Housing: Accessibility Standards

Debate between Baroness Brinton and Baroness Penn

Monday 5th February 2024 Lords Chamber

[Baroness Penn (Con)]

I am afraid I will have to disappoint the noble Lord, as I cannot give a specific timeframe for that further work. The building safety regulator is responsible for introducing updates to the building regulations and it is a new organisation with a busy programme of work. However, his points are well made. To reassure him, we are taking these considerations into account in a number of ways. For example, last December we published an updated NPPF which included a specific expectation that, when planning housing for older people, particular regard is given to retirement housing, housing with care and care homes. This reflects the Government’s understanding that we need to take into account accessibility and the changing needs of our population as we build new homes.

[Baroness Brinton (LD)]

My Lords, Habinteg housing research shows that only 7% of our existing housing stock meets even the most basic accessibility standards. The Government’s report says that, on average, it would cost only an extra £1,400 to build a new three-bedroom semi-detached house to this standard—a tiny percentage of the cost of a new house. This would mean that thousands of elderly and disabled people could remain in their homes for life. The Government keep saying that they want to implement this standard. What is the delay?

[Baroness Penn (Con)]

My Lords, local planning authorities should already assess the housing needs of different groups, including accessibility needs for those with disabilities or older people, and reflect them in their policies and decisions. Guidance was introduced in June 2019 to help councils implement this policy and make use of the currently optional technical standards for accessible and adaptable housing, including M4(3) and M4(2)-compliant homes. As I have set out, we plan to take forward our commitment to move to mandatory for M4(2).

Ambulance Pressures

Debate between Baroness Brinton and Baroness Penn

Tuesday 19th July 2022 Lords Chamber

[Baroness Brinton (LD) [V]]

My Lords, I start by paying tribute to our ambulance and paramedic staff, as well as the ambulance call handlers. They are doing the absolute best they can despite the circumstances, and we owe them an enormous debt of gratitude.

There is no doubt that our ambulance services are at breaking point. Record-long ambulance waits are leaving vulnerable patients stuck in the heat outside hospitals, waiting for the treatment they need. There was a new first over the weekend, as temperatures rose, when patients inside ambulances were in a hospital car park for over 24 hours because A&E was full and there were no beds in the hospital.

This is not a recent crisis. Among many incidents reported in the press, a couple of months ago a senior NHS trust doctor in Gloucestershire rang 999 having had a suspected stroke, and was told to get a family member to drive her to hospital because no ambulance could get to her for at least an hour and there would then be a considerable delay after that. There are daily reports of people dying waiting for ambulances or in the back of an ambulance outside A&E.

Frankly, this Government have run ambulance services into the ground, with every single target being missed for the most severe cases. For months, they have failed to act on warnings that ambulance services are struggling to maintain a safe and timely service. The Government need to get a grip of this emergency. Even Liz Truss, one of the contenders to be the next Prime Minister and a very senior member of Cabinet, said in the ITV leaders’ debate on Sunday that ambulance waiting times in her rural constituency were “appalling”. Surely now is the time for Ministers to finally commit to commissioning the CQC to conduct an investigation into the causes and impacts of ambulance service delays, which would not just look at the very front line but take a whole, systemic approach.

One of the solutions proposed by the Secretary of State in the Statement is more use of 111 to ease pressure on call handlers receiving 999 calls, but there is already a major problem with 111: it takes much longer to get through and sometimes calls are not even answered. Not getting through to 111 will exacerbate waiting times and not help get them under control, because it risks piling even more pressure on our ambulance services, as desperate people whose conditions have worsened struggle and then turn to 999 instead. Can the Minister say what extra staffing and training there will be for the 111 service? Specialist training will be needed, because staff do not receive the highly specialised training that the 999 service call handlers do.

We need to remember that this is not just about ambulances, but they are the very visible evidence of a broken health and social care system. We on these Benches, and others around your Lordships’ House, have regularly been asking questions about our ambulance and A&E services, under pressure for well over the last six months. For years, we have also highlighted the shortage of hospital beds compared with other OECD countries. In 2021, the UK had 2.3 beds per 1,000 people, compared with France at 5.7 and Germany at 12.6. It was a mistake to cut so many beds. So will the Government undertake to fund thousands of extra beds to stop handover delays at A&Es, so that ambulances can get back on the road as soon as possible?

All of this is compounded by the lack of training and education places for doctors, nurses and other vital healthcare professionals, such as physios, occupational therapists, and speech and language therapists. Will any of the long-term plans to provide finance and support to enable hospitals to recruit and train more specialist healthcare staff be brought forward? Otherwise, we will just continue to lurch from crisis to crisis.

