Cardiovascular Illnesses

Baroness Winterton of Doncaster Excerpts

Thursday 12th June 2025 Grand Committee

[Baroness Winterton of Doncaster (Lab)]

I congratulate the noble Lord, Lord Booth, on securing this debate, on his very personal account of what he went through and on sharing with us his experiences and what we can learn from them.

As a former Health Minister who had some responsibility in this area, I know that cardiovascular illness can be particularly prevalent in areas of high deprivation. NHS figures show that, in 2023, the most deprived 10% of the population were almost twice as likely to die of cardiovascular disease compared to the least deprived. An NAO report published in 2024 said that, in 2020, deaths in those aged under 75 due to cardiovascular disease were four times higher in the most deprived areas compared to the least.

I recently attended an event organised in Parliament by the All-Party Parliamentary Group on Vascular and Venous Disease, where I was particularly struck by the points made about those regional variations—not just in death rates but in treatment and prevention. In the South Yorkshire ICB area, only 3.1% of the population received a health check in 2023-24, despite 32% of adults being obese and 23.5% being physically inactive. There are also worrying disparities in amputation rates. In Yorkshire and Humber, there are 12.6 amputations per 100,000 people, which is almost double that of London; only the north-west and north-east of England have higher amputation rates.

I know that the British Heart Foundation has welcomed the Government’s recognition of CVD as one of the UK’s biggest killers and their ambition to reduce premature deaths from heart disease and stroke by 25% in the next decade. The foundation has also called for a national cardiovascular disease plan. I wonder if, in her closing remarks, the Minister might address whether the Government are looking at that idea to bring together areas that need to be tackled, such as obesity, smoking, air pollution and increased research.

In the time I have available to me, I want to make a few practical points that could address some of these disparities. Health checks are so important, but the 2024 NAO report said that there was “no systematic” way of

“targeting … those most in need of”

health checks, as well as little incentive for primary care providers to provide them. It also said that

“DHSC and local authorities cannot … access data … so cannot assess the impact”

that health checks are having. Perhaps my noble friend could address this or write to me if she does not have the information to hand.

The all-party group has made a number of points. For example, appointing more nurse practitioners would enable what it called hot clinics. In many ways, this would help to reduce the length of waiting times. At present, there are patients who are at risk of amputation of their legs. Obviously, they need to be prioritised. A hot clinic could do this by having nurse practitioners who could assess the patients, compare their blood pressure on the arm and on the leg, see how bad their condition is, then fast-track them through the system. That is one suggestion from the APPG. Also, appointing multidisciplinary team co-ordinators could greatly assist in keeping track of patients, moving them through the system and reducing the time that consultants have to spend on doing this.

Co-locating services is also vital. For example, if there were ultrasound scanners and access to sonographers in out-patient departments, they could increase the number of out-patients because patients would not have to go back and forth to and from hospital. This would improve the patient journey. Hybrid theatre facilities would allow consultants to do a range of services in the same space, again, without having to duplicate services and the patient having to go backwards and forwards for different appointments.

That brings me nicely on to the fact that, as my noble friend the Minister knows, the Doncaster Royal Infirmary is greatly in need of some investment. The recent announcements of an increase in NHS capital spending are very welcome. Part of the plans would be to help in this important area, so I hope that she might cast a sympathetic eye over the points that I have made.

Doncaster Royal Infirmary

Baroness Winterton of Doncaster Excerpts

Monday 12th May 2025 Lords Chamber

[Baroness Merron (Lab)]

I can tell your Lordships’ House that we have inherited an undercapitalisation over the past few years, and it is essential—including to cut waiting lists and provide proper care—that we provide resources. However, the noble Lord is very aware of the extent of the backlog; it stands, according to the latest NHSE figures for 2022-23, at £13.8 billion. Even more worryingly, the critical infrastructure risk within that, which the highest-tier hospitals are wrestling with, is £7.6 billion. We have had to find the best route forward to be fair and efficient. Is it a major mountain to climb? Yes, it is. Are there various options for doing it? Yes, there are, but we believe that we have been as transparent and fair as we can be.

