Health and Social Care Leadership Review

Lord Young of Norwood Green Excerpts

Thursday 9th June 2022 Lords Chamber

[Lord Young of Norwood Green (Lab)]

My Lords, I echo the point made by my noble friend Lady Merron about the health service and the people who have done such sterling work within it. After all, they saved my life twice so I certainly recognise that.

However, I have to say that, like the report, the NHS is a bit of a curate’s egg, and we know it; it is good in parts. When it is good, it is very, very good, but when it is bad, it is dreadful—really dreadful. People die unnecessarily, as we saw in the gynaecology scandal at Telford. What worries me about that case is that I still do not see anyone being held to account for those appalling management failures. Even worse than that is the report yesterday from Birmingham of the consultant who was removing non-existent cancers from breasts and went on to practise for years without being uncovered, not only in the NHS but in private practice. We have to ask ourselves how on earth such appalling failures in accountability, management and checking are possible. I would welcome the Minister’s response on that.

I recommend that the Minister look at the Twitter account of a guy called Roy Lilley, because it is worth a look. I will give a flavour of it:

“There’s a problem with bullying and racism in the British Army. A BBC Three documentary shone a light on racism in the Army and there is still the shadow, cast by the events at Deepcut. It’s a hot topic for the Top-Brass. They’ve had reviews and all-sorts to try and stamp it out”—


and they failed. He continues:

“If they can’t fix racism and bullying in a small outfit like the Army, what chance does the NHS have … with around a million and a half people, a budget of about £3bn a week, a million customers a day and if it were a country it would be the thirtieth largest in the world. In the Army, the NHS, sport and wider society we’ll find good people, bad people, energetic, lazy, thieves, thugs, saints, angels, bullies and racists”—

[Baroness Penn (Con)]

My Lords, I encourage the noble Lord to reach his question.

[Lord Young of Norwood Green (Lab)]

I will, but hardly anyone has contributed to this debate. I have posed one question and I will pose a few more—I do not see why I should not take the opportunity. I would see why if the Chamber were full of people participating, but it is a bit rich that there is hardly anyone—

[Baroness Penn (Con)]

My Lords, attendance in the Chamber does not change the guidance in the Companion about questions on a Statement being brief and direct.

[Lord Young of Norwood Green (Lab)]

I have posed one question, and I will pose a couple more. I will move to further questions and my criticism of the report. First, I agree with a lot that the noble Lord, Lord Lilley, said. On diversity, we recently had a situation, on which I would welcome a comment from the Minister, where the NHS could not bring itself to define a woman in gynaecological circumstances—I find that somewhat unbelievable.

What are we doing about fixing the situation in A&Es where paramedics stand by trolleys for hours on end while people are dying of strokes outside? I have raised this question with the noble Lord a number of times. It can be fixed, but you have to be determined. If the noble Lord wants an example of best practice, I recommend that he look at Wolverhampton, where he will find an example. There is no mention of best practice in this report, which I find astonishing. I also note the importance of new technology being adopted in a coherent way. I look forward to the Minister’s answers to those questions.

[Lord Kamall (Con)]

I thank the noble Lord for his questions. I say up front that I am not a fan of Twitter, even though I am still on it. Frankly, I do not like social media and I try not to look at it too much—but I welcome that the noble Lord shared some of his concerns.

The noble Lord is absolutely right on bullying and harassment; they are not acceptable in any form and should not be tolerated—this is part of the NHS people plan. This goes to the heart of the review: it is about leadership and culture. We have to make sure that there is a culture where bullying and discrimination are not tolerated. Frankly, it is about not diversity officers but greater diversity, which are not always the same. As I said, we have a diverse workforce, but why do we not see more diversity in the upper echelons of our health service? It is important that bullying is tackled and that we have that culture—but this also comes from local leadership.

I am grateful to the noble Lord for the number of times that he has suggested thinking outside the box on A&E. We have looked at various pressures on it; sometimes people go to it because they cannot get a GP—how do we address that? Sometimes, people do not want to go to A&E and try other routes but end up there—so how do we make sure that those other routes are available? We are looking at how to triage better and how people can use 111 instead. There are a number of issues and, as the noble Lord rightly said, technology can play a role.

Covid-19: Antiviral Pills

Lord Young of Norwood Green Excerpts

Monday 31st January 2022 Lords Chamber

[Lord Kamall (Con)]

The noble Earl will be aware, given all the news stories around it, that many people will be concerned about the effects of long Covid. I know there have been studies and interesting stories in the press about the long-term impact. As I said to the noble Baroness, I will find out what is being done in detail and write to her.

