NHS: Performance and Innovation
Baroness Merron Excerpts(3 years ago)
Lords ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Baroness Merron (Lab)
My Lords, I am most grateful to the noble Lord, Lord Scriven, for securing this debate and giving us the opportunity to think about the link between current performance and innovation. I am also grateful for his introduction of the subject before us.
The noble Lord, Lord Crisp, and other noble Lords were absolutely right to remind us that innovation is about not just technology, important though that is—I will come back to that—but people, their practice, their professionalism and the way they work together. I hope the Minister will bear that in mind, because we are going to come to the issue of the workforce plan, which we still await.
A number of noble Lords have made the point that they have resisted talking about the difficulties faced by the NHS, but I am not going to resist. While the Minister has had a break, we must return to that subject because the fact is that the NHS has just not been able to meet many of its pledges—for example, on maximum waiting times—in recent years. The noble Lord, Lord Allan, made reference to the gap between the expectation that people have of the NHS and the delivery that they experience. We have raised that many times in this Chamber, and it is not just about expectation; it is also about people’s absolute need. It is more than disappointing that so many legitimate targets—which were set for a very good reason, which was to provide the best kind of healthcare—have just fallen by the wayside.
At the beginning of the year, the number of people on a waiting list for hospital treatment rose to a record 7.2 million. That number consistently rose between 2012 and 2019, and has risen more quickly since early 2021. I hope the Minister will resist constantly blaming the pandemic. It is of course true that the pandemic exacerbated waiting lists and has created many new challenges, but these problems existed before the pandemic and it would not be right to hide behind it, particularly when, for example, the 18-week treatment target has not been met since 2016.
The percentage of patients who have waited more than four hours in hospital A&E also rose consistently between 2015 and 2020, with a new record high reached in December 2022. We have discussed ambulance response times in this Chamber many times. These too have risen, with the average response time to a category 2 call in December 2022 standing at over one hour and 30 minutes, when the target was 18 minutes.
On cancer waiting times, targets are repeatedly missed and performances in April were among the worst on record. To give just one example, in April the 62-day target of 85% was not met, as only 61% of people started their treatment for cancer within 62 days of an urgent referral. This means that some 5,200 people who started treatment for cancer in April waited longer than 62 days after an urgent referral, when we all know that speed is of the essence.
In all this, my noble friend Lord Parekh and other noble Lords were right to say that there is much concentration on hospital care. Hospitals are of course a key part of the infrastructure, but we need to have more focus on primary care and to see joining-up—not just across government but, as noble Lords have said, across the whole NHS, along with social care. Noble Lords also spoke rightly today about the importance of prevention. The noble Lord, Lord Addington, and others raised this; we have to put far greater emphasis on prevention.
It is true that there has been a number of innovations and they are very welcome, but they are small fish when we compare them with the big picture. When we look at the revolution taking place in medical science, technology, working practices and data, we are missing out on the potential to transform our healthcare. There is absolutely no reason why this country should not be leading the rest of the world in this field, but it so often feels as if the NHS is stuck in something of an analogue age and that it has been allowed to happen under the watch of this Government. The future of the health service has to see, as noble Lords have said, more care taking place in the community. That would reduce the burden on hospitals; it would also allow patients to receive healthcare in their own home or close to home. But a slow adoption of technology has worked against this, as has the lack of joining-up within the system.
In his welcome intervention, my noble friend Lord Turnberg gave examples of both existing and previous practices that could be called upon. He also referred to the importance of having higher standards and a higher regard, and reward, for social care workers. If we are to support the development of social care and the healthcare system, those workers are absolutely essential.
The noble Lord, Lord Crisp, drew on examples of the network of community health workers in other countries, including Brazil. When I was an International Development Minister, prior to being a Health Minister, I also saw such networks growing and flourishing across African countries. They were built on trust, on locality and on harnessing people’s abilities and their links with communities. As the noble Lord asked, is it not interesting that that has inspired innovation in places such as Westminster and Calderdale? Who would have thought that?
I must say to the Minister that throughout the debate, I have been left reflecting that innovation, while it does exist, is patchy, and that is part of the problem. The IPPR estimates that, for example, the introduction of automation could be worth some £12.5 billion to the National Health Service by freeing up, among other things, staff time and by creating better productivity. Why are we not drawing on that?
