Adult Social Care

Baroness Keeley Excerpts

Wednesday 1st December 2021 Commons Chamber

[Gillian Keegan]

On the latter point, I cannot say much more at this point, but a White Paper is being developed and will be available early next year. My right hon. Friend is absolutely right that that is another key part of making sure that councils can deliver on the obligations in the Care Act 2014.

The levy raises £12 billion a year, more or less. For the three-year period, the majority of that sum will go towards catching up with electives in our NHS. There are now 6 million people in urgent care, so that is the right thing to do. However, we know that we will need an increasing share of that fund as we go beyond the three-year period. Many of the reforms in the White Paper and many of the things that we will be working on will help to inform the discussions with the Treasury.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Social care is a vital service that has been in crisis for a decade. What we need is reforms to bridge the funding gap so that unmet needs can be met and more care packages can be delivered; a dramatic improvement in pay and conditions for care staff, to halt the exodus out of care work; and decent support for the 11 million unpaid carers who have done so much extra caring during the pandemic. Sadly, what the Minister has announced falls far short of what is needed. Does she actually believe that these half-hearted measures in any way match up to what the care sector needs to survive?

[Gillian Keegan]

This is a big reform that needs to take place, and it is based on demographic changes in the population all over the world. It is complex, and it will take a lot of time: it is a 10-year vision. I know that the hon. Lady has not had the chance to read our White Paper yet, but I am sure that she will see that there are a lot of things in it.

If we are actually looking to fix something—if we are looking to put a sustainable system in place that offers independence, choice, a great place to work and a great career—we need to fix a lot of solid foundations. I know that the Labour party always wants to throw money at the problem, but actually we need to make sure that the foundations are in place and that proper and sustainable funding is in place. That is what the White Paper delivers.

Covid-19 Update

Baroness Keeley Excerpts

Monday 29th November 2021 Commons Chamber

[Sajid Javid]

My hon. Friend makes a very important point. I know he rightly takes a close interest in this; we do want to minimise any impact on our excellent transport and travel sector. He is right to raise the importance of making sure that PCR tests are available, the pricing is correct and the Government website where providers are listed is properly monitored so that anyone who breaks the rules is delisted.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Although the measures taken so far are welcome, now that we have community transmission of omicron in Brentwood and in Scotland, we need more protective interventions. Mask wearing can obviously play an important part, so can the Secretary of State say whether he agrees with the call from the British Medical Association to extend it to all indoor and enclosed settings? Will he also consider measures to increase ventilation in enclosed settings, encourage working from home and give proper sick pay to those who need to isolate?

[Sajid Javid]

I think we have been clear about why we have set out the new rules on masks, and I think our response is the proportionate one. The hon. Lady is right to raise the importance of ventilation. That is why it is very clear in the guidelines, and many places are following that. When it comes to sick pay, it is right that we have kept the rules in place that allow people, should they test positive or have to self-isolate, to claim sick pay from day one.

Health and Care Bill

Baroness Keeley Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Matt Hancock]

It happens on an ad hoc basis, but it is not a right. The NHS is a great British institution, and access should apply right across the board.

Finally, in my last few seconds, may I simply say how strongly I agree with my right hon. Friend the Member for Maidenhead (Mrs May) about amendments 93 to 98?

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I rise to speak to amendment 73, which would introduce safeguards around the discharge-to-assess process.

The discharge-to-assess process may have been a necessary element of the NHS’s pandemic response, but it contains gaps in safeguarding that leave unpaid carers vulnerable to financial impact and risks to their health. Many unpaid carers have to begin caring overnight, when their relative or friend, who may be quite unwell, is discharged from hospital without a plan for their care at home. Without a carer’s assessment to check whether a person has the capability or capacity to take on such a commitment, weeks can pass before any plan is made, leaving carers and the people they care for struggling in a desperate situation.

The Government’s own impact assessment on discharge to assess states baldly:

“There is an expectation that unpaid carers might need to allocate more time to care for patients who are discharged from hospital earlier. For some, this could require a reduction in workhours and associated financial costs.”

