Queen's Speech

Lord Kakkar Excerpts

Thursday 3rd June 2010 Lords Chamber

[Lord Kakkar]

My Lords, it is with great humility that I beg your indulgence on this, the first occasion on which I address your Lordships’ House. In the few weeks since my introduction, interrupted by the general election, I have enjoyed the warmest of welcomes from so many noble Lords and Baronesses, for which I am most grateful—as I am for the courteous, kind and thoughtful help that I have received from numerous members of staff, including the Clerks and the dedicated Doorkeepers. My happiness in making this speech is tempered by thoughts for Black Rod, who was particularly kind to my family at my introduction and whom I have had the chance of seeing, most recently yesterday evening, in hospital. I know that all our thoughts are with him and his family.

I also express my particular thanks to my supporters: the noble Lords, Lord Higgins and Lord Patel, and the Convenor of the Cross Benches, the noble Baroness, Lady D’Souza.

I could not let this occasion pass without recognising the role of the House of Lords Appointments Commission in my being here. Its thorough interrogation to which I was subjected was without doubt the most demanding and insightful of my professional career to date.

My emotions always run high as I enter the House. I never cease to be amazed by the history that attends our deliberations and the vital role that your Lordships play in ensuring that potential legislation enjoys rigorous scrutiny, so that the best possible laws may join the statute book for the benefit of all our people. That this important work is conducted in such a decent, thoughtful and selfless fashion, calling upon a wide range of scholarship, expertise and, above all, experience, makes this House truly unique.

Nor do I cease to be amazed that I find myself among your Lordships, something I could never have imagined on 7 December 1977 when, as a schoolboy, I made my first visit to this House, on which occasion I was filled with awe, excitement and a passion for our nation’s democracy, debate and political discussion. The educational outreach programmes conducted by your Lordships are invaluable, and I hope to be able to contribute to these to help enthuse future generations of schoolchildren about the important work of your Lordships and about what is done in this House and how it forms a cornerstone of our much cherished democracy.

My professional life outside your Lordships’ House is as professor of surgical sciences at Barts and The London School of Medicine and Dentistry, part of Queen Mary College in the University of London, and consultant surgeon to University College Hospital. I also have the privilege to be director of the Thrombosis Research Institute in London, a world-leading centre dedicated to better understanding the problem of blood clots and how best they can be prevented and treated.

In the practice of medicine and my interest in thrombosis, I follow my father, a professor of surgery, and my mother, an anaesthetist, who came to our country in 1961 to complete their medical training. They were part of a substantial wave of immigration from India made possible because of a national consensus, long held, that has ensured opportunities and advancement for immigrant communities willing to integrate and contribute broadly to British society. What excitement there must now be among all British citizens of Indian origin on learning in the gracious Speech about the Government’s desire for enhanced partnership with India, a wonderful opportunity for this vibrant community to contribute to securing broader opportunities for the entire nation.

In many ways, consensus and institutions define our national character. It is about one of our great national institutions, the one in which I continue to have the privilege to practise as a surgeon and about which I must therefore declare my interest—the National Health Service—that I would like to speak to your Lordships today. Like any great institution, the NHS cannot and must not be taken for granted. It needs to be nurtured, nourished and pruned thoughtfully and sensitively where necessary but, above all, respected.

The gracious Speech indicates the Government’s desire to enhance the voice of patients and strengthen the role of doctors in the National Health Service. These are indeed important ambitions, and are made recognising the nation’s serious fiscal challenge, a situation that will dominate the way that all public services can be delivered for years to come.

Time and again, Governments have felt an obligation to turn to the question of NHS reform. Why is this necessary despite substantial investment, a dedicated and talented workforce and its unique place in the nation’s affections? Why is it that the care received by patients, and their experience of it, varies so considerably; that patient safety and dignity can still regularly be jeopardised; that we have not been able to define models and pathways of care that successfully cross the barriers of the hospital and general practice environment; that we are still witness to some shocking inequalities in health, none more so than those experienced by the homeless; that we have failed to develop a sustainable public health strategy; and that we are often unable to successfully disseminate and rapidly adopt innovation and the findings of medical research for the benefit of our patients? So much has been achieved, yet there is so much more that we need to do if we are to retain a sustainable National Health Service for the benefit of all. The nation’s continuing commitment to the NHS offers both opportunities and important challenges to the medical profession.

All life is a journey, and in my own as a clinical practitioner and academic I have learnt so much about the dignity and resilience of human beings, but also about their frailty and insecurity. It is with this in mind that individual practitioners must deliver healthcare, at a time when both patients and relatives are at their most vulnerable. Beyond the delivery of care to our patients, however, clinicians will have to direct their current skills, and develop new ones, to help ensure that the very best possible gains in public health can be achieved, and that we facilitate the most effective use of the public funds available for healthcare to deliver maximum societal gain.

This is an impressive challenge, but one with which my own profession must fully engage, and I am sure it will, through providing clinical leadership. Indeed, in its report, Future Physician: Changing Doctors in Changing Times, the Royal College of Physicians of London recognises this to be a critical issue and an obligation for the medical profession. However, there is an important distinction between leadership and management in the NHS, a distinction that needs to be clearly understood so that the development of true leaders across both primary and secondary care can become enshrined in the way that we nurture the careers of our most able clinicians.

Leadership is never easy, and clinical leadership will require healthcare professionals to engage with difficult decisions. How can resources be most efficiently utilised? How can the delivery of care be safe and effective while always ensuring that patients are treated with dignity and humanity? How do we ensure that advances in medical research and innovation, once proven, are rapidly adopted for the benefit of our patients, communities and society more broadly?

To effect change, partnership will be essential—partnership between patient and doctor, academic and clinician, hospital doctor and general practitioner, and of course Government and healthcare professional—always focused on the best that we can achieve for our patients while working to ensure that the precious and generous funding available for healthcare provides maximum benefit.

Despite being one of our country’s most cherished and important institutions, the NHS, like all healthcare providers around the world, faces immense challenges. With ever increasing costs on the one hand, and both the delivery of care and the nation’s health failing to meet expectations on the other, courage will be required to secure a sustainable NHS for the benefit of our people. The forthcoming health Bill offers the opportunity to ensure clinical leadership and partnership within the NHS. The expertise of your Lordships’ House will play an important role in achieving that. I thank noble Lords for having given me the opportunity to speak.