Finally, as the Statement notes, the Met Office has issued the first ever red warning for extreme heat, at a time when all 10 of our ambulance services in mainland England are already at the highest level of alert. The news this afternoon is of a number of serious fires in London and elsewhere; Hertfordshire, my local area, has had 240 calls to its fire service, which is many more than usual. Temperatures peaking at over 40 degrees centigrade just demonstrates that the pressure on ambulances, A&E and our wider NHS is likely to increase from injuries sustained by firefighters and those caught up in the fires.

The Statement talks as if the only effect is on people currently in hospital. The effects of climate change will make heat waves more frequent and intense in the future, so I ask the Minister what the Government are building in to help the NHS tackle the problems arising from these heat incidents, which sadly we must now plan for on a regular basis.

[Baroness Penn (Con)]

My Lords, I thank both the noble Baronesses for their questions. I will do my best to address them. The noble Baroness, Lady Merron, first asked how these pressures had developed. It is fair to say that, while not all ambulance trusts were meeting their targets before the pandemic, there has been a significant shift in performance since the pandemic. The levels of service we are seeing at the moment are tied to that event, but I acknowledge pre-existing pressures in the system. There was a real change due to Covid, which has affected a number of factors, including staff absence, infection control and pent-up demand, where people might not have accessed health services during the peak of the pandemic.

The noble Baroness, Lady Merron, talked about the lack of a social care plan. The Government have been working to address social care over a number of years, putting in additional resources and measures to spread best practice and to increase the recruitment and retention of staff. There is more to do, and we are doing it. In 2022-23 the local government finance settlement made an additional £3.7 billion available to councils. Local authorities can make use of more than £1 billion of additional resources specifically for adult social care this year. That is part of £5.4 billion over the next three years to end increasing care costs and support the workforce. Specifically, £0.5 billion of that is to support and develop the workforce.

The noble Baroness asked me about the recruitment and retention of staff. Just to touch on two areas in terms of staff, we know that some of the delays are due to delayed discharge and its impact on social care, so we are making efforts to recruit more social care staff. Care workers are eligible for the health and care visa; they have been added to the shortage occupation list. There has been a national recruitment campaign in this area, and we are working with DWP to promote adult social care careers. We have also put in resources to increase the number of certifications that people can get if they want to train in this area.

To touch on another area of staffing, the paramedic workforce, the number of ambulance staff and support staff has increased by almost 40% since February 2010. The number of paramedic-qualified staff has grown year on year. Health Education England has mandated a target of training 3,000 paramedic graduates nationally per year between 2021 and 2024, further increasing our workforce.

The noble Baroness, Lady Brinton, also asked about the workforce. Of course we have our targets to increase the number of nurses and doctors in the NHS and the number of domestic training places for both those occupations, and we continue to make good progress on both those areas. We need additional staff in our NHS, and efforts are being made to train them.

The noble Baroness, Lady Merron, and the noble Baroness, Lady Brinton, I think, asked about the letter that went out about measures to reduce the handover times with ambulances. My understanding is that that will not involve new pieces of hospital estate but rather making better use of the existing hospital estate. I assure them that that is looking not at more corridor care but at how the estate is used more flexibly.

The noble Baroness asked what reassurance I could give to families waiting for ambulances or those in ambulances waiting to be transferred to emergency departments. That was the aim of the letter that has gone out from NHS England. We are looking at the balance of risks. We now need to reduce handover times and wait times in the community because, when people have been through the urgent care process, there is a lower risk of having to manage increased demand through additional flexibilities at that stage, rather than people waiting in the community not having been assessed by a paramedic, for example. That is the aim of what was in the Statement yesterday.

As the Secretary of State made clear yesterday in the House, a contract is being procured for auxiliary ambulance services. That is expected to be concluded shortly. The noble Baroness also asked about the process around the COBRA meetings we have held. It is the Chancellor of the Duchy of Lancaster’s responsibility to chair the civil contingencies COBRA meetings, and that is what he has been doing. There were several meetings over the weekend, I think, and one yesterday. It will continue to meet as long as that is needed. I am afraid I do not have a response to her on the national resilience strategy consultation, so I will happily write.

The noble Baroness, Lady Merron, also talked about the support for staff working in the heatwave. That is absolutely part of NHS trusts’ plans for this kind of scenario. It was also re-emphasised in the letter from NHS England and NHS Improvement to trusts yesterday. She is absolutely right that we need to take steps now to build more resilience in the system ahead of the winter, when we know pressures grow. That is absolutely a focus for the Department of Health and Social Care, NHS England and NHS Improvement and others.

