NHS App: Medical Records

Baroness McIntosh of Hudnall Excerpts

Tuesday 19th December 2023 Lords Chamber

[Lord Markham (Con)]

Patient records is what the federated data platform is very good at, in terms of drawing data and information from all sorts of sources into one place, so it is always in the ownership of the person, the GP or the individual place. You can make your data available to the private care providers, if you are having an operation with them, for instance, but the data always remains within the NHS and in the ownership of the person.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, following the question from the noble Baroness, Lady Bull, is the Minister confident, in all the talk about advances in technology, that data-sharing within the NHS is fit for purpose? We frequently encounter an apparent disconnect between different departments in the NHS, or different levels of care, where information which should be available to everybody is palpably not or, if it is, it is not being taken any notice of.

[Lord Markham (Con)]

The noble Baroness is absolutely correct. While I think everybody would say that 90% digitisation is pretty good—it is not 100%, but it is pretty good—always making sure people are talking to each other is often the issue. I am sure we have all had examples of that. That is what the federated data platform helps to do, in terms of drawing it all in. For example, Chelsea and Westminster has put what was on 10 different spreadsheets and records into one place. We are getting a lot better at that, but is it perfect and seamless? No, there is still some work to be done.

Sexually Transmitted Infections

Baroness McIntosh of Hudnall Excerpts

Tuesday 5th December 2023 Lords Chamber

[Lord Markham (Con)]

My noble friend is absolutely right: young people—15 to 24 year-olds—represent one of the highest levels of this. In 2020 we made relationships, sex and health education classes available compulsorily in schools. We are currently reviewing that to see the effectiveness of it, with a view to expanding it further.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, can the Minister tell the House what the current rate of take- up is for vaccination against HPV—human papillomavirus —and what efforts are being made to make sure that all those who should be vaccinated are?

[Lord Markham (Con)]

I will need to come back with the exact figure for the vaccination rate. I know that it is proving quite effective, which is important. On the measures we are taking, we are investing £25 million in women’s health hubs precisely to enable these sorts of vaccination programmes. I will happily follow up in writing with the detail.

Paediatric Care: Wating Times

Baroness McIntosh of Hudnall Excerpts

Monday 16th October 2023 Lords Chamber

[Lord Markham (Con)]

Unfortunately, industrial action is impacting on waiting times; we estimate that about a million appointments have been lost to date. Clearly, that is a matter of regret and not good news for anyone.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, I take the Minister back to the question from the noble Lord, Lord Allan, who referred to the necessity for parents to do a lot of running around and following up for themselves. Does he agree that this is a particular problem with the management of long-term conditions in young people—for example, ADHD and other things relating to autism—where the challenge is not just to get the diagnosis but to then get a consistent level of treatment over the long term? Can he comment on what steps have been taken to improve that? Can he also comment on the reported limited availability of appropriate drugs for treating young people with ADHD?

[Lord Markham (Con)]

I am aware from personal experience that, when you have a child with neurodiversity or developmental needs, it is a long journey. We are seeing this manifest itself much more in recent years; I was talking to Minister Caulfield about this just this morning. One-to-one is always preferable but, where capacity is constrained, group education and help can sometimes lend themselves to this space. It is a long-term condition, and clearly it will not be solved by treatment over a few months but needs many years.

NHS: Staff Numbers

Baroness McIntosh of Hudnall Excerpts

Tuesday 12th September 2023 Lords Chamber

[Lord Markham (Con)]

In every area, anaesthetists being a very good example, we need to be looking at where the bottlenecks are and moving to free up those situations. I think we would all agree that with practitioners such as anaesthetists and in other areas, it is a very sensible approach to make sure that the most highly skilled are focused on the most highly skilled jobs and that they can have people underneath them who can be trained to work within that. So hearing that there is a certain amount of opposition from certain colleges and the BMA to those sorts of roles is quite disappointing. I hope they would accept that this is a key way of addressing the issue.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, can I take the Minister back to the original Question from my noble friend Lord Clark? He put before the House some quite startling statistics about the number of medical staff—particularly but not exclusively doctors —who are leaving following or shortly after the completion of their training, either for other countries or for private practice? What view does he take of that drain away from the National Health Service and the effective loss of the investment that the country makes in the very expensive training of clinicians?