[Baroness Winterton of Doncaster (Lab)]

My Lords, I know that Secretary of State Wes Streeting is determined to increase NHS productivity. DRI’s bid for urgent work to the tower block would do just that; for example, by stroke services having a same-day emergency care centre linked to the in-patient ward with a knock-on effect on vascular services. That is all impossible with the current state of the hospital. Will my noble friend the Minister ensure that Ministers, officials and, crucially, the Treasury not only are aware of the patient safety concerns raised by the right reverend Prelate, but know that the DRI bid will increase productivity and efficiency, as well as improve patient care?

Primary Healthcare Facilities

Baroness Winterton of Doncaster Excerpts

Monday 17th March 2025 Lords Chamber

[Baroness Merron (Lab)]

Although I cannot give a specific answer to the noble Lord on that point, I will be happy to look into it. As I mentioned earlier, in our discussions with the Ministry of Housing, Communities and Local Government we are, for example, looking at how we can lever greater contributions from developers who are working on new developments, where they will be providing much-needed health services and infrastructure. So we are taking a creative approach because we recognise the need to do more.

[Baroness Winterton of Doncaster (Lab)]

My Lords, my noble friend referred to creativity and the noble Baroness on the Lib Dem Benches talked about facilities in the community. Well, in Doncaster, we are already ahead of the game, as Mayor Ros Jones has worked with the local health community to provide a “health on the high street” facility, which will not only reduce pressure on the hospital but make it easier for patients to access services and, crucially, help regenerate the city centre. Will my noble friend join me in congratulating Mayor Ros Jones on this initiative, but also work with the local community to address the issue of urgent repairs that are still needed at the hospital?

[Baroness Merron (Lab)]

I am very pleased to congratulate Mayor Ros Jones on this initiative, as I would be pleased to congratulate such initiatives up and down the country. My noble friend is right to talk about the great benefits to local communities, which I myself remember, as will my noble friend, from the previous Government, in terms of walk-in health centres, which made a huge difference. To the point about repairs to the local hospital, it is vital, if we are to create the right NHS going forward through the 10-year plan, that we repair and rebuild the healthcare estate, which has a very considerable backlog maintenance bill after years of underinvestment. That is why the Chancellor confirmed extra investment for the backlog of critical NHS maintenance and repair upgrades.

Musculoskeletal Health: Chiropractors

Baroness Winterton of Doncaster Excerpts

Wednesday 26th February 2025 Lords Chamber

[Baroness Merron (Lab)]

I am glad that the noble Lord acknowledges the ongoing work, because we are indeed exploring how best to support dealing with MSK conditions—not least to encourage and provide greater parity in the support that is given. That will be alongside the 10-year plan and the long-term workforce plan. Of course, we keep all evidence continually under review.

[Baroness Winterton of Doncaster (Lab)]

My Lords, I take the point my noble friend the Minister makes about national commissioning and the ability of integrated care boards to do some commissioning, but would not the answer be for the integrated care boards to get all preventative healthcare practitioners to sit down together and work out local strategies? It may well be that one condition can have an effect on another, and perhaps that would make the commissioning of chiropractors easier and fit in with a local preventative healthcare strategy.

[Baroness Merron (Lab)]

My noble friend helpfully emphasises the point about the need to provide for local populations, and ICBs are in the pole position to do that. I am sure that noble Lords will recall that we recently announced changes in the NHS operating model to move power from the centre to local leaders. I particularly refer to the NHS planning guidance, whereby we follow the recommendations of the noble Lord, Lord Darzi, to take a whole new approach and reduce the number of national targets from 32 to 18. The reason for that is to give the local systems my noble friend refers to greater control and flexibility on how local funding is deployed. Indeed, one such model could be the one my noble friend referred to.

