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House of Lords
Tuesday, 15 March 2005.
The House met at half-past two of the clock: The LORD CHANCELLOR on the Woolsack.
Prayers—Read by the Lord Bishop of Chelmsford.
Lord De Mauley, having received a Writ of Summons in accordance with Standing Order 10 (Hereditary Peers; by-elections) following the death of Lord Burnham—took the Oath.
Prisoners: Diabetes
Lord Harrison asked Her Majesty's Government:
The Parliamentary Under-Secretary of State, Department of Health (Lord Warner): My Lords, from 1 April 2005, NHS primary care trusts will commission primary health services in almost all publicly run prisons in England. Mainstreaming prison health services in that way will bring about further improvements in the treatment of diabetics in prison, in line with the National Service Framework for Diabetes. Improvements will include better identification on reception, the establishment of specialist diabetes clinics in prison and closer links with NHS diabetes services, the introduction of retinopathy screening and practice-based registers, and improved continuity of treatment on transfer or release.
Lord Harrison: My Lords, I thank my noble friend for that Answer and for the welcome news that he conveys. However, does he appreciate that at the moment only 29 per cent of PCTs have a dedicated policy on diabetic prisoners? That leads to a mismatch between custodial and clinical care, which results in diabetic prisoners not doing their blood sugars well and having wrong diets, wrong meal times and, on occasion, inadequate physical exercise. In addition to what he proposed, will he study and possibly replicate the good practice at HMP Littlehey in Huntingdon, where supervision and clinics are provided in close partnership with specialist diabetologists from local hospitals?
Lord Warner: My Lords, my noble friend is right. HMP Littlehey ran one of the 18 pilot schemes, which we will roll out nationally in April. As he says, it has been a great success. The improvements taking place in prison health services have been mentioned by the Chief Inspector of Prisons. Some of the improvements in places such as Littlehey are shown in Diabetes UK's bimonthly magazine for March and April.
Baroness Masham of Ilton: My Lords, is the Minister aware that there are now specially trained
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diabetes nurses? Would it not be a good idea for them to train all the prison staff and prisoners on the needs of diabetic patients, who have hypos, pass out and have all sorts of problems if their sugar levels go too low? Are Canderel and Splenda—sugar substitutes—provided in prison for prisoners?
Lord Warner: My Lords, my grasp of the inner workings of the Prison Service do not extend to answering the noble Baroness's question on the availability of Splenda, but I will look into it. She made a more general point about nurses. We have made the transfer to the NHS taking responsibility for prison healthcare so that, from April, primary care trusts will be able to commission the services most appropriate for prisoners in their circumstances. The kind of ideas that she suggests will be one of the things that they will consider, I am sure.
Baroness Barker: My Lords, what progress has there been on the recommendation from the prison health service in 2002 that there should be a register of diabetic prisoners? In the Minister's response to the noble Lord, he talked about public prisons. What is the position in contracted-out prisons?
Lord Warner: My Lords, one matter that is being improved is that there should be a register of prisoners with diabetes. I cannot say what the precise arrangements are, but that is certainly one requirement that should be put in place. Another improvement is that a lot of work has been done on transfer out. An example is ensuring that NHS Direct credit cards are available. Prisoners can fill in a claim form—NHS HC1—for help with healthcare costs. Prisoners are also helped to get back on to GPs' lists on release.
Baroness Morgan of Drefelin: My Lords, now that the Department of Health has responsibility for healthcare in the Prison Service, will the Minister assure us that inmates will have access and the opportunity to take up the department's advice on healthy living, such as access to five portions of fruit and vegetables a day and regular exercise?
Lord Warner: My Lords, I am sure that primary care trusts will consider that issue when they consider services for the health of prisoners. I can reassure my noble friend by saying that the Government have put extra resources into prison healthcare. About £40 million extra will be spent over the next year or two in strengthening those services.
Lord Harrison: My Lords, will my noble friend work with his colleagues in the Prison Service to ensure that prison staff training is adequate? For instance, a distinction should be able to be made between a prisoner having a hypoglycaemic reaction and one who is simply acting up.
Lord Warner: My Lords, I am sure that the Prison Service will take account of those issues in the training of staff to achieve better integration between the
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custodial services and the health services, but I shall certainly draw the attention of the Prison Service to my noble friend's point.
Lord Hylton: My Lords, the Minister mentioned that almost all prisons are now covered by national health services. Which prisons or which categories of prisons are not yet covered?
Lord Warner: My Lords, there are two or three, but I cannot remember which, so I shall write to the noble Lord.
NHS Hospitals: Mixed-sex Wards
Baroness Knight of Collingtree asked Her Majesty's Government:
Lord Warner: My Lords, we have set clear standards that require single-sex accommodation to be provided. Data collected for 2003 show that 97 per cent of National Health Service trusts provide single-sex accommodation. This is defined as single-sex sleeping areas, separate bathroom and toilet facilities for men and women and, for those trusts providing mental health services, safe facilities for those who are mentally ill.
The remaining 3 per cent of trusts are undertaking building projects and will be compliant when these are complete. We are currently collecting data for 2004 and will publish this in May. We expect this to show that the rate of compliance has risen.
Baroness Knight of Collingtree: My Lords, is the Minister aware that press reports in recent weeks have indicated that there is a doubt about the 97 per cent figure? Does he recall telling this House only last Wednesday that his Government keep their promises? Can he explain why a promise made in 1997 and again in 2001 to abolish all mixed-sex wards has still not been kept? The promise was made eight long years ago and those wards still exist.
Is the Minister also aware that, for many sick people who are conscious and aware of their surroundings, it is a gross indignity to be forced to be in a ward where there are members of the opposite sex? Is he not concerned that the most recent government diktat—that hospitals will be penalised if they do not get rid of mixed-sex wards and waiting lists—is liable to increase the problem?
Lord Warner: My Lords, I am not sure that I recall all of the noble Baroness's lengthy questions, but I shall do my best to respond to their spirit. I remind her and the House that the Conservative Party's policy on mixed-sex accommodation had exactly the same
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objectives as that of this Government. We have not changed the guidelines in any way from those that were issued on this subject before 1997. The difference is that they set no targets for their achievement, put no resources into it and cut the number of hospital beds by nearly 160,000, which made achieving single-sex accommodation far more difficult.
However, we have kept the promise that we made and perhaps I may refer the noble Baroness to the announcement made by my noble friend Lord Hunt on 13 January 2003, which showed that we had met the target of 95 per cent that we promised. I shall provide a few figures to help the noble Baroness with this difficult issue. There are about 10,000 general wards in the NHS and only between 100 and 120 do not have single-sex accommodation.
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