[Lord Markham (Con)]

My first point on that is to ask what the real facts are. Five years on from qualification, around 95% of doctors are still registered with the General Medical Council and still practising in the UK. So the fact is that retention is very high. That notwithstanding, we want to do everything that we can to retain people, and professional development is what the long-term workforce plan is all about. Also, we all know that pensions were a big reason for a lot of the brain drain and doctors leaving the profession, and that was something we were quite radical in supporting and changing. We are going through this bit by bit, asking what key things we need to do to retain our staff and resolve this.

Ultra-processed Food

Baroness McIntosh of Hudnall Excerpts

Tuesday 18th July 2023 Lords Chamber

[Lord Markham (Con)]

On any advisory body you clearly want to get experts in the field. Necessarily, they will often be experts from companies as well. It is vital that they abide by the principles of conduct in public life and make sure they declare any conflicts. As such, we are content that we have a proper expert panel.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, may I take the Minister back to the question from my noble friend Lord Brooke, who asked about the content of school meals? The Minister replied that school meals are a good thing and more people should have them, with which I do not suppose anybody would want to disagree. However, I did not hear him say in what way the Government are ensuring that the content of those school meals is appropriate and free from salt, sugar and fat in the way that my noble friend Lord Brooke was asking for.

[Lord Markham (Con)]

My understanding is that those guidelines are there; it is absolutely the right question. The Department for Education, working with the Department of Health, makes sure that a nutritionally balanced diet is there. There is also a joint DfE/DHSE programme in respect of nursery milk and fresh fruit and vegetables for young children, to give them a good start in life.

NHS Long-term Workforce Plan

Baroness McIntosh of Hudnall Excerpts

Tuesday 4th July 2023 Lords Chamber

[Lord Markham (Con)]

I would like to think, as I mentioned before, that increasing the supply and training of the whole medical profession would help the whole sector. This is quite close to my heart; as I have mentioned before, my mum became a nurse later on in life and went through an apprentice-type route, for want of a better phrase. Having different entry points is a very positive thing. I sincerely hope that people going into a social care environment will see that as a building block to onward career progression and that it will set them up to take further qualifications later on in life, if they wish, in the nursing profession. We are looking to expand the whole sector, and the general belief is that that will benefit both social care and the NHS.

[The Deputy Speaker (Baroness McIntosh of Hudnall) (Lab)]

My Lords, the noble Baroness, Lady Brinton, is contributing remotely.

[Baroness Brinton (LD) [V]]

My Lords, while this NHS plan is welcome, can the Minister say whether this Government will undertake to commit to the plan and, crucially, to its funding and not change the number of education and training places, as happened last year and in too many previous years, causing chaos in planning for doctors, nurses and allied healthcare professionals? On hospital training places for junior doctors after they have finished their medical school courses, last year 790 medical graduates could not begin their junior doctor in-hospital training because the NHS did not have enough placements. Given that university medical school places are already capped and highly competitive, this is a complete waste of newly qualified medical graduates.

Mental Health In-patient Services: Improving Safety

Baroness McIntosh of Hudnall Excerpts

Monday 3rd July 2023 Lords Chamber

[Baroness McIntosh of Hudnall (Lab)]

My Lords, on the Minister’s last observation, I think there are a number of noble Lords here who would say that the quality of the output has not been that great from some private providers. It is just an observation.

