Drugs: Methadone

Lord Brooke of Alverthorpe Excerpts

Monday 28th October 2019 Lords Chamber

Asked by

[Lord Brooke of Alverthorpe]

To ask Her Majesty’s Government what plans they have to assess the regulation, and the general effectiveness, of methadone.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)]

My Lords, methadone is a cost-effective and evidence-based opioid substitution treatment. The National Institute for Health and Care Excellence has published several pieces of guidance on drug treatment. It recommends opioid substitute treatment with either methadone or buprenorphine, delivered alongside psychosocial treatment, as the front-line treatment for heroin dependency. There are no plans to undertake any further review.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful to the Minister for that reply. I am disappointed that the Government are not prepared to undertake a review. I do not want methadone treatment to end, but I believe that the cost is now becoming astronomical and have sent the Minister questions about this previously. People in the industry say that it now costs £1 billion a year, yet an increasing number of people are dying from methadone and a shortage of resourcing for support and advice. We are going nowhere. They are parked in a cul-de-sac. Should we not take a look at what alternatives may be available, where that kind of money could be put to better use and give people hope, rather than just abandon them?

[Baroness Blackwood of North Oxford]

I thank the noble Lord for his question. He will know that the DHSC does not collect data on the costs of supply of methadone centrally, as he has asked this question. However, I reassure him that Public Health England carried out an evidence review in 2017 on the effectiveness of drug treatment across the UK, which found that our outcomes are as good as or better than those internationally, including on effectiveness and value for money. However, we recognise the challenge of drug deaths and drug treatment across the UK and the challenge to local authorities. There will be an effective review of drugs policy, which will include Carol Black’s review of drugs.

Asthma

Lord Brooke of Alverthorpe Excerpts

Wednesday 3rd July 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I thank my noble friend. She is right that we need to improve our response to those at high risk of respiratory illness. That is partly why we are improving our offer on mobile lung-health screening, specifically as part of the national targeted lung health checks programme. It is also why we are offering smoking cessation advice and treatment as part of that service. We offer the general population and vulnerable groups advice via the daily air quality index, but she is right: we need to improve our monitoring of air pollution if we are to make progress on this issue. It is something that I will take up with the department.

[Lord Brooke of Alverthorpe (Lab)]

In view of the gravely damaging effect of asthma on children, does the Minister agree that the abolition by the former Mayor of London of the west London zone for congestion charging has increased the amount of air pollution in London over recent years? Many children have died and many people have suffered as a consequence. Will she ask the candidates for the Tory leadership whether they are prepared to reintroduce such a zone in London?

[Baroness Blackwood of North Oxford]

The noble Lord is asking me to step in and comment on matters that are slightly outside my brief. However, I am pleased that we have brought in the clean air strategy, which is a significant step forward. He is also asking me to commit the Mayor of London rather than leadership candidates to a policy area. We do need to move further and faster on air pollution; that is what I expect to see in the prevention Green Paper which will be published shortly.

Children: Gaming

Lord Brooke of Alverthorpe Excerpts

Thursday 23rd May 2019 Lords Chamber

Asked by

[Lord Brooke of Alverthorpe]

To ask Her Majesty’s Government what plans they have to sponsor research into the benefits of gaming for children’s mental health and wellbeing.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)]

My Lords, the department funds research through the National Institute for Health Research. The NIHR spend on mental health research for 2017-18 was £74.8 million, the highest ever. The NIHR welcomes funding applications for research into any aspect of human health. Existing research has shown some positive impacts of gaming—such as cognitive, emotional, motivational and social benefits—but has also shown that a small number of young people’s gaming can become harmful.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful for that reply. Yes, gaming can be harmful, and this Question is about gaming, not gambling. There is increasing evidence that gaming can help children in a whole variety of ways, particularly with mental health problems, yet little research is being done and the Minister did not really give a great list of what is happening with that. I wonder whether she could try to give more information about the scale of it and see whether we can try to persuade the internet companies to get more involved and to use their funding to start producing games of goodness and benefit to children rather than negative ones. She reported recently that there had been a summit at which the Secretary of State spoke to the internet companies. I wonder whether she will look into the possibility that, when the next meeting takes place with him or his colleagues, this item will be on the agenda and those companies will be encouraged to participate jointly in providing games of good to the country.

