Inflammatory Bowel Disease

Lord Kamall Excerpts

Monday 20th May 2024 Lords Chamber

[Lord Markham (Con)]

The Getting It Right pathway was very much informed from that best practice around the world and, in the last year, NICE has approved four new drug treatments. We are trying to look at the best medicines around the world. One of them, risankizumab, has resulted in a 44% reduction in the disease—so, yes, we are trying to learn from the best in the world.

[Lord Kamall (Con)]

My Lords, the noble Lord, Lord Hunt, asked about awareness. We know that certain communities are vaccine hesitant or less aware of some of the conditions and less likely to come forward. What lessons have been learned from some of the other programmes? Are there communities that are underrepresented for this? What efforts have been made to learn from other programmes to make sure that those communities come forward?

[Lord Markham (Con)]

First off, it is trying to learn the lessons: the best parallel that I have so far is around the bowel cancer screening and that faecal screening programme. The real thing here is the difference between the 10% of the population who suffer from irritable bowel syndrome, a lot of which is diet-based in terms of the cure, and the 1% which really is serious in terms of inflammatory bowel disease. That is where we need the education and awareness.

Immunisation: Children

Lord Kamall Excerpts

Wednesday 8th May 2024 Lords Chamber

[Lord Markham (Con)]

It has to make sense to take more measures that are easy for people, including maybe less skilled people, to operate. Funnily enough, I was talking just today to the head of Moderna about how it is packing syringes, or has planned to for vaccinations going forward, rather than vials, to take that step out of the process. The easier we can make it, the better.

[Lord Kamall (Con)]

My Lords, the right reverend Prelate rightly spoke about the role of faith communities in reaching those hard-to-reach communities. I know that my noble friend the Minister has answered these questions previously, but I wonder what lessons the department has learned from previous vaccination campaigns—Covid, MMR, et cetera—to make sure that the initiatives it is using to reach those hard-to-reach communities are more effective.

[Lord Markham (Con)]

It really is about having the whole toolkit. Clearly, it is about making sure that we are using communications in 15 different languages. It is about the outreach groups and, particularly, the catch-up programmes. We have been doing one for 17 to 25 year-olds for polio and MMR. It is about all those strategies and the pop-up clinics, so that it is very easy to catch people in places that are convenient for them.

NHS: Dementia Commission Report

Lord Kamall Excerpts

Thursday 22nd February 2024 Lords Chamber

[Lord Markham (Con)]

As ever, my colleague the noble Lord is correct. The blood biomarkers are central to this. We have set up the NIHR biomarker challenge to try to understand those, and my understanding is that a Swedish blood test is quite promising. NICE is bound to approve the two early-stage drugs that the noble Lord mentioned over the summer, in July and September, but then we need to look at scale-up issues. Often, we are talking about having to deliver them through drips, which means a whole workforce scale-up. So there are a lot of issues around this that the noble Lord rightly brings up, and I hope the panel can discuss them further.

[Lord Kamall (Con)]

My Lords, I would like to ask the Minister about the role of music therapy in helping dementia patients. It is well known that when someone listens to music, sometimes it takes them back to a place and time immediately. There has been research on the role of music therapy. I quickly skim-read the report but did not see music therapy mentioned in any way or in detail. If I am wrong, perhaps the Minister can correct me, but could he also tell me about the role that music therapy can play?

[Lord Markham (Con)]

My noble friend is correct; I did not see reference in my noble friend Lord O’Shaughnessy’s report to music therapy either. I am familiar with some of the principles behind it. My personal experience myself with the elderly dementia patient that I cared for was that bringing my five year-old son along took them out of their position and made them care for that child and forget about their own situation. Those sorts of therapies—and music is similar—have a vital role that we will look into further as part of this plan.

Care Home Staffing

Lord Kamall Excerpts

Thursday 18th January 2024 Lords Chamber

[Lord Markham (Con)]

The noble Baroness is correct that the numbers are a result of flow. We are seeing thousands more people hospitalised through A&E, so the fact that we have managed to reduce the back end indicates a positive way forward. To measure precisely what the noble Baroness asked about, we have now set up a kind of flight control system for each integrated care board, as I have mentioned, which looks at data across the system to monitor the number of hospital beds and places needed on a case-by-case basis. The noble Baroness is absolutely correct that having that data is key.

