Epilepsy: New Treatments
Debate between Lord Patel and Baroness Jolly
Baroness Jolly
As the noble Lord would expect, I am very uncomfortable about any large corporations, or indeed very wealthy individuals, avoiding paying their tax.
Lord Patel (CB)
My Lords, going back to the original Question on new treatments for epilepsy, does the Minister agree that the problem is that there is no single drug that is effective for the full spectrum of epilepsy? Therefore, many treatments are promoted, including cannabidiols, which have not been fully evaluated. Until a drug is accepted by the regulatory authorities in the EU and the USA, and has been evaluated by NICE, it should not be available to patients.
General Practitioners: Hippocratic Oath
Debate between Lord Patel and Baroness Jolly(9 years, 11 months ago)
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Baroness Jolly
I really do not have the experience on which to draw. It sounds like a good idea, but how practical it is I do not know.
Lord Patel (CB)
My Lords, does the noble Baroness agree that part of the problem with GP contracts is that GPs are independent practitioners who can negotiate their contracts, whereas hospital doctors, when they apply for a job, have to comply with the job description for that job?
Baroness Jolly
That is probably an issue for the BMA, the GMC and others to sort out.
NHS: Hospital Medication
Debate between Lord Patel and Baroness Jolly
Lord Patel (CB)
When I was chairman of the National Patient Safety Agency, it produced the guidance that the noble Baroness mentioned. It identified the failure of reconciliation of medicines in acute admissions as a major patient safety issue. The failure rate in hospitals ranged from 10% reconciliation to 80% reconciliation. Those hospitals that achieved 80% reconciliation did so for one reason: pharmacists were involved. These are acute patients on multiple drugs. There is no other way except that those who know drugs and reconciliation are involved in the reconciliation of medicines on admission.
Baroness Jolly
The noble Lord is absolutely right. Pharmacists need to show leadership and expertise and to support all their colleagues to ensure that this happens appropriately.
Care Bill [HL]
Debate between Lord Patel and Baroness Jolly(11 years, 5 months ago)
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Lord Patel
My Lords, I have added my name to both these amendments in the names of the noble Baroness, Lady Emerton, and the noble Lord, Lord Willis of Knaresborough, and I strongly support the principles behind both. The key issue here is that a training curriculum should be developed by the Nursing and Midwifery Council, as the amendment says. In a way—to pre-empt the Minister regarding what the Cavendish review might recommend—whatever the review recommends will have to be taken on board by whoever develops the curriculum. Although the Cavendish review is not defunct, the principles of this amendment are not based on what it might say. Presumably the review will focus on the necessity for training and the kind of training that support and healthcare workers should have. These amendments put a duty on Health Education England to make sure that a curriculum is developed.
The other important point is that the training should be mandatory—not the training curriculum but the training—and the employers must ensure that they employ only those who, having been trained, hold a certificate showing that they have completed it. It is just the same as I would have to do when seeking employment at a hospital. I would have to produce a degree certificate from a university proving that I have been trained as a doctor before they will employ me. It would be an offence to do otherwise. The amendment does not provide for a penalty but that issue will have to be addressed. Although “register” might be the wrong word, the implication is that the employer should be obliged to keep a list of all the healthcare support workers in its employment who have completed the mandatory training and hold a certificate.
The completion of training and the holding of a certificate are the key issues. As nobody can be employed unless they have done that, the care for patients will be safer. The process will define the competencies of these people. It will define what further development they have to go through professionally to be able to do other tasks. It will also make the life of the supervisor easier as they will know what competencies these people have and they will not delegate to them tasks which are beyond their competencies. In that respect, these amendments fulfil all the requirements that the Francis report and several other reports have alluded to—the need to make sure that we have a fully trained and competent workforce which delivers front-line healthcare. I hope that the noble Earl takes the amendments in that spirit.
Baroness Jolly
My Lords, I want to add quickly to what has been said by the noble Lord, Lord Patel, and the noble Baroness, Lady Emerton. I very much support what they said. What I can add over and above that is that the amendment in the name of my noble friend Lord Willis, Amendment 23A, refers to,
“working directly with patients or clients”,
so it works not only in a health context but in a care context.
