United States: Trade Deal
Debate between Lord Hunt of Kings Heath and Baroness Manzoor
Lord Hunt of Kings Heath
To ask Her Majesty’s Government what assessment they have made of the government of the United States’ negotiating objectives for a future trade deal with the United Kingdom, published on 28 February.
Baroness Manzoor (Con)
My Lords, negotiating an ambitious free trade agreement with the USA that maintains our high standards for business, workers and consumers is a priority. We welcome this demonstration of the commitment by the US to begin negotiations. The UK and US economies are already highly compatible. We welcome the emphasis on state-of-the-art provision in financial services and digital trade, where the UK is recognised as a world leader. We will publish UK objectives for parliamentary consideration ahead of negotiations.
Lord Hunt of Kings Heath (Lab)
My Lords, I think that is a generous interpretation of the aims of the United States Government. It is clear that the price of a trade deal with the US, which this Government will be desperate to achieve, will be high. It will certainly include the possibility of the UK having to pay more for US medicines, of our data protection provisions being swept away, and, with US access to our food markets, of lower standards in food safety and animal welfare. That comes with the added bonus of the US ambassador lecturing our farmers on the delights of chlorine-washed chicken and growth hormones in cattle. In their desperation for a deal, are the Government exchanging so-called vassalage to the EU with subjection to the United States Government?
Baroness Manzoor
My Lords, I do not agree with the noble Lord. As with all negotiations, these objectives mark the starting point for the USA and not the end. They are entirely in keeping with the objectives mandated in US legislation for all trade negotiations and are not surprising. In relation to the NHS, the Government have consistently made it clear that they will continue to ensure that rigorous protections for the NHS are included in all trade agreements. Protecting public services, including the NHS, is of the utmost importance, and the Government will continue to ensure that all decisions about public services are made by the UK Government and not by our trade partners.
NHS: Stroke Care
Debate between Lord Hunt of Kings Heath and Baroness Manzoor
Baroness Manzoor
I thank my noble friend for that question. Reconfiguration of stroke services is very important because there is strong evidence that consultant-led specialist treatments in large, centralised hyperacute stroke services, where geographically appropriate, save lives, improve recovery and can reduce the length of hospital stays, while saving money. Three pilots have taken place in London, Manchester and Northumbria. They have seen a 9% reduction in the length of hospital stays in Greater Manchester and a cost saving of £800 per patient in London.
Lord Hunt of Kings Heath (Lab)
My Lords, I remind the House of my membership of the GMC. Coming back to the question about hyperacute stroke services, which have been such a huge boost to patient outcomes, the Minister says this is up to CCGs, but all over the country CCGs have been obstructive to this move. They have defended their own district general hospitals, attempting to keep all their stroke services at the expense of the quality and safety of patient care. The Government have to intervene, surely?
Baroness Manzoor
The noble Lord makes a very valid point. As I said, evidence-based medicine is speaking about a hub-and-spoke way forward. There is the national plan. We have set up a primary board that will look at reconfiguration of services and the workforce planning within it. We hope that some of those challenges can be met head on.
Human Bodies: Commercial Exhibition
Debate between Lord Hunt of Kings Heath and Baroness Manzoor(5 years, 9 months ago)
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Lord Hunt of Kings Heath
To ask Her Majesty’s Government what consideration they have given to updating the Human Tissue Act 2004 to ensure that human bodies being imported into the United Kingdom for commercial exhibitions are governed with the same ethical and legal responsibilities that pertain to bodies originating from the United Kingdom.
Baroness Manzoor (Con)
My Lords, in England and Wales and Northern Ireland, the law requires that people who wish to be displayed in public after death must give written permission. This does not apply to bodies imported from abroad and any change to the provisions would require amendment of the Human Tissue Act. The Government are working with the Human Tissue Authority to consider what more can be done within existing legislation to address any concerns around the display of bodies.
