Health

11 Feb 2009 11:26:58

Health questions, including: assaults on NHS staff are rife

Mike_penning_mpIt was time for questions to the Health Department yesterday. Perhaps the most noteworthy question came from Mike Penning (pictured right), who spoke in light of the revelation that in 2007-08 criminal sanctions following cases of assault in the acute sector rose by thirteen per cent.

Shadow Health Secretary Andrew Lansley asked about sport in schools:

"I welcome the announcement of the Active England strategy, but it has taken a year to get there. I am afraid that the Secretary of State has got it wrong about school sports. The Government are not meeting their commitment to ensure that all pupils get two hours of sport a week in schools. In the school sport survey last October, the number of 11 to 16-year-olds getting two hours of exercise had gone down from 88 per cent. to 83 per cent. in a year. Will the Secretary of State, with his colleagues at the Department for Children, Schools and Families, ensure that the commitment to a minimum of two hours of exercise in schools is achieved, and will he tell us when will it be achieved?

Alan Johnson: From memory, the proportion of young children getting two hours of exercise in schools was about 24 per cent. when we came into government, so a drop— [ Interruption. ] Incidentally, I am not sure about the statistics that the hon. Gentleman just quoted. If there has been a slight drop, it should be seen in that context. Sport in our schools is essential to the sort of message that we seek to deliver, which is why we have pledged not just effort and time, but a huge amount of finance to meet those targets. And we will meet the target in 2010, just as I am absolutely sure we will move on to meet the extended target in 2012."

Shadow Health Minister Mark Simmonds was concerned about access to GPs:

"In Battersea, the provision of primary care is vital to the health of the community, but according to the Royal College of General Practitioners, seeing a doctor who knows the patient and their medical condition personally is important to more than 75 per cent. of patients. Yet the Secretary of State recently said that he “could not care less” which GP he sees. That is totally out of touch with patient needs both in Battersea and elsewhere. Can the Minister confirm that continuity of care is important to the vast majority of patients, particularly those with long-term conditions? If so, why are he and the Secretary of State centrally imposing polyclinics, against patients’ needs and wishes?

Mr. Bradshaw: Yes, I am happy to confirm what the hon. Gentleman asks me to confirm. However, what he says is another of the myths that were peddled by both the Opposition and the British Medical Association, at the time, in their opposition to new GP health centres. I do not know whether he has now abandoned the Conservative party’s opposition to the centres. I suspect that the Conservatives will quietly abandon that opposition, because where the new centres are opening, they are incredibly popular, not least with local Conservative councillors and Conservative MPs who want theirs to open as quickly as possible.

Of course continuity of care is important for many patients, particularly those with long-term conditions. However, many people, such as professionals who are otherwise healthy and who are juggling work and family life, find it very difficult to see their GP, because of opening times. They warmly welcome the opportunity to see a GP, and they do not particularly mind whether it is always the same GP."

It stretches credulity to say that people are indifferent about who their GP is; Mr Simmonds is correct.

Continue reading "Health questions, including: assaults on NHS staff are rife" »

13 Jan 2009 10:14:54

MP of the day - Charles Walker for his speech on mental health

Charles_walkerThe television signal at my home in Oxford is a capricious thing, and so I was delighted the other night to discover that I can now pick up BBC Parliament. (I know it's available online but sometimes I want to tear myself away from my laptop, and it is easier to watch it on the TV.) Idly flicking through the channels last night, I stumbled across Broxbourne MP Charles Walker making an excellent speech on mental health.

It emerged that he was responsible for the adjournment debate on mental health advocacy. Mental ill health episodes may result in someone being detained, and an advocate's role is to support that person in their encounters with health professionals and advise them that they can question treatments. Mr Walker compared an advocate to a lawyer going into bat for a person who has been arrested.

The Mental Health Act came into force in November last year, but the portion relating to mental health advocacy goes live in April. Mr Walker expressed concern about the complex nature of the legislation and fears that the tendering process favours large organisations. He also highlighted an ongoing worry that Afro-Caribbean men are twice as likely as white people to be detained when exhibiting the same mental health problems.