[Lord Kamall (Con)]

My Lords, my noble friend the Minister mentioned the importance of a career structure to encourage people to work in the care sector. On the question from the noble Baroness, Lady Pitkeathley, about visas for carers, one issue that has not been addressed is that of personal carers. It is very difficult to sponsor or get a personal carer for individuals, and therefore there is a massive shortage. Can my noble friend the Minister say what the Government are doing to make sure that we can have more personal carers, whether from a domestic workforce or through immigration?

[Lord Markham (Con)]

My noble friend is correct that the recruitment of personal carers is harder. I know that this is close to his heart. I can probably serve him best by giving him a written reply setting out the details of what we are doing.

Health: RSV Immunisation

Lord Kamall Excerpts

Wednesday 17th January 2024 Lords Chamber

[Lord Markham (Con)]

The JCVI process is similar to the NICE approach. They look through the quality-adjusted years framework and make sure that it reaches within that. That is how they came up with their calculations. So far it is only the older ones, 75-plus, that they think are enough of an at-risk group in terms of hospitalisations and mortality to justify that. But I will inquire further and get back to the noble Baroness I am sure that they are capturing the data so that we can check on the younger ages.

[Lord Kamall (Con)]

My Lords, a number of noble Lords referred to the fact that there were disparities between different communities in the take-up of previous vaccines. My noble friend the Minister acknowledged that. Given the experience of previous vaccine rollouts, what specific lessons has his department learned that it will put into practice to make sure that it reaches some of those hard-to-reach communities in the rollout of those vaccines?

[Lord Markham (Con)]

You have to have the data and the records so that those who you know have not been vaccinated you have to go and get specifically. In London we have been running an under-fives programme, calling all those who have not been vaccinated to come and get a vaccine. That will be rolled out to under-11s and even up to under-25s, having learned precisely those lessons.

Suicide Prevention Strategy

Lord Kamall Excerpts

Thursday 26th October 2023 Lords Chamber

[Lord Markham (Con)]

It is understood that people’s financial well-being—or lack thereof—is one of the key causes here. Interestingly, as I looked at the statistics, there was a big jump up in the suicide rate from 2008 onwards, following the financial crisis. It is about making the point that, when people feel under more stress, they are, unfortunately, more likely to commit suicide. However, if you look at the statistics over the past five years, the rate has been pretty flat; so far, there is no evidence to show that, in the past year or so, the cost of living crisis has caused more suicides. None the less, it is something that we absolutely need to stay on top of and ensure that we are monitoring closely, as the right reverend Prelate the Bishop of London mentioned.

[Lord Kamall (Con)]

My noble friend the Minister rightly said earlier that suicide prevention is all our responsibility—or something like that—and that we need more awareness. Can he enlighten us on some programmes to increase awareness of suicide prevention so that we recognise that it is the responsibility of someone’s wider family, wider community and others and so that they are aware of the signs to look for?

[Lord Markham (Con)]

Yes. Effective bereavement support comes into this in a similar way. There are a number of communication methods, which I will happily share in writing so that noble Lords can see them, but there is also a full marketing and support plan around them.

Paediatric Care: Wating Times

Lord Kamall Excerpts

Monday 16th October 2023 Lords Chamber

[Lord Markham (Con)]

I like to think that we have good contact on this, centred around, as I said, Start for Life, which is a £300 million joint programme between ourselves and the Department for Education. There are also other things; for example, noble Lords might remember me mentioning the Bradford pilot previously, where we are looking at children’s scores in test environments and using those where there may be early indicators of ADHD or other neurodiverse needs. There is quite a bit of work going on in this space. No doubt we could always work more closely, but there is some promising work being done.

[Lord Kamall (Con)]

My Lords, looking at the waiting lists, there is clearly an issue of different needs and levels of seriousness in the conditions that people are suffering. Can my noble friend the Minister tell us what sort of prioritisation process has been put in place to make sure that those who need care immediately are prioritised over those who could possibly wait a little longer?

