Mental Illness: Job Security and Inequality

Baroness Jolly Excerpts

Thursday 4th July 2019 Lords Chamber

[Baroness Jolly (LD)]

My Lords, this has been a varied debate with interesting contributions: the noble Baroness, Lady Redfern, talked about the criminal justice system and how all this fits in; the right reverend Prelate the Bishop of St Albans talked about discrimination and how wearing that can be, as well as the importance of work at the end of life and the TUC voluntary charter; and the noble Baroness, Lady Hollins, spoke of how less than 6% of people with a learning disability are in employment.

I should declare my interests as set out in the register. The organisation I chair also works towards placing those it cares for in appropriate work settings.

At the end of last year, I attended a round table on health and ageing at the European Parliament. We looked at the human rights of the older person. It gave me an interesting insight into policy-making in the context of our human rights. I decided to pursue this line for this debate, so I hope noble Lords will excuse me if this sounds a little unusual.

Last week, mental health was discussed at the 41st session of the UN Human Rights Council. The noble Lord, Lord Bird, referred to this in his opening speech, and I thank him very much for instigating this debate. At the UN, the special rapporteur argued that good mental health and well-being cannot be defined by the absence of a metal health condition but must be defined instead by the social, psychosocial, political, economic and physical environment that enables individuals and populations to live a life of dignity, with full enjoyment of their rights in the pursuit of their potential.

One of our human rights is that of health, which of course includes good mental health, along with others such as participation in democracy, provision of adequate and suitable housing and education, a family life, access to justice, participation in society and workers’ rights. In many parts of the world, these are observed in the breach, but here in the UK—a wealthy nation and one of the founder signatories of the Universal Charter of Human Rights—there is no excuse if they are not observed.

There are protective factors such as social inclusion, community resilience, LGBT rights and rights for workers, as well as, interestingly, access to good housing and green spaces. On the other side of the coin are risk factors, including social exclusion, violence against the person, bullying, discrimination and poor working conditions. It is clear to see that these two kinds of factors are the determinants of good and bad mental health. They are easy to recognise and we can readily identify components of each, yet we struggle to amplify those protective factors and reduce the risk factors. All this fits neatly with the title and thrust of this debate.

This rights-based approach gives us a framework to work with. States have an obligation to respect, protect and fulfil all our rights, including our right to good mental health. National Governments may directly contravene the obligation by cutting benefit levels, failing to make suitable housing available and restricting education opportunities. In areas of low employment, we should not be surprised to find a greater than average incidence of poor mental health.

In England, health and well-being boards convened by local authorities are well placed to look at this issue in their local areas. Consisting of representatives from local government, health, police, the local LEP and the voluntary sector, they are well placed to identify risk factors for their areas and work together to mitigate them. Similarly, they are able to identify the local protective factors. Local authorities and the LEPs should identify local opportunities and local risks.

In 2017, Public Health England produced a toolkit to understand health and well-being at a local level, acknowledging that stable and rewarding employment is a protective factor for mental health, and unemployment and unstable employment are risk factors. This toolkit helps the health and well-being boards to produce their joint strategic needs assessment, which needs to be done on an annual basis. Of course, any local plan to improve mental health should be determined with the active involvement of service users and carers, and the local voluntary sector.

The noble Lord, Lord Stevenson of Coddenham, and Paul Farmer, the chief executive of Mind, wrote an excellent report called Thriving at Work, a review of mental health and employers, which was welcomed by both the Department of Health and Social Care and the Department for Work and Pensions. Its vision was to embed the following changes within 10 years:

“Employees in all types of employment will have ‘good work’, which contributes positively to their mental health, our society and our economy … Every one of us will have the knowledge, tools and confidence, to understand and look after our own mental health and the mental health of those around us … All organisations, whatever their size, will be … equipped with the awareness and tools to not only address but prevent mental ill-health caused or worsened by work; … equipped to support individuals with a mental health condition to thrive, from recruitment and throughout the organisation; … aware of how to get access to timely help to reduce sickness absence caused by mental ill health”.


And this would,

“dramatically reduce the proportion of people with a long term mental health condition who leave employment each year and ensure that all, who can, benefit from the positive impacts of good work”.

