NHS: Primary Care Surgeries

Baroness Pitkeathley Excerpts

Wednesday 24th November 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness for her speech. In answering, as this is for judicial review, I am sure she understands that I cannot comment on it. But I saw an interesting documentary over the weekend, so let me just read some words from it:

“Yes the NHS is a public service but how it spends its vast procurement budget, how it uses IT, how it fashions new processes and pathways for patients, plainly benefit from private sector experience.”


I admit I have plagiarised these words from Tony Blair, the last Labour Prime Minister to win an election.

[Baroness Pitkeathley (Lab)]

Is the Minister familiar with the research that shows that the longer the relationship between a patient and a GP, the less likely the patient is to need out-of-hours care or emergency hospital treatment, or to die, within 12 months? Are patients not right to be afraid that profit-making will interfere with those important relationships?

[Lord Kamall (Con)]

The standards of care that CCGs expect are clear in the contracts that they sign with GPs. However it is provided, patients should continue to expect the same standards of care.

Covid-19 Update

Baroness Pitkeathley Excerpts

Wednesday 10th November 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Lord for that question and other noble Lords for their questions. I am not the Prime Minister’s keeper; it is as simple as that. We all decide for ourselves. I wear a mask whenever I can and when I talk to different people, I make sure that we are seen to be wearing masks. I thank noble Lords across the House who are leading by example by wearing a mask.

[Baroness Pitkeathley (Lab)]

Patients in care homes and hospitals suffered very badly from not receiving visitors during the three lockdowns. Family ties were strained and a lot of extra distress was caused. From next April, if all, or the majority of, health service staff are vaccinated, what plans do the Government have for ensuring that visitors do not bring Covid into hospitals and care homes?

[Lord Kamall (Con)]

In many cases, that decision will be left to the individual trust or care home. We know that a number of care homes and different trusts are already concerned about unvaccinated visitors. Many will know already that during the previous lockdowns it was very difficult to visit your loved ones in hospital. I was not able to see my father between January last year and when he died last September. It was incredibly challenging, but we understood the reasons given by the care homes.

Social Care

Baroness Pitkeathley Excerpts

Wednesday 27th October 2021 Lords Chamber

[Lord Kamall (Con)]

It is quite clear that, if we want to make sure that the social care system is fit for purpose, we have to make sure that, in the model, enough money is going in to reform the system. Part of the funding does go to helping local authorities push for reform, but, at the same time, it is true that some of the additional productivity as a result of digitisation will help make the NHS more efficient.

[Baroness Pitkeathley (Lab)]

My Lords, is it not an unfortunate fact that not a single penny from the levy will actually go to the front line of social care to relieve those overworked and underpaid staff making 15-minute visits, which is the real urgency? Even when the money does come to social care, some way down the line, will not much of it be taken up with bureaucracy, in making assessments and testing eligibility for the cap that the Government have put into the system? Surely that is something that we have to look at. How much of the money is actually going to go to the front line, not just now but in three or four years’ time.

[Lord Kamall (Con)]

The noble Baroness makes a very important point: we have to see reforms in the social care sector. The spending of £5.4 billion includes £1.7 billion for wider system reforms, including at least £500 million to support the adult social care workforce in professionalisation and well-being. We are also working closely with providers of care, local government charities, the unions, professional bodies, and users of care and their representatives, and will respond to their views in the forthcoming adult social care system reform White Paper, later this year.

Coronavirus Act 2020

Baroness Pitkeathley Excerpts

Tuesday 26th October 2021 Grand Committee

[Lord Naseby (Con)]

My Lords, I declare an interest in that I am married to a doctor, a former GP who ran a big practice in Biggleswade.

[The Deputy Chairman of Committees (Baroness Pitkeathley) (Lab)]

I am sorry, there is a speakers’ list. The noble Lord, Lord Scriven, is next.

--- Later in debate ---

[Lord Robathan (Con)]

My Lords, I certainly do not oppose these measures since I believe them to be going the right way. I am pleased with that.

