argyrotsipi/train-dataset huggingface dataset:
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-10-15
Topic: Health
Elaine Murphy (Crossbench, Unknown): My Lords, I added my name to the amendment of the noble Baroness, Lady Jolly. In view of my previous comments, people may be surprised that I did because it seems to be making life more complicated. In fact, I saw the more professional pre-authorisation process for the smaller group who will eventually be subject to this Act, I hope, as introducing something for the high-risk people who will be assessed by professionals. I like the role of the new AMCP ,which sort of takes over from the best interests assessor, because I think it will be a well-qualified group. It would add some solid support if the care home manager’s role is to continue. I saw this, when I first read it, as a good way of providing some pre-authorisation backstop, if you like—a solid foundation on which we would have more confidence that the care manager role could work. I am still anxious about the care management work for all the reasons that the noble Lord, Lord Hunt, and the noble Baroness, Lady Thornton, mentioned, but this was one way that I saw of adding some professional expertise that would give confidence to the mental capacity community that we were taking this seriously.
Counter-Terrorism and Border Security Bill — House of Lords, 2018-11-12
Topic: Health
Alexander Carlile (Crossbench, Unknown): I promise to intervene only once more. Has the noble Baroness had cited to her projects—and will she tell us which ones if that is the case—that fall into the mistrust category? I have a sense that Prevent is being demonised as a campaigning route and not on an evidential basis.
Long-term Plan for the NHS — House of Lords, 2018-06-19
Topic: Health
Mary Watkins (Crossbench, Unknown): I welcome this additional contribution to the health service. However, have there been overoptimistic algorithms on improving productivity? We know that staff are currently stretched, and to expect continued productivity increases before we invest in modern technology will result in more staff leaving, and that would not be rational.
Modernising Defence Programme — House of Lords, 2018-12-18
Topic: Defense
Peter John Hennessy (Crossbench, Unknown): In the noble Earl’s judgment, what above all in this defence review distinguishes it from its 13 predecessors since 1945? As a footnote, I am greatly interested in the new tauter approach to strategic policy-making, with the new net assessment unit. To enable your Lordships to test the quality of this new approach, I wonder whether the Minister could place in the Library a copy of the new strategic assessment of the high north, undertaken as a pilot project, which is mentioned in today’s document?
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-12-11
Topic: Health
Ilora Gillian Finlay (Crossbench, Unknown): My Lords, I am most grateful to the Government for adopting the principle of the amendment that we put forward on Report and for recognising its importance. I am glad to see that this will be in pre-authorisation reviews and to hear the assurances that it will act as a trigger for all types of reviews and will be put into the Bill when it goes to the other place I also recognise that the Minister has touched on staff induction, which will need to include training on liberty protection safeguards and cover when the review should trigger further action. However, I seek a categoric assurance from the Minister that the code of practice will state that staff will have the full protection of whistleblower legislation whenever they raise a concern, even if, for whatever reason, it does not proceed to initiating a review. I was grateful that during our meetings the Minister openly discussed the possibility of vexatious triggers, although I estimate that these would be very few and that triggers for reviews would involve legitimate concerns about a person’s welfare I also seek assurance that in its inspections the Care Quality Commission will be asked specifically to check that all staff know that they can request a review to be triggered and that they know that they will be protected. In addition, the responsible body, whenever asked to undertake a review, will need to keep a register of all such requests so that an emerging pattern of several requests coming from an institution will trigger a more major review into the type of care provided for everyone there One of the difficulties I anticipate arising at the interface between the Mental Health Act and the Mental Capacity Act is over the principle of objection. Among this cohort of people, objection may not be active; it may be passive. Sitting quietly, being withdrawn and being unhappy should be enough objection for people to consider whether the person should have been placed somewhere different or whether the conditions of their liberty protection safeguards should be altered. I have the impression that the type of objection envisaged in the Mental Health Act review was much more active than this type of passive objection, which could be interpreted as consent The other worrying aspect relating to this Bill and to the entire mental health review is the acute shortage of accommodation for people, both in the short and long terms. There is a shortage of suitable accommodation for people in crisis and of long-term accommodation that can meet people’s needs. Some are therefore accommodated in places not really adequate for their needs, but there seems to be no other option I repeat my gratitude to the Minister for having listened and brought forward this government amendment, and for all the other amendments that have gone into the Bill and have brought about substantive changes. I look forward to hearing those reassurances in his response.