The noble Baroness, Lady Brinton, asked about resources going into 111. We are further building the capacity of NHS 111. We are increasing staffing throughout this year, scaling up call handling across regional footprints while maintaining a focus on getting patients access to local services. Additional funding was also put into this—£50 million in 2022-23—to support increased call-taking ability. I think I have addressed her points on training places. In terms of extra beds, to stop the A&E delays we have talked about, we are looking to make efforts to reduce the handover time to 30 minutes. I know that in other actions on delayed discharge, initiatives have been made such as step-down beds to try to increase the flow of patients through A&E.

Finally, the noble Baroness, Lady Brinton, mentioned the fires, which are of course extremely concerning. The London Ambulance Service is currently supporting the London Fire Brigade in responding to several fire incidents across London. They are in attendance, on scene, at a number of locations. The DHSC and NHS England are monitoring the situation closely. That is quite a live situation, so that is the best update I can give at this time.

Schools Bill [HL]

Debate between Baroness Brinton and Baroness Penn

Committee stage & Lords Hansard - Part 2
Wednesday 15th June 2022 Lords Chamber

[Baroness Penn (Con)]

I will check and follow up with the noble Lord in writing, but I know that having the lead in place means that they can then be the person to whom other staff in the school can go and with whom they can interact, to get guidance and help shape the school’s approach. It is not for the lead to be singly responsible, but they can get training that can then inform other staff as well.

I was just coming on to say that we have put funding in place. Our aim is that all schools will have a lead in place. More than 8,000 schools and colleges in England, including half of all state-funded secondary schools, have taken up this training offer so far. We recently confirmed further grants to offer training to two-thirds of schools and colleges by March 2023, with the ambition that, by 2025, all state-funded primary and secondary schools, as well as colleges, will have had the funding made available to train a senior mental health lead.

In addition to training for senior mental health leads, there are also the mental health teams to which I referred. The noble Baroness, Lady Chapman, asked for an update on our progress in delivering these. They currently cover 26% of pupils in schools and further education. Our ambition was to cover 25% by next year so we have already met that ambition; indeed, we have raised it to cover 35% of pupils in England by next year.

More broadly, when those specialist teams are in place, they need to be able to refer students to more specialist support where needed. That involves more money going into children’s mental health. I can confirm to noble Lords that there is record NHS funding for children’s mental health services. It will grow faster than the overall NHS budget and faster than adult mental health spending in the coming years. There is more to do, but increased funding and priority are being given to this issue by the Government, not just in schools but in the NHS where those specialist services need to be delivered.

I am grateful for the opportunity to set out again the priority the Government are giving to this issue, the progress we are seeking to make and the approach we think is right to support schools in supporting the mental health of their pupils. I hope that the noble Baroness, Lady Brinton, will withdraw her amendment.

[Baroness Brinton (LD) [V]]

My Lords, I thank everyone who has taken part in this short debate. Before I respond on Amendment 88, I want to offer my support to the noble Lord, Lord Woolley, for his Amendment 171E, which would require Ofsted to ensure that schools take account of the public sector equality duty to tackle discrimination, promote equality and assess extracurricular activities at the school. It may seem obvious but, at the moment, there seems to be some confusion about that duty and various parts of our public sector; it is good to see the amendment there.

I am grateful for my noble friend Lord Addington’s helpful comments, further to mine, on Amendment 88 and how essential it is to ring-fence mental health funding to ensure that education staff are effectively trained, as well as being supported by CAMHS.

The noble Baroness, Lady Chapman, talked about some excellent initiatives, such as Place2Be. She echoed my concerns about the patchy nature of CAMHS provision and how long severely affected children can wait. Just last week, I heard of a family friend with a daughter who shows clear signs of serious clinical mental health problems. However, the queues at their local CAMHS are such that they have been told that she will be seen only if she is suicidal. She is eight. That is just too late. It also places unacceptable pressure on a little girl, her family and her school. I recognise that this is an NHS problem—I applaud the Government for trying to join some of this up—but it is why we must have some ring-fenced funds: to make sure that the school side of this, the mental health partnership, will actually work.

Schools Bill [HL]

Debate between Baroness Brinton and Baroness Penn

Committee stage
Wednesday 8th June 2022 Lords Chamber

[Baroness Penn (Con)]

Again, I think that would be something that would not be set out in the academy standards but would be best developed by schools themselves. I think I have covered all the points raised in this group, and I hope the noble Baroness will feel able to withdraw Amendment 8.

