argyrotsipi/train-dataset huggingface dataset:
Access to Medicinal Cannabis — House of Lords, 2019-04-09
Topic: Health
Meral Hussein-Ece (Liberal Democrats, Centre to centre-left): My Lords, I declare an interest in that my grandson has intractable epilepsy, so we have been through the whole process, and I have some understanding and experience of this issue. He has recently been prescribed Epidiolex after a long struggle for him to be allowed to use it. Over the past few months, we have seen some incredible benefits from it. Does the Minister accept that rather unfair barriers have been put in place as regards access to this drug for children? I have heard of other cases where the British Paediatric Neurology Association, which she has mentioned, has said that Epidiolex, which is manufactured without THC, could be used for the treatment of childhood epilepsy as long as all other treatment avenues have been explored, including brain surgery and VNS. My grandson has had this treatment, where a device is attached to the spinal cord. These are incredibly invasive, dangerous and risky procedures. Surely it would be better to allow Epidiolex to be tried out rather than insisting on other routes? One mother told me that they are insisting that her child has brain surgery first. That cannot be right.
Birmingham Commonwealth Games Bill [HL] — House of Lords, 2019-07-09
Topic: Health
Dominic Hubbard (Liberal Democrats, Centre to centre-left): My Lords, on Amendment 14, I am afraid that steroid abuse is growing in this country, not just among professional athletes but generally among the population and the lower tiers of athletics—rugby union suffered in Wales from too much of it, and there has been a little bit of a hotspot down there. There is also the matter of body image. Okay, it may be the drug of choice for only a period of time, but we have had to take action. Indeed, the Liberal Democrats and the Minister have had a wonderful exchange about "Love Island" on various points about this, because it was quite clear that people on that were very pumped up from using unregulated drugs. There is a problem with steroid abuse and body mass-building drugs in this country at the moment. It would be interesting to hear, through the vehicle of the noble Lord’s amendment, about the Government’s current thinking on this. There will be considerable disagreement over whether criminalisation is the right way forward. However, some form of strategy is clearly required, as is some form of intervention, even if it is just better education around this. But surely the fact that athletes are getting away with this at an elite level is not helping.
Learning Disabilities Mortality Review — House of Lords, 2019-05-15
Topic: Health
Judith Anne Jolly (Liberal Democrats, Centre to centre-left): My Lords, I should declare my interests. I am chairman of Hft, a learning disability charity which cares for more than 2,000 adults. I thank the Minister for repeating the Statement and understand the limitation of her responses, but I am not sure that the Secretary of State’s words will console parents and other relatives of someone with a learning disability. If the Secretary of State were to take immediate action on any part of the leaked report, I should like it to be on the issue that the noble Baroness, Lady Thornton, just raised about "do not resuscitate" orders No one dies from a learning disability or Down’s syndrome. The reason for the annual report is to identify why people with learning disability die much earlier than the population average. Why and how well-trained doctors do not know and appreciate that appals me. Can the Minister put a note in the Secretary of State’s in-tray to suggest that this might be an area to look at urgently and remedy quickly? Can she ask him to ensure that all doctors in training learn to care for people with a learning disability, and that that is regularly refreshed as part of their ongoing professional development? Will she flag up to him that I look forward to discussing the report with him as soon as it is finally published?
Healthcare (International Arrangements) Bill — House of Lords, 2019-03-12
Topic: Health
Timothy Francis Clement-Jones (Liberal Democrats, Centre to centre-left): My Lords, that was exactly the kind of robust response from the Minister that I was hoping for. It is very rare that I listen to a government response and nod all the way through, so I thank her for that very careful response, both on the Caldicott principles and the framework for data ethics, and for going into the accountabilities, and the affirmative procedure guarantee at the end—that was a bouquet. It is not that we on these and other Benches do not understand the value of NHS data and the real importance of that balance. This is not designed as a negative approach to the use of NHS data; it has huge potential benefits, but we have to make sure that it is kept within that ethical framework. The Minister has demonstrated that that kind of culture is ingrained—or is certainly expected to be ingrained—in the NHS and that Caldicott Guardians, post 1 April, will be very much on the case. In those circumstances, with pleasure, I beg leave to withdraw my amendment.
Healthcare (International Arrangements) Bill — House of Lords, 2019-03-12
Topic: Health
Sarah Virginia Brinton (Liberal Democrats, Centre to centre-left): My Lords, I support the amendment moved by the noble Baroness, Lady Thornton. Without repeating our debates at previous stages of the Bill, it would be helpful to have reassurance from the Minister that the content of the list in the noble Baroness’s amendment is exactly the sort of detail we need. It is important to reassure people on exactly how any financial arrangements for healthcare will be made.