My favourite passage in Mr Walker's speech was a blast against tabloid newspapers:

"I conclude by noting that our tabloid press are having great sport with discriminatory remarks made by a member of the royal family. The reporting of the tabloid press on people with mental illness is atrocious and appalling, and it is discrimination of the worst kind. Many people are fearful of coming forward with mental health problems because they fear that they know how their community will react to them. There is still hostility in our communities to people with mental illness and I firmly believe that a lot of that hostility is whipped up by hysteria in the tabloid press. It is the worst kind of discrimination; it is vile discrimination. I hope that our tabloid press gets their house in order before we have to get it in order for them."

This is outstanding Parliamentary work. The Conservative Party has had a good record on mental health for several years, but it never hurts to keep up the good work. This is the best sort of modernisation - getting hold of an important subject and pleasantly surprising people with your interest in and mastery of it.

Mr Walker has shown himself to be well-briefed, courteous, proportionate and determined. If we are to have a reshuffle, Mr Cameron should take note.

Tom Greeves

17 Dec 2008 10:04:14

Andrew Lansley criticises the government for misusing hospitals' knife wounds data

Andrew_lansleyShadow Health Secretary Andrew Lansley spoke in the House of Commons yesterday. He took Alan Johnson, his opposite number, to task over knife statistics:

"The Secretary of State will know that the NHS Information Centre provided to 10 Downing street information from hospitals about people presenting with knife wounds—data that were unpublished, not yet validated and incomplete. That was done on the basis that the information would not be used publicly in that form. Can the Secretary of State tell the House whether he knew about 10 Downing street’s intention to use those data and, whether he did or not, what steps he personally is taking to make sure that NHS data are not used for partisan purposes in that way?

Alan Johnson: I have nothing to add to the Home Secretary’s comments yesterday, particularly her apology for what happened. The hon. Gentleman has written to the Information Centre and made a number of points, all of which will be answered in due course."

To her credit, the Home Secretary did indeed apologise yesterday for what Sir Michael Scholar, head of the UK Statistics Authority called the "premature, irregular and selective release" of knife figures. Officials had pleaded with the Government not to release the statistics.

I try to avoid hyperbole on this page. So when I write that New Labour's use of statistics has been wildly irresponsible and fraudulent throughout their time in office, I hope you all know I mean it!

Tom Greeves

9 Dec 2008 13:58:31

Mike Penning asks the Government about drug abuse in London

Mike_penningShadow Health Minister Mike Penning - MP for Hemel Hempstead and polymath - has posed a noteworthy written question to the Government:

"To ask the Secretary of State for Health how many problematic drugs users were estimated to be residing in London in the last year for which figures are available. [240585]

Dawn Primarolo: The estimated number of problem drug users(1) in the London government office region, aged between 15-64, is 74,822. This figure for the latest period available 2006-07.

(1) Problem drug use in this context refers to use of opiates and/or crack cocaine, including those who inject either of these drugs. It does not include the of cocaine in powder from, amphetamine, ecstasy or cannabis, or injecting by people who do not use opiates or cocaine."

Why aren't the abusers of these other drugs included? Is it because their numbers are too hard to calculate or estimate? Is it becase these drugs are considered less problematic? It seems to be a very odd approach.

(Please note that the typo in the minister's answer is not ConservativeHome's.)

28 Nov 2008 09:55:13

Earl Howe asks when the EU is going to start messing with food supplements

Update: GB£.com - I've changed the offending headline! Tom Greeves

Freddie_howeEarl Howe - a gentleman who reminds us of the many merits of a hereditary system - is a Shadow Health Minister. He has recently had an answer to a question about food supplements. The matter of the European Union wanting to set maximum levels for minerals and vitamins has been a cause of concern for several years.

Both athletes like me and normal people like you are worried, and annoyed, about it.

