Health: Talking Therapy

Debate between Earl Howe and Earl of Sandwich

Tuesday 3rd December 2013 Lords Chamber

[The Earl of Sandwich (CB)]

Does the noble Earl share my concern about the overprescription of psychiatric drugs? Can he think of anything to do about this apart from encouraging CBT and talking therapies?

[Earl Howe]

My Lords, the noble Earl is right. I share his concern, and I think it has been a widespread concern across the mental health community. Nowadays, the guidance given to doctors is much broader than the guidance that was given some years ago. It embraces the talking therapies in particular and it seeks to avoid the overprescription of sometimes very strong pharmaceutical products.

Health: Prescription Drugs

Debate between Earl Howe and Earl of Sandwich

Thursday 11th July 2013 Lords Chamber

[The Earl of Sandwich]

To ask Her Majesty’s Government what changes have been made in the training of junior doctors and nurses in the long-term effects of prescription drugs and in the availability of services to those suffering from addiction to and withdrawal from such drugs.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, recent changes to key documents governing the training of doctors have strengthened the requirements for their training in the long-term effects of prescribed drugs. The training of student nurses, due to the introduction of new educational standards, has been strengthened. Services to treat dependants, including for addiction to medicines, are commissioned locally. Information on changes to the availability of services locally to those suffering from addiction to and withdrawal from prescribed medicines is not collected centrally.

[The Earl of Sandwich]

My Lords, prescribed medicines can be every bit as dangerous as hard drugs, and the length of withdrawal can be much longer—up to three or four years, as I know from personal experience. Their victims lead a half-life and are out of the range of the NHS, with only the voluntary services to help them. Despite what the Minister has just said, which is encouraging, does he agree that the training being given to the younger generation of doctors and psychiatrists, and even the older ones, is still inappropriate and inadequate? What can the Government do to strengthen this training and to reinforce what the voluntary sector is already doing?

NHS: Walk-in Centres

Debate between Earl Howe and Earl of Sandwich

Thursday 11th October 2012 Lords Chamber

[Earl Howe]

In many areas that is an entirely valid observation. Commissioners are saying to GP practices that they expect them to respond to the needs of their local patient populations. If Saturday opening makes sense in that context, they should seriously consider it.

[The Earl of Sandwich]

The Minister knows that there are patients who are suffering acute symptoms from prescribed-drug addiction and withdrawal, as well as from taking illegal drugs. Some of those people are in great distress. Where should they go now in the NHS if they suffer these acute symptoms?

[Earl Howe]

My Lords, if they are acutely ill and it is an emergency, they should go to an A and E department.

Drugs: Prescribed Drug Addiction

Debate between Earl Howe and Earl of Sandwich

Thursday 12th July 2012 Lords Chamber

[The Earl of Sandwich]

To ask Her Majesty’s Government whether they plan to develop separate treatment programmes for those suffering from acute symptoms of addiction to and withdrawal from legally prescribed drugs, distinct from programmes for illegal drug addiction.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, treatment should be based on individual need, not the legal status of a drug. The Health and Social Care Act places responsibility for commissioning services to treat dependence at the local level. My honourable friend Anne Milton is leading work to improve the prevention and treatment of addiction to medicines, and has visited local areas where support for dependence on prescription drugs is an integral part of the local treatment system.

[The Earl of Sandwich]

My Lords, I thank the Minister and I know that he and his fellow Minister are fully aware of the problem. However, there are only a handful of voluntary organisations and one or two primary care trusts dealing with this. The basic question is surely the control of prescription drugs. Does the Minister recognise that the British National Formulary guidelines are being routinely breached? Is there nothing that the Government can do effectively to control and monitor these prescription drugs, separately from illegal drugs?

[Earl Howe]

My Lords, the report commissioned by the Department of Health from the National Addiction Centre brought together published evidence on the scale of the problem. That report suggested that while some GPs prescribed for longer than the recommended period, most prescribing in fact falls within current guidelines. I say to the noble Earl that what matters most in these circumstances is that patients should be treated according to the level of their need, regardless of what the dependence is and where it has come from.