Organisations that support unpaid carers are outraged by that statement. The Government’s expectation that carers can just drop everything to take on a new caring burden is insulting, particularly given the extra caring burden that 3 million people have already taken on during the pandemic.

I recently queried that point with the Secretary of State at the Health and Social Care Committee. In response, the he wrote to the Committee to say that the Government do

“not expect unpaid carers to need to give up work or reduce their working hours to look after friends or family while their long-term health and care needs assessments are completed”.

When the impact assessment says one thing and the Secretary of State, after being questioned about it, says another, I have to question the understanding in the Department and among Ministers of the discharge-to-assess policy and its impact on the 13 million carers in the country.

[Daisy Cooper (St Albans) (LD)]

Does the hon. Member agree that it would be helpful if the NHS had a duty, as I have attempted to capture in new clause 63, to identify carers, so that their health and wellbeing is taken into account when decisions are made about the people for whom they care? Does she agree that it would be helpful if the Minister responded to new clause 63 in winding up?

[Barbara Keeley]

I do indeed. The hon. Member may not know that, a few years ago, I introduced a Bill to try to persuade the Government to accept that the NHS should have a duty to identify carers. I have tried to introduce it on two more occasions since then, and I will send her a copy. I hope that the Minister will respond to what she has said.

Carers UK has reported high levels of fatigue and stress among unpaid carers, three quarters of whom feel exhausted and worn out because of' caring responsibilities during the pandemic. It would constitute a poor recognition of the sacrifice and dedication of those carers if discharge to assess was left without adequate safeguarding measures for them. Although discharge guidance already states that unpaid carers must be involved in discharge planning decisions when a patient has new or additional care needs, more than one in four are not consulted prior to discharge, and 60% say that at the point of discharge they received insufficient support to protect the health and wellbeing of the patient, or their own health.

Amendment 73 would protect carers from being left waiting an indefinite amount of time for care plans it would ensure that integrated care boards held responsibility for monitoring and reporting on any failures. I support its inclusion in the Bill, and, like the hon. Member for St Albans (Daisy Cooper), I hope that the Minister will respond to these points when he sums up the debate.

[Mr John Baron (Basildon and Billericay) (Con)]

Thank you for calling me, Mr Deputy Speaker, and I thank Mr Speaker for selecting my new clause 19. I also thank all those who have kindly supported it.

It remains an inconvenient truth that although our cancer survival rates are improving, we continue to lag behind international comparators. The primary reason for this is that the NHS does not diagnose cancers early enough. New clause 19 seeks to put that right by placing improved outcomes—that is, survival rates—at the heart of the NHS.

Health and Care Bill

Baroness Keeley Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Edward Argar]

I understand where my hon. Friend and Members from both sides of the House are coming from. This is the first major step forward in the reform of social care that we have seen in decades and must be seen as part of an overall package of changes.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

rose—

[Edward Argar]

I would like to make a little progress, if I may.

The reforms will make the existing means test far more generous. We are increasing the upper capital limit from £23,250 to £100,000, which will make masses of people with moderate assets eligible for some state support towards the cost of care earlier, and the lower capital limit will also increase, from £14,250 to £20,000. Below that level, people will contribute only from their income, fully protecting their savings and assets below £20,000.

Over recent days, people have compared our policy proposals to previous, abandoned and never-enacted proposals for reform. I am clear that our proposals will deliver the changes needed where others have failed and see a significant improvement on the system that is in place today.

[Barbara Keeley]

rose—

[Catherine West]

rose—

--- Later in debate ---

[Edward Argar]

While the hon. Lady and I do not always agree on everything, she asks a perfectly a reasoned and measured question. I pay tribute to Andrew Dilnot’s work on his report. I just happen to think that, on this point, we diverged from what he proposed and we believe that what we are proposing is the right way forward. We have always intended for the cap to apply to what people personally contribute, rather than on the combination of their personal contribution and that of the state. It will mean that people with fewer chargeable assets meter towards the cap more slowly, because they are paying much less each week than people who are entirely self-funding. This amendment will make it simpler to understand the amount that will go towards the cap and make it fairer.