"Earl Howe asked Her Majesty's Government:

    What is the timetable for setting maximum permitted levels for vitamins and minerals under Article 5 of the food supplements directive; what consultation the Food Standards Agency will hold on any such proposed maximum permitted levels; and what steps they will take to ensure that Parliament is involved in considering those levels prior to their finalisation and transposition into domestic law; and [HL6475]

    When Ministers will next meet Commissioner Androulla Vassiliou; what subjects they will raise at that meeting; and whether they will discuss the implications for consumer choice in the United Kingdom of setting restrictive maximum permitted levels for nutrients in food supplements; and [HL6476]

    What assessment they have made of the likelihood of achieving in negotiations in the European Union their objectives for the setting of maximum permitted levels for vitamins and minerals in food supplements; and whether the resources devoted to the negotiations by the Food Standards Agency are sufficient. [HL6477]

The Parliamentary Under-Secretary of State, Department of Health (Lord Darzi of Denham): The European Commission has indicated that it intends to publish proposals for minimum and maximum levels for vitamins and minerals in food supplements in early 2009.

In the absence of proposals, no formal assessment has been made of the likelihood of achieving the Government's objectives in European negotiations.

In the mean time, the Food Standards Agency (FSA) has been holding bilateral meetings with its counterparts in other member states to promote the Government's objectives, in addition to promoting these objectives in working group meetings with the European Commission and other member states.

We have been advised by the FSA that they have sufficient staff resource capacity to manage the process of setting maximum permitted levels of vitamins and minerals in food supplements.

When the proposals for setting maximum levels are published, the FSA will conduct a full consultation with United Kingdom stakeholders in line with the government code of practice on consultation. The FSA will ensure that copies of the consultation documents are placed in the Library.

There are no current plans for Health Ministers to meet the European Commissioner for Health to discuss matters relating to the setting of maximum permitted levels for vitamins and minerals in food supplements."

Honestly - can't we just decide this stuff for ourselves?!

23 Oct 2008 15:50:53

The Government fails to answer another simple question

Mike_penningMike Penning - raconteur, aesthete, Shadow Health Minister and MP for Hemel Hempstead - has uncovered yet another extraordinary example of Governmental ignorance. This came out in a written answer.

"Mike Penning: To ask the Secretary of State for Health how many NHS dentists there are per 1,000 people in Hemel Hempstead constituency. [228365]

Ann Keen: Information is not available in the format requested.

The number of dentists with national health service activity during the years ending 31 March 2007 and 31 March 2008 per 100,000 population is available in Table G1 of Annex 3 of the report NHS Dental Statistics for England: 2007-08. Information is available by strategic health authority and by primary care trust. This information is based on the new dental contractual arrangements introduced on 1 April 2006.

Following a recent consultation exercise, this measure is based on a revised methodology and therefore supersedes previously published workforce figures relating to the new dental contractual arrangements. It is not comparable to the information collected under the old contractual arrangements. The revised methodology counts the number of dental performers with NHS activity recorded through FP17 claim forms in each year ending 31 March.

This report, published on 21 August 2008, has already been placed in the Library and is also available on the website of the Information Centre for health and social care at:

Figures relate to headcounts and do not differentiate between full-time and part-time dentists, nor do they account for the fact that some dentists may do more NHS work than others."

Complicated to calculate it may be. Impossible it would not be.

23 Oct 2008 15:33:37

Anne Milton on the South-east Plan

Anne_miltonDebates in Westminster Hall are by no means universally popular. In 1999 MPs began sitting there, in what is a parallel chamber to the main one in the Commons. The building itself is steeped in history, however.

Yesterday Anne Milton, MP for Guildford and part of the Conservatives' Health Team, spoke in Westminster Hall about the South-east Plan. Tomorrow the consultation period for the Government's proposed amendments comes to an end. She highlighted the fact that:

"The publication of the plan was shrouded in secrecy. It was impossible to get an answer from the Minister about when it would be published even 12 hours beforehand. It was not widely available and is not accessible to people without the internet. If it had not been for the co-operation of my local newspaper, the Surrey Advertiser, and local radio station, 96.4 Eagle, I doubt whether anybody in Guildford without the support of the residents association would be aware of the plan’s existence, let alone its importance. Yet it will have a significant and irreversible impact not only on Guildford, but across the south-east.

I will mention the gross figures. The original plan proposed building 578,000 new homes. Despite the serious challenges of achieving that, the Government have returned with an increase of some 85,000, making the total 662,500 new homes. As the regional assembly has already made clear—and I am no fan of regional assemblies—Government proposals threaten to destroy an already delicate balance between housing growth on the one hand and providing decent infrastructure and protecting the environment on the other."

