Failures of the 111 Helpline

Lord Hunt of Kings Heath Excerpts

Tuesday 26th January 2016 Lords Chamber

[Lord Hunt of Kings Heath (Lab)]

My Lords, I am very grateful to the noble Lord for repeating that. I start by paying tribute to Melissa Mead and her husband Paul, who have fought to know the truth about their son’s death and who are now campaigning to raise awareness about the care of sepsis and how we can improve it.

Clearly, the key is to learn lessons and take action in the immediate future. Ministers were warned about poor sepsis care back in September 2013 when an ombudsman report highlighted shortcomings in initial assessment and delay in emergency treatment that led to missed opportunities to save lives. Can the Minister say what action has been taken by the Government? Will he urgently meet the UK Sepsis Trust to discuss what needs to happen to raise awareness among GPs, the NHS and the public?

The Minister outlined the failures in the 111 response. He will know that the replacement of NHS Direct, which was predominantly a nurse-led service, with NHS 111 means that the service now relies mainly on call handlers who receive as little as six weeks’ training and where turnover among staff can be very rapid. Is he going to review the training that call handlers receive and will he consider increasing the number of clinically trained staff available to respond to calls?

The Minister will be aware that there are two other inquiries into NHS 111 failures at the moment: in the east Midlands and on the south-east coast. Can the public have confidence that the 111 service is fit to diagnose patients with life-threatening conditions?

[Lord Prior of Brampton]

My Lords, I echo the tribute that the noble Lord paid to the Mead family and their recognition that we can only learn from these terrible tragedies. The fact that they are prepared to make available the report to other parts of the NHS will help in that learning process. I, or one of the other Ministers concerned, will certainly undertake to meet the UK Sepsis Trust.

The noble Lord raised the issue of the 111 service. It is worth making the point that, in this case, the call handler took the call and referred it to a GP who was part of the out-of-hours service. The GP then spoke directly to William’s mother and decided on what the right course of action was. However, I take on board exactly what the noble Lord said about training and the mix between clinicians and non-clinicians in 111 call centres. It will become a better service when the out-of-hours service and the 111 service are integrated.

One point that came out of the report was that had there been an electronic patient record indicating the evidence of the time that William had spent with GPs in the preceding six weeks, the GP who took the call might possibly have come to a different decision. This was a tragic case of all the holes in the Swiss cheese lining up to cause this awful tragedy. Therefore, I take on board what the noble Lord said about 111 and will pursue that with NHS England.

Health: Hormone Pregnancy Tests

Lord Hunt of Kings Heath Excerpts

Thursday 21st January 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, I understand that to be the case but I will double-check and, if it is not, I will of course write to the noble Baroness.

[Lord Hunt of Kings Heath (Lab)]

My Lords, is it absolutely clear that there will be full disclosure of all public documents and the regulators’ documents for this review?

Health and Social Care: State Pension

Lord Hunt of Kings Heath Excerpts

Thursday 21st January 2016 Lords Chamber

Asked by

[Lord Hunt of Kings Heath]

To ask Her Majesty’s Government what is their response to the suggestion by the Chief Executive of NHS England that they should look at all the options for adequately funding health and social care, including revisiting the guaranteed annual increases in the state pension until 2020.

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, the Government are committed to both a state pension system that ensures financial security in retirement, and a sustainable health and social care system. We are increasing funding for the NHS by £10 billion a year in real terms to fully fund the NHS’s plan. Alongside this, local authorities have been given access to up to £3.5 billion extra a year by the end of the Parliament with the social care precept and additional investment.

[Lord Hunt of Kings Heath (Lab)]

I am grateful to the noble Lord. He mentioned billions of pounds, but he will know that the analysis by the King’s Fund shows that over the five years of this Parliament the real-terms growth rate for the NHS is actually less than in the last Parliament, and social care will see a continuation of the cuts. Research published today shows that 25 other countries spend more of their share of GDP than we do on health; we have fewer doctors and nurses and less equipment and access to new drugs than many comparable countries. The NHS is facing a huge crisis. When are Ministers going to tackle this and get a grip?

