Crohn’s Disease and Ulcerative Colitis
Baroness Greengross Excerpts(3 years, 4 months ago)
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Lord Bethell (Con)
My Lords, Covid-19 has hit all services in the NHS. I pay tribute to those involved in the IBD area who have moved extremely fast to anticipate these problems. Rapid guidelines for gastrointestinal and liver conditions treated with drugs have been made available over telephone, email and text messaging services. NICE issued new guidance in August 2020 to advise healthcare professionals on gastrointestinal and liver conditions.
Baroness Greengross (CB) [V]
My Lords, what plans do Her Majesty’s Government have to introduce sanitary bins in public toilets for men? There is a terrible shortage of these, and many men need somewhere to put items such as pads when they have a disease.
Lord Bethell (Con)
I am afraid that the management of public toilets is outside the reach of the department, but I will take that idea back to the department and write to the person responsible.
Health and Social Care Update
Baroness Greengross Excerpts(3 years, 5 months ago)
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Lord Bethell (Con)
My Lords, from the beginning, we have put in place arrangements for the UK manufacture of vaccines, which, in the light of events, has proved to be a pragmatic and sensible move. We are hopeful that the EU will continue in the spirit of partnership and will respect contract law. I stand by the statement I made on our expectations on the supply of the vaccine to cohorts one to nine and all adults that I articulated earlier.
Baroness Greengross (CB) [V]
My Lords, what is the Government’s response to the 2020 report from Amnesty International which suggests that the Government, while knowing the vulnerability of many older people, failed completely to protect care home residents? People were discharged into care homes without testing, which, according to Amnesty, breached their human rights and contributed to the fact that the UK had the highest death toll in Europe at the time.
Lord Bethell (Con)
My Lords, I simply do not recognise the characterisation that the noble Baroness has just presented. The view of our treatment of the elderly and vulnerable taken by Amnesty during the pandemic is completely inappropriate and inaccurate. Huge steps have been taken to protect those who are vulnerable and elderly. I cannot think of a country that could have done more under the circumstances. I therefore reject its analysis.
NHS: Staff Numbers after Covid-19
Baroness Greengross Excerpts(3 years, 5 months ago)
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Baroness Greengross (CB) [V]
My Lords, the All-Party Group on Adult Social Care—[Inaudible.]
The Deputy Chairman of Committees (Baroness Watkins of Tavistock) (CB)
We are having difficulty hearing the noble Baroness. We will come back to her after the next speaker, the noble Lord, Lord Willis of Knaresborough.
Baroness Greengross (CB) [V]
My Lords, I am co-chair of the All-Party Group on Adult Social Care. Our recent report found that the government target of recruiting 20,000 additional social care workers was not enough—[Inaudible.]
The Deputy Chairman of Committees (Baroness Watkins of Tavistock) (CB)
I am sorry; I think the difficulty is that the noble Baroness is not close enough to her microphone. When she was tested, it was fine. If we cannot hear her again, perhaps she could write and the Minister will pick up the issues she would like to raise? I will give the noble Baroness one more try right now.
I am sorry; our connection is just too poor for us to hear the noble Baroness. If she could send an email in, the Minister will pick up the issues when he sums up. I thank her very much for her patience.
I call the noble Lord, Lord Winston. No, the noble Lord has withdrawn. I call the noble Lord, Lord Balfe. No, he has withdrawn too. I call the noble Baroness, Lady Bennett of Manor Castle.
Covid-19: Adult Social Care Complaints
Baroness Greengross Excerpts(3 years, 10 months ago)
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Baroness Greengross
To ask Her Majesty’s Government, following the suspension of all casework by the Local Government and Social Care Ombudsman between 26 March and 29 June due to the COVID-19 pandemic, what steps they have taken to ensure that complaints made during that period were handled in line with the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009; and what steps they are now taking to ensure that complaints about adult social care are handled appropriately.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, it is essential that people can voice concerns about their care and have complaints properly investigated. The ombudsman is a vital part of that process. The ombudsman temporarily suspended its usual procedures to protect front-line services. It has now fully reopened and is working through complaints received during that pause. No one has lost their access to justice because of the pandemic and usual time limits on complaints have been eased to allow for this.
