NHS: Health Tourism

Lord Foulkes of Cumnock Excerpts

Monday 28th May 2012 Lords Chamber

[Earl Howe]

The rules are complex, depending on whether the person is from the European Union, where certain rules apply, or from other parts of the world. There is no mandatory requirement for people to carry health insurance unless there is a transparent medical need when they enter the country. For example, a heavily pregnant woman might be asked to produce proof that she could pay for treatment if giving birth was likely. There are clear rules for NHS trusts where a patient who is chargeable presents. The trust must seek either to secure payment before treatment or to bill the person immediately afterwards.

[Lord Foulkes of Cumnock]

My Lords, in answer to the question asked by the noble Lord, Lord Roberts of Llandudno, the Minister rightly described the situation as it currently is. Is the Department of Health doing any study into the disaster that would happen in terms of healthcare between Scotland and England if Scotland were to separate from the rest of the United Kingdom? If it is not doing a study, why not?

[Earl Howe]

My Lords, were that situation to occur, the issues arising from it would be little different from the issues today in that health is already devolved. However, I cannot speculate on whether there would be a different policy on immigration in Scotland compared to south of the border as we are really not in that territory yet.

Health: Clinical Commissioning Groups

Lord Foulkes of Cumnock Excerpts

Thursday 26th April 2012 Lords Chamber

[Earl Howe]

The noble Baroness makes an extremely important point, which is why we have laid great stress on training and ensuring that the NHS Commissioning Board will develop appropriate guidance on procurement, avoiding conflicts of interests and avoiding unfair competition entering the arena.

[Lord Foulkes of Cumnock]

My Lords, what is the estimated extra cost of all this extra bureaucracy?

[Earl Howe]

My Lords, I do not accept that it is extra bureaucracy. Conflicts of interest arise in all walks of life and have to be managed. I do not think that issuing guidance represents extra bureaucracy.

National Institute for Health and Clinical Excellence

Lord Foulkes of Cumnock Excerpts

Wednesday 14th December 2011 Lords Chamber

[Earl Howe]

My Lords, part of the objective of the growth strategy is to break down some of the barriers that undoubtedly exist to pharmaceutical companies conducting clinical trials in this country. There have been unwelcome delays in the system and we are putting in place several measures to get rid of them, which in turn should encourage pharmaceutical companies to view the UK as the platform of choice for clinical research.

[Lord Foulkes of Cumnock]

My Lords, has the Minister thought—

Health: Funding

Lord Foulkes of Cumnock Excerpts

Tuesday 1st November 2011 Lords Chamber

[Lord Foulkes of Cumnock]

Did I catch the Minister’s first answer right—did he say that it would be the new head of commissioning who would have this responsibility? Am I right in saying that this is the professor who was described by MPs as not having the experience necessary and not understanding the job of head of commissioning, and who was only approved by the committee in the House of Commons on the casting vote of the chairman? Is this the guy who is going to be responsible?

[Earl Howe]

My Lords, the chief executive-designate of the NHS Commissioning Board is Sir David Nicholson, who is currently chief executive of the NHS. He is not the gentleman to whom the noble Lord referred. He currently runs the NHS. Professor Malcolm Grant, to whom I think the noble Lord was referring, will be chairman of the NHS Commissioning Board Authority, in a non-executive capacity.

Smoking

Lord Foulkes of Cumnock Excerpts

Thursday 8th September 2011 Lords Chamber

[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.

[Lord Foulkes of Cumnock]

My Lords, I moved Private Member’s legislation in the other place in the early 1980s and got nowhere on it. Only when legislation was moved was there a real reduction—a complete ban—on smoking in public places and only through legislation can effective action be achieved. Is it not also the case that smokers lighting up cigarettes in cars are dangerous in terms of road safety? That is an extra reason for doing it. Will the Minister therefore stop pussy-footing around and saying that this can be achieved voluntarily, when we all know that it can only really, successfully and effectively, be achieved through legislation?