[Lord Prior of Brampton]

My Lords, the NHS produced its five-year forward view 18 months ago, which called for additional spending in real terms from the Government over the five-year period of £8 billion. The Government have met that in full and are front-loading that investment, as the noble Lord knows, spending £3.8 billion in the forthcoming year. So the Government are fully supporting the NHS’s plan.

Health: Cancer

Lord Hunt of Kings Heath Excerpts

Wednesday 20th January 2016 Lords Chamber

[Lord Hunt of Kings Heath (Lab)]

My Lords, I, too, thank the noble Baroness, Lady Walmsley, for instituting this debate. Clearly, we have made progress over the past 10 to 15 years but much more needs to be done. International comparisons show that to be the case. I also acknowledge briefings from many different organisations for this debate, including Macmillan Cancer Support, Cancer Research UK and the Teenage Cancer Trust. Of course, my noble friend Lord Wood has already spoken very eloquently about the devastating impact of cancer on young people.

I have a number of questions for the Minister. First, can he clear up the status of the Cancer Taskforce report? A number of noble Lords referred to this being accepted. I would like to know what that means. Does it mean that, in essence, NHS England is committed to implementing all its recommendations or is it a broad-brush acceptance of the philosophy behind the report? I believe that there is some confusion here.

Secondly, I move on to early diagnosis. A number of noble Lords mentioned GPs. There are any number of conditions where issues are raised about GPs and diagnosis. I am not one who rushes to blame GPs but there is now a general issue about how you get the benefits of general practice, which are many, and then ensure that diagnosis is better than before. It is a very difficult question. At the very least, are the Government working with the profession on this?

Thirdly, there was the question about screening and the age limits. Why, for instance, is the screening for bowel cancer stopped at the age of 74? I have tabled Written Questions about this and I am not convinced that there is an answer. I am not at all sure whether the National Screening Committee is keeping up to date with the demographics in this country. Also on screening, there is the recommendation from the NSC about making changes to both bowel and cervical cancer screening programmes to make them more effective. What has happened to those recommendations? One of the tests is called FIT; the other is for HPV in relation to cytology tests. I would be grateful if the Minister could at least write to me on that.

A lot of charities have expressed concerns that we do not have enough diagnostic capacity. I know from the latest OECD survey that, in the UK, we have less access to new equipment than in many other countries. What is going to happen in relation to that?

I would like to ask the Minister about drugs. A number of noble Lords, in particular the noble Baroness, Lady Walmsley, mentioned the fact that we have an appalling record in getting innovative new drugs to our patients. We have an accelerated access review. The question that I keep asking the Minister is: where is NHS England’s commitment to this? I sense that there is no commitment and that it sees drugs as a burden and a cost, rather than a huge advance for patients. It is essential that the philosophy of the NHS is changed in terms of the accelerated access review.

The noble Lord, Lord Freyberg, raised very important points. The Minister is very generous with his time, but I wonder whether he would be prepared to meet him to discuss the points that he raised about data and huge variations. The noble Lord referred to Germany but he could of course have referred to the UK in those terms.

Finally, the noble Lord, Lord Aberdare, raised a lack of co-ordination. Will the Minister agree to bring back cancer networks locally? They were brilliant and it was a pity that they were dissolved. They should be brought back.

Health: Red Cell Folate

Lord Hunt of Kings Heath Excerpts

Tuesday 19th January 2016 Lords Chamber

[Lord Prior of Brampton]

The proposal is that bread should be fortified with folic acid. The point of doing it through bread is that most people eat bread and that it would reach the widest number of people. It would be fortifying a product that most people eat; that is the purpose of it.

[Lord Hunt of Kings Heath (Lab)]

My Lords, is the Minister really saying that adding a very small amount to flour is mass medication; is that not overdoing it? I say to him, as I said on 21 December: can Ministers not come to a decision, yes or no? I get the sense that it is no, because he is putting much more stress on the issue of mass medication now than he has ever done on previous questions. I also go back to the answers that his noble friend Earl Howe gave over the last two or three years. Can the Minister not make that decision? The last thing we need would be to refer it yet again to another expert committee for yet more research, when it is quite clear that it would be effective and safe.