[Barbara Keeley]

rose—

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

rose—

[Edward Argar]

If the shadow Secretary of State will forgive me, the hon. Lady has attempted on a number of occasions to get in, so it is only fair that I give way to her.

[Barbara Keeley]

On the point the Minister is making about the Dilnot proposals and a comparison, let me tell him that the Alzheimer’s Society said that 15% of people with dementia in the north-west would reach the cap under the Government’s proposals, compared with 34% under Dilnot’s proposals. That is a massive amount, and those are the people, with their families, who are paying hundreds of thousands and pounds. That is the comparison.

[Edward Argar]

I am grateful to the hon. Lady. I do not think that she posed a question, but she made her point clearly, as she always does.

--- Later in debate ---

[Edward Argar]

I am grateful to my hon. Friend, a member of the Health and Social Care Committee, for his intervention. He makes the point well that this is another step on the journey, but it is a journey that only this Government have actually got round to starting. Previous Governments have failed to make that progress. The previous Labour Government produced two Green Papers, one Royal Commission, and one spending review and nothing was done, so this Government are making significant progress.

[Barbara Keeley]

Will the Minister give way?

--- Later in debate ---

[Justin Madders]

My hon. Friend must have sneaked a look at my speech, because I will say later that it is Robin Hood in reverse.

[Barbara Keeley]

The proposal is grossly unfair. I gave the example earlier that in our region, 15% of people with dementia will reach the cap, whereas 34% would have under the Dilnot proposals. The cap also does not protect working-age adults who are accessing social care, or people with a disability, but Sir Andrew Dilnot’s proposals would have done. It is the second major area in which the proposal is grossly unfair.

[Justin Madders]

Again, my hon. Friend must have read my speech because I will make that point later. The proposal shows that the Bill is not a plan to fix social care but a very thin attempt to change parts of the system. There are many other elements that clearly need dealing with.

In case Conservative Members need reminding, in the Prime Minister’s first speech on taking office, he promised to,

“fix the crisis in social care once and for all, with a clear plan that we have prepared”.

We are still to see that plan. What we have is a new tax and a broken promise.

Covid-19 Update

Baroness Keeley Excerpts

Monday 15th November 2021 Commons Chamber

[Sajid Javid]

As my right hon. Friend will know, the reason that third doses, or boosters—however they are classified—are not currently shown on the app is that they are not required for domestic purposes to demonstrate someone’s vaccine status. However, I fully understand the significance of my right hon. Friend’s point. I recognise that this is now a requirement in some countries, and I think it important that we respond. I want to reassure my right hon. Friend, and other Members, that we are considering how best to make such information available, and I will have more to say about that shortly.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

The booster programme is critical to ensuring that those who are most vulnerable are protected this winter, and to driving down covid infection rates. In Salford, however, partners receive just £12.58 per vaccination for the programme, which they tell me is not enough to cover the costs of the infrastructure needed to run it, such as venue hire, call and recall, logistics, transport and security. Will the Secretary of State look again at that funding, and ensure that local areas are funded adequately to run the vaccination programme and increase the pace of the delivery of booster vaccines?

[Sajid Javid]

I listened carefully to what the hon. Lady said and I will take that away, but let me give her some reassurances. We work very carefully on the vaccination programme with GPs, local authorities and others. Obviously it is vital to ensure that costs and payments are covered, and we keep that constantly under review.

Endometriosis and Polycystic Ovary Syndrome

Baroness Keeley Excerpts

Monday 1st November 2021 Westminster Hall

[Barbara Keeley (Worsley and Eccles South) (Lab)]

It is a pleasure to speak in the debate with you in the Chair, Mr Mundell. I thank my hon. Friend the Member for Coventry North West (Taiwo Owatemi) for the way she opened this important debate.

Endometriosis and polycystic ovary syndrome affect one in 10 women and those assigned female at birth in the UK. As we have discussed, that means that over 1.5 million individuals are enduring a painful condition that can affect every aspect of their life. It is staggering that these conditions are so under-recognised. Common symptoms for a diagnosis include severe pain and heavy bleeding, but for those who have these conditions, that description barely scratches the surface of the reality of living with such a severe gynaecological disease.

