argyrotsipi/train-dataset huggingface dataset:
Junior Doctors: Industrial Action — House of Lords, 2016-04-25
Topic: Health
David Prior (Conservative, Centre-right): My Lords, I am personally massively sympathetic to the concerns expressed to me by many junior doctors over the last three or four months, and in fact over the last 12 or 13 years. For family and personal reasons, too, I feel hugely in sympathy with the situation in which they find themselves. There is no doubt that the training of junior doctors is wholly inadequate. Their placements are short term and they move from one rota to another, with many rotas unfilled. There is a lack of teamwork now that the old firm has gone and nothing has replaced it. There is also a lack of leadership and mentorship for juniors When I compare the training and TLC that junior doctors get with that received by those going into accounting, law, big corporates, investment banking or other areas like that, I think that the lot of the junior doctor is not a good one. I remember reading a paper, probably 10 years ago, by Dame Carol Black when she was president of the Royal College of Physicians. She talked about the deprofessionalisation of the profession, and that really will come to pass if we are not careful. So I am hugely in sympathy with many of these issues and I have particular sympathy for women—especially young women with families and so on But let us be honest about this. That is not what this contractual dispute is about. Those are the big issues but this dispute is about pay on Saturdays. That is the issue that the contract fell down on. The noble Lord and the noble Baroness opposite talked about a pilot—but are we really talking about piloting a different Saturday pay structure? Everything else was agreed between the BMA and Sir David Dalton. To be honest, it is disingenuous to say that we could pilot something like that. Fundamentally, this is about pay, and I think that the junior doctors have got it wrong when they go on strike and withdraw emergency cover over an issue related to premium pay on Saturdays. It is simply not a big enough issue to cross the threshold of withdrawing emergency cover. They must recognise that. There will be a time to address the more fundamental issues affecting the training of junior doctors, and they must be addressed for the sake of the profession, of patients and of hospitals—but, sadly, that is not the issue that we are confronting today Two other important issues were raised. In answer to the noble Baroness, not all cardiologists and cardiac surgeons are rushing off to an A&E department. They will cover urgent and emergency cases in their own specialties as well Although in a way it is not for debate today, the noble Lord, Lord Hunt, raised the very fundamental, long-term problem of whether there are the resources within the system to deliver the ambitions that we all have for a world-class health service. Maybe today is not the time to answer that: we should probably focus on the matter in hand.
Junior Doctors: Industrial Action — House of Lords, 2016-04-25
Topic: Health
David Prior (Conservative, Centre-right): My Lords, first, the need for a seven-day service has been recognised by the medical profession for a number of years. I remember reading the Future Hospital report four or five years ago in which the Royal College of Physicians talked about a seven-day service. Of course, it was the academy of the royal colleges that produced the 10 clinical standards that underpin a seven-day service. The issue is not whether or not there should be a seven-day service; the more serious issue that has been raised is whether we have the resources to deliver a seven-day service. We argue that we are putting enough resources into the NHS to do that. So I think that the principle of a seven-day service, certainly for urgent and emergency care, if not for elective care, is well accepted by the medical profession Interestingly, on the point about the number of people leaving—the resignations that the noble Lord referred to—I was pretty horrified to hear about the son of someone on the noble Lord’s Benches who had left the NHS to go to work in America two years ago, I think. He described a pretty torrid time working in the NHS as a junior doctor. To cap it all, when he went, there was no exit interview. No one was really concerned or knew that he had gone. That is just another illustration of the fact that we have not sufficiently respected or valued junior doctors in the NHS.