[Lord Prior of Brampton]

My Lords, I can only repeat what I said: we are in the process of making a decision and that decision will be made shortly.

National Health Service: In-Patients with Learning Disabilities

Lord Hunt of Kings Heath Excerpts

Monday 18th January 2016 Lords Chamber

Asked by

[Lord Hunt of Kings Heath]

To ask Her Majesty’s Government what is their estimate of the number of avoidable deaths of National Health Service inpatients with learning disabilities since 2011.

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, this Government are committed to reducing the level of avoidable deaths. The learning disabilities mortality review, commencing this year, is piloting local reviews of premature deaths of people with learning disabilities. The Care Quality Commission will also be undertaking a wider review into the investigation of deaths in a sample of acute, mental health and community trusts.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I am grateful to the Minister for his Answer. He is clearly aware of the recent reports which have shown that there have been many avoidable deaths of people with learning disabilities within the care of the National Health Service. Indeed, some estimates have put it at more than 1,000 deaths per year. He is aware that Sir Bruce Keogh, medical director of NHS England, has very recently written to NHS and foundation trusts asking them to carry out a self-assessment of avoidable deaths. Given that the NHS seems to have a real problem with providing decent care generally to people with learning disabilities, how confident can we be that this self-assessment will actually identify people with learning disabilities who have suffered avoidable deaths within its care?

[Lord Prior of Brampton]

My Lords, this is a very important question. The fact that so many people with learning difficulties die much younger than people without them is of concern to everybody in this House. The review being conducted by Sir Bruce Keogh, to which the noble Lord referred, is a self-assessment tool. It is due to report quickly—by April—so is a short-term attempt to get the bottom of this. It is not a long-term effort, which would be much more comprehensive. We have two forms of looking at avoidable or excess deaths. One is the standardised system, which is a statistical basis for looking at the number of excess deaths. The other looks at avoidable deaths and is done by looking comprehensively at a wide sample of case reviews to give us a much more accurate picture of what is really happening.

General Dental Council (Fitness to Practise etc.) Order 2015

Lord Hunt of Kings Heath Excerpts

Monday 18th January 2016 Grand Committee

[Lord Hunt of Kings Heath (Lab)]

My Lords, I, too, thank the Minister for his careful explanation of the order. I welcome the opportunity to debate it as well as the performance of the General Dental Council.

This is one of a number of Section 60 orders that the Minister has brought before your Lordships’ House in the absence of a Bill following up the Law Commission’s work. Will the Minister be able to update the Committee on exactly where we stand with the Government’s intention with regard to whether they see that any part of the Law Commission’s work will lead to legislation in the future? On the order itself, its terms seem unexceptional, although I would like to raise a few points with the noble Lord. The real question before us is whether the General Dental Council is a fit and proper organisation, capable of implementing the changes.

I shall start, however, with the order and will come on to the issues with the GDC and the various reports that have been published about its poor performance over the past four years. On the order, first, I refer to paragraph 8.4 of the Explanatory Memorandum, which refers to a number of organisations which have commented. The British Dental Association is not listed there. I have received a briefing from the British Dental Association, and I wondered whether it had submitted a response to the department. If it has, I am surprised that it is not listed in paragraph 8.4.

The other point I want to make about the order concerns the question raised by the noble Lord, Lord Colwyn, which is about the performance of the GDC. The BDA briefing that I have received states that while the GDC is,

“Britain’s most expensive healthcare regulator”,

it,

“is also the least efficient, most troubled and enjoys little confidence among”,

either dentists or the Professional Standards Authority. It states that the GDC failed to meet eight out of 24 of the PSA standards of good regulation in its 2014-15 performance review and, crucially, fully met only one of the 10 standards relating to fitness-to-practise processes, representing what the PSA describes as,

“a significant decline in its performance compared to the assessment of the year before”.

