argyrotsipi/train-dataset huggingface dataset:
National Health Service — House of Lords, 2016-01-14
Topic: Health
Keith Bradley (Labour, Centre-left): My Lords, I congratulate my noble friend Lord Turnberg on obtaining this timely and wide-ranging debate. I declare my health interests as shown in the register. I will concentrate my short contribution on mental health, which I believe has never been higher on the public’s agenda The NHS currently spends only about 13% of its budget on mental health treatment and support, including GP time, prescriptions and secondary mental health services. However, evidence from prevalence surveys shows that only 25% of people, including children, with common mental health problems receive any treatment. There has been a great deal of talk in recent years of parity of esteem between physical and mental health and I welcome recent announcements of additional funding for mental health services, but the funding gap is still huge The King’s Fund and the Centre for Mental Health identified that a third of people with long-term physical conditions—4.6 million people in England—have a co-morbid mental health problem, most commonly depression and anxiety. The cost of care for this group is 45% extra and more still for those with multiple conditions. This adds up to an additional cost of £10 billion nationally each year. The extra costs are for a variety of reasons, including poorer self-care and condition management. This can increase the cost of prescriptions, cause or lengthen the hospital admissions and dramatically increase both morbidity and mortality At least £1 billion more is spent on the cost of staff mental health in the NHS, at least half of which is likely to be hidden, as staff present at work but may be struggling to do their jobs as well as they would wish. A significant part of the £14 billion cost of untreated mental health care could be saved while offering better healthcare. For example, liaison psychiatry in acute hospitals has been found to save £3 to £4 for every £1 invested, cutting costs by an average of £5 million per hospital Crucially, earlier intervention is vital in all areas of mental health care. There is clear evidence that investing in perinatal mental health care, parenting programmes to help families to manage children’s behaviour, treating childhood depression, anxiety and conduct disorder, promoting mental health in schools and early intervention in psychosis all generate savings far in excess of their costs I hope that the Government will also invest in liaison and diversion services and that the Treasury will shortly approve the business case for mainstream funding of these services. Huge savings can be made here in the criminal justice system and the health service. By investing wisely in mental health support, the NHS may be better able to sustain itself. Reaching out to people with physical conditions and symptoms whose mental health needs are unmet will improve health at a lower cost. I hope that such integrated proposals will be pursued by the devolution of health and social care in Greater Manchester, building on the work of Salford that my noble friend Lord Turnberg so well described.
National Health Service — House of Lords, 2016-01-14
Topic: Health
Sushantha Bhattacharyya (Labour, Centre-left): My Lords, I thank my noble friend Lord Turnberg for securing this debate and declare my interest as an engineer and chairman of the Warwick Manufacturing Group at the University of Warwick. I also run the Institute of Digital Healthcare jointly with the medical school Two years ago, I was treated for pneumonia at the Queen Elizabeth Hospital Birmingham, a fantastic new hospital led by an outstanding former nurse, Dame Julie Moore. The care I received was immaculate, and I understood then why the NHS is sometimes called our other national religion. However, I see it as our national science. After all, it is the subject of many experiments and is constantly being tested One current test is higher care standards, which requires more medical staff on wards. As a result, agency staff costs have soared. Monitor expects the bill to be over £4 billion this year, blaming a fundamental mismatch between supply and demand for medical staff. A lot of companies have made very good profit exploiting this, and it is rather ironic that Ministers are now proposing a cap on rising bills as the answer. The truth is that, whether in energy or agencies, price caps are a short-term fix. The solution is to increase supply Several medical schools, including Warwick, offer four-year medical degrees for graduate entrants. Such graduates do very well both academically and in their career. Warwick graduates are currently second only to Cambridge medics in gaining specialty training places. Shorter courses also mean qualified students can contribute to the NHS earlier. Four-year graduate entry degrees broaden access, attract quality applicants and give faster returns on public spending. It would be ludicrous to close such programmes. Yet medical schools could be forced to do so, as EU legislation demands that medical qualification takes five years. Currently, the fifth year for graduate entrants is the first-year foundation programme. During this time, graduates are provisionally supervised under the GMC before full registration as an independent practitioner is granted However, after the Greenaway review, the Government proposed merging degree graduation and full registration. This would unintentionally make four-year courses impossible, as removing the year under provisional registration would leave graduate entry courses short of the EU demand for five years’ training. To resolve this, graduate entrants could continue to do their first foundation year under provisional registration, and I understand the GMC may favour such a solution. We must innovate to attract outstanding medical students, then get them working as soon as we can. To achieve this, I urge the Government to pledge that future graduate entrants will retain the option of a four-year medical degree.