Can the Minister tell the House how far away we are at the moment from having a sustainable welfare and support system operating in tandem with the health system and partners across all authorities in England? Could she tell the House what stage we have reached with the vision of Paul Farmer and the noble Lord, Lord Stevenson? And who is the Minister responsible?

Disabled People

Baroness Jolly Excerpts

Thursday 28th June 2018 Lords Chamber

[Baroness Jolly (LD)]

My Lords, I join noble Lords in thanking my noble friend Lady Thomas of Winchester for initiating this excellent debate. I think it is the first that I can remember in getting on for seven years in which we have discussed such a wide range of disabilities. As often happens in this place, a huge range of experience and expertise has been demonstrated, which brings me to my second point: to join noble Lords in welcoming the right reverend Prelate the Bishop of London. I am delighted that she brings with her expertise on the south-west as well as on health. She will enrich our debates.

When we think of a disability, invariably it is physical and often visible. For those with a learning disability, it is not always physical and not always visible. When considering the challenges those with disabilities face in the UK, we need to remember that it is about making that person’s life the best it can be: how they can experience a meaningful life, ensuring their safety, well-being and interests are met.

Many organisations work in a person-centred way and some do not. I declare my interest in the register as chair of Hft, a charity supporting those with learning disabilities through independent housing and support services across England. I will talk about learning disability and the challenges faced, and about what two young people with learning disabilities did about them.

Person-centred models exhibit the right and freedom of choice, while always keeping in mind a person’s health and safety. People with learning disabilities enjoy engaging in hobbies and interests, just as we do, but sometimes extra support or care are needed to take part in these activities. Charitable organisations such as my own ensure that those with learning disabilities can do the things they love the most while also having fun in a safe and independent environment. Socialising is part of most of our daily routines but for those who live in a sheltered environment, meeting and chatting to friends can be challenging and opportunities infrequent. That is precisely why Luv2meetU and Hum Tum were created at Hft. Luv2meetU, a friendship and dating service, brings together people with learning disabilities at Hft-run events: games, sports, nightlife events and more. Hum Tum allows adults with learning disabilities of south Asian heritage to bond on social, cultural and religious levels. The funding we raise as a charity goes towards running those sorts of events.

The noble Lord, Lord Holmes of Richmond, spoke about disability on TV. I was delighted recently that “Silent Witness” had a storyline about a young couple with learning disabilities who were in love. It does happen. The point is for people to connect, laugh, share stories and feel that spark with someone special. We take these things for granted. Those with learning disabilities should not feel alone—don’t we all need that friend who understands?

We have considered the challenges facing those with learning disabilities but it is also critical to consult trusted friends and families. At Hft half the trustees are family members of those supported by the charity. At our council, the human elements are never forgotten. Family members can articulate to other trustees and executives issues that those without that experience could not understand in the same way. This offers invaluable insight. It would not be right or fair for charities to make critical decisions about those they care for without the consultation of the very people whom they support. The voices of those with learning disabilities must be heard, especially when it comes to preferences in care.

That is why our staff and people with learning disabilities are partnered up at local, regional and divisional level. Each house and region has a group where concerns and questions are posed and deliberated. These councils are to ensure consistency of communication and that shared knowledge and experience lead to better understanding. We call the meetings Voices to be Heard. It is worth mentioning that a frequent topic of concern is “mate/hate crime”, where somebody befriends you and hate comes out of it. The noble Baroness, Lady Uddin, demonstrated that admirably today.

Two people with learning disabilities in our care travelled to Geneva to share their personal experiences of the effects of austerity with a United Nations hearing. The noble Lord, Lord Low, mentioned this earlier. They are two members of our national Voices to be Heard council. They attended the 18th session of the United Nations Committee on the Rights of Persons with Disabilities. The hearing invited disabled people to share their personal experiences to help inform the committee’s investigation into how the UK Government’s austerity policies have impacted on people with disabilities. Hft’s evidence fell under Article 19, the right to inclusion and participation in the community. Each addressed the 18 members of the committee, warning that increased pressures on care funding are impacting on the opportunity for people with disabilities to live the life they choose. We believe that this violates the rights enshrined in Article 19 of the CPRD:

“Living independently and being included in the community”.


