Social Care: Apprenticeships

Baroness Farrington of Ribbleton Excerpts

Thursday 29th November 2012 Lords Chamber

[Earl Howe]

The noble Lord makes some centrally important points. The CQC, which is the regulator of national minimum standards in this area, is very clear that the need to safeguard the vulnerable is one of the most important tasks that it has to assure itself about when inspecting providers. The role that employers play is key here and he is right to point out that it is the responsibility of management to ensure not only that those working for them have the right skills but that there is also the right supervision, for apprentices in particular.

[Baroness Farrington of Ribbleton]

My Lords, can the Minister assure the House that a voluntary scheme will not allow those very people who have a culture of not caring or of neglect—we know that happens from time to time in this sector—not to take up the option of voluntary registration? Surely it is most important in this field that we protect people from the very people who may well not take voluntary action.

[Earl Howe]

My Lords, accreditation by the Professional Standards Authority will help to foster high standards, because it will allow practitioners and people who use services to distinguish more easily between registers that meet nationally accredited standards and those that do not, and therefore between those social care workers who are accredited to a high standard and those who are not. In addition, we have commissioned Skills for Health and Skills for Care to develop a code of conduct and recommended induction and minimum training standards for healthcare support workers, as she will know. The key here is to progress to a system that encourages employers to employ those with the right qualifications and for users to be able to see that the employees in an organisation are accredited.

NHS: Health Tourism

Baroness Farrington of Ribbleton Excerpts

Monday 28th May 2012 Lords Chamber

[Earl Howe]

My Lords, it is incumbent on NHS trusts when a patient presents directly to them to ensure that the person in front of them is entitled to NHS care, and they have various means of doing that. However, primary care in this country—care delivered by GPs—is not subject to any checks of that order.

[Baroness Farrington of Ribbleton]

My Lords, would somebody from anywhere in the world who had a British passport be entitled to NHS treatment were they to be in this country at the time of need?

[Earl Howe]

My Lords, the answer is no because the entitlement to NHS care is and always has been dependent upon an ordinary residence test, so that the mere possession of a UK passport does not necessarily indicate that a person is ordinarily resident.

Health and Social Care Bill

Baroness Farrington of Ribbleton Excerpts

Monday 19th December 2011 Lords Chamber

[Baroness Farrington of Ribbleton]

My Lords, I rise to speak about the importance of the role of the police. I made my maiden speech in your Lordships’ House on the subject of care of mentally ill people taken into custody in police cells. I was struck at that stage—I declare a former interest as a member of a police authority and a visitor of police cells—that time after time, I was informed and became aware that people were being taken into custody, not because it was most appropriate, but because their problems were mental health related. They were being taken into police cells for their own protection or for the protection of other people, because there was nowhere else for custody officers to deal with this. I hope the Minister will take this carefully into account when looking at the role of the police, in particular at that initial point of contact. Sadly, many people who end up in custody and police cells have problems that are either mental health related or drug or alcohol related. It creates a problem for the police service, particularly at weekends. It also leads to a reaction to those people who have behaved in a way that causes them to be taken into custody so that they end up in prison, rather than receiving a course of treatment.

[Baroness Donaghy]

My Lords, I support the amendments of the noble Baroness, Lady Finlay of Llandaff, which refer to allied health professionals, and I want to widen them to include the whole health team. We have been talking about structures, consultation, rights of representation, and roles and responsibility in the new structures, but we need to ensure that the service is delivered to the patients by the health team. Nowhere does the Bill appear to acknowledge the importance of the majority of staff in the health and care services: the invisible majority. I know from working in universities for 33 years that there are academics and students, and then all the rest who are often referred to in the negative as non-teaching staff. In the health service, there are doctors, sometimes nurses, and patients, while the rest are rarely referred to as people: they are back office or integrated services. I want to place on record the importance of the health team: the cleaners, caterers, maintenance staff, technicians, receptionists, secretaries, administrators, finance staff, and those involved with transport, as well the allied health professionals mentioned by the noble Baroness, Lady Finlay.