I want to concentrate on face masks. The noble Lord, Lord Scriven, mentioned them quite a lot because he believes that everybody wearing them would save lives; they were mentioned in the Minister’s final words as well. They have become a bit of a totem for both sides of the argument on coronavirus restrictions. They divide society, actually. On the one hand—I find myself on this side—I do not believe them to be effective so I do not wear one. It is an act of individuality, if you like; you might even call it an act of rebellion against being told what to do. On the other side of the argument, where the noble Lord, Lord Scriven, is, believers in further restrictions believe that wearing a mask shows virtue and solidarity and provides reassurance to others. That is a perfectly reasonable position, I suppose.

Whatever the opinion polls say, I reckon that about 40% of people on the Tube do not wear a mask now—not 13%, as the noble Lord suggested. That 40% has given up, basically. Children are not required to wear them, of course, but they obviously cannot pass on the virus; I will come back to that later.

In the Chamber of the House of Commons, there is a great political divide between the Government on the one hand, wearing hardly any face masks, and the Opposition on the other, where practically everyone wears one. Last month, I went to a packed memorial service in the Brompton Oratory. It is a huge church—perhaps not the biggest Catholic church in London, but huge. One person was wearing a face mask. None of the clergy was. However, last week, I went to David Amess’s memorial service, where probably about 20 masks were being worn in the congregation. All the bishops and clergy, as they processed behind the unmasked choir, were wearing them. We almost have a Reformation divide now, with Catholics versus Anglicans.

My question for the Minister is simple. Are masks effective? We have, I fear, had some mixed messaging from the Government over the past 18 months. Either masks work or they do not. I am certainly not an expert; I do not pretend that they will or will not do good because, unlike the noble Lord, Lord Scriven, I do not know whether they work.

However, full surgical masks worn in operations presumably work. All the doctors and nurses wear them and have done so for some time—but they are proper surgical masks. Flimsy paper masks are being worn by several people in this Committee, and by the general public. I do not know whether those masks do any good, but I suspect that they do not. What I do know is that Jenny Harries, who is now the chief executive of the UK Health Security Agency and was the Deputy CMO previously, said in March last year that it was “not a good idea” for the general public to wear them. She also said that they “trap the virus” and cause people to start breathing it in.

I have a series of quotes, if the Committee will bear with me, that show the confusion in this matter. I am not saying that I am right. Professor Jonathan Van-Tam, who noble Lords will know, said on April 4 last year that the wearing of face masks by those who are not sick was not recommended by the British Government. He said that there was

“no evidence that the general wearing of face masks by the public who are well affects the spread of the disease in our society.”

That is his view—or it was in April last year. I do not know. Sir Patrick Vallance, who, again, we have got to know well over the past 18 months and is the Chief Scientific Adviser to the Government, told MPs last May:

“The situation with masks … is that the data and the evidence are not straightforward”.


In this House, the then Minister, the noble Lord, Lord Bethell, said on 21 April last year that

“the British Government have been sceptical about the efficacy of face masks. We do not want to be in a position of misleading or providing false reassurance for the public when there is not sufficient scientific evidence for the relevance of face masks.”—[Official Report, 21/4/20; col. 22.]

The following month, on 19 May, he said:

“There is an instinctive human belief that face masks make a difference, but the scientific proof that they do so is not crystal clear.”—[Official Report, 19/5/20; col. 1096.]


Then on 11 June he quoted the World Health Organization and said that

“‘the widespread use of masks by healthy people … is not yet supported by high quality or direct scientific evidence’”.—[Official Report, 11/6/20; col. 1908.]

On 22 June, 11 days later, he said that the mandatory of wearing of face masks was not recommended by the Government.

Now I genuinely do not know, but the situation is certainly confusing; I think everybody can agree on that. I am willing to accept that I am a bit confused. At the Labour Party conference, everybody wore face masks in the hall—we saw them all on television—but they did not wear them at the karaoke parties or receptions. The Liberal Democrat conference was of course virtual, so that was fine. However, they would not have had to wear them because it would not have been very crowded.

