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House of Lords

Wednesday, 4th October 2000.

The House met at half-past two of the clock: The LORD CHANCELLOR on the Woolsack.

Prayers--Read by the Lord Bishop of Bradford.

National Health Service: Winter Demand

Baroness Sharples asked Her Majesty's Government:

    How they propose to ensure that there will be no crisis this winter in the National Health Service.

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): My Lords, a great deal of work has gone into planning for this winter. Immunisation against influenza has been extended across the UK to include all those over the age of 65 as well as other at-risk groups. In May this year an additional £150 million was made available for the expansion of critical care services in England. No one can guarantee that there will not be difficulties in the health service this winter. It is simply not possible to solve every bed problem or every staff shortage by then. However, the NHS is in no doubt about the importance of improving its ability to respond.

Baroness Sharples: My Lords, I thank the noble Lord--tired but still noble--for his reply. Does he accept that UCH is one hospital which has not had a single extra bed? With a reported shortage of 3 million flu jabs, will that not present terrible problems by January?

Lord Hunt of Kings Heath: My Lords, I certainly do not accept that there is a shortage of flu jabs. My understanding is that in the UK 11 million doses will be available in the coming year as compared with 7.8 million this year. So far as concerns capacity, we are doing everything that we can, particularly through an expansion of over 340 critical care beds, to ensure that the facility exists to deal with extra pressure. We must also face the fact that great pressure arises in relation to recruiting sufficient staff, and that is a very real challenge.

Lord Renton: My Lords, what steps will the Government take to ensure that the work of the National Health Service is not increased by bogus asylum seekers or other illegal immigrants?

Lord Hunt of Kings Heath: My Lords, I believe that since its formation a great tradition of the National Health Service has been to offer its services to all who need them. That must include asylum seekers.

Lord Clement-Jones: My Lords, does the Minister deny that GPs have had to cancel appointments because of shortages of vaccines? Has not the

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Department of Health admitted that it has only 65 per cent of the flu vaccines needed to vaccinate people over the age of 65? Will the Minister now undertake to withdraw the major publicity campaign launched by the department until he has adequate stocks?

Lord Hunt of Kings Heath: No, my Lords. I believe that the arrangements that have been made will enable us to ensure that those 11 million doses are available in GPs' surgeries. The campaign is very important because we wish to make sure that we reach the target of at least 60 per cent of the over-65s who will present themselves for the vaccination.

Baroness Masham of Ilton: My Lords, perhaps I may ask the Minister whether the flu that is expected is a new strain. Will he tell the House a little about it and what people should do if they get it?

Lord Hunt of Kings Heath: My Lords, I do not believe that I should enter clinical waters. We receive very important information from the World Health Organisation regarding the particular strains that are likely to confront this country. That enables us to prepare the vaccines. Certainly we have found the WHO service to be extremely helpful.

Lord Turnberg: My Lords, does my noble friend the Minister agree that one of the many reasons why there are problems in the NHS over the winter period is the rather prolonged closure of hospitals to all but emergencies during the four or five days of the Christmas period when staff are given a well-earned break? Does he also agree that one of the ways through that problem would be to stagger the holidays and breaks and improve the rota arrangements so that work can continue during that rather critical period?

Lord Hunt of Kings Heath: My Lords, I am not sure about staggering Christmas Day. I believe that that may prove to be rather challenging. However, I certainly accept that the issue can be a problem. In the winter planning arrangements that have been developed, we have put particular emphasis on ensuring that services across both health and social services sectors continue to function during Christmas and the New Year. We have said that a near-normal service is expected to be provided on working days in that period with access to key services on non-working days.

Baroness Gardner of Parkes: My Lords, is the Minister aware that the staff situation is greatly aggravated not only by the Christmas break, which I believe the staff value greatly, but by the fact that many staff either are themselves ill or suffer ill effects after Christmas and fail to return to their duties on the first day of work? Can the Minister provide a suggestion as to how to improve that situation?

Lord Hunt of Kings Heath: My Lords, I hesitate to caution NHS staff against over-indulgence over the Christmas period. They work very hard and when they

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have time off they are entitled to enjoy themselves. The important issue of staffing has been a real challenge to the health service. I believe that recruitment campaigns and the increased emphasis that we are placing on flexible working conditions will enable us to meet some of the staff issues that we face. We must keep working at it.

Lord Bruce of Donington: My Lords, is the Minister aware that whatever hazards may lie before the people of this country during the forthcoming winter, they can be confident that the entire personnel of the health service is dedicated to the task with which it has been entrusted? The nation ought to have complete confidence in the staff this coming winter.

Lord Hunt of Kings Heath: My Lords, I echo the remarks of my noble friend. I understand that he is 88 today and I am sure that all noble Lords congratulate him. I know he was present in another place, although the proceedings took place in this actual Chamber, when the NHS Bill was taken through Parliament in 1948.

Baroness Northover: My Lords, is the Minister aware that many hospitals have still not made arrangements for dealing with an increased demand this winter? Does he agree that such plans should have been worked out at least months ago, given that winter tends to come around on an annual basis? As the plans that are now being considered involve cutting operating lists so that beds can be freed, can he tell us how the Department of Health intends to avoid extending waiting lists so that the spring does not become the new time for "trolley-waits"?

Lord Hunt of Kings Heath: My Lords, the Government have targeted waiting lists and that is why we are well on course to meet our manifesto pledge. In relation to factoring in the impact of winter pressures on waiting lists, every trust has to make such calculations. On planning, every local health community has a local winter planning group which involves the whole of the health community, the authorities, the trusts, the social services and the independent and voluntary sectors. Each community had to produce a plan by the end of September. We shall monitor that situation carefully. Where we believe there are likely to be problems we shall not hesitate to intervene.

House of Lords: Nomination of Members

2.45 p.m.

Lord Campbell of Alloway asked Her Majesty's Government:

    Whether they consider that it is in accordance with the status of this House that members of the public should be invited to propose themselves for membership.

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The Lord Privy Seal (Baroness Jay of Paddington): My Lords, the short Answer is yes, indeed the Government believe that the new arrangements for nomination of Cross-Bench Peers should, by their openness, enhance the dignity of the House. The Government want the process to encourage nominations from all sections of society and clearly self-nomination has a role in opening up the process. I am confident that that will not diminish the quality of membership as the standards for appointment to be used by the noble Lord, Lord Stevenson of Coddenham, and his co-commissioners are exacting.

Lord Campbell of Alloway: My Lords, I thank the noble Baroness for her Answer. Is she aware that there is a body of contrary opinion that takes the view that the status of the House would be adversely affected? Can she tell the House why making self-nomination available to candidates for the non-political peerages, promoted on government funding and in implementation of a government policy to modernise this House, would not require the approval of Parliament?

Baroness Jay of Paddington: My Lords, I know that the noble Lord is aware that the process of establishing the non-statutory Appointments Commission to take forward the process of reviewing the nomination procedure for Cross-Bench Peers in the House was part of the House of Lords Act arrangements we dealt with extensively last year. Of course, we must await the outcome of the consideration that the noble Lord, Lord Stevenson, and his commission are undertaking. I believe that it is a little pessimistic at this stage to say that it will lead to a reduction in the quality of membership of the House. It is not a view shared by the Government.

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