Lord Hunt of Kings Heath (Lab)
My Lords, I am grateful to the noble Baroness. The Human Tissue Authority does a very good job. However, as the noble Baroness said, the key provisions of the Act do not apply to bodies imported from abroad. This means that, when it comes to commercial exhibitions such as the Real Bodies exhibition in Birmingham last year, there is no guarantee that the bodies used are not those of executed prisoners, including prisoners of conscience from China. The noble Baroness said that the Government were prepared to work with the HTA to look at the existing legislation. Does she accept that we need an amendment to the HT Act in order to be able to regulate these commercial proceedings? Will she agree to meet noble Lords to discuss that?
Baroness Manzoor
My Lords, I am always happy to meet noble Lords to discuss this issue. As the noble Lord knows, changes to primary legislation will be required to activate the change that he is seeking. To be clear, the Human Tissue Authority ensured that the Birmingham exhibition met licensing standards and licensed it in line with the law. We have no evidence to suggest that the exhibition contained the cadavers of political or other prisoners from China.
NHS: Accident and Emergency Departments
Debate between Lord Hunt of Kings Heath and Baroness Manzoor
Lord Hunt of Kings Heath
To ask Her Majesty’s Government what is their response to the assessment of the President of the Royal College of Emergency Medicine that removing the four-hour accident and emergency treatment target would have a “near-catastrophic impact” on patient safety in many emergency departments.
Baroness Manzoor (Con)
My Lords, I note the concerns of the Royal College of Emergency Medicine and assure it, and the House, that patient safety remains paramount in any NHS care setting. As I mentioned in the excellent debate that the noble Lord, Lord Hunt, introduced last week, the NHS long-term plan will reform urgent and emergency care, and NHS England’s clinical review of standards will report its interim findings in spring 2019. Until then, we are clear that existing core access standards will remain in place.
Lord Hunt of Kings Heath (Lab)
My Lords, I am grateful to the Minister. She will know that, before the four-hour target was introduced, we had dangerously overcrowded A&E departments, very long waiting times and unsafe care generally. It is clear from the evidence that the chief executive of the NHS recently gave to a parliamentary committee that he wants the clinical standards review to get rid of the four-hour target under the guise of giving greater priority to the most urgent treatments. The problem with that is that most urgent treatments get priority already. There is a real risk that, if you let the four-hour target go, many patients will have to wait longer and longer. The royal college is concerned about patient safety. Is the answer not to invest in more beds and adult social care for frail, older patients and then get a more effective flow of patients through hospitals? In that way, the target could be met.
Baroness Manzoor
My Lords, the noble Lord is absolutely right: performance targets are important. However, we must ensure that the NHS is focusing on clinically appropriate targets. The clinical review of standards is considering standards for both physical and mental health. Following its interim findings, any recommended changes will be carefully field-tested across the NHS before they are implemented. An impact assessment will be published and changes to the NHS constitution will be consulted on, as is legally required.
Organ Donation (Deemed Consent) Bill
Debate between Lord Hunt of Kings Heath and Baroness ManzoorFriday 1st February 2019
(5 years, 9 months ago)
Lords ChamberRead Full debate Organ Donation (Deemed Consent) Act 2019 View all Organ Donation (Deemed Consent) Act 2019 Debates Read Hansard Text Amendment Paper: HL Bill 141-I Marshalled list for Committee (PDF) - (30 Jan 2019)
Baroness Manzoor
My Lords, I thank the noble Lord, Lord Morrow, for raising the issue of territorial extent and its application in this Bill. I clarify that that the Bill does not change the rules of consent in Northern Ireland and introduces deemed consent only in England. The reason Northern Ireland is included in the extent is because the Bill amends an existing piece of legislation, the Human Tissue Act 2004, which extends to England, Wales and Northern Ireland. While the Bill has been drafted to have a matching extent to that Act, which is the recommended approach when an existing Act is amended, we are changing the law to introduce deemed consent in England only. Deemed consent will not apply to Northern Ireland.
