NHS: Performance and Innovation

Lord Turnberg Excerpts

Thursday 15th June 2023 Lords Chamber

[Lord Turnberg (Lab)]

My Lords, I am extremely grateful for being able to speak in the gap. May I say how much I resonated with the speech by the noble Lord, Lord Scriven? I will follow him by talking not about the problems of the NHS—there are far too many of those—but about three possible innovations that might help.

The first relates to the integration of services within a locality. An innovation was introduced by David Dalton in Salford Royal Hospital and the whole town of Salford, with a population of 250,000. He arranged to oversee the care not only in the hospital but in the community. He employed GPs, set up the social care requirements, some social care homes and the mental health services. It was all under his control, and the local authority gave him the funding to do it. He did it locally. This was local innovation: local development of an integrated service with patients’ records available to all those involved in the care, including pharmacists. It was a remarkable innovation at the time. But it has not been followed to any great extent. There is lots of talk about integrated systems boards, and so on, but we need more of that sort of arrangement.

Second is public health and the preparedness for the next outbreak of a pandemic. Many years ago, probably before the Minister was born, I was chairman of something called the Public Health Laboratory Service. It was disbanded in 2004. It was changed to Public Health England and has had several other iterations since. One of its main attributes at the time was that it had a network of peripheral laboratories dotted around the country in every district, with specialists in public health. They detected outbreaks of E. coli infections, testing the water and the food. They were there to detect outbreaks wherever these occurred in the country and reported them straight back to the central laboratory in Colindale. In that way, we had a network that could detect and deal with infection as it occurred, wherever it was in the country. Unfortunately, it was a Labour Government who pruned the Public Health Laboratory Service and removed the network of laboratories that we had around the country. My second plea is therefore for the Government to reintroduce a service of that type, which involves peripheral laboratories.

Finally, the third point I wish to make is one that I have banged on about for some time, and which the Minister is probably bored of: social care, and the ability to give social care workers the respect they deserve by giving them career prospects, training, graduation and qualification. My time is up, but those are my three points.