharge process should start at admission. If the carer is brought in at that point and works with people to make the discharge process work, it will be better. This has never happened. Does the Minister agree that it really must?

[Lord Prior of Brampton]

I entirely agree with the noble Baroness. Good practice means that as soon as a patient comes into a hospital, an estimated date for discharge should be agreed then with the carer, which would enable all the services to come together at the point of discharge. Where that does not happen, one can have long delays.

Breast Cancer: Innovative Drugs

Debate between Baroness Greengross and Lord Prior of Brampton

Monday 24th October 2016 Lords Chamber

[Baroness Greengross (CB)]

As the Minister will know, there is an enormous delay in innovative drug production due to the regulatory bodies internationally not working very closely together or taking a very long time to work together. Will the Minister tell us whether there has been any progress on bringing those regulatory bodies together, as was initiated after the former Prime Minister did a lot of good work in this respect regarding dementia?

[Lord Prior of Brampton]

The noble Baroness is absolutely right. The delay in bringing a new drug to the market can very often be between 12 and 14 years, which is a huge amount of time. Part of the reason for that is indeed the regulatory process. The whole purpose of the Accelerated Access Review is to truncate that time. The report talks about reducing for some drugs the time it takes to bring them to market by up to four years, which would be very considerable progress. In terms of international regulatory bodies, if one takes the EMA in Europe and the FDA in the US, clearly they do work together at one level but probably not closely enough, and I suspect that there is too much duplication in regulation. Certainly, as we leave the European Union, we need to be very careful that we do not have a duplicatory regulatory system in this country.

Carers over 80: Support

Debate between Baroness Greengross and Lord Prior of Brampton

Monday 13th June 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, clearly it is essential that older people have access to at least annual check-ups from their GPs. A large part of the review that is being undertaken will be about how we signpost and inform people of the need to have these health check-ups. I am sure that will be a part of the strategy announced at the end of the year.

[Baroness Greengross (CB)]

Under the new legislation, the Care Act, carers have a right to an assessment of their needs. Will the Minister assure the House not just that those needs will be assessed but that enough resources will be put into the system so that they can be met?

[Lord Prior of Brampton]

My Lords, under the Care Act there is an assessment, eligibility criteria and a support plan. Clearly there is no point having a plan without the support.

National Living Wage: Social Care

Debate between Baroness Greengross and Lord Prior of Brampton

Thursday 5th May 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, the better care fund should be seen in a longer-term context of bringing together health and social care. The sustainability and transformation systems that are now being developed are the logical extension of the better care fund. Until prevention, healthcare and social care are brought together in a single budget, it will be extremely difficult to ensure the right allocation of resources.

[Baroness Greengross (CB)]

My Lords, if a huge number or even a fairly large number of care homes close down—we have been reading about this in the papers—there will be huge pressure on the NHS. That will be the effect. What plans have the Government put in place to deal with what might be a really big crisis in the NHS?

[Lord Prior of Brampton]

My Lords, the Government are putting £10 billion of new money into the NHS over the five-year period. Clearly, if there is a crisis in social care, that will have a direct knock-on effect on the NHS. We fully recognise that. The CQC has an obligation to keep a very close eye on this and to produce early warnings if a major, hard-to-replace provider looks as if it is getting into financial difficulty. It is an area that we are acutely conscious of and are keeping a very close eye on.

Pharmacies: Funding

Debate between Baroness Greengross and Lord Prior of Brampton

Wednesday 2nd March 2016 Lords Chamber

[Lord Prior of Brampton]

The noble Lord raises a very important issue. I do not have the answer to his question. If it is all right with him, I will investigate the matter and write to him.

[Baroness Greengross (CB)]

My Lords—

--- Later in debate ---

[Baroness Greengross]

My Lords, has the Minister considered the relationship between hospital pharmacies and local community pharmacies? At a hospital I know well 56 people are discharged every day. However, they cannot be discharged until their prescriptions are ready from the hospital pharmacy. As people wait up to four hours, beds are blocked 56 times for four hours while they wait. A closer link—which exists in one or two areas—between the two types of pharmacy might remedy that situation. Has the Minister any plans to look at that issue?

[Lord Prior of Brampton]

The noble Baroness makes a very important point. There are many delayed discharges from hospital because people are waiting for their medications and many hospitals do not have the automation within their in-house pharmacies to meet the demand to which she refers. The big driving force going through healthcare and community pharmacy today is one of integration, which means that community pharmacies must in future work more closely with their local hospitals and GPs.