One constituent wrote to me with a powerful testimony about her experience of living with polycystic ovary syndrome. She told me of the wide range of debilitating symptoms of her condition. She felt lacking in confidence and scared for her health and future. She felt that no one understood her, and she felt alone and overwhelmed by the condition. Constituents who have contacted me about endometriosis or PCOS report significant diagnosis times of between four and 14 years. This is an unacceptable amount of time for patients to wait while not getting the right care or even having a name for the condition that is causing their symptoms.

I had endometriosis and it had a big impact on my life. I was not diagnosed until the age of 32. I had multiple surgical interventions over more than 10 years. Surgery, as we have heard from my hon. Friend the Member for Streatham (Bell Ribeiro-Addy), does not cure endometriosis; it just comes back and back. Delays in diagnosing and managing endometriosis and PCOS can affect quality of life. Worse than the impact on quality of life, they result in a dangerous progression of the disease.

We have all touched on the work of the all-party parliamentary group on endometriosis, and I join Members in paying tribute to the work of Sir David Amess as its chair. There was an excellent report produced following an inquiry. I recommend that report and its 34 recommendations to the Minister, particularly those on investment in further research into gynaecological diseases, so that the waiting time for diagnosis can be reduced.

To these recommendations, we must now add the need to address the gynaecology backlog made worse by the pandemic. NHS England data indicate that the waiting list for gynaecology services has seen the largest increase of all the specialties since the pandemic began. Endometriosis UK’s recent survey showed that four fifths of patients with confirmed or suspected endometriosis had had NHS appointments for their condition postponed or cancelled due to the pandemic, and a third had not been given a new appointment date.

Sarah Lambrechts told the Health and Social Care Committee about her experience of having surgery for endometriosis delayed due to the backlog caused by the pandemic. The delay is, in her case, going to be for 18 months to two years. She said:

“I am 25 years old. For the next 18 months or two years—however long—I cannot plan my life. I cannot plan my career progression. I cannot plan to have a family. I cannot take care of myself some days.”

It is very sad that Sarah and thousands of others have experienced such an impact from the disease. We need urgent action so that those who have lived with the debilitating symptoms of endometriosis and PCOS for so long are not suffering because of a long wait for treatment caused by the backlog in NHS care. We owe it to those who have lived with these symptoms, often for many years, as I did, to reduce diagnosis time, improve treatments and, eventually, find a cure.

[David Mundell (in the Chair)]

I now call Alex Davies-Jones, who will not be our last Back-Bench contributor. I did not realise that Gavin Robinson wanted to speak. We will be able to squeeze him in, I think.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

I thank the hon. Member for Coventry North West (Taiwo Owatemi) for securing the debate, as well as all the petitioners who made it happen. I join everyone in paying tribute to Sir David Amess; I know he would have been here, holding my feet to the fire on what I was going to do about the important issues that have been raised.

Members on all sides of the House have spoken about the challenges faced by women suffering from endometriosis and PCOS. I pay tribute to the hon. Member for Streatham (Bell Ribeiro-Addy), who could not have put it better on not only the struggle for diagnosis, but the trauma of going through treatment. That is not an uncommon experience, unfortunately. There are serious issues to address. As my hon. Friend the Member for Thurrock (Jackie Doyle-Price) said, the conditions affect a significant number of women across the country. We are not talking about a small problem; its effects are on a wide scale.

Members have spoken about the pain, the heavy periods or lack of periods, and the facial hair or hair loss. However, it is about not only the symptoms, but the long-term implications. Fertility is an issue for both conditions, but they also affect relationships, the quality of life and mental health. The effects are wide-ranging.

It is unacceptable that the average diagnosis time for endometriosis is seven to eight years and that 40% of women take 10 or more appointments even to get to the stage of getting tests done and being diagnosed. It is imperative to have a greater focus on women’s health and to address some of those inequalities.

