Health Bill [HL]

I give general support to the principles underlying the extremely important amendment. Having a national bed bureau for patients with spinal injuries is a wholly admirable idea, as is that of having a single commissioning service across England and Wales for the provision of beds in spinal units. As the noble Baroness, Lady Wilkins, has said, the existing spinal cord injury centres have grown up largely for historical reasons in places where, if one were planning the service from the beginning, one would not necessarily place them. I knew the late Doctor Ludwig Guttmann personally. He was most outstanding and inspirational. His idea—his vision—was to develop that famous spinal injuries centre at Stoke Mandeville, where the quality of treatment, management and rehabilitation and after-care of patients was of such very high quality, as it continues to be today. The National Health Service has funded it substantially, but a lot of the funding for the unit and many of the facilities that have been developed there has come through charitable activities—not least those of Jimmy Savile and others, who have produced an enormous amount of funding. I have to declare an interest, first, as a patron of the Spinal Injuries Association and, secondly, because my younger daughter, who suffered a spinal injury three years ago, received outstanding care at Stoke Mandeville. Elsewhere, for historical reasons, Dr Silver established a nascent spinal injuries centre in Southport, which has grown and developed. He later became the director of Stoke Mandeville. For many years in the northern region, which is where I have lived and spent much of my professional life practising neurology, few services were provided for spinal-injured patients. I was brought up in the middle of the Durham coalfield in a mining community. At one stage, there was an attempt to build a spinal injuries unit in a district general hospital at Hexham, but the staffing levels and the ability to attract the appropriate level of staff, including nursing and medical, was not good. Eventually, the region decided to establish a spinal injuries unit at Middlesbrough. That unit at the James Cook University Hospital, Middlesbrough, has an excellent reputation and has developed very well. But Middlesbrough is 50 miles from the biggest centre of population on Tyneside. The region includes Carlisle and Whitehaven. Patients suffering spinal injuries in the west of the region have to travel enormous distances to get to that centre in Middlesbrough. The unevenness of distribution of these centres across the country is unsatisfactory, despite the level of service that they give. The one caveat that I have to say to my noble friends Lady Masham and Lady Wilkins is the heading of the proposed new clause, "Admission of patients with spinal injuries". It is important to recognise—I speak as a neurologist—that these centres also treat effectively patients with non-progressive spinal chord deficits, illnesses such as transverse myelitis, spinal artery thrombosis and so on, which also cause quite severe degrees of paralysis. I shall never forget, in the first year that I was a consultant, being called out by a GP at lunchtime to see a boy aged 17 who had cycled to school that morning. On the way home, he developed weakness in one arm and subsequently in the other arm, along with sensory loss. By the time he got home, he could no longer ride his cycle and was becoming paralysed in both lower limbs. I saw him at noon. By one o’clock we had him in hospital and by two o’clock he was on a respirator, paralysed in all four limbs, due to transverse myelitis. Subsequently, he was cared for brilliantly and, finally, was transferred to a spinal injury unit. He made an excellent recovery, eventually went to university and got an excellent degree. That kind of non-traumatic neurological illness also needs to be handled in these units. It is important to take account of all those needs as well. It is crucial and, I fully appreciate, extremely difficult for the Government to overlook the historical background which led to the establishment of some of those units, frankly, in the wrong places; that is, remote from major centres of population. But the idea of having a national bed bureau and a single national commissioning service to improve the facilities of spinal injured patients and patients with spinal disease causing paralysis across the country is admirable. Hence, even though I would perhaps dabble a little with some of the wording, I strongly support the principle of this amendment.