To ask Her Majesty’s Government what plans they have to implement the recommendations in the Chief Medical Officer’s annual report of 16 March on the management of chronic pain.

My Lords, we welcome the recommendations on the management of chronic pain in the Chief Medical Officer’s 2008 annual report. Many of the recommendations are already in line with existing guidance and practice in the NHS. We will consider what further action may be needed in the context of advice from the National Quality Board on clinical priorities for the NHS.

My Lords, I am grateful to the Minister for that positive reply. Does she accept that the 8 million or so people of all ages who suffer from chronic pain can do a surprising amount for themselves to control their pain provided that they have access to multidisciplinary pain management teams? In view of the fact that only 14 per cent of them have access to any pain specialist, will she urge the Government to give the highest possible priority to implementing the Chief Medical Officer’s recommendation—to use his own words—

“to widen access to high-quality pain services”?

My Lords, I thank the noble Lord for bringing this important issue to the attention of the House and recognise that, in the tradition of the House, he has been persistent in his questioning and championing of this issue. He is absolutely right that we cannot have people accepting pain and using expressions such as, “I musn’t grumble” or, “I suppose I’m not too bad today”, as they have in the past. We are delighted that our Chief Medical Officer has taken this issue so seriously in his report, which is independent and will be received in the spirit in which it is meant. We are taking action already in line with his recommendations and we will definitely take them further after the National Quality Board has given its advice.

My Lords, my noble friend will know that I am an ankylosing spondylitis sufferer, which means that I live in constant pain. I wonder whether she has had time to consider the call by Anne Begg MP in the other place for a national advocate—a champion—who could deal with issues of pain and co-ordinate research by all the medical institutions and companies throughout the United Kingdom. These organisations are currently doing a lot of work but a lot of it overlaps.

My Lords, although I know that my noble friend has an aversion to words such as champion or tsar, I will use the word champion. We welcome the contribution that, for example, members of the British Pain Society have made to the improvement of chronic services, and this is one of their demands. We will consider the need for a national champion in the light of the advice which we receive on the priorities for clinical improvement that were outlined by our Chief Medical Officer. Our view is that such appointments need to be made very selectively as they inevitably raise expectations, but following a detailed national strategy and the possibility of ring-fenced funding. So we have not ruled this out and we will be considering it.

My Lords, are any specialist nurses trained to deal with chronic pain? If not, what plans do the Government have to introduce such training? Specialist nurses have been very helpful to patients in all sorts of fields.

My Lords, the noble Baroness raises a very important point. Indeed, the Chief Medical Officer’s report pointed specifically to the training that medical staff should receive in the treatment of chronic pain. We have discussed the CMO’s recommendations with the Nursing and Midwifery Council and asked it to consider putting new professional standards into its training on precisely this subject.

My Lords, do the Government recognise that there is need for an all-systems approach to improve the management of pain? Undergraduates in nursing and medicine all need to know that they have learning outcomes in the assessment and management of pain which are examined in their final exams and become part of the revalidation procedures. The public also need education in what to expect from analgesics and in how they can help themselves to cope with chronic pain. Postgraduate training is needed for the safe and appropriate prescribing of analgesics and the use of other therapies such as those championed by the chronic pain management programmes.

My Lords, as ever, the noble Baroness gives me more information than I am likely to give her. She is absolutely right. We accept that more needs to be done to ensure that all patients have access to high-quality pain services, including pain management, and we intend to grow the number of expert patients—that is, people who are supported in the management of their conditions and the pain that they experience.

My Lords, will the department enable staff of care homes and nursing homes to develop pain management skills above and beyond the administration of analgesic drugs?

My Lords, I think that the last time this issue was discussed in the House the noble Baroness mentioned the Help the Aged and Patients Association reports about older people. Of course, we believe that older people should be treated with dignity and respect and that they should receive appropriate and humane care in all care settings. Therefore, we welcome those two reports as important contributions to this debate. We will review the individual recommendations addressed to the Government in the light of advice and the discussion that is taking place with the National Quality Board.

My Lords, what note have the Government been able to take of the wide experience of hospices in the management of pain? Is there movement to take account of that experience in the proposals that are being developed?

My Lords, the right reverend Prelate makes a very important point. The guidance that we are preparing is being developed with leading pain clinicians and a large range of stakeholders. They include those in the hospice movement, who are very experienced in such matters.

My Lords, is the Minister aware that there is a new parliamentary pain group? A lot of people are very interested in this subject, including the issue of pain in children.

My Lords, I am aware of the establishment of the All-Party Parliamentary Group on Chronic Pain. It will be launched next week, on 11 May, and I hope to get along to the meeting. I am not at all surprised that the noble Baroness will be an active participant in this group.