Alcohol: Children’s Health

Baroness Farrington of Ribbleton Excerpts

Monday 3rd April 2017 Lords Chamber

[Lord O’Shaughnessy]

The noble Baroness will know that on minimum unit pricing a court case is ongoing in Scotland, where the proposed introduction of minimum unit pricing has been challenged by the Scotch Whisky Association. We are awaiting the outcome of that court case before we move ahead.

[Baroness Farrington of Ribbleton (Lab)]

Will the Minister give an undertaking that, in looking at this issue in the broad, the Government will have regard to the number of children who grow up in households where there is a severe alcohol problem among the parents or adults? Will he undertake to monitor carefully how much the public health authorities are providing and enhancing alcohol treatment centres, which appear to be diminishing in some parts of the country? Many children grow up suffering because of this sort of family problem.

[Lord O’Shaughnessy]

The noble Baroness highlights a difficult and, indeed, tragic area. The other day, my honourable friend the Public Health Minister met the APPG on Children of Alcoholics. In preparing for a debate last week organised by the noble Lord, Lord Brooke, I discovered that Alcohol Concern estimates that there are 95,000 children under the age of one who live in a family where the parent has an alcohol problem. That is a rather horrifying statistic. One way we are dealing with that is through the family nurse partnerships; indeed, more than 16,000 places are now available and one of the capacities they have is to provide help for families struggling with addiction, whether it is to alcohol, drugs or other things.

Tobacco Control Plan

Baroness Farrington of Ribbleton Excerpts

Thursday 23rd February 2017 Lords Chamber

[Lord O'Shaughnessy]

My noble friend is right to raise the issue of e-cigarettes. Something like half the 2.8 million current users of e-cigarettes are no longer smoking tobacco, so it has proved to be an extremely effective way of helping people to stop smoking. The UK has one of the most welcoming approaches to e-cigarettes in the world. We have a proactive approach of encouraging smokers to switch to vaping, and ensuring that that continues will be a part of the plan.

[Baroness Farrington of Ribbleton (Lab)]

My Lords, I declare my interest. Will the Minister have regard to a comment from a grandson? I asked him whether he smoked. He said that most of his friends did, but he did not because he thought it was something old ladies do. He was very polite about it and said he did not want to be rude. Would it not be better to discourage young people by showing pictures of old ladies smoking, because none of the young people concerned want to look like old ladies?

[Lord O'Shaughnessy]

I would not like to comment on the particular instance to which the noble Baroness refers, but she is quite right about role models. Part of the importance of ensuring that there is no longer smoking in public places is that we do not want young people to think that it is normal, as it were, to smoke but something, whether it is for old ladies or not, that should not be done.

Social Care

Baroness Farrington of Ribbleton Excerpts

Thursday 1st December 2016 Lords Chamber

[Baroness Farrington of Ribbleton (Lab)]

My Lords, I thank my noble friend Lady Pitkeathley for her introduction to the debate and the noble Baroness for her maiden speech, which leads me to the point I wish to raise. I want to speak to the Minister about the huge looming health costs to be faced by carers. I remember a child carer, a school friend of mine, who never had lunch because she had to go home to an incontinent mother. She had to go home to wash her, clean the sheets and come back to school. Schoolchildren are suffering. There is a picture that all of us, as we get older, become pleasant, reasonable old people. We do not. Some of us—I count myself among them—become irascible, demanding and difficult.

I wish to draw attention to the problem of carers so that the Minister can take an argument about not building up another problem for the future if we do not look after the health of carers. This debate could have taken place tomorrow in the most reverend Primate the Archbishop’s debate on the role of people in the community. Many carers are informal carers. They are members of the family, neighbours or people who fit it in. These people are being put under intolerable pressure.

I have sat with a carer when the patient was asked if they would like to go to home. They said yes. The patient knew that they could not cope on their own. The carer was in tears when she was asked by the hospital, “Will you be able to look after her?”. She had to say no. Two years later, that carer had a stroke herself, in her early 60s. The pressure of being a carer is horrendous, whether they are children or older people.

