Health Professionals: EEA and Non-EEA Citizens

Lord Winston Excerpts

Thursday 8th September 2011 Lords Chamber

[Lord Winston]

My Lords, in January 1944 the American VI Corps of the Fifth Army was engaged in a bitter struggle at the Anzio beachhead when a doctor, Henry Knowles Beecher, ran out of morphine. In his field station with these desperately wounded patients, his nurse in desperation decided to put up a drip for each patient and tell them that inside the saline drip was a powerful pain reliever. The remarkable effect on these soldiers was such that very few of them complained of the pain, the amputations and the other horrific surgery that they were undergoing. Beecher founded in consequence the randomised control trial, which—the Minister will be aware—led to our partial understanding of the placebo effect. It was very clear that the communication with those patients was the key issue.

Since that time, Dr Bensing in the health service’s research department in Utrecht has looked at the growing tendency in medicine towards the business-like interview between patient and doctor, and has taken video tapes over some 20 years showing that. They show a gradual deterioration in the kind of care that is going on—probably throughout Europe. Bensing’s work is really very interesting. This is not due simply to a placebo effect. There is a very important publication from as long ago as 1976 by Patel and Daley showing that 77 per cent of hypertension patients’ condition improved simply by talking to the doctor and the doctor listening to them in great detail. It is obvious that this was not a placebo effect because in the main these patients did not require drugs afterwards to suppress their hypertension. Most of them required at least a reduction in drugs and some needed no drugs at all. What is impressive about the study is that that effect continued for at least six months or a year.

That is something that we will come back to during our discussions on the health Bill. Communication between the patient and the professional is vital. We run the risk of losing it with nurses who cannot speak English and who have been trained in a different way. I am particularly concerned about nurses coming from the eastern bloc of Europe—for example, from Romania or Bulgaria. Having been extensively in the far east of Europe when we were still in the Cold War with my research, I am well aware of the limited communication even in their own language that healthcare professionals had. If we are not careful we will increase that in our health service.

I hope that we will make sure that that, plus the fact that record-keeping is not fully understood by those nursing staff, are aspects that we will fight on in the European Union. I know that the Minister is caring and responsible, has high integrity and communicates and listens brilliantly. I understand that it is not entirely his problem because he has to communicate with BIS to represent our views in Europe. As he knows, Europe has already threatened our health service in other ways and I hope that we can make the strongest case possible to ensure proper communication between patient and carer.