Mental Health Treatment: Waiting Times

Baroness Winterton of Doncaster Excerpts

Monday 3rd February 2025 Lords Chamber

[Baroness Merron (Lab)]

I certainly do, and with the NHS being such a large employer, that is one of the areas that we will be attending to. The long-term workforce plan will provide its report around the summer of this year and there will be much detail on how the workforce will be but also on the ways that we can improve its health and retention as well as recruitment.

[Baroness Winterton of Doncaster (Lab)]

My Lords, my noble friend Lady Warwick spoke particularly about young people and provision in schools. Does my noble friend the Minister agree that there is a key role for educational psychologists and school nurses in ensuring that diagnosis can take place early? Does she believe there could be a greater role for academies and schools working together at local level to provide that type of provision?

[Baroness Merron (Lab)]

I agree with my noble friend’s suggestions. Of course it is a team that provides the mental health support that is necessary, but I am particularly pleased that we are working to deliver a mental health professional in every school. That is a starting point, not necessarily the end point, so my noble friend makes some very helpful suggestions.

Community Pharmacy Closures

Baroness Winterton of Doncaster Excerpts

Tuesday 28th January 2025 Lords Chamber

[Baroness Merron (Lab)]

Commercial over the counter products will have a part to play. However, I take the point that the noble Lord makes. I am sure it is true that their vital role, and the opportunities that they offer, were not exploited as much as they could have been—when I say “exploited”, I mean that in a positive way. The Minister for Care, Stephen Kinnock, issued a press release today. In his last point he says:

“I am committed to working closely with Community Pharmacy England to agree a package of funding that is reflective of the important support that they provide to patients up and down the country. I am confident that together we can get the sector back on its feet and fit for pharmacies and patients long into the future”.

[Baroness Winterton of Doncaster (Lab)]

My Lords, the Government are on the right track in recognising the role that community pharmacists can play in public health by preventing illness and reducing the number of people turning up at A&E. However, is my noble friend the Minister aware of reports that some GPs have been unwilling to direct patients to community pharmacists, even under the Pharmacy First programme? Will she look at whether further action is needed to ensure that GPs work with community pharmacists to deliver services to patients?

[Baroness Merron (Lab)]

I am aware of the reports that my noble friend refers to. This is a new service; it needs to bed in. NHSE is working closely with ICBs, GPs and the community pharmacy sector to improve referrals. Funding has also been provided to ICBs for primary care network engagement leads, who should be well placed to support GP teams to refer into the service. We are aware of my noble friend’s point; we are acting on it and we will continue to keep it under review.

Health and Social Care: Winter Update

Baroness Winterton of Doncaster Excerpts

Tuesday 21st January 2025 Lords Chamber

[Baroness Merron (Lab)]

The noble Lord is right to remind us of the challenge of having people in the right place, rather than in hospital when they do not need to be there. We have already taken action, so I am pleased to be able to reassure him that, while the noble Baroness, Lady Casey, will look at long-term solutions for social care, she will present a report within a year from her commencement, which will add to the actions that we have already taken.

The noble Lord talked about unpaid carers—and I certainly share the respect that he holds for unpaid carers, so I am very pleased that we have given the biggest boost in income to family carers through eligibility for the carer’s allowance. That has meant an additional —on average, of course—£2,300 a year. That is the biggest boost since carer’s allowance was introduced in the 1970s. We are also legislating for a fair pay agreement, for the first time ever, which will help to tackle the number of vacancies, now standing at 131,000. There will be immediate action, because discharge requires being able to be in the right environment, which might be home but it might need an adaptation. Through the disabled facilities grant there will be a further 7,800 adaptations to homes both this year and next year. So we have taken the immediate action—and, yes, there is a lot more to do.