NHS: Preventive Medicine

Debate between Baroness Greengross and Lord Prior of Brampton

Wednesday 20th January 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, it is a very serious issue that over 40 years, and probably for longer, the difference between the life expectancy of the rich and the poor has always remained at about 10 years: and for healthy living it is more like 25 years. I think it is fully understood from Sir Michael Marmot’s report and thereafter that the social determinants are more important in closing that gap than anything we can do in healthcare directly, so what the noble Lord says is absolutely true.

[Baroness Greengross (CB)]

In the 2015 report Opportunity Knocks: Designing Solutions for an Ageing Society, the University of Cambridge Engineering Design Centre, the ILC-UK and the IET highlighted the vital role of good design and technology in supporting preventive medicine, particularly, but not exclusively, for older people. The OBR warned us last year that without technological innovation over the next decade, health spending in 2063 might be 5% of GDP higher than currently projected. Do Her Majesty’s Government agree that we must invest in technology to save money by facilitating the preferred solution of sustaining independent living, particularly among older people and those subject to the revolving door syndrome? Will the Government support this and invest in it?

[Lord Prior of Brampton]

My Lords, good design is very much part of any long-term strategy towards improving the lives of our citizens, so it is a hugely important part of our longer-term strategy.

Four Seasons Group

Debate between Baroness Greengross and Lord Prior of Brampton

Monday 11th January 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, the collapse of Southern Cross in 2011 was the main reason that the previous Government gave the CQC market oversight responsibilities, which will give early warning of any failure of a large provider. It is worth noting that the LGA believes that at least 95% of all local authorities have contingency plans ready to be implemented.

[Baroness Greengross (CB)]

My Lords, the former Health Minister, Norman Lamb, called for a cross-party commission to review future funding for health and care services in this country. Does the Minister not agree that we have to start talking, honestly and openly, about what standards of health and care older people can expect now and in the future? Having a commission to look in depth at this and to come up with strong recommendations seems—to me, at any rate—a rather good idea. Does the Minister agree, and will he comment on whether such a commission might be established?

[Lord Prior of Brampton]

My Lords, the idea of having a commission has been discussed a number of times in this House, and there will be a long debate on this matter on Thursday. In the spending review the Government are enabling local authorities to increase their precept by 2% and they are increasing the contribution to the better care fund by £1.5 billion, which will see a real increase in the resources available for adult social care.

Health: Adult Pneumococcal Vaccination

Debate between Baroness Greengross and Lord Prior of Brampton

Tuesday 8th December 2015 Lords Chamber

[Baroness Greengross]

To ask Her Majesty’s Government what plans they have to improve the efficacy of the adult pneumococcal vaccination programme and to ensure optimal coverage of target populations in the United Kingdom.

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, vaccination of children, adults and risk groups with pneumococcal and influenza vaccines has led to a significant reduction in pneumococcal disease in the UK. The Joint Committee on Vaccination and Immunisation published an interim statement on adult pneumococcal vaccination on 18 November. The JCVI statement is subject to stakeholder consultation before being finalised. The interim statement advises continuation of the existing adult pneumococcal vaccination programmes. The Government will respond fully once the advice is finalised.

[Baroness Greengross (CB)]

I thank the Minister for that reply. As he knows, this disease puts an enormous pressure on the NHS and on patients. The recent report that he mentioned from the ONS showed that pneumonia was the underlying cause in almost a fifth—19%—of the 43,900 excess deaths in England and Wales just last winter. The recent review by the Joint Committee mentioned by the Minister recommended no changes to the adult pneumococcal vaccination programme at this time, which is a bit surprising. The committee is currently consulting, as the Minister mentioned, and it acknowledged that there are weaknesses with the levels of protection offered to at-risk adults. Will the Minister look into this issue and work to make sure that the pneumococcal vaccination programme provides optimal protection for vulnerable adults?

[Lord Prior of Brampton]

My Lords, the report by the JCVI was very clear in its recommendation that the existing vaccination, PPV, was the most appropriate for those aged over 65 and that PCV 13, which is the vaccination used for young children, because it provides herd protection—that is, young people who are treated with it can no longer carry the disease—offered the best long-term protection for the elderly as well.