The BDA points out that, in comparison, last year, the GMC met every one of the 24 standards while charging its members less than half of the annual retention fee that the GDC charges.

I also pick up the point raised by the noble Lord, Lord Colwyn, about the importance of the independence of case examiners. This is a point that we have raised before on some of these Section 60 orders. It is crucial because of the problems that have arisen from the way the GDC has conducted cases in the past, as identified by the various inquiries. I very much support the noble Lord in emphasising that case examiners must be, and be seen to be, independent.

We then come to the real issue for me, which is GDC governance. The Minister will be aware that in February 2013, the Professional Standards Authority published a report following the resignation of the GDC’s chair, Alison Lockyer, in May 2011. The Department of Health had asked the PSA to investigate several concerns which the then chairman had raised in a letter she had written to the Secretary of State on her resignation.

The PSA’s findings were complex. It did not find that the GDC was failing, but it identified some general learning which could be gained from the experiences of the GDC. Following the PSA’s report into the allegations made by Lockyer, it wrote that new evidence had come to light about poor practice in the support and operation of the GDC’s investigation committee. In July 2013, a member of the investigation committee raised concerns under the GDC’s whistleblower policy that certain processes were compromising the independence of the investigating committee’s decision-making. The GDC also commissioned an independent review into the concerns of the whistleblower, which was published in 2014, but in April 2014 the PSA started its own investigation. This was published on 21 December 2015.

The PSA came to a number of conclusions and found several areas of improvement for the GDC. I will come to the main recommendation but I read this report with considerable disquiet. I do not think I have ever seen a report relating to a statutory regulator quite like it. It was published only a few weeks ago, before Christmas. Paragraph 2.1 of the summary states:

“The approach taken by the GDC to recruiting, training and supervising the Investigating Committee Secretaries is likely to have contributed to the development/continuance of objectionable practices”.

These are objectionable practices by the statutory professional body concerned with dentistry. It is a very long report of more than 300 pages but, to get the flavour of it, here are some of the objectionable practices listed that the PSA looked into. First, there are:

“Discussions about cases between Investigating Committee Secretaries and Investigating Committee Chairs prior to Investigating Committee meetings”.

Then, quite remarkably, there is,

“advance drafting of Investigating Committee decision documents/reasons by Investigating Committee Secretaries”.

There are irregularities around the,

“provision of legal advice by Investigating Committee Secretaries to the Investigating Committee during Investigating Committee meetings … Inappropriate interventions/undue influence by Investigating Committee Secretaries during Investigating Committee meetings”,

and,

“amendment of Investigating Committee decision documents after Investigating Committee meetings by Investigating Committee Secretaries without appropriate authorisation”.

There are other identified irregularities but I do not need to go into them; I have made the point. The PSA report goes through this in great detail and its overall recommendation is:

“The GDC’s Council, executive management team and the relevant committees should consider this report in full, both individually and collectively, in order to identify all the lessons that should be learnt in particular in relation to governance, accountability and management oversight, as well as the actions the GDC should take to address our recommendations”.

The point I want to make about this is that these matters now go back some years. It was 2011 when the then chairman first raised those issues. This report was started in 2014 and finished only a few weeks ago. It clearly found continuing improper practices—or at least those that would not accord with good practice. Reading between the lines, I see here a culture of utter complacency within the GDC. It looks as though the GDC has simply not accepted the core conclusions of the various reports written about its conduct and carried on with that complacent culture. It is also clear from reading between the lines of the report and the careful way it has been put together that the PSA lacks confidence in the performance of the GDC. Frankly, I would have expected the entire board of the GDC to resign in the light of that report just before Christmas. I understand that the chief executive has resigned but no one else on the board seems prepared to take responsibility for a culture that has clearly lasted over a good many years. That is not acceptable. Can there be any confidence that this organisation is fit for purpose?

I now understand the concerns that the profession has about the GDC. I had not realised until I went through this information just why there was so much angst within the profession. It is absolutely justified. I would be doubtful of putting any order through in relation to the GDC unless we were absolutely certain that it is able to carry out its job properly.