I will refer to some missed opportunities, and then perhaps the Minister can explain why we find ourselves in this position. There are now tools which can map radiation therapy on to cancer cells and avoid organs more precisely than can an oncologist working alone. They do that in seconds, rather than the hour it takes a doctor. This is standard technology, used across the United States. However, just one in three radiotherapy planning centres in England uses this technology.
Between 1 million and 2 million mammograms are done across the UK every year. Although 96% will not find cancer, women are currently left in the dark for weeks, and even months, waiting for their results. The noble Lord, Lord Allan, suggested something quite obvious: why is there not a better technological means to notify people of their results? Why is there a hold up on mammograms? Because two clinicians are required to check them, and there is a workforce crisis. However, AI could rule out cancer-free screens in seconds, giving patients their results faster and freeing up clinicians to focus on the tests that display abnormalities. It has been rolled out across Hungary since 2021, but not across the National Health Service.
AI can also help to interpret chest X-rays, saving 15% of a radiologist’s workload. When combined with interpretation by a consultant radiologist, it could reduce missed lung cancer cases by 60%, but it has yet to be fully adopted by the NHS. Can the Minister tell us why?
We all know that staff shortages across the NHS workforce are not only a barrier to meeting important waiting times but also limit the NHS’s ability to adopt and develop innovation, in both a technical and technological sense, and a people sense. We have recently been told that the NHS workforce plan will arrive shortly—after many years of it not arriving shortly. Perhaps the Minister could again answer the question of when we will see it, whether it will be fully funded, whether it will ensure a look to the future and how it will deal with the immediate.
The NHS should not be lagging behind. It is a universal, single-payer service and it ought to be the best-placed healthcare system in the world to take advantage of changing technology and medicines. After all, what other health service can offer innovators a market of some 50 million patients and give the life sciences industry access to a diverse and large population sufficient to develop new medicines, in the way that our NHS can?
In drawing my comments to a close, I want to offer some solutions from these Benches to add to the points raised by noble Lords in this debate. On procurement, the NHS should identify the goods and services that should be purchased at scale and buy them at a discount. This would also cut out unnecessary bureaucracy and stop new technology being re-evaluated for years, while the world moves on and beyond. In clinical trials, I suggest that every trust could operate through a standard system so that the number of contracts needed is minimised and the administrative burden is eased across the system.
While I accept the point made by the noble Lord, Lord Allan, that apps are not everything, they are important and proper use of the NHS app could be made and extended. It currently has some 30 million users—that is a tremendous reach—but every patient should be able to see their medical records through it. They should be able to use it easily to book appointments, order repeat prescriptions and link to appropriate self-referral routes. When patients reach an age at which they should be screened or need a check-up, the app should alert them, just as we are constantly alerted by apps in other areas. If people are eligible for a clinical trial, the app should tell us.
For the NHS to be fit for the future, it has to make fundamental change and there has to be a different way of doing things. I hope the Minister will reflect on the debate today and take heart from the fact that we all want to see change, but that he has the responsibility to deliver it at present.
NHS GP Surgeries: Purchase by US Companies
Baroness Merron Excerpts(3 years ago)
Lords ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Lord Markham (Con)
My understanding on this is that actually it is not a massively profitable area at the moment. The biggest provider in this area, Babylon Health, as we all know, did not manage to make it work. So, while I think we all understand my noble friend’s concerns, I do not believe that this is the case with the GP funding model.
Baroness Merron (Lab)
My Lords, research has shown that GP surgeries owned by some private limited companies have been offering a lower level of care, with unqualified staff seeing patients. So, in view of the Minister’s comments on quality, how much of a concern is this for the Government? On top of this, with some 4,700 GPs being cut over the last decade, cuts to training places and the many years that it takes to train a GP, what response will the Minister make to the latest GP patient survey, which reports that patients are now ever less likely to be able to see a GP?
Lord Markham (Con)
Clearly, we have our targets in terms of making sure that people can see a GP. I am glad to say that 70% of appointments are now face to face, and we are on target to hit our 50 million increase in appointments. So it is good to see that we are getting that done. Do we need to do more? Clearly, there is ever-increasing demand from the demographics of the situation, so we need to increase supply through additional training places, as I said.