Junior Doctors: Industrial Action — House of Lords, 2016-04-25
Topic: Health
David Prior (Conservative, Centre-right): My Lords, I echo the sentiments of the noble Lord. I recognise the vocational commitment of junior doctors and that they are not natural strikers. It is a tragedy that we have got into this situation. There are no winners in this dispute and only one absolutely clear loser: the thousands of patients who are now suffering. The noble Lord asked whether we could have got here with greater stealth. These discussions have been going on for three years. We have had one independent review done by the DDRB and a number of independent assessments of the impact on mortality of not working at weekends. The Government are putting £10 billion of new money into the health service over the next five years, which was asked for by the NHS. In the NHS there will always be a lack of resources: demand will always exceed supply in a system where there is no price mechanism. That is an issue that all Ministers have lived with in the NHS since 1948. However, I echo his views: it is tragic that we find ourselves in this position with junior doctors. They are not natural strikers.
Junior Doctors: Industrial Action — House of Lords, 2016-04-25
Topic: Health
David Prior (Conservative, Centre-right): My Lords, there is an important distinction to be made around withdrawal of emergency cover. I can of course sympathise with the tens of thousands of patients who have been badly inconvenienced—that is bad enough—but when you withdraw emergency cover, people can die. It will be surprising if there are not some severe outcomes from what is happening tomorrow. Tens of thousands of people have been severely inconvenienced; tens of thousands of people have had their treatment disrupted, but the real tragedy will be when people lose their lives.
Children and Social Work Bill [HL] — House of Lords, 2016-10-18
Topic: Health
John Nash (Conservative, Centre-right): My Lords, in Committee, quite rightly, we had a substantive debate about the importance of the mental health of looked-after children and care leavers. The Government share the views of noble Lords about the need to ensure that the mental health and emotional well-being of this vulnerable group of children and young people are given as much consideration as their physical health. As my honourable friend the Minister for Vulnerable Children and Families explained when he met Peers last week, we have reflected on the points raised in Committee. As a result, we have tabled an amendment to Clause 1 to put beyond doubt that promoting the health and well-being of looked-after children and care leavers will mean promoting their mental and physical health.
Children and Social Work Bill [HL] — House of Lords, 2016-10-18
Topic: Health
James O’Shaughnessy (Conservative, Centre-right): My Lords, I rise to speak on this group of amendments not least because children’s mental health and well-being was the subject of one of my amendments in Committee. I am delighted that noble Lords have brought this issue back to the fore with their amendments, and I am even more pleased that, from Amendment 1, we can see that the Minister listened to those concerns, because the change it proposes makes explicit the importance of the mental health of the vulnerable young people who are the subject of the Bill. This is a significant concession. I congratulate the many noble Lords who have been working hard to achieve it. This is, surely, what those of us who put down amendments in Committee were seeking—for this to be taken seriously and put in the Bill. The Government should be congratulated on making this significant concession.
Children and Social Work Bill [HL] — House of Lords, 2016-10-18
Topic: Health
James Peter Hymers Mackay (Conservative, Centre-right): My Lords, I wonder how the Government’s amendment can be carried out without giving effect to the other amendments in this group. Amendment 1 has the effect of requiring that in carrying out its functions, a local authority must, "have regard to the need … to act in the best interests, and promote the physical and mental health and well-being, of those children and young people" How one could promote their health without knowing what they may need in the way of health I cannot understand. Therefore I assume that these amendments are all covered by the generality of the words in Clause 1(1)(a) as amended.
Children and Social Work Bill [HL] — House of Lords, 2016-10-18
Topic: Health
John Nash (Conservative, Centre-right): I think we can do that. I am happy to discuss this further with the noble Lord but, as I understand it, we are proposing to list them as conditions and draw practitioners’ attention to them. As I was saying, I am reluctant to do anything further on this in relation to mental health until the expert group has met, but I invite the noble Baroness, Lady Tyler, to meet that group.
