ONS: UK Life Expectancy

Lord Kirkhope of Harrogate Excerpts

Thursday 17th December 2020 Lords Chamber

[Lord Bethell (Con)]

The right reverend Prelate is right to emphasise some of the disappointing figures around children, and the north-east is one area where the challenge is greatest. But I remind him that we have strategies for healthy behaviours in school, we are committing a huge amount of funding for more physical activity in schools, and we think that this will have a major impact on both the fitness and healthy outcomes of children. That kind of project will make a big impact.

[Lord Kirkhope of Harrogate (Con) [V]]

My Lords, can my noble friend give any real explanation as to why the UK is so low down on the OECD figures for average annual increases in life expectancy at birth? On the ONS tables, England is 18th out of 21 countries, with Scotland and Wales faring even worse. Is there a particular reason he can think of—could it be methodology or social habits? Has he any further explanation of the comparative situation here?

[Lord Bethell (Con)]

My Lords, I cannot give an answer in the round and explain every element, but we have to face up as a nation to the fact that some of our habits are unhealthy. In some communities smoking rates are extremely high, and the difference between different communities is profound—1.6% in west London, compared to 25.7% in Blackpool. Our obesity, BMI and consumption of high-calorie food is just too high. This is not the sole explanation, but as a nation we have to face up to some of our behaviours.

Queen’s Speech

Lord Kirkhope of Harrogate Excerpts

Tuesday 22nd October 2019 Lords Chamber

[Lord Kirkhope of Harrogate (Con)]

My Lords, I am very pleased to participate in this debate, which underlines the need for action to be taken to maintain our health provisions and to keep them—despite sometimes expressing to the contrary—among the best in the world. I speak as a founder lawyer member of the multidisciplinary Mental Health Act Commission, so I hope that noble Lords will understand if I concentrate on the issue of mental health this evening.

One in four of us will suffer at some time in our lives from some form of mental illness. I do not believe that that statistic is properly understood or appreciated. Other types of illness are easier to accept, and sympathy is more likely to be extended. Proportionally, the percentage of health spending on mental health is only 10%, despite a clear need for greater and more comprehensive resources in that sector. The needs are extensive but are still unmet.

Back in 1983, one of the aims of the new commission was to protect patients’ human rights and examine the legality of detention in appropriate cases. However, we were also obliged to suggest improvements in the system. As a result of our work, which dealt mainly with previously detained patients, we wanted to make sure that when they rejoined the wider community, proper social care and support was available for them. We were also charged with providing a report every two years, and in initial and successive reports we were obliged to point out the inadequacy of the social care in the community situation. That was over 30 years ago, and successive reports and comments that have taken place in the interim have suggested that we have not done nearly enough to put things right.

Since then, society’s attitudes towards those with mental illness have undoubtedly improved, but there remains a level of stigma, at worst, and disinterest, at least, in the subject. Luckily, we now have a much broader understanding of what mental illness may be. Many acknowledged conditions do not appear to fit within the strict category or interpretation but which are either close to it or have the effect of contributing adversely to the mental health of an individual. Obsessive compulsive disorders, depression, anxiety through stress and PTSD are clear examples. The mental health of those who are autistic is also often overlooked. The incidence of mental illness in this group is substantial. All this requires a more individual approach tailored to specific needs. This should include not only sharp-edge treatment and resource but, in appropriate cases, obtaining suitable employment, where discrimination and other obstacles are in the way.

I therefore hope that the Government’s promise of 1,000 more staff—which, if one divides that across the country, I suggest is still inadequate—and the £2.3 billion of extra investment proposed in mental health will be not only implemented but used in a really effective way, and in such a way that the individual needs of more people can be sympathetically and effectively met, along with a greater understanding of mental health issues, which I think we all agree as necessary.

Unpaid Carers: Support

Lord Kirkhope of Harrogate Excerpts

Thursday 13th June 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

This is a really important question, because the carer’s allowance has increased and is available as a non-means-tested support. I can reveal today that one of the key issues that is being looked at as part of the social care Green Paper is ensuring that financial support and employment status for carers are clearer, so that they can access all the support they are entitled to, but also to try to make things simpler.

[Lord Kirkhope of Harrogate (Con)]

I declare an interest as a former Mental Health Act commissioner. While we are talking about carers, there is a considerable number of people who are caring for members of their family who have been suffering from mental illness and are now in the community. Would my noble friend not agree that we should be more concerned to give assistance there as well, rather than merely to those who care for people with physical ailments?

[Baroness Blackwood of North Oxford]

The burden of ill health, anxiety and depression is an important issue that has been clearly identified, and it can be caused by caring for a loved one. There is specific evidence about the threshold at which the number of hours spent caring causes such challenges. My noble friend is right that we should not only identify those who are caring but signpost them clearly to the support available for carers and make sure that they can access that care easily.

Children: Gaming

Lord Kirkhope of Harrogate Excerpts

Thursday 23rd May 2019 Lords Chamber

[Lord Kirkhope of Harrogate (Con)]

Does my noble friend not agree with me, though, that we should deal with this extremely carefully? I am aware of a number of cases in which children have become obsessed with gaming. In desperation, parents have been in touch with their representatives and medical advisers to try to deal with the effect of the psychosis that results from the obsession with gaming among quite a lot of young people. Can she therefore make sure that, however she looks at the positive effects in certain cases, she also fully recognises the dangers of an open approach to this?

