Health Bill [HL]

My Lords, in Committee, this amendment had wide support from all sides, for which I am grateful. The noble Lord, Lord Tebbit, is a supporter, but is taking his wife to hospital today. The noble Lord, Lord Carlile, supports it too. A spinal cord injury can happen to anyone at any time. It can be you, your dearest and nearest, your sons, daughters or grandchildren. You can fall from a fruit tree while pruning it, have an accident playing rugby or riding a horse, or dive and hit the bottom of a pool or a submerged object. You can have a road traffic or industrial accident; you can fall downstairs or down a mountain; or you can be injured on military service. It can happen in a split-second. If your spinal cord is severed or squashed, you can remain paralysed from the lesion down. Both my noble colleague Lady Wilkins and I have to declare an interest: we are both paraplegics as a result of accidents and were treated in spinal units, otherwise we would most likely not be here today. I have added "cord" to the amendment. In Committee, the amendment said only "spinal", which is far too wide. The damage to the cord is the vital element which makes these patients different and in need of specialised care, otherwise disasters happen—such as pressure sores, contractures and depression, costing extra billions of pounds to the National Health Service—because medical and nursing staff in general hospitals are not trained in this field and do not have the correct equipment and expertise. The amendment has been tabled because the current system is failing spinal cord-injured patients. Newly injured patients are not being admitted to a specialist spinal cord injury centre in time to limit the damage and prevent further complications. Readmitted patients, too, receive inappropriate treatment in district general hospitals. While the nine spinal cord injury centres in England and Wales are doing good work with limited resources, the current system is failing to use them to the best effect. Research has shown that two-thirds of those who sustain complete spinal cord injury as a result of cervical dislocation while playing rugby and who receive specialist treatment within four hours of injury will make a full recovery. Only 5 per cent of those receiving treatment after four hours will make a useful recovery, and none will recover fully. There are no national data on the number of people with spinal cord injuries, but there are estimated to be 40,000 in the UK. Seven hundred traumatic spinal cord injuries are estimated to be sustained every year. A further 300 or more non-traumatic spinal cord-injured people need access to a spinal cord injury centre. The amendment is asking for a national bed bureau for spinal cord injuries, which would enable accident and emergency teams to identify where there was a bed available in an appropriate spinal cord injury centre, so that newly injured patients could be admitted without delay. It is not a case of asking for more money to be spent on spinal cord injury care, but rather that it should be spent in a different way. A national bed bureau requires a single commissioning service. Currently a national bed bureau might identify a bed vacancy, but unless a commissioning arrangement were in place the bed could not be used. A single commissioning body would work towards a national standard of care, ensure that all spinal cord injury centres were funded to provide the same level and quality of service, and so remove the current postcode lottery. Audit funds allocated by the commissioners to ensure that funds are used by the spinal cord centres provide a framework for the exchange of knowledge, plan for the long-term future of the spinal cord injury centre service and identify gaps in service provision. I thank the noble Baroness, Lady Thornton, for all her help. She is a Minister who understands the situation. The director of the Spinal Injuries Association, the noble Baroness, Lady Wilkins, the chair of the spinal injury parliamentary group—Kevin Barron MP—and I had a meeting with the National Health Service National Commissioning Group for Highly Specialised Services which was hopeful and useful. Ann Keen, the Minister involved, wrote that she was very pleased to hear that our team had proposed some practical solutions to improve the situation, which included co-ordinating the establishment of an England-wide strategy group for spinal cord injuries, strengthening commissioning arrangements, developing and disseminating best practice, resolving information requirements and testing the feasibility of a bed bureau approach for spinal cord injuries. We from the Spinal Injuries Association would like to see appropriate, good-quality treatment and care for all. It is cost-effective in the financial sense and vital for the patient’s well-being and for the families, who can also be devastated. James Servars, who had a sporting injury in December and broke his neck, was in the Norfolk and Norwich University Hospital for four months on a respirator in intensive care. He has just been transferred to the Sheffield Spinal Unit. His sister tells me he feels safe for the first time since breaking his neck. He is off the respirator and has started making progress. What a wasted, expensive four months. He is now with people who know how to treat him with the correct equipment and attitude. He says he would like to help in any way he can and he thanks the Spinal Injuries Association for its help. Because we have a very serious situation, it seems to me that there should be something written in the Bill, as it is possible there might be a change of government, a change of Ministers—they might not understand the situation—and a change of civil servants. Might the Minister therefore bring his own amendment at Third Reading so that we can be assured that progress will continue? I beg to move.