Community Pharmacy — House of Lords, 2016-10-17
Topic: Health
Caroline Chisholm (Conservative, Centre-right): My Lords, with permission, I will repeat an Answer given by my honourable friend the Parliamentary Under-Secretary of State to an Urgent Question in the other place on community pharmacy. The Statement is as follows: "Members of the House will have seen there has been media coverage over the weekend about our consultation on the community pharmacy contractual framework. I will now set out the current position, the process going forward and how the final decision will be announced to the House In December 2015, 10 months ago, the Government set out a range of proposals for reforming the community pharmacy sector. Our intent was to promote the movement of the sector towards a future based on value-added services together with much stronger links to the GP sector. We also proposed ways to make a reduction to the £2.8 billion currently paid to the sector. Part of the rationale for this was the increase of 40% in the budget and 18% in the number of establishments over the past decade or so Each establishment now receives an average of £220,000 of margin over and above the cost of drugs disbursed. Many of these establishments are in clusters. The 2015 spending review reaffirmed the need for the privately owned community pharmacy sector to make a contribution to the publicly owned NHS efficiency savings which we need to deliver. We are confident that the changes proposed will not jeopardise the quality of services required or patient access to them. Some services will be delivered differently, which is why we have set aside £112 million to recruit a further 1,500 pharmacy professionals to be employed directly by the NHS and GP practices The Government have been consulting on these reforms since December 2015. On 13 October this year the PSNC rejected our proposed package and sent a list of remaining concerns. We are now in the process of considering its final response and expect to be in a position to make an announcement to the House shortly".
European Union Migration: National Insurance — House of Lords, 2016-05-12
Topic: Health
Andrew Lansley (Conservative, Centre-right): My Lords, does my noble friend agree that access to the National Health Service is defined by ordinary residence and therefore is not signified simply by the possession of a national insurance number? I fear that, too often in the National Health Service, if somebody has a national insurance number they are treated as if they were ordinarily resident. Is it not therefore welcome that the Government are looking to tighten up all these issues in the forthcoming Queen’s Speech, including where migrants do not have proper access and should pay for NHS services, because that will assist the NHS, which clearly has financial pressures?
Community Pharmacy in 2016-17 and Beyond — House of Lords, 2016-10-20
Topic: Health
Caroline Chisholm (Conservative, Centre-right): I thank the noble Lord for his questions. These reforms will make the necessary modernisation to provide the best possible service for the patient. He mentioned the problems with pharmacies closing and asked where that was going to leave us. We are investing £112 million to deliver a further 1,500 pharmacies in general practice by 2020. The NHS England pharmacy integration fund will be focused on the deployment of clinical pharmacies and pharmacy services in the community and primary care settings, including groups of general practices, care homes and urgent care settings, such as NHS 111. This will improve access for patients, relieve the pressure on GPs and A&E departments, ensure optimal use of medicines and derive better value, improving outcomes for patients The noble Lord also asked about pharmacies in deprived areas and rural communities. That is why we are setting up the primary access scheme and are today publishing the list of those pharmacies that will be eligible for funding from the pharmacy access scheme. These pharmacies will be protected from the full effect of funding reductions, and the scheme will include a review process to deal with any inaccuracies in calculations or any unforeseen circumstances. I hope that that answers the noble Lord’s questions.
Community Pharmacy in 2016-17 and Beyond — House of Lords, 2016-10-20
Topic: Health
Caroline Chisholm (Conservative, Centre-right): It is important that we offer a level of certainty and stability to pharmacy businesses and contractors providing NHS pharmaceutical services under the community pharmacy contractual framework, which will receive £2.687 billion funding in 2016-7 and £2.592 billion in 2017-8. The pharmacy integrated fund, as I said earlier, will make a huge difference to the NHS integrated fund, which will focus on the deployment of clinical pharmacy services in the community and primary care settings.
Community Pharmacy in 2016-17 and Beyond — House of Lords, 2016-10-20
Topic: Health
Joan Anna Dalziel Seccombe (Conservative, Centre-right): My Lords, as a great supporter of pharmacies, especially in rural areas, may I draw my noble friend’s attention to one rural area where a pharmacist wished to open a pharmacy, but it was objected to by doctors, because they had their own pharmacies in their practice? That is a great disservice to the community, which had to go six miles to find a chemist’s shop.