The Minister and the Government are looking at what they propose to do about benefits for younger pensioners—in your Lordships’ House, “younger” is a flexible term—and what benefits they get, including increases to their pension. I sadly do not have living parents or parents-in-law, so I make no plea for myself. My worry is that, among the so-called “younger pensioners”, there is a group of people who are holding our society together. They are the people who are carers, who support voluntary groups in our communities and who are members of voluntary associations, churches or informal groups of people. I think that the Government should look at who the real carers are. I agree with the noble Baroness that we often undervalue the work and professionalism needed by those who are employed as carers, but we also undervalue the commitment of those who are working hard.

All of us in this Chamber have a responsibility to speak up for those in greatest need. I know that many Members of your Lordships’ House have faced the problem of being the first pit-stop for caring in their own families and I know that many Members are committed to helping friends and former colleagues here. I hope the Minister will believe me that, if we do not do something, we will have bed-blocking by former carers who have been taken ill because we have put too much pressure on them. These are the people who make us the civilised society that we are and we ought to ensure that they do not become bed-blockers because we are trading on their good will and generosity too much by not tackling this problem.

I will read what the noble Lord, Lord Patel, said about insurance. It is interesting that, as I have got older, every birthday I get a letter from insurance companies asking me if I want to take out a policy to pay for my funeral. I have never yet had a letter from anybody offering to sell me a policy for when I become old, difficult, irascible and immobile. Perhaps the insurance companies are missing something there. I have not known them miss anything before—perhaps, I say to the noble Lord, Lord Patel, it would not be financially viable for them.

NHS: Primary and Community Services

Baroness Farrington of Ribbleton Excerpts

Monday 7th November 2016 Lords Chamber

[Lord Prior of Brampton]

The thrust of the Carers UK report is that 5.5 million carers take huge responsibility for their loved ones and that the primary responsibility often falls—I think, rightly—on carers and families rather than on the Government.

[Baroness Farrington of Ribbleton (Lab)]

My Lords, would the Minister care to join me in condemning Members of Parliament who have voted nationally to force local authorities to reduce services but have then attacked the local authorities because they wanted the libraries kept open, the bus services run and the care packages maintained—all of those things—while washing their hands of any responsibility?

[Lord Prior of Brampton]

I think the noble Baroness will agree with me that there are very difficult choices to be made when it comes to public spending. Sometimes, there is perhaps not always a high degree of consistency from our colleagues in the House of Commons.

Carers over 80: Support

Baroness Farrington of Ribbleton Excerpts

Monday 13th June 2016 Lords Chamber

[Lord Prior of Brampton]

As part of the consultation that is being conducted in preparation for the publication of the strategy at the end of the year, the Government have called for evidence, looking at international comparisons as well as an economic review, which I am sure will take into account the issues the noble Lord raises.

[Baroness Farrington of Ribbleton (Lab)]

My Lords, in recognising the serious concerns about people over 80, and people under 80 with health needs themselves, will the Minister assure us that the review will have regard to the number of children who are carers for adult members of the family? The needs of the parent are assessed, quite rightly, but the needs of the child or children concerned are not always taken into account. Can we have an assurance that the new strategy will cover both my noble friend’s Question and concerns, and the needs of children?

[Lord Prior of Brampton]

The noble Baroness is absolutely right. There are many tens of thousands of children who have very substantial caring responsibilities for their parents or grandparents. The impact on their education and future careers is certainly something that the strategy will want to take into account. Of course, the Children and Families Act sets out the rights of children. We need to assess them very carefully in the forthcoming strategy.

NHS: 111 Service

Baroness Farrington of Ribbleton Excerpts

Monday 21st March 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, there are two things which we need to do to improve the 111 service. First—and this is in response to part of the Question asked by the noble Lord, Lord Hunt—we need to have more clinicians within the 111 hubs. Secondly, people need to have access to the patient’s electronic summary care record so that they can see what has gone on before coming to a final judgment.

[Baroness Farrington of Ribbleton (Lab)]

My Lords, the Minister referred to 90% satisfaction. How many people are involved in the other 10%? It does not strike me that 90% is acceptable.