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-11-21
Topic: Health
Mary Watkins (Crossbench, Unknown): My Lords, I support this group of amendments and I am delighted that the Minister has had his mind changed. Not using this phrase will change how people feel about their relatives who may be suffering from mental disorders. I am also optimistic that, in the longer term, using such modern nomenclature will make mental health professions more attractive to young people.
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-11-21
Topic: Health
Ilora Gillian Finlay (Crossbench, Unknown): My Lords, I also welcome these amendments; removing "unsound mind" is a major step forward. I have a couple of questions for the Minister and I hope he can clarify. I may have misheard him but I understood him to talk about head injury. It would be helpful if he could clarify that he was referring to acute head injury—or acute brain impairment of any sort—as opposed to long-term damage such as frontal-lobe damage, which can happen when you have had a major brain injury. This can result in very long-term problems and difficult behaviours, which may mean that people currently need to be assessed as subject to deprivation of liberty. Could he clarify that we are not discounting a whole group of people who, it is generally felt, benefit from being properly assessed and safeguarded I would also like confirmation from him on another group. In January 2015, the then Mental Capacity Act deprivation of liberty safeguards policy lead in the Department of Health wrote out quite widely. There had been a concern about people who were nearing the end of life, including palliative care patients and patients in hospices. It was made clear in this letter that if somebody had consented to a care package and then went on—as part of their disease process when they were dying—to need some restrictions, and possibly to be moved to another place of care, that would not fulfil the acid test as such; neither would it in the case of people who were being nursed in a side room who were not under continuous supervision and control. The reason was that, in palliative care cases, there is often a time when the family cannot cope as the patient becomes unconscious, is moved to a hospice or develops another condition that had not been anticipated. It would be an inadvertent consequence if this letter from January 2015 no longer stood. It has been important and has made care easier. It was following this letter that we were able to change the regulations for what had to be referred to a coroner. That made a major difference, because families found it terribly traumatic to find a relative subject to a deprivation of liberty safeguard having to be referred to a coroner. I simply seek clarification on those two issues, but I in no way question the importance of removing "unsound mind" from the Bill. I hope this is the beginning of us seeing the end of that term, which is stigmatising.
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-11-21
Topic: Health
Sheila Clare Hollins (Crossbench, Unknown): My Lords, I welcome the replacement of "unsound mind", but I ask the Minister to consider adding a safeguard to ensure that no one has their liberty denied because of a mental disorder without first being seen by a qualified doctor. It is essential that individuals are assessed for a mental disorder and not another condition presenting as a mental disorder, such as delirium or the side-effects of medication, which are common among older people. It is important that consideration is given to whether the disorder can be managed without depriving the person of their liberty. This requires assessment not only of their mental state but of their past and current physical health and medication. The assessment is a core part of this process. It has great significance because it relates to the deprivation of a person’s liberty. Who can carry this out should be stipulated in the Bill rather than in a code of practice. I ask the Minister to reconsider bringing forward an amendment to add this requirement to the Bill.
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-11-21
Topic: Health
Ilora Gillian Finlay (Crossbench, Unknown): My Lords, there is a tone of disappointment because I welcome all the government amendments, but the role of my amendment to government Amendment 52 was twofold. First, I am disappointed that speech and language therapists were not in that list read out by the Minister, because we had a debate about the importance of communication skills. When communication is impaired, particularly with disorders that affect any part of the speech or throat cycle, it is very difficult to assess someone’s capacity I included skills because I worry that experience and knowledge are sometimes just not enough. If the Government insist on "skills" going into the code of practice, I hope that the Minister will be able to confirm that the skills will be assessed and reviewed at appraisal, and that they demonstrate an understanding of the impact of fear—being frightened—on the way the person behaves The assessorsmust have a high level of communication skills and awareness of all the different ways that communication can be enhanced. I hope that they would also have an awareness of the impact of different types of medication on someone’s capacity, because sometimes changing the medication can really improve a person’s ability to make a decision for themselves Amendment 53 links to Amendment 74, which is in my name and will come up later. I am concerned that, without strong reassurance, some of these issues could slip by and we could inadvertently end up having superficial assessments of some people and not the thorough and in-depth ones they deserve. The whole principle of the Mental Capacity Act is to empower people to make their own decisions, and we are talking about trying to have the least restrictive option so that we can enhance a person’s liberty as much as possible. If that assessment is not meticulous with the appropriate skills, the wrong judgments could end up being made.