Baroness Greengross (CB)
My Lords, I thank the Minister for his reply. Can the Government confirm that they still intend to introduce a statutory appeal system for adult social care, as originally planned for in April 2020? If so, do they intend to reopen consultation on that process, given that this was last undertaken more than five years ago, and no response was published?
Lord Bethell (Con)
The noble Baroness is entirely right that in April 2016 we committed, in fact sheets about the Care Act, to introduce an appeals process. That is still on the horizon, but this is best placed as an overall reform of the social care system that puts it on a sustainable footing where everyone is treated with dignity and respect. We have, therefore, delayed the implementation of this appeal system until we can make it part of a larger commitment to reforming social care.
Covid-19: Medical and Funeral Expenses
Baroness Greengross Excerpts(3 years, 11 months ago)
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Lord Bethell (Con)
My Lords, the noble Baroness is correct that the calculation is dependent on close relatives being on social benefit. It is a sliding scale, but it is applied in an open-hearted and generous-minded way, and there are relatively discretionary payments, of up to £1,000 for ancillary costs that go beyond the funeral parlour costs, to try to create the kind of funeral that marks the passing of a loved one. We are keeping this payment under very close review, given its sensitivity, and will review it if there are concerns.
Baroness Greengross (CB)
My Lords, given that the number of deaths in the UK has increased by 60,000 on last year, do the Government have up-to-date figures for the number of public health funeral claims being made to local authorities?
Lord Bethell (Con)
My Lords, I do not have up-to-date figures for the claims up to this month, but the number is expected to have risen. We published refreshed non-statutory good practice guidance this month, for all local authorities, to ensure that public health funerals are delivered respectfully and with care, both for the individuals and their families.
Mental Health Services: Young People
Baroness Greengross Excerpts(3 years, 11 months ago)
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Lord Bethell (Con)
My Lords, face-to-face appointments are incredibly important for some people, which is why we have emphasised the return to work, particularly in GP surgeries. However, I would like to make the case for internet or telephone services. They have proved to be extremely popular among some mental health patients, who find the direct intimacy of face-to-face too overwhelming and prefer instead to do Zoom or telephone consultations. We are supporting analysis of where these rightfully work and in the meantime are supporting face-to-face when preferred or necessary.
Baroness Greengross (CB) [V]
My Lords, I declare my interests as in the register. Like young people, many older people have suffered a significant deterioration of their mental health during the pandemic. Due to social distancing restrictions, many counselling and other mental health services can be accessed only online. Recent research by the International Longevity Centre found that 11.9 million people in the UK lack the digital skills they need for everyday life, and ONS figures published in May show that only 47% of adults aged 75 and over use the internet. What support will the Government give vulnerable older people experiencing mental health issues, and how will they support those who are digitally excluded so that they can still have access to mental and other important health services?
Lord Bethell (Con)
My Lords, the digital gap in social care, particularly for older people, is enormous, and the noble Baroness is entirely right. NHSX has a large programme called Joined up Care, which is seeking to help bridge that gap. It includes, for instance, the provision of a large number of iPads to social care homes. However, the noble Baroness is right that that will not be enough to provide the care for those for whom digital access is simply too challenging or unavailable, which is why we will continue to support face-to-face and direct forms of care when necessary.
Covid-19: Mental Health Services
Baroness Greengross Excerpts(4 years, 1 month ago)
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Lord Bethell [V]
I pay tribute to charities and other community projects which have contributed to a wide range of projects across mental health, learning disabilities, dementia, isolation, befriending, domestic abuse, women’s issues and BAME groups. As I mentioned earlier, the Mind and mental health consortia are making recommendations about the progress of the fund. I look forward to their recommendations and we will act on them wherever we can.
