Health Bill [HL]

My Lords, it is extraordinarily difficult for me to know where to begin, so I think I will begin with the noble Lord, Lord Darzi. He is a mister. If he were not a noble Lord and you were to write to him, would you put an ““Esq”” on the back, because he is ““of Denham””? I will begin with Denham. I must declare an interest because if you do not these days you may get into trouble—people will think that you have none. My first interest in this goes back to my great-grandfather who had a house at Denham. He was the first person with a dairy herd to isolate tuberculosis and to keep badgers out in defence of his property, which upset many people. I have always been interested in tuberculosis, and in bugs and viruses. I found that I had the weakest of all things—a weak stomach. Whenever the food was bad, I was sick, but I have never spent a day in bed in my life. The Saudis once suggested that I should be appointed royal taster. I thought that we were here to debate making people better, keeping them well and letting them live longer. We seem to have somehow lost our way. I now return to one of the noble Lords on my own Bench, my noble friend Lord McColl. He is a doctor and a great man and does a lot of good around the world. In my days in the Middle East I often wondered why people lived so long. Ayatollah Khomeini’s father was meant to have died at 123. I was told that Gaddafi’s father had died at 106. I asked the noble Lord, Lord McColl, ““You were sometimes in Africa. Were you ever in Libya?””. He was not really interested in talking to me because he was talking on a much higher level, but he said yes. I said, ““Would it be possible that Gaddafi’s father could have lived to 106?””. He said, ““Yes, I think I last operated on him when he was 103, but I'm not sure whether it was lunar or solar””. That for me was almost as great an event as when the noble Lord, Lord Darzi, saved the life of the noble Lord, Lord Brennan, and the most reverend Primate the Archbishop of York was praying on the other side. I can say this because the noble Lord said that it was public property. He turned afterwards to the most reverend Primate and said, ““I won””. Those were great events, but the speech of the noble Baroness, Lady Campbell of Surbiton, was also great because it made me think. The problem facing us is bureaucracy. We have potentially the most powerful health unit in the world. It accounts for somewhere around 12 per cent of GDP. It was 8 per cent of GDP but GDP has fallen so quickly. The one thing that we have in this country which employs a lot of people is the health service. I must declare an interest. My uncle, my brother-in-law, my sister’s husband and a nephew all worked in it and I have a great respect for it, but not for the bureaucracy. In this country, we have things that we have forgotten about. We need to be able to research, diagnose and then treat. We need to know what it is we are seeking to diagnose and treat. In all the time that I have been involved in building hospitals, my favourite appointment was when I was director for many years of the oldest healthcare company in the world—Terme di Porretta near Bologna. We built healthcare centres in places as old as Roman times—for example, in Zarka Majin, in Jordan, where Herod beheaded John the Baptist. We studied where the pharaohs were and we believed in the mind and the body. It was almost ““physician heal thyself”” in that the body will heal itself. In this country, we have some of the best research in the world. Unbeknown to many of you, we are almost the most successful pharmaceutical country in the world. We export somewhere around £12 billion a year and have a turnover of £20 billion. We employ 72,000 people and the production per person in the pharmaceutical or healthcare sector is higher than in any other sector of the industry in the world. Also, the R&D in pharmaceuticals is greater by far than even defence. Here we are, one of the leaders in Europe and a net exporter when, at the moment, we have a deficit in visible exports this year of maybe £100 billion. The health service is employing 1.2 million people. It employs more people than any other health service in the world. That does not matter, but the people who are already there need to be reorganised to be more productive. We should also recognise that with our historic links, the English language and the ability to speak Latin in English—I did not know that many great physicians can—we are at a point where this could be the most important commercial business of this country for the next 25 years. Rather like the noble Lord, Lord Stoddart of Swindon, I do not believe that we should say that it is free at the point of delivery. We are all clients. We are customers. We have our rights and people would like to serve us. The potential does not seem to have sunk in. From time to time, on the basis that I was interested in tuberculosis, I became interested in MRSA and all the hospital-borne diseases. I tried to work out where the bugs came from. I call them bugs although you are not allowed to do that. Suddenly, I was on a human embryo and stem cell committee. I was the only one who did not know what I was talking about or what other people were saying. A certain noble Lord would whisper to me, ““Why didn't you ask the Chief Medical Officer about the primitive streak?””. So I asked about the primitive streak and he could not tell me about it. Then I suddenly realised that the Home Office was involved and what we were talking about was effectively DNA—the original cell. I got involved and I declared an interest. I spoke to the Minister at some point, who then wrote me a letter and asked me whether I would be kind enough to go and see him. I took all the papers that I had written myself and he could have papered his office with them, but I know that he would have given them to someone and they would have ditched them. I then said that I would come and see him again because here within Europe we have really great potential. We have the R&D here. We have the people who have been trained. I have never really understood why a vet trained for five years and a doctor for only four years, but a surgeon trains for ever. I have talked about some of the latest things in diagnosis and the latest equipment. Unfortunately, historically, all the diagnostic equipment was British. That has all gone out of the window. Much of the surgical stuff has gone. One of my earliest clients was Thackeray, which made hip joints. Now we find that the continent of Europe has BMW service stations where you can do elective surgery—nine operations per surgeon per day of 40 minutes each. There are right-handed and left-handed people on the right sides of the bed and everything is there—bone banks and blood banks. I am president of the Anglo-Swiss Society. We tried to close it down but we could not quite. Switzerland was where we all went. I was looking at how we might be able to use adult stem cells for regeneration. The people in Switzerland are pretty good at that and we were looking to set up an adult stem cell bank using the latest cryotechnology for research into treatments. I said, ““Do you have any MRSA or C. difficile?””. In Holland they have the least, at 6 per cent; in the United Kingdom we have 23 per cent. You cannot take a Dutchman into Germany and send him back again unless he is treated. This is a bug. I said, ““Do you have any incidence?””. They said, ““Yes, I think so. We'll let you know””. The next day in Davos they said, ““Two””. I said, ““Two per cent?””, and they said, ““No, two””. I asked them why and they said, ““It doesn't survive here””. I suddenly thought that when people went to higher altitude stations when they had tuberculosis, they would not be cured, but maybe the bugs would not mutate. Therefore, in that cold, dry atmosphere you would have clean hospitals. I do not know whether that is true. Down below the Swiss hospitals, there are bunkers. You have to be ready to be invaded. There is a nuclear bomb shelter that is absolutely clean and clear. What we are going to try to do with the British side—it is accepted as the best in research—is to see if we can start to go back to using people's body parts to heal themselves, which has worked extremely well. There are many instances of this and I will not go into allogeneic or all the types of stem cells. I have to learn them by heart. But here is one technical area that is really very exciting. There is also money to be made. We have the biggest balance of payments surplus in drugs of anyone in Europe and we are right in the forefront of it, but somehow the bureaucracy of our great organisation does not realise that the noble Lord, Lord Darzi, on his own with three people could probably do the same amount as 500 people. I talked to him also about some of the latest technology, including the da Vinci machines for elective surgery, whereby remotely you look to combine drugs and elective surgery without the need for hospitalisation. I am getting a bit carried away.