Last week saw the Health and Care Bill pass through the House of Commons and down the other end of the building to the House of Lords. I welcome the Bill, and I particularly welcome its aims and objectives to provide the best possible health and care to everyone in this country. However, to achieve that, things must change in the legislation.
On this basis, I tabled a number of amendments to the Bill, in areas that I believe need strengthening. I had the opportunity to speak in the debate on Monday about some of the following issues.
Currently, CCGs limit the types of medicines and medical devices they provide to patients in order to remain in budget whilst optimising patient outcomes. This results in a postcode lottery across the country to life improving and lifesaving drugs; something which a number of constituents have previously raised with me. To tackle this, I believe that ICBs should:
- Be required to ensure all NICE approved medicines/devices are available and promoted to their population because the cost of these drugs are already covered by the VPAS reimbursement scheme agreed between the NHS and pharmaceutical industry.
- If a treatment is unavailable in one ICB footprint, they should be required to commission the required treatment from another ICB.
- Promote uptake of Nice-approved medicines and report uptake of new medicines annually.
Governments of all persuasions over recent years have spoken regularly about the desire to achieve parity of esteem between mental and physical health, including in the NHS 10-year plan. However, for this to be meaningful there must be a legal obligation to that effect supported by reporting mechanisms on inputs to the mental health system (money and people trained/training places), outputs resulting including the number of mental health appointments/services made available/uptake, and the outcomes (i.e. patient numbers discharged from care).
Domestic abuse is a scourge on our society. While a crime it most often first manifests itself in GP surgeries not at police stations. Currently there is no training for GPs or other health professionals enabling them or expecting them to be able to spot, treat an individual suffering from mental or physical abuse or instruct them how to engage with police. Devon is the only health system to have a dedicated individual on the CCG board and a health and care strategy for victims of abuse. It has improved health and care outcomes through training and other interventions. This should be the case nationally and therefore I’m pushing to have it replicated.
The changes to the social care cap announced last week as an amendment to the Bill were done so at the last minute and without much detail. Having looked at the detail, I was concerned by the lack of proper impact assessment of the proposals and also the apparent need to rush this amendment through. Given it is amending the Care Act, it could have simply been enacted via Statutory Instrument (SI) at a later date once we had seen and been able to digest the forthcoming social care proposals. Therefore, I do not believe now was the right time to be making this change and I abstained on this amendment.
To completely oppose the Bill, as some have suggested, would be a complete dereliction of duty, bypassing the opportunity to improve the provision of health and social care services for Teignbridge residents. It is an opportunity to make much needed improvement to the system that currently exists, and I will continue to raise the issues I believe need addressing, such as the ones outlined above. My next move will be to meet with like-minded colleagues in the House of Lords to see if we can make some movement on these very important issues.
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