However, the question I want to ask will take us back to the original observations by the noble Baroness, Lady Buscombe—I was also a member of the Joint Committee. The Minister gave a very brief reply to her questions about what has happened to the many recommendations, the vast amount of evidence and a great deal of hard work that went into producing that report. He even mentioned that it was going to be responded to in a “timely” manner. I think the moment for that has passed. Will the Minister have another go at explaining what has happened to the report and when there will be a response to it?

[Lord Markham (Con)]

I am afraid I do not have the timing of a response on that. Minister Caulfield is very engaged in this area. A number of things have been mentioned. I mentioned the community treatment orders, where we are very mindful of the point made earlier by the noble Baroness, Lady Uddin, about black males being eight times more likely to be given one, and the recommendation that they should be abolished altogether. Those recommendations are very much in our thinking and our knowledge base. I know that Maria Caulfield is working on them, but I am afraid I cannot give the noble Baroness an exact time yet.

Cancer Referral Targets

Baroness McIntosh of Hudnall Excerpts

Monday 5th June 2023 Lords Chamber

[Lord Markham (Con)]

I did not know whether the noble Lord was referring to GRAIL and the comment from the noble Lord, Lord Patel, about false positives. This question probably deserves a detailed reply but, as with any test, it is not about just specificity but sensitivity, which is key, so that the number of false positives is minimised. I will provide a detailed reply.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, the noble Lord has referred at several points in this discussion to early diagnosis. He will be aware that cancer very often develops later in life and that the older you are the greater the risk is. Yet older people are excluded from routine screening tests past a certain age. Can he explain the thinking behind that?

[Lord Markham (Con)]

It is about trying to make sure that we are screening those of highest risk, given the impact on quality of life, and catching it early. I know that is very specifically the thinking around it. Beyond this, while we know the challenge around waiting lists, we have increased the supply through a 15% increase in activity. We are supplying more than ever, but we know that a lot more needs to be done to meet the demand.

NHS National Health Inequalities Improvement Programme

Baroness McIntosh of Hudnall Excerpts

Thursday 25th May 2023 Lords Chamber

[Lord Markham (Con)]

I would be happy to. I need to find out more first, and I would be delighted if there was some information or if we could meet on this, but I would be happy to take it up.

[Baroness McIntosh of Hudnall (Lab)]

The Minister has twice cited the figure of 37.5% of children now receiving free school meals, which, as he rightly says, is an achievement of a sort. However, if the standard of food those children are receiving is insufficiently good—and there appears to be some evidence of that from the information that has been going around the House this morning—adding to the number on the list of those receiving free school meals, although admirable in terms of the numbers, may be contributing to the problem. Does the Minister agree?

[Lord Markham (Con)]

I do not think anyone would say that the current school food standards are insufficient. I think the feeling is that it has been a while since they were changed because of Covid, and it is time to ask whether improvements can be made, because this is an ever-evolving situation. So I would not agree with that categorisation, but we should indeed always be looking to see whether we can make better choices.

Pharmacies: Medicines at Home

Baroness McIntosh of Hudnall Excerpts

Wednesday 17th May 2023 Lords Chamber

[Lord Markham (Con)]

I am sorry: I will try to be clear to make sure that I am fully understood. There are many, many people for whom a blister pack is absolutely the right solution. Basically, what has been put in place here is a structured medicine review, so that, in each case, it will be the responsibility of the pharmacist to make sure that they have the right solution for the patient. What I am saying equally is that blister packs are not a blanket solution, and it needs to be done on a case-by-case basis.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, I cannot claim any expertise in this matter; I have just been listening to the conversation that has been going on. My noble friend’s original Question referred to the burden on carers. I have not heard the Minister say much about that, particularly when the negotiation over what is the right way of dispensing certain kinds of medicine presumably has to go on between a patient, a pharmacist and, presumably, a doctor somewhere in it, or somebody representing the patient who would, in many cases, be the carer. In what way are carers being helped to engage in that negotiation, with all the knowledge and expertise that they bring about what actually works in the circumstances?