Human Medicines and Medical Devices (Amendment etc.) (EU Exit) Regulations 2019 — House of Lords, 2019-09-30
Topic: Health
Christopher Rennard (Liberal Democrats, Centre to centre-left): My Lords, I begin by declaring my interests as in the register. My work with the British Healthcare Trades Association has identified concerns among the manufacturers of medical devices about what might happen with the future regulation of their products as a result of Brexit The regulation of medical devices and medicines is, of course, very necessary to protect patient safety, and it enables businesses to sell their products in the UK market, the much larger EU market and overseas. The evident need for the technical amendments that we are now considering suggests that the Government’s preparations to leave the EU are being made in great haste. It is also clear from them that there will be no benefit to anyone in changing the basis of the existing provisions for the regulation of medicines and medical devices Most countries recognise the great worth of current EU standards when they consider whether to allow products to be imported and sold to their citizens. If we leave the EU on 31 October, existing products that have been approved by the EU regime will of course continue to be approved, but surely problems will arise with new products as standards diverge in future—as inevitably they will. Will the Minister therefore say something about the potential impact of this legislation on the innovation of medicines and medical devices? British businesses will in future have to apply for licences to UK authorities if they want to sell new products here, and they will also have to seek approval from EU bodies if they wish to sell those new products in the European market and in the many other countries that already respect EU standards. This will mean two application processes, a potentially longer wait for approval and two sets of costs incurred in securing approval for new products Does the Minister accept that some businesses will feel inhibited in seeking approval for new products on that basis, that they might be tempted just to continue trying to sell old products that have already been approved, and that such inhibition might have a damaging impact on patient care and on the capacity of businesses to grow, especially if they seek to export new products? Will the Minister say something about how this impact on innovation might be ameliorated Most fundamentally, will the Minister confirm that leaving the EU on a no-deal basis will mean that we deny ourselves, and the rest of the EU, the benefits of sharing costs and expertise concerning the regulation of medicines and medical devices? Furthermore, does he accept that in the long run we need to work towards greater worldwide acceptance of standards to avoid new products requiring the approval of multiple agencies in the UK, the EU and elsewhere?
Northern Ireland (Executive Formation) Bill — House of Lords, 2019-07-17
Topic: Health
John Alderdice (Liberal Democrats, Centre to centre-left): As someone who had to work with the guidance before the legislation came through— and this is for reassurance to colleagues—I know that the problem was that the medical profession had to work without guidance for a long time. What happened was that the guidance was introduced partly to satisfy—
Northern Ireland (Executive Formation) Bill — House of Lords, 2019-07-17
Topic: Health
Elizabeth Barker (Liberal Democrats, Centre to centre-left): My Lords, I thank all noble Lords—particularly the noble Baroness, Lady O’Loan—for their contributions. It is extremely important that we have discussed these matters in the fashion that we have. At this late hour, I do not intend to say anything in great detail. I thank the Minister for the very thorough way in which he has addressed questions from all sides of the House. He has managed to put to rest a number of fears There are just three matters on which I need to respond. The first concerns Amendment 19A in the name of the noble Baroness, Lady Finlay. In the light of comments—not least those of my noble friend Lord Steel—I hope that she will understand why it would be inadvisable to go ahead with her amendment, and I hope that she will not press it The second and key point, made by a number of noble Lords, was whether there would be an interregnum in which there would be no regulation whatever on abortion in the Province. The answer to that is quite clear: there will not be. Notwithstanding what the Minister has said about what the Government intend, there are the professional ethics of bodies such as the RCOG, the RCGP and the Royal College of Midwives. Those bodies have backed this amendment but they have professional standards to which they must adhere. There is also general guidance in general medical law which would be unaffected by any of this Thirdly, I say to the noble Lords who pointed out the anomalies between different Acts of Parliament in relation to 24 or 28 weeks that that makes the case for updating the law, and this is an occasion on which we could do so. I take the Minister’s point about his problem with the deadline in my amendment, and I hope that we might be able to discuss that between this stage and the next This is an important matter and we have had an important debate. I therefore wish to test the opinion of the House.
Personal Independence Payments — House of Lords, 2019-07-23
Topic: Health
Celia Marjorie Thomas (Liberal Democrats, Centre to centre-left): My Lords, is it not clear, in the light of this and other judgments, that the PIP descriptors in the field of mental health need substantial amendment? It sounds as if that is what the Government have in mind, and I am very pleased that the department is upholding the judgment as much as the rest of us. We really need a cool, hard look at all the descriptors, and for the Government to consult on them fully and come back with detailed amendments. We also need better-trained assessors and a genuine stage of mandatory reconsideration, instead of the rubber stamp that we all too often get now. There is a huge number of successful appeals and consequently an unacceptably long wait for a tribunal hearing.