[Lord Young of Norwood Green (Lab)]

My Lords, for the Minister’s information, a trial is currently going on using xenon gas and MRI scans, which is looking particularly at the damage to lungs as a result of long Covid. It might be useful for him to get his officials to advise him on this.

[Lord Kamall (Con)]

I thank the noble Lord. Maybe next time I get a question like that I will ask the Lord Speaker whether I could delegate the answer to him.

NHS England: Waiting Lists

Lord Young of Norwood Green Excerpts

Tuesday 16th November 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the right reverend Prelate for that question. Unfortunately, I do not have the statistics with me, but I shall write to him.

[Lord Young of Norwood Green (Lab)]

My Lords, will the Minister tell the House whether he is encouraging the use of best practice, including new technology, between hospital trusts? There are still many examples where there is good practice out there, but it is not being spread.

On a point that we touched on last night, in relation to A&E, we have a serious problem. Paramedics are waiting for significant periods of time, which means that they are not getting out on the road to treat other patients. We really need to bring in some drastic measures to ensure that we create a new system. We cannot leave it for months and months because, if we do, the impact will mean that people’s lives will be lost. What measures does the Minister have in mind to deal with this problem?

[Lord Kamall (Con)]

The noble Lord made a very perceptive intervention last night when asking us to think outside the box, and I gave an example of someone who I know suffers from asthma and forgot to take his blue inhaler with him to another city. His wife went to a number of places to try to get an inhaler from the pharmacy and from A&E, while telling him to stay in his hotel room. In the end, he was told that the only way to get an inhaler was to call the ambulance. We need to think outside the box and be more creative about when those situations occur—it is not necessarily political, but we need to be creative.

On technology, one of my jobs is Minister for Technology, Innovation and Life Sciences. I have been forceful, when talking to the NHS, that we have to digitise and share data. I accept that there are some concerns over sharing data, but the way to have an NHS that is fit for purpose is to make sure that we digitise and share data.

Covid-19

Lord Young of Norwood Green Excerpts

Monday 15th November 2021 Lords Chamber

[Lord Kamall (Con)]

A lot of investment has gone into making sure that there is ventilation in schools. I will talk to my counterpart in the Department for Education to see what more can be done, but I know that the department is very aware of this issue and is looking more into it.

On the noble Baroness’s first question, we want to be clear and not confuse the message: vaccinations work and are our best line of defence. We do not want people to get a false hope that there are other ways to protect themselves. Not all people who do not take the vaccine are anti-vaxxers: some of them think that just wearing a mask may well protect them.

We want to focus on this message: get vaccinated; if you have been, get your booster; and if you have had your first vaccine, get your second one. There is nothing to fear from getting vaccinated. We are not only sending that message out but actively looking at different campaigns to reach those difficult-to-reach individuals in many communities.

[Lord Young of Norwood Green (Lab)]

My Lords, on the importance of vaccination, what are the Government doing to combat the anti-vax message? My second point is on the terrible situation in hospitals, where paramedics are forced to stay and wait with patients. There must be something that we can do to alleviate that situation until there is a long-term solution. Have we identified best practice? The Government ought to be thinking outside the box about what we can do to stop paramedics being trapped in hospital, denying them the ability to deal with other urgent cases.

[Lord Kamall (Con)]

I am sorry, but my memory has gone. What was the noble Lord’s first question?

[Lord Young of Norwood Green (Lab)]

It was on anti-vaxxers.

[Lord Kamall (Con)]

The issue of anti-vaxxers is very difficult in a society where we believe in freedom of speech. Clearly, if they are impeding people from attending school, going to certain places or getting vaccinated, that is obstruction. However, if they are saying that they do not believe that the vaccines are safe or whatever, it is really difficult and we have to get that balance right. We are clear that we want people to be vaccinated but, at the same time, we believe in freedom of speech. Quite often, if you really believe in freedom of speech, you have to allow people to say things that you disagree with, I am afraid. However, where they are actively blocking people from getting vaccinated, I think we have work to do.

As for thinking outside the box, we are looking at a number of different areas. For example, the other day I heard a case of someone who had forgotten his asthma inhaler. His partner told him, “Stay here, I’ll get you another one from the all-night chemist”. The all-night pharmacist said, “I can’t administer that”. She then went to A&E with her partner’s details. A&E said, “No, he has to come in here”. In the end, when she went back to the hotel, the hotel said, “We’ll have to call the ambulance”. All that could have been avoided had there been a way for the person who had forgotten his inhaler simply to get another one, rather than having to call in paramedics. Therefore, there are a number of different ways that we can think outside the box to make sure that we do not put undue pressure on the NHS at this time.

