My Lords, financial education is something that the Department for Education looks at and, I believe, is supportive of. The noble Lord is right that more and more people are getting involved in crypto assets. That is why the Government took the decision to bring crypto assets into the financial promotions regime. One of the proposals in there is to limit the amount that any individual can hold in crypto assets.
My Lords, I declare my interests as set out in the register as co-chair of the All-Party Parliamentary Corporate Responsibility Group, which last week heard evidence that the blockchain technology used to power cryptocurrencies is increasingly being used to ensure both security and transparency in the supply chain. What steps are the Government taking to encourage research and investment in blockchain technology, which would mean that the UK could be a world leader in this area?
The noble Baroness is right that we should not forget the opportunities that the underlying technology for crypto assets present for businesses in the UK. The Government are very focused on that; for example, in financial services, we have announced a financial market infrastructure sandbox to support technological innovation in financial markets using that technology. That is something we want to learn from and build on.
(2 years, 9 months ago)
Lords ChamberMy Lords, this has been a long debate but it has touched on a number of different and important subjects. I join noble Lords in paying tribute to the work of the noble Baroness, Lady Greengross, and her work.
I turn first to Amendments 290 and 291. I reassure noble Lords that the Government are absolutely committed to the rollout of social prescribing across the NHS. We exceeded the targets in our manifesto and the NHS Long Term Plan of 1,000 new link workers by 2020-21 and are aiming for at least 900,000 people to be referred to social prescribing by 2023-24.
NHS England, the National Academy for Social Prescribing and Music for Dementia have produced guidance for social prescribing link workers to expand music prescriptions for those with dementia. The department has also published two resource guides for social workers on embedding music in personalised social care plans for people living with dementia and their carers.
While the Government are committed to promoting the benefits of social prescribing of music and arts for people living with dementia, it would be inappropriate to focus in the Bill on one form of therapy. Instead, we rightly provide scope in the Bill for the NHS to undertake a range of social prescribing.
Turning to Amendment 291 and the need for a dementia strategy, I reassure the noble Baroness and others that the Government are committed to publishing a new strategy this year. As part of this, we will be looking at arts and music-based interventions. More broadly, the strategy will focus on the specific health and care needs of people living with dementia and their carers, including looking at dementia diagnosis, risk reduction and prevention, and—importantly, as noble Lords have mentioned—research. Our priority is for the strategy to be credible and shaped by a range of experts, including people living with dementia and their carers. At the end of last year, we established a stakeholder-led task and finish group to help develop the strategy and deliver it in a timely way.
Moving on to Amendment 297D, we fully agree that visits from loved ones are of vital importance to care home residents’ health and well-being. DHSC guidance emphasises that visits to care homes should be facilitated, based on individualised risk assessments. Care home residents should also be supported to nominate an essential caregiver, who may visit in most circumstances, including if the care home has been closed to visiting for any reason.
There is an existing process in place if a resident or their family are concerned that guidance is not being followed. We encourage anyone with concerns to raise them. That can be done both with the care home, which has a legal obligation to operate a complaints procedure, and with the CQC. The CQC will follow up on concerns and take regulatory action if needed. It has provided mechanisms for people to feed back on concerns over care. The CQC responds to all concerns passed to it, and can receive concerns anonymously via representative groups, such as Rights for Residents. Where those concerns have named the provider or service in question, the CQC has followed up the cases. Some 54 concerns regarding care home visiting arrangements have been raised during the pandemic. The CQC gained reassurance in all cases that visiting is now in line with guidance. In 12 cases the CQC secured this assurance by inspecting the service.
My department has not seen any data or reports on evictions of residents following complaints against care homes. If a care home were taking such action, it would be in breach of guidance. A complaint should not lead to a resident being asked to move to a different home, and the terms of evictions and processes followed should comply with consumer law, as per the CMA guidance. People should feel confident that complaining will not cause problems for them.
I recognise this has been a difficult time for care home residents. However, the existing powers in legislation are robust and give protection to those who need it. We therefore do not feel at this time that an independent review is necessary.
I turn to Amendment 297A. Continuity and oversight of care is crucial in meeting the needs of all patients, including those aged over 65. That is why, since 2015, all practices have been required to assign their registered patients a named, accountable GP. This GP must lead in ensuring that any GP services that they are contracted to provide, and are necessary to meet the patient’s needs, are co-ordinated and delivered to that patient. Practices must take reasonable efforts to accommodate patients’ requests to be assigned a particular accountable GP and must endeavour to comply with all reasonable requests to see a particular practitioner. Practices are also required to take steps each year to identify any registered patient over 65 who is living with moderate to severe frailty. The practice must undertake a clinical review of any such patient and provide them with any other clinically appropriate interventions.
