(8 years ago)
Lords ChamberI am not going to be drawn into discussing specific hospitals and I have given my reasons for that. However, I will say that the statement made in July by the Royal College of Surgeons and the Society for Cardiothoracic Surgery said:
“We fully support these standards. NHS England must ensure that the standards are applied for the benefit of patients, by ensuring that expertise is concentrated where it is most appropriate. The proposals put forward by NHS England today should improve patient outcomes and help address the variations in care currently provided.
It is fundamentally important that specialist surgical centres are large enough and treat patients regularly enough to develop full expertise to treat all conditions. It’s vital they are properly staffed to provide on-call rotas and teams have the time to create a supportive environment where new techniques are shared and future specialists can learn”.
My Lords, I declare an interest in that I was a member of the hospital board of the Brompton for some 15 or 17 years —a long time. You have to look at this case specifically because the Brompton has been quite outstanding and does not work in complete isolation. I am a cardiac patient under the Chelsea and Westminster Hospital, and the same consultants work at both these hospitals and work fairly closely together. However, I do not think that anywhere exceeds the Brompton in standards of care for congenital heart conditions. Indeed, there are Members of this House whose children have had very successful treatment there. We cannot ignore the very special circumstances of this world-famous hospital.
I appreciate the concerns that noble Lords have raised and the concerns of the hospital trust. However, we must remember that no final decisions have been made and a public consultation will begin shortly. That is when all points can be raised and addressed.
I do not disagree with the noble Lord. That is why we are working so hard and why we have provided £7.5 million to local authorities to make sure that we encourage people to get on to the register. As I said earlier, we have made it much easier to do that, and all we can do is to keep plugging and make sure that we succeed.
My Lords, in these days when the web is considered to be so insecure and is so frequently hacked, are the Government confident that all these methods of voting will be legitimate? There was concern about postal voting, with in many cases the names of 30 people being sent in from a single house? Will this method of registration be more secure than that?
Absolutely. The whole point about IER is that it reduces the risk of electoral fraud by ensuring that entries are confirmed as genuine. Last year’s election court judgment on Tower Hamlets exposed the real threat of fraud.
To ask Her Majesty’s Government what steps they are taking to ensure that carers employed by care service agencies provide the care for elderly, disabled and other people for which they are paid.
My Lords, care providers are responsible for ensuring that care workers provide the care for which the provider is paid. They must ensure that workers have the necessary training, skills and behaviour to deliver safe, effective and personalised care, and should allow workers sufficient time to travel between appointments. It is not acceptable for the provider to condone shortened or missed visits.
My Lords, I thank the Minister for that reply. When carers were employed directly by councils, local authorities thought it very important to have someone who acted as a supervisor. That person’s duty was to do spot checks and pop in to see whether someone was really there doing the job that they were being paid for. Recently, we have seen on television and read in the newspapers—and I have heard directly from carers—that some people are often simply not doing the job, they are popping in merely to sign for the hours for which they should have done the job. They are often leaving the client—they use the phrase “the client”—unchanged, unwashed and unfed, not even seeing that they get their necessary medication. Given the present situation, does the Minister consider that care agencies should pay for local councils to employ an inspector, or do the Government need to investigate and regulate to protect those vulnerable members of society who rely on home care?
My Lords, I should say at this point that the majority of carers do a superb job and look after everybody beautifully. Of course, even one carer giving poor care is not satisfactory. Local authorities have the duty to ensure that providers give a high standard of care. In 2014, tougher inspections were brought in and the CQC can penalise providers if the standards are not to those high expectations.