[Baroness Winterton of Doncaster (Lab)]

My Lords, my noble friend the Minister has just reiterated what the Statement said—that one of the key levers for easing winter pressures is NHS reform, particularly moving some hospital services into the community, which could deal with some of the issues raised by the noble Baroness, Lady Brinton, including X-rays, scans, tests and so on. Does she agree that this will require close collaboration between NHS trusts, hospital trusts, local authorities, ICBs and, sometimes, the private sector? Will she work with Ministers in other departments, not only to remove any obstacles there might be to this but to actively encourage it to happen at the local level? By the way, there are some good examples in South Yorkshire of this happening, and proposals for it to happen.

[Baroness Merron (Lab)]

My noble friend is quite right to highlight the good examples in South Yorkshire. There are good examples across the country and one of our challenges, as the Secretary of State has said, is taking the best to the rest. This is a very good example of that. I certainly agree with her observations. This requires joined-up working locally and nationally, which is why we work closely with other departments in both the immediate term and the longer term as we seek to reform health and social care.

Hospice Funding

Baroness Winterton of Doncaster Excerpts

Monday 6th January 2025 Lords Chamber

[Baroness Merron (Lab)]

As I mentioned, it has been confirmed that there will be funding for children and young people’s hospices for the forthcoming year, which I know had been hoped for but not actually delivered. I am very glad that the Secretary of State was able to confirm that. On long-term sustainability, Minister Kinnock is very much looking forward to meeting major stakeholders and is working with NHS England to find the best funding mechanism, in respect of the £100 million capital grant and more generally.

[Baroness Winterton of Doncaster (Lab)]

My Lords, it is very good news that the commission is in the safe hands of Sir Mike Richards, who I worked very closely with when I was a Health Minister. Could my noble friend set out the ways in which the Government might assist the hospice sector with training, because there must be a crossover in the different tasks undertaken? In particular, could some of the changes announced for social care workers be transferred to the hospice movement?

[Baroness Merron (Lab)]

My noble friend makes a very helpful point that I will certainly follow up. The fact that the majority of hospice care is provided through the NHS suggests that there is room for further co-operation between the independent hospice sector and the NHS. I am grateful for her comments and will follow that up.

NHS Plan: Consultation

Baroness Winterton of Doncaster Excerpts

Monday 2nd December 2024 Lords Chamber

[Baroness Merron (Lab)]

I thank the noble Lord. Yesterday, I was at an in-person event in Folkestone, and as with all such events up and down the country, it had used systems to find a wide range of people, including young people, who, as he rightly says, are often unlinked with the health service. I emphasise our continued monitoring and our efforts to reach the groups he speaks of. So far, we know that men, those aged under 35, and black Asian and black British people have engaged least with Change NHS. We are now stepping up our efforts.

[Baroness Winterton of Doncaster (Lab)]

My Lords, will my noble friend the Minister look at the role that pharmacists might play in any consultation? While they may not be an obvious source of reaching out, they are embedded in communities and talk to patients and users frequently. If they could be harnessed, it would much improve the consultation.

[Baroness Merron (Lab)]

I am very grateful to all those, including pharmacists, who have used all their networks and contacts to spread the word. That is why we have had over 60,000 responses and more than 1 million visits in what is the largest ever consultation in the history of the NHS. I call on all groups to continue their efforts to ensure that voices across all communities are heard loud and clear.

NHS

Baroness Winterton of Doncaster Excerpts

Thursday 23rd May 2024 Commons Chamber

[Victoria Atkins]

It is going better than it is in Wales. Under the Labour-run NHS in Wales, a quarter of people are on a waiting list in that part of the NHS. The number of patients waiting two years is higher in Wales than it is in England. Patients are waiting on average six weeks longer in Labour-run Wales than in England. If that performance were replicated here in England, waiting lists could be as much as six million higher. The choice is clear: unfunded Labour failure or a clear plan for a more secure future with the Conservatives.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call the Chair of the Health and Social Care Committee.

