Sodium Valproate and Pelvic Mesh

Baroness Uddin Excerpts

Monday 25th March 2024 Lords Chamber

[Lord Markham (Con)]

My Lords, I thank my noble friend for her tireless work in this area. It is something which, in the Chancellor’s very own words—because it was the Chancellor who, as Health Secretary, first commissioned the report—remains a top priority to both him and the Government. That remains the case. I spoke to Minister Caulfield about it just this morning, and it is a complicated area, but it is something that we are very keen to redress in the next few months.

[Baroness Uddin (Non-Afl)]

My Lords, I am really grateful to the noble Baroness, Lady Cumberlege, for raising this issue. On previous occasions, I have raised my ongoing concerns about the use of sodium valproate, especially for patients with mental health issues incarcerated in hospital. Do the Government collect information on how many people have been prescribed this terrible medication in some cases, and whether it is being disproportionally applied, particularly to young men from minority communities in the mental health institutions?

[Lord Markham (Con)]

I thank the noble Baroness. I will provide the precise figures, but the incidence has gone down by 34% in terms of the amount that has been prescribed. At the same time—and this is particularly fitting, as tomorrow is National Epilepsy Awareness Day—for some people, this is the only treatment for epilepsy that will work for them. It is therefore important to make sure that protocols are in place for prospective mothers and prospective fathers to make sure that, in those cases, they are not being prescribed sodium valproate, because in other cases it is often the only medicine that works.

Mental Health Patients: Discharge

Baroness Uddin Excerpts

Tuesday 5th March 2024 Lords Chamber

[Lord Markham (Con)]

There is, quite rightly, a balance to be struck. For people with learning difficulties and autism, which noble Lords have debated before, we set a 50% target for that reduction—not 100% because, as has been mentioned, it is not always appropriate as a number of people in those situations need additional support. However, as a general sense of direction I think we all agree that, where we can put support into communities, that is the right thing to do. That is what the £1 billion extra investment is about.

[Baroness Uddin (Non-Afl)]

My Lords, I declare my interest as a former practitioner. I have spoken before about the disproportionate numbers of black and Asian men in the system using mental health services. There is a gross disconnect between the amount of funding available and the services that they receive, particularly regarding carers’ involvement. We must admit that the amount of medication that they are given is not often monitored successfully after discharge. Maybe that is one of the reasons why there is a high suicide rate. How can the Minister ensure that, when patients are discharged to the services of social workers, they are not put in extremely expensive mental health provision or private healthcare housing, which is often not needed? The services are wasting huge amounts of money. Will the Minister look at the disconnect between social services and the healthcare system to ensure that the money is used effectively?

Mental Health In-patient Services: Improving Safety

Baroness Uddin Excerpts

Monday 3rd July 2023 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend for her tireless work in this space. We believe that a number of constructive points were made in the committee report, which I know Maria Caulfield is working on and looking to get a timely response to. Maybe that is something on which we can meet up and discuss later.

[Baroness Uddin (Non-Afl)]

My Lords, I raise the issue of the mental well-being of men from black and Asian backgrounds. I particularly raise the issue of the care they are receiving at the hands of very poorly qualified, untrained, unsympathetic people, who do not adequately understand the complexity not just of mental health and well-being but the way that they should be operating. They are not working in tandem with the families, which is one of the requirements. There have been suggestions from a number of community organisations that black and Asian men are four times more likely to be detained, and sometimes it is more than likely that there has not been any consultation with their families, which is one of the prerequisites. Can the Minister assure this House that any formal forward-thinking and examination of these issues is looking at the disproportionality of the effects and the causes of very poor services, particularly for men from black and Asian minority backgrounds?

[Lord Markham (Con)]

Yes, we are very aware of the points made very well by the noble Baroness, including some of the stats on the community treatment orders and the fact, I believe, that if you are a black male, you are eight times more likely to be detained. I know that that led to some of the recommendations from the pre-legislative scrutiny committee. I can give an undertaking that that will be fundamental to what we are trying to do here.

Health Promotion Bill [HL]

Baroness Uddin Excerpts

2nd reading
Friday 2nd December 2022 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, it is a pleasure to follow the noble Lords, Lord Crisp and Lord Lansley. I applaud and thank the noble Lord, Lord Addington, for his leadership in pursuing this debate.

