Government Vision on Prevention - Statement

Part of the debate – in the House of Lords at 12:51 pm on 6th November 2018.

Alert me about debates like this

Photo of Lord O'Shaughnessy Lord O'Shaughnessy The Parliamentary Under-Secretary for Health and Social Care 12:51 pm, 6th November 2018

My Lords, with the permission of the House, I will repeat a Statement made in another place by my right honourable friend the Secretary of State for Health and Social Care on the publication of the Government’s prevention vision document. The Statement is as follows:

“Last week, the Chancellor confirmed that the NHS budget would rise by £20.5 billion over the next five years, because we care about the NHS being there for everyone. As well as money, however, reform is crucial. Before Christmas, we will bring forward a long-term plan for the NHS. We know that so much of what contributes to good health comes not just from what happens when someone is in hospital but from what we do to stay out of hospital. Prevention is better than cure. Today, I have laid before the House our vision for the prevention of ill health. It covers what the NHS needs to do, including more funding for community and primary care and the better use of technology. The plan also outlines what we need to see more broadly; everyone has a part to play.

As well as the rights we have as citizens to access NHS services, free at the point of use, we all have responsibilities too. Individuals have responsibilities, and we want to empower people to make the right choices. For instance, smoking costs the NHS £2.5 billion each year and contributes to 4% of hospital admissions. That is despite the massive reduction in smoking over the past 30 years. The next step to a smoke-free society is targeted anti-smoking interventions, especially in hospitals.

As well as stopping smoking, we must tackle excess salt. Salt intake has fallen 11% in just under a decade, but if it fell by a third, that would prevent 8,000 premature deaths and save the NHS over £500 million annually. We are working on new solutions to tackle salt, and we will set out more details by Easter and deliver on chapter 2 of our obesity plan too.

Next, prevention can save money and eliminate waste. At the moment, it takes too long, with too many invasive tests, to diagnose some illnesses. Doctors often have to try several different treatments before they alight on what is right for a patient. However, two new technologies—artificial intelligence and genomics—have the potential to change that. I want predictive prevention to help prevent people becoming patients and to deliver more targeted interventions with better results when people do fall ill. Instead of simply broadcasting messages to the nation, technology allows us to support much more targeted advice, messages and interventions for those most at risk.

Turning to environmental factors, our health is not determined only by what happens in hospitals. In fact, only a minority of the impact on anyone’s healthy lifespan is delivered by what hospitals do. The other factors include the air we breathe, whether someone has a job and the quality of our housing. That means our GP surgeries, our hospitals and our care homes all working more closely with local authorities, schools, businesses, charities and other parts of our communities.

Of course, the record number of people in work is good news on that front, and employers have a big role in helping their staff to stay healthy and to return to health after illness. That is where we can learn from the excellent record of our brave armed services, which have an 85% return-to-work rate after serious injury, while the equivalent rate for civilians is only 35%. Building on all that, the Government will next year publish a Green Paper on prevention, which will set out the plans in greater detail. This is all part of our long-term plan for the future of the NHS.

If I may, I will now address two separate issues that I know are of interest across the House today: the treatment of those with learning difficulties and autism, and the medical use of cannabis. Since becoming Health and Social Care Secretary, I have been shocked by some of the care received by those with autism and learning difficulties. Where people deserve compassion and dignity, they have been treated like criminals, and that must stop. Like everyone across the House, I have been moved by the cases of Bethany, Stephen and so many others, whose stories have laid bare what is wrong with our system and what needs to change. I have instituted a serious incident review, but this is not just about individual cases; it is about the system.

Three years ago, the Government committed to reducing the number of people with learning disabilities or autism in secure mental health hospitals by at least a third. Currently, it is down by a fifth, but that still leaves 2,315 people with learning disabilities or autism in mental health hospitals. I want to see that number drastically reduce. I have asked the NHS to address that in the long-term plan, and I know that its leadership shares my determination to get this right. I have also instigated a Care Quality Commission review into the inappropriate use of prolonged seclusion and segregation. The long-term use of seclusion is unacceptable both medically and ethically. It must stop. The review will recommend how to protect vulnerable people better and how to ensure that everyone is cared for with the compassion, respect and dignity they deserve.

On the prescription of medicinal cannabis, I pay tribute to my right honourable friend the Member for Hemel Hempstead, my honourable friend the Member for Dover and the honourable Member for Inverclyde for their campaigning on this issue. We have changed the law to make it possible to prescribe medicinal cannabis where clinically appropriate. Urgent cases have been brought to my attention, including concerns that those who have received treatment on an exceptional basis are now being denied that treatment. There is no reason for that to happen. The treatment of each individual patient is, and must be, down to the decision of the specialist doctor, working with patients and their family to determine the best course of treatment for them.

I met the head of the NHS on that this morning, and I have immediately instigated a system of second opinions. We have put out a call for research to develop the evidence, and we have also commissioned the National Institute for Health and Care Excellence to produce further clinical guidance on this issue. No one who currently gets medicinal cannabis should be denied it, and there is a system in place now for those who need to get it in future.

We want to deliver the best possible care to the most vulnerable, and we want to help build a more sustainable health and care system for all. Today’s announcements will help to do that, and I commend this Statement to the House”.

My Lords, that concludes the Statement.