Queen’s Speech

Baroness Finlay of Llandaff Excerpts

Wednesday 12th May 2021 Lords Chamber

[Baroness Finlay of Llandaff (CB)]

My Lords, somewhat unusually, before I start I would like us to record that Her Majesty commanded ever-greater respect, renewed admiration and deep affection in the hearts of all who witnessed Her Majesty’s presence here with us yesterday. Turning to today, I congratulate the noble Baroness, Lady Blake, and the noble Lord, Lord Lebedev, on their speeches and welcome them to this House. The right reverend Prelate the Bishop of Portsmouth, who is about to give his valedictory speech, has brought greatly appreciated insights and will be missed across the House.

On the contents of the gracious Speech, I will focus on some aspects of health and social care, obesity and addictions, and professional regulation. The pandemic has certainly taught us a great deal. We ignored obesity for years, pretending that it was even discriminatory to attempt to tackle it and the poor nutritional status of many in our population. Covid revealed that just being overweight is a highly significant predictor of developing complications from Covid-19, including the need for intensive care support, and a predictor of death. By the end of February this year, 2.2 million of the 2.5 million Covid deaths reported worldwide were in countries where more than half the population is classified as overweight.

Obesity, mental health problems and domestic violence all feature in the gracious Speech, but the common underlying factor of alcohol harm has been ignored. So I ask: why is there no alcohol strategy? Last week, the Office for National Statistics reported a 20% increase in deaths caused directly by alcohol. Alcohol-fuelled domestic violence has also risen alarmingly during the pandemic. The Commission on Alcohol Harm, which I chair, recommended calorie labelling, minimum unit pricing and measures to decrease harms in off-sales. We must tackle root causes. Talk of personal responsibility from the industry ignores the addiction behind alcohol misuse.

Our health and social care workforces are exhausted. Supporting people through post-Covid recovery and rehabilitation will mean more professions and practitioners need to be brought into the scope of an updated regulatory framework, as proposed by the Health and Care Professions Council. Voluntary registers are not adequate. Regulation needs to focus on tasks and function. The public need the assurance that all practitioners are trained to agreed standards and can access the care that they need. The Medical Act 1983 was written for a different age; the General Medical Council wants legislative reform for complaints to be resolved more quickly, to support good practice and for the registration framework to fit today’s needs, bringing physician associates and anaesthesia associates into regulation.

Even before Covid, both the health and the social care workforces had staff shortages, chronic excessive workloads and high levels of stress, absenteeism and turnover. Covid revealed the importance of integration and collaboration for managing every aspect of the pandemic. That must not slip back into bureaucratic silos that demoralise and blame, rather than foster initiatives and support. For care in the community, especially for those in the terminal phase of illness, there must be better out-of-hours support, with seven-day services and access to specialist expertise. That is why I am entering my access to palliative care Bill into the ballot again. As we invest in research and innovation, we must also invest in the infrastructure so that the systems through which care is delivered will avoid overcrowding, reduce waste and drive public health improvements.

True levelling up of public health requires decreasing the drivers to addiction, gambling, alcohol, tobacco and violent pornography on the internet. It also means improving nutrition and understanding the social determinants of health. Our future prosperity depends on an agile, healthy population, with skills and adaptability in the face of future challenges. This requires legislation that understands problems in depth and drives policy for long-term stability and social responsibility, not short-term quick fixes on paper.