Although hon. Members have rightly said that this is not just about fertility, if it is about fertility for some women, those seven to eight years may be the only chance they have. That is seven to eight years too long. That is why we are embarking on England’s first women’s health strategy, which will set out a new agenda. I can confirm that it will include a section on gynaecological conditions, including endometriosis and polycystic ovary syndrome, and it will look at the research element. In the short time I have, I cannot expand too much, but I will announce more details shortly, because we hope to publish that before the end of the year.

I know that many, many women, men and families will be listening to this debate, and I want to put it on the record that I hear the concerns and issues that are being faced. I have my listening ears on and we will be taking steps to deal with some of the issues. The NICE guidelines on endometriosis are really clear. They list the symptoms that should be picked up and addressed, and that should alert healthcare professionals to the need to refer women, not gaslight them. It is concerning that, despite the NICE guidelines, many women are struggling in the way that they are. For PCOS, the clinical knowledge summary highlights symptoms that should be picked up and that should be flags for referral and care.

I take the point of the hon. Member for Belfast East (Gavin Robinson). We heard from the hon. Member for Arfon (Hywel Williams) that, when there are issues in Wales, women can access services in Liverpool. I am happy to meet the hon. Member for Belfast East to see what options are available for women in Northern Ireland.

In the short time I have, I want to turn to research—the subject of today’s debate. We have a world-class research system, as the vaccine rollout has shown, but we know that women are under-represented generally in research, whether that is older women, women from ethnic minority groups, women of childbearing age or women with disabilities. There is evidence that research is not addressing women’s issues. It is crucial that we have an evidence-based approach to dealing with endometriosis and PCOS because that is how we will ensure that the gold standard of treatment is being followed and that women know what they should expect. That is half the problem: women are in the dark about how they should be treated and their condition managed.

Funding is available. Over the past five years, the National Institute for Health Research has funded £8.52 million of endometriosis research. There is a £2 million trial on peritoneal endometriosis, looking at surgery versus non-surgical interventions to manage chronic pain. There is a study of endometriosis in primary care and the experience of both GPs and patients to see what is going wrong at the diagnosis stage. A practical toolkit has been put together to help patients and clinicians. We are also funding a study interviewing up to 80 women about what it is like to have a urogynaecological condition and the experiences they go through. There is £6.65 million of research into PCOS, including a £2 million randomised control trial looking at fertility options for women whose eggs are not being released from their ovaries.

Research is happening. My plea to researchers is that funding is not the barrier. There is a really robust system whereby research is presented, whether from clinicians, researchers, charities or other organisations, and judged on its merits in terms of what it is trying to achieve. The funding envelope is not the barrier. I encourage those who want to do research to come forward. If that is not happening, I am very happy to work with the APPG to find out where the gaps are and, if the research is not being accepted or funded, where we can do better.

[Barbara Keeley]

The Minister has not yet covered the serious point I made earlier about the backlog in gynaecology. Some 80% of women who are confirmed or suspected to have endometriosis have had their NHS appointments postponed or cancelled because of the pandemic. In my remarks, I quoted somebody who will now have to wait 18 months to two years for her surgery. That is not acceptable.

[Maria Caulfield]

I absolutely take the hon. Lady’s point. In the spending review, money for elective procedures was allocated to clear some of that backlog. People are waiting a long time, and every effort will be made to clear the backlog as soon as possible.

I reassure colleagues that we want to ensure not just that there is an evidence-based pathway for both endometriosis and PCOS in the NICE guidelines, but that it is followed in clinical settings, so that women know what to expect; in clinical education, to improve both undergraduate and postgraduate training, so that clinicians have the knowledge that they need on both conditions; and in primary care, to ensure good robust knowledge among GPs about both conditions, which are not just about bad periods or abdominal pain, and about the referral pathways that should be followed. On school education, it is so important that young women know what is and is not acceptable in relation to both conditions, so that they are pushing GPs rather than waiting seven to eight years for diagnosis or 10 to 12 appointments for an answer.