[Earl Howe]

My Lords, I do not agree with the noble Lord’s analysis. It is true that, on current evidence, the legislation is having a beneficial effect; I would not dissent from that. However, we know that voluntary behaviour change is eminently possible. It would explain why, between 1996 and 2007 when the legislation came in, secondhand smoking exposure in children in England declined by 70 per cent. That was driven by not only the evidence but also awareness campaigns and increased awareness in the lead-up to the legislation. Therefore, voluntary action can have a beneficial and marked effect.

NHS: University Health Centres

Lord Foulkes of Cumnock Excerpts

Monday 4th July 2011 Lords Chamber

[Earl Howe]

My Lords, the characteristics of each GP practice will naturally vary according to the patient population. Although a practice situated on a university campus may have higher numbers of patients who require mental health advice and support, there may well be fewer patients in need of other services. I am not aware that there is a particular issue of underfunding of university practices in relation to the mental health burden. As the noble Baroness will know, the QOF was adjusted in 2008 with a two-year time delay, so university practices have had a chance to adjust and prepare for the change.

[Lord Foulkes of Cumnock]

Are university health centres gearing up to deal with cases of anxiety and depression among students at English universities who wish to go to Scottish universities for a further degree and who find that they will have to pay the full fees, unlike students from other countries in Europe? Is that not a disgraceful, discriminatory proposal by the Scottish Government? Can this Parliament not find a way of outlawing such discrimination?

[Earl Howe]

My Lords, I congratulate the noble Lord for introducing this vexed topic into a health Question. It would be improper for me to comment on the deliberations of the Scottish Parliament.

NHS: Consultation on Reform

Lord Foulkes of Cumnock Excerpts

Tuesday 26th April 2011 Lords Chamber

Asked By

[Lord Foulkes of Cumnock]

To ask Her Majesty’s Government how they propose to report the outcome of the consultation on NHS reform to Parliament.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, we ran a public consultation on NHS reform last year and received some 6,000 responses. As a result, we brought forward important changes to our modernisation proposals. We are now taking advantage of the natural pause in the legislative process to listen and reflect, supported by advice from the new NHS Future Forum. The Government will then respond to the forum’s report and the wider listening exercise, setting out the improvements that we will make to the Bill based on what we have heard.

[Lord Foulkes of Cumnock]

My Lords, did the Minister see the Statement by the Secretary of State that the reason for the pause was because the Bill was allegedly not understood and he had to explain it better? Will he explain to Mr Lansley that it is precisely because the Bill is well understood that there is such widespread opposition, including an unprecedented vote of no confidence by the Royal College of Nursing? Will he give a guarantee that substantial amendments will be brought before Parliament after the current consultation? Otherwise, it will be seen as a complete sham.

[Earl Howe]

My Lords, I think there is widespread agreement that the principles on which the Bill is based, such as devolving control of the NHS to local levels, placing patients at the heart of decisions about their own care and improving public accountability are the right principles for us to be guided by, but that there are also, as the noble Lord said, questions and concerns, some quite deep, about what we are doing and the mechanics of putting the principles into practice. As the Prime Minister and Deputy Prime Minister made clear, this is a genuine chance to make a difference. Where there are good suggestions to improve the legislation, those changes will be made.

Health: Sickle-Cell Disease

Lord Foulkes of Cumnock Excerpts

Monday 14th March 2011 Lords Chamber

[Earl Howe]

My Lords, I am aware of the tragic case to which my noble friend refers, which is of course the subject of an investigation at the moment. The facts, as I am aware of them, suggest that the failings that occurred in that case were more to do with poor practice than a lack of training, although we will see what emerges from the inquiry. However, I can tell her that there is national guidance on the symptoms and emergency treatment of people with sickle-cell disease, published by the Joint Royal Colleges Ambulance Liaison Committee. All ambulance crew staff receive training in the assessment and management of patients with sickle-cell conditions in line with those guidelines and further national guidance was issued to staff in 2009. It is regularly updated and it is taken very seriously.

[Lord Foulkes of Cumnock]

Do both of the Minister’s replies apply also to Scotland?