Cancer Referral Targets
Baroness Merron Excerpts(3 years ago)
Lords ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Baroness Merron
To ask His Majesty’s Government what steps they are taking to ensure that NHS trusts in England meet their target for cancer patients to be treated within two months of an urgent GP referral.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)
My Lords, NHS England continues to actively support those trusts requiring the greatest help to cut cancer waiting lists. This work is backed by funding of more than £8 billion from 2022-23 to 2024-25 to help drive up and protect elective activity, including for cancer. To increase capacity, we are investing in up to 160 community diagnostic centres—CDCs. Within CDCs, we are prioritising cancer pathways to help reduce the time from patient presentation to diagnosis and treatment.
Baroness Merron (Lab)
My Lords, nearly 90% of cancer patients in 2010 received their first treatment within two months of urgent referral, which exceeded the operational standard, something the Government have not achieved since 2014, while last year fewer than 65% of cancer patients were treated within this standard. With earlier intervention being key to saving lives, what is the Government’s estimate of how many lives are lost each year due to failure to meet this agreed standard? What is the impact on survival rates of continued delays to a workforce plan promised long before the pandemic and still being reported as not having been signed off by the Treasury?
Lord Markham (Con)
The noble Baroness is correct about early diagnosis. That is why we have invested in 160 CDCs, which will be primarily focused on cancer, and why there are 11,000 more staff than in 2010, a 50% increase, as well as 3,000 more consultants, a 63% increase. We are seeing more supply than ever but at the same time, given Covid and the pent-up demand caused by that, we are also seeing more than demand than ever. The major expansion of supply is focused on making sure that we quickly detect those people.
National Health Service (Dental Charges) (Amendment) Regulations 2023
Baroness Merron Excerpts(3 years ago)
Lords ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Lord Allan of Hallam (LD)
My Lords, I am very grateful to the noble Lord, Lord Hunt of Kings Heath, for giving us the opportunity to have this debate. I think he is having an even busier day than the Minister, given his contribution to the Illegal Migration Bill debate that we just had.
There are two real questions that people are asking about access to NHS dental services. The first is whether they can get an NHS dentist. That is something that we have debated in the context of other regulations along similar lines discussing the way in which the remuneration scheme works. The second question is about how much will it cost if they do get one—if they are the lucky few who can navigate through the system and find an NHS dentist, and that is what we are primarily discussing today.
It is also important to touch on dental deserts, particularly in rural and coastal areas. I hope that the Minister may also have some to say on availability. He has assured us in this House previously that the Government have ideas to try to improve the ability of NHS dentists generally, and I know he had some creative ideas about attracting dentists into under-served areas.
Having got through the barrier of finding an NHS dentist, we now need to think about the question of charges—a question that is entirely academic if you are unable to get one in the first place. The Government are proposing in these regulations an uplift—in common language, an increase, but they prefer to use “uplift”, which I think is supposed to sound a little softer— of 8.5%. I find that curious language. When I go to supermarkets they do not tell me that they are applying an uplift value to their prices; they apply an increase to their prices, but here we are told it is an uplift value.
In paragraphs 7.8 and 7.9 of the Explanatory Memorandum we get a lengthy and quite convoluted explanation of where that money goes, which makes it clear that patient charges make no direct contribution to the remuneration that the dentist receives. People out there may think that the payment they are making to the NHS goes to the dentist, but it does not. Again the Explanatory Memorandum makes it clear that there is intentionally no link between the contract price paid to the dentist and the contribution that the individual pays. Paragraph 7.8 states that the money is essential to improve access challenges, and that current and future work to improve NHS dentistry would be undermined by the risk of reduced funding if the patient charge revenue was lower. Yet, as we heard from the noble Lord, Lord Hunt, it is reported that there was a £400 million underspend in the NHS dentistry budget for last year, so I have a couple of questions for the Minister, a maths question and a logic question. The maths question is: will he confirm that £400 million is approximately five times as much as the £78 million in extra revenue that we are told that this 8.5% increase will achieve? In other words, if we were not to have the increase but were simply to roll the underspend into dentistry, we could cover five years of that additional revenue-raising from the underspend that already exists. The logic question is simply: how can we say logically in this paragraph that these charges are essential to improve NHS dentistry when we are not spending the money that is already available? Perhaps the Minister is going to make us all happy by confirming that that £400 million underspend is all going to be spent on NHS dentistry, in addition to the extra £78 million, but I suspect that is not going to be the case. Listening to the noble Lord, Lord Hunt, I wondered whether one of the solutions might be that the new charges should not be allowed to be levied unless and until all the existing budget has been spent. If there is going to be a £400 million underspend, perhaps the patient should benefit from that if the money is not going to be rolled back into NHS dentistry.