Research can make a real difference in a number of areas. Before I hand back to the hon. Member for Coventry North West, I reassure colleagues that funding is available. I urge all researchers who want to conduct research in this area to submit applications and bids, because there is no way that we will deal with many of the issues that have been raised today without them.

Oral Answers to Questions

Baroness Keeley Excerpts

Tuesday 19th October 2021 Commons Chamber

[Gillian Keegan]

We have started the trials and they are well under way. We are using three trial providers. Our final evaluation report is due in spring 2022 and I would be very happy to share that with my hon. Friend. The outcomes of this trial and the evaluation will inform the plans for the roll-out across the country. I am working closely with Paula and Tom, Oliver McGowan’s parents, who, incidentally, grew up in the same place that I did—in fact, two streets away. They are key stakeholders and, obviously, we will make sure that we set out the detailed plans for roll-out as soon as possible. I thank my hon. Friend and Paula and Tom for all the work that they have done in this area; it really is remarkable and will make a massive difference. On the annual health checks for people with learning disabilities, the NHS has already met its target two years ahead of time for 75% of people on the GP learning disability register to receive an annual health check. I would urge anybody to come forward to make sure that they take advantage of that very important step.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

The Government have not responded to the report of the Health and Social Care Committee on the treatment of autistic people and people with learning disabilities and that response is now well overdue. Sadly, there is continued evidence of ongoing abuse of people with learning disabilities and autistic people. I point the Minister to the deaths reported at Cawston Park. There was a terrible report on that recently. This needs immediate and assertive action. Autistic people and people with learning disabilities are often trapped in inappropriate units for six years on average. By delaying their response, the Government are demonstrating apathy with regard to the terrible treatment in places such as Cawston Park and other units. When will the Government respond and act?

[Gillian Keegan]

I share the hon. Lady’s concerns; it simply is not good enough. The events at Cawston Park—my first response as a Minister to an Adjournment debate was on that subject—were unbelievable and deeply traumatic. My deepest condolences are with the families of Ben, Joanna and Jon. I have committed to meeting with the families at the earliest opportunity so that I can understand their experiences directly. This is currently being arranged by officials and the Norfolk Safeguarding Adults Board. The Department continues to work at pace through the delivery board of cross-Government and cross-system partners to drive progress on implementing the Building the Right Support national plan, which is ultimately the answer to have much better support in the community. We will publish an action plan, outlining all of the plans that we have, how we will improve outcomes and how we will enable people to live well in our communities.

Covid-19 Update

Baroness Keeley Excerpts

Thursday 22nd July 2021 Commons Chamber

[Nadhim Zahawi]

I am grateful for my right hon. Friend’s question, and for what he has done during this pandemic in vaccinating and protecting people and helping with the covid vaccination programme. He raises an important question about flu, which I addressed earlier. I am concerned about the flu season, which is why we are being ambitious and looking to co-administer wherever possible. The operational plan is to go early—in early September—for both the covid boost and the flu campaign. However, he will know that flu is not in the covid category in that it is endemic. We are hoping to transition covid towards where flu is with an annual vaccination programme, but it is a very different virus to deal with.

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

On the vaccine roll-out, I would like to ask for the prioritisation of two groups. First, can unpaid carers be prioritised for boosters in the autumn? The JCVI has not put them on the priority list, but they were put in cohort 6 for earlier vaccines. Secondly, can I join my hon. Friend the Member for Ealing Central and Acton (Dr Huq) in asking for a solution to be found for the wonderful volunteers on the Novavax vaccine trial? They now find themselves not able to travel as they cannot get a vaccine certificate and their vaccines are not recognised in the EU. Will the Minister prioritise boosters for unpaid carers to ensure that they are fully protected this autumn? Will he also enable those trialists who have received live Novavax vaccines to have vaccine certificates?

[Nadhim Zahawi]

I am grateful for the hon. Member’s question. The Novavax trial participants will have their vaccine pass in the United Kingdom. We are working with other countries to make sure that that is recognised, but as far as the UK is concerned, they will be considered fully vaccinated, whether they have had the placebo or the vaccine. On her very good question on the booster campaign, the JCVI’s interim advice is that phase 1 should be the old categories 1 to 4, plus the immuno-suppressed, and phase 2 should be categories 5 to 9, which include unpaid carers in category 6.