[Lord Prior of Brampton]

My Lords, a number of points have been raised. I will start with those raised by my noble friend Lord Colwyn. He said that independence is critical for the case examiners; I will address that issue first. It is important to remember that case examiners will not be making findings of fact in respect of whether a registrant’s fitness to practise is impaired. They will make the decision about whether a case needs to proceed to the adjudication stage and be considered by a practice committee.

Additionally, in its rules and guidance, the GDC will provide that the case examiners must make decisions based on documentary evidence, which will be supplied to them in the same manner as is currently the case for the investigating committee. The case examiners will not be involved in evidence-gathering. There will be one lay and one registrant case examiner considering an allegation. I accept, however, that they will be employees of the GDC. Nevertheless, our feeling is that sufficient safeguards are built into the way that case examiners will work.

The issue raised by my noble friend and expanded on by the noble Lord, Lord Hunt, is fundamental. If the GDC is not a fit organisation—if its governance and performance are not right—that is a much more profound worry than the details of the order before us today. Before I address this, I will deal with one other point that the noble Lord raised. He asked whether the BDA had submitted anything. It has; it was omitted in error and is now being attached.

Clearly, we are concerned about the performance of the GDC. The report from the PSA is indeed extremely worrying. As the noble Lord said, this has not happened just recently; it goes back many years. It is very important that the council takes responsibility for the proper running of its organisation. My colleague Ben Gummer is the Minister with direct responsibility for the GDC and he has a meeting coming up in the very near future to discuss the GDC’s performance in the light of the PSA report. It is not all bad news in that report. There are some signs that the GDC is working hard to improve. Nevertheless, as my noble friend and the noble Lord have both said, there is a lack of confidence in the GDC among the profession and that confidence must be rebuilt.

Perhaps I might bring to Ben Gummer’s attention the comments that have been made by my noble friend and the noble Lord and ask him to draw them to the attention of the GDC when he meets it in the near future. Clearly, he will wish to keep a very close eye on the performance of the GDC as we go forward. I do not think I can say much more today about that. I do not have the information with which to comprehensively address the issues that the noble Lord has raised. Is he content on that basis? If he would like to meet my honourable friend Ben Gummer, I can arrange for him to do that.

[Lord Hunt of Kings Heath]

My Lords, I am very grateful. One of the problems is that this was scheduled very late and therefore I was able to look at the information only over the weekend. I suspect that I would have put a Motion down for a debate in the Chamber if I had had time to do that.

Secondly, I realise that this is quite a difficult situation. Clearly, the independence of the regulators of the health profession is very important and I have always been keen to protect it. The PSA has a crucial role and I think it does a great job. I pay tribute to the chairmanship of my noble friend Lady Pitkeathley, and Mr Harry Cayton, the chief executive. I think they have done a fantastic job, but it seems to me that there is a gap.

It is patently obvious when you look at it from the outside that the board should have read those reports, accepted its ultimate responsibility and stood down. I accept the invitation; I would be very glad to meet Mr Gummer. Of course, this will be debated tomorrow in the other place, and other Members may come back on that. This message clearly needs to go to the GDC council: that it is not good enough and the members should consider their position. I wonder whether it is right that the board carries on willy-nilly simply because the chief executive has stood down.

I am not someone who rushes to say that this, that or the other board should resign because something has gone wrong, but this has been a continuing problem. I accept that improvements have been made, but only a few weeks ago the PSA had to publish a report that continues to draw attention to what is, essentially, the culture of the organisation. Therefore, I very much hope that Ministers will take the appropriate action; that is all that they can do. Ultimately, I am surprised that the board of the GDC feels that it is able to carry on and I think there needs to be a change.

I am grateful to the Minister for the way that he has responded; clearly, he understands the issues that are being faced.

[Lord Prior of Brampton]

My Lords, perhaps we can leave it on the basis that I will organise for the noble Lord to meet Ben Gummer and perhaps ask Harry Cayton to come along, too, as he fundamentally authored the report, so that the noble Lord can express his concerns directly to them. On that basis, I beg to move.