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-11-21
Topic: Health
Molly Christine Meacher (Crossbench, Unknown): My Lords, I put my name to this amendment and I very strongly support it. Having been a Mental Health Act commissioner for many years and having visited independent hospitals as well as NHS hospitals and other establishments, I remember those independent hospitals as being the most alarming environments that I ever visited. Very often, the biggest problem was indeed the conflict of interest. People would get into those hospitals and be treated, and that was all good, but whereas in an NHS hospital the pressure all the time, from the day of arrival, is to plan the exit and aftercare in the community, once those hospitals had got the person better they had a lovely ride. The patient was there and was no trouble, no longer had symptoms and was miles—maybe hundreds of miles—from their family. They did not get visits. The conditions in which those people were held were shocking, and the degree of the deprivation of liberty was often deeply shocking. Did they go out in the grounds? Probably not. Did they go out for walks? Probably not. Any kind of a sense of liberty could be lost, not just for days, weeks or even months, but for years. We would do our tiny best, but the fact was that we might get round to one of those hospitals every two years. It was inadequate to say the least. I therefore urge the Minister to take this very seriously. We are worried about care homes, which are probably local and have the family nearby, if there is one. They can be a problem, but this is on another scale and of another degree of severity, so I strongly support this amendment and urge the Minister to consider it.
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-11-21
Topic: Health
Ilora Gillian Finlay (Crossbench, Unknown): My Lords, I, too, have put my name to this amendment. My noble friend Lady Meacher has laid out very clearly some of the problems and conflicts of interest that can arise. One of the difficulties is deciding which will be the responsible body. If the place where somebody is treated is quite a long way from whoever commissioned their care, it can create real problems for a local authority or a clinical commissioning group, which might be funding outside the range of common care for somebody to be some distance away. That is why we have to decide which is to be the responsible body, and that responsible body must take those responsibilities seriously. The advantage of the responsible body being a designated NHS trust is that the private hospital is likely to have consultant-level staff who are likely to have an NHS contract somewhere at another trust, which may be nearby, or if they are part of a specialised group they will be subject to a degree of oversight, appraisal and so on within that specialist area. They are less likely to have local GPs who would be answerable to clinical commissioning groups. One just does not know. They have to go to one or the other. The most dangerous of all would be to have what one might term a mixed economy of a responsible body in some situations and a clinical commissioning group or local health board in another. In Wales, things are a little different because the local health board covers the hospital sector and the community, so we have clearly defined geographical boundaries with much easier lines of answerability. My feeling is that we need to plump for one. I hope that the Government will, and I can see that there may, on balance, be advantages in saying the designated NHS trust is the responsible body.
Ebola: Sierra Leone — House of Lords, 2016-01-19
Topic: Health
John Montagu (Crossbench, Unknown): The Minister spoke about the value of community groups. Is she satisfied that there is proper co-ordination between civil society organisations and government health services? In view of the recent incident, is there perhaps a disconnect between the WHO’s analysis and that of the Government of Sierra Leone?
Welfare Reform and Work Bill — House of Lords, 2016-01-27
Topic: Health
Michael Berkeley (Crossbench, Unknown): My Lords, I ask for a little clarification. I was somewhat astonished by my noble friend Lady Meacher referring to patients with multiple sclerosis, motor neurone disease, Parkinson’s, and diseases that can in fact be terminal. I understand that there is a distinction between the point at which people are diagnosed and the point at which they might be assessed as being able to work, but these are progressive diseases and the danger is that these people could very quickly become not able to work and indeed very ill. It is on this point that I would welcome some clarification.