I will declare my mother—as the noble Lord, Lord Campbell-Savours, did his—as an interest. She is a lady who I visit regularly and is well over 90. Somebody comes to see her in her home every day—for the most part they are very nice young women—but I have no idea where they come from or what training they have. Amendment 23A would give me confidence that they have been trained and are certificated. Furthermore, these people tend to be quite a mobile population. If their certificates were to follow them from one establishment to the next, it would give the next establishment confidence that their training had been delivered to the right standard and that, all other things being equal, it is appropriate to employ them. That adds weight to Amendment 23A.
Care Bill [HL]
Debate between Lord Patel and Baroness Jolly(11 years, 5 months ago)
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Lord Patel
My Lords, I support these amendments. My name is attached to Amendments 17, 20 and 32 in the name of the noble Lord, Lord Turnberg, and to Amendments 37 and 39 in the name of the noble Lord, Lord Willis of Knaresborough, who, as we have heard, was taken to hospital yesterday. I spoke to him in his hospital bed just before we started and he was beginning to feel better. I am sure we will want to wish him well.
I strongly support the amendment because, through the Health and Social Care Act, we gave prominence to the need to promote research and innovation in the health service, and it is right that we did that. It would be a pity now if the only gap in that duty would be for it not to apply to the key body, Health Education England, and the local education and training board committees. As the noble Lord, Lord Turnberg, so eloquently put it, the amendments are about education and training by research, and about making sure that LETBs also have a responsibility to make sure that they conform to the functions of the HEE. They are all related to research, training, innovation, continuing training and research and supporting research. They cannot be wrong and I hope the Minister will accept them. They are well meaning and promote research further.
Baroness Jolly
My Lords, I thank the noble Lords, Lord Turnberg and Lord Patel, for helping me with these amendments. The noble Lord, Lord Willis of Knaresborough, is unwell and may not be returning to us in time to help with the Bill. His twin passions are training and research, and Amendments 37 and 39 to Clause 90, which are all about the functions of LETBs, completely underpin that. I would be doing him a disservice if I did not ask the Minister to explore these areas when he sums up.
It is critical not only at a national level, with HEE, but at a local level, with the LETBs, that this area is not forgotten. Staff must understand not only the implications but all aspects of research. That must be plugged in at HEE and, with these amendments to Clause 90, at the LETB level.
Health and Social Care Bill
Debate between Lord Patel and Baroness Jolly(13 years ago)
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Lord Patel
In response to the amount of funding, as I understand it—I am sure the noble Baroness, Lady Northover, will correct me if I am wrong—the Bill suggests that the funding for HealthWatch England will be a grant in aid provided by the department to the CQC.
Baroness Jolly
My Lords, they say that too many cooks spoil the broth, but I think this is an occasion where that probably has not happened. Many hands might make light work. I ask the Minister to take these amendments away because there is an awful lot of good to be found in each of them, but not in each together, as it were.
Amendment 318C, tabled by the noble Lord, Lord Whitty, inserts a new clause and subsection (2)(a) of the new clause is about complaints. It is a nice idea that complaints could be taken to HealthWatch England. Complaints are a big issue to which we will be returning on Amendment 108.
The noble Baroness, Lady Cumberlege, raised the relationship between local and national healthwatches. It is critical. We would support the election of local healthwatch representatives to the national body.
Finally, on independence and finance, I believe very strongly that it is very difficult to criticise and challenge an organisation if you sit within it. I understand the point about the benefits, but if you are local, and you sit within your local health authority or nationally you sit within the CQC, generally the feeling that you are monitoring the organisation that is your host is never a good place to start. Similarly, I, too, have had letters from people who were CHIPs and then LINks about budgets being not just cut a little bit but absolutely hacked away. I would be really uncomfortable if, for example, locally the healthwatch was going to be located within the principal local authority that held the budget. We have had it already today. Intentions will be good and then somebody will come along and say, “We really need a bit more just for this”. It will happen in a meeting where they are not present and, all of a sudden, there will be another slice taken. We have seen it before with lots of other things. You could look at it from a negative point of view and say these are like curate’s eggs and bad in parts or good in parts, but I think too many cooks will not spoil this broth. Many hands will make light work. I ask my noble friend to take this away and have a look at it.
NHS: Reorganisation
Debate between Lord Patel and Baroness Jolly(13 years, 8 months ago)
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Noble Lords