Community Pharmacy in 2016-17 and Beyond — House of Lords, 2016-10-20
Topic: Health
Caroline Chisholm (Conservative, Centre-right): That is why the pharmacy access scheme is very much there to make sure that pharmacies in these rural areas will be fully protected from any funding reductions. But the competition is there. Pharmacies on the whole are privately owned. It is important and only fair that, in these strapped times for the NHS, private companies should in some way also help the publicly funded NHS.
Community Pharmacy in 2016-17 and Beyond — House of Lords, 2016-10-20
Topic: Health
Caroline Chisholm (Conservative, Centre-right): The point about the pharmacy integration fund is that we want to think up more joined-up ways in which we bring everything together. That is why we very much focus on the deployment of clinical pharmacies and pharmacy services in the community and primary care settings. It will include groups of general practices, but it also includes care homes and urgent care settings, such as NHS 111.
Community Pharmacy in 2016-17 and Beyond — House of Lords, 2016-10-20
Topic: Health
Andrew Lansley (Conservative, Centre-right): I am grateful to my noble friend for repeating the Statement. She has rightly highlighted that over recent years the number of community pharmacies has increased—indeed, by more than 1,000 pharmacies in the last five years. That is welcome, because it is a means by which there is a reach into the community that is unparalleled elsewhere in the health and care services. But it is about how we go about diversifying pharmacy income. For a long time, it has been clear that it should not be wholly reliant on dispensing fees and the global sum, as it has been in the past. We need additional services, enhanced and locally commissioned services, to grow. My noble friend’s Statement said exactly that, but the question is how we do it. By and large, it will not be done out of the public health budget of local authorities, although some will be. It is potentially mainly out of things such as the better care fund, enabling us not just to have pharmacies embedded in GP and other health services but using the community pharmacies’ reach in the community to deliver support to people with chronic conditions. Will my noble friend say that there will be an effort to promote this? At the moment, we have no good data from the past two years on local commissioning of those enhanced services. Can we get those data sorted out so that we can see whether pharmacies are being used as they should be and diversifying their income?
Community Pharmacy in 2016-17 and Beyond — House of Lords, 2016-10-20
Topic: Health
Caroline Chisholm (Conservative, Centre-right): As I said, the impact assessment was published today. I think that I did answer the noble Lord’s questions. He asked how pharmacies were going to be looked after in deprived areas and I explained about the pharmacy access scheme and how these pharmacies will indeed be protected. He also asked about the integrated pharmacies and as I said there would be £112 million to deliver a further 1,500 pharmacies. They will be integrated into general, joined-up practices within the NHS. This has to be the way to go—multidisciplinary areas where we will be focused on the deployment of clinical pharmacies and pharmacy services in the community and primary care settings. This will make a difference to groups of general practices, care homes and urgent care settings that all have pharmacies within them.
Community Pharmacy in 2016-17 and Beyond — House of Lords, 2016-10-20
Topic: Health
Caroline Chisholm (Conservative, Centre-right): Pharmacies are privately owned and there is competition among them. On the whole, it is beneficial for them to provide the necessary services but, as I said earlier, as far as keeping pharmacies open in rural areas is concerned, we are absolutely committed to that with the pharmacy access scheme.
Queen’s Speech — House of Lords, 2016-05-25
Topic: Health
Thomas Jeremy King (Conservative, Centre-right): , as amended on Monday 23 May That an humble Address be presented to Her Majesty as follows: "Most Gracious Sovereign—We, Your Majesty’s most dutiful and loyal subjects, the Lords Spiritual and Temporal in Parliament assembled, beg leave to thank Your Majesty for the most gracious Speech which Your Majesty has addressed to both Houses of Parliament, but regret that the gracious Speech did not include a bill to protect the National Health Service from the Transatlantic Trade and Investment Partnership".