[Baroness Brinton (LD)]

I am very grateful to noble Lords for their very helpful interventions in this short debate. Rather than go through and respond to each of the contributions made, I want to pick up on what the Minister said earlier: that it is not necessary to put these things—particularly my interest, mental health—into the standard. The problem is that without a framework you are entirely reliant on what happens in regulations or statutory guidance. The noble Lord, Lord Nash, may well remember that during the passage of the Children and Families Bill we negotiated for some considerable time over the statutory guidance for children with medical conditions. Many schools said to me afterwards that they were very grateful for that, but, even more, parents of children with long-term medical conditions and the charities that supported them were delighted that for the first time the law said that a head teacher could not gainsay a medical professional. Unfortunately, three years ago the Government rewrote that statutory guidance and all the points have now become advice for a head teacher to consider. The power that is still in the Act—there is a section that says “must follow the health guidance”—has now gone in the statutory guidance, and Parliament was completely unaware of it. I warn the Minister that I will be tabling an amendment because it also affects the out-of-school attendance register and various other issues that we will come to later on.

We are back to the big strategic debate about what the Bill is about. To say that we do not need to worry and that it is not necessary to put it in because we will fill that in later places us in exactly the same debate as in the health Bill. On the SEND stuff, we should be waiting until the SEND consultation is back and the Government decide what they want to do because we should not have a new education system left blank for filling in on things as important as SEND and mental health.

On mental health, I take issue with the noble Baroness, Lady Fox. It is not just an issue about Covid. The stats I cited were all from before Covid. That is why various Governments over the past decade said that something needed to be done, including providing support for teachers in the way that the noble Baroness, Lady Blower, outlined, because what schools need to do—teachers do it brilliantly—is to build resilience, but they now also start to recognise when there are problems, and then the pyramid works to get the few children who need it into specialist support.

Dasgupta Review

Debate between Baroness Brinton and Baroness Penn

Thursday 7th April 2022 Lords Chamber

[Baroness Brinton (LD) [V]]

My Lords, the Dasgupta review said that it was vital that UK aid assists countries with population and family planning issues because of the biodiversity implications. The Government’s response last June confirmed that they would continue to prioritise aid for family planning. However, following the Chancellor’s cuts to ODA in November, there is a £132 million reduction in grants for family planning—that is a 60% cut which will result in 9.5 million fewer women and couples receiving any family planning services. How does this match the commitment which the Government gave only five months earlier?

[Baroness Penn (Con)]

My Lords, this House has discussed many times the difficult decision that the Government took to cut ODA spending, and they have set out the criteria for returning to 0.7%. I say to the noble Baroness that we have committed significant funds to nature-based solutions to climate change internationally and to protecting biodiversity.

Coronavirus Act 2020 (Early Expiry) Regulations 2021

Debate between Baroness Brinton and Baroness Penn

Monday 5th July 2021 Grand Committee

[Baroness Brinton (LD) [V]]

My Lords, at the one-year review of the Act, we pushed for it not to be reviewed. It would have been really useful to understand why there has been such a delay. I remind the Minister that we were concerned over some of the civil liberties issues in the Act, such as on policing, protests and fines—we know the fines did not hold up when applied in practice—and over transparencies. We have raised repeated concerns about the transparency on the dashboard. We were also concerned about people not understanding the rules. Famously, where guidance versus the law happened, it was interesting to watch the Government having to retreat very fast when they realised that they were telling people in Greater Manchester that something was covered by the law, yet the people in Greater Manchester were clearly able to show that it was guidance.

There are also concerns about the enormous blank-cheque powers that this legislation has provided. I am grateful to the noble Lord, Lord Bethell, for saying earlier that the expiry of these provisions was announced on 25 March. His exact words then were:

“We made a promise to Parliament that we would not keep any provision in place for longer than was necessary, and we have made good on that promise.”—[Official Report, 25/3/21; col. 985.]


It has been 14 weeks since the Government decided that they did not need the provisions, and they have not yet removed them. They are still in place until this SI comes into force.

We also had particular concerns about the provision of social care. Part 1 of Schedule 12 and Section 15 enabled local authorities to divert resources to care and support from other duties. This was used eight times and not since 29 June 2020. We were really concerned about this provision because those who needed support for care suddenly found it was removed. The parents of disabled children who needed 24-hour care had found that their entire support mechanisms were removed from them. On the Disabled Children’s Partnership website today, one mother has been saying that the lack of that support has meant that she and her husband have had no more than two hours of consecutive sleep in over a year, because they have had to try to manage it. They are both utterly exhausted and extremely concerned that they might be making mistakes. That is because of the loss of this diversion support. What is particularly worrying is that most local authorities have not yet reinstated it.

