NHS and Social Care: Staffing

Debate between Baroness Blackwood of North Oxford and Lord O'Shaughnessy

Wednesday 15th January 2020 Lords Chamber

[Lord O’Shaughnessy (Con)]

My Lords, the Government are to be commended for wanting to raise the number of staff in the NHS and social care. In the near term, it is equally important that we make sure that we use the staff we have as efficiently as possible, and that we give them the tools and skills to be as productive as they can, including through the use of technology. To what extent will the digital tools that already exist and are on the market feature in the people plan?

[Baroness Blackwood of North Oxford]

My noble friend is a great advocate of investment in innovation and technology—and for good reason. One of the health infrastructure plan’s key priorities is ensuring that we bring forward the data and digital transformation solutions that will enable staff to spend more time on caring and less time on administrative and repetitive tasks that could be much better undertaken by some of the digital solutions that are now available. Some of those solutions would manage rotas more effectively and others, such as those being delivered by the £200 million AI hub, will enable, for example, AI solutions in radiology and pathology, which could lead to much earlier and more effective diagnoses in areas such as cancer.

Healthcare: Brain Tumours

Debate between Baroness Blackwood of North Oxford and Lord O'Shaughnessy

Thursday 24th October 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

The noble Baroness has raised a very important issue. Obviously, the Government are working to deliver the Carers Action Plan, which retains the strategic vision of recognising, valuing and supporting carers. It includes a commitment to 64 actions across five priorities to ensure that we improve support for carers, including recognition and support, and build evidence to improve outcomes, especially in these very difficult areas. We are also working hard with the Tessa Jowell Brain Cancer Mission to ensure that we improve pathways for those with very challenging brain tumour diagnoses.

[Lord O’Shaughnessy (Con)]

My Lords, I declare an interest as a patron of the Tessa Jowell Brain Cancer Mission. The noble Baroness, Lady Wheeler, has highlighted a very important topic, because the outcomes and experiences of people with brain tumours and brain cancers are terrible and have not improved in decades. The actions my noble friend has set out are important, but it took the leadership of our late and much missed noble friend to galvanise action. Part of that action was a pledge from the Government of £40 million from the National Institute for Health Research to improve research into treatments, therapies and care for people with brain tumours. Can my noble friend update the House on what progress has been made on that and how the money is being spent?

[Baroness Blackwood of North Oxford]

I thank my noble friend for his question and I pay tribute to his leadership on this issue. He is absolutely right that we must improve outcomes for those diagnosed with brain cancer, and one of the ways of doing so will be through earlier diagnosis. That is why the Prime Minister announced measures with the aim of seeing 75% of all cancers detected at an early stage by 2028 to save 55,000 lives a year. My noble friend is right, however, that we will deliver this only through improved research specifically targeted at brain cancers. The Government announced £40 million over five years for brain tumour research. This can be delivered only through the submission of high-quality research and I know that the Tessa Jowell mission is working to ensure that that becomes a reality.

Learning Disabilities Mortality Review

Debate between Baroness Blackwood of North Oxford and Lord O'Shaughnessy

Wednesday 15th May 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I can say absolutely that priority will be given to this. The mandatory training consultation, which has just been completed, was published on 13 February. The consultation lasted eight weeks but such was the volume of responses to it that it was extended by a further month; it received more than 5,000 responses, which the department is currently going through. There has been a commitment to a response within two to three months. The Government are taking this extremely seriously.

[Lord O’Shaughnessy (Con)]

My Lords, I thank my noble friend for her answers and the commitment and empathy she has shown, but let us be clear: what we are describing is appalling. The fact that people with learning disabilities—Down’s syndrome, autism and the like—have shorter life expectancies is completely unacceptable. I know that the Government and the Minister personally are committed to doing something about that but I want to return to the issue of training. To change a culture, we need to change not just the curricula of people training to enter the profession but the attitudes of everybody already working in the caring profession who do not always take these issues seriously. I appreciate that my noble friend will not be able to give details ahead of the consultation response in two to three months’ time, but can she give a commitment that we will think about not only training—in medical colleges, on nursing courses and so on—but continuing professional development so that everybody who is likely to have contact with people with learning disabilities in a care setting will have the opportunity to retrain, to understand the needs of these people and to make sure that we provide them with the care they deserve?

[Baroness Blackwood of North Oxford]

I thank my noble friend for his question. He is absolutely right: it is a disgrace that the reports demonstrate that too many people with learning disabilities are still dying prematurely and, all too often, for preventable reasons. We must ensure that we drive through the entire health system a change to make this come to an end. This is partly a matter of leadership, which is why it is absolutely right that Stephen Powis, the NHS England medical director, will write personally to doctors saying that it is not appropriate for DNRs to be based on disability and learning disabilities. It is why learning disabilities have been made a priority throughout the long-term plan and key programmes in the plan prioritise improving the physical healthcare of people with learning disabilities; that is important because it drives the issue up the priorities list of those working on an already busy schedule. It is also why the consultation on mandatory training will be brought forward as a matter of priority. Only when you have that combination of leadership, the practical healthcare programmes funded in the long-term plan and training will you get the culture change that my noble friend rightly identified as necessary.

