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Lord Swinfen: My Lords, will the Government ensure that where a patient has been fitted with a heart monitor or a blood pressure monitor for 24 hours, that information is e-mailed to the consultant immediately or as soon as possible after it is removed from the patient so that the patient can be treated immediately and before their condition deteriorates? They may well
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Baroness Thornton: My Lords, the noble Lord points exactly to the benefits of telehealth, which involves electronic sensors and equipment that will monitor peoples health. For example, those with COPD and breathing difficulties will monitor their own oxygen levels at home, but that information will also go directly to the clinician or expert in the area who can monitor the levels and get in touch with the individual within days in order to avert, for example, hospital admittance. The noble Lord is completely right about how it should work.
Baroness Tonge: My Lords, an article in this weeks BMJ written by a general practitioner says that the transfer of ordinary in-patient reports, X-rays and scans still takes weeks to reach GPs, and hence the patients, and that this delays their treatment. The situation is so bad that some NHS managers are considering outsourcing medical secretarial work to India. Will the Minister admit that neither telehealth nor the new IT system that we hear so much about addresses this basic problem, and will she resolve to tackle the matter urgently during the Recess?
Baroness Thornton: My Lords, I think that the noble Baroness is suggesting that I should not have a holiday. As we have discussed in the House before, issues about new technology and rolling out information technologieswhich are of enormous benefit within the health servicetake time to resolve and there will be problems. However, I undertake to explore the issue that the noble Baroness raised, and to do so during the Summer Recess.
Baroness Knight of Collingtree: My Lords, will the Minister confirm that, however health technology may advance, she will ensure that what happens in so many large organisations does not happen in this field? From BT to councils and even Parliament itself, it is quite impossible to talk to a real person on the telephone. If that should develop here, you would have to have a very long-term condition indeed before it could be cured.
Baroness Thornton: My Lords, I have some sympathy with the noble Baroness, having spent some time this weekend on the telephone trying to deal not with the health service but with another part of technology. Telecare and telehealth aim to help people to stay at home. Bed sensors, for example, will tell a warden that someone may have gone to the loo but has not got back into bed. That will give an early warning. It is about providing people with personal care where they most need it.
Baroness Gardner of Parkes: My Lords, I can see the great merit in the remoteness of this care, and where it works, it will work very well. However, does the Minister agree that a great many people with
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Baroness Thornton: My Lords, the noble Baroness is absolutely right. However, I have elderly parents who would not dream of looking on the internet for information about their chronic conditions and it is up to me to make sure that they get it. Both also receive a great deal of printed information through their doctors surgeries, which is exactly as it should be.
Baroness Masham of Ilton: My Lords, does the Minister agree that nothing can substitute for a face-to-face consultation with the doctor, when changes in a patients condition can sometimes be picked up?
Baroness Thornton: My Lords, the noble Baroness is right, but this is not a substitute for face-to-face consultations with the doctor. The point here is that many people want to stay in their home, and the point of this technology is that it provides those who have care of them with alerts to warn that things may be going wrong.
Lord Bassam of Brighton: My Lords, Network Rail is a private sector company limited by guarantee. Changes to Network Rails corporate governance are matters for its board and members, not for the Government. The independent Office of Rail Regulation is currently consulting on changes to Network Rails licence, aimed at strengthening the companys accountability. This includes a review of Network Rails governance arrangements.
Lord Foulkes of Cumnock: My Lords, does my noble friend not agree that the targets and governance of Network Rail cannot be right when on the one hand the executives get huge bonuses while on the other passengers suffer so much misery and inconvenience? Is my noble friend aware of the Co-operative blueprint The Peoples Rail, that at its annual general meeting last week members of Network Rail called for a review, and that even today the House of Commons Select Committee has published a report calling for more effective governance and scrutiny of the company? Surely it is time that the Government joined the growing groundswell to give the British people real power over Network Rail.
Lord Bassam of Brighton: My Lords, I am certainly aware of the outcome of the annual general meeting the other week and I congratulate my noble friend
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Lord Hanningfield: My Lords, we are where we are, but does the Minister agree that, while Network Rail is a private company, it has members rather than shareholders? What we might do straightaway is review the membership to make it more all-encompassing so that it can put right some of Network Rails defects.
Lord Bassam of Brighton: My Lords, I welcome the noble Lords conversion to reviewing governance issues. Of course it was his party that left us with the mess of rail privatisation all those years ago, and we are still paying the price. The Peoples Rail is a useful and valuable contribution to what will no doubt be a broadening debate, and it seems that the party opposite may at last be moving in the right direction.
Lord Bradshaw: My Lords, the members of Network Rail have now voted to conduct an imminent review of the companys governance structure. Does the Minister agree that this should be concluded very speedily and that the Government should not intervene in the affairs of the company in this instance, as they have done whenever the companys shortcomings have been raised in the past?
Lord Bassam of Brighton: My Lords, I have read the terms of my noble friend Lord Berkeleys motion, which I understand was carried unamended. It suggests that the review group should submit its findings and recommendations to members by December this year. It is not the role of the Government to interfere in this review; it should be conducted independently. I agree with the noble Lord that that is the right way to proceed.
Lord Marsh: My Lords, does the Minister not agree that it is time we looked at this situation again? There were many arguments with the then Prime Minister about nationalisation of the railway industry. The fact is that Britain is one of the very few countries in the world whose railway system is not state-owned.
Lord Bassam of Brighton: My Lords, we are where we are. Rail nationalisation and the review of the governance structure are two separate issues. The Governments role is to ensure that we have the right level of investmentwe have been increasing it over the past decadeand that we improve the range and quality of services. That is exactly where our commitment has been, and we are now reaping the benefit of that investment as the number of people travelling by rail40 per cent up on 10 years agodemonstrates.
Lord Faulkner of Worcester: My Lords, following on from his previous answer, does my noble friend
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Lord Bassam of Brighton: My Lords, I am not going to get drawn into a debate over the relative merits of leading members of the military and the chief executive of Network Rail. That is quite the wrong way to proceed.
Lord Snape: My Lords, does my noble friend not accept that it is bizarre for a Minister to say, in effect, that the governance of Network Rail is nothing to do with us, when billions of pounds of taxpayers money are directed to that organisation? There is something wrong with the governance of Network Rail when, despite the dislocation, particularly to the West Coast Main Line, every weekend and right through the forthcoming holiday season, its chief executive and some of its directors are paid bonuses that, frankly, many of us feel are obscene.
Lord Bassam of Brighton: My Lords, the noble Lord is absolutely right to express his robust views on this subject. It is right that the Office of Rail Regulation should be looking at the licence arrangements. We have to observe a proper distance between government and governance issues. It would be a profound mistake for us to attempt to micromanage at all times.
Lord Dubs: My Lords, surely there is a problem in that it is public money, as my noble friend said; there are no shareholders to vote out the directors; and the Government set this thing up. Are they totally immune to any criticism or change?
Moved, That the draft order laid before the House on 18 June be approved. 21st Report from the Joint Committee on Statutory Instruments, Considered in Grand Committee on 16 July.(Baroness Scotland of Asthal.)
Moved, That the draft regulations laid before the House on 30 June be approved. 25th Report from the Joint Committee on Statutory Instruments, Considered in Grand Committee on 16 July.(Baroness Royall of Blaisdon.)
Moved, That the draft orders and regulations laid before the House on 4, 11 and 19 June be approved. 21st, 22nd and 24th Reports from the Joint Committee on Statutory Instruments, Considered in Grand Committee on 16 July.(Lord West of Spithead.)
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