Several good points, and well-made. Does it matter that they weren't made in the main chamber?

18 Jun 2008 10:11:16

Lansley urges Government to rethink polyclinics

Opposition Day Motion:

"That this House opposes the Government’s plans to impose a polyclinic, or GP-led health centre, in every primary care trust; regrets that this could result in the closure of up to 1,700 GP surgeries; is concerned that the imposition of polyclinics against the will of patients and GPs could be detrimental to standards of care, particularly for the elderly and vulnerable, by breaking the vital GP/patient link; further regrets that these plans are being imposed without consultation; is alarmed at the prospective loss of patient access to local GP services at a time when care closer to home should be strengthened; believes that the Government’s plans would jeopardise the independence and commissioning capability of general practice in the future; supports the strengthening of access to diagnostic and therapeutic services without undermining the structure of GP services; and calls on the Government to reconsider its plans for polyclinics.

Andrew Lansley MP: "Last Thursday, the local medical committees, which are the statutory bodies required to represent GPs across the country, met in conference and passed a vote of no confidence in the Secretary of State and the policies of the Labour Government. On the same day, the British Medical Association delivered to Downing street a petition against the Government’s polyclinic proposals consisting of 1.2 million signatures. Patients care about the future of their local surgeries and about their GP services. They and GPs are concerned that the Government’s top-down, one-size-fits-all imposition of polyclinics in London and in each primary care trust across the country will reduce access to their GP services and undermine the GP-patient relationship, which is at the heart of the successful delivery of health care. Today’s motion is very simple. It urges the Government to think again. If the Government had offered additional funding to support the creation of extra GP practices in under-doctored areas, we would have supported them."

More from Hansard here.

24 Apr 2008 09:21:00

Andrew Lansley calls for reform in family doctor services

Lansleyincommons_3

Shadow Secretary of State for Health Andrew Lansley sets out his position on GPs in this opposition day debate:

Motion: That this House supports the family doctor service, and recognises that it is the first point of contact for the majority of patients; further recognises the invaluable role that GPs have in the NHS; regrets the undermining and undervaluing of GPs by the Government; is concerned about the lack of empirical and clinical evidence for the establishment of polyclinics in every primary care trust; opposes the central imposition of polyclinics against local health needs and requirements; is further concerned about the delay in publishing evidence on the cost-effectiveness of walk-in centres; believes that patients should be able to choose the most convenient GP practice, whether close to home or work; calls for GPs to be given real budgets, incentives to make savings, the freedom to re-invest for their patients and the ability to innovate in contracts with healthcare providers; supports rewarding GPs who choose to provide services in deprived areas or areas of expanding population; and further supports the incorporation of patient-reported outcome measures into the Quality and Outcomes framework and the development of structures and services in general practice that are designed by GPs and primary care providers in response to patients’ needs and choice.

"The purpose of the motion is straightforward. Through the new contract with general practitioners, the Government had a major opportunity to revive general practice in this country, and to rebase the NHS in patient-centred care and primary-care-led services. They failed to do that; by contrast, they have entered into a conflict with general practitioners that will undermine the service. The Government are taking an approach to the reconfiguration of primary care services that matches the dangers of the approach that they took to reconfiguration of secondary care. The progressive centralisation of services, the progressive undermining of access to care, the progressive undermining of the ability of clinicians across the NHS to determine what is best for their patients—those are the tragic consequences of the Government’s failure to negotiate the GP contract successfully. Their mean-minded approach is not to negotiate in partnership with general practitioners, but to try to arrive at a solution that cuts costs and centralises services, while undermining the independence and clinical effectiveness of general practice."

More from Hansard here.

1 Mar 2008 07:24:27

Lord Mancroft reflects on his unhappy experience of the NHS

Mancroft Lord Mancroft is under fire in many of today's newspapers (see The Times and Daily Mail) for controversial remarks about certain nurses that were responsible for his care during a time he spent in hospital.  But many will sympathise with his reflections on his NHS experience.  He found the hospital very dirty and noone appeared to be in charge of his ward.  He also watches a man die alone.