Flu Vaccination and Blood Test Cancellations

Lord Young of Norwood Green Excerpts

Tuesday 14th September 2021 Lords Chamber

[The Deputy Speaker (Lord Brougham and Vaux) (Con)]

I call the noble Baroness, Lady Stuart of Edgbaston.

[Lord Young of Norwood Green (Lab)]

My Lords—

[Noble Lords]

Oh!

--- Later in debate ---

[Lord Young of Norwood Green (Lab)]

After my unfortunate trans moment, I shall now ask my question in all seriousness. Does the Minister recognise that this winter it is particularly important that we get the maximum number of flu vaccinations in this round? It is important every winter, but this winter somebody contracting flu and then Covid is in serious danger.

[Lord Bethell (Con)]

My Lords, I reassure the noble Lord that we have strained every sinew to deliver the most impactful flu vaccination programme in the history of the country. We have expanded the range of the flu vaccination and the number of vaccinations available. The NHS depends on us keeping people out of beds. That is why we are highly focused on this.

Women’s Health Outcomes

Lord Young of Norwood Green Excerpts

Thursday 8th July 2021 Lords Chamber

[Lord Young of Norwood Green (Lab) [V]]

My Lords, I, too, thank the noble Baroness, Lady Jenkin, for this debate and for her thoughtful and informative intro. She pulled no punches—rightly so—in her description of the often painful lifelong journey of women and girls. I welcome the statement by Nadine Dorries, the Minister for Patient Safety, on the government-led women’s health strategy—the first one.

In May 2020, in response to a Written Question on whether hospitals were required to provide single-sex services, including spaces for patients, the noble Lord, Lord Bethell, said that the revised guidance on delivering same-sex accommodation published by NHS England and NHS Improvement stated that

“providers of National Health Service-funded care are expected to have a zero-tolerance approach to mixed-sex accommodation, except where it is in the overall best interest of all patients”.

Many NHS trusts interpret that in a number of ways that are not always conducive to the health and treatment of women and girls as patients. As many noble Lords have said, we should be listening to patients and seeking examples of best practice. Women often favour single-sex wards for good reason. Rates of sexual assault are far higher in mixed-sex wards. In 2009, Channel 4 discovered that almost two-thirds of sexual assaults by patients occurred in mixed-sex wards.

The Minister stated that there were

“no plans to withdraw the guidance.”

Can I suggest to the Minister that he reconsider this whole issue? He also stated:

“NHS trusts have not been asked to provide the information required to make an assessment of the impact of allowing patients to self-identify their gender and there are no plans to ask them to do so.”


There are many examples of assaults on women in mental hospitals and other areas. Surely we recognise that, when women enter hospital, they do so to experience a calm, safe and non-threatening environment. I ask the Minister to meet Peers concerned about this issue.

NHS Digital: Primary Care Medical Records

Lord Young of Norwood Green Excerpts

Tuesday 8th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, engagement with the Royal Colleges, the BMA and GPs on a one-to-one basis has brought about a system that has a national data opt-out and a tier 1 opt-out with GPs. This is fully explained in all our materials and there has been a campaign to raise awareness among patients. We are taking a brief pause to ensure that patients have almost as much time as they could possibly have to make the decisions they would like to make. That is a wise decision in the circumstances.

[Lord Young of Norwood Green (Lab) [V]]

My Lords, by coincidence, I received a text from my GP surgery yesterday inviting me to click on a link if I wished to opt out of having my data shared. I do not. Does the Minister agree that data sharing plays a vital role in advancing diagnosis and cures for a range of diseases and illnesses? Of course we need to ensure that there is public trust on anonymity. Can he give us more information on that and on cybersecurity?

[Lord Bethell (Con)]

I am grateful for the noble Lord’s anecdote. It is no coincidence that he got the text yesterday. We have energetically promoted this opportunity to patients and we are grateful to those who have engaged. He is entirely right. Patient data played a critical role in the development of the shielding list during Covid, in the recovery clinical trials programme and in the vaccine priority list. Clinical data is essential for patient safety. That is why we are modernising the system by which we access it.

