NHS: Fracture Liaison Services

Debate between Lord Lexden and Lord Markham

Monday 5th February 2024 Lords Chamber

[Lord Markham (Con)]

As I mentioned, I agree with the noble Baroness that the FLS has shown many cases of prevention. There is a good argument in terms of investment and the return on it all. That is something that we are working towards and, as the noble Baroness will know, it is part of the major conditions strategy for musculoskeletal. So it is something that we are looking to expand.

[Lord Lexden (Con)]

My Lords, do the Government regret dropping the commitment that they gave in a debate in this House in September to expand financial provision for fracture liaison services? Is the health department considering the introduction of a best-practice tariff to reward those trusts that establish and maintain these vital services?

[Lord Markham (Con)]

I think that the statement made previously has been corrected on this, but, as I mentioned, we accept that these services are very effective in what they do. That is why we have musculoskeletal as part of the major conditions strategy. It was something that we put £400 million behind last year, in terms of a workforce package. We are looking at the effectiveness of FLS and, in ICBs that are not doing it, whether there is a case to expand them further.

Reinforced Autoclaved Aerated Concrete: Hospitals

Debate between Lord Lexden and Lord Markham

Wednesday 13th September 2023 Lords Chamber

[Lord Markham (Con)]

Three of those have already had the RAAC eliminated from them. The remaining ones are part of the programme and the commitment to have their RAAC eradicated by 2035, but in the meantime the remedial measures are there and that is what the £698 million is all about. I visited them first hand to see the work, and all credit to the team—they have become real experts on the subject. At every hospital I visited, you could see that the team were right on their game and understood very well what work they needed to do there, always using expert advice from the Institution of Structural Engineers and others.

[Lord Lexden (Con)]

My Lords, do the details that my noble friend gave in answer to the noble Lord, Lord Hunt, represent the current position in implementing the clear commitments given by Mr Johnson in the 2019 manifesto, which I do not think have advanced quite as swiftly as had been hoped?

[Lord Markham (Con)]

The commitment to 40 hospitals is absolutely there, but, as noble Lords have mentioned, we have prioritised the seven RAAC ones—in fact five of those were new, while two were already in the programme—which clearly have to be done by 2030. So, just as we moved those in, we moved the others into the cycle of 2030-35, but we will still be delivering 40 hospitals by 2030, albeit, because of the RAAC hospitals, of a slightly different complexion.

NHS Staff: Food Banks

Debate between Lord Lexden and Lord Markham

Tuesday 7th February 2023 Lords Chamber

[Lord Markham (Con)]

Clearly, food banks should be a last resort for people; that is definitely my hope. I am glad to say that there are some good examples of where hospitals have thought that this is the appropriate thing to do and have set them up to help people in that circumstance. However, the biggest increase has been in energy bills, which we have sought to protect people from. I am glad to see that prices are forecast to reduce in future. Actually, gas futures prices are down 71% for next year, so things are starting to get better. Is it challenging right now? Yes.

[Lord Lexden (Con)]

My Lords, are the means of improving the conditions and welfare of all aspects of our much-valued NHS workforce forming a central part of the discussions that are continuing in an effort to reach an agreement in this current tragic dispute?

[Lord Markham (Con)]

They are a central part of the discussions, but at the same time, we have to work out how we can best spend the budget. There are difficult choices here. Clearly, we want to make sure that we are protecting elective recovery and front-line services in A&E, so there are a lot of competing demands in this space. We are seeking to balance those in the best way possible, with the help of the independent pay review bodies, to make sure that we protect and pay what is appropriate in the circumstances.

PPE Expenditure

Debate between Lord Lexden and Lord Markham

Wednesday 25th January 2023 Lords Chamber

[Lord Markham (Con)]

I think we all agree that, at the time, some mechanism was needed to sift the thousands upon thousands of offers of goodwill to help with PPE. A decision was made to take recommendations —the so-called VIP lane—and I think we all accept now that was not the right decision. Going forward, a different sifting mechanism would be set up in place of that. Now, of course, we have supply chains set up to do this, so we hope that occasion will not arise in future.

[Lord Lexden (Con)]

My Lords, my noble friend was right, was he not, to remind us of the context in which those decisions were taken three years ago? There was an overwhelming sense of crisis, to which the Government had to respond with extreme rapidity.