In the first part of his speech Lord Mancroft talked about his horrendous experiences in one unnamed NHS hospital:

Hospital cleansiness: "When I was taken ill, I was taken to an accident and emergency department in a hospital not in London but in the West Country. I can tell your Lordships only that it is a miracle that I am still alive. It was exactly as the noble Baroness described the hospital down in Maidstone in Kent. I will not tell your Lordships which hospital I was in, but the wards were filthy. Underneath the bed next to me was a piece of dirty cotton wool, and there it remained for seven days; the ward was never cleaned. It was a gastroenterology ward, with lots of people with very unpleasant infectious diseases. The ward, the tables, the beds and the bathrooms were not cleaned. I was extremely infectious at that time and no precautions were taken with me at all. The staff were furious when my wife wanted my bed cleaned when it clearly needed cleaning. I was just lying there, a pathetic person. It was appalling."

The slipshod and lazy nurses: "The nurses, who probably are the most important people in this complex area, were what I would describe as an accurate reflection of many young women in Britain today. What do I mean by that? I shall now break your Lordships’ rules and read the next bit, because I thought very hard before I wrote it. The nurses who looked after me—not all of them; we should never generalise and there were one or two wonderful ones—were mostly grubby, with dirty fingernails and hair. They were slipshod, lazy and, worst of all, drunken and promiscuous. How do I know that? If you are a patient, lying in a bed and being nursed from either side, the nurses talk across you as if you are not there. I know exactly what they got up to the night before. I know how much they drank and what they were planning to do the next night, and it was pretty horrifying."

Noone was in charge of the ward: "My bed was next door to the nurses’ station, so you could see how the whole place was being run. Actually, you could not: I have seen lots of things being run, but after a week, I could not tell you who was in charge. I had absolutely no idea who was telling who to do what. My view is that nobody was telling anybody."

Continue reading "Lord Mancroft reflects on his unhappy experience of the NHS" »

10 Jan 2008 10:22:00

David Burrowes urges action to preserve Umbilical Cord Blood

On Tuesday David Burrowes MP presented a Ten Minute Rule Bill that encourages the donation of umbilical cord blood and for it to be stored for public use: "The purpose of the Bill is to increase the awareness of the value of umbilical cord blood for the treatment of diseases and for further research of new treatment methods using cord blood stem cells. The Bill will require doctors to inform all parents of the benefits of collection and storage of cord blood and to presume consent for collection from families with a history of cord blood treatable diseases."

His speech is reproduced below:

Burrowesdavidtmrb "Mr Speaker, I beg to move that leave be given to bring a Bill to promote the donation of cord blood from women after giving birth; and for connected purposes.

With 6 children I should be declaring an interest in the subject of this Bill- the donation of umbilical cord blood. Living in my constituency of Enfield Southgate adjacent to Barnet General Hospital, which is one of only 4 NHS Hospitals which collects umbilical cord blood, there would seem to be good reason for developing an interest. However we have not donated umbilical cord blood despite 6 opportunities and a nearby hospital to do so. Like most parents throughout the UK we were not informed about the value of umbilical cord blood and the possibility of collection. Until recently I did not consider the umbilical cord, once clamped after birth, as anything more than a waste product.

The first purpose of this Bill and the opportunity of speaking about donating umbilical cord blood is to encourage parents and the wider public to be more informed about the value and benefits of umbilical cord blood.

Hon Members may be ignorant like I was of the nature of cord blood. The baby’s blood in the cord contains different types of cells including stem cells. Cord blood has been used for the last 20 years for blood transplantation. It has treated patients with leukaemia, sickle cell diseases, immune deficiencies and other diseases with 85 different treatments to date. There are possible treatments in the pipeline outside of blood therapy. Trials for the use of cord blood in brain injury in children are underway and cord blood is being developed for many other therapies including Diabetes and Liver Therapy.

Treatment for leukaemia highlights the value of cord blood transplants which can be used as an alternative to bone marrow transplants. Such cord blood transplants are less complicated, with fewer delays and are more readily available, being able to be stored and frozen for years. Significantly it is easier to find a match from stem cells than from bone marrow. Umbilical cord blood leads to increased access to transplantation, particularly for patients from ethnic minorities.