NHS England: Pre-exposure Prophylaxis for People at Risk of HIV — House of Lords, 2016-06-07
Topic: Health
David Prior (Conservative, Centre-right): My Lords, with the leave of the House, I shall now repeat in the form of a Statement the Answer given by my honourable friend the Minister for Public Health to an Urgent Question in another place on pre-exposure prophylaxis. The Statement is as follows "HIV can be a devastating illness. We know that PrEP can make a difference to both those at risk of contracting HIV, and those who are already HIV positive. However, it is crucial that we have a full understanding of all the issues surrounding PrEP. As with any new intervention, PrEP must be properly assessed in relation to clinical and cost effectiveness. That is why we have today asked NICE to conduct an evidence review of Truvada for pre-exposure prophylaxis of HIV in high-risk groups This evidence review signifies the next step forward and will inform any subsequent decisions about commissioning. It will look at the evidence for effectiveness, safety, patient factors and resource implications. The NICE evidence summary will run alongside a pilot scheme in which we are investing up to £2 million. Public Health England is currently identifying the most effective places for the pilot to take place It is also important to remember that the drug used for PrEP, Truvada, is not yet licensed for this use in the UK. That is why, as well as the pilot scheme, the Government want to see an evidence review, which will help inform future commissioning decisions about PrEP PrEP is only one of a range of activities to tackle HIV. Our £2.4 million national HIV prevention and sexual health promotion programme also gives those at highest risk the best advice to make safer choices about sex. The UK has world-class treatment services. The UK is already ahead in reaching two of the three UNAIDS goals of 90% diagnosed infection, 90% of those diagnosed on treatment and 90% viral suppression by 2020. In 2014, 17% of those living with HIV had undiagnosed infection but 91% of those diagnosed were on treatment, of whom 95% were virally suppressed. We are determined to continue to make real progress to meet these goals and are considering carefully the role that PrEP can play in helping us get there".
NHS England: Pre-exposure Prophylaxis for People at Risk of HIV — House of Lords, 2016-06-07
Topic: Health
David Prior (Conservative, Centre-right): My Lords, I am not going to proffer the argument that it is too expensive, because that is not the issue today. The issue today is that NHS England feels that it does not have the power to commission this particular drug. Whether or not it has that power may well be judicially reviewed, so I cannot comment on the outcome of that judicial review The PROUD study produced strong evidence of the effectiveness of Truvada as a preventive drug. The work that NICE is going to do, and the pilot scheme to look at the effectiveness of this drug—it will cost £2 million and will be funded by NHS England and PHE—will ensure that when the question whether NHS England has the power to commission this drug is resolved, there will be the evidence on which to make that decision.
NHS England: Pre-exposure Prophylaxis for People at Risk of HIV — House of Lords, 2016-06-07
Topic: Health
David Prior (Conservative, Centre-right): I do not know how long a judicial review will take. I guess that it will be months rather than years, but I simply cannot answer that question as I do not know the answer to it. Again, this is a legal issue, not an efficacy issue. This is a question not of the Government saying that we do not want to fund this prophylactic, but of NHS England simply saying that it has been advised it does not have the power to do so.
NHS England: Pre-exposure Prophylaxis for People at Risk of HIV — House of Lords, 2016-06-07
Topic: Health
David Prior (Conservative, Centre-right): My Lords, NHS England and PHE are consulting on how those trials should be constructed. Clearly, they will be focused on high-risk individuals but choosing who goes on to the trial will be up to PHE and NHS England.
NHS England: Pre-exposure Prophylaxis for People at Risk of HIV — House of Lords, 2016-06-07
Topic: Health
David Prior (Conservative, Centre-right): I would be very happy to meet with the noble Lord. It may be better for him to meet with my honourable friend in the other place who is responsible for public health, but either one of us will be very happy to meet with him.