When I was a non-executive director of a foundation trust, we had to deal with the issue of staff who were employed by PFI projects. It is not my intention to discuss the rights and wrongs of PFI, but to illustrate the huge efforts required to ensure that the PFI staff felt part of the health team, even though the foundation trust had no direct management responsibility. The same applies to contracted-out staff generally. Some, though not all, of the problems of hygiene in hospitals and failure to feed vulnerable patients were caused by the separation of these contracted-out staff from the health team. If transport is not co-ordinated, a patient can be in a ward for an extra day. An efficient receptionist can make the difference between an efficient department and a failing department. Those are only two examples. There has been a deafening silence about the health team, and I am seeking a statement of support for all the staff in the health service and an acknowledgement that the future of the service, whatever that is after this unnecessary Bill, will depend on the health team being able to work together in an integrated way.

Health: Cancer Drugs Fund

Baroness Farrington of Ribbleton Excerpts

Monday 14th November 2011 Lords Chamber

[Earl Howe]

My Lords, as I told the noble Baroness, Lady Morgan, discussions are ongoing as to the arrangements that will be in place after the abolition of strategic health authorities. I cannot say that we have definite plans in place but I hope that we will be able to announce our plans soon.

[Baroness Farrington of Ribbleton]

My Lords, cancer treatment drugs are often used in a range of measures to treat people suffering from cancer, including both chemotherapy and radiotherapy. Is it not the case that concern is being expressed about the closure of access to radiotherapy in some hospitals, and that people are having to travel for up to three hours? I understand that this is a problem in Essex and other parts of the country. Does the Minister share the concern about people not being able to get the treatment they need if these centres close? Who is responsible now, and who would be responsible in the future under the Government’s proposals, for ensuring that reasonable access is maintained?

[Earl Howe]

We are concerned to ensure that patients have reasonable access to the treatments that they need, including radiotherapy. I can tell the noble Baroness that part of the additional funding that we are making available under the strategy for cancer that we published earlier this year will go towards widening access to radiotherapy—not only better utilising the facilities that we have but commissioning new facilities. However, I am afraid it is the case that we increasingly see specialised units being concentrated in fewer locations. Unfortunately, this will mean that some patients have to travel a little further than they otherwise would have.

NHS: Cost-effectiveness

Baroness Farrington of Ribbleton Excerpts

Monday 12th September 2011 Lords Chamber

[Earl Howe]

I am grateful to my noble friend. A Written Answer was published in Hansard recently that tracked the changes in productivity of the NHS between 1996 and 2008. He will know if he read it that there was a decrease in productivity over that period of around 3.1 per cent. The pressures on the NHS are increasing. In order for it to respond to the needs of the future, including an ageing population and the cost of new technologies, it needs to adapt to new ways of working that reduce cost pressures while delivering improved outcomes. The measures that are before Parliament seek to do just that.

[Baroness Farrington of Ribbleton]

My Lords, can the Minister give an example of any major reorganisation and restructuring that has not cost more money and put the brakes on improvements in the service that were being made, particularly when the Government bringing in to the system such major changes comprise two parties that said that there would be no major reorganisation of the National Health Service were they to be in government?

[Earl Howe]

I commend to the noble Baroness the impact assessment that we published on the Bill. It shows clearly that, over the next 10 years, the savings that we will bring about will dwarf the cost of making the changes that we propose.

NHS Reform

Baroness Farrington of Ribbleton Excerpts

Monday 4th April 2011 Lords Chamber

[Earl Howe]

I agree with every word my noble friend said. It is illustrative of the truth of his remarks that, in the final year of the Labour Government, the administrative costs of the NHS rose by no less than £220 million. The rise in administrative costs was exponential. My noble friend is right: at the moment we largely have an NHS that is managerially and administratively led, rather than clinically led. We want to reverse that balance.

[Baroness Farrington of Ribbleton]

My Lords—

[Baroness Tonge]

My Lords—

[The Earl of Listowel]

My Lords—

[Baroness Farrington of Ribbleton]

Will the Minister give the House two assurances? One is that the Government have done nothing that is not legal in anticipation of the Health and Social Care Bill being passed. Secondly, although he may not have the figures with him, what are the relative administrative costs of private healthcare providers and the NHS?

[Earl Howe]

My Lords, I do not have the figures that the noble Baroness asked me for in the second part of her question. On the first part I can give a categorical assurance: the answer is yes.