argyrotsipi/train-dataset huggingface dataset:
Nursing and Midwifery (Amendment) Order 2018 — House of Lords, 2018-06-25
Topic: Health
Francis Hare (Crossbench, Unknown): My Lords, the noble Baroness, Lady Thornton, and the noble Lord, Lord Willis, asked about the impact of this new profession on the wider healthcare workforce. I wonder whether it is helpful to ask the Minister at this point a little about possible impact, if any, on heath visitors. There is real concern about the decline of health visitors; they had a resurgence in recent years but are in serious decline now. I do not wish to detain the House for too long if this seems a bit beyond the main business I am a patron of the charity Best Beginnings, which provides mental health and perinatal support for parents. I spoke with the chief executive last week. We recognise that health visitors are very important, as healthcare professionals working in the vital perinatal period to ensure the best attachment between parent and child. I recently spoke with the president of the Institute of Health Visiting, Dr Cheryll Adams. Again, she expressed concern about the decline of the number of health visitors. As we establish a new healthcare profession, do we not need also to think about this other, declining profession under the healthcare umbrella I imagine that there is no plan to replace health visitors with these new healthcare professionals, but sometimes there is a misunderstanding that health visitors are just there to weigh the baby, when anyone could do that. In fact, when family-nurse partnerships were introduced to support vulnerable parents, the outcome was significantly better when higher qualified practitioners worked with the families. This job is challenging, because people are often working with vulnerable families in poor housing and poor conditions. It is a demoralising profession, unless one has a good professional foundation I emphasis the importance of the vital early years. As Graham Allen and Mr Field MP have established, the first 2,000 days in a child’s life are the most important. We need to ensure that the best professionals are available to them. Two or three years ago, health visitor funding went from the Department of Health to local authorities. We all know that local authorities have very little money to spend, so it is not surprising that there has been a significant decline in the number of health visitors. Does the Minister recognise concerns about that decline? Will he assure the House that he is keeping in mind the health visiting profession and what can be done to sustain it and ensure its continued health I have a final question. This particular new brand of healthcare professional gives rise to the problem of professionals from the developing world being pulled in to fill the niche. I am sure that the Minister can assure us that we will not poach healthcare professionals from Nigeria, Ghana and elsewhere, but the possible risk of that certainly comes to my mind. I welcome the order and I look forward to the Minister’s response.
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-10-22
Topic: Health
Molly Christine Meacher (Crossbench, Unknown): My Lords, I feel that I should contribute to this debate although I have no speech prepared because, in the discussion with Sir Simon Wessely that I referred to last week, I challenged him about this issue. I asked what we were doing by debating this Bill before his review came out. He was clear and while I cannot say what he is proposing, maybe I can indicate the sort of areas he is looking at. These may help to illuminate the clear differences in certain ways between the two sets of debates and legislation. For example, he is looking at the role of the Ministry of Justice in relation to people under restriction orders. There are specific mental illness issues in that area. He is looking at how community treatment orders operate—there might be less use of such orders—and how detentions in hospital for people with psychotic illnesses operate, and so on. Those areas are, in general, probably quite distinctive to the Mental Health Act. The bit where I feel there really is a potential overlap is in the area of mental health tribunals, which I will raise when we come on to deprivation of liberty concerns in the context of specific domestic situations. I will have a proposal to make then. I will not go into it here, as it would not be appropriate Sir Simon Wessely’s position is clear: he feels that the Mental Health Act needs reform and I think he will have very interesting proposals to make about that. We also all agree that the DoLS system needs reform and we are discussing how that should be done. What he is doing and what noble Lords are trying to do here are both quite complex sets of reforms. Sir Simon Wessely’s view—I hope that he would agree with me—is that these two sets of reforms need to be in place for quite a period. He talked about a decade, actually. There is also the Northern Ireland situation; there are proposals for some bringing together of these things there. There is of course no government in Northern Ireland but Sir Simon Wessely wants that Northern Ireland Government to be formed and for them to be the pilot of all this and see how that works over a period of years. We would then come forward with some proposals, as and if appropriate, for bringing these two pieces of legislation together I hope that I have represented Sir Simon Wessely properly. It is important for us all to be aware that we do not have the support of the person in charge of the review of the Mental Health Act when we say, "Come on, what are we doing by having this first? Surely it should all be done at once".
