Diphtheria

Baroness Manzoor Excerpts

Tuesday 18th April 2023 Lords Chamber

[Lord Markham (Con)]

All I can say is that the Department of Health co-operates very closely with the Home Office. We have a screening programme for all migrants coming in, as I mentioned, and an 88% vaccination rate for diphtheria among them, compared with 93% of UK children. It is a very high rate indeed; that record speaks for itself.

[Baroness Manzoor (Con)]

My Lords, as the Question implies, the UK has an excellent record on uptake of vaccinations, but my noble friend will know that the level has fallen among children for the MMR vaccine. What action are the Government taking to ensure that the most vulnerable are given this vaccination and that rates go back up to pre-Covid levels?

[Lord Markham (Con)]

We are all aware of the rumours and allegations about the safety of the MMR vaccine, which we are all delighted to know were totally unfounded. As my noble friend says, it has been quite a task to regain confidence in it, but we are doing so and vaccination rates have gone up. I will provide her with the exact details of those new take-up rates.

Patient Deaths: Ambulance Waiting Times

Baroness Manzoor Excerpts

Tuesday 14th March 2023 Lords Chamber

[Lord Markham (Con)]

The noble Baroness is absolutely correct. Some 50% of all wait times—I have used this statistic before and I will correct it if I have not got it exactly right—come from I think 20 trusts. Clearly, there is a focus on working on those areas. That is starting to bear fruit, with each of those trusts having specific plans to ensure that they use best practice. We have tried to pick the best practitioners in an area— I have done this on two occasions recently—and bring them into the centre to help us advise across the board. That really is making a difference.

[Baroness Manzoor (Con)]

My Lords, as well as disseminating good practice, there is the issue of accountability. The Government have put significant sums of money into the NHS, so what are the regulators —NHS England and others—doing to ensure that good practice is disseminated and, more importantly, that the chief executives and the boards are delivering on the commitments they have made?

[Lord Markham (Con)]

My noble friend is absolutely correct: with responsibility for these things comes accountability, and it is the job of us all to hold people to account where performance is not where it should be. I know each Minister has their own set of ICBs— I have a particularly close relationship with seven; other Ministers have the same—so that we can bear down on exactly these sorts of differences and hold people to account.

Physiotherapy: Rehabilitation Services

Baroness Manzoor Excerpts

Thursday 23rd February 2023 Lords Chamber

[Lord Markham (Con)]

Absolutely. That is why, as part of my research, I was pleased to read up on the national integrated community stroke service, which is designed to give personalised stroke rehabilitation in every person’s home. Its work is vital in achieving this. The House has heard me talk many times about the 13,000 beds that are blocked in our hospitals, and a lot of the way to free them is by having rehabilitation and getting people back into their home environment. I absolutely agree on the importance of this issue, and that is why noble Lords will see it as an important part of the workforce plan.

[Baroness Manzoor (Con)]

My Lords, I welcome the Answer my noble friend the Minister gave, but I will give him a real-life example, and declare my interest in doing so: somebody had two strokes, then had a third while waiting over an hour for an ambulance to arrive, has had no physiotherapy rehabilitation at home, and is still waiting a year on for that. This is a real example of people on the ground. Does the Minister agree that we must connect our policies with very clear outcomes?

[Lord Markham (Con)]

Totally. I am sorry to hear that case, and I think that we would all agree that that is not the sort of service we would want to see. As I said, we have put increases in staff in place—there have been 3,300 extra staff since 2017—but, clearly, we need to do more. That is why I was very pleased to read that this area is an important part of the workforce plan, which noble Lords will be happy to hear we are now seeing drafts of.

Maternity Services

Baroness Manzoor Excerpts

Thursday 9th February 2023 Lords Chamber

[Lord Markham (Con)]

I welcome the noble Lord’s pursuit because that is absolutely the right thing to do. I think we all agree with that, and we would all say that what happened in East Kent and the other examples from the Ockenden report are clearly not something that we are happy with or that we should put up with. The Kirkup and Ockenden reports gave us a north star, a way forward. I am pleased to see that we are making progress on that, but I expect the noble Lord to hold us fully to account because I am holding the department to account on this.