Tessa Jowell Brain Cancer Mission

Debate between Baroness Blackwood of North Oxford and Lord O'Shaughnessy

Monday 13th May 2019 Lords Chamber

[Lord O’Shaughnessy (Con)]

My Lords, a year ago yesterday we lost somebody who was a colleague, a friend and an inspiration to us all. I do not think that any of us who were involved in the debate that Lady Jowell initiated in January last year, whether they had known her for a long time or were only just getting to know her, will ever forget the extraordinary courage and leadership that she showed that day. As my noble friend pointed out, the impact has been truly profound, including through the brain cancer mission set up in her name, of which I am proud to be a patron. I am delighted that the Government have chosen this anniversary —an unwanted one, of course—to give us an update on the very important progress that they have made.

I am delighted by the news on the pink drink, which was one of the issues that Lady Jowell highlighted that day, as well as with other progress. As well as paying tribute to my noble friend and colleagues in the department, I join other noble Lords in congratulating the brain tumour charities, Cancer Research UK, patient groups, and of course Jess and her family for keeping up pressure and momentum so that we can make a difference on this dreadful disease.

Of course, the work of curing brain cancer is one not of months but of years and even generations. While I absolutely welcome the announcements today, can my noble friend give a commitment—which I am sure she will be happy to do—that the support the Government are providing will never waver during the long periods when we have to go through research and have to change things to improve outcomes, and that that commitment will always be there for this Government and any future one?

On a specific point, it is good to hear my noble friend talking about adaptive trials through BRAIN-MATRIX, and about Health Education England training a new generation of neuro-oncologists. Is she able to give specific details about the kind of support that the Government and others are prepared to offer for those? For untreatable cancers, having highly specialised staff as well as different ways of carrying out trials is critical to keeping people alive for longer—which is of course what Tessa’s speech and the leadership she showed was all about.

[Baroness Blackwood of North Oxford]

I thank my noble friend for his comments and in particular for the leadership he showed in responding to Tessa’s call to arms to improve outcomes for those with brain cancer diagnoses. I can absolutely give him the commitment that the Government’s commitment to the mission will not waver, and there is a very good reason for this. The outcome we are already seeing is so significant; over the last 12 months there has been the launching with partners of the mission and the making available of funding that has resulted in 24 brain cancer research proposals—the highest number ever—with a further four under active consideration. In addition, progress has been made on moving towards new service and staffing models, with commitments in the long-term plan and the life sciences sector deal. This will deliver exactly what my noble friend is talking about: namely, better care and support for patients, targeted to the kind of diagnoses they have, which is exactly what the brain cancer mission has recognised, and exactly the specialist advice which government needs to tailor care for patients in the most appropriate way when they most need it.

NHS: Shortage of GPs and Nurses

Debate between Baroness Blackwood of North Oxford and Lord O'Shaughnessy

Wednesday 8th May 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I thank the noble Baroness, who is very expert in this area. She is absolutely right that there is no point in our bringing new trainees into the system if we do not retain the expertise and the teaching quality within the system. We can be very proud of the quality we have within the system, which is why we have put in a number of programmes to address this. We have put in a targeted, enhanced recruitment stream to attract doctors into parts of the country where there have been consistent shortages. We have put a broad offer of support for GPs to remain within the NHS, including GP Career Plus, the GP Retention Scheme, the Local GP Retention Fund and the national GP Induction and Refresher Scheme. We have also put in place a number of schemes for nurses, including a scheme that will attract nurses into specific, targeted areas, such as mental health, learning disabilities and district nursing, where we believe we should make the career more attractive. We recognise that there is more to do, and in areas such as pensions, which the noble Baroness rightly raised, we are taking that issue up with the BMA and the Treasury.

[Lord O’Shaughnessy (Con)]

My Lords, the increased numbers of staff coming through GP and nurse training are of course incredibly welcome but the truth is that we have a problem now, which is that we need more doctors and nurses practising today. One way to do that is to look around the world to recruit people, but another way is to make sure that we make the most of the resources we have through technology. Can my noble friend tell the House what the department is doing to enable us to use technological solutions to improve the efficiency of the GPs who are practising today?