National Health Service — House of Lords, 2016-01-14
Topic: Health
Rita Donaghy (Labour, Centre-left): My Lords, I thank my noble friend Lord Turnberg for initiating this debate and congratulate the noble Baroness, Lady Watkins, on her wonderful maiden speech It is quite a while since I have spoken on health or social care matters, but I am fearful for the future. The ingredients of broken promises on social care funding, inadequate funding of the National Health Service, increasing demand and creeping privatisation mean that the pressure cooker may one day explode. The Government seek to avoid blame by making doctors and nurses subsidise our health provision, and finding a scapegoat in local government for the failures of social care. Student nurses are paying for their own training and working for nothing in the NHS for half their time; their pay has been capped and they are paying for their lodgings; safe staffing ratios have been scrapped; and nurses are doing even more outside work for the privilege of working up to 70 hours a week. That does not create a positive climate for the future The Government need to take a step back on the junior doctors dispute, which has been badly handled. The overwhelming vote of 98% on a 76% turnout is not just a problem for the Government; it places an enormous responsibility on the doctors’ leaders, because any settlement is going to look like a comparatively poor deal. It is important to allow ACAS to get on with its job. I read a very moving letter in the paper from the father of a junior doctor, who said of his son: "He regularly works weekends and nights, and spends much of his ‘free’ time adjusting his sleep patterns. He almost always works between one and three hours extra daily because of understaffing … His social life is almost nonexistent due to exhaustion and antisocial hours" All that is on a basic pay of £28,000 a year, and he is paying for his own insurance fees as well as very expensive examinations Finally, the recent hasty announcement to devolve health budgets to five London boroughs is not genuine devolution. It is more like being persuaded into a life raft only to find the substantial figure of Boris Johnson jumping in at the last minute. Apparently, he is going to oversee the process—clearly, part of the "Keep Boris Busy" campaign. The massive funding gap for social care will be slightly narrowed at the expense of healthcare, and the London boroughs will take the flak. These piecemeal experiments will lead to more complex structures, more contracting out and huge dividends for management consultants, who will hope to increase their £600 million a year income. The losers will be patients and the elderly. I really am fearful for the future of the NHS.
National Health Service — House of Lords, 2016-01-14
Topic: Health
Meghnad Desai (Labour, Centre-left): My Lords, as a professional economist—the only one speaking in this debate—I should say that any service that is free at the point of use will perpetually suffer from excess demand. The NHS is no different; more or less since its founding, it has faced a continuous demand for more money and the public fisc has been unable to quite meet it, so we have had a history in which it is perpetually in a funding crisis. At the same time, though, there is a great deal of satisfaction with the service, so we need to understand how it works We have to be careful about the fact that the percentage of GDP spent on health is not a good measure of outcomes; it is a measure of inputs. As someone has said, we have one of the best-ranked health services, despite not being the highest-spending nation. The highest-spending nation is probably the United States, which has a lousy health service Having said that, we need to make the user more aware of the costs of the service, as my noble friend Lord Brooke said. In many previous debates, I have suggested that every user of the NHS be given an annual return showing what they have used it for and how much that has notionally cost the NHS. They should be made aware that even if they miss an appointment it costs money. Whatever they have had, somewhere it has been paid for. They do not have to pay for it themselves, but they ought to be made aware that there is a cost to each thing that they do or indeed do not do. At the same time, we ought to provide people with another sheet of paper showing how the total NHS money is spent, just for information. People ought to understand what their money goes on. Right now they do not understand, and they take it for granted I shall say just one more thing because my time will be up very soon. We have made all sorts of predictions about what proportion of GDP should go on health. I can more or less tell the House, with all the certainty that I can command, that the era of high growth is over and that for the next 10 or 15 years the GDP growth rate will not be high, and nor is inflation. Whatever we do, we will have to find ingenious ways to achieve efficiency, perhaps by nudging users to be more economical with their use of the NHS, and somehow changing behaviour so that we do not always take for granted that there will be more money, and if there is not more money, it is someone’s fault. One of the last—no, I do not think I have any more time.
