Health: Parkinson’s Disease

Baroness Thornton Excerpts

Monday 10th January 2011 Lords Chamber

[Baroness Thornton]

My Lords, I congratulate my noble friend on initiating this debate, and thank her for her commitment to Parkinson’s disease and for chairing the important all-party group’s report. I doubt I shall address a question to the Minister that someone else has not already asked. None the less, as is traditional in your Lordships’ House, I shall continue to speak.

As noble Lords will know, Parkinson’s is a long-term degenerative neurological condition. Symptoms can include stiffness of movement, pain, incontinence and dementia, which fluctuate from day to day, as noble Lords have mentioned, and worsen over time. It has a profound impact on people who have it, their families and their carers. I might be the first person in this debate to mention that one of the key problems with Parkinson’s disease is the stigma that goes with it. People may not recognise that people have Parkinson’s. They might think that they are drunk or that there is something else wrong with them. That is an additional burden that people with Parkinson’s disease have to carry with them.

The background to this debate is the brilliant report Please Mind the Gap, which took evidence from 360 people with Parkinson’s, their carers, health and social care professionals and representatives of public bodies, royal colleges and the Government. It brought to light many of the geographical inequalities in availability of services across the UK.

We know that the timely intervention of a specialist nurse or a physiotherapist and proper access to services can reduce hospital admissions and greatly improve quality of life. We have discussed this. We could substitute many conditions for Parkinson’s disease. We know that is the case. We know, therefore, that getting the provision of services for people with Parkinson’s disease right is not only right but cost effective.

Take, for example, Parkinson’s nurses. As a result of the investment from Parkinson’s UK, which pump-primes nurses for two-year periods and to which I pay the highest tribute, there are more than 300 Parkinson’s nurses. I have to say that I agree with other noble Lords: there must be a question mark over their future. I ask the Minister whether there can be some monitoring of what happens to these nurses. As pressures increase on primary care trusts and reform moves forward, what happens when you lose a Parkinson’s nurse? How many more people are admitted to hospital? The Government need to look at what evidence there is.

The same applies to allied health professionals, such as physiotherapists, occupational therapists, speech and language therapists, psychologists and specialists in neurology. They are all vital in treating Parkinson’s and other neurological conditions. The Minister will not be surprised to hear me ask how such coherent and co-ordinated provision will be made available under the proposed changes to the NHS commissioning structures. Parkinson’s UK is extremely worried that it will mean a worsening of access to Parkinson’s nurses, as well as all the other allied health professionals that are needed. Indeed, Parkinson’s UK reports that it is hearing of posts remaining empty following retirement.

It is clear that proposals to transfer commissioning powers from PCTs to GPs are of great concern, not only to Parkinson’s UK but to many organisations that deal with long-term and complex conditions. I agree with the noble Lord, Lord Walton of Detchant, that there must be a question mark over the ability of an NHS commissioning board to make sure that these services are delivered adequately by GP commissioning when we are not even sure how many GP commissioning boards there will be. One needs to ask: how will those consortia be able to commission the expertise to supply the support for this and the other neurological conditions mentioned by the noble Lord, Lord Walton of Detchant?

How will the Government ensure that the GP consortia involve the third sector in the delivery of these services? This question is being asked not just by Parkinson’s UK. I happened to be at a meeting attended by the Multiple Sclerosis Society and the Motor Neurone Disease Association and they expressed the same concern about the ability of the consortia to commission the right services at the right level at the right time for patients when a doctor may only ever see two patients with Parkinson’s disease as it is such an uncommon disease. We know that you effect change in the NHS through leadership. How can the Government ensure that the leadership for this condition will continue and develop? The NICE guidelines are to be reviewed this year. If the Government do not go ahead with that review and do not come forward with robust guidelines, how will they ensure that the leadership for this condition will be maintained?

The Minister cannot have failed to notice that the same questions have been asked with regard to stroke, diabetes, MS and epilepsy. With all those conditions the same level of anxiety is evident about what the future holds under the proposed changes to the NHS. I am merely amplifying what has already been said but we are getting to the point where we need answers about how these conditions will be managed.