The overriding concern is one that the noble Lord, Lord Hunt, also referred to: that the long-term commitment from this Government to provide dentistry within the National Health Service just is not there. The right words are being spoken, but the actions are telling us a different story.
The Government’s own impact assessment notes, at paragraph 37, tell us:
“There remains uncertainty about whether higher patient dental charges would lead to lower levels of patient access”.
They say that, although the research is not clear,
“it is very likely that higher charges will reduce the number of patients seeking NHS dentistry services, relative to there being no patient charge uplift.”.
So, again, the Government’s own notes tell us that it is likely there will be reduced demand for NHS dentistry as a result of the charges that we are discussing today.
Paragraph 32 very tellingly talks about the relationship between NHS and private dentistry, which, of course, is an alternative in most parts of the country. It says:
“There is also a risk that increases in NHS charges could mean that the cost of NHS dental treatment becomes closer to prices of private dental care. Some patients may choose to receive private care if the cost differential is lower”.
It seems logical that, if a patient is confronted with real difficulty in getting an NHS dentist compared with getting a private dentist and if they understand that there is no real price differential, those two forces combined will act to steer people away from NHS dentistry towards private dentistry.
As I know the Minister and I have heard him speak on these issues before, I suspect he will say that this is not the Government’s intention—but we need more than words. We need evidence that we are not seeing a succession of measures leading inexorably in one direction: a direction in which dentistry ceases to be available on the NHS at a fair NHS price for people in large swathes of this country.
Baroness Merron (Lab)
My Lords, I am grateful to my noble friend Lord Hunt for tabling this regret Motion and speaking so clearly to it, describing for your Lordships’ House what this actually means for people by its effect on NHS dentistry.
I am glad to follow the noble Lord, Lord Allan, and I absolutely associate myself with his remarks about the word “uplift”. It is a very positive way of describing an increase in costs to those who need NHS dentistry. We should remind ourselves that this is why we are having this debate, not only about the costs but about the sorry reality of the state of NHS dentistry at present—and bearing in mind that all this takes place in the context of a cost of living crisis.
It is incumbent on us this evening to remind ourselves that poor oral health—which is where we end up when people do not look after their teeth because they cannot afford and/or cannot access NHS dentistry—does not just affect the teeth. It impacts on our general health and well-being; it affects what we can eat, how we communicate, and how and whether we can work, study and socialise with ease, and it affects our self-confidence. Yet it is right to say that tooth decay is largely preventable.
There is also a significant public health problem linked with considerable regional variation and inequality. A three year-old living in Yorkshire and the Humber is more than twice as likely to have dental decay as a three year-old who lives in the east of England; and one in three five year-olds in the north-west has experience of dental decay, compared to nearly one in five in the south-east of England. It would be helpful if the Minister could tell us: what is the Government’s aspiration in respect of NHS dentistry? That aspiration and the practical means to achieve it seem to have got rather lost on the way.
As we heard from my noble friend Lord Hunt, the last 13 years have seen dentists quitting in very considerable numbers. In 2021 alone, 2,000 quit the NHS, which represents almost 10% of all dentists employed in England. An estimated 4 million people cannot access NHS care, with some parts of the country now described as dental deserts, where remaining NHS dentists are not taking on new patients.
To secure a future, we need staff, which I will refer to later, and the equipment, technology and access to ensure that patients get the treatment they need. This raises a number of wider questions. We are spending less on dentistry per head of the population in the areas with the highest levels of deprivation. Statistics from the British Dental Association suggest, for example, that 1 million new or expectant mothers have lost access to dental care since the start of the pandemic. Could the Minister say what the Government are doing to prevent those on low incomes or in more vulnerable groups being disproportionately impacted?
Tooth extraction in hospital due to tooth decay remains the most common reason for hospital admissions in the six to 10 year-old age group, with an estimated cost of hospital admissions for children aged between nought and 19 for this intervention being some £33 million per year. What steps are being taken on early preventive action to reduce what has become a shameful situation?
We know that 91% of dental practices are not able to accept new adult patients in England and 80% are not able to accept new child patients. Millions are having to face the unpalatable options of waiting for months in agony, resorting to their own DIY dentistry, or stumping up for private dental fees they simply cannot afford. My question to the Minister is not just about what the Government are doing to tackle this crisis, but how did they allow it to get to this situation? From inadequate support for the prevention of oral ill health in childhood to dental deserts, net government spend on general dental practices in England has been cut by over one-third over the past decade. Again, perhaps the Minister could explain how the situation has been allowed to deteriorate to this extent.