Because we still do not know when this SI will come in, it is a little difficult to approve it until we also know the exact details about the level of Covid in our communities and its effect on the NHS. The Prime Minister famously talked about “data, not dates”, but the dialogue in recent weeks has become entirely the other way around, with cheery communications about the mask mandate being about to go. It is very noticeable that people have taken that as a signal that they can stop wearing masks already. Yet just over a year ago in June, when we lifted that first lockdown, cases were down to around 1,000 a day. This last week, it was around 25,000 new cases per day with hospitalizations increasing, even if at a lower rate, and certainly—thank goodness—ICU occupancy at a lower rate. However, GPs, doctors and nurses in hospitals all report that the NHS is nowhere near going back to being normal.

Today on LBC, a member of ICU staff at a hospital called in to say: “They can keep the medal and just get everyone to keep wearing masks, if they truly care about NHS staff”. I am with her on that one. Also today Chloe Smith, the Constitution Minister, said that some people more susceptible to infection than others may wish to carry on using a face mask. She cited her recent cancer, saying that she sympathises with those who want to carry on taking precautions.

As the Minister knows from my repeated raising of this issue, for some people this is not a matter of choice. That is so for at least 1 million people in the country: the clinically extremely vulnerable. Current government guidance to the CEV, which came out on 21 June, says:

“We are also advising clinically extremely vulnerable people to … follow the practical steps described below to minimise your risk of exposure … close contact with friends and family will be a personal choice, but you are encouraged to exercise caution”.


They were advised to work from home but, if they could not, to get their employer to make their workspace Covid-safe—I am paraphrasing because the guidance goes on at some length—and otherwise to get advice from professionals. It also says that the furlough scheme will end in September.

In addition, from 1 April there was no longer any SSP for clinically extremely vulnerable people who could not work from home. It is really important that provision is made to avoid clinically extremely vulnerable people having to go to work. Will the Government now take this up? Losing the mask mandate and lifting regulations mean that this group in our society and their immediate carers are put at risk.

I also note that the clinically extremely vulnerable advice says that pupils should be back in schools but the Department for Education lifted the mask mandate for schools some time ago. These children are still at high risk of Covid, which could indeed—

[Baroness Penn (Con)]

I remind the noble Baroness that the speaking limit for Back-Benchers is five minutes.

[Baroness Brinton (LD) [V]]

Thank you. I have finished.

NHS Test and Trace

Debate between Baroness Brinton and Baroness Penn

Monday 28th June 2021 Lords Chamber

[Baroness Brinton (LD) [V]]

My Lords, I refer the Minister back to her answer to my noble friend Lord Scriven. The American FDA pointed out that the previous analysis pointed to Innova providing false statistics. What new evidence do the Government have that the FDA is wrong?

[Baroness Penn (Con)]

My Lords, my understanding is that the Innova test has passed the UK’s assessment process and that ongoing assurance work is conducted in labs and in the field to ensure that the tests consistently perform to the required standard. My understanding is also that the latest evidence suggests that Innova lateral flow devices have a specificity of around 99.97%.

Coronavirus Job Retention Scheme: Working Parents and School Closures

Debate between Baroness Brinton and Baroness Penn

Monday 18th January 2021 Lords Chamber

[Baroness Penn (Con)]

My Lords, as I said to the noble Lord, Lord Woolley, the Government consider that a voluntary arrangement for the furlough scheme is the appropriate one, while being very clear that the eligibility criteria allow parents and carers to be furloughed where they are unable to work, including from home, due to Covid affecting their caring responsibilities. We have put more support in place during this third national lockdown, including keeping childcare settings open for preschool children, to help alleviate the burden on parents.

[Baroness Brinton (LD) [V]]

My Lords, one group has definitely been left out. This report also calls for access to the furlough scheme for the clinically extremely vulnerable who cannot work from home but are required medically to shield. Currently, these individuals are entitled only to statutory sick pay; at just £95.85 per week, how are these shielding people meant to be able to support their families over many months? When will the Government correct this inequality and add them to the furlough scheme?

[Baroness Penn (Con)]

My Lords, the guidance for the furlough scheme is also clear that those required to shield because they are clinically extremely vulnerable are eligible for the scheme under its current rules. The other piece of hope for the clinically extremely vulnerable is the fact that we have sent out 5 million letters, starting today, to those over 70 and the clinically extremely vulnerable to start their programme of vaccination.