[Baroness Blackwood of North Oxford]

I thank the noble Lord for his question. He is absolutely right that gaming can have positive effects; there are some areas in which the UK Government are funding research into this. In partnership with industry, NHS England is funding work to develop and test how immersive gaming technology can be used to increase therapy adherence and tackle children’s anxiety. He is absolutely right that, following the Secretary of State’s social media summit, a partnership between industry and the Samaritans was formed. I shall certainly raise his proposal with the Secretary of State. The NIHR is also funding research to develop and evaluate therapy that uses virtual reality technology to treat patients with psychosis. The noble Lord is absolutely right that more can and should be done in this area, and I shall take that point away with me.

Social Media and Health

Lord Brooke of Alverthorpe Excerpts

Tuesday 30th April 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I do not have access to the statistics now, but I know that a lot of research has gone into assessing the amount of peer-to-peer support young people access online from medical charities and other charities via social media routes, or other online routes such as blogs or influencers who engage very effectively with various different medical charities. There is some very encouraging evidence that social media can be used in this way to direct people to the help and support they need, if it is used effectively. As the noble Lord says, we must be very careful not to throw the baby out with the bathwater and must produce alternative narratives to direct young people and vulnerable people to access the support they need in the most effective way. This is done very effectively by many organisations. It is a matter of making sure that, wherever possible, young people and vulnerable people are protected as much as possible from harms that they really should not be exposed to.

[Lord Brooke of Alverthorpe (Lab)]

I am grateful for the Statement. I want to address the social media aspect rather than vaccination. We have a paper from DCMS on social media—the online harms White Paper. The Minister mentioned coherence; I am finding the situation increasingly incoherent, and I will be raising this topic later. Who is giving a lead in this area? The Statement said:

“This partnership marks, for the first time globally, a collective commitment to act, build knowledge through research and insights, and implement real changes that will ultimately save lives”.


It also said that there was a second summit, but DCMS and the Home Office were not involved. The Education Secretary has been attending those meetings. Are more meetings planned? What agenda will be pursued at those meetings? Which departments will be involved? Who is going to take the lead?

[Baroness Blackwood of North Oxford]

The noble Lord asks a number of questions, but I think the nub of the issue is to ensure coherence across government in approaching an important and complex policy issue. He is right, in that the correct approach is to ensure effective implementation of our significant policy commitments in the online harms White Paper and in the outcomes from this summit. Of course, DCMS and the Home Office have been engaged in different policy proposals, development and engagement, and they will continue to be so. The Department of Health and the Department for Education have been leading on this in relation to the mental health Green Paper because of the policy specialisms around vaccinations, suicide and harm and the effect on young people. That work started some time ago so it makes sense for the department to continue, but it will be working hand in glove with the online harms White Paper. I am sure that that discussion will continue in the next debate this afternoon.

Healthcare (International Arrangements) Bill

Lord Brooke of Alverthorpe Excerpts

Committee: 1st sitting (Hansard): House of Lords
Tuesday 19th February 2019 Lords Chamber

[Baroness Jolly (LD)]

My Lords, I thank the Minister for her letter, but I rather feel that it posed as many questions as it has answered. Much of what I was going to be talking about with this group of amendments has been said very elegantly by the noble and learned Lord, Lord Judge. However, I am supporting Amendments 1, 2, 12, 13, 45, 46 and 47. As has just been said, your Lordships’ House has many committees. The refrain of the Second Reading was the expression “breath-taking scope”. The 47th report of the Delegated Powers Committee continues in the same vein:

“Under the powers in clause 2(1)(a) and (b) of the Bill, the Secretary of State could fund the entire cost of mental health provision in, say, the state of Arizona as well as the cost of all hip replacements in, say, Australia. If this might appear fanciful, we assess powers by how they are capable of being used, not by how governments say that they propose to use them. The fact that the powers could be used in these ways suggests that they are too widely drawn”.