NHS Update

Baroness Keeley Excerpts

Wednesday 21st July 2021 Commons Chamber

[Helen Whately]

My hon. Friend makes an important point, and it is why I am working closely with my hon. Friend the Minister for Health, who is leading oversight of the elective recovery work. We are very much discussing how we can make sure that, with the pressure of looking after people with covid, with winter approaching and with elective recovery, we are looking after our workforce through this period. Of course, looking ahead to the winter, it is important that people get not only the covid vaccination, if they are eligible, but the flu vaccination, so we can try to have as little flu as possible in what may be a challenging winter ahead.

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

Although it is welcome that the Government have launched their new autism strategy, they will need to do more than that to ensure that the 2,000 autistic people and people with learning disabilities currently detained in inappropriate in-patient units can move back into the community. For 10 years since the Winterbourne View scandal, the Government have failed to invest in the high-quality community services needed, and they have done nothing to stop the flow of people into in-patient units from the community.

Will the Minister commit to the funding needed to support all current in-patients in the community? Can she say when the Government will finally bring forward reforms to our social care system so that it provides the support autistic people and people with learning disabilities need?

[Helen Whately]

The hon. Lady refers to the importance of making sure that only those who really benefit from in-patient treatment should be in in-patient units. We know that is often not the case for autistic people, and sometimes those with learning disabilities, who are in-patients. We are working through our “building the right support” programme to reduce the number of in-patients, and we will continue to do so.

Health and Care Bill

Baroness Keeley Excerpts

2nd reading
Wednesday 14th July 2021 Commons Chamber

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I pay tribute to everyone working in health and social care and to unpaid family carers. All of them have gone above and beyond in their caring roles during the pandemic. The Government’s response to that could have been to give NHS staff a proper pay rise, to publish plans to put social care on a sustainable financial footing, or to recognise fully the tremendous contribution made by unpaid carers. Instead we have this Bill, and a top-down reorganisation of the NHS that will concentrate power in the hands of the Secretary of State, offering no guarantees of better outcomes for patients and removing rights from carers.

It is welcome that the Bill brings an end to every NHS contract having to be put out to tender and that some changes in the Bill reference unpaid carers, but further changes are needed. Change is needed to put a duty on the NHS to have regard to carers and to promote their health and wellbeing.

It is welcome that the Bill includes a duty on both NHS England and the integrated care boards to consult carers, but rather than just involve and consult them in relation to patients, the duty that is needed is for the NHS to consider carers in their own right, as proposed by the Health and Social Care Committee in its report.

It is worrying that the Bill undermines carers’ rights in relation to hospital discharge. Clause 78 removes carers’ fundamental rights by removing the need to assess a patient at the point of hospital discharge. The way that is done removes carers’ fundamental right to have an assessment to ensure services are provided to make sure the patient is safe to discharge into their care. This is an issue, as Carers UK quotes research showing that only 26% of carers were consulted about discharge and that a third were consulted only at the last minute.

The Bill proposes to extend the Care Quality Commission’s remit to cover the delivery of social care services. However, that excludes social care provided through NHS continuing healthcare. The Parliamentary and Health Service Ombudsman found last year that people continue to be seriously let down by failings in how continuing healthcare is delivered. I ask the Minister to agree with the Continuing Healthcare Alliance that there should be an additional duty on the CQC to assess integrated care systems’ delivery of their continuing healthcare duties and to hold them to account where these duties are not being met.

The Care Quality Commission will have a remit to rate local authorities’ delivery of social care, but when £9 billion has been taken out of social care budgets and long-term reform is consistently delayed, the Government should recognise that inadequate social care services are a problem of their own making.

Finally, I question the timing of the Bill. Staff are exhausted and are facing another wave of covid infections over the summer. I urge the Secretary of State to recognise that and adjust the timeframes for implementing these reforms so that they do not end up distracting from the NHS’s real job of caring for patients.

[Several hon. Members rose—]