[Lord Prior of Brampton]

My Lords, 100% is clearly the only acceptable level but, realistically, it would be extremely difficult to get to that. Referring back to the charge of complacency, we recognise that significant improvements need to be made to the 111 service, but it can be a vital part of the way that we deliver urgent care in Britain.

NHS: Mental Health Services

Baroness Farrington of Ribbleton Excerpts

Monday 14th March 2016 Lords Chamber

[Lord Prior of Brampton]

I agree with my noble friend that it is essential that we have people who come from the communities of those who are suffering and who are receiving mental health care facilities. I cannot give her a specific answer, but I agree entirely with what she is saying.

[Baroness Farrington of Ribbleton (Lab)]

In looking at provision in the community, where people, quite rightly, can be treated for mental health conditions, will the Minister please have regard to the fact that, while the person who is ill may be behaving in an unusual, difficult or even frightening way, those concerned with the patient’s care sometimes disregard the problem of children in the family who are trying to cope 24/7 with this difficulty? Will he ensure that, in looking at services at home, due regard is paid to young people who become carers—in a way that, sometimes, other adults in the family have avoided?

[Lord Prior of Brampton]

The noble Baroness raises a broader point, which is that mental illness and mental health problems can cause chaos in families. Often, those who suffer most are the children of people who are going through a very difficult time, and due regard must of course be given to those children.

Health: Adult Psychiatric Care

Baroness Farrington of Ribbleton Excerpts

Monday 22nd February 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, I am not aware that we have had any discussions in the Scotland Office. However, there is no doubt that in Scotland they are approaching quality improvement extremely effectively. I had a recent meeting with people who have been involved in that, so I can assure the noble Lord that, at that level, if we can learn things from what they are doing in Scotland, we will do so.

[Baroness Farrington of Ribbleton (Lab)]

My Lords, will the Minister give an undertaking that the very good system of encouraging treatment at home is not at the expense of families where children are the primary carers? When children are trying to cope with someone in very difficult circumstances they are often alone for long periods and are unable to cope with a mother or father whose behaviour can even be frightening.

[Lord Prior of Brampton]

My Lords, the noble Baroness raises an important point. So much of this comes down to judgment, and so much of that judgment is judged with hindsight. We put a huge onus on clinicians and people working in health and social care to make the right judgments on where to treat people. In normal circumstances, where people can be treated at home rather than in an in-patient setting, that will be best; but there will be exceptional circumstances such as those that the noble Baroness mentioned, where it may not be.

Accident and Emergency Departments

Baroness Farrington of Ribbleton Excerpts

Monday 30th November 2015 Lords Chamber

[Lord Prior of Brampton]

I am afraid that I am not aware of how A&E departments collect and collate this information, but I will write to the noble Lord on that matter.

[Baroness Farrington of Ribbleton (Lab)]

My Lords, would the Minister care to reflect on the fact that when this Government talk about reducing public expenditure, it is often by putting those with full training, experience and knowledge in charge, because they have won a tender, of a particular answering service, and that the health service is just one example of that? I call to mind other mistakes or misjudgments, such as police officers with skill and experience being replaced by people who just answer the phone. Will he take that issue back to the Government?

[Lord Prior of Brampton]

The noble Baroness makes an interesting point. In the main, contracts, particularly in the health service, are now based on outcomes: it is outcomes, rather than inputs, that are most important.

NHS: Costs of Operations

Baroness Farrington of Ribbleton Excerpts

Monday 9th November 2015 Lords Chamber

[Baroness Farrington of Ribbleton (Lab)]

My Lords, I have heard consultants getting very cross not with patients, but with patients with complications being referred from private hospitals when the procedure got too complicated for them to deal with. Could the Minister write to me detailing the available information he has about this? I stress that in both cases, the consultants were genuinely caring of the patients; but both said that in their view, this happened too often.

[Lord Prior of Brampton]

I will certainly look into this and write to the noble Baroness, as she requests. There is no question but that in complex cases, the NHS is better equipped than most private hospitals to deal with such complexity; and of course, even when a simple case is handled in a private hospital and something goes wrong, that may lead to a referral back to an NHS hospital. However, I will certainly look into this and write to the noble Baroness.