On the second part of the noble Lord’s amendment, the Bill as drafted ensures that organs removed in England under deemed consent can still be stored and used in Northern Ireland as now, even if Northern Ireland does not have deemed consent. This is why Northern Ireland is included in Clause 2(2) and (3). However, for such a provision to have effect in Northern Ireland, there will be a need for a legislative consent Motion from Northern Ireland.
I hope this reassures the noble Lord that we have not undermined policy in Northern Ireland in any way, and reassures the Committee that this amendment is not necessary. I hope the noble Lord will withdraw his amendment.
Lord Hunt of Kings Heath
My Lords, the noble Lord has asked me to confirm the view of the Minister, and I so do.
Health: Chief Medical Officer’s Recommendations
Debate between Lord Hunt of Kings Heath and Baroness Manzoor
Lord Hunt of Kings Heath
To ask Her Majesty’s Government what steps they intend to take to implement the recommendations in the Annual Report of the Chief Medical Officer 2018, published on 21 December 2018.
Baroness Manzoor (Con)
My Lords, in her most recent annual report, the CMO set out a compelling vision for the future of healthcare by 2040. The Government are carefully considering all the recommendations made in this annual report and, as noble Lords will know, have taken substantive and sustained action on the contents of all previous reports. Indeed, the NHS Long Term Plan is addressing many of the issues that are at the heart of the CMO’s report, such as data, research and prevention.
Lord Hunt of Kings Heath (Lab)
My Lords, I am grateful to the Minister for that Answer. She will know that the CMO’s report was a devastating critique of the state of public health at the moment, showing wide inequalities in health, which have been widening under the current Government. She recommends strong fiscal action to increase taxes on tobacco and alcohol, as well as on foodstuffs with high contents of sugar and salt. The NHS England 10-year plan makes no mention of that. Will the Government accept the CMO’s recommendations?
NHS Long-term Plan
Debate between Lord Hunt of Kings Heath and Baroness Manzoor
Baroness Manzoor
My Lords, I thank both noble Baronesses for their contributions to this Statement. I am very grateful for some of the positive comments that were made from both Benches. I am very proud that this Government are putting £20.5 billion into the NHS. That is an amazing achievement. We must recognise that this is a great achievement for the NHS. The NHS is working closely within itself and with the Government to ensure that we can deliver the outcomes we all want, which are improved care for those who use the NHS and to prevent people from getting ill in the first place. I welcome this. As someone who worked in the NHS in my early days I recognise the importance of this money. We are not being disingenuous in what we are trying to achieve—far from it. It is because we passionately care about the NHS that we are doing this.
A number of points were raised by both noble Baronesses. I hope that they will appreciate that I have only just got this brief, but I will endeavour to do my best to answer all the questions. However, if there are any that I have not responded to, I will of course write to the noble Baronesses and place a copy in the Library. The noble Baroness, Lady Thornton, quite rightly raised the issue of staff. We need staff in the NHS if we are to carry out any plans. They are very important to us. She asked what we were doing. There are record numbers of dedicated NHS staff and they work tirelessly to make sure that patients get excellent care. We support them by training 25% more doctors, nurses and midwives, giving a significant pay rise to over 1 million staff and listening to the issues that matter to them. We know that this is a complex area and we are listening and talking to staff to see how we can bring about greater improvements in workforce planning.
To put this into context, there are currently record numbers of doctors, paramedics and ambulance staff, and all HCHS staff. The monthly workforce statistics for September 2018 show that since May 2010, there are over 45,900 more professionally qualified clinical staff working in NHS trusts and CCGs, including 16,500 or 17.4% more doctors, over 6,500 or 2.2% more nurses, midwives and health visitors, and 13,400 or 8.3% more nurses on our wards. We recognise that it is a complicated issue and that there are staff shortages in some areas, and we are actively engaging with staff and looking at solutions as we move forward.