National Health Service — House of Lords, 2016-01-14
Topic: Health
Bhikhu Parekh (Labour, Centre-left): My Lords, I thank my noble friend Lord Turnberg for introducing this debate with great wisdom and erudition. While I entirely agree that the principle underlying the NHS is noble and widely acclaimed, in practice it leaves much to be desired Noble Lords have concentrated on funding and other things but I want to concentrate on the more elementary aspect of some of the practices that characterise the NHS. It is very striking, for example, that doctors are inundated with paperwork so that they have hardly any time to talk to their patients or spend much time with them. It is also striking that when a GP refers a patient to a consultant, the consultant’s letter does not arrive until about two or three weeks later, either because—so I am told—he does not have the typing facilities or because he would not use electronic devices to communicate with the GP. I cannot understand why this sort of thing should go on in this age As we have talked about our ageing population, it is worth bearing in mind that more and more of our people suffer from Alzheimer’s, dementia and other conditions. The result is that they forget to take many of the medications prescribed for them, or for some reason they take it earlier when they feel ill and stop when they begin to feel better. It may be a good idea to remind them in some way from time to time that they have forgotten to take their medication. I gather that some experiments are being done, and there is no reason why the NHS cannot be technologically more imaginative. Why can blister packs, for example, not be devised so that they warn patients at the appropriate time that they should be taking their medication? Or, for example, why should chemists not be able to monitor whether a particular medicine has been taken by a patient and, if necessary, ring them up and tell them they should be taking it? Therefore, technologically, we ought to be able to produce smarter and more sophisticated packages of medication than we do. My third point has to do with some of the infrastructure of our surgeries, some of which are located in old terraced houses. Doctors would love to provide all kinds of services but they are unable to do so because of the cramped environment in which they have to function. I cannot see why local authorities and other bodies cannot provide purpose-built medical facilities where GP services can be housed. This would mean that GPs could provide the kind of services they would like to and patients would not be cramped and would feel much more comfortable My last point has to do with the way the Government have treated junior doctors. Doctors remain our main asset, and if they are alienated and feel resentful they may leave in large numbers, which would be no credit to our society.
National Health Service — House of Lords, 2016-01-14
Topic: Health
Lyndon Henry Arthur Harrison (Labour, Centre-left): My Lords, like the noble Baroness, Lady Ludford, I too will concentrate on diabetes, which absorbs 10% of the national budget—some £10 billion—which will inevitably grow as we move from the current figure of 3.5 million diabetics to some 5 million in 2025. We have epidemics of type 1 and type 2 diabetes. I report from the front; as a high-risk foot person with diabetes I attend a monthly podiatric clinic. Those lists are now being slimmed, including for diabetics. The clinic tells me that it is as worried as anything because future problems, which inevitably arise from diabetics with poor feet, will not be identified. Similarly, I stand here today because I benefit from the shoes that are made for me in Liverpool to protect my feet because of the neuropathy I have—I have no feeling in my feet. That enables me to stand here today and enables other people to be economically active. We must not contract these services, as is now happening, with delays falling upon delays Diabetes UK has identified that four out of 10 diabetics do not get the necessary care processes. It has identified that some 135 amputations as a result of diabetes take place every week, when four out of five of those amputations are preventable. What are the Government doing about that startling statistic? The Diabetes Think Tank also recognises that 95% of diabetic care is self-administered, and we should concentrate on this area. However, in January two years ago for some reason the Government gave up the Patient Experience of Diabetes Services survey, which had been so useful in analysing what diabetics felt about the services they received. I therefore invite the Minister, as I did when he first came in, to attend the Diabetes Think Tank, and I hope that he will be able to attend it. I commend what my noble friend Lord Turnberg said in introducing this debate, that there are enormous opportunities in sharing best practice with our colleagues within the European Union which we are about to neglect I finish on an optimistic note. When I was declared a diabetic in 1969, they said, "You’ll get a medal after 40 years if you survive that period". I can now report that I have long been past the 40-year mark, but an 88 year-old type 1 diabetic has recently received the HG Wells medal—he was a diabetic—for surviving for 80 years.