[Lord Markham (Con)]

Absolutely. I remember well, as I am sure do others, watching the news about planes being diverted to other countries and it being asked how come they were not coming to the UK and what the department was doing to get on top of it. I am sure there was criticism from this House—it was before my time—asking what we were doing as a Government to get a grip of it. Well, we did get a grip of it; we did buy the PPE and it did not run out. Yes, we ended up buying too much of it because, thankfully, the pandemic did not turn out to be as bad as we thought it would. I think we did a sensible thing at the time, and now we are going after all those people who did not keep to their supply agreements, and we are recovering the funds. By and large, with the benefit of hindsight, I think we did a fairly decent job—not perfect but pretty good.

Osteoporosis: Early Detection

Debate between Lord Lexden and Lord Markham

Thursday 19th January 2023 Lords Chamber

[Lord Markham (Con)]

One of the many things for which I am responsible is NHS performance, as I think the House is aware, and these are exactly the sorts of issues that I am interested in, so I am happy to undertake to give an update on that. We all know that effective spend, which we need to make sure is always put to best use, involves identifying where these problems are, and 3 million people are affected every year. As I said earlier, a fractured femur is the second biggest reason for intake into hospitals, in terms of beds. That is something that I am happy to be measured by and report back on.

[Lord Lexden (Con)]

My Lords, following on from the question from the noble Lord, Lord Rennard, is it not the case that, while the Government accept that everyone over 50 should have equal access to fracture liaison services, insufficient progress is being made towards that crucial goal? Is there not a case for the appointment of a strong and determined national specialist adviser on osteoporosis to speed things up?

[Lord Markham (Con)]

As I mentioned earlier, this is the responsibility of all the ICBs. Part of my job is making sure that we as Ministers now regularly communicate with all the ICBs. There are a number of boards that I regularly speak to, check in with and visit on a frequent basis, and one of our checkpoints is making sure that they are on top of services such as these. I am delighted to say that every ICB has now set up a community base fall service, to make sure that if someone should fall in a case such as these, rather than an ambulance and two paramedics, we can have someone specially set up to right these people, put them on their feet and avoid an A&E visit.

NHS: Backlogs

Debate between Lord Lexden and Lord Markham

Wednesday 9th November 2022 Lords Chamber

[Lord Markham (Con)]

I agree that it is an area of key priority; that is why the spend in this year as reported by NHS trusts has gone up by 57%—an increase to £1.4 billion. So we recognise that this needs to be worked on, but I put it in the context of an overall £10 billion capital programme, including a new hospital build. We very much recognise that making sure we have excellent facilities is key to success in the NHS.

[Lord Lexden (Con)]

My Lords, what has become of the great hospital building programme that Mr Boris Johnson promised in the 2019 Conservative election manifesto?

[Lord Markham (Con)]

I am very pleased to say that the hospital programme is very much a feature. We are already working on five hospitals, which are in the process of being delivered. The programme for the 40 hospitals is very much in progress, and we see it as a real opportunity for the UK to take a lead, as we are looking at using a whole new series of modern methods of construction, which we believe will be world leading in this space.

Bereavement Support

Debate between Lord Lexden and Lord Markham

Wednesday 9th November 2022 Lords Chamber

[Lord Markham (Con)]

I agree; we have to address every group. Part of the research into this is about ensuring that every group has access to support. I cannot speak in detail on the group mentioned, but I will make sure that the new team we have set up addresses this, because mental health and the causes of suicide are often the tip of the iceberg, and we need to make sure that every single group is addressed.

[Lord Lexden (Con)]

My Lords, for centuries, people at times of bereavement have turned to their priests, pastors and other spiritual leaders. Should not the Churches, and the Church of England in particular, react to this report by renewing and indeed enlarging their spiritual mission to comfort and succour the bereaved? Or could it be that in the diocese of London there is a feeling that some are no longer equal to this task, it having caused a bereavement in 2020 by driving to suicide a priest who was the friend of my heart in Cambridge years ago, accusing him, falsely, of sex abuse, refusing to disclose the allegations to him and then later asking a commoner to cover up for it?

[Lord Markham (Con)]

I am afraid that I do not have any knowledge of the case in point. As I said before, I welcome the role of the right reverend Prelate the Bishop of London in producing this report, which I know all the bishops and all the Church, of whatever faith, will take directly to heart. Again, I can only repeat the title of the report: Bereavement is Everyone’s Business. The Church has a key role to play in that, as it fully understands.