The Long-term Sustainability of the NHS and Adult Social Care

Baroness Masham of Ilton Excerpts

Thursday 26th April 2018 Lords Chamber

[Baroness Masham of Ilton (CB)]

My Lords, I thank my noble friend for his persistence in securing this debate. I am sure that a great deal of time and work was put into the report.

The NHS is, without doubt, our most important insurance policy. Nobody knows when an accident or illness will strike them or their family. One minute you can be fit and well, the next minute paralysed from the neck down and unable to move. Or you may become critically ill with organ failure from sepsis if it is not diagnosed quickly and the correct treatment given.

The world seems very unstable at the moment. We need, as a top priority, sustainability in our NHS and social care. The NHS should not become a political pendulum. It faces so many problems: relentless needs and not enough GPs and hospital beds—especially intensive care beds—to care for the serious cases, which leads to the unfortunate cancellation of operations. Surely we cannot go on with ambulances piling up with patients waiting outside hospitals, and patients waiting in corridors for treatment and beds. We must do better in future.

As a member of the parliamentary group on alcohol harm, I want to mention the fact that cheap alcohol harms the health service in so many different ways. The liver units are full. Liver transplants are the last resort but they can be expensive and dangerous, given the increasing resistance to antibiotics. Far more should be done in the prevention of illness and accidents. This means, however, co-operation and collaboration between public health, NHS and social services.

Cutting public health funds is a retrograde step. Already, gonorrhoea is proving challenging because of drug resistance. There should be greater awareness of factors such as postural hypertension and autonomic impairment, which can cause “funny turns”, faints and falls. These can, in turn, cause injury from bruising and fractures, which can be debilitating and sometimes life-threatening.

I have received a letter from the chair of the Harrogate Parkinson’s UK group, who says that several older people who have been in hospital for a short time cannot be discharged to their homes because no care is available. They are, therefore, shunted off to care homes, causing great unhappiness. The letter goes on to say that this will become a much bigger issue as the elderly population grows in the coming years. Are the Government aware of this situation, and do they have any plans to deal with it? I need an answer to give them—they are waiting.

As I said earlier, Brexit is exacerbating the serious staff shortage problem, which must be solved if there is not to be a monumental catastrophe. I agree with this House of Lords report, which states:

“We are concerned by the absence of any comprehensive national long-term strategy to secure the appropriately skilled, well-trained and committed workforce that the health and care system will need over the next 10-15 years. In our view this represents the biggest internal threat to the sustainability of the NHS”.


There is concern that changes in procurement policy for wound care brought about by the Carter review could effectively restrict the availability of the most clinically appropriate wound care products. This could have serious results and add extra costs to the billions already spent by the NHS. Those with complex needs, such as leg ulcers, pressure sores and burns, could be most affected. I declare an interest in this regard, as for years I have been nursing a pressure sore in a very awkward place. As part of the NHS long-term sustainability strategy, the UK needs a national wound care strategy covering the complexity and variety of wounds, with improved diagnosis, prevention and timely treatment.

I end by saying that good health is so important to so many people. Access to rare disease medicines is paramount to those suffering from more than 6,000 rare diseases. I read last week that Brussels is cutting the UK out of the key role in approving new drugs. Nobody will benefit. We have brilliant researchers whose expertise, working with the European Medicines Agency, will be wasted. For the good of patients, everyone should be working together. Whatever happens, safety should come first.