Since February last year, through its It Doesn’t Add Up campaign, Hft has been aiming to raise awareness of the funding pressures faced by social care providers following the introduction of the national living wage in April 2016. This has not always been reflected in money given by the Government to local authorities to fund care packages. Data from the campaign was used to respond to calls for information from the UN Office of the High Commissioner for Human Rights on service provision for persons with disabilities. This was a great opportunity for Henry and Becky to have their voices heard at the highest level and to play a key role in driving positive change against the austerity measures disproportionately affecting people with learning disabilities. They argued that inadequate funding of the social care sector was prohibiting providers properly supporting adults to live independently.

Reductions in benefits are preventing people living as full a life as before, and benefits are now more about enabling people to survive rather than thrive—their expression, not mine. They expressed concerns about provision of Easyread resources in several settings, particularly in health and at elections. Do the Government have a view about where Easyread communications should, and could, be available? It is worth noting that last year, an awful lot of people with learning disabilities, carrying a polling card, were turned away from their polling station by the officer in charge, who told them, “People like you can’t vote”. We visited our MPs. It happened, and we are going to try to sort something out for the next election. However, that was really shameful.

The chair of the committee called the UK Government’s policies a “human catastrophe” for disabled people. It issued recommendations under all chapters of the CRPD. Regarding Article 19, it argued for adequate and earmarked ring-fencing of moneys so that local authorities are properly able to execute their responsibilities in enabling disabled people to exercise choice and independence. Our Government responded by saying that the UK maintains that it is a world leader in disability rights. The response will be published in the summer.

The sector feels that conversations about funding for social care are always about older people, not those with disabilities, despite the fact that within a few years the funding required for people with disabilities will outstrip that for elder care. Can the Minister feed back the frustration of the learning disability sector that, when discussing disabilities, the Government invariably refer to those with a physical disability and rarely to those with a learning one?

I commend to the Minister, if she has not already seen it, the British film “The Silent Child”, which won an Oscar this year. It is all about the power of sign language. The makers of that film went to see the Department for Education and they were promised a GCSE in sign language.

Those with disabilities share many of our own desires: a voice wanting to be heard, preference in the way our daily lives work, a friend or companion to call or hold. The challenge is enabling the quality and opportunity of those practices. Whatever the disability—whether it is hearing loss or lack of sight, mobility problems or a learning disability—it is all about making a life safe and worth living. We should all agree that that is something which brings value and happiness to everyone.

Improving Lives: Green Paper

Baroness Jolly Excerpts

Monday 31st October 2016 Lords Chamber

[Lord Freud]

We have deliberately designed this Green Paper to ask for responses from a lot of key areas. Noble Lords may remember that when we started off on this process, it was by looking down a direct White Paper route. We have pulled back and gone for the Green Paper route, with a lot of areas for consulting. We plan to hear from and work with disabled people and people with long-term health conditions. We want to hear from employers, health and care professionals, the voluntary and community sectors and the devolved Administrations. We really want to build a consensus on what we can do and get the widest support that we possibly can for any changes.

[Baroness Jolly (LD)]

My Lords, can I ask the Minister not to forget education, because the transition for young people from schools into work at 18 is really important? If they start working from 18, it is much more likely that they will remain in work during their lives.

Apprenticeships

Baroness Jolly Excerpts

Wednesday 26th March 2014 Lords Chamber

[Lord Tunnicliffe (Lab)]

My Lords, by our normal conventions, we would start the QSD but there was wide expectation in the House that there would be a vote now and at least half of our speakers are not present. Perhaps I may put it to the government Whip that she adjourns the House during pleasure for 10 minutes so we can all assemble for the next debate.

[Baroness Jolly (LD)]

I beg to move that the House do now adjourn until 5.49 pm.

Queen’s Speech

Baroness Jolly Excerpts

Tuesday 14th May 2013 Lords Chamber

[Baroness Jolly]

My Lords, I thank the noble Lord, Lord Freud, for introducing this debate and giving the House a concise breakdown of the legislation. I also note with interest the remarks of the noble Lord, Lord Hunt of Kings Heath, and I am sure we shall return them in due course.

