NHS: Targets

Baroness Gale Excerpts

Thursday 6th February 2020 Lords Chamber

[Baroness Gale (Lab)]

My Lords, it is a great pleasure and privilege to follow my noble friend’s maiden speech and I congratulate her on it. It will be the first of many such speeches in your Lordships’ House that we will all have the pleasure of hearing.

I have followed my noble friend’s career over many years and watched her progress both in the Labour Party and in local government. She is a formidable campaigner and a straight talker. She has a no-nonsense approach to whatever she undertakes, as I am sure noble Lords will have noticed in her maiden speech.

Like me, she was born and brought up in the Rhondda Valley, which no doubt gave her a good grounding in local politics. She has a keen interest in education and worked as a teacher in Brixton in south London, was head of drama and media studies at Hartridge High School in Newport, and head of the performing arts faculty at Hawthorn High School in Pontypridd, with over 35 years’ experience in front-line education. She was an external examiner for the WJEC and AQA examination boards for over 25 years and became principal examiner for A-level theatre studies.

She also has an interest in local government, as she mentioned. She has served as a Newport councillor since 2004 and by 2016 she was elected leader of Newport Council—the first woman to hold such a post. Those of us who are involved in Welsh politics will appreciate what an achievement that was: for a woman to be elected leader of a local council.

But it did not stop there. By 2017, my noble friend had been elected leader of the Welsh Local Government Association—again, the first woman to hold such a post. That was even more of an achievement, as the Welsh Local Government Association has been dominated by men for so long—I could say “centuries”, because it feels like that; we waited for so long to get a woman in post. In 2018, my noble friend was invited to become a Fellow of the Royal Society of Arts, an award granted to individuals whom the RSA judges to have made outstanding achievements in social progress and development.

My noble friend has certainly smashed her way through the glass ceiling of Welsh politics and has been an example and an encouragement to women in Wales. I know that she will continue to be so as she begins her life in your Lordships’ House.

I thank my noble friend Lord Hunt for bringing this important debate before us today. I intend to focus on two NHS priority areas that impact people with Parkinson’s: mental health and dementia. I declare an interest, as I co-chair the All-Party Parliamentary Group on Parkinson’s.

Up to 40% of people with Parkinson’s will have depression, and up to 31% of people with the condition will experience anxiety. In 2017, in response to reports from Parkinson’s UK information and support staff, the APPG on Parkinson’s held an inquiry into the experiences of people with the condition who have anxiety and depression. The inquiry and subsequent report, published in 2018, found that people with Parkinson’s wait months, and sometimes years, to see a mental health professional once a problem has been identified; that the difficulty of diagnosing a mental health problem in someone with Parkinson’s is compounded by a lack of guidance for health professionals; and that there are complexities in the referral process, as a Parkinson’s professional must send an individual back to their GP so that they can refer them on to a mental health professional, which creates further, unnecessary delays. Professionals who presented evidence to the inquiry described communication barriers between departments, difficulties accessing patient notes, and a shortage of mental health professionals with the knowledge and skills to meet the specific needs of people with Parkinson’s. The mental health support received through improving access to psychological therapies, or IAPT, is not tailored to the needs of people living with Parkinson’s, and specialists such as neuropsychologists and neuro- psychiatrists are in short supply, leaving many people with Parkinson’s accessing IAPT services that are not tailored to their needs.

It is almost two years since the release of our report, and we are yet to see progress on several of the recommendations, which included funding research on effective mental health interventions for people with Parkinson’s, training in Parkinson’s for talking therapists working in IAPT services, and the publication of data on how mental health services for people with Parkinson’s are performing.

Every two years, the UK Parkinson’s Excellence Network, started by Parkinson’s UK to link up professionals who treat people with the condition, conducts an audit on the quality of Parkinson’s services. While the audit is not mandatory, an increasing number of services are taking part to track how they are improving. The results of the 2019 audit were released last week. They showed that, from 2017 to 2019, there was a reduction in the number of people with Parkinson’s being reviewed each year by their neurologist or elderly-care consultant, and less than 20% of these services were offering multidisciplinary clinics.

The results around mental health show how improvements are needed in screening and access to referrals. Almost a fifth of Parkinson’s services across the UK could not refer psychiatric services. The Excellence Network will now support Parkinson’s professionals to deliver an action plan to improve their services ahead of the next audit cycle, which will happen next year. Parkinson’s UK is currently interviewing people with Parkinson’s-related dementia and their carers about their experience of the health and social care system. Initial findings show that carers are struggling with some of the more distressing symptoms of Parkinson’s-related dementia, such as challenging and aggressive behaviour. They also show that NHS support for people with Parkinson’s-related dementia drastically reduces after entering a care home, and that social care staff do not generally understand the condition, leaving families and carers to step in and explain how they should provide care.

Acknowledging the importance of social care to an effective NHS, can the Minister say what progress the Government have made towards a future funding solution for social care, so that people with Parkinson’s dementia are not continually let down?