[Baroness Manzoor (Con)]

My Lords, building on what the noble Lord, Lord Patel, has said, my noble friend will know that continuity of care is really important and has been recommended by the Better Births maternity review. That builds up with better medical understanding of the woman, the pregnancy and the issues related to it. However, only 37% of women are afforded this, and that drops down to 27% in antenatal care. What are the Government doing to take steps to address this so that the terrible examples that we have seen recently are averted?

[Lord Markham (Con)]

I agree with the work by my noble friends, including the noble Baroness, Lady Cumberlege, to put the importance of midwifery continuity of care at the centre of everything. The survey to which my noble friend’s question refers shows that that is coming through in terms of a consistent message that having that confidence in the person in treating them is vital to all of this. That remains important. Key to this is the workforce, so this is one of the things that is being built into the workforce plan. That is starting with ensuring that we have new people coming in. The 1,200 graduates that we now have going into training each year are a vital part of making sure that we can deliver.

Osteoporosis: Early Detection

Baroness Manzoor Excerpts

Thursday 19th January 2023 Lords Chamber

[Lord Markham (Con)]

As previously mentioned, prevention is always better. Exercise, as I have learned from my noble friend Lord Sandhurst, is a good way of preventing osteoporosis. Where we can find cost-effective ways of getting that exercise, such as swimming pools, we should be promoting them.

[Baroness Manzoor (Con)]

My Lords, having identified the causes of osteoporosis, could my noble friend say how the message is being communicated? He mentioned vitamin D, which could be an issue, but the reality is that some vulnerable women in communities do not get some of the messages regarding exercise or indeed have access to those facilities. I know walking and so forth can help, but what are the Government doing to put that preventive message across in a very firm and consistent way?

[Lord Markham (Con)]

My noble friend is correct that education and awareness are always the start point on any of these health issues. It was a key part of the women’s health strategy that came out in 2022. Osteoporosis is a key part of that, and promotion and awareness are a key part if it as well.

Streptococcus A: Antibiotics

Baroness Manzoor Excerpts

Thursday 15th December 2022 Lords Chamber

[Lord Markham (Con)]

The key mechanisms always involve broadening the supply chain. I have given exactly that instruction to the department, which is very much taking it on board. It is looking at supply across a number of sources, not just from the UK but worldwide, as well as the substitution of antibiotics. Penicillin is currently the advised one, but a number of others are being advised right now which will also work well, so that there is as much choice as possible.

[Baroness Manzoor (Con)]

My Lords, my noble friend will be aware that, while some people are making profits, 16 children under the age of 15 have died as a result of strep A. Exactly what advice is being given to GPs so that parents have direct access to them very quickly? Of course, there is also a concern about antibacterial resistance as a result of overprescribing antibiotics.

[Lord Markham (Con)]

I thank my noble friend and will take this opportunity to offer that public health advice. A rash, which is often the first sign of a bacterial infection in this case, or a child being floppy, drowsy or dehydrated are all key signs that they should urgently seek medical help. People can call 111 or 999 and be guided through the triaging process to make sure that they get help quickly. At the same time, medics have been told to lower the barrier for prescribing, so to speak, so that they can make sure that people get it early. Although every death is a tragedy, we are clearly now seeing some reduction in the death rate, which is welcome.

NHS: Backlogs

Baroness Manzoor Excerpts

Wednesday 9th November 2022 Lords Chamber

[Lord Markham (Con)]

I agree on the importance of that; as the noble Lord says, often these are easy savings to make, but they are not the right ones. I assure the House that it is a key priority of mine that even such things as operational maintenance, which sounds very unsexy, are a key element in all this. As I say, that is why we have seen a 57% increase in the past year. At £10 billion a year, I hope we all agree that this is a good plan, albeit that there is a lot that needs to be done.