The reality is that umbilical cord blood which is thrown away routinely after birth has a life saving value.

Continue reading "David Burrowes urges action to preserve Umbilical Cord Blood" »

16 Oct 2007 10:09:32

Ann Widdecombe tackles Alan Johnson on appalling state of the Maidstone Hospital Trust

Widdecombe_ann_new Ann Widdecombe MP: "May I draw the Secretary of State’s attention to the debate in the House on 23 January 2007? After listing a catalogue of neglect and disaster at Maidstone hospital, I said:

“One of my constituents telephoned his brother to say that he was in Maidstone hospital with C. difficile, sitting in his own diarrhoea, and that he wished he was dead.”

I asked the then Secretary of State:

“Can anyone believe that when that is the standard of nursing, it has nothing to do with the spread of infection?"

That was 10 months ago.

May I draw the Secretary of State’s attention to something that I identified at the time, but has not mentioned in his responses so far? It is the crucial role of ward sister. Ward sister, unlike management, matron or the director of nursing, is there all day. She used to fulfil the role of boss: “Nurse, why is that drip empty?”; “Nurse, why is this man in his own diarrhoea?” If she still fulfilled that role— [Interruption.]

Mr. Speaker: Order. I hear the hon. Member for North Durham (Mr. Jones) saying from a sedentary position, “It is a speech.” We are considering a serious matter, which is why I have allowed an urgent question. Let the right hon. Lady speak because I understand that she has lost constituents.

Miss Widdecombe: I am very grateful, Mr. Speaker. I apologise for the length of the question, but we are considering my Trust and I am concerned about what is going on.  Does the Secretary of State accept that, if ward sister fulfilled her former role, many of the difficulties might have been avoided? Does he agree that there are three main reasons for her not fulfilling that role? First, short-staffing means that she is nursing when she should be bossing and supervising. Secondly, she has become too much a commissioner of bandages and blankets rather than active on the wards. Thirdly, she spends too much time filling in forms—whether that is related to targets or anything else is not the point; she spends too much time on officialdom. Does the right hon. Gentleman accept that I was right to say 10 months ago that if we get the role of ward sister right we will make a huge impact on the situation?

Alan Johnson, Secretary of State for Health: I do agree with that. If the role of the ward sister or matron is got right, we will go a long way towards tackling the problems. The right hon. Lady made important points, and I have no argument with the amount of time that she took to make them. She should be congratulated on raising the issue in January. Of course, as she will accept, the Healthcare Commission was in the midst of its investigation then.

I also agree with the right hon. Lady that the standard of nursing had everything to do with the problem, as the Royal College of Nursing and others have pointed out. We made an announcement a couple of weeks ago. I do not say this with the benefit of hindsight in relation to what happened at Tunbridge Wells and Maidstone. The right hon. Lady made the point that the matron and ward sister should have direct control not only over the cleaning arrangements and the contracts agreed for the hospital, but over the making of a report, at least quarterly, to the NHS trust board. The views of the ward sister and matron could not be filtered through various layers of management because the report, on these and other specific issues, would go directly to the trust board. That was the gist of our announcement.

I am afraid that I do not entirely agree with another point made by the right hon. Lady, because I think it detracts from her point about the standard of nursing at the particular hospital and her graphic account of patients being told “Go in the bed”. That is the term that was used. The right hon. Lady and others will surely accept that that is not the standard of nursing that we find in our hospitals across the country; it is absolutely exceptional.

The excuse cannot be given that the management of the trust did not receive the right support. The right hon. Lady spoke of a staff shortage, but there are now about 85,000 more nurses in our hospitals than there were 10 years ago, and 280,000 more care assistants and the like. As she will accept, there is no excuse for the dreadful things that happened in that hospital.

I accept that there are issues that we need to tackle in relation to ward sisters and matrons. We should give them more power and make them much more assertive, and remove any bureaucracy that they feel is a hindrance to their role. As I said in my statement, I am perfectly willing to shoulder that responsibility. My point is that nothing must detract from the failure that occurred in those three hospitals, and nothing must excuse the appalling standard of nursing that was in operation."

More from Hansard here.