Like many noble Lords, I have spent a lifetime trying to improve health and social care in my backyard, alongside the work we do in this House. It would be remiss of me to not acknowledge the immense results we achieved back in the early and mid-1980s, which saw great improvements, particularly in perinatal and postnatal mortality rates, immunisation and breastfeeding. Most of those changes are under much stress now, adding to the improvements required in maternity services, which need urgent attention, and to the gross disparities we have talked about in this place and elsewhere on health and well-being, as well as air pollution, mental health and long Covid, particularly for those people living with disabilities and from minority communities.

Alongside this, the dissatisfaction rate among the general population for our GPs and much-beloved NHS and A&E services suggests that services have become inadequate. There is a lack of good quality maternity services, with women unable to receive adequate care during pregnancy, childbirth and postnatal care; one can see the trajectory of the health and well-being deficit in the family being set very early on. This is worsened if there are disabilities, mental health and care needs, in addition to the bullying, racism and discrimination within the system and which staff experience. If this is embedded in the services, is it any wonder we are facing this crisis? If noble Lords are minded to underestimating the effect of racism within institutional structures, I ask the Government to speak with Dr Chaand Nagpaul prior to setting up the new office proposed in the Bill to ensure that we do not just consult but involve those who have a track record of achieving changes within communities, even with restricted and constrained resources.

The Health Promotion Bill contains potential and important milestones to achieve better services. However, I would like us to pay the requisite attention to ensure that the issues of workforce balance, leadership in commissioning and senior management, and board representation are given equal attention and support. I welcome this Bill and agree that the national plan must be integrated, as has been said. What it does not explain is how we will set and benchmark standards, how implementation will be monitored, or how this will be embedded within the equality framework. This must be based on an absolute commitment from the Government to address workforce balance and leadership in commissioning and senior management. This must be a perquisite to the changes that are required.

This new office can flourish only with the determination of better collaboration which integrates sufficient resources and a commitment to achieving this, and by placing at the heart of any changes the service users and leadership which reflects all the communities in which these services are based.

Abuse and Deaths in Secure Mental Health Units

Baroness Uddin Excerpts

Wednesday 9th November 2022 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, I declare my interest as a registered social worker. Last year, I had the opportunity to look at mental health services in east London, where the overrepresentation of black and Muslim men is absolutely horrific. Their experiences are vastly different, and there is no recognition of the fact that they are suffering not just bullying but racism and Islamophobia. As the Minister will be aware, the problem is that, as well as cases of bullying, these services are understaffed. More importantly, the staff who are supposed to be supporting these individuals who are very unwell are underqualified and severely underpaid. There is a great deal for us to be concerned about, including underresourcing and staff training. What is the Minister’s department doing about this? Having just announced one set of funds after another, which had no effect at all on the ground in those wards, can the Minister say what the reality is on the ground?

[Lord Markham (Con)]

We are investing, and I understand and agree with the point that training is key to this. We have committed to spend £2.3 billion more in 2023-24 in the mental health arena, exactly around this space. It is something that we are working on, and we understand that we need to ensure that the mental health of all our citizens, whatever their race or colour, is well served and looked after.

Disabled People: Personal Assistants

Baroness Uddin Excerpts

Wednesday 7th September 2022 Lords Chamber

[Lord Kamall (Con)]

On the face of it, that sounds a very sensible suggestion, so let me take it back to the department, and if I am still here, I will respond.

[Baroness Uddin (Non-Afl)]

My Lords, I very much welcome this Question, at a time when my family has just started experiencing the hard stuff of social care. It is completely absent from many people’s lives because they are stuck in hospitals and not able to leave. People who are already in employment will be suffering exactly the same problems and issues with personal assistance. The Minister has been in his post for a long time, and we have all been requesting that he listen to what many of us with long-standing experience have said. What will he do now?

[Lord Kamall (Con)]

I first pay tribute to the long-standing experience of the noble Baroness and to the many conversations we have had on this. That this Question has been asked will raise and highlight the issue. It also allows me to go back to the department, kick a few desks, as it were—without being accused of harassment or violence—and make sure that government can look at this in a joined-up way.

Polio

Baroness Uddin Excerpts

Thursday 23rd June 2022 Lords Chamber

[Lord Kamall (Con)]

I am aware that there are still some countries that use the oral polio vaccine, as opposed to the IPV we use in this country. I do not have the exact numbers with me. If the noble Baroness with allow me, I will go back to the department, see if that information is available and then write to her.