We know that not enough is being done to recruit and retain dentists and dental care professionals. A recent British Dental Association member survey showed that more than nine in 10 owners of dental practices with a high NHS commitment found it difficult to recruit a dentist, with 43% of vacancies unfilled for more than six months.
On the workforce, there is a point I want to underline following the points raised by my noble friend Lord Hunt. In June last year the House of Commons Health and Social Care Committee reported the findings of its inquiry into the health and social care workforce. It found that the headcount—to underline this—of primary care dentists in England providing NHS treatment or otherwise conducting NHS activity in 2020-21 was at its lowest level since 2013-14. While the register has the highest number of dentists, the number doing NHS work is decreasing. In 2021 alone there was a decrease of 951 dentists with NHS activity in England. That is the near equivalent of the whole intake target of dental students for the whole year. Perhaps the Minister could explain how this all stacks up.
On the matter of substance—we have heard much about this from the noble Lord, Lord Allan, as well as my noble friend Lord Hunt—at almost 500 practices across England the British Dental Association tells us that the amount paid by NHS patients was greater than the amount paid to that practice to provide NHS services. The analysis suggests that patients at those surgeries were topping up government funding by an estimated £2 million last year. It would be helpful to hear from the Minister how and in what way this makes sense.
NHS National Health Inequalities Improvement Programme
Baroness Merron Excerpts(3 years ago)
Lords ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Lord Markham (Con)
Absolutely. We work very closely together. The Healthy Start programme gives seven fruits a day to kids up to the age of seven to make sure that they get fruit and vegetables, and that is very much a joint initiative. Clearly, we need to be joined at the hip on some things, but as regards school meals, the DfE takes the lead.
Baroness Merron (Lab)
My Lords, the levelling up White Paper promised to design and test a new approach to ensure compliance with school food standards. Although pilot schemes were meant to start last September, a recent Written Answer from the Schools Minister stated that
“standards are being kept under review”,
with no sign of the pilot scheme. Have the Government given up on their promise and does the Minister consider the existing standards for school meals and the means of compliance sufficient to tackle nutritional inequalities across the country?
Lord Markham (Con)
As mentioned previously, the review did not happen because of Covid, and it is very much within the plans that it is time to look at school standards again. Clearly, that is key to making sure that there is a healthy diet in schools, and of course that goes across the board.
Autism: Diagnosis Targets
Baroness Merron Excerpts(3 years ago)
Lords ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Lord Markham (Con)
First, I totally agree with my noble friend’s sentiment about the power that AI, when done in the right way, can have in this space. Clearly, the stress is on the words “the right way”. I think it is fair to say that we are all on the nursery slopes as regards what it can do. I have seen how effective it can be in taking doctors’ notes, recording a meeting and drafting action points, which a doctor can then review. I am sure that we would all agree that that is very promising. There are future generations of AI being talked about that may be able to perform diagnosis. In the 10 to 15 years of looking ahead in the long-term workforce plan, these are some of the things that we will have to try to take into account. However, we are in the very early stages.
Baroness Merron (Lab)
My Lords, when it comes to autism services, we know that there are major disparities across the country which predate the pandemic but which were made much worse by it. The number of people waiting for an assessment has grown by 169% from pre-pandemic levels. How will the Minister ensure that the national framework and the standards for autism assessment within it are deliverable at a local level and in every part of the country?
Lord Markham (Con)
First, each ICB now has to have a lead for autism and learning difficulties. The noble Baroness is correct that there are some disparities— I am sure that she is aware of the two ICBs which have restricted their services quite significantly, although, thankfully, they are now rowing back on that. We need to make sure that we are on top of all of them. As the noble Baroness is aware, I and other Ministers are taking a personal interest in this. Clearly, there is a lot of work to be done.
NHS: Allocation of Financial Resources
Baroness Merron Excerpts(3 years, 1 month ago)
Lords ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Lord Markham (Con)
Yes, and we are doing it. We have committed to an up to £7.5 billion increase in funding over the next two years. We announced last month a social care plan which is addressing this and reforming the sector, and we are starting to see the changes.