[Baroness Blackwood of North Oxford]

My noble friend is absolutely right, and he has his own expertise in this area. I am pleased to be able to report that we have had an increase in recruitment of nurses and NHS workers from abroad. Compared with June 2016, we have over 5,200 more EU health and care staff working in the NHS, and we have had a 126% increase in the number of non-EU NHS workers, which shows the attractiveness of working within the NHS. But he is also right that we need to make sure that those who work in the NHS have access to the most innovative and effective tools possible, which is why, particularly within GP practice, we are launching the GP IT Futures programme. That will provide GPs with the best tools possible so that we can make their job more efficient while also allowing them to provide the best-quality care to patients.

Health: HIV

Debate between Baroness Blackwood of North Oxford and Lord O'Shaughnessy

Monday 25th March 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

We can be incredibly proud that the UK is a world leader in efforts to end the AIDS epidemic, including through our huge investment in the Global Fund, which has provided 17.5 million people with treatment since 2017, and of course through DfID’s research on HIV prevention. That is exactly why DfID has committed to continuing its focus on HIV prevention technologies and I am happy to share that commitment with the noble Baroness.

[Lord O'Shaughnessy (Con)]

My Lords, may I echo my noble friend Lord Black’s praise for the Secretary of State’s ambition and associate myself with his policy suggestions? My noble friend will be aware that there is a similarly infectious, life-limiting disease that affects similar people, called Hepatitis C. We now have a cure for that disease: we are able not just to eliminate it as a public health risk but actually to cure people. In drawing up any strategy, will the Minister ensure that the department also makes sure that curing Hep C and making that cure available to those people is as big a priority as eliminating HIV?

[Baroness Blackwood of North Oxford]

I thank my noble friend for his question and also for his leadership on this issue while he was in the department. He knows that the Government are committed to being a world leader in domestic eradication of Hepatitis C. He will know also that a legal challenge by AbbVie delayed the start of contracts on this issue by six months. I am pleased to be able to inform the House, however, that in January the High Court found in NHS England’s favour on all grounds in this matter. We can now go forward with those innovative contracts, which are worth about £1 billion over five years. That will be rapidly put in place over the coming months, which will allow us to make progress on this matter.

Healthcare (International Arrangements) Bill

Debate between Baroness Blackwood of North Oxford and Lord O'Shaughnessy

Committee: 1st sitting (Hansard): House of Lords
Tuesday 19th February 2019 Lords Chamber

[Lord O’Shaughnessy]

I shall follow the theme expounded by the noble Baroness, Lady Finlay, and talk about Northern Ireland and the Republic of Ireland. It will come as no surprise to noble Lords that with a name such as mine I have family in Ireland, but more importantly, I had several meetings with Irish Health Ministers during my time as Minister and I want to provide insight and reassurance from those conversations. Noble Lords will understand that during those conversations we had to discuss difficult issues—more challenging topics, shall we say—within the Brexit realm, but there was absolute clarity in every meeting about the intended outcome being continued cross-border delivery and co-ordination of healthcare. That could be done under the aegis of the common travel area and the Belfast agreement and there was no reason for the fact of the United Kingdom leaving the European Union to interrupt that. Clearly that needed to be established as well as the legal processes and basis, but that was deep, long-standing and productive work.

I wonder whether the Minister can update the Committee to give a flavour of where we have got to; it is not just about the Republic and the north, as people from the Republic of Ireland use tertiary healthcare services in the UK. This is an incredibly deep and long-standing relationship with huge benefits, and I am sure that the Minister will be able to confirm that we are at the right point in those discussions to provide reassurance. I can tell her that it has always been the intention of the UK Government, and it was clearly the intention of the Irish Government, to achieve that.

Perhaps I may reflect briefly on the amendments in the name of my noble friend Lord Lansley, which in a sense are about clarifying who benefits. I absolutely agree that that is necessary, and I am sure that the Minister will be able to respond.

I shall risk partially agreeing with the noble Lord, Lord Foulkes, and my noble friend Lord Dundee in the sense that they make a very strong case for our agreement with the European Union incorporating pensioners and those with long-term conditions, as indeed is the case now. I do not think that that needs to be in the Bill, not least because their amendments include the word “preserves”. Of course, these are ongoing and dynamic relationships that will change over time; nevertheless, that is the Government’s objective.

The noble Lord, Lord Foulkes, made a very compelling case for the Bill having a global reach when he talked about those with long-term conditions being unable to travel outside the EU because the arrangements are not in place. I hope that that is a sign that there might be agreement across the aisle about how it is necessary to formulate these agreements so that when our people travel to Australia, New Zealand, Serbia, Gibraltar, Guernsey and other places, they are able to do so with the same kind of reassurance with which they are able to travel in Europe now.

[Baroness Blackwood of North Oxford]

I offer my thanks to my noble friend Lord Lansley for his Amendments 7 and 8, to the noble Baronesses, Lady Thornton and Lady Jolly, for Amendment 17, and to my noble friend Lord Dundee and the noble Lord, Lord Foulkes, for Amendments 18 and 19. I also thank all noble Lords for a good debate on this group.