[Lord Markham (Con)]

Probably the best example of that is in the whole area of cancer, which we all agree has to be the absolute priority. We have set up children’s cancer networks precisely around that. They are also set up so we can do whole genome sequencing for all children with cancer and start to introduce specific point-of-care medicines especially for them. These are examples of where we are saying that this really is the priority and that it is what we will devote all our resources to.

Respiratory Syncytial Virus

Lord Kamall Excerpts

Tuesday 25th July 2023 Lords Chamber

[Lord Markham (Con)]

It depends on the type of jab. For instance, the maternal jab can be given to the mother as part of her prenatal check-ups. Either way, if it is for her or for the baby, there will be an education campaign. The other at-risk group is, as I am sure the noble Baroness knows, the over-75s. We are looking at a targeted programme for them as well, which they can go to their GP to find out about.

[Lord Kamall (Con)]

Further to the noble Baroness’s question about public information, we found previously when rolling out vaccines, not just for this but for Covid, that there were certain communities which were difficult to reach or to persuade to take up the vaccine. As an extension to the question from the noble Baroness, what more is being done to encourage people in those communities who are reluctant to be vaccinated to come forward, or to go to meet them in their communities and take the vaccine to them?

[Lord Markham (Con)]

We had this question on MMR just the other day. Some groups are much harder to reach than others. Very young children are the prime at-risk group. There, it is much easier because, naturally, they are seen by their GP and medical staff either prenatally, if it is maternal, or post in terms of the baby check-ups. The group that we are talking more about here is post 75 year-olds, and there those education programmes will be put in place.

Stroke Care

Lord Kamall Excerpts

Monday 24th July 2023 Lords Chamber

[Lord Markham (Con)]

I agree that last winter was particularly difficult; as we all know, ambulance wait times were too long, which undoubtedly caused issues. We have a recovery plan for the emergency services and have invested more in ambulances, but it is all about flow, which we have spoken about many times in this House, and making sure that people can get to where they need to be as soon as possible.

[Lord Kamall (Con)]

My Lords, I will take this opportunity to ask my noble friend a more general question about guidelines. I am sure he receives correspondence about parts of the NHS not meeting guidelines, not only on strokes but on other issues. What are the Government and the NHS doing to make sure that, where there are guidelines, they are followed through and adopted by ICSs and medical practitioners right across the system?

[Lord Markham (Con)]

I thank my noble friend. As we all agree, there are always two steps involved: setting out the guidelines that we believe are best practice and making sure that they are then implemented. ICBs have that responsibility and regional managers look into them. As I think I have mentioned before, each Minister personally takes charge of six or seven ICBs—I will visit a few of them in the next few weeks during Recess—so we can make sure that they are really delivering on the ground.

Cancer Referral Targets

Lord Kamall Excerpts

Monday 5th June 2023 Lords Chamber

[Lord Markham (Con)]

The noble Baroness is correct about early diagnosis. That is why we have invested in 160 CDCs, which will be primarily focused on cancer, and why there are 11,000 more staff than in 2010, a 50% increase, as well as 3,000 more consultants, a 63% increase. We are seeing more supply than ever but at the same time, given Covid and the pent-up demand caused by that, we are also seeing more than demand than ever. The major expansion of supply is focused on making sure that we quickly detect those people.

[Lord Kamall (Con)]

My noble friend the Minister mentioned Covid. One thing we learned from Covid was the importance of testing at home and rolling out home testing. A few weeks ago, I received a letter from the NHS asking me to provide a sample to test for a certain cancer—a test given to people my age. I thought that that was very interesting. How much more rollout of home testing are the Government intending to do, so that we can catch these cancers early—not just colon cancer but a whole range of cancers?

[Lord Markham (Con)]

I am not exactly familiar with the test that my noble friend might have taken but many of us will have heard about the early promise shown by the GRAIL programme. It is a simple blood test and, right now, has a two-thirds success rate for early detection. Those are early indicators, but early diagnosis and innovative approaches such as the GRAIL blood test are important.