Baroness Merron (Lab)
My Lords, the Royal College of Emergency Medicine described as unambitious the Government’s plan to see 76% of A&E waits meeting the four-hour standard by 2024. As this target has not been achieved in the past two years, how does the Minister see it working to drive down waiting times? How will the Minister ensure that hospitals are not prioritising patients with minor conditions at the expense of those in greater need of admission simply to allow them to meet the target?
Lord Markham (Con)
Numbers out just this morning show that we are now at 75% of people being seen within four hours, so we are close to the 76% target. That is the best since September 2021. I am the first to admit that we want to go further, as the noble Baroness states. It is about making sure we have got the care in the right places. We are triaging to make sure that the most important cases are seen first and, as I mentioned in a previous answer, we have things such as fall services, which can avoid trips to A&E in the first place, and more primary care in place to avoid visits in the first place. That is what the primary care recovery plan is all about.
Life Expectancy: Pensions, Health and Insurance
Baroness Merron Excerpts(3 years, 1 month ago)
Lords ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Lord Markham (Con)
My noble friend is correct: it is a key issue. There have been successes such as the sugar tax levy, which has reduced sugar consumption by about 40%. But clearly, you need only to look at the statistics to see that all western nations, including the UK, are facing this problem. It is a challenge that we have to attack. We can learn a lot in this space from Japan, where employers and the whole society are very much involved in the healthy lifestyles of their workers and people.
Baroness Merron (Lab)
My Lords, life expectancy for those with a learning disability is particularly shocking: only four in 10 live to see their 65th birthday, nearly half of their reported deaths are avoidable, and those living in the north-west and the Midlands are at greater risk. What action are the Government taking to address the specific barriers faced by people with learning disabilities in getting access to the timely, quality healthcare which could perhaps extend their life expectancy?
Lord Markham (Con)
As noble Lords are aware, we have been putting significant investment into mental health; from memory, there has been a £2 billion-plus increase over the last year. In recognition that learning disability is an issue we particularly need to tackle, as the noble Baroness is aware, we are putting investment into schools so they can identify it early on. Some 35% of schools now have the right educational leads in this space, and the figure will rise to 50% next year. It is a big improvement, but do we need to do more? Absolutely.
Long Covid
Baroness Merron Excerpts(3 years, 1 month ago)
Lords ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Lord Markham (Con)
I thank the noble Baroness. My understanding is that the 90 specialist adult centres and 14 specialist children’s centres have care pathways which they are supposed to adhere to. Therefore, I hope that the instances which the noble Baroness brings up are the exception, but I am happy to investigate because I think we all agree that a consistent care pathway is vital in this space.
Baroness Merron (Lab)
My Lords, despite the provisions that the Minister has outlined, the reality is that just a fraction of the people who have long Covid are seen and supported. What steps are being taken to ensure that GPs recognise long Covid in those who do not self-label as having the condition, and how will the Minister respond to the data that shows inadequate access to specialised health services?
Lord Markham (Con)
As I say, the data that I have been working with indicate that 80% are seen within eight weeks, which I think most noble Lords would agree is a pretty good statistic. My understanding is that GPs are fully briefed on referrals and disability types. It is clearly important that people who are suffering in the long term make sure that they get treatment.
Diphtheria
Baroness Merron Excerpts(3 years, 1 month ago)
Lords ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Lord Markham (Con)
As I mentioned, we are doing the screening. We lead Europe on this; my understanding is that no other European country is taking the extensive measures that we are. I can also reassure the House—I was speaking to Susan Hopkins on this just yesterday—that UKHSA has deemed that there is a very low risk to the general population. The uptick in cases that we are talking about is in the migrant population, and the fact that we are vaccinating 88% of them against diphtheria shows that we are on top of the problem.
Baroness Merron (Lab)
My Lords, we know only too well from pandemics that diseases do not respect borders, and though, as the Minister says, we ought to be well protected against diphtheria in this country given the vaccination programme, recent increases in vaccine hesitancy have given cause for concern. On the steps that the Minister referred to that should be taken to maximise vaccination rates, can he indicate whether this will reflect regional variations, bearing in mind that the National Audit Office has reported a lower level of vaccine take-up in London?
Lord Markham (Con)
Absolutely. As the noble Baroness is aware, vaccination take-up is the responsibility of the ICBs in their areas. Like many other places, London has unique demographics. As I mentioned, our record is pretty good in this area, but it needs to be done nationally on a uniform scale.