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-10-22
Topic: Health
Ilora Gillian Finlay (Crossbench, Unknown): I shall continue on the theme that my noble friend Lady Murphy has set out. Last week, I chaired the National Mental Capacity Forum leadership group. One of the people there said that: "While there was an initial knee-jerk reaction amongst care providers and the local council, if you consider the," liberty protection safeguards, "in more detail you quickly come to understand that it is actually quite an innovative solution", because there is such a backlog and so much difficulty in trying to get anything in place I am concerned that we are trying to draw clear lines between different types of illnesses and conditions when it is pretty impossible to do so. There are mental health conditions that impair your capacity, even though you may be compliant with treatment, there are physical illnesses that result in impaired capacity, and there are illnesses—Lewy body dementia is one of them—where part of the illness means that you may be a risk to other people. Huntington’s disease is similar and a horrible disease to have. Trying to draw clear lines between those different groups is difficult I looked at the amendment and for a definition of "fluctuate" and "short". I tried to think how I would define "fluctuate" or "short" in a clinical context, and I could not because "short" might be short to some people and long to others and fluctuation can be all kinds of directions and with different degrees of severity. The difficulty we are grappling with here is that we are trying to write something in legislation that will be literally black and white: black words on a white page. The people we are dealing with are incredibly individual and have very different needs. That is why, returning to our previous debate, the stress on wishes and feelings and on consulting people who know the person becomes incredibly important. We will go on to talk about ways that people can call for external scrutiny because, if they care about the person, they need to be able to do that.
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-10-22
Topic: Health
Ilora Gillian Finlay (Crossbench, Unknown): My Lords, this has been a fascinating debate. I listened very carefully to the speech of my noble friend Lady Hollins. Her experience shone through, and there was much wisdom in her comments. I worry that perhaps in this and the previous group of amendments we have not adequately focused on the need to support the cared-for person as much as possible in making their own decisions and in supporting them. I can envisage a situation where the appropriate person has limitations for whatever reason and it would seem very sensible that they were then able to request an IMCA be appointed However, just on the other side of it, we must not forget the enormous burden out there already. Only last week I spoke with a brain injury case manager, Dr Mark Holloway, who works with a care home. He said he is currently managing 13 cases of clients with acquired brain injury who are awaiting DoLS approval from the local authority. Despite the efforts of the care home staff and their solicitors, they have not been able to get this through. We must not lose sight of the fact that the current system is, quite frankly, completely failing. He was saying that they have worked very hard to make sure that it is the least restrictive option, but he is concerned at the lack of scrutiny of their decision-making. In their efforts to acquire DoLS authorisations, the care home staff have sought and paid for expert legal advice on multiple occasions to support them constructing clear and evidenced capacity assessments. He stresses the difficulty of assessing capacity in acquired brain injury and the need to assess function: not just what is said but how the person is actually functioning—what is done and the complexity of it I hope that we will return to the issues behind this set of amendments, because in a way I do not feel that we have done justice to the subject tonight. It does need a bit more discussion outside this Chamber. I beg leave to withdraw my amendment.
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-10-22
Topic: Health
Elaine Murphy (Crossbench, Unknown): My Lords, Amendment 84, in the name of the noble Baroness, Lady Thornton, is possibly one of the most important amendments we have tabled to the Bill. It has become so much more important over the last 20 or 30 years to try to encourage people to make decisions in advance about what should happen to them and to encourage them to think about what will happen in the event of things going wrong—to think about things such as lasting powers of attorney and advance decisions on mental health services. I understand that Sir Simon Wessely will recommend some changes that are very similar to this to go into the new mental health legislation. It would be good, bearing in mind our previous discussions, if we could feel confident that the same sort of approach was being taken in this Bill Advance decision-making in legislation has proved quite difficult to implement, because you have to have a widespread campaign of understanding how people can make these decisions. It also has to have the individual making the decision accept that things will happen to them that they are not expecting, which is sometimes very difficult. That is why it so difficult to get people to sign up to insurance against long-term care; they simply do not believe that it will ever happen to them. It is very difficult to get these bits of legislation implemented and widespread, but we have to start somewhere. This is such an important piece to try to get into a Bill, to start people thinking about their future and what is acceptable. This would be a very important thing for the Bill I would also like to see Amendment 85 implemented. It is something that the Law Commission had in originally. I am not quite sure why it came out. It sort of just disappeared in the transcription somewhere. It is an important safeguard. We tend to forget all those Victorian cases a couple of hundred years ago when people were quite regularly held in circumstances against their wishes and unlawfully deprived of their liberty. It is as well to be reminded that it can, and probably does, still happen quite frequently. To have something on the statute book would be helpful, so I support the two amendments.