National Security Capability Review — House of Lords, 2018-01-15
Topic: Defense
Menzies Campbell (Liberal Democrats, Centre to centre-left): As far as I am concerned—and perhaps this is in the mind of others—the word "realistic" conveys a certain ambiguity. I appreciate that the Minister is unable to go into detail about what the defence proposals may amount to, but I ask him as a matter of principle to agree three things: that it is necessary in a defence review, first, to state clearly your foreign and defence policy objectives; secondly, to determine the military resources needed to meet those objectives; and, thirdly, to provide the funding to ensure that those military resources are delivered. It is being said that the defence review is fiscally neutral. If that be so, how can all three of those principles be met?
NHS and Social Care: Winter Service Delivery — House of Lords, 2018-01-25
Topic: Health
Elizabeth Barker (Liberal Democrats, Centre to centre-left): My Lords, I thank the noble Baroness, Lady Wheeler, for the opportunity, as the noble Baroness, Lady Pitkeathley, just said, to return again to this subject. I will not make a long speech as I would like to leave as much time as possible for the debate that will follow. On behalf of my colleagues on these Benches, I wish the noble Baroness, Lady Jowell, all the very best and ask her colleagues to convey that to her The noble Baroness, Lady Pitkeathley, is right: we have been back to this ground so many times. In preparing for this debate, I thought back to many of the debates that we have had in the past. The origins of the problem we are looking at go back to the National Health Service and Community Care Act 1990. In that Act, for the very first time, welcome things happened: we began to break down procedures within the NHS and to cost and quantify them. But the problem was that we made them into individual units of activity, and to this day, within the NHS, the systems that join up those individual units are failing. They fail completely when they have to be matched up with the social care system, which is completely different Those problems were identified and partially addressed in 2003 with the Community Care (Delayed Discharges etc.) Act, when the then Minister, the noble Lord, Lord Hunt of Kings Heath, was sitting there trying to answer questions from very talented opposition spokespeople such as me. We asked him a question that he never could answer, which was why the then Government thought that the answer to the problems in the NHS was to fine social services departments. I never understood that. We still have, within the whole system of discharge, a system of penalties.
NHS and Social Care: Winter Service Delivery — House of Lords, 2018-01-25
Topic: Health
Elizabeth Barker (Liberal Democrats, Centre to centre-left): The issue that I think the Government were trying to solve was one for which we have never had any evidence: that of local authorities trying to game the system. It is correct that the overall amount of funding has gone down, but we have not had evidence of people gaming the system We have never had a system, or even part of a system, that incentivises GPs and those in charge of social care to prepare for winter pressures, invest in programmes that will see older people through the increased incidence of illness that we know happens in winter, and avoid unnecessary admissions to A&E. What has changed in that time is that we now have better data and better information systems, but in many ways we are still failing to take all that and improve those systems. At the moment we still have ambulance services being rated on completely different systems across the country so we cannot generate data The Government have done some things that are very welcome. Everyone agrees that the primary care streaming system, into which they put £100 million, is a worthwhile initiative. Unfortunately, the initial evidence is that it is failing simply because it takes people from another part of the system—GPs—and locates them in hospital. What are the Government going to do to properly monitor that system in its entirety as part of an overall approach to winter pressures, to see whether it is worth more investment or whether it simply takes resources from other parts of the system On the question of beds, we have a national system of monitoring general and acute beds and ways of measuring the overall occupancy rate. We do not have a method of assessing the number of beds in relation to need. For example, we can open up a load more beds, as the NHS always does at times of crisis, but if there are no more staff to look after the people in those beds then we are not really addressing the need. We need to refine the measurement of this so that we have a metric along the lines of "nurses per bed per day". That is the point at which things become really bad. I remember talking to a nurse about a patient—actually my mother—and being told that she was far too good to be in hospital and would be going home. She died two days later, which was not a surprise to any of us. I say that because it is not an uncommon experience for patients We have been through this time and again. The one thing that we have failed to do is incentivise GPs to work with community organisations from the summer onwards to predict the people in their area who are going to be most at risk and to put in place very low-level, simple and low-cost packages of care for them that can be there very quickly when they are discharged. The biggest cause of delayed discharge is not the absence of social care but the absence of community nurses and NHS staff available to work in the community to ensure that we do not send people home only to see them return unnecessarily into acute care.