Covid-19: Government’s Publication of Contracts

Lord Young of Norwood Green Excerpts

Thursday 11th March 2021 Lords Chamber

[Lord Bethell (Con)]

I am grateful for my noble friend’s remarks. Absolutely—the public expected us to act, not to push paper. I pay tribute to officials from the Department of Health and in particular from the Crown Commercial Service and the MoD who stepped forward in unbelievably difficult circumstances, particularly around PPE, to transact on a very large amount of extremely complicated and very difficult procurements that ensured that our front-line healthcare workers were safe.

[Lord Young of Norwood Green (Lab) [V]]

My Lords, I declare an interest as I am on the advisory board of a local clothing manufacturing company in Haringey in an unremunerated capacity. Can the Minister explain why a high-quality SME capable of supplying reusable, RFID-tagged PPE gowns which can be laundered 70 times at a cost of 80p per wash—compared to disposable gowns which cost £10—and which are better for the environment and support local employment has not been given a contract?

[Lord Bethell (Con)]

My Lords, I personally share the noble Lord’s frustration over the subject of reusable gowns. It strikes me as sensible and good for the environment for us to be able to use reusable gowns wherever we can. However, those who do the procurement understand fully what is required of a fully sterile gown and, unfortunately, with the amount of moisture and liquids that are involved in operations and in the front-line healthcare service, quite often it is not possible to have reusable protocols in place. That is why we use so much disposable PPE kit. It is a huge regret to me, and I share the noble Lord’s frustration. If he would like to write to me with details, I would be glad to pass them to the right people.

Puberty-blocker Drugs

Lord Young of Norwood Green Excerpts

Thursday 10th December 2020 Lords Chamber

Asked by

[Lord Young of Norwood Green]

To ask Her Majesty’s Government what assessment they have made of the administration of puberty-blocker drugs to children under the age of 16.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con) [V]]

My Lords, the Government are committed to providing the best possible care for children and young people accessing gender identity services. Earlier this year, the National Institute for Health and Care Excellence was asked by NHS England to undertake a thorough review of the latest clinical evidence on the use of puberty suppressants and cross-sex hormones. An independent group, under the chairmanship of Dr Hilary Cass, will make recommendations about the existing clinical policies based on this evidence.

[Lord Young of Norwood Green (Lab) [V]]

My Lords, I wish to make my position clear: I am opposed to all forms of transphobia and transgender discrimination, but this should not override the rights of women as defined in law. I welcome the Minister’s statement on the guidance and the research, and I am sure he agrees with me on the importance of the NHS guidance. Does he also recognise that this needs to be ported? What actions will the Government take to ensure that local services, such as CAMHS, are sufficiently resourced to provide psychological support to all children and young people with gender-related distress?

[Lord Bethell (Con) [V]]

My Lords, the noble Lord puts his point extremely well. I share his concern for those with trans or gender concerns of any kind. I reassure him that provision of gender identity services at all levels is an absolute priority for the NHS. In the recent court case, we have seen a clarification of the guidelines attributed to some of those services, but it in no way mitigates against or suggests a lack of commitment on the part of the NHS to such services.

Covid-19 Update

Lord Young of Norwood Green Excerpts

Monday 21st September 2020 Lords Chamber

[Lord Bethell (Con)]

It is a war, that is why we are focused on how we manage extra resources such as the Nightingales. We have put in new systems and artificial intelligence for algorithms to help us with our triage. We have invested £450 million in A&Es, which will include building new holding bays. As my noble friend rightly points out, these need development. We have invested in 5,000 DnaNudges and other point-of-care devices to give front-line care workers the diagnostic help they need.

[Lord Young of Norwood Green (Lab) [V]]

My Lords, I welcome the statement from the Minister, but to be candid, when I hear talk about Moonshot, I will believe it when I see it. What members of the public want is the ability to access Covid tests in places such as Bagshot, or Aldershot, or any other testing centre. The reports we get are that they cannot get appointments. Schools are closing because they cannot get test results, classes are being sent back; therefore, it is not just the number of tests, it is how long they are taking to turn around. To say we are surprised by the surge, when we were opening schools, does surprise me.

I have two other points on which I would welcome a response from the Minister. One, raised by noble Baroness, Lady Barker, is about domiciliary care. It is essential that PPE is available. It must be the right quality; we have had examples where large batches have been ordered from Turkey and China and they have been no good. We want quality PPE that is available.

[Baroness Penn (Con)]

Could the noble Lord address his question to the Minister now?

[Lord Young of Norwood Green (Lab) [V]]

I am addressing all these questions to the Minister. My last point is this: will there be testing capacity in general practice surgery?

[Lord Bethell (Con)]

My Lords, we are introducing a new scheme for bringing testing capacity straight to the desks of general practice, and the results from that initiative are promising.