Queen’s Speech

Baroness Jolly Excerpts

Thursday 9th January 2020 Lords Chamber

[Baroness Jolly (LD)]

My Lords, I declare my relevant interests in the register: chair of a learning disability charity providing services for people with a learning disability and president of RoSPA.

It may surprise noble Lords to hear that there are more accidents in the home than in any other setting, and they affect the most vulnerable, so I welcome the building safety Bill. It is much needed and, I hope, an opportunity to recognise how modifying low-cost housing design features and specifications can save lives.

Naturally, following the Grenfell tragedy, there is a focus on fire safety and cladding, and this is vitally important. However, I draw attention to the fact that, for every fire-related hospital admission in England, 234 are caused by accidental falls. Indeed, falls make up 60% of total accident-related hospital admissions. Simple regulation and guidelines have the potential to ensure that tragic accidents, which most often involve infants or the elderly, are avoided and we can all feel safe in our own home. I refer the House to measures outlined in RoSPA’s Safer by Design guidelines for how this can be achieved.

I note that a new employment Bill was announced in the gracious Speech, which has the stated purpose to protect and enhance workers’ rights. However, the accompanying briefing document lacked detail about how that would apply to the most fundamental of all workers’ rights—the right to go home safe and healthy at the end of the working day. Will the Minister clarify that the Bill will contain the measures about a worker’s right to work in a safe environment that were taken out of the October EU withdrawal Bill when the December Bill was published?

There is much to be welcomed in the Government’s health plans in the Queen’s Speech. However, as with all these things, the devil will be in the detail, and I am sure that the combined expertise of this House will leave the Bills better than when they arrive. Although funding pledges enshrined in law are welcome, I regret that there is no clear plan to address issues of capital funding or public health. The Government pledge to build 40 new hospitals, but clarity is needed on the issue of funding for general infrastructure, and this includes expensive medical equipment such as CAT scanners—and, as the right reverend Prelate the Bishop of London said, we also urgently need to address the issue of staffing. The Government’s plans to introduce fast-track visas for healthcare workers are in the right direction. But the policy does not go far enough, given the scale of the current crisis facing the NHS. With more than 100,000 current vacancies and a nursing shortage of 40,000, we need urgent action. With the UK’s approaching exit from the European Union, this issue will only become more urgent.

It is important that it is made clear exactly who is responsible for the recruitment and retention of staff, and who will be held accountable if the Government fail to meet their ambitious targets. In Questions yesterday, the Minister suggested that it was the Secretary of State, but I wondered which organisation this had been devolved to.

I also urge the department to engage meaningfully in a reflection about international health worker recruitment processes. The UK has a responsibility to recruit in an ethical way. This means ensuring that our efforts in international health development and health system building are not undermined by the drain of health workers from lower-income or understaffed countries.

It is encouraging to see mental health services mentioned in the Queen’s Speech, and the rewrite of the Mental Health Act that Sir Simon Wessely has been involved in is long overdue. I would also like to see the issue of the transition from adolescent to adult services given due consideration. Mental health conditions do not recognise arbitrary age boundaries. Although such transitions are often handled well, support and continuity can be an issue. Staffing issues are also prevalent in this sector, with 10% of full-time consultant posts in psychiatry being vacant and a shortage of mental health social workers and community nurses. We also need to ensure that young people receive prompt diagnosis, so that mental health services can provide timely early support, preventing the need for crisis management later in life.

The Government’s new visas do not include staff who wish to work in social care, many of whom will fall below the Government’s £30,000 threshold for points-based immigration. How do the Government intend to address the gaps in the stretched social care workforce and ensure that work is valued? As providers of learning disability services, we often have difficult conversations with our commissioners to ensure that we can offer the service levels required by the Care Quality Commission. Local authorities are underfunded and are unable to work within their budgets for service provision. That means often that the services provided are often not up to standard. The new Government’s majority presents an opportunity to introduce reforms that have been widely recognised as necessary for years. Now is the time for action and I look forward to hearing the Government’s proposals in the very near future so that collaboration can begin.