[Baroness Blackwood of North Oxford]

I thank my noble friend for his question. Hundreds of millions of people globally play videogames, and for the majority it is a positive recreational activity. He is right, however, that there is some evidence of a moderate correlation between gaming and depression and anxiety symptoms in young adults, and evidence that exposure to violent gaming can have an impact on sleep and mood. However, that is dependent on the nature and duration of gaming. We also support the WHO’s classification, which identifies addiction within the classification of diseases. The CMO said in her evidence review, however, that there is insufficient evidence to support a specific evidence-based guideline on screen time. That is why we support more applications to the NIHR for research so that we can have a better understanding of the impact of gaming on young people. We would encourage anyone who is concerned to contact their GP.

Brexit: Reciprocal Healthcare (European Union Committee Report)

Lord Kirkhope of Harrogate Excerpts

Tuesday 3rd July 2018 Lords Chamber

[Lord Kirkhope of Harrogate (Con)]

My Lords, I will first say what a great privilege and pleasure it has been for me to serve on this sub-committee under the chairmanship of the noble Lord, Lord Jay, and to debate and discuss this matter with some excellent witnesses from a broad range of backgrounds. My only knowledge and expertise in the health field is that I was a member of what was then called Northern Regional Health Authority back in the 1980s. In doing that job, I learned an enormous amount about the excellence of those who work in our health service, both then and, I know, since.

I have also seen the great changes that have taken place since the 1980s, in terms not only of healthcare but of international relations between our health professionals and those in particular in the EU. I shall not go over the ground so excellently covered by my noble friend Lord Ribeiro, but we have reached a point where the National Health Service in this country is highly dependent on those who come to us from other European countries. Whether or not that is a direct point on freedom of movement is a matter which no doubt the Government will want to consider—but, in all my experience and from my connections still in the health service, I am aware of the considerable problems that we are already starting to experience with either potential members of staff who are not confident in making applications because of the lack of clarity as to their future positions if they come over here to work or with those who have worked in the health service and have become unhappy about their future prospects for remaining in that service.

I agree with the points made by the noble Lord, Lord Jay, about the Government’s reaction to this report. I pay tribute not only to my noble friend the Minister but to his department for seeming to have reacted to our report in a better way than have, sadly, one or two other departments to what we suggested in other reports in other fields. It has been a positive reaction. However, of course, good intentions are one thing—there are plenty of those in evidence in the Government’s response—but delivery in a way that deals with the issues that we have raised is entirely another matter. Not being the major issue in the eyes of the Government, and in the forefront of the media, may or may not be a good thing. It may a good thing in the sense that we hope that negotiations are taking place which will secure the future reciprocity of healthcare satisfactorily—or it is possible that, because there is not the pressure or publicity so far, the Government have not yet have negotiated these things or set about them properly. I hope that the former is the case and not the latter.

I will raise one or two points about current relationships and how we need to improve things in a post-Brexit situation. We are talking as if there is a free healthcare arrangement for everybody around Europe wherever they may be at any time, but, more recently, we have had arrangements of cross-charging between the EU states and ourselves. From the evidence that we heard, we learned that the performance of the National Health Service in collecting moneys from the EU for the treatment of EU citizens has been, to say the least, extremely patchy. I am not convinced that, institutionally, the health service has equipped itself properly to deal with that matter. My noble friend Lord Balfe spoke about Belgian administration and paperwork. It seems that we are almost at an opposite extreme in some parts of the health service, where no one appears to be able to take responsibility for making the charges that they ought to make against other EU countries. As a result of that, the health service has been denied resources that it ought to have had and which it desperately needs. In the event of Brexit proceeding in the way planned, but with some safeguards in this field, to what extent will my noble friend’s department prioritise the ongoing collection of the moneys that the health service is entitled to have from our European friends?

Following on from that, there is an issue regarding educating the public. It is amazing that, even now, with the very close co-operation and arrangements that are in place, a considerable number of people in this country who travel in Europe are unaware of their safeguards, protections and entitlements in respect of health. The result is that there are quite a number of insurers which, in my opinion, take advantage of that situation. There are also many people who pay money to get insured in areas where, to be honest, they do not need to have that insurance. What concerns me is that if, post Brexit, we do not educate people clearly as to what they will then have to protect themselves from by insuring, it will result in considerable extra expense for British people—and, I would guess, probably also for EU citizens in reverse. It would benefit only the insurance companies, which may well take advantage of that situation.

Finally, I will comment that we have really achieved an enormous amount over the last few years. Like my noble friend Lord Balfe, I had the honour of serving in the European Parliament for a considerable time. I never intended to be there for 17 years, and the time flew. Throughout it, what impressed me most about our NHS, which we are so proud of, as we should be, was that many of the developments and innovations that came into our health service have been shared with our European friends. That has been recognised in the European Parliament, and no doubt here also. Nevertheless, it has been a big issue. The British component—leadership in so many fields of innovation, including in the health field—is something which our European neighbours would be loath to lose. Similarly, we should be loath to lose those connections. That is why I hope that, in response to this excellent report, the Government will at least determine themselves to conclude negotiations that do no damage to the people of our country, or indeed any European citizen, in the field of health.