| Previous Section | Back to Table of Contents | Lords Hansard Home Page |
Lord Clement-Jones: I rise briefly to strongly support the amendment tabled by my noble friend Lady Northover. I do so firstly because of my connection with Cancer Bacup, which has a strong ethos of provision of information to cancer patients, not only by telephone, which is accessible, but through written printed information available in hospitals. It is important that hospitals ensure that such information is available. That seems to me to be a key function to allay some of the fears cancer patients have about the treatments they are undergoing. My second reason is to point out a number of issues which the Improving Lives coalition has brought to my attention in relation to those who are visually impaired.
There is a clear link between how well health services meet disabled people's requirement for accessible information and the quality of care offered to such groups. Indeed, failing to provide accessible test results or to ensure that patients have timely and accessible information about appointments or information leaflets about their condition can have a potentially devastating impact on the health of visually impaired patients and their ability to manage their own health effectively. It is their belief that the
performance of the health service in that area is wholly inadequate. The existing duties under the Disability Discrimination Act to provide information about services in an accessible format do not appear to be biting.A number of surveys have been carried out. One in 1997 by the RNIB demonstrated that less than half of the health authorities which answered the questionnaire had guidelines for meeting the health information needs of blind and partially-sighted people. An RNIB survey of over 200 visually impaired eye clinic patients found that six in seven people attending ophthalmic patients' outpatients' departments receive their appointment letter only in normal-size print. One in four people had to get someone else to read their appointment letter for them.
The latest research by the RNIB on accessible information should provide a severe jolt to all health service policy makers and practitioners. It found that more than one in five of the total adult population struggle to read labels and instructions on medicines or letters from their doctor. That rises to two in five of those who are 75 or over and to three in four people with sight problems.
The consequences of inaccessible health information can be severe. There are a number of cases of mixing up medication; taking the wrong drugs and missed appointments. Sometimes, patients are in the position of undergoing procedures or operations without accessible information explaining what will happen to them. On the other hand, the provision of accessible health information has been shown to result in more effective and appropriate use of health services, reduced stress, improved recovery of illness and operations and increased compliance with medication and treatment.
I believe that the case for the visually impaired is particularly strong. The health service is not responding adequately to their needs. It should not be left to charities to be responsible for monitoring provision in this area. We should not place the onus on individual disabled people to continually complain and threaten legal action under the DDA. For those reasons, I strongly support the amendment.
Lord Filkin: I agree with the objectives of most of those who have spoken on the amendment. However, I believe we have adequate statutory provisions in place to address them.
The department strongly recognises the importance of provision of accessible information for patients. The noble Earl, Lord Howe, put it clearly: moving away from a paternalistic service which doled out what professionals thought was appropriate to a much more informed dialogue with patients so that they understand what is happening and are able to participate in that process. That clearly is the goal of the health service to which we are strongly committed. We have taken steps to ensure that NHS bodies make such information widely available. We do not for one second imply that we are where we want to be in terms of fully realising that.
On health and safety, we also recognise the importance of the NHS having in place both arrangements for, first, monitoring the provision of health and safety legislation and, secondly, measures for infection control. Enforcement of the provisions of health and safety legislation which are statutory requirements, is already carried out by the Health and Safety Executive in relation to the NHS. CHI is working to develop a memorandum of understanding with the Health and Safety Executive to further co-operation between the two bodies.
On infection control, the NHS Plan implementation programme makes it clear that hospitals must have effective systems in place to prevent and control hospital acquired infections. This is a core requirement underpinning the targets in the NHS Plan and the department has already taken a number of actions to ensure that these systems are in place. The national standards for hospital acquired infection (controls assurance standard) was revised in December 2001.
Hospital infection control guidelines were published in January 2000 and community infection control guidelines are currently under development. The first two quarters' data of the mandatory surveillance of MRSA were published for the department by the Public Health Laboratory Service in February this year as part of the development of a comprehensive National Health Service surveillance service.
The control of healthcare associated infections was recently highlighted in the Chief Medical Officer's strategy for combating infectious diseases, Getting Ahead of the Curve, and an action plan is currently being developed. The noble Baroness, Lady Masham, asked who is in overall charge of infection issues. Clearly the Department of Health has the overall responsibility. On the distressing case of a nurse with TB in an open ward, the chief executive of every board in that situation is responsible to his board for achieving the appropriate quality and preventing infection in such circumstances.
The noble Baroness also raised the important issue of what is happening with modern matrons. A considerable number of them are in post. They are highly relevant to the issue of cleanliness and infection control, as the noble Baroness made clear, and there are positive signs that they are having a good effect. The Department of Health also conducts spot checks on cleanliness, which we believe are necessary.
Turning to monitoring and the improvement of infection more generally, Section 18 of the Health Act 1999 places a duty on those National Health Service organisations providing healthcare to individuals to put and keep in place arrangements for the purpose of monitoring and improving the quality of that healthcare.
The extension of the definition of "healthcare" in Section 18, by Clause 11, means that there will be a general duty on National Health Service bodies, pursuant to Section 18, to monitor and improve the quality of the patient environment. That implies a duty to have regard to the availability of information to patients. I concur with the noble Earl, Lord Howe,
that services undoubtedly have to incorporate not just the provision of a technical product or service but the totality of the patient relationship that encompasses the dialogue of requests for information and understanding. One cannot deliver good services for any sector without that sort of relationship being in place. By reason of the extension of the definition, CHI will also clearly be able to comment on these matters in its reports, although enforcement of the health and safety legislation will be a matter for the Health and Safety Executive.The noble Lord, Lord Clement-Jones, raised the extremely important issue of visual impairment. That is an example of the sort of issue on which we would expect and hope patient forums to focus. They would look at the quality of service provision, not just to the public generally but to those who need access to a different form of service from the standard service that is good enough for the vast majority. Those who are visually impaired are four-square within that definition. We very much hope that the patient forums will attend to those issues.
NHS Direct also has some relevance. It is by no means a total panacea, but it clearly helps those who are visually impaired to have access to high quality information and advice. As the Committee knows, the progress so far is not perfect, but the service is extremely highly valued by many members of the public. We want to take it further and make it better, which is of enormous relevance to the visually impaired.
Patient surveys are being undertaken in every acute trust, and we expect them to pick up on some of those issues of whether the particular disadvantages suffered by some people are being adequately met by the current services. As the clause already refers to the environment in which services are delivered in general terms, which includes having regard to the provision of information and any hazards or risks of infection, I suggest that the amendment to Clause 11 is not necessary and should be rejected.
The issue is not one of having more statutory definition, which is in place, but having the persistence, resolution and drive from the department, together with the commitment of managers, to make some of those goals that already have statutory effect commonplace and universal throughout the service.
Baroness Northover: I thank the Minister for that sympathetic reply. I also thank other Members of the Committee who have participated in the debate.
Clearly more needs to be done to make information accessible. I am encouraged by the Minister about the direction in which the Government are heading. It also sounds encouraging that CHI will be doing more regarding health and safety.
One of my concerns about infection control is that there are various other bodies looking at the issue. With these new structures there is a danger that things may become fragmented. I hope very much that the Minister is right that with persistence and resolution
the Government will move these matters forward. I shall read in Hansard what the Minister has said. I beg leave to withdraw the amendment.Amendment, by leave, withdrawn.
9.15 p.m.
Baroness Northover moved Amendment No. 95:
- After Clause 11, insert the following new clause—
| Next Section | Back to Table of Contents | Lords Hansard Home Page |