Welfare Reform and Work Bill — House of Lords, 2016-01-25
Topic: Health
Molly Christine Meacher (Crossbench, Unknown): My Lords, before the Minister sits down, perhaps he would help us by explaining what the technical problems are in a simple referral to NHS by IAPT of people who have a diagnosis of a mental health problem.
National Health Service — House of Lords, 2016-01-14
Topic: Health
Audrey Emerton (Crossbench, Unknown): My Lords, it is my great privilege to welcome the noble Baroness, Lady Watkins of Tavistock, to the House and to extend warm congratulations to her on her most excellent maiden speech. It is an indication of the expertise that we can look forward to in her future contributions I thank the noble Lord, Lord Turnberg, for the opportunity to debate this important topic, which is to see how the NHS can be turned from a national sickness service back into a national health service. The rapid development of scientific knowledge, the growth of technology and research into the etiology of disease have led to valuable treatments for many conditions, and continue to do so, but at the same time the concentration on public health that was a priority at the inception of the NHS—preventing disease and promoting the health and well-being of the population—has decreased, although it remains a very important ingredient. Highly technical treatments and shorter hospitalisation now are appropriate but, because of the lack of community support, hospital beds become blocked As a retired nurse with 62 years’ experience, I am aware that the intent has always been to preserve the place of public health, but it has been overshadowed by the more exciting treatment side. The well-being of patients remains a requirement for nurses in the nurses’ code of conduct. A few lines refer to the fact that well-being in public health and care standards should be included in the syllabus of the nursing degree The NHS constitution also includes well-being as a responsibility of all staff. However, it is recognised within the Five Year Forward View that public health remains in urgent need of revival. That is for several reasons, the most important being the health of the population and the cost-effectiveness of a healthier population. Recently, Simon Stevens said that we cannot put more on the overstretched NHS staff. Healthcare professionals are the key to the future of the National Health Service. Unless they take a lead in promoting health and prevention of disease, nobody else will have the knowledge or the skills to take that forward. I do not refer just to doctors and nurses but to social services and all charitable contributors There is an in-built resistance to breaking down professional and organisational barriers but we must have the right leadership—leadership has been mentioned several times this morning—to take forward the health service so that it is not only a sickness service. It should be possible to influence and persuade lateral thinking and bring the holistic culture to health. It should start with the promotion of health, the prevention of disease, the treatment of disease and the well-being of the population, which should provide an evidence-based and cost-effective service The idea of the royal commission is good but, my goodness, a royal commission takes a long time. This is an urgent need and perhaps we may ask the Minister for a full debate on public health quickly.
National Health Service — House of Lords, 2016-01-14
Topic: Health
Paul Anthony Elliott Bew (Crossbench, Unknown): My Lords, like other noble Lords I thank the noble Lord, Lord Turnberg, for securing this debate and for the wise speech which he gave in introduction. I will address one issue only: the cost to the NHS of litigation arising out of cases of alleged medical negligence. Of course this is not a new problem. For at least five years, those who seek to join the UK Register of Expert Witnesses have been told that alternative dispute resolution—ADR—is becoming an increasingly important adjunct to litigation, and in significant parts of the UK this idea has taken grip. None the less, it is hard to believe today that all opportunities for early resolution are being taken in the NHS. There are still cases on treatment issues that may have lasted over decades, which involve hundreds of documents that cover several years. This is obviously very difficult for the patients and inevitably involves a drift of financial resources out of the NHS toward the legal profession Finally, in the same context it is important to draw attention to a change in the guidance for experts in such cases. In 2007 there was a total ban on payments to experts that depend on the outcome of the case. This was softened in 2014 but is still greatly discouraged. This is a surprising development and not consonant with the need to protect at all cost the resources of the NHS financial position, which, as every speech in this House today has indicated, is inevitably difficult, and is likely to be for some time to come.