Education (Student Support) (Amendment) (No. 2) Regulations 2018 — House of Lords, 2018-05-21
Topic: Health
Susan Garden (Liberal Democrats, Centre to centre-left): My Lords, I rise to speak briefly in support of the noble Lord, Lord Hunt, and my noble friend Lady Walmsley, who set the scene very comprehensively for us. I note that these regulations came into force on 7 May, so presumably any impact we can have on them is going to be retrospective at best I share the concerns about adults coming back into the nursing workforce. They will be more risk averse but by and large they are invaluable members of the nursing community, so putting them off seems extremely foolish. I also share the concerns of the noble Lord, Lord Clark, about the apprenticeship route, which obviously has got off to a very slow start. I think that the health fraternity is finding it complex working out how the apprenticeships are going to fit in. In due course degree apprenticeships may be able to take up some of the slack, but it will be a long time before that happens and certainly it will not be quick enough to solve the nursing shortfall that we are experiencing at the moment Equally, as the noble Lord, Lord Clark, also said, we must take into account the fact that EU nurses are leaving in droves at the moment because they find this country unwelcoming, as indeed are EU workers in a number of other sectors as well. That situation is not going to get better. I will therefore add my voice to those asking for a delay in implementing these damaging proposals until there has been time for a full impact assessment, or at least until the review of post-18 education and training has reported. The NHS is too important to be left to chance like this, and with a crisis in the nursing workforce, this is not the time to embark on measures that will do nothing but worsen the position. I urge the Minister to think again.
Immigration White Paper — House of Lords, 2018-02-05
Topic: Health
Brian Paddick (Liberal Democrats, Centre to centre-left): My Lords, presumably the Minister will have seen the political coverage over the weekend about the damage caused by the uncertainty over Brexit, not least to the National Health Service, which EU nationals are leaving because of the uncertainty. From a situation where they felt they had some certainty, we now learn that there is no certainty during or after the implementation period. The Minister talks about there being plenty of time, but the longer the delay, the more people will leave. What further damage does the Minister believe this delay and the publication of this White Paper will cause to an already understaffed and underresourced National Health Service?
NHS Winter Crisis — House of Lords, 2018-02-05
Topic: Health
Judith Anne Jolly (Liberal Democrats, Centre to centre-left): My Lords, this morning I visited a suburban hospital in London, with an almost brand new A&E unit and a well-managed winter crisis. But despite all that, it has still had to face a bed occupancy rate of 97% on several days, which is stretching its ability to make this work. Money was clearly an issue—the hospital was quite anxious about what its end of year accounts might look like. Today, the Liberal Democrats launched a report looking again at a different way of funding the NHS through the creation of an office of budget responsibility for health and care, long-term health and care funding, and a ring-fenced tax to replace national insurance. Also, there is a clear need for some sort of short-term fix, and we have suggested that £2 billion should be raised by adding a penny to our income tax. Has the Minister looked at this report and will he agree to meet with me to discuss it?
Breast Cancer Screening — House of Lords, 2018-05-03
Topic: Health
Kishwer Falkner (Liberal Democrats, Centre to centre-left): My Lords, the Minister mentioned that the Government will be looking at public information campaigns to ensure that women who may not have captured the periodic screening letter that is sent out would be aware that they need to take the initiative themselves and find out if they should have been screened. But, if I understood him correctly, when the Minister gave the figures in the Statement, 270 was the upper limit of deaths that would have been caused. If that is the case, I am slightly perturbed in terms of frightening people. He would probably accept that, whatever the figure, it is impossible to be precise about the number of deaths that "would" have been caused. Perhaps he meant to say "may" have been caused—because screening of itself does not cure breast cancer. That is an important distinction to make.
Defence Modernisation Programme — House of Lords, 2018-01-29
Topic: Defense
Menzies Campbell (Liberal Democrats, Centre to centre-left): My Lords, I join in the congratulations to the noble Earl on his birthday and thank him for repeating the Statement. He must feel, to some extent, that today is a rerun of the discussion we had last Monday. On these occasions tribute is often paid to the Armed Forces, but I have a question on that. What evidence is there of any impact on recruitment and retention as a result of the uncertainty that has surrounded these issues? I also remind the noble Earl that, as some of us in the House will remember, a lot of the language in the Statement is very similar to what we saw and heard in Options for Change and Frontline First. We know that the outcome of both exercises was a substantial reduction in defence expenditure and hence in capability as well There are only two passing references to NATO. I press the noble Earl on how far, and to what extent, interoperability with NATO and our other allies will lie at the very heart of the exercise it is now proposed to carry out. As has been said on a number of occasions in response to questions in the other place, the Secretary of State asserted that the exercise would not be fiscal-neutral. Last Monday the noble Earl rather adroitly avoided answering my question as to whether he agreed with the Secretary of State, and indeed the head of the Army, that more money needs to be spent on defence. I offer him another opportunity to answer that question and I hope he will forgive me if I ask: yes or no?