Diabetes (Hansard, 29 June 1999)

§ Baroness Hayman
My Lords, we have announced that we shall be drawing up a National Service Framework for diabetes over the next two years. While it is for National Health Service trusts and health authorities to determine the numbers and grades of staff they need in order to provide good quality services, we shall consider issues of staffing and professional education and training as we develop the National Service Framework.

§ Baroness Masham of Ilton
My Lords, I thank the Minister for that Answer. Is she aware that about 100 consultants in district general hospitals dealing with this most complex condition, and in sole charge of patients, desperately need cover? Does she agree that there is a need for more specialised dieticians and nurses working within the hospitals and the community?

§ Baroness Hayman
My Lords, I agree that dieticians and nurses specialised in diabetes are key members of multi-professional teams co-ordinating care pathways for patients and that they need to work across the primary, secondary and tertiary care sectors. We must 173 ensure that we continue the training of qualified nurses with post-registration awards in diabetes care so that people are available to undertake that job.
Furthermore, I understand that at the end of September 1997, 297 consultants in England and Wales specialised in diabetes. There has been an increase in the number of trainees, and it is estimated that by 2005 there will be 472 consultants. They ought to be able to provide the cover to which the noble Baroness referred.

§ Lord Walton of Detchant
My Lords, does the Minister agree that the increased incidence, to which the Question refers, does not relate to Type I insulin-dependent diabetes, but to Type II non-insulin-dependent diabetes, which tends to develop in older people? Does she further agree that one of the major factors responsible is the increasing number of cases in Western society of another disease; namely, obesity? What advice are the Government giving to the public at large about the dangers of over-eating?

§ Baroness Hayman
My Lords, I believe that the public at large would prefer to take advice from the noble Lord, Lord Walton of Detchant, than from me. He is right to highlight diet, which is important in lowering the risks of obesity and cardio-vascular disease. That applies not only to people with diabetes, but across the population. I am sure that our forthcoming White Paper will, in dealing with the broad public health issues, take account of the noble Lord's suggestions about diet and, I would add, exercise.

§ Lord Rea
My Lords, does my noble friend agree that one way of reducing the load on diabetic specialists is to develop proper diabetic clinics in primary care and that the nurses she mentioned should play a major part in running those clinics? Furthermore, perhaps I may put in a plug for the Parliamentary Food and Health Forum, of which I am chair. It is holding a meeting at six o'clock this day week on obesity.

§ Baroness Hayman
My Lords, I am sure that Members of your Lordships' House will have noted the meeting, just as they note the times of the weigh-ins held by the noble Baroness. Lady Fookes, for those of us who wish to lose a little weight. My noble friend is absolutely right to highlight that a great deal can be done in primary care in terms of the care and education programmes for patients suffering from diabetes. Nurses specialising in diabetes lead education programmes to ensure that colleagues who are general practitioners and practice nurses are equipped to care for patients locally.

§ Lord Balfour of Inchrye
My Lords, I am grateful to my noble friend for asking those questions. I have an interest in that my wife is an insulin-dependent diabetic. Bearing in mind the expected rise in Type I and Type II diabetes, can the Minister indicate whether plans are in hand not just to increase the number of diabetic 174 nurse specialists but in particular to encourage GPs and practice nurses to take a greater interest in the problems associated with diabetes?

§ Baroness Hayman
My Lords, it is because we want to improve the care for patients who suffer from diabetes that the National Service Framework is being drawn up. In 1997 we issued guidance on key features of a good diabetes service. We want to build on that. The work we have been doing on the National Service Frameworks for coronary heart disease and mental health shows how we can use these as vehicles both for improving the quality of care overall and for improving the access to high-quality care in different parts of the country. The National Service Framework for diabetes will be a step forward in that respect.

§ Lord Clement-Jones
My Lords, in view of the massive, threefold increase expected in diabetes over the next 10 years, can the Minister say whether the Government will commit to a national screening programme for diabetes? What is the state of current consideration by the National Screening Committee?

§ Baroness Hayman
My Lords, certainly we must look carefully to see whether there is potential for screening programmes both for Type II diabetes and for diabetic retinopathy. The National Screening Committee, chaired by the Chief Medical Officer, is currently considering both those cases. I believe that preliminary advice may well be available at the turn of the year. However, many possible different approaches are being considered. Consideration of Type II diabetes screening is still at an early stage, but we hope to have some progress from the screening committee towards the end of the year.

§ Baroness Masham of Ilton
My Lords—

§ Lord Carter
My Lords, we are in the 25th minute. I think that we should move on to the last Question.