When I read the Bill, parts of it read very much like a trade Bill. We believe that reciprocal arrangements with other than EU states are better dealt with one-to-one, much like those with Australia and New Zealand, for example. I am not convinced that arrangements with other than EU states will all fit in the same pattern. If the Minister wishes to bring a subsequent Bill for worldwide minus EU, we would be happy to look at it. Will she confirm that the Bill before us has been drawn up to fit in with future trade agreements across the world? Would any further secondary legislation be required? What parliamentary scrutiny would there be and are there any red lines?

[Lord Brooke of Alverthorpe (Lab)]

My Lords, first, I apologise to the Committee for not having been able to speak at Second Reading. Secondly, I welcome the Minister to her new post and wish her well with it, although I am sorry, like the noble and learned Lord, Lord Judge, that she has been given a hospital pass on this one. I shall speak briefly in support of Amendment 1 in the name of the noble Baroness, Lady Thornton. I am sorry to hear that the clause stand part may not be pushed to a vote, but perhaps the way that the debate goes may necessitate that.

My interest goes back before the Minister came into the House. I asked a series of questions about the proposed trade agreement between the UK and the USA. I have been particularly concerned, as have many in the health industry, that this agreement will open up an opportunity for the USA to come in very strongly indeed. The health industry in America is a very big part of the economy, and one area in which it has not been able to make great movement is within the NHS. Some of us have been concerned that the trade agreement would open that up, and we have been seeking to have it taken off the agenda. I have tabled Questions asking for it not to be on the agenda, and the Government have so far not been prepared to give any such assurance. I have contemplated moving an amendment to this Bill to ensure that, while the Minister is saying that this has nothing to do with that, she could accept such an amendment and set my mind at rest very quickly.

I read very carefully what she said in response to similar criticisms of the Bill at Second Reading:

“The Government are completely committed to the guiding principles of the NHS—that it is universal and free at the point of need. Our position is definitive: the NHS is not and never will be for sale”.—[Official Report, 5/2/19; col. 1488.]


She was not saying anything there with which I would disagree, but one worries about trade agreements whereby people can effectively take over and, while not owning it, can run parts of a major utility such as the NHS. That is why some of us have been seeking an agreement that it would not be on the agenda at all and the NHS would be left as it is, free of any trade agreement, particularly with the United States. I would be grateful, therefore, if the Minister could reassure me that in no way would a trade agreement with the USA have the NHS as part of it. If not, I may have to go away and see whether I can bring back an amendment on this issue.

[Lord Ribeiro (Con)]

One can see why, in the event of a no-deal Brexit, the amendment moved by the noble Baroness, Lady Thornton, would be attractive, as it focuses our minds on restoring reciprocal healthcare arrangements with the EU 27, other EEA countries and Switzerland. As I said on Second Reading, a disproportionate number of UK citizens benefit from the S1 scheme compared with EU citizens in the UK, so there is much to lose in a no-deal scenario.

In March 2018, the UK reached an agreement in principle with the EU on the implementation period which would ensure continuation of the current reciprocal healthcare rights until 31 December 2020. If we crash out, there has to be a plan B which allows us to consider reciprocal healthcare arrangements with other countries. Although I understand the need to write “international arrangements” into the Bill, it presents problems. They were identified by the Delegated Powers and Regulatory Reform Committee, as mentioned by the noble Baroness, Lady Jolly, which described as “fanciful” the idea of providing the Secretary of State with wide powers to fund the costs of healthcare anywhere in the world—for example, as the noble Baroness described, mental health provision in Arizona or all hip replacements in Australia.

This is far too wide, and the focus of international arrangements should in the first instance be applied to Britain’s 13 overseas territories, far-flung as they are—some in the Falklands and the Galapagos, as the noble and learned Lord, Lord Judge, stated—but the closest of which is Gibraltar: close to us and close to Europe. Ninety-six per cent of Gibraltarians voted to remain in the EU, and our focus should be to ensure reciprocal healthcare for those overseas countries for which we have responsibility. Post Brexit, whatever the arrangements are, we can then think about the wider international arrangements; but for now, we should focus on the areas for which we have responsibility.

