Health and Social Care Act 2012: Risk Register

Debate between Earl Howe and Lord Hughes of Woodside

Wednesday 4th December 2013 Lords Chamber

[Earl Howe]

The noble Baroness would have cause to complain if, in accordance with the debates that we had in this House on accountability, my right honourable friend did not hold the NHS to account on some of the areas of its activities where there were concerns. That is exactly what he does, and he does it quite properly.

[Lord Hughes of Woodside (Lab)]

Is it not the case, in relation to the Chilcot report, that it is not the Government who are holding it up but something else? Will the Minister not hide behind red herrings like that? It is he and his Government who are refusing to publish the risk register, and they surely must do so.

[Earl Howe]

My Lords, over the passage of time a view can be taken about the sensitivity of the Department of Health risk register. That is what we have undertaken to do and what we will do. Next spring, we will reach one of the regular review points for the risk register. I can tell the noble Lord that work to review the register has already started in anticipation of that date.

Health: HIV

Debate between Earl Howe and Lord Hughes of Woodside

Thursday 29th November 2012 Lords Chamber

[Earl Howe]

My Lords, yes. We believe that the complex needs of people with HIV will be best served by the work being done by the HIV national clinical reference group of the NHS Commissioning Board. The board will commission these services in the future, and that will drive greater consistency and quality throughout the system.

[Lord Hughes of Woodside]

My Lords—

[Baroness Trumpington]

Our turn. I am not sure whether I am in order but I should like to congratulate, through this House, the Minister on his award yesterday as Minister of the Year in the Lords.

[Earl Howe]

I am exceedingly grateful to my noble friend for that and for not asking me a question that I was unable to answer.

[Lord Hughes of Woodside]

My Lords, I am grateful that I gave way. In view of the reports of an alarming increase in the incidence of HIV, is not the old adage that prevention is better than cure even more important? Is this significant rise in HIV incidence caused by less use of condoms, or what?

[Earl Howe]

In fact, the numbers are more or less stable if one compares this year to last. However, the noble Lord is right: we cannot drop our guard in this area. There is a pressing need to reduce undiagnosed HIV. It is estimated that about 23,000 people are undiagnosed and 47% of those newly diagnosed with HIV are diagnosed late—that was the figure for last year. That is why the prevention campaign through local authorities will be so critical in this area.

Health and Social Care Bill

Debate between Earl Howe and Lord Hughes of Woodside

Monday 12th March 2012 Lords Chamber

[Earl Howe]

We have a Motion before us in the name of the noble Lord, Lord Owen. That question will be addressed then.

[Lord Hughes of Woodside]

My Lords, the Minister said that the details of the risks had been well canvassed in this House. If that is the case then in the absence of proper information, with the best will in the world, the discussions must be based on hearsay. That cannot be the right way to go about discussing business.

[Earl Howe]

My Lords, I think back to numerous debates that we have had in this House, which of course are recorded in Hansard. Many of the risks that I articulated on 28 November last have been gone through by your Lordships almost ad nauseam.

Organ Transplantation

Debate between Earl Howe and Lord Hughes of Woodside

Monday 27th February 2012 Lords Chamber

[Earl Howe]

The noble Baroness is absolutely right. The record in Spain is particularly interesting because the rate of donation is about twice what it is in this country. It is interesting to observe that Dr Matesanz, who is head of the transplantation effort in Spain, observed that this was not, in his opinion, due to the opt-out system which Spain employed in 1979. It is much more to do with the organisation of the service which came in about 10 years later. That is what we are trying to replicate in this country.

[Lord Hughes of Woodside]

My Lords, is it not the case that despite the great advances that have been made there is still a problem, whereby if someone carries a donor card the relatives still have to be consulted, and very often they say no? Can we do something to speed that up, if we cannot go for the proper opt-out system?

[Earl Howe]

The noble Lord makes a good point. It is generally the practice that the relatives are consulted even where someone has expressed a wish to donate an organ after death. Doctors will normally respect the wishes of the relatives; however, it is equally true that that person’s wishes will be emphasised to the relatives. There is a delicate balance to be struck here. The moment that action by medical teams is seen to be high-handed, it risks damaging the credibility of the transplant service.

NHS: Management Consultants

Debate between Earl Howe and Lord Hughes of Woodside

Monday 13th February 2012 Lords Chamber

[Earl Howe]

My noble friend is quite right. As I said earlier, the use of consultants—provided that that use is judicious and they are engaged in open competition processes—can be very cost-effective. It is a very flexible way of obtaining high-class advice without incurring long-term costs.

[Lord Hughes of Woodside]

Has McKinsey been given access to the risk assessment studies, which have been subject to some controversy in this House?

[Earl Howe]

I am not aware that it has or that it would need to have been.

Health: Early Diagnosis

Debate between Earl Howe and Lord Hughes of Woodside

Monday 21st November 2011 Lords Chamber

[Earl Howe]

The noble Baroness draws attention to an issue which we have been debating in various forms under this Bill, which is how we join up services and make the whole system hang together in the way that we all wish to see. The short answer to her question is that, at local authority level, the health and well-being boards will be responsible for co-ordinating that kind of information. However, we will also want to make sure that this takes place at a national level too. The outcomes data that we get from secondary care providers will in time, I am confident, produce information that will feed into public health campaigns.

[Lord Hughes of Woodside]

My Lords, I welcome the emphasis on and campaigns for early diagnosis, but will the Minister recognise that equally important is early treatment, and therefore not abandon targets for ensuring that people get early intervention of the highest quality?

[Earl Howe]

Yes, my Lords, we recognise fully that waiting times are important, and in particular diagnostic waiting times. I am certain that the noble Lord will be reassured to know that waiting times in both respects remain low, and we intend that they should remain that way.