Baroness Greengross (CB) [V]
My Lords, one consequence of the pandemic has been increased rates of violence or harm against old, young and other vulnerable people. Increased pressure on people’s mental health during the lockdown will likely have contributed to that. Should the Government make it obligatory for threats of violence, which could be bravado but which could also be dangerous, to be reported to the police as well as to social services, and would such measures help reduce domestic and other forms of abuse and ensure early intervention when someone is having a serious mental health episode?
Lord Bethell [V]
My Lords, threats of violence under any circumstances are reprehensible, and those aimed at the old and the vulnerable are in a category of their own. It is up to the clinical judgment of those involved in social care to decide whether the involvement of the police is of benefit and worth. I would not want to apply a blanket ruling on that, but the noble Baroness makes an extremely important point, which we are constantly reviewing.
Nursing and Midwifery
Baroness Greengross Excerpts(4 years, 6 months ago)
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Baroness Blackwood of North Oxford
The scheme is more generous than the previous scheme.
Baroness Greengross (CB)
My Lords, until a few years ago, community nurses looked after the whole population in the area in which they worked. Lately, they have looked after only children up to the age of about five. Is it planned for them to go back to looking after the community as a whole, which is an important part of their work?
Baroness Blackwood of North Oxford
The noble Baroness is very knowledgeable about this. She is right that when we strengthen community practice, it is important to have a holistic approach. That is exactly what underpins the ICS having a much more joined-up approach to social care, general practice and mental health. It is what lies behind developing a holistic people plan. Such an approach will come forward when this is published.
Queen’s Speech
Baroness Greengross Excerpts(4 years, 7 months ago)
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Baroness Greengross (CB)
My Lords, in my brief remarks today I will address three issues which are of major importance in the fields of health, social care and the way we meet carers’ needs. I declare my interest in the International Longevity Centre UK and the ILC Global Alliance as entered in the register.
In the gracious Speech we learned that
“Steps will be taken to grow and support the National Health Service’s workforce and a new visa will ensure qualified doctors, nurses and health professionals have fast-track entry to the United Kingdom.”
It is vital that workforce shortages within the NHS are addressed. According to projections by the Nuffield Trust in 2019, there is a current shortage of one in 12 NHS staff. However, we also need to see continued commitments to prevention along the life course to ease pressures on the NHS, as outlined in the NHS long-term plan. New research by ILC-UK has found that across better-off countries in 2017 alone, 27.1 million years were lived with disability due to largely preventable diseases. That number is projected to increase by 17% in the next 25 years if we do not prioritise prevention across the life course. That is an imperative.
We also heard in the gracious Speech that the Government will
“seek cross-party consensus on proposals for long term reform of social care. They will ensure that the social care system provides everyone with the dignity and security they deserve and that no one who needs care has to sell their home to pay for it.”
It was great to hear the strong message of the noble Lord, Lord Forsyth, on that point. Reform of adult social care is long overdue. As Age UK informed us,
“the care system is broken”;
it is ignoring 1.4 million people with an unmet need. Spending on adult social care by English local councils has fallen by 5% in real terms between the 2009-10 financial year and 2017-18, according to the Institute for Fiscal Studies in 2018. Recent research carried out by ILC-UK and the Salvation Army found large gaps between upper-tier local authorities’ spending power: in 2014, their spending power ranged from £31,368 in Lambeth Council to £5,762 in Dorset Council. That is totally unacceptable.
Lastly, we heard in the Queen’s Speech:
“Measures will be brought forward to encourage flexible working, to introduce the entitlement to leave for unpaid carers and to help people save for later life”.