I will talk briefly about public health and then spend time on parts of the Care Bill, but not in any great detail, because that is for Second Reading next week. The coalition Government’s mid-term review commits to “reducing preventable early death” as a key priority. Nothing would do more to reduce the number of preventable early deaths than dissuading children from drinking or smoking.

Aside from the cost to our economy of policing drunken young people, and later the NHS looking after their liver diseases or offering a diagnosis of cancer to those who are too young to hear it, we owe it to society to do whatever it takes to stop young people killing themselves early with too much alcohol or too much tobacco.

Her Majesty said in her speech:

“Other measures will be laid before you”.

I sincerely hope that as soon as the Government have finished their consultation they heed the advice of the Minister for Public Health and that of the chief executive of Public Health England and bring before Parliament measures to standardises cigarette and tobacco packaging and introduce minimum alcohol pricing.

Those of us who have sat through debates in the past couple of years know that the legal provisions relating to adult social care in England have been scattered over many Acts during the post-war period. Those of us who have caring responsibilities know what a quagmire the current system is. It lacks cohesion and a common purpose; there is no recognition of the role of carers or provision for them; it is a postcode lottery.

There have been plenty of well argued reports during the past 20 years, but it has to be said that successive Governments have put all this in the too-hard-to-deal-with box. The issue of funding catastrophic care costs was parked and the care of the most vulnerable was ducked for decades. However, a Liberal Democrat Minister of State was intent on rectifying that. I am proud that my honourable friend Paul Burstow, as Care Minister, persuaded his colleagues in the Department of Health to consult on these issues, resulting in the White Paper Caring for our Future. Furthermore, in line with the coalition agreement, the Department of Health asked Andrew Dilnot to chair a commission, with commissioners the noble Lord, Lord Warner, and Dame Jo Williams, to examine the funding of adult social care.

The Dilnot-led commission—we have already heard of it today—developed an elegant model leading to a solution for the affordability of catastrophic care costs. Implementation of the report was made tougher by the emerging reality of the recession. It was welcomed by the sector but it was several months before it gained Cabinet approval. I commend those from all Benches in your Lordships’ House who used all avenues of communication to influence that decision.

Based on the White Paper and the Law Commission report on social care, last summer my honourable friend Paul Burstow published the draft Care Bill. Health Bills seem to come along quite often, but social care Bills are few and far between, so the outcome had to be right. The decision was taken to put it before a joint scrutiny committee. I had the privilege to sit on this along with some of Parliament’s acknowledged experts in the field. We took some considerable time taking evidence from those in the sector, supplemented by a public consultation, and a report was produced with nearly 100 recommendations.

A Bill was published last week to reform the law relating to care and support for adults and the law relating to support for carers. It puts the individual’s well-being at the heart of decision-making and gives carers new legal rights to services. It places duties on councils and the NHS to work together, defines a single, streamlined assessment and eligibility framework, and, for the first time, gives adult safeguarding boards a statutory footing. All the legislation of past decades has been updated and put into a single Bill.

When we visualise a carer, what do we see our mind’s eye? Do we see one in the mirror every morning? Do we think of someone our own age, a neighbour or relative? I expect that very few think of a child, yet a BBC survey in 2010 showed that there are 700,000 young carers in the UK, many of whom care for more than 50 hours a week, and they go to school, too. They care for parents, siblings and sometimes grandparents.

In this legislation, I fear a lacuna. In general, issues surrounding children are dealt with by the Department for Education. It is imperative that children have the same rights as an adult carer or an adult carer caring for a child, so there must be adequate cross-referencing of the Care Bill and the Children and Families Bill to make sure that that is the case. My noble friend Lady Tyler of Enfield is not in her place today, but I am sure that many others will join her in making sure that this is achieved.

It is worth remembering that this Bill is for adult social care. Many assume that it is solely to address the care of those who are old, but we have to remember that the Bill applies equally to adults of working age and those who have care needs as a result of disability, long-term mental health problems or enduring illnesses.

This Bill championed by one Lib Dem Care Minister is being delivered by another. They share a Liberal perspective of fairness, guided by principles for social care set out in a 2010 Lib Dem policy paper: partnership, personalisation, prevention, protection, performance and productivity—I apologise for the alliteration. Some may say, “Bring it on”.