Health: Liver Disease

Lord Brooke of Alverthorpe Excerpts

Wednesday 9th December 2015 Lords Chamber

[Baroness Masham of Ilton (CB)]

My Lords—

[Lord Brooke of Alverthorpe (Lab)]

My Lords, may I quickly return to the issue of minimum unit pricing, because—

[Noble Lords]

Order!

Health: Post-polio Syndrome

Lord Brooke of Alverthorpe Excerpts

Tuesday 20th October 2015 Lords Chamber

[Lord Prior of Brampton]

NHS England’s approach to most people who are suffering from long-term conditions is best summed up through its House of Care programme, which is very much based around the individual and their carers and so is personalised. Of course, personal health budgets can have a big role to play for people with long-term, complex, chronic conditions.

[Lord Brooke of Alverthorpe (Lab)]

Is the Minister entirely content with the change that has taken place whereby we do not develop single-disease strategies? I speak as a patron of the British Liver Trust. We have long argued that there should be a strategy on liver disease, but this has been resisted. We find an increasing number of people dying from liver cancers, yet no strategy exists because of the decision that the Minister explained to us.

[Lord Prior of Brampton]

I agreed that I would meet with the noble Lord opposite to talk about post-polio syndrome, but perhaps this raises wider issues, including about liver disease and other disease categories, which we can cover at the same time.

NHS: Reform

Lord Brooke of Alverthorpe Excerpts

Thursday 16th July 2015 Lords Chamber

[Lord Prior of Brampton]

Interestingly, the number of consultants has increased very significantly over the past 15 years across not all but most specialities. The noble Lord refers to dreadful weekends, and how he dreaded them, particularly bank holidays. That is really why we are here today, so that in future patients like him do not dread them.

If I indicated earlier on that I blame the 2003 contract for the difference between five days’ and seven days’ working, and if that was the implication of what I said, I withdraw it. What I meant to say was that I felt that that contract to some extent de-professionalised the profession.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, most people will welcome much of what is in the Statement.

I would like to come back to the issue of seven-day working that in principle this side supports and accepts. Some of the problems that we have at the moment in the NHS are the top issues with patients. We keep talking about patients being “top of the tree” and being in charge. Can the Minister tell the House what issue about NHS performance at the moment disturbs patients most of all? We have a list of issues where we are doing well: tell us what is worst.

The worst is the inability to access a GP, on a timely basis, five days a week, not seven days a week. This is not new. The position was bad in 2010, when Labour, my party, was in power, but it deteriorated while the Lib Dems and the Conservatives were in the coalition. I can point to Questions in Hansard raised in 2012, when we were promised by the noble Earl, Lord Howe, that discussions were taking place in the profession about trying to improve access to GPs, particularly where there were problems in London. I speak as a patient with a GP in London, who asks how he is to provide a seven-day week service when he cannot get the GPs and does not have the money to do it.

My noble friend Lord Hunt asked a basic question which is of prime concern to people, particularly in London. Will spreading this over seven days until such time as you can provide the 5,000 trained GPs who were promised, which will be seven years down the road, lead to a further deterioration in the ability to access a GP during the week?

[Lord Prior of Brampton]

There is no doubt that, looking forward over the next five years, the resource to be put into primary care will be greater, relatively, than it has been in the past. We wish to deliver more care outside hospital. That is why we are committed to training and having in place 5,000 more doctors in general practice by the end of this Parliament—not just GPs, but others who will support GPs.

The model of primary care will change significantly over the next five years, and it is fundamental to the five-year forward view that we reduce the number of people going into acute hospitals and that we discharge people at the other end of their journey through an acute hospital much quicker.

NHS: GP Clinics

Lord Brooke of Alverthorpe Excerpts

Thursday 25th June 2015 Lords Chamber

Asked by

[Lord Brooke of Alverthorpe]

To ask Her Majesty’s Government whether they will provide an annual report to Parliament regarding the operation of seven-day opening of general practitioner clinics.

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, we are committed to seven-day GP access. We have already invested £175 million in 57 schemes covering 2,500 practices, offering improved access including evening and weekend appointments. The 2016-17 mandate to NHS England, to be published later this year, is expected to reflect Government commitments, including on access. The Government hold NHS England to account for progress against these objectives and publish an annual assessment of NHS England, including progress in delivering the mandate.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful to the Minister for the information he has just given. Will he recall that earlier in the week, in reply to a Question about the number of GPs in practices, he said that the general practice model “is largely broken”? His second statement was that it “is probably broken”. In the light of that expression of his concerns about what was happening in GP practices, I presume that he was associating himself with those millions of NHS patients who increasingly find it difficult to see a GP within the time they want, or to see a GP of their choice. If so, can he say whether moving from what is broadly a five and a half-day weekly GP practice to seven days for all will improve matters for those patients or make matters worse, especially as it is being done on a broken model, to use his own words? In those circumstances—

[Noble Lords]

Too long!

[Lord Brooke of Alverthorpe]

In those circumstances will he say what the new model will be, spell it out to the public and say how many GP practices will have to close?

[Lord Prior of Brampton]

The noble Lord makes a number of interesting points. One of the leaders of the BMA talked yesterday about the need for a renaissance in general practice, which was about the only thing in that speech that I agreed with. We need a renaissance and a complete transformation in general practice because the structure of primary care is largely unchanged since being set up in 1947, and the population’s requirements have changed fundamentally. So over the next five years, I expect primary care to go through a renaissance and be transformed from the bottom up.