Health: Non-communicable Diseases

Baroness Masham of Ilton Excerpts

Thursday 6th October 2011 Lords Chamber

[Baroness Masham of Ilton]

My Lords, I thank my noble friend Lord Crisp for bringing up this most important topic today in your Lordships’ House. He is an important ambassador, taking expert knowledge to the World Health Organisation and the United Nations and bringing information back to the UK. This is a timely debate for your Lordships as we will be debating the Health and Social Care Bill next week and non-communicable diseases need to be highlighted. They are a huge part of the health agenda.

My husband, who was a Member of your Lordships’ House and for a time Deputy Chief Whip, sustained several non-communicable diseases. He had several strokes, diabetes, Parkinson’s disease and a cancer tumour of his lower bowel. After 10 years of living with these conditions, he died of a respiratory disease—pneumonia—in an A&E department on a Sunday evening. My father died of coronary heart disease on a Sunday morning in Scotland when I was 18. The locum doctor thought he had a chest infection. He died half an hour later. Perhaps your Lordships will understand why I am so passionate to see correct diagnoses, care facilities improved, and the prevention of and research into the hundreds of different NCDs high on the agendas of countries across the world. In the mean time, however, the correct drugs should be available to help with the different diseases.

The UK, as a so-called developed country, has many improvements to make. Many people who watched the recent “Panorama” programme on the treatment of vulnerable people living in a care home near Bristol are still reeling from the horror of what they saw. Many people are surprised to learn that care assistants can get a job with no registration. They can be nurses who have been dismissed for dangerous and disgraceful practices and then be taken on as care assistants with no registration and no control. Surely all patients with non-communicable diseases who are vulnerable should feel safe and protected. I hope that the Government will take the safety of all patients very seriously. There have been far too many unkind and unacceptable incidents in recent years. That just cannot go on.

The Global Status Report on Noncommunicable Diseases 2010 states:

“Noncommunicable diseases (NCDs) are the leading global causes of death, causing more deaths than all other causes combined, and they strike hardest at the world’s low- and middle-income populations. These diseases have reached epidemic proportions, yet they could be significantly reduced, with millions of lives saved and untold suffering avoided, through reduction of their risk factors, early detection and timely treatments”.

The Global Status Report on Noncommunicable Diseases is the first worldwide report. It shows ways to map the epidemic, reduce its major risk factors and strengthen healthcare for people who already suffer from NCDs.

It is important that the World Health Organisation gets support from Governments worldwide. Of the 57 million global deaths in 2008, 36 million—or 63 per cent—were due to non-communicable diseases, principally cardiovascular diseases, diabetes, cancers and chronic respiratory diseases. As the impact of NCDs increases, and as populations age, annual NCD deaths are projected to continue to rise worldwide. Accurate data from countries are vital to reverse the global rise in deaths and disabilities. At the high-level UN meeting this September, world leaders unanimously adopted the political declaration on non-communicable diseases, agreeing that the global burden and threat of NCDs continues to be one of the major challenges for development in the 21st century, undermining social and economic development throughout the world. The director-general of the World Health Organisation, Dr Margaret Chan, told the meeting that NCDs are,

“the diseases that break the bank”.

Recommendation No. 6 is of the utmost importance. It is to:

“Recognize the urgent need for greater measures at global, regional and national levels to prevent and control non-communicable diseases in order to contribute to the full realization of the right of everyone to the highest attainable standard of physical and mental health”.

There are thousands of non-communicable diseases across the world, but there seem to be clusters in different parts of the UK. Two such conditions are spina bifida and leukaemia. Why should that be? There is a vital need for ongoing increased research into all non-communicable diseases. The health department, universities, pharmaceutical bodies, specialised units of experts and voluntary associations should all be working together to address the multitude of needs.

Diabetes has become a serious global emergency. The epidemic is now imposing a heavy dual burden of infections and non-communicable diseases on already under-resourced health systems. To date, no country has succeeded in turning around the figures. There are 50.8 million people with diabetes in India and 92.4 million in China. Africa will have the highest percentage increase in the number of people with diabetes over the next 20 years; 80 per cent of people with diabetes in Africa are undiagnosed. It is encouraging that countries are working together to try to find ways to stem that ever-increasing problem.

The Neurological Alliance is the collective voice of 80 brain and spine charities, representing the 8 million people in England with a neurological condition. They are often called the neglected 8 million. I hope that the Minister will see that every person diagnosed with a neurological condition has access to high-quality, joined-up services and good information.

Being a member of the all-party group on cancer and rarer cancers, I must make your Lordships aware of the great concern that exists about late diagnoses, especially of rarer cancers. The Government must be congratulated on setting up the rarer cancer fund, but research from the fund on the diagnosis of rarer cancers revealed that GPs are failing to diagnose almost a third of people with rarer forms of cancer at an early stage, damaging their chances of long-term survival. Late diagnosis is the major reason why cancer survival rates in England lag behind those in other developed countries. GPs should be rewarded for identifying the signs and symptoms of cancer when they are at an early stage and for referring patients for investigation; they should not be encouraged to delay referrals, which seems to be a worrying trend. I hope that the Minister will help over this serious matter.

I hope that the specialist voluntary associations which bring members’ needs to the Government’s and the public’s attention, and which lobby for better conditions, will be listened to. I have experienced at first hand with my husband’s condition the value of specialist nurses when they are involved in the treatment of patients. They support patients with conditions such as diabetes, strokes, Parkinson’s disease, MS, rarer cancers, and so many others. Not having specialist care would downgrade treatment and care.

Many improvements can be made for adults and children with non-communicable diseases here in the UK. I refer to services such as wheelchairs and prosthetics. Assessments of patients and the supply of aids and equipment can take months, if not years. Someone with a condition such as motor neurone disease needs help immediately. Sometimes patients languish in hospitals far longer than necessary due to the inefficiency of the system.

I end by asking the Minister whether he is satisfied with the training of doctors in pain control for thousands of patients with non-communicable diseases, such as arthritis, when pain can interfere with employment and the quality of life. Is it not the case that several pain clinics have had to close down for lack of funds? I hope that this debate will highlight some of the needs of people living with non-communicable diseases.