Queen’s Speech

My Lords, I welcome the opportunity to speak in this debate on the gracious Speech, as there are three Bills concerned with children, learning, schools and health. I was interested to hear the noble Lord, Lord Lucas, say that big strides have been made in health provision in this country over recent years. For instance, the Healthcare Commission has applauded NHS improvements, citing the enormous benefits derived from increases in funding, the improving health of the nation, a sustained improvement in achieving government targets and a reduction in waiting times. However, had noble Lords been listening to the BBC this morning and heard its interpretation of the commission’s findings, they would have a completely different idea and would think that the NHS improvements were being criticised. There is a question to be answered here: why is public opinion to a large degree sceptical about the advances made in the NHS? Noble Lords who have received healthcare recently should ask themselves whether they were happy with the outcome. For myself, I have done very well from many wonderful people in the health service. However, when people are asked about their perception of the NHS as a whole, they seem to have a dimmer view of it. Touching again on a point made by the noble Lord, Lord Lucas, this is more to do with perceptions bred in the press, and no less in the BBC, where a certain negativity and lack of balance in the presentation of reports sometimes snares us. I want to point out to my noble friend the findings of the Economic and Social Research Council, which has also examined public perceptions of the NHS. In an important article published recently, the council points out that NHS reforms are often presented as bureaucratic and budgetary in nature where perhaps greater emphasis should be placed on the Government providing resources for doctors, nurses and all the other staff working in the NHS to provide care to patients and those who wish to maintain good health. Perhaps we have to make progress in this regard because we are not going to get much help from the media. I want to concentrate on the treatment of diabetes, the condition known as the ““silent killer””. I welcome the appointment of Dr Rowan Hillson as National Clinical Director for Diabetes. This week she addressed the Parliamentary All-Party Group on Diabetes. While recording many advances, she declared that there is still much to do. I take just one point from her address, when she asked why the life expectancy for men with diabetes is 17 years shorter than for those without the condition, and for women it is an astonishing 20 years. For all the advances made, why is that the case? We need to recognise that when diabetes is properly treated, people can lead long and fulfilling lives. I have a series of specific questions for my noble friend, although he may wish to pass them on to my noble friend Lord Darzi. We have seen the establishment of a successful retinopathy screening initiative recently, in which I have taken part, as well as vascular risk assessments, which are so important to diabetes sufferers. However, we need more investment in raising awareness of diabetes. Diabetes UK believes that there are still some 1 million undiagnosed diabetics who, if their symptoms were recognised early enough, could benefit from the success of earlier intervention. The incidence of diabetes may be high in Britain, but it is certainly also very high elsewhere in the world. Why is the take-up of insulin pumps dramatically lower in the United Kingdom than in other countries of comparable economic standing? This is an important point because pumps provide a better way of controlling the condition. Will he also note that diabetic in-patients are still having considerable problems if they have to stay in hospital? A recent survey demonstrated that only one in four patients in that situation is visited by a diabetic specialist, which is deplorable. Will he also consider training for paramedics and ambulance staff to enable them to better recognise when someone is having problems with diabetes after a hypoglycaemic reaction? Have the Government considered whether there should be a separate approach towards the treatment of diabetes 1 and diabetes 2? They are both diabetes but in many ways they separate and diverge and perhaps we need greater sophistication of treatment. The transition from paediatric to adult services for young diabetics needs to be planned around the needs of young people and, again, we need more sophistication there. On the issue of children with diabetes, there was a parliamentary day here on 18 November to which I went along, as did some Ministers. This was in the wake of an excellent paper from DCSF about making all children matter, which has some useful things to say about young diabetics in school. It was an inspirational day, not only for the children involved but also for their parents. I know that the noble Baroness, Lady Pitkeathley, who is on the Woolsack at the moment, has a very strong interest in carers, and those of us who have had the experience within families of seeing a mother—and it often is the mother rather than the father—having to care for a young diabetic and trying to get them to inject themselves with insulin will know that it is a terrible imposition. These people are real heroes and heroines, if I am still allowed to use that phrase within our society. There are too many bad practices in schools. As someone who is married to a teacher, I realise that teachers have to absorb an enormous amount of knowledge, but I received a letter from a woman with a young diabetic child who had come to see us on that parliamentary day on 18 November. She describes how bad it was in the first school that her five-year old attended. The teacher there stated that she was not aware that the child needed insulin injections, even after she had read the literature. She said that once the child had had a hypoglycaemic reaction it should be treated by an injection of insulin—but it is deadly to get that wrong. There was also a desire to keep from the rest of the children the fact that the child from time to time had to leave the classroom to administer whatever was required for her therapy. The mother then moved the child to an adjacent school some two miles away and she describes—this is the heartening bit—how astonished she was at how seriously this school took the treatment of the child within the educational set-up. The head took the view that the other children should be involved and know that the child had diabetes and, in time, help to ensure that she was able to have a successful day in school. The mother said that she was absolutely stunned when the teaching assistant thanked her for entrusting the child to her. She also tells me that the head and the other teachers had planned the transition to year two at least one month in advance and had called her in to discuss it. We have contrasting good and bad practices and we should encourage the good practices as much as we can. I also wish to mention Parkinson’s disease. The Parkinson’s Disease Society, of which I am a vice-president, welcomes the opportunities provided by the welfare reform Bill for helping Parkinson’s sufferers to remain in or to return to work. However, we need more support, resources and understanding of Parkinson’s, which is an unusual disease in that it is complex and fluctuating in nature. I end with the example of the single equality Bill. Some 17 per cent of Parkinson’s sufferers have had to give up work because of the difficulty in accessing key public transport services, so we support what the Government are doing, but resources must be supplied on the other side to ensure that those who are suffering—from Parkinson’s, in this case—have the ability to remain in work or return to it.