[Baroness Manzoor (Con)]

My Lords, the Public Accounts Committee has stated that £8.6 billion was lost by the DWP last year in overpayments to benefit claimants and fraud. That is £8.6 billion that could be used to maintain the NHS estates. Can my noble friend the Minister say what the Government are doing to ensure that not only are the inefficiencies cut in the NHS, but efficiencies are made within the wider government departments?

[Lord Markham (Con)]

Thank you. I am sure the whole House will agree the need for efficiencies to make sure every pound is well spent. I have a little knowledge in the DWP space. Although it falls outside my responsibilities now, I was the lead NED there and I know that the team worked very hard during the pandemic to make sure that universal credit reached people quickly, and as a result they did not proceed with as many checks as they would do normally. It was deliberate policy to make sure money was paid quickly to those who needed it. At the same time, they absolutely understand that they need now to get on top of it and it is key to their action because, as my noble friend says, the more money we can free up in other departments, the more we can focus it on the front line where we really need it.

Care Homes: Energy Costs

Baroness Manzoor Excerpts

Thursday 8th September 2022 Lords Chamber

[Baroness Manzoor (Con)]

My Lords, the NHS has a great history of running great campaigns. I am thinking of “Clunk, click” and the campaigns against smoking and alcohol. Can the Minister say, because not only the cost but the supply of energy is very important, how the department is co-ordinating to ensure that there is a campaign to reduce the energy used in homes, particularly those in the higher income brackets?

[Lord Kamall (Con)]

I thank my noble friend for the question. The issue is much wider than just health. We are working with local authorities to understand the impact on the care sector, but there is also a huge cross-government approach on education and energy efficiency. We have to wait and see the package before we can look at this in detail with the sector, and at what measures can be offered.

Social Care: Adults

Baroness Manzoor Excerpts

Wednesday 22nd June 2022 Lords Chamber

[Lord Kamall (Con)]

I am afraid I will have to humbly disagree with the noble Lord, because this has been a problem for subsequent Governments, as we discussed during the passage of the Health and Care Bill. In some cases we can see reports going back 50 years. What has happened over the years is that Labour, Conservative and coalition Governments have put those reports on shelves to gather dust. We were the first Government to introduce an integrated health and care system and to grasp the nettle.

[Baroness Manzoor (Con)]

My Lords, there is some anecdotal evidence that patients are being discharged from hospital without having a full care package in place. Could my noble friend say exactly what the Government’s policy is to ensure this does not happen? These are some of the most vulnerable people, such as individuals who have had a stroke. On occasions, they are sent home with no support mechanism at all.

[Lord Kamall (Con)]

I thank my noble friend for the question. It is a really important issue that we discussed many times not only during the passage of the Health and Care Bill but subsequently. We have to make sure that everyone in the system is working together to make sure that a hospital knows who it is discharging to and that the carer who will receive or help that person has not only the support but the facilities and capabilities at home, or wherever that person is being discharged to, to work with that person. There are gaps in the system; it is not perfect in all places. We are working with local authorities and others to make sure we improve the system.

Personal Protective Equipment: Waste

Baroness Manzoor Excerpts

Tuesday 14th June 2022 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Lord for that suggestion. I am not aware of the product to which he refers, but I should be grateful if he would write to me with more detail and I will pass it on to the department.

[Baroness Manzoor (Con)]

My Lords, it is important that lessons are learned from the PPE purchasing, but will my noble friend the Minister say what action the Government are taking to reduce people’s waiting times for surgery, diagnostic testing and clinical assessment, because that is the follow-on from the delays as a result of Covid-19?

[Lord Kamall (Con)]

My noble friend is absolutely right that there has been an elective backlog. In analysing the backlog across the system we have found that about 75% to 80% of those waiting are waiting not for surgery but for diagnosis. This is why we have rolled out community diagnosis centres and will continue to do so, not necessarily in NHS settings but also in sports grounds, shopping centres, et cetera. On top of that, about 75% to 80% of those who require surgery do not require an overnight stay. We are trying to work through the elective backlog as quickly and effectively as possible.