Government Vision on Prevention — House of Lords, 2018-11-06
Topic: Health
Ajay Kakkar (Crossbench, Unknown): My Lords, I declare my interests as chairman of UCLPartners and business ambassador for healthcare and life sciences. In repeating the Statement, the Minister focused on the important opportunities provided by genomics and the application of artificial intelligence to transform the landscape for prevention. In answer to a previous question, he identified the importance of trust for the ability to marshal this vast amount of deeply personal data and ensure that it can be appropriately applied for individual benefit and, more broadly, population benefit. In that regard, I make two points to the Minister First, what progress has been made towards achieving that social licence which will ensure broad trust with regard to the mechanisms available and the security of the structures, not only for data collected in hospital but now in the community and the prevention setting, so that it may be shared and applied for individual as well as population benefit? Secondly, there will need to be a substantial investment in skills to ensure that not only professionals who work in healthcare for the delivery of health services but those who will have to engage more broadly in the prevention agenda are able to respond to this vast amount of data, and help individual citizens and patients apply it for maximum benefit.
The NHS — House of Lords, 2018-07-05
Topic: Health
Peter John Hennessy (Crossbench, Unknown): I add my congratulations to the noble Lord, Lord Darzi, on an inspiring opening speech. In the life of a nation, there occur a few ripe, golden days—the kind of day that you want to "bite to the core", to borrow a line from the poet Edward Thomas. Undoubtedly, 5 July 1948 was such a day. The British state came as close as it ever has to institutionalising altruism when the Attlee Government created the National Health Service. As we have heard already, it was shaped by that man of genius and brilliant word power, Aneurin Bevan, who the noble Lord, Lord Morgan, once aptly described as "an artist in the use of power". Its core principle was the pooling of human risk and financial resource—that the National Health Service should be taxpayer funded and free at the point of delivery—which has been sustained by every Government since The National Health Service was, and is, one of those national banners around which my generation rallied, as it has served us since we were in our cradles. No doubt we will still laud it as it eases us towards our graves. Talking about the welfare state in 1948, Nye Bevan said to his Parliamentary Private Secretary, Barbara Castle, who recorded it for me in a television interview 20 years ago: "Barbara, if you want to know what all this is about, look in the perambulators" Given our average age, that encompasses many of us in the Chamber—we very fortunate children of the early post-war period Let us go back to vesting day 70 years ago. More anxiety was lifted off more shoulders on 5 July 1948 than possibly any other single day in British history. It was an extraordinary day. The creation of the NHS was a declaration of great national purpose. Achieving it over seven decades has been freighted from the beginning by the core problem that we have heard much about this afternoon: demand has always outrun the funds available to meet it. We now have a golden chance to tackle that. Let us rally once around the banner of the NHS, the flag that we have rallied around all our lives In this vexing era, when we torture ourselves daily with our differences over Brexit, perhaps here at last is a consensus that is there for the taking. I dearly hope that it will be taken, shaped by that rigorous, realistic national debate of which the noble Lord, Lord Winston, spoke so forcefully. We owe it to the founders of 1948 and the generations who have devoted their professional lives to this extraordinary institution over the past 70 years. This is an hour for seizing.
The NHS — House of Lords, 2018-07-05
Topic: Health
John Bird (Crossbench, Unknown): I am really pleased to be talking in this debate about the National Health Service. I started life in St Mary’s Hospital. My mother, a lovely Irish lady, said that I was the most difficult birth because instead of it taking 10 Woodbines to birth me, it took 20. I should not really be here: I should be dead, because I come from poverty. I am in the House of Lords because of poverty, to try to dismantle poverty and to prevent poverty happening I do not want to sound like Mark Antony at Caesar’s funeral, but talking about the National Health Service raises a number of questions for me. One is: are we talking about the National Health Service or the "I will get you back to health" service? My problem is that when I look around, I look at the big, ugly sun that sets and rises over all of us, which is poverty. According to a friend of mine who worked at St Thomas’ Hospital, 60% to 70% of the people the NHS has to deal with come from poverty. Because they come from poverty, they present their poverty in many ways and one of the big ways is in their health I will quote two human beings. One, John Newton, is the director of Public Health England, who makes the point that 40% of all illnesses that present in hospitals and the National Health Service are preventable and 23% of deaths need never have happened I have a quotation from 1944, from the MP for Rochdale, Dr Hyacinth Morgan, who said: "The whole question of social medicine, with the questions of good milk supply, prevention of disease, good food and nutrition, good housing, good recreational facilities, prevention of mental disability in its early stages—all this has been left out of the White Paper".—[Official Report, Commons, 16/3/1944; col. 494.] Looking at the National Health Service over the past 70 years, I would say that it is an absolutely wonderful invention that has saved many members of my family. I have yet to use it, but, when it does come along, I am sure you will give me a brilliant send-off The point is that, unless we find a way, instead of spending 5% of the national health budget on prevention, to move it mainstream, we will always be worshipping at the altar of the accomplished fact. We will always be dealing with health rather than the terrible reality that exists behind it, which is the fact that we live in a poverty culture; we have poverty capitalism, where the poorest among us have to resort to the kind of food that can lead only to bad health. Until we get rid of poverty capitalism, we are not really going anywhere, and we will be talking about more and more needs for the National Health Service. The National Health Service will become even bigger unless we tackle the elephant in the room, which is poverty.