The noble Baroness, Lady Tyler, is right that delivering on this is linked to the number of GPs in the system. I assure her and others that the Government remain committed to growing the number of doctors. There were 1,841 more full-time equivalent doctors in general practice in September 2021 compared to September 2019. In 2021-22, a record-breaking number of doctors started training as GPs. I therefore consider that existing regulations already address the welcome intention of my noble friend Lady Hodgson, and I regret that the Government cannot accept the amendment for that reason.
I hope I have given noble Lords and noble Baronesses some reassurance on the amendments in this group and that the noble Baroness will feel able to withdraw the amendment.
My Lords, I have listened to an extraordinary range of speeches and addresses. People have spoken from the bottom of their hearts. I am very moved myself by what I have heard. I thank all colleagues and Ministers who have spoken today. I will look very carefully at the record of today and come back, but, in the meantime, I beg leave to withdraw the amendment.
(3 years, 4 months ago)
Lords ChamberMy Lords, I welcome today’s debate on women’s health outcomes and thank the noble Baroness, Lady Jenkin of Kennington, for bringing this Motion to the House today in an extraordinarily moving way.
We know that there are many conditions where women are overrepresented—for example in mental health, where 26% of young women have experienced anxiety, depression or eating disorders. We know that with gynaecological conditions it often takes seven to eight years to receive a diagnosis of endometriosis, with 40% of women needing 10 or more GP appointments before being referred to a specialist.
In one area of women’s health, I became aware late last year that there was a national shortage of widely used contraceptive preparations and hormone replacement therapy products. In response to my Written Question, the Minister, the noble Lord, Lord Bethell, responded that this shortage was due to
“Issues such as regulatory or manufacturing problems, problems accessing supplies of pharmaceutical raw ingredients and commercial decisions to divest certain products”,
which
“can affect the supply of medicines.”
Throughout 2020, thousands of women were not able to access their normal oral contraceptive or hormone replacement therapy products. This is one recent example of women not having access to the pharmaceutical products they regularly used, though this also happens, as we know, with various medicines that both men and women take.
I declare my interest in the register as co-chair of the All-Party Parliamentary Group on Bladder and Bowel Continence Care. Women are five times more likely to develop urinary incontinence than men. This is something many women feel uncomfortable talking about or raising with their GP. For many women, bladder continence issues can result in a loss of independence, as they feel unable to leave their homes unless they know there are accessible public toilets near to where they are going. Much like gynaecological conditions, issues with continence care can take time to diagnose and cannot always be treated. Much greater awareness is needed of these conditions and, in particular, how they impact on women’s lives.
My final point is to draw attention to some depressing findings from the 2020 Marmot report, about which the noble Lord, Lord Rooker, spoke so movingly just now. According to Sir Michael’s 2020 report on health disparities, women living in the most deprived 10%—
My Lords, I am afraid I am going to have to remind the noble Baroness of the time limit for Back-Bench contributions, given the number of speakers we have in this very important debate.
My Lords, I suggest to the noble Baroness that perhaps she is already over the time limit and that we move on to the next speaker.
My Lords, I do not agree with that assessment of the situation. We have been providing support to care homes since the start of this pandemic, including ensuring that proper staffing is in place to help with, for example, infection control methods.
What consideration have the Government made of utilising currently unused NHS land and buildings for care accommodation? This type of hospital accommodation, similar to that in Scandinavia and other parts of continental Europe, has been a better solution than discharging hospital patients into care homes and other residential accommodation, especially given the challenges of testing for Covid-19 in early 2020.
My Lords, in our response to the pandemic, we have introduced a policy of designated settings, where if someone in hospital who is otherwise ready to be discharged tests positive for Covid, they can be discharged to a designated setting. More broadly, the noble Baroness is right: the use of step-down accommodation can be very useful in discharging people from hospital to social care. The point about NHS land is, I am sure, one that we will want to take away.
My Lords, my noble friend is perhaps referring to the balance in priorities that we need to address when looking at tax rates. We raise a relatively high amount from inheritance tax and assets compared to peer countries, and we believe that we have got that balance right.
My Lords, when the merits of specific tax changes to help pay for the costs associated with the pandemic are being assessed, I am really anxious that pensioners do not disproportionately bear the cost of the crisis. Are the Government looking at the pension triple lock in relation to older people who are working? Are they, strictly speaking, pensioners or are they really older workers to be treated differently?
My Lords, the pension triple lock remains government policy and the state pension remains the foundation of the Government’s support for older people. I am not aware of any work looking at treating pensioners who choose to work after the state pension age any differently.