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[Victoria Atkins]

I thank the right hon. Lady for all her work. She may recall that, when the inquiry was announced by the then Prime Minister, my right hon. Friend the Member for Maidenhead (Mrs May), we had a debate on that matter where I spoke as a Back Bencher on behalf of a constituent; I very much hope that he and others gain some reassurance from the fact that I understand exactly the issues they have faced over many years. As Health Secretary, it is my responsibility, and indeed my privilege, to try to help them now.

In relation to the compensation schemes for those who have not yet received payments, I know that the right hon. Lady will have carefully pored through the responses of my right hon. Friend the Minister for the Cabinet Office and Paymaster General. We want to give the independent compensation authority—I underline independent because I am sympathetic to the sensitivities of families and victims around the role that the Department of Health and others played in their pain—and Sir Robert the chance to set up the scheme, assisted by the expert panel.

I promise the right hon. Lady that I have been discussing psychological support with the chief executive of NHS England for some time. We want to recruit the right people to conduct that incredibly sensitive work. It will take us a little more time, but I assure her that NHS England is acting quickly to bring in those services, we hope, by the end of the summer.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call the Father of the House.

[Sir Peter Bottomley (Worthing West) (Con)]

I thank the Secretary of State for her answer to the right hon. Member for Kingston upon Hull North (Dame Diana Johnson). I hope that the letter that her Department received from us will get a full reply, and I thank her for her interim words.

I hope that the Secretary of State will be able to come to the opening of the new integrated care centre by the town hall in Worthing—a local authority enterprise carried on by the present administration in Worthing. There has been great concern about dentistry in my constituency. The pressure is coming off, but not fast enough. Would she please encourage everyone in NHS England to ensure that dentists are encouraged to provide the kinds of service that all our constituents want?

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[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. I am extremely grateful for all the terribly kind comments, which means that I am a bit reluctant to say this, but we need to crack on, so I ask for brief questions and brief answers. [Interruption.] It appears that the Whips agree with me. They know that we have the business statement and then the Finance Bill to get through. A good example will be set by Sir Christopher Chope.

[Sir Christopher Chope (Christchurch) (Con)]

Thank you, Madam Deputy Speaker, for giving such as good example to this House, as always.

My right hon. Friend was kind enough to meet me and our right hon. and learned Friend the Member for Kenilworth and Southam (Sir Jeremy Wright) to discuss the plight of people who are victims of covid-19 vaccine damage. She sounded very sympathetic at the meeting and promised to look into the vaccine damage payment scheme, so it was rather disappointing this week to be told in answer to a written question:

“Formal consideration of whether any reforms to the VDPS are necessary will form part of Module 4 of the COVID-19 Inquiry”.

The inquiry will not be heard until January next year, and it smacks of kicking the can down the road and ignoring the victims, who need help. The sum paid—£120,000—has not been increased since 2007.

[Madam Deputy Speaker]

Order. I fear that my authority is draining away, so I will make another plea for brief questions. I thought the hon. Gentleman was going to set a superb example. However, I am sure the Secretary of State will now respond briefly.

[Victoria Atkins]

I very much share my hon. Friend’s concerns. I will take away what he has said, but I want to look into this issue, because I understand the points that he and our right hon. and learned Friend the Member for Kenilworth and Southam (Sir Jeremy Wright) have made.

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[Victoria Atkins]

That is an irresistible invitation, if I may say so, and I will very much look forward to visiting my hon. Friend’s constituency to support her in her campaign for a community diagnostic centre.

I think we are on the last question, Madam Deputy Speaker, so, as we enter into this general election period, may I give my sincere thanks to every single member of our NHS staff and to every single person working in social care across England? You all do amazing jobs, and it is my great privilege to serve as your Secretary of State. I wish everybody a very calm—not quiet—six weeks. The medics will understand what I mean by that.

[Madam Deputy Speaker (Dame Rosie Winterton)]

On that note, I thank the Secretary of State for her statement. Once again, I thank everyone who made very kind comments.