Space Policy — House of Lords, 2018-07-18
Topic: Defense
David Brownrigg Craig (Crossbench, Unknown): My Lords, I very much welcome the Statement, which is forward-looking and much more proactive than is sometimes the case in this field. Will this site be used entirely for civilian activity or will there be room for Ministry of Defence activity as well, if its northerly latitude does not prevent the launching of MoD-type satellites, which normally go up from nearer the equator?
Health and Social Care (National Data Guardian) Bill — House of Lords, 2018-10-26
Topic: Health
Narendra Babubhai Patel (Crossbench, Unknown): My Lords, I am very pleased to support the Bill. It is a simple Bill, which has been a long time coming. I pay tribute to two friends: Jo Churchill and Dame Fiona Caldicott, both of whom I know extremely well. Dame Fiona Caldicott has been a staunch guardian of the public interest so that patients can have confidence that whenever their data is kept and used, it is secure and used responsibly and transparently. In 1997, after her first review, she established what became known as Caldicott Guardians in every hospital in the land. As somebody who was involved in the use of patient data at that time, I can tell your Lordships that you had to satisfy the Caldicott Guardians—they were no pushover. They were there to make sure that patients’ data was used appropriately and responsibly and that the purpose was clear. It is because of this that all the professional bodies—the royal colleges, the GMC, the researchers and research organisations, and all others—back the Bill It is a simple Bill. It is necessary to put on a statutory basis what has been working extremely well on a non-statutory basis. Following the disestablishment of the national governance board, there was no statutory body to be the arbiter and the guardian of patient data. Putting the National Data Guardian on a statutory basis will provide that. As has been laid out clearly and in detail by the noble Baroness, Lady Chisholm, it is there to give guidance and help and to work on behalf of patients and the public so they can have confidence that the data about them or their health is used appropriately and for a clear purpose. This becomes even more important as we go further in using data to develop genomic information to improve healthcare and to develop things such as artificial intelligence for diagnosis. The National Data Guardian will therefore have an extremely important role to play I support what the noble Baroness, Lady Chisholm, said: we must not confuse the Bill with taking over any of the role of the Information Commissioner, or, for that matter, the Data Protection Act. This is completely different from them. It is focused on health and care data—how it is used and who is the guardian of that information in the public interest. I strongly support the Bill and hope that we will not hold it up in any way whatever. It would be a great pity if the Bill failed because of some misunderstanding of what it is all about.
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-10-15
Topic: Health
Ilora Gillian Finlay (Crossbench, Unknown): My Lords, I have one amendment in this group and I wonder whether the group is focused on lines of answerability. Who is going to be responsible? If the person is in the community in any setting the responsibility will go or should go, as I understand it, to the local authority. If the person is in hospital then it would go to the hospital. However, we have a problem. A lot of people on continuing care funding are in the community. I am concerned that if the authorisation for those people sits with the clinical commissioning group rather than the local authority, we may end up with some people getting lost in the system. The standards and criteria against which the different assessments and processes are benchmarked and what is expected, particularly how the process is monitored, could be unclear. It will be much harder to monitor out in the community than in a hospital or in-patient setting Following on from our previous debate, I had a quick look at the requirements to be a best interests assessor. As far as I can see, to enrol on the course you must have had two years’ post-registration experience as an approved mental health professional social worker, registered with the Health and Care Professions Council, or be a nurse, a psychologist or an occupational therapist. The people who potentially will migrate to become approved mental capacity professionals are registered professionals. That is incredibly important and we should not lose that in any aspect of the Bill. If they are registered professionals they have a raft of professional duties that go with that This part of the Bill and the process is not terribly clear, and I worry particularly about people on continuing care out in the community, or those who may become self-funders, managing their own budgets for care.