I hope that my noble friend can provide assurances as to how best to protect the overseas territories in the event of no deal and give further consideration to what the Government intend “international arrangements” to cover.

--- Later in debate ---

[Baroness Blackwood of North Oxford]

He may have said that, but I have clarified this point with the department, the Secretary of State, and others: that is not the case. The Bill is not about trade deals; it is about reciprocal healthcare. In addition to that, I have clarified that free trade agreements, including those to which we are currently party as EU members, contain specific wording to safeguard public services, including the NHS. As we leave the EU, the UK will ensure that future agreements have the same protections. I clarified this at Second Reading and I reiterate it now: the NHS is not and never will be for sale to the private sector, overseas or domestic. If the noble Lord, Lord Brooke, would like to follow up on the points he has raised today, I would be happy to do so outside this Chamber.

I have heard the concerns raised today and at Second Reading regarding the global scope of the powers and I will explain why the Government have drafted the Bill in this way. We believe that the reciprocal healthcare arrangements that we enjoy with EU member states are a positive and beneficial policy. This view has been supported in today’s debate, and by both Houses. It has broad public and clinical support. Indeed, the EU Home Affairs Sub-Committee of this House remarked in its Brexit: Reciprocal Healthcare report:

“Reciprocal healthcare oils the wheels of the day-to-day lives of millions of citizens”,


and the arrangements,

“bring greatest benefit to some of the most vulnerable members of our society”.

In addition, we already have reciprocal healthcare agreements with non-EU countries such as Australia and New Zealand, other European countries such as the Balkan states, and the British Overseas Territories. These often pre-date the EU and have never been limited to Europe.

[Lord Brooke of Alverthorpe]

Do we have one with America?

[Baroness Blackwood of North Oxford]

There would be significant challenges to a reciprocal healthcare agreement with the United States, because it has a different payment system. I do not envisage one being on the cards. Having listened to the debate today, I do not believe that there is an in-principle objection to non-EU reciprocal healthcare agreements. There is, however, a concern about the nature of the powers in the Bill, to which I now turn.

As noble Lords have mentioned, Clause 1 gives the Secretary of State a new power to make payments, and to arrange for payments to be made, to fund healthcare abroad. Currently there are limited domestic powers in relation to funding healthcare abroad so at the moment non-EU healthcare agreements do not transfer money. The payment system for funding EU reciprocal healthcare is currently set out in EU law. For this reason, if we want to enter into international healthcare agreements, whether with EU or non-EU countries, we need the powers in the Bill to extend beyond 2020 or in certain no-deal scenarios. Clause 1, therefore, enables the funding of any reciprocal healthcare agreements that the UK may enter into with EU member states, non-EU states and international organisations, such as the EU, as well as unilateral funding of treatment abroad in exceptional circumstances.

In the future, detailed provisions could be given effect domestically by regulations under Clause 2(1), which we will debate in the fifth group of amendments. This approach speaks to Amendment 3, tabled by the noble Lord, Lord Marks, with whom it is always a delight to tangle in the Chamber. He has proposed that the power in Clause 1 should be used only after regulations have been laid. I completely understand the motive behind this amendment, but there is a reason why the Bill has been drafted in this way. While it is making good progress through Parliament, it is very unlikely that the Bill will achieve Royal Assent before March. With the best will in the world, it would not be possible to lay regulations using the powers in the Bill until, we estimate, at least summer 2019. In an unprecedented no-deal situation, there may be a need to use the powers before then.

The UK has recently concluded citizens’ rights agreements with the EFTA states and with Switzerland to protect reciprocal healthcare for people living in those countries on exit day, or in other specified cross-border situations. It is good news that we would have an operative agreement in those states in a no-deal scenario, as they will guarantee healthcare for those covered by the agreements. However, in that situation, it is likely that we would need to use the power in Clause 1, alongside Clause 4, to temporarily implement those agreements to share data or make healthcare payments and associated arrangements, where required under the terms of each agreement, before laying regulations to implement them more transparently at the earliest opportunity. This may also be true of other agreements we conclude before or shortly after exit day if complete reciprocity was not agreed with EU countries. If this is the case, we will make Parliament aware of it, along with our plans to legislate for these agreements.

