National Health Service: Workforce Race Equality Standard

Baroness Howells of St Davids Excerpts

Wednesday 24th February 2016 Lords Chamber

[Lord Prior of Brampton]

I think we are probably straying quite a long way from the Question, but I will certainly consider what the noble Earl said.

[Baroness Howells of St Davids (Lab)]

My Lords, I would like to put this on record so that some of the answers to the Question do not keep coming up. No self-respecting person, black or white, will accept a job that they are not capable of. No person who served the National Health Service from any Caribbean country has ever been sacked because of lack of ability. They have suffered racism, but they contributed immeasurably in the days when there were very few white people entering the service. When the Queen gave out her medals to mark the 60th year of her reign, the black community was left out. I appealed on their behalf and they were given medals. There were articles in the newspapers that showed that most of the women who went into the health service as nurses were overqualified.

Sugar Tax

Baroness Howells of St Davids Excerpts

Wednesday 3rd February 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, exercise may be a part of our strategy to tackle obesity, but certainly not the major part.

[Baroness Howells of St Davids (Lab)]

My Lords, I am sure that the House is aware that sugar comes from many sources—sugar cane, sugar beet and in fruit. Which sugar would we tax?

[Lord Prior of Brampton]

The noble Baroness makes an interesting point. This is one of the difficulties with the proposal for a sugar tax. We must be very careful about which sugars we would tax. I cannot give the noble Baroness a proper answer save that where sugar taxes have been introduced, they apply to where sugar is added as part of the manufacturing process or where it is present in syrups and fruit juices, but not where it occurs in, for example, fruit or vegetables.

Care Sector

Baroness Howells of St Davids Excerpts

Tuesday 25th November 2014 Lords Chamber

[Baroness Howells of St Davids (Lab)]

My Lords, I, too, congratulate the noble Baroness, Lady Kingsmill, on raising this debate and giving a very thorough insight into her report on what is happening in the care field. I have a particular interest in carers because so many immigrants from the early 1950s and 1960s from the Caribbean, when they were invited to come to support the mother country, found work in the caring sectors and were happy to do so. It is no secret that I have been a tireless campaigner for better services for black communities, but today I speak for all citizens of the United Kingdom.

I was very struck in October by a Statement read out in this Chamber by the Parliamentary Under-Secretary of State in the Department of Health. It was entitled Five Year Forward View. This Statement brought to our attention how the proposed plan would make the service better and fit for purpose. The Government claimed to have recognised the challenges facing care and declared that continuing with a comprehensive tax-funded NHS was intrinsically doable and that there were viable options for sustaining and improving the NHS over the next five years.

The Statement also claimed that the challenges of an ageing population can be met by a combination of increased real-terms funding efficiencies and changes to the models of how care is delivered. Much was said of the value of greater integration, of releasing hospital beds by combining primary community and specialist tertiary sectors alongside national urgent and emergency networks. The Statement went on to say that this would give older people in particular the personal care we would all want for our own parents.

That is very laudable, but what has been done? What has happened? When the Statement talked about reducing variations in quality in the wake of the tragedy of Mid Staffs, they were all very grand words. Can the Minister tell the House what has gone wrong? We are told that the economy is doing well, so cash should not be a problem. Did the Government really mean to downgrade the workers who carry out some of the most important work; the sort of work that is meant to have a real impact on those receiving care?

The trade union Unison cites that there are a number of appalling examples of exploitation. Employment rights are not properly observed and bogus self-employment presents a big problem. Employers operate with relative impunity in an unregulated sector. This is not care; it is an abuse in this century not only of those needing care but of those giving the care. They need to be cared for so they can offer good care.

Those who are engaged in caring know what a difficult task it is. They do it because they care. To them, the patient is first but needs time. The report highlights that the sick, elderly and disabled people who rely on care services are increasingly facing a 15-minute visit from carers. What can you do in 15 minutes? If the person is well and healthy you might do something, but if they are not, 15 minutes can never be enough to bathe, dress and feed a patient. Some people may need 15 minutes, but others need a lot more.

I recently met carers who have had nervous breakdowns because of the strain of getting to places on time. Caring is natural, but we need to help. We need not only to train carers but to be aware of their circumstances and to give them more. I urge the Minister to put his weight behind the recommendations of the Kingsmill report. Most of those needing care are those who have paid into the health service. It is not a charity. Those who advocate 15 minutes per patient are those who live inside the radar of the healthy, the employed and the respectable. They have no idea of what it is like to be in the other camp.