Longer working lives could bring economic opportunities to the economy. Recent research by ILC-UK reveals that the earned income generated by people aged 50 and over may account for 40% of total earnings by 2040. However, research by ILC-UK in 2014 also showed that over 1 million people between 50 and 64 leave the workforce involuntarily due to health and care needs or caring responsibilities, at a huge economic cost to the country and social cost for both individuals and their families. As such, initiatives to support older workers to juggle work and caring responsibilities, improved occupational health services and opportunities to learn and retrain throughout people’s careers are paramount to unlocking this economic potential. I hope that the Government will ensure, in line with government policy, that these important needs can be rapidly implemented.
Queen’s Speech
Baroness Greengross Excerpts(4 years, 10 months ago)
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Baroness Greengross (CB)
My Lords, in my brief speaking time, I will focus on three important issues: first, the Government’s proposals to reform adult social care; secondly, the NHS long-term plan, prioritising prevention in an ageing world; and, thirdly, the Domestic Abuse Bill.
While I welcome the additional funding that the Government have announced for social care, what legislation can this House expect to scrutinise in this Session—or, perhaps I should say, the next Session of Parliament? Over the past 25 years, we have seen a lot of policy reports on how to reform adult social care but little substantive action. The problem has not gone away and will not do so until it is solved, which is why I hesitate to recommend another report to the Minister. She will no doubt be aware that, in July this year, the Intergenerational Fairness Forum, which I chair, published a cross-party report, Sustainable Funding for Social Care & Intergenerational Fairness. It put forward a range of recommendations seeking to build consensus through the prism of intergenerational fairness. In brief, the report recommended a Dilnot-style funding system built on a national pooling of risk, with a means-tested threshold for personal contributions and a cap on overall care costs. This would be partly paid for by a 1% social care insurance contribution for those aged over 40 until they retire and the replacement of higher-rate pension tax relief with a new, flat-rate relief below 40%, along with other tax and benefit changes to meet the existing, unmet demands for care. I hope that the Minister will consider these suggestions.
On the NHS long-term plan and prevention, I welcome the commitment to strengthen our NHS by addressing workforce shortages and improving service delivery, building on the set of recommendations published by the NHS last month. According to projections by the Nuffield Trust released this year, there is a current shortage of one in 12 NHS staff. Strengthening the NHS is especially important in the context of an ageing society, as recognised by the Government’s healthy ageing challenge. We know that there are currently 10 million people aged 65 and above living in the UK; that number is expected almost to double, to 19 million, by 2050. This means that we will see greater strain on health services still, and a growing number of limiting co-morbidities that require more costly and complicated secondary and tertiary care services. To ensure the future sustainability of our NHS, and to support people to lead longer, healthier and more productive lives, the prevention of ill health is crucial.
Therefore, I welcome the fact that,
“The Long Term Plan sets out how Government will improve the prevention, detection, treatment and recovery from major diseases, including cancer, heart attacks and strokes”.
However, the ambition should go further and be global, which is why the International Longevity Centre UK has launched an international programme of work, entitled “Prevention in an ageing world”. It is estimated that, in 2017 alone, 27.1 million years were lived with disability due to largely preventable diseases; that number is projected to increase by 17% in the next 25 years if we do not prioritise the prevention of ill health right across the life course. It was therefore welcome that the G20 leaders’ summit in Osaka this summer—and the G20 Health Ministers only last week—pledged to promote prevention across the life course. I hope that the Minister can help ensure that the UK positions itself as a world leader in the prevention of disease.
On the Domestic Abuse Bill, I am largely pleased that the legislation has now been carried over from the last Session, and I look forward to this House’s scrutiny of the Bill when it reaches us. However, I am concerned that the Government did not accept the recommendations of the Joint Committee, which considered the draft Bill, regarding the definitions of the “same household” criterion and “personally connected”. We may also wish to clarify further how abuse by carers is covered by the Bill, because domestic abuse is more than just abuse by a spouse. Depending on what amendments the other place makes to the Bill, I suggest to the Minister that we may wish to amend the Bill particularly in this respect.