National Health Service — House of Lords, 2016-01-14
Topic: Health
Parry Mitchell (Labour, Centre-left): My Lords, first, I thank my noble friend Lord Turnberg for securing this debate. He is not only my noble friend but a personal friend. Few have committed more to the NHS than him. To the noble Baroness, Lady Watkins, I can say, "It’s over. You can relax, and you did really well" I speak as a parent of a junior doctor who qualified at the University of Nottingham and now is a resident doctor at NYU medical centre in New York. It might be interesting if I were to compare and contrast aspects of the two systems as seen through his eyes The first aspect is the teaching. At NYU each resident receives around 14 hours of high-powered classroom teaching each week. The regime is free food, phones off, high concentration. Lectures are given by specialist consultants. As he puts it, "Every day I lunch with giants". At Nottingham he was lucky to get two hours per week As for attitude, at NYU he feels a valued member of the team; in the east Midlands he and all his colleagues felt underappreciated. Most NHS medical staff were disgruntled and demotivated. Of his colleagues in Nottingham, a third either left the profession or went to work abroad. Each one had cost the NHS £300,000 to train but, when they left to go elsewhere, no one noticed, no one took responsibility, there was no exit interview and no one cared Then there is the pay. In his final year in Nottingham, he earned about £40,000. It is true that his basic pay was £23,000 but, with unsocial hours banding, the pay soon mounted. At NYU he earns $60,000—exactly the same amount—but in the United States almost all junior doctors carry student loans in the region of a quarter of a million dollars, and repayment starts immediately Finally, there are the hours. Last month in New York, he worked 80 hours per week, as he has done every month. He works six days every week, including many weeks on night shift. Even on daytime shifts, he leaves home at 5 am and often gets home at 8 pm The American junior doctors are the ones with really unsocial working hours. They are the ones who struggle to make ends meet and the ones who should be complaining, but there are no picket lines to be seen on First Avenue and 32nd Street. The question is why? Let me hazard a guess. In much of the UK, junior doctors—indeed, even senior doctors—are treated as objects: cogs in the wheel or items on the spreadsheet to be moved here and there at will. There seems to be little realisation that to get the best out of people you have to encourage them, you have to integrate them as part of the team and, most of all, you have to make them feel valued. It is called leadership. Looking at this junior doctor crisis, there seems to be little of that in evidence in our NHS but it is what we really need.
Syria: Madaya — House of Commons, 2016-01-11
Topic: Defense
Brendan O'Hara (Scottish National Party, Centre-left): It is a terrible irony that, on the day that the UK Government announce the first use of Brimstone missiles—the ones we are told minimise civilian casualties—we are forced to watch children starve to death in Madaya. If the convoys do not get through, does the Minister agree that if we have the ability to drop bombs, then surely we have the ability to drop bread?
Armed Forces Bill — House of Commons, 2016-01-11
Topic: Defense
Kirsten Frances Oswald (Scottish National Party, Centre-left): The SNP fully supports the new clause and its aims of creating accountability and ensuring the speedy implementation of the compensation. We are supportive of its efforts to raise awareness and to move at some speed It is inescapable that there has been real inequity in how we have treated veterans suffering from mesothelioma. I entirely agree with the hon. Member for Blaydon (Mr Anderson) that until now the situation has not been consistent with the military covenant and has not been an appropriate way to treat our armed forces As we have heard, this is a matter of urgency because veterans who are suffering from mesothelioma simply do not have time for us to delay. The campaign run by the Royal British Legion has been incredibly effective. It is right to highlight what a terrible disease mesothelioma is and the injustice of this situation The tragedy of a mesothelioma diagnosis cannot be overstated. As the hon. Member for South Antrim (Danny Kinahan) said, veterans and their families in this situation do not have time to spare. While rectifying this unfair treatment will not make anyone who is suffering from the disease any better, it may well improve the quality of the life they have remaining and it may mean less anxiety about those they leave behind Ensuring that there is a swift process and a campaign of awareness would be useful mechanisms in allowing us to deal better with our veterans as we should, so we fully support them. I call on the Government to look just a little further and to deal fairly with the group of about 60 veterans who are currently in receipt of a war disablement pension by allowing them to access this contribution. That would simply be the right thing for the Government to do.
Zika Virus — House of Lords, 2016-02-02
Topic: Health
Raymond Collins (Labour, Centre-left): My Lords, I thank the noble Baroness for repeating the Answer to the Urgent Question. I welcome, too, the Government’s response, working with Public Health England and the Department of Health to ensure that the public in this country receive clear and proper guidance, particularly those who travel. However, our thoughts must be with those affected, with 16,000 cases of microcephaly occurring. There is no test, no cure and no vaccine. People are facing a life of disability and poverty Ebola has shown the limitations of the global community’s approach to heath emergencies and it triggered a huge debate on how we should reform the WHO to make it fit for purpose. While I, too, welcome the speed of the emergency committee’s response to Zika, what steps have the Minister’s department taken in pressing for a review of the international approach to health emergencies, incorporating the function, structure and funding of the WHO? I am particularly concerned about the expectations and role of major donors. I note what the Minister said about Britain’s contribution but our part in this must be to encourage others to do more. This crisis also underscores the importance of investing in a strong system of research and development for global health. We had a debate on neglected tropical diseases in which we highlighted this issue. On a point of clarification, in relation to the additional funds being made available through the Ross fund and the Gates Foundation, it was not clear whether there would be additional money for the development of vaccines. I would be grateful for an answer on that.