Health Bill [HL]

I must declare an interest in relation to this amendment, which is about spinal cord injuries. I broke my back in 1958 and was taken to a nearby accident hospital at Swindon. I sustained a complete lesion at T5 and had many fractured ribs, a suspected head injury and serious internal haemorrhaging. My top half was in agony and I had no feeling below my breasts, which was most confusing. My life was saved by blood transfusions. Having lived through the night, and when the bleeding was controlled, I was transferred to the spinal unit at Stoke Mandeville Hospital the next day. We were treated in an old nissen hut but the medical nursing and physiotherapy were world-renowned, and the support from fellow patients was invaluable. Once I left hospital and got married, I realised that not all paralysed people went to spinal units, with the disastrous results of bowel and bladder problems, sepsis from infected pressure sores and irreversible problems such as joint contractures. That is why, with colleagues, I founded the Spinal Injuries Association 35 years ago. We are extremely concerned about the crisis situation that many people with spinal cord injuries, and their families, find themselves in at present. In many part of the country, people cannot be admitted to a spinal unit with the expertise needed to treat and rehabilitate them, so complications set in. One of the worst is depression. Since 1980, the number of beds has fallen while the proportion of people surviving spinal cord injuries has increased. Pressure on specialist spinal cord injury beds has led to long-term spinal cord injury people being admitted to general hospitals where they are not offered basic spinal cord injury care requirements, get the complications I mentioned and so increase long-term costs to the NHS. Amendment 126 inserts a new clause entitled, ""Admission of patients with spinal injures"." It states: ""The Secretary of State shall by regulations establish a national bed bureau for patients with spinal injuries to monitor and manage the availability of hospital beds for patients with spinal injuries … The bureau must in particular aim to meet the following objectives … to provide a single commissioning service across England and Wales for the provision of beds in spinal units … to work with primary care trusts and hospital trusts to co-ordinate information on the availability of hospital beds for patients with spinal injuries within each strategic health authority; and … to ensure that beds are made available to patients with spinal injuries as soon as possible following admission, both when a patient is admitted for the first time and when a patient is urgently readmitted"." Spinal cord injury centres are classed as specialised services under the Department of Health’s national definition set. Specialised services are those with low patient numbers requiring a critical mass of patients to make care costs effective. Specialised services are vital, but expensive in isolation. Primary care trusts currently come together to form consortia to commission such services. The Government’s commissioning framework includes many of the recommendations made by the independent review of commissioning arrangements for specialised services led by Sir David Carter. However, the system does not seem to be working as far as spinal cord injury patients are concerned. If it were working, a spinal cord injury patient with a medical emergency, whether a new acute injury or a readmission condition, would be promptly admitted into a place of safety. This is not happening in a large proportion of cases. I am told that there has been no improvement in the care offered to spinal cord injury patients since the South of England Board was established. Matters are worse than before, and I keep hearing of severely injured tetraplegics—people with broken necks—having to be kept in general hospital intensive care units on respirators, costing, on average, £2,000 a day. They could be having expert treatment in spinal units for less cost if the facilities existed and if free spinal beds and funding were transparent across the country in a true National Health Service spirit. At the opening of a cancer centre two weeks ago, Alan Johnson, the Secretary of State for Health, said: ""This centre should reassure patients that the advances we have made recently in cancer services are only the beginning of what we intend to be able to provide in the near future"." That is good news, but in the amendment we are only asking for the correct treatment for spinal cord-injured patients, whose fate at the moment is a lottery. The noble Lord, Lord Darzi, always quotes his wish for high quality care for all. I hope that the Minister will seriously consider the amendment. I beg to move.