National Health Service

Lord Hunt of Kings Heath Excerpts

Thursday 14th January 2016 Lords Chamber

[Lord Hunt of Kings Heath (Lab)]

My Lords, if the Minister is going to have any time at all, I should cut my contribution short. First, I declare an interest as president of the Health Care Supply Association and the barcoding association GS1, because I want to comment on the remarks of my noble friend Lord Carter on efficiency.

I very much welcome this debate. I was very taken with my noble friend’s description of the ideal world. I wonder if noble Lords think, as my noble friend Lord Carter does, that elements of that are in existence in the NHS at the moment, and that the issue is how to get that going in every part of the NHS. That is one of the essential conundrums.

I will focus also on the very important contribution of my noble friend Lord Winston, who talked about the risks to our medical research. Our medical research has always been one of the best in the world. On it our whole life science sector has depended. The fact is that we in this country have always had a very strong, innovative pharmaceutical and diagnostic industry. When my noble friend says that all of that is at risk, we need to listen.

There is no doubt—I pick this up consistently—that there is a hostility in the NHS to the kind of time that is needed for doctors to practise in research, and even to take part in Royal College activities. This has really got to stop. Seeing the noble Lord, Lord Lansley, here, I have to say that the introduction of NHS England does not help, because, for all the fine words that are in both the mandate and what NHS England says, I do not see any commitment in NHS England to these kinds of issues.

I will raise one further issue in aid of that. Our record on the introduction of new, innovative medicines in this country is a disgrace. We have some fantastic inventions, but the NHS is pathetically slow in introducing them. The noble Lord probably knows very well that we have an accelerated access review under the chairmanship of Sir Hugh Taylor. The word on the street is that it is simply not going to get anywhere because the NHS is not going to play ball and is not going to insist that NHS bodies invest in these medicines. A whole sector of our economy is at risk because of this. I know that the Minister is as concerned as I am and I hope that he might say something.

I come to the issue of junior doctors—not to talk about the dispute but because both my noble friends Lord Winston and Lord Mitchell raised the issue of why junior doctors are so disengaged. Anyone who has met them will know how angry they feel. It is partly about the Secretary of State’s manipulation of statistics—which, frankly, given the brightness of junior doctors, was always going to be very unwise. It is also about their distrust of management. Part of the problem is that they just do not believe that, locally, NHS employers will do the right thing.

My noble friend is right. Why are junior doctors treated so abominably by NHS employers? Why can they not get access to decent hot food at night? Why are the junior messes not in places where they can go and meet? I do not know what can be done to get this home to the NHS. Anyone who meets our juniors knows that they are the brightest of the bright and are hugely committed—yet, somehow, we seem to have made them wholly disenchanted with the NHS. It is a very serious issue.

This brings me to the issue of leadership, which my noble friend mentioned. In June last year, the noble Lord, Lord Rose, produced an excellent report on how to enhance and improve leadership in the NHS. He asked the Government three questions. How do we get better leadership? How to we recognise it? How do we find and mature the people who are needed to lead the NHS? I am afraid that there has been virtually no response to this from the Government. That is very disappointing. In fact, all that has happened is that the turnover of chief executive officers has continued at an alarming rate. Again, as one of my noble friends said, we have got to get rid of leadership by bullying. There is a bullying culture throughout the system and it is having a corrosive impact on the ability of people locally to lead organisations.

Of course, funding is very important. I do not need to repeat all the arguments that noble Lords have put forward. Essentially, they concern growing population and demographic pressures. We in this country spend less on health than any comparable country. The OECD figures that came out just before Christmas were very convincing on this. The Government’s claims in the Autumn Statement frankly do not ring true. We know that they are front-loading some of the money for the next five years, but the annual increase from here to 2020 will be 0.85%— even less than the average increase from 2010 to 2015.