[Baroness Uddin (Non-Afl)]

My Lords, water quality in east London is appalling enough without this scare. I spoke with three of my neighbours yesterday, all with very young children, and not one was aware of this campaign. What steps are being taken to ensure sufficient and urgent awareness is created among East End multilingual communities, who are already struggling with a daunting array of health and well=being information?

[Lord Kamall (Con)]

As it happens, I was at an event yesterday at which a GP from east London was present; we were talking about the whole range of issues, not just this specific issue. Let us be clear: no one has got polio and no cases have been identified. We have found it in the sewage, and it probably came from someone who had the oral vaccine overseas, came to the UK and excreted it into the system. there are no cases of polio at the moment—we should be absolutely clear about that—but we are saying that this is a warning that people should ensure that they get vaccinated and check their records.

The noble Baroness makes a really important point about health disparities and there are lots of issues we must tackle. I have said many times that we must see how we can work on a community-led solution, rather than having someone in Westminster or Whitehall who thinks they have all the answers. To be honest, we have to show due humility and say that people sitting in this House can sometimes be out of touch with those communities.

Social Care: Adults

Baroness Uddin Excerpts

Wednesday 22nd June 2022 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, 500,000 is a staggering number, but the number experiencing the deepest emotional and physical impact on families may be in the millions. Is the noble Lord and his department aware of the costs associated with neglecting these people and how many may have lost their lives while waiting for these services?

[Lord Kamall (Con)]

When we look at the 500,000 number, we are talking about an assessment of any kind. These are not people who are outside the system; sometimes they may be in the system but waiting for another assessment within the system. For example, they could be waiting for Care Act deprivation of liberty safeguards, occupational therapy assessments, the beginning of direct payments or a review of their care. It means they are in the system but just waiting for another part of the system to work. The other thing about the report was that there was a 61% response rate, and it was extrapolated from that. Anyone who has read behavioural economists Daniel Ariely or Daniel Kahneman will know that people are more likely to focus on losses rather than gains and, similarly, in surveys people are more likely to report bad things than things that are going well.

Sugar Reduction Programme: Bread

Baroness Uddin Excerpts

Wednesday 25th May 2022 Lords Chamber

[Lord Kamall (Con)]

I would have hoped that the noble Baroness would have lined up the noble Lord, Lord Rooker, to be in his place. Only yesterday, I had a meeting with him, the noble Lord, Lord Patel, and a number of other noble Lords, together with departmental officials.

We have to do this within the general picture of the Bread and Flour Regulations. At one stage, the dispute was about the upper limit of folic acid. We have agreed that we will push forward as quickly as possible. We were waiting for the Northern Ireland elections. It has now been confirmed that the Northern Ireland Minister will remain in place until a new Executive is formed. He has promised to push his officials to give approval so that we can get on with the consultation and get this measure in place as soon as possible. I hope that the noble Lord, Lord Rooker, was happy with the progress we made yesterday. I am sure he will tell us in due course.

[Baroness Uddin (Non-Afl)]

My Lords, addiction to sugar begins very early. It is included in baby foods. Will the Minister ensure that manufacturers attend to this sector as a critical component of the Government’s strategy? Does he accept that many people who are digitally excluded may not have adequate access to these campaigns and information from the Government?

[Lord Kamall (Con)]

The noble Baroness makes a very important point. Following our commitment in the Advancing Our Health: Prevention in the 2020s Green Paper, we launched a consultation on baby food. We are aware how important it is to reduce sugar intake. Those aged four to six should have no more than 19 grams of sugar—five cubes—per day. From the age of 11, this increases slightly to seven cubes. This shows the importance of addressing this issue at a very early age, and we are speaking to manufacturers about possible formulations.

NHS Dental Services

Baroness Uddin Excerpts

Tuesday 24th May 2022 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, access to dental services for those with learning and other disabilities has been dire. What assessments and actions will the Government take to ensure that clear pathways are laid for them to access those services? They are not getting the kinds of services they rightly deserve.

[Lord Kamall (Con)]

The noble Baroness is absolutely right that everyone—not just people from deprived areas—should have as much access as they can to dental care. As I said, we are looking at the picture at the moment. During the pandemic, 700 urgent dental care centres were set up. As more dentists have come back on stream after the pandemic, the number has been reduced to 550. If someone is not getting care, they can ring 111 and be signposted to an NHS dentist.