Cannabis: Medicinal Use

Lord Howarth of Newport Excerpts

Monday 4th March 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I thank the noble Baroness for her question. This is a challenging area, and the evidence base is still developing. However, the Government are working hard to ensure that awareness is increasing, which is why we have asked NICE to develop guidance to be released later this year and have asked HEE to develop a training package to increase knowledge and awareness among health professionals. It is also why officials are working closely with suppliers and importers to ensure that prescriptions are filled when they are given. We understand that there is work to do on this issue and will continue to do so.

[Lord Howarth of Newport (Lab)]

Will the Minister comment on the issues illustrated in the predicament of a person who has been prescribed the cannabinoid dronabinol, branded as Bedrocan, which is the only medication that has proved effective for her following the failure of 35 different medications previously prescribed to relieve her chronic pain from cervical and lumbar spondylosis? Given that the Chief Medical Officer stated last summer that there is conclusive evidence that cannabis-based products are effective for certain medical conditions, why is this patient still forced to travel to Holland every three months to obtain the medication that her consultant considers essential for her, and why does confusion still reign over licensing procedures? Will the Minister meet me and the person I have mentioned to see if she can introduce some more sense into these arrangements?

[Baroness Blackwood of North Oxford]

I thank the noble Lord for his question. I am very sorry to hear about the situation he raises and will be very happy to meet him. As far as I can see, there should be no reason for the situation he has outlined. It is up to clinicians to prescribe as they see fit under the guidelines that have been issued.

Social Care

Lord Howarth of Newport Excerpts

Thursday 7th December 2017 Lords Chamber

[Lord O'Shaughnessy]

As ever, my noble friend makes excellent and wise suggestions, which I am grateful for. She highlights an important point, which is that social care is a co-funded service for most people. Most people make a contribution to their social care and the state will often make a contribution, too. Therefore, vehicles that allow people to save up in advance, whether through pensions, ISAs or the other means that my noble friend has suggested, are an excellent idea. I am sure that they will be part of considering the financial sustainability and build on products that are already in the market, whether equity release or deferred payments, so that people can go into their old age with confidence that, whatever their care needs, they will be able to afford them.

[Lord Howarth of Newport (Lab)]

My Lords, I think I heard the Minister mention in the Statement that his ministerial colleague had written to chairs of relevant all-party parliamentary groups to invite their participation in preparatory work in the department leading up to the publication of the Green Paper. Does he think there may have been an oversight here, because, as co-chair of the All-Party Parliamentary Group on Arts, Health and Wellbeing, I have received no such letter? I know that the Minister has seen the report of the APPG entitled, Creative Health: The Arts for Health and Wellbeing, and was kind enough to speak warmly of it in the House last week. Will he and his colleagues in the department study the substantial evidence presented in that report that engagement with the arts can confer considerable benefits in the field of social care in terms both of quality of life for people receiving care and their carers, whether family members or professional carers, and of value for money? Will he investigate the possibility of the APPG on Arts, Health and Wellbeing being involved in the process that he has mentioned?

[Lord O'Shaughnessy]

I will certainly be happy to do that. I absolutely endorse the ultimate finding of that report about the valuable contribution that the arts have to make. I shall investigate whether a letter has perhaps gone astray.

Health and Social Care: Falls Prevention

Lord Howarth of Newport Excerpts

Thursday 30th November 2017 Lords Chamber

[Lord O'Shaughnessy]

The noble Lord is quite right to highlight this important issue. The statistics are quite alarming, as he has pointed out. Every year, about one in three over 65 year-olds will experience a fall, and that rises to one in two for those aged over 80. This is a very significant problem with a very obvious human cost, as well as the economic cost that he described. The main area we need to work on is obviously prevention. I point him to the increased funding going into the disabled facilities grant, which has doubled over the last few years and is continuing to grow. That is about preventing falls in the home, which is where most falls take place. The consequences of doing that are huge. It means fewer hospital admissions, people can stay in their homes for longer, and reduced harm to patients.

[Lord Howarth of Newport (Lab)]

My Lords, is the noble Lord aware, as I am sure are many noble Lords who are of more advanced years than the Minister, of the benefits of dance for the health of older people? Is he aware that 85% of people who participate in Dancing in Time, a falls-prevention programme in Leeds, completed the course, compared to some 40% who complete standard NHS falls-prevention courses, and that evidence shows that dancing, even for just an hour a week for six months, brings measurable benefits to the cognitive and motor functions of healthy older people? Will the Government encourage health and well-being boards to consider the merits of prescribing dance and, indeed, other artistic activities?

[Lord O’Shaughnessy]

I will happily do so. Dance is very popular in my household, with “Strictly Come Dancing” on the television at the moment. Debbie McGee might not be quite over 65 but she is a great advert for older people dancing. I absolutely support what the noble Lord says. I have seen the evidence on the impact that was published as part of the APPG’s work on this; it is very convincing and we will certainly let health and well-being boards know that this is exactly the kind of thing—social prescribing, if you like—that they should be looking at to prevent falls.

End of Life Care

Lord Howarth of Newport Excerpts

Tuesday 5th September 2017 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness is a true expert on this topic and we had a very good debate on the subject, which she initiated, in March this year. In terms of the experience of care, I will check exactly what the charity is looking at. I know that there is now a measure—a questionnaire—of maternity bereavement which is looking at the experience of care and trying to learn from that, and I will see whether that is more broadly the case in terms of siblings and others, and indeed for non-neonatal child deaths. On 24/7 provision, again, we know that it is not yet universal but a couple of pilots are taking place on 24/7 nursing community care, so we are making some progress on that. Indeed, one of the metrics by which we will measure our success is the number of admissions and the time spent in hospital in the final 30 days of life, which speaks to the point she was making in trying to keep those who are dying out of hospital if that is not where they want to be.

[Lord Howarth of Newport (Lab)]

My Lords, does the Minister accept that we live in a society animated by humane values, which is also one of the richest societies in the world, and that there can be no excuse for the extensive failure to provide appropriate palliative care for children who are terminally ill or bereavement support for their parents that has been reported by the Royal College of Paediatrics and Child Health and the charity Together for Short Lives? Will the Secretary of State, who is accountable for these matters, use the authority of his office to ensure that sufficient services are commissioned and sufficient qualified staff are available so that the NICE guidelines can be implemented fully and consistently across the country?

[Lord O'Shaughnessy]

I agree that there is more to do but progress has been made since the first national framework was published a couple of years ago, building on the work of successive Governments. Staffing is important. There are more early-life nurses than there were seven years ago. More than that, additional training is also going on. This is a really important part of this. Health Education England’s mandate now includes end-of-life care training within various care packages. Indeed, through the Nursing and Midwifery Council, midwives are starting to get systematic end-of-life care training. Given that, unfortunately, 40% of these child deaths happen in the neonatal and newborn setting, that is incredibly important. But I take the noble Lord’s point.