At the same time, we know that half of that extra money has come from raiding the budgets of Health Education England and Public Health England, from capital funds and from the cost of pension payments. At the same time, what do Ministers do? They pile on more pressure. Not a week goes by without another press release from the Department of Health or an announcement by the Secretary of State that something else has got to be done. No wonder his credibility is shot in the NHS.

Of course, the gap between the money that is going in and the £30 billion per annum that it is generally believed will be required by 2020 is huge. I pay great tribute to my noble friend Lord Carter, because obviously he is helping the NHS to see if it can close part of that gap. I am sure that is right and that, on procurement in particular, a much more cohesive national approach is needed—but at the end of the day, there is still going to be a gap.

Should there be a royal commission? I cannot help repeating Harold Wilson’s famous diktat that royal commissions take minutes and waste years. That is, of course, when they are used simply to postpone a decision. I understand why noble Lords want some kind of neutral and impartial commission to look into those issues. However, we have already had the Barker commission, and I doubt whether anyone is going to improve on that. In the end, it is a matter of political will. I say to the Minister that, at the very least, what we seek is some honesty from the Government: admit that the financial gap is not going to be met and stop piling on the pressure.

[Baroness Williams of Crosby]

I apologise to the noble Lord, but there is a question that is central to this: would he and his party be prepared to take part in an all-party commission, possibly a parliamentary one, in order to get the quickest possible effective answer for the terrible crisis that has been outlined in this debate?

[Lord Hunt of Kings Heath]

My Lords, this is a time-limited debate and I want to leave the Minister a little time to respond. I would certainly be very happy to discuss the issues with noble Lords here—I like the idea of a group of politicians in this House looking at it. On the subject of a royal commission, I do not think I can go as far. In the end, we sometimes have to have the courage of our convictions and come up with proposals to sort this out.

Children: Obesity

Lord Hunt of Kings Heath Excerpts

Tuesday 12th January 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, we all recognise, as does the Prime Minister, that obesity is a scourge in this country that affects many thousands of young people. Some 2.1 billion people worldwide are overweight or obese, so it is a huge global problem that requires a comprehensive strategic response. I hope that our obesity strategy will be announced in the very near future.

[Lord Hunt of Kings Heath (Lab)]

My Lords, in developing this strategy, is his department talking to the Department for Education? He will understand that this is a particular issue at primary school level. There is evidence that the incessant determination of the Government to test primary school children at every age at every moment is squeezing the curriculum of playtime and physical activity. I hope that his department will talk to the Department for Education to turn this around.

[Lord Prior of Brampton]

My Lords, we have got to have a collective response to the obesity problem across many government departments, as the all-party parliamentary group made clear in its paper. Education is a critical part of that. The noble Lord will know that in the spending review the Government committed to continue the PE and sports premium in primary schools because we recognise that physical exercise and playtime at all levels in schools, but particularly in the early years, are vitally important.

Pregnancy: Neural Tube Defects

Lord Hunt of Kings Heath Excerpts

Monday 21st December 2015 Lords Chamber

[Lord Prior of Brampton]

My Lords, I think they were helpful and wise words from the noble Lord, Lord Blunkett. This is a difficult issue, and it is not as black and white as is sometimes portrayed. As I said, my honourable friend in the other House is taking all these matters into consideration.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I must inform the House that I am president of the Fluoridation Society. Therefore, although I always welcome my noble friend Lord Blunkett’s interventions, perhaps I welcome this one not quite as much as usual. I have great respect for the Minister’s colleague, the Minister for Public Health, and know that she is committed to public health. But she has had the evidence from the research, which caused the Government to delay a decision, for nine months. Is it not a fact that she cannot get agreement inside government, and that the Government have decided not to go ahead? Is not it time for them to be straight on this?

[Lord Prior of Brampton]

My Lords, I do not think that what the noble Lord has said is entirely correct. My honourable friend Jane Ellison received a letter from the SACN, the committee on nutrition, on 20 October that indicated that many more women were below the foliate level than had previously been thought. That evidence is quite new and came in at the end of October. That is what she is now considering.