Each of the amendments seeks to provide clarity about the nature of the reciprocal healthcare agreements that we are seeking to implement after exit for the people who benefit from them. I understand that these are uncertain times and that people want to know that the UK Government are doing all they can so that there are no disruptions to people’s healthcare abroad after the UK exits the EU. I hope that noble Lords can all agree that this legislation is important, as it grants the public the confidence that this Parliament is working to ensure that people can continue to access healthcare abroad.

The Government’s intention is to continue current reciprocal healthcare arrangements with countries in any exit scenario—deal or no deal—as they are now until 2020. In any exit scenario, we are committed to the principle of equal treatment—that is, that UK nationals are not treated differently from local citizens when accessing healthcare in the EU. The Government are also committed to ensuring good value for taxpayers’ money and will carefully consider the associated costs of any future reciprocal healthcare agreement that they enter into. I think that that speaks directly to the points made by my noble friend Lord Lansley.

I agree with the sentiment of my noble friend’s Amendments 7 and 8, but I suggest that requirements such as the scope of people to be included in regulations and the principle of equal treatment are matters for the healthcare agreement. Questions around who should be eligible within specific reciprocal healthcare agreements and the affordability of those agreements would naturally be part of the scrutiny of any international healthcare agreement brought before Parliament as part of the CRaG process.

I just note, again, that the purpose of the Bill is to implement those agreements, not to define their parameters, as we do not yet know how the negotiations will proceed between now and the final agreements. However, my noble friend is absolutely right when he says that questions of eligibility, the principle of equality of in-country care, the impact on the NHS and value for the taxpayer will be at the heart of the Government’s consideration as they move forward with reciprocal healthcare. It is certainly our intention to be clear and transparent about this, not least because we are discussing the personal healthcare arrangements of UK citizens. As the noble Baroness, Lady Finlay, put it, this goes to the human heart of the Bill.

In addressing the specific concerns raised by the other amendments, I shall offer reassurances about some of the specific cohorts of people mentioned in the debate. First, I shall speak directly to Amendment 17 in the names of the noble Baronesses, Lady Thornton and Lady Jolly, and spoken to by the noble Baroness, Lady Finlay, and my noble friend Lord O’Shaughnessy. I can confirm that it is the UK’s negotiation strategy to continue UK-Irish healthcare co-operation regardless of EU exit. Both the UK and Ireland are committed to continuing reciprocal healthcare rights so that UK and Irish nationals can continue to access healthcare when they live in, work in or visit the other country.

To turn to a point raised by the noble Baroness, Lady Finlay, we also want to maintain co-operation between the UK and Ireland on a range of health issues, including planned treatment. We want people to be able to live their lives as they do now and for our healthcare systems to continue supporting each other. The common travel area provides an important context for this. The CTA holds a special importance for people in their daily lives and it goes to the heart of the relationship between these islands.

To answer the point raised by the noble Baroness, Lady Jolly, about overlapping competences, two amendments have been tabled on devolution, so we will be looking at that when we reach Amendment 42 and I will deal with that matter in more detail then.

With regard to Amendments 18 and 19 tabled by my noble friend Lord Dundee and the noble Lord, Lord Foulkes, the Government are acutely aware of how reciprocal healthcare arrangements benefit UK state pensioners and those with long-term conditions. Speaking as someone with a rare condition, when I travel, I travel at risk; I am not eligible for insurance. I understand this only too personally. Therefore, I thank the noble Lord, Lord Foulkes, for rightly raising the question of how effectively we communicate with those who currently rely on reciprocal healthcare arrangements. As well as speaking from a personal perspective, I can say that the Government are very conscious that it can be difficult to get insurance. We are working with Kidney Care UK to ensure that advice is sensitive to these issues and that people have the information they need to make the best decisions. We will discuss this issue in a lot more detail when we reach the group commencing with Amendment 20, but I want to offer the noble Lord my personal thanks.

The noble Lord also referred to a letter from a friend of his. I think that that would have gone to my right honourable friend the Minister with responsibility for Brexit. However, if he has not received a response, will he please let me know?

Access to healthcare overseas is obviously vital for the groups we have mentioned. The Government are seeking to maintain reciprocal healthcare rights for pensioners and those with long-term conditions through the “in principle” withdrawal agreement in a deal scenario, and in a no-deal scenario through our discussions with member states, the two EU withdrawal Act SIs that we have introduced, and of course through the powers in this Bill.

In responding to these amendments, I hope that I have made it clear that the Government’s negotiating position is to provide for the continuation of the current reciprocal arrangements and the ease of access to healthcare that these provide, especially to the people on the island of Ireland, those with long-term illnesses and pensioners. I hope that this reassurance addresses the concerns of noble Lords and that my noble friend will feel sufficiently reassured to withdraw his amendment.