I have heard concerns about spending public money. This is obviously closely monitored; money spent under Clause 1 would be no exception to that rule and the usual Treasury safeguards would apply. This will be debated in more detail in the seventh and eighth groups of amendments, so I will leave that until then.

I turn to Amendment 5, in the name of the noble Lord, Lord Patel. I understand completely the basis for concern about how the power to confer functions has been drafted, so it may be helpful if I explain the intent of these provisions. The current EU reciprocal healthcare agreements are implemented in partnership with a number of NHS bodies and organisations. For example, the NHS Business Services Authority has responsibility for customer services in EU reciprocal healthcare. It prints and distributes EHICs, processes claims and recovers costs. NHS England is responsible for authorising applications for the S2 route. NHS trusts are obviously responsible for identifying visitors and making sure that they are not individually charged, and for ensuring that the UK can recover costs from member states.

It is important to note that it is not just healthcare bodies that are relevant to delivering reciprocal healthcare. For example, the DWP has a role with its responsibility for pensions and social security. When we lay regulations to implement healthcare agreements, such as those currently operating, we will need to confer the relevant functions on each organisation according to the role it plays, giving it a clear legal responsibility and operating mandate. That is the purpose of these two provisions. I note the concerns raised by noble Lords on this point and am open to discussing this issue in further detail.

Finally, I shall address Amendment 44 in the names of the noble Lords, Lord Patel and Lord Kakkar, and the noble and learned Lord, Lord Judge, which would limit the legal effect of the Bill to a two-year period after exit day. I entirely recognise the rationale behind this approach, but I have some concerns about the amendment’s potential consequences. It would mean that hundreds of thousands of people who access healthcare under these arrangements would have no certainty that their healthcare could continue two years after exit day. It would also mean that it would be difficult for the Government to enter into medium and longer-term healthcare agreements. I hope noble Lords will understand that the Government cannot support an amendment that places such uncertainty on the people for whom these arrangements are intended. However, I recognise the nature of the concerns raised by noble Lords and, as we proceed through Committee and on to Report, I want to continue working with and listening to noble Lords, on an individual and party level.

For these reasons, I hope the noble Baroness will withdraw the amendment and that the noble Lords, Lord Patel and Lord Kakkar, and the noble and learned Lord, Lord Judge, will not oppose Clause 1 standing part of the Bill.

NHS: Waiting Times

Lord Brooke of Alverthorpe Excerpts

Tuesday 18th December 2018 Lords Chamber

Asked by

[Lord Brooke of Alverthorpe]

To ask Her Majesty’s Government what assessment they have made of the effect of NHS Foundation Trusts offering private healthcare services on waiting times for NHS patients.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord O'Shaughnessy) (Con)]

My Lords, since the founding of the NHS in 1948, NHS hospitals have been able to generate small amounts of additional income by treating both international and British private patients. Since 2010, this has remained well below 1% of hospitals’ total income. Any surplus created is used to improve the services that NHS patients receive.

[Lord Brooke of Alverthorpe (Lab)]

I am grateful to the noble Lord for his Answer. I declare an interest: I am an ordinary user of the NHS. I do not have any private medical care, nor do I make any private payments. Is it not true that there are now over 4 million people on queues waiting for treatment in the NHS? Did he see the article in the Times last Thursday headed “Patients pay £1bn to jump NHS queues”? Chelsea and Westminster Hospital recently offered me insurance, terming it the best of both worlds. How many trusts offer opportunities for people to go private, and what is the effect on ordinary users of the NHS? Surely with the shortage of resources, it can mean only that they will wait longer than at present.

[Lord O'Shaughnessy]

I am not familiar with the type of insurance the noble Lord is talking about, but would be delighted to see what he has been offered. The 2012 Act obliges income from non-NHS activities to be tied to a foundation trust’s principal purpose, which is,

“the provision of goods and services for the purposes of the health service of England”,

and that is the standard by which it should be held. He is right that waiting lists have been growing. The NHS is doing more than ever—2 million more operations in 2017-18 than in 2010—but we realise that we need to do more, which is why the Prime Minister made the historic commitment to increase funding in the NHS by £20 billion in real terms in five years’ time.

