Health and Social Care

Baroness Bennett of Manor Castle Excerpts

Monday 6th December 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness for the points she makes. We are doing what we can to support the dedicated NHS staff in healthcare services. This year alone, we have invested over £15 billion on top of the existing NHS annual budget, and that includes funding to help get patients out of hospital, freeing up beds and supporting hospitals to manage Covid-19. In addition, we are looking at how we can tackle capacity issues on NHS 111 and A&E. We are giving NHS 111 £98 million to boost capacity, help people avoid unnecessary ambulance trips to A&E and take pressure off hospitals. We realise that NHS 111 is often the first port of call to provide urgent medical advice quickly and book time slots for people at their local A&E or appointments at alternative services. We are also delivering the largest ever seasonal flu vaccination programme, so we hope to tackle it on that basis. A number of CCGs and others are having conversations about how we can tackle the pressures on A&E.

The noble Baroness makes the point about staff who, during Covid, went way beyond the call of duty, and we managed temporarily to address those concerns. We are very grateful to staff who had retired and returned, and we are looking at whether that can be a long-term solution. We need to make sure that no one who is willing to come back is disincentivised. I do not have the details at the moment but I commit to write to her.

[Baroness Bennett of Manor Castle (GP)]

My Lords, the first paragraph of this Statement says that it outlines

“the preparations we are making so that health and social care services remain resilient … and available to patients”.

How does that square with the fate of the residents of Berkeley House in Kent, which was home to adults with severe learning difficulties and autism, who were told at 7.30 in the morning that they would have to leave by 5 that evening? Among them was one resident who had to be sedated to ensure he could safely be moved. Berkeley House is owned by Achieve Together, one of a chain of companies registered through the tax haven of Jersey that ultimately appears to be owned by AMP Capital, a global investment firm based in Australia. How does providing a “resilient … and available” social care system line up with homes such as this being run for profit, not for the public or the residents’ good?

[Lord Kamall (Con)]

We have to recognise that if we look at the social care system, there are an awful lot of private providers. Quite often, when we look at private providers, it is private patients who subsidise their ability to provide places for state-funded patients. In our health system overall, there will always be a mixed economy, including state provision. Lots of our GPs, for example, are partnerships—they are not state-run, some of them are co-operatives, some are even for profit. When we look at the overall health system, there will be a general balance. I am not aware of the particular case, so I thank the noble Baroness for raising it, but one of the things we are committed to is making sure that we improve services, whether they are state-funded or private, as part of the overall system of healthcare that we have in this country. Clearly, where providers are not providing a service, there will be CQC and other assessments to see whether they are fit.

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[Lord Kamall (Con)]

When you look at our health and social care sector, you see that one of the issues is a lack of joined-up thinking over the years. We have seen report after report about the future of adult social care gathering dust on the shelves—not forgetting that lots of people who are not older are also in the social care system. The White Paper we published last week was a first attempt to try to tackle the problem long term. We recognise that you have to look at the long-term issue—which, frankly, successive Governments have kicked down the road for years, and not really tackled—and we have made an attempt to do that with the 10-year vision we published last week. But we have also committed to the first three years of funding, to realise that vision. We now have a framework against which to judge future progress in adult social care, so that, overall, it is no longer seen as a poor relation of the rest of the health system and is properly joined up on a number of different levels—not only career paths but also the data that can be shared, so that you do not have the drop-off that happens when someone leaves hospital and enters a social care home and you have to find all that data again; the home is prepared to accommodate that patient with all their specific needs at the beginning.

In the longer term, with increases in technology, we hope that, instead of patients leaving hospital to go to a residential home, they will be able to return to their own home with the help of technology. All that will take time, but we have laid out that vision.

In the short term, we have laid out the winter plan, which includes looking at how we tackle some of these social care issues and how we recruit more social workers via the £162.5 million. The Made with Care plan will make sure that social care seems more attractive. For a long time, no one has really “sold” social care as a career. We want to ensure that it is seen to be just as valid a career as any other and offers a real career path. We also want to see a professionalisation of the industry, so that people feel valued.

[Baroness Bennett of Manor Castle (GP)]

My Lords, in responding to my last question, the Minister referred to the mixed economy of ownership of healthcare provision. I am sure that he is aware that 84% of care home beds are provided by for-profit providers. Tonight, the “Panorama” programme is looking at HC-One, which is the biggest care home chain provider, with 321 care homes, formed in 2001 from the collapse of Southern Cross. I will not ask the Minister to watch the programme, since I know that he is a very busy person, but will he undertake to look at a summary of it, particularly the fact of the funding of HC-One, which appears to include a £540 million interest-only loan from a New York-listed property company? A great deal of this has been uncovered by the Centre for International Corporate Tax Accountability & Research.

[Lord Kamall (Con)]

I thank the noble Baroness for sharing all that data with me. The point remains that our system of healthcare will, through CCGs at the moment and integrated care services in the future, continue to commission some from the state and some privately; that is the way it is. What is really important is not who provides it but the care that the patient receives at the end of the day, and the fact that taxpayers are getting value for money. We should judge outcomes, not inputs.