Health and Social Care Bill

Debate between Earl Howe and Earl of Sandwich

Wednesday 29th February 2012 Lords Chamber

[The Earl of Sandwich]

My Lords, as the noble Baroness, Lady Thornton, implied, we are moving to the fast-track of this Bill, and I do not want to hang around for too long. I thank my noble friend Lady Masham for bringing to our attention the issue of early death, and my noble friend Lord Williamson, who has a lot of experience, for his support. My noble friend Lady Finlay made the important point that the responsibility falls within primary care, and I am encouraged by what she said about guidance. However, the Minister did not even pick that up. One might have thought that he could have just said, “Yes, we are going to do something in the guidance”, but I do not know whether he actually heard the point.

[Earl Howe]

I am happy to pick that up, because it was a point that arose in connection with an intervention from the noble Baroness, Lady Finlay, in the previous group of amendments. Of course, we will be relying on the NHS Commissioning Board to issue guidance in a number of clinical areas. Again, when the noble Earl and I meet, I will update him to the extent that I am able to on the thinking in that regard. The point of such guidance—which will relate to numerous areas of care and services—is that it should inform joined-up commissioning in local services, so that we really do get a step change in the quality of commissioning in local areas.

[The Earl of Sandwich]

It is quite true that the CCGs are going to be overwhelmed with guidance from all directions, but I maintain that this is an important aspect.

I thank my noble friend Lady Hollins for the very important point that she made. I did not even talk about prescribing today but I hope to come back and talk about it later—the whole question of training and what young doctors are being told. “Rational prescribing” is a phrase that I will now be able to repeat.

I know that the Minister accepts the arguments, and of course there are many things that we have in common—good practice and the use of the voluntary sector. I take the point about the duty that falls on local authorities, but I still maintain that we have to separate this out from the mainstream of drug addiction and alcohol treatment. It is the kind of treatment that only the very careful, experienced volunteers can describe. I do not think that I can begin to describe the actual treatment. However, the NHS will soon get to grips with what is happening. I welcome the chance of having a meeting. I will of course come to talk, and I hear that there is to be a range of experts. I feel that the Minister has given a little bit of a Civil Service answer, because there are only but one or two people who follow this subject in the department. I do not mind talking only to two people—it will be a very good opportunity to take this further. Meanwhile, I beg leave perhaps to consider this again at a later stage of the Bill, and to withdraw the amendment.

Drugs: Prescribed Drug Addiction and Withdrawal

Debate between Earl Howe and Earl of Sandwich

Thursday 23rd June 2011 Lords Chamber

[The Earl of Sandwich]

To ask Her Majesty’s Government what action they propose following the latest two reports from the National Addiction Centre and National Treatment Agency on prescribed drug addiction and withdrawal.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, my honourable friend the Minister for Public Health, Anne Milton, has discussed the findings of the reports with the All-Party Parliamentary Group on Drug Misuse and the All-Party Parliamentary Group on Involuntary Tranquiliser Addiction at a meeting chaired by my noble friend Lord Mancroft on 14 June. She wrote to my noble friend yesterday setting out the collaborative action that she will be taking in the light of that helpful discussion. She will be convening a round table meeting to discuss the key issues.

[The Earl of Sandwich]

My Lords, I thank the Minister for that information. Does he accept that this is an emergency for the victims of withdrawal from prescribed drugs and their families? Cannot the Government recognise the good practice that is already out there, set up withdrawal clinics and spread the word that no longer are these prescribed drugs but that they are turning into dangerous substances which can cost lives? These people cannot wait for further reports and consultation.

Earl Howe: My Lords, dependence on prescription or over-the-counter-drugs can be every bit as distressing and debilitating as dependence on illegal drugs and clearly has an impact on not only those suffering from dependence but their families and their communities. It is an important issue which we have clearly resolved to address as part of the national drug strategy by focusing on all drugs of dependence, including prescription and over-the-counter medicines. Many NHS and voluntary organisations provide support to people in relation to prescription and over-the-counter medicine use and support is available to people who develop problems in relation to those issues in most local areas. However, it is clear that there is variation in the levels of support provided between local areas and we need to address that problem.