Unless you have been a carer you have no idea of what is happening. I cared for my husband for seven years, and I assure noble Lords that the man I married was not the man I was caring for. Being unhealthy, unemployed and treated as not respectable so that any old thing will do is not good enough for citizens of the United Kingdom. Care workers should be treated fairly, and I trust the Minister will revisit the five-year plan because patients and carers deserve better.

This country can do better and must take heed of the report and implement the recommendations as soon as possible. As lawmakers, we are guilty of failing the most vulnerable, those most in need. I say this not because I want to make noble Lords feel bad but because I have seen carers, some of whom have retired from nursing, who have had to take breaks because of the strain of caring. Those who are caring and those who are dependent on them need our help. If not, we are very guilty as lawmakers.

Health: Anorexia and Bulimia Nervosa

Baroness Howells of St Davids Excerpts

Thursday 11th July 2013 Lords Chamber

Asked by

[Baroness Howells of St Davids]

To ask Her Majesty’s Government whether they are taking steps to ensure that those suffering from mental health disorders such as anorexia and bulimia nervosa are receiving the most appropriate care; and what provisions exist for urgent cases, particularly those of 17 to 18 year-olds.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, early intervention is essential for those with eating disorders. We have been clear that GPs are expected to use guidance produced by the National Institute for Health and Care Excellence—NICE—when choosing the most appropriate treatments, from physical and psychological treatments to medicines. The NICE guidance is due for review in January 2014.

[Baroness Howells of St Davids]

I thank the Minister for his Answer. Does he recognise that talking therapies are more effective for treating eating disorders, yet to date there is no legal right to receive talking therapies, as there is for drugs? Recent figures outline that more people than previously are waiting longer than the targeted access time of 28 days to receive those therapies, especially those under 18. In fact, the figures show that those under 18 are sometimes referred to mental hospitals rather than being given such therapy at the time. I respect the fact that the Government have committed to make measurable progress by March 2015 to parity of esteem, and that they cannot make any commitments before that. However, I am concerned that there appears to be no monitoring of this situation. The fact that this is urgent does not seem to be taken on board and many young people under 18 are suffering.

[Earl Howe]

My Lords, the mental health of children and young people is a major priority for the Government. Half of those with lifetime mental illness first experience symptoms by the age of 14 and three-quarters before their mid-20s. That is precisely why we are investing a large sum of money—£54 million—over the four-year period 2011-15 in the Children and Young People’s Improving Access to Psychological Therapies programme. We know, as the noble Baroness rightly emphasises, that those talking therapies can make the most difference, particularly if early intervention is achieved.

Health: Diabetes

Baroness Howells of St Davids Excerpts

Wednesday 25th July 2012 Lords Chamber

[Earl Howe]

Exercise is recommended under the Change4Life programme and under the advice given by NICE. However, the noble Baroness is absolutely right to mention a possible genetic cause. The cause of diabetes is not fully understood and is multi-factorial. Healthy eating, weight control and exercise can help reduce the risks, but that is not the full picture. It is suspected that there is a genetic component in the case of black and ethnic-minority communities.

[Baroness Howells of St Davids]

My Lords, I have some of the statistics that have already been mentioned. We now know that manifestations of diabetes are three times higher among the Afro-Caribbean people who came to Britain to assist after the war than among the majority population. We also know that deaths are three times higher and 40% are at a higher risk of morbidity, kidney failure and blindness. As a result, they really do put a higher cost on the NHS. Some who have returned home have to come back here for treatment because this is where they paid their way. I would like to know whether Her Majesty’s Government have really taken on board the NICE recommendations that health programmes should be culturally appropriate and that cooking guidance should be given and tailored to the needs of people and to what they eat at home. We believe that educators are necessary to inform sufferers of their needs, so that they can make a choice, not only about what they eat but also about how they prepare it. I ran classes for a group of people and I can assure your Lordships that there has been a change in the way they respond. If the Government have not taken up that particular part of the NICE recommendations, why not?

[Earl Howe]

My Lords, the advice given by NICE makes 20 specific recommendations, many of which are highly relevant to the population group mentioned by the noble Baroness. She is absolutely right that there is a need to educate those in black communities about a healthy diet. There is a lot of work going on in that area, which is too detailed and complicated for me to mention at the moment, and in the area of self-education to enable patients to understand their own condition and to manage it better.