Other issues raised by the noble Baroness, Lady Thornton, related to Brexit and to scrapping the 2012 Act as part of the long-term plan. That was about legislation and I shall deal with legislation first. I think the basis of the noble Baroness’s question was whether we are going to scrap the Lansley reforms. In June the Government asked the NHS to come forward with proposals for legislative reform to support the ambitions of the long-term plan, which have now been set out clearly. NHS England will continue to engage nationally and locally to refine the proposals over coming months. The Government will consider updating legalisation where there is clear evidence that doing so would improve services for patients.
The noble Baroness, Lady Thornton, mentioned performance and the noble Baroness, Lady Tyler, also touched upon it. The Government have been clear that through the long-term plan the NHS must get back on the path of recovering performance. The plan is clear on proposals for updating urgent and emergency care and on expectations to reduce waits for planned operations. We must ensure that we have a health system which focusses on clinically appropriate targets. The ongoing clinical review of standards, which will report in the spring, will be followed by a period of testing and evaluating any new or refined standards. The review is considering standards for physical and mental health.
The public health grant was touched upon by the noble Baronesses. We are already giving local government more than £16 billion for public health services over the current spending review period. The Government recognise the important role played by local authorities in supporting people to live longer, happier lives and managing demand for health services. We have a clear commitment to ensure that public health services continue to do that. Future budgets for PHE and the public health plan, which is part of the financial settlement for local authorities, will be finalised at the upcoming spending review.
Baroness Manzoor
I have a couple of minutes. On the adult social care Green Paper, it was recently announced that the Government will provide local authorities with £240 million this financial year, 2018-19, and £240 million next year for adult social care so that people can leave hospital when they are ready and go into a care setting that best meets their needs. This will help to free beds over the winter. There is a further £410 million for social care.
We recognise that the NHS and social care provision are two sides of the same coin and that we cannot have a plan for one side and not for the other. While the long-term funding profile of the social care system will not be settled until the spending review, we will publish the social care Green Paper soon, ahead of the spending review.
I am conscious that there were a couple of other issues, particularly in relation to the role of the NHS in relation to public health, which the noble Baroness, Lady Tyler, raised. I think I have highlighted it. On going forward and the implementation plan, as indicated in the Statement, the Secretary of State has asked my noble friend Lady Harding about how we move forward, particularly on workforce planning. An implementation plan will go to the Secretary of State by the spring and a more detailed implantation plan will be put in place once the spending review figures are available as part of the spending review framework. There will be a framework in terms of quality. I am conscious that my time is up, so I will write to the noble Baroness on the two other questions on adult social care and the differences in mental care for young people.
Lord Hunt of Kings Heath
My Lords, I apologise to the noble Baroness for intervening. She paused, and I thought she had finished.
I refer noble Lords to the register and particularly to my advisory role with SweatCo.
I turn to public health issues. The plan makes a very bold statement about tackling some of our major public health problems. When it comes to specific government action, it is silent. I refer the Minister to the Chief Medical Officer’s annual report for 2018 which was published just before Christmas. It was very hard talking in some of the recommendations that the Government need to take. I shall cite just one of them. In relation to obesity the Chief Medical Officer recommended that the Government review the use of fiscal disincentives in relation to foods high in sugar and salt and of incentives to increase fruit and vegetable consumption. Why is the plan silent on these issues?
Baroness Manzoor
The plan is an overall strategy. The detail will be filled in over the coming months and years as we work closely with clinicians and people working in the NHS. That is why, looking at obesity, we introduced the sugar tax, which has been very successful. Noble Lords may say that we did not get as much money as we thought we would, but to my mind that is great; it means we have got preventive action because companies are now putting less sugar into drinks et cetera, which is a bonus. The noble Lord is right. That is why we are putting so much more money —£4.5 billion—into the preventive agenda so that we tackle the issues that he has just indicated.