Provision of Epilepsy Services

Lord Smith of Leigh Excerpts

Tuesday 30th November 2010 Lords Chamber

[Lord Smith of Leigh]

My Lords, I signed up to a dinner break debate. It is now somewhat beyond my normal dinner time, so I shall try to be as brief as possible. I start by declaring my interests. I, too, am a member of the All-Party Parliamentary Group on Epilepsy, and through that became a vice-president of Epilepsy Action. I am also the leader of Wigan Council, and the reason for mentioning that will come later. The all-party group, although it was not much to do with me, has made some significant contributions to the understanding of epilepsy and has had some distinguished members—not only the noble Earl, Lord Howe, but also David Cameron, for obvious reasons.

At this point in a debate a lot has been said. My noble friend Lady Ford introduced the debate with a speech that showed her comprehensive understanding of the problem. She came from a personal angle, and we thank her for that as well as for securing the debate. It is not her fault that it is being held late. I want to pick up on two areas that have not been talked about very much. The first is the role of Epilepsy Action in the light of government policy, and the second is the impact of changing government policy on the possible treatment of epilepsy.

For 60 years Epilepsy Action has been making a real difference not only to sufferers of epilepsy and their families, but also by contributing to a wider understanding of the condition. It seeks to improve the treatments available and to engage with partners in education, health and social care. I was impressed by the description in the annual report of its website, which has received almost half a million hits, and I recommend that noble Lords visit it. In the past year, the organisation provided materials for 170,000 individuals and has helped in 16,000 personal cases. That is a lot of help for families who turn to Epilepsy Action when there is not much more on offer. I want also to refer to the work of the local groups, which is very important. I have become engaged with the group in my area. It provides mutual support for families by ensuring that, if necessary, there is a shoulder to cry on.

The Government may think that Epilepsy Action is a blueprint for the big society, but the organisation has been fulfilling its role for 60 years. However, we need to understand that it does not replace what is going on in the public agencies; rather it provides support and help for families. Together they can do well, but Epilepsy Action cannot be used as a replacement.

The two areas of policy I want to briefly mention are the health White Paper and the consequences of the CSR. Noble Lords have referred to the weaknesses in the current commissioning processes within the health service. In the health White Paper we are proposing to take commissioning from a number of professional organisations, such as the PCTs, and put it into some newly created organisations—the GP commissioners. What worries me is whether we will get a consistent pattern in terms of the size of those areas. Will they be geographically sensible? Noble Lords have mentioned the importance of the specialist epilepsy nurse. Will the new organisations be of a size where it would be practical to employ such a person? In this complex and new system, will epilepsy have priority? I think that is what the Government need to ask as we come to understand that. How will epilepsy make itself heard as a condition and get the reforms that it needs that noble Lords have mentioned?

Finally, I want to turn to the CSR and to my own specialist area of local government. I remind noble Lords that local government was one of the biggest losers in the comprehensive spending review, with a headline figure of 28 per cent—but do not be fooled by that; for many areas it will be much higher. Of course, it is not a consistent 7 per cent over four years because the biggest hit is in year 1. Now most local authorities are planning significant reductions in their spending for the next 12 months. Of course we will all try to do what we can for efficiency, but there will be significant reductions in services. These include services that families with epilepsy have relied on in the past and would like to think they can continue to rely on, whether in social care or in education support. Unfortunately, all these services cannot be left untouched by the scale of those cuts. In the forthcoming months, announcements will be made, and I am sure that families will find that the services they value will be reduced and they may be charged for. All these things will have to be considered by local authorities. I am just praying in aid that we do not simply ask the families to blame those who are making the cuts but to think where the responsibility lies.

There have been some strong cases made by noble Lords speaking before me of the need to improve the services to epilepsy sufferers and their families. What I am concerned about is not whether we get improvement, but that we do not get deterioration because of other impacts.