Childhood Obesity

Lord Brooke of Alverthorpe Excerpts

Thursday 13th December 2018 Lords Chamber

Asked by

[Lord Brooke of Alverthorpe]

To ask Her Majesty’s Government what progress has been made, if any, in discussions between the BBC and Public Health England regarding a joint strategic plan on childhood obesity.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord O’Shaughnessy) (Con)]

My Lords, Public Health England and the BBC are firmly committed to working together on childhood obesity. Since July, the teams have met three times for discussions and are currently working on the detail of future plans.

--- Later in debate ---

[Lord Brooke of Alverthorpe (Lab)]

I am grateful to hear that there have been three meetings since we met in July. Unfortunately, the latest statistics on obesity in children aged from 12 to 16 show a further deterioration. It is time we really got something moving in the form of a national campaign on obesity. The BBC has an important part to play in that. Will the Minister persuade his Secretary of State to lean on the BBC and Public Health England to get a move on so that we can see programmes being introduced, and then issue chapter 3 of the obesity plan to incorporate that into it?

[Lord O’Shaughnessy]

I agree with the noble Lord about the importance of the issue and I am grateful to him for the role he has played in bringing that relationship together. He knows very well that the BBC has played a critical role over decades in many very important health campaigns, such as on HIV or the “Just Say No” campaign on drugs. The BBC is absolutely committed. Of course, it would be inappropriate for Ministers to lean on the BBC, which has editorial independence that I am sure we are all anxious to protect. However, it is committed to doing more. It is doing a number of activities through its programming, including the “Blue Peter” cooking club, various CBBC programmes and so on. I do not think anyone doubts the BBC’s commitment to this, and we will see the fruits of that soon, I am sure.

Diesel Emissions

Lord Brooke of Alverthorpe Excerpts

Wednesday 5th December 2018 Lords Chamber

[Lord O’Shaughnessy]

We provide a range of support. In fact, my colleague, the Parliamentary Under-Secretary of State for Public Health and Primary Care, wrote to directors of public health in October to remind them of their responsibilities and to make sure that they focus on this issue. Just yesterday, our Deputy Chief Medical Officer held a round table with stakeholders and others in local government to think about how we can improve policy and communicate locally with people to make sure that they understand the consequences of things such as idling and other unnecessary uses of diesel.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I welcome the news that there will be research in London. Will any assessment be made of the number of deaths and the damage to health in London due to Boris Johnson’s refusal to apply the congestion charge to west London?

[Lord O’Shaughnessy]

The important issue is that, whoever holds the post, the Mayor of London has the power to take action. It is notable that that has not been reinstated by a Labour Mayor of London, so maybe there was something in that decision in the first place.

Obesity

Lord Brooke of Alverthorpe Excerpts

Wednesday 18th July 2018 Lords Chamber

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful to the noble Lord, Lord McColl, for securing the debate and for the wise words he always gives us on this topic, from an authoritative position. Like him I look forward greatly to the maiden speech of the noble Baroness, Lady Boycott. I am sure that she will add greatly to our deliberations not only today but in the future.

I shall focus on child obesity. I am sorry that our time is limited, because this is a very big subject. I do not understand why, because we have no further business today—

[A noble Lord]

Yes, we have.

[Lord Brooke of Alverthorpe]

We have some more business, do we? Then I withdraw that comment.

I shall focus on the child obesity plan. Contrary to some of the criticisms I have made in the past—although I shall make a few today—I share the view of the noble Lord, Lord McColl, that we are at last moving in the right direction. I believe that the publication of chapter 2 of the plan, which came out not too long ago, included some bold adventurous measures. My first question to the Minister is therefore to ask him whether the current consultations are within a specific timeframe. If so, when they conclude, will there be additions to chapter 2, or will the Government produce a chapter 3 to follow it?