Health: Breast Cancer

Debate between Earl Howe and Lord Hughes of Woodside

Monday 3rd October 2011 Lords Chamber

[Earl Howe]

My Lords, my noble friend is right that we have historically targeted women in a certain age group for breast cancer screening. We are looking to see whether that age group should be widened but it is generally true to say that screening is more cost-effective in older women. It has certainly been the case that the breast screening programme over the past number of years has increased the detection of cancer and saved an estimated 1,400 lives a year.

[Lord Hughes of Woodside]

My Lords, can the Minister confirm that there is something in the NHS called the two-week procedure whereby GPs can refer patients to a hospital and they are therefore seen by that hospital within those two weeks? If I am right in that, will that be more widely used and advertised so that patients know what they can ask of their GP?

[Earl Howe]

The noble Lord is right. We are not changing that target, which we believe is clinically well founded. It is largely up to GPs to make sure that, if cancer is suspected, that referral pathway should be followed.

Smoking

Debate between Earl Howe and Lord Hughes of Woodside

Thursday 8th September 2011 Lords Chamber

[Earl Howe]

My noble friend speaks with great authority on this subject, and I find little to disagree with in anything that he has said. He is absolutely right that children are particularly vulnerable to the harms of second-hand smoke: more than 300,000 children in the UK present passive smoking-related illnesses to their GP every year. We have to take this matter seriously, and we are. However, despite the evidence my noble friend cites from Canada, it is still early days to judge how effective that legislation has been, over and above voluntary measures. The second issue that poses problems is enforcement. However, we continue to look at these questions very closely.

[Lord Hughes of Woodside]

My Lords, as a former heavy smoker, I still have a guilty conscience over what I must have done to my own children. I fully support every effort to attack passive smoking. But did the Minister see in a report in today’s press that a council somewhere in England has refused to allow an adoption because the male of the family had once smoked a cigar at a wedding and had once smoked a cigar at a party? Is this not taking things to a totally ridiculous level?

[Earl Howe]

My Lords, I did not see that report, but what the noble Lord says disturbs me. I think we all want to see an increase in adoption rates and we do not want to see potentially good adopters turned aside for what may appear to be trivial reasons.

Health: Visitor Service

Debate between Earl Howe and Lord Hughes of Woodside

Monday 14th March 2011 Lords Chamber

[Earl Howe]

My noble friend makes a good point. The kind of intensive interventions that she is referring to are very much the domain of the family nurse partnerships, which are there to assist and support those families with the greatest needs, particularly single mothers, families where there is addiction and so on, and try to keep the family together. With regard to the health visitors, however, I take her point that there is suspicion out there. It comes down to creating a relationship of trust with a named health visitor, and we have seen the success of that over the past few years. The results of the assessments have been very positive.

[Lord Hughes of Woodside]

My Lords, when health visitors were attached to local authority services, co-operation between the different arms of local authorities was much easier. In many cases, health visitors are now attached to general practice services. Can the noble Earl assure me that there will be the widest possible consultation to make sure that health visitors can reach out to the community at large, which would be very valuable in terms of public health?

[Earl Howe]

My Lords, the noble Lord makes an extremely good point. The health visitor initiative is very much part of our public health drive. Local authorities will have an important part to play in commissioning services in the future. However, at the start of this big programme of recruitment, it is very important to have a concerted national drive. That is why we have said that it will be the responsibility initially of the National Health Service Commissioning Board to push this agenda forward. Thereafter, we will see much more local commissioning as the programme moves on.

Health: Sickle-Cell Disease

Debate between Earl Howe and Lord Hughes of Woodside

Monday 14th March 2011 Lords Chamber

[Earl Howe]

My Lords, I am aware of the suggestion to which my noble friend refers. The wearing of badges is very much a matter for local determination. Clearly, it is desirable that there should be consistency across the country. I understand that there is a regular meeting of the chief executives of ambulance trusts under the chairmanship of Peter Bradley, the London Ambulance Service chief executive. I suggest to my noble friend that the proposal is put to Mr Bradley as one that the joint chief executives could look at.

[Lord Hughes of Woodside]

My Lords, does the Minister accept that it is not simply the health service that needs education about sickle cell but also vulnerable communities themselves that need a great deal of education and knowledge to help them?

[Earl Howe]

The noble Lord is quite right. One of the successes in recent years has been the universal screening programme for sickle cell that has certainly raised awareness among all communities about this devastating condition. The screening programme alerts healthcare professionals to the needs of children with the disease and also enables them to provide the necessary support for families.

Health: Influenza Vaccination

Debate between Earl Howe and Lord Hughes of Woodside

Thursday 20th January 2011 Lords Chamber

[Earl Howe]

My Lords, we are very clear that the amount of vaccine produced for this season’s flu to address the probable need for vaccination was more than adequate. It is up to GPs to order the quantity of vaccine that they see as appropriate for their patients. That is what has happened over the past couple of years. Supplies are also ordered independently by private pharmacies. As regards my noble friend’s point on the H1N1 monovalent vaccine, I am afraid that 90 per cent of deaths have been from what is called swine flu, so that is a very appropriate vaccine to use in these circumstances.

[Lord Hughes of Woodside]

Will the Minister comment on reports in today’s press that the Department of Health is intending to take back in house the ordering of flu vaccines because GPs have not done it properly?

[Earl Howe]

My Lords, almost all vaccines, except the seasonal flu vaccines, are procured centrally because central procurement provides a cost-effective arrangement that can take account of the variation in supply and demand. It also gives us the ability to track where the batches of vaccine have gone. We are therefore looking at taking into the department the procurement of the seasonal flu vaccine.