Health and Social Care: Malnutrition

Debate between Baroness Blackwood of North Oxford and Lord Hunt of Kings Heath

Tuesday 5th November 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

The noble Baroness is absolutely right to identify some of the very significant health consequences of malnutrition. This is one of the reasons why it has been taken on board as a top priority by not only NHS England but the care system from top to bottom. The start is to have the right screening and to gather the right data so that we can identify where this needs to be improved. She is right that it needs to be integrated into nursing practice so that we not only prevent malnutrition in the first place but, where it does occur, provide the right support to put it right and the right care where there are health consequences for individuals due to clinical, social or economic problems.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I must confess to the House that I am president of the Hospital Caterers Association. Would the noble Baroness agree that there is no shortage of good advice on dealing with malnutrition and good food in the health service; nor is there a shortage of good catering professionals? The issue is trust boards that will not invest sufficiently in this area. Will she start to instruct the NHS to get serious about this if we are going to deal with this big problem?

[Baroness Blackwood of North Oxford]

The noble Lord is quite right that this is about leadership not only at board level but from the very top. It has been instructive that not only the Secretary of State but the chief executive of NHS England, Simon Stevens, have made it one of their priorities to ensure that the quality of food and food safety standards throughout the hospital and care systems should be improved. This is one of the key ways that we will drive out malnutrition from our health and care sector.

National Health Service: Bullying

Debate between Baroness Blackwood of North Oxford and Lord Hunt of Kings Heath

Wednesday 3rd July 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

The noble Baroness asks an important question. There are structures built into the NHS to enable those people to speak up. There is a “freedom to speak up” champion and a system of champions, so that it is perfectly clear to those experiencing bullying by senior managers who they can speak to.

[Lord Hunt of Kings Heath (Lab)]

Does what the Minister suggests apply to the actions of Ministers? She will recall, from when he was Secretary of State, Mr Jeremy Hunt’s practice of insisting on a weekly Monday morning meeting with the key national regulators, at which the sacking of chief executive officers was often discussed. Bullying starts at the top. If Ministers take a bullying attitude towards the NHS, they can hardly be surprised if that behaviour is followed at local level.

[Baroness Blackwood of North Oxford]

I am afraid I do not recognise the characterisation set out by the noble Lord. One of the key characteristics set out by the former Secretary of State in his leadership was that the NHS should be open and not have a culture of blame, and that people should feel free to speak up, so that when mistakes are made they should be corrected.

Lung Health

Debate between Baroness Blackwood of North Oxford and Lord Hunt of Kings Heath

Monday 1st July 2019 Lords Chamber

[Lord Hunt of Kings Heath]

To ask Her Majesty’s Government what steps they will take to implement the recommendations of the Taskforce for Lung Health’s five year plan for improving lung health in England.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)]

My Lords, the NHS has worked closely with the Taskforce for Lung Health and the British Lung Foundation to develop a national programme for respiratory and cardiovascular disease. This will improve lung health by piloting a lung health check programme, expanding quality-assured spirometry, undertaking pharmacy medicine reviews in primary care networks and improving self-management support. In addition, access to smoking cessation interventions will be increased and a national workforce group will be established. Finally, the Government have committed to improving choice and ending variation in end-of-life care services.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I am grateful to the Minister for that response. She will be aware that lung disease is often underestimated as a problem; one in five of us is likely to be affected in our lifetime and priority has not really been given to it over the past few decades. Given that outcomes have hardly improved either, will she look again at the response and commit the Government to implementing the task force report in full?

[Baroness Blackwood of North Oxford]

I thank the noble Lord for that question. He is absolutely right that respiratory illness can be extremely serious. The UK has a higher rate of respiratory deaths than any other country in the OECD; this is a clinical priority for the NHS and the Government are committed to driving it forward. We are working with the British Lung Foundation and the NHS to deliver the co-designed lung foundation’s plan and I am happy to give him that commitment now.

Unpaid Carers: Support

Debate between Baroness Blackwood of North Oxford and Lord Hunt of Kings Heath

Thursday 13th June 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I completely agree with the noble Lord, Lord Patel, who is absolutely right that we must ensure that we sustainably fund social care. The Government have provided £3.9 billion more in dedicated social care funding, but we recognise that there is a need for a sustainable financial footing for social care as a whole, which is what we are working towards with the spending review. Nevertheless, carers will continue to play an important part in our healthcare system, as they do within our society. Many people consider that they are making a rewarding and important contribution within their family and community, and we must be grateful to them for that.