I ask that question because I have previously raised a number of points about two or three fundamentals that had been missed from both the first plan and chapter 2. In particular I, like the noble Lord, Lord McColl, believe that there is a case for a wide-ranging and focused national campaign involving everyone but focusing especially on children. I argued that there was no mention of the broadcasters in chapter 2 or the earlier plan, other than in the context of the watershed and advertising, which is an entirely separate issue. I believe that there is a role for broadcasters working with government to try to ensure that this major problem that we face is addressed properly and over the widest possible front.

I have had some conversations with the BBC, and asked it to point me to a major programme that it had produced focusing solely on child obesity and communicating primarily with children. It is doing a lot of programmes, but it struggled to identify such a programme. I am pleased that Public Health England has now taken up the baton, is in conversation with the BBC and will have further talks early in September. That is good progress in the right direction, but I would welcome some advice from the Minister about how that will fit in with the present plan.

To make my second point I return to what the noble Lord, Lord McColl, said. To recover from any problem we need a diagnosis in the first instance. The real problem we have now with obesity is that people do not think that they are overweight: there is great dispute about that. We do not know what the weights of children from 11 to 16 or 18 are. We have a lot of evidence about children aged four and 11, but once they get to 11 we move to a different system of measurement, and only a couple of thousand people aged from nought to 16 are analysed. Of those, surprisingly, 50% required a visit by a nurse, which suggests there is a problem there that has not been fully examined.

I notice that I am running out of time, so I shall conclude quickly. I have been writing about the need for weighing people so that they are aware of what they weigh. Public Health England does not as yet agree with that, and neither do the Government, but I believe we need to get back to the hard facts to take the programme further forward. I hope that the Minister will be prepared to have a look at this topic with others who, like me, believe we need the facts in the first instance to make the progress required.

The NHS

Lord Brooke of Alverthorpe Excerpts

Thursday 5th July 2018 Lords Chamber

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful to my noble friend Lord Darzi for a towering speech, made with spirit and committed to the fundamentals of the health service. We are extremely grateful to him. I express my gratitude to all who work in the NHS for all the outstanding work that they continue to do, often in difficult circumstances. I wear no badge today, but I have a kind of badge on my head, as I am wearing an NHS bandage from treatment I had this week. I shall be going to my doctor’s surgery tomorrow morning.

It is all part of my life. I was born before the health service was created, but I have had two near misses with my life. When I was 55, I had bowel cancer and was saved by the Royal Marsden. I was quite close to death, and here I am, 20 years on and still enjoying a fruitful life, for which I am eternally grateful to the health service and the people who work in it.

I shall take a different approach from anyone else. I have a different concern about the extent to which the public and I are responsible for the care of the NHS and how we deal with it. People can take it for granted in many instances and, as a consequence, the health service suffers. We do not get efficiency and effectiveness from it because of that—people not turning up for appointments and so on. It is important to continue to look at what we as individuals can do to make the health service even healthier.

I have suggested, and raised previously with the Minister, that one way in which we might bring about a change in attitude is to know what the cost of our health services is; after all, there is not much that we get in life whose cost we do not know, but that is not so with the health service.

The Government do not like this idea because they say that it might discourage people from taking up services. That is questionable. I have suggested in turn that those who would like to know the cost should be told, so that, if they feel gratitude to the NHS, they could make a charitable contribution towards a fund. It would be a fund that not just went towards the hospital where they had been treated or given the service but would be redirected to those areas in the country where we see the most ill health and the greatest deprivation in terms of health services.

The Minister has not responded very positively to these suggestions on previous occasions, so my appeal today is not to the Government but to my fellow Peers and to MPs: we should come together and, instead of words, words, words with nothing happening, we set up an all-party parliamentary group to look at how we might establish a charity that commemorated the 70 years of service that we have had from the NHS but in turn found ways of taking in contributions from those who were able to make them and wanted to express their gratitude for the services or operations that they had had from the NHS. I would certainly be prepared to do that. We would have a group of qualified people—maybe Peers or surgeons—who redirected the funds or gave advice on where they should go in the NHS. We should do it ourselves. If the Government will not do it, this is a source of considerable money among the public at large to which the NHS fails to respond. There is great feeling for the service. I believe that people would make bequests or offerings after they had had operations. It is time that we took advantage of what is there for us. I hope the Minister will respond that when he replies.