[Lord Hunt of Kings Heath (Lab)]

My Lords, the implication of what the noble Baroness has just said is that the work around the Green Paper on a sustainable mechanism for funding long-term care is focused on the medium and long term. If that is so—and I think the Minister could say something about the actual remit of the work—the question then arises, what about the short term? We know that the money she talked about is a drop in the ocean compared to the money that has been taken away from social care, alongside the increasing demographic pressures. Can she tell me whether, as part of the spending review, which I assume will occur at some point, the immediate pressures are also going to be taken care of?

[Baroness Blackwood of North Oxford]

The noble Lord will know that the spending review has not yet started, so I cannot tell him what is happening in the negotiations. What I can tell him about is the work that has already gone on to improve social care funding: giving local authorities access to around £10 billion more in dedicated funding for social care from 2017-18 to 2019-20; an additional £410 million of new money to improve social care for older people, people with disabilities and children; and £240 million more for winter pressures. However, the noble Lord is absolutely right that it is no good improving the medium to long-term outlook for social care if we do not ensure that we also address the immediate challenges that it faces.

Access to Medicinal Cannabis

Debate between Baroness Blackwood of North Oxford and Lord Hunt of Kings Heath

Tuesday 9th April 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I thank the noble Baroness for her question, and I know that she has campaigned on this issue for some time. NHS England has clarified that clinical guidance does not remove or replace the clinical discretion of the prescriber to act. I know that the process review will look at the impact of clinical guidance, which will hopefully be helpful. We will also look at the role of second opinions. I hope that that has answered some of the noble Baroness’s questions; she made a number of points, and I will write to her on the rest.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I want to come back to the point about NICE made by the noble Baroness, Lady Walmsley. My understanding is that, at the moment, the evidence on which doctors can base a decision to prescribe these medicines is very limited. Clearly, relying on the NICE guidance is one way through. My problem is that, if we look at another area such as cataract operations, we see that despite NICE guidance many patients are now being denied treatment that has absolutely proven to be effective. My concern is that the Government seem to be trying to find a way round the evidence relating to these medicines when, up and down the country, patients are being denied interventions that we know will be successful and that can help thousands of people. Can the Minister comment on that?

[Baroness Blackwood of North Oxford]

The noble Lord is right that it is important that guidance is provided. The point of bringing the guidance forward is to look at the most up-to-date evidence available across the country. The challenge with medicinal cannabis is that the evidence base is developing. Currently, more than 100 clinical trials are ongoing worldwide. We are bringing the NICE guidance forward in the autumn to take all that clinical evidence into account in the most up-to-date guidance, so that patients can benefit and clinicians can have more confidence in prescribing. The NIHR call for clinical trials has been brought forward so that the evidence base can be strengthened even further as we go forward because, in the long term, the only way for us to move from an unlicensed prescribing route, which is where we are now, to a licensed route is through clinical trials and a greater evidence base. That is what the Government are keen to encourage.

Child and Adolescent Mental Health Services

Debate between Baroness Blackwood of North Oxford and Lord Hunt of Kings Heath

Monday 25th March 2019 Lords Chamber

[Lord Hunt of Kings Heath (Lab)]

My Lords, on pace, will the Minister acknowledge that this Government and their predecessor, the coalition Government, have made any number of promises about investment in and prioritisation of mental health services, particularly for children and young adults, but that when it comes to the decisions made by clinical commissioning groups, the reality is that they have not brought them to fruition? What guarantees do we have that this time clinical commissioning groups will do what they have been asked?

[Baroness Blackwood of North Oxford]

The noble Lord, Lord Hunt, is very experienced in this area and has been involved with local clinical commissioning groups. The NHS has already opened 117 additional new mental health beds, and we have introduced new waiting standards for psychosis and eating disorders among children. Progress is already being made, but we should not dismiss the frustrations of those trying to access services. That is why we have put in place ambitious new targets with the long-term plan: we want to see 100% of children able to access the care they need.