So what is the evidence now? Can the Government publish the evidence that made them change their position of last year, with the quotes I have given, to encouraging people to wear face masks? Perhaps there are studies. If they are conclusive, I will wear a mask. That is a promise—but I warn the noble Lord, Lord Scriven, who has just spoken, that one should not rely and base one’s policies on opinion polls.

All the calls that we hear for a return to restrictions should, again, be based on evidence. Are things getting worse? The vaccines certainly seem to work. Indeed, I had a message today to get my booster jab. Deaths are actually right down on what they were a year ago. Can the Minister tell us the percentage of deaths from the virus among those who are over 85? I understand that the average age of death is 85, which is actually higher than average life expectancy.

The Office for National Statistics shows that about half of all new infections are among school-age children—in other words, the unvaccinated young—with few lasting ill-effects. Is that true? Perhaps the Minister can enlighten us on that. Is it the case that there are now studies predicting that cases are likely to fall sharply in the winter? That was in a study from the London School of Hygiene & Tropical Medicine, which was covered in the press yesterday. Is that the case?

We have now heard one or two doctors panicking about flu and calling for the wearing of face masks because there will be flu around. Wear face masks for ever. Every year, on average—it varies dramatically—about 11,000 people die from flu. That is about the same number who are dying every week. So will the Minister reassure me that the Government will not be panicked into reintroducing any dramatic restrictions, or plan B, without basing the decision on very serious evidence?

[The Deputy Chairman of Committees (Baroness Pitkeathley) (Lab)]

The noble Baroness, Lady Wheatcroft, is not with us, so I call the noble Baroness, Lady Foster.

--- Later in debate ---

[Lord Balfe (Con)]

My Lords, I start with a quote from the front page of the regulations which I find quite over the top:

“These Regulations are made in response to the serious and imminent threat to public health which is posed by the incidence and spread of severe acute respiratory syndrome coronavirus”.


Presumably this threat arose in the week between Parliament rising for the Conference Recess—

[The Deputy Chairman of Committees (Baroness Pitkeathley) (Lab)]

My Lords, there is a Division in the Chamber. The Committee will adjourn temporarily.

--- Later in debate ---

[Lord Balfe (Con)]

I shall go back to the beginning because I cannot remember where I stopped.

I start with a quote from the regulations, which

“are made in response to the serious and imminent threat to public health which is posed by the incidence and spread of severe acute respiratory syndrome coronavirus”.

This could not have occurred in the week between the session we had in September and the Minister making this instrument on 22 September. The text carries on,

“the Secretary of State is of the opinion that, by reason of urgency, it is necessary to make this instrument without a draft having been laid before, and approved by a resolution of, each House of Parliament.”

The first thing I ask the Minister is to get an agreement to discontinue this way of making legislation. It may be some time before the Government repeal all the Acts but they could certainly give an undertaking. I realise that the Minister cannot do that today, because he has to consult the department, but the department could give an undertaking that future regulations will be made after consultation with Parliament.

This pandemic has shown me something. The noble Baroness, Lady Foster, referred to her travels around the world. I have done a lot of lecturing on history, particularly the history of western Europe. I will not castigate any country in particular, but all countries have an undertow of authoritarianism in their public dimension. The pandemic has brought that out in this country. We have seen a level of authoritarianism in the way that people have used their power which is totally unacceptable. It can be seen in the way that the doctors have rewritten national health protocols, and the way that the police decided that they would or would not enforce parts of the law. Let me stress that “would not”; I sometimes wonder why we are here, when I look around and see how much of the law the police decide is not worth enforcing.

So we have an authoritarianism problem in this country but, as we move forward, we will have to learn to live with this. It will perhaps decline, as Spanish flu did in 1920-21, but it will not go away, and the possibility of further viral attacks is on the horizon. I echo the call made to the Minister that the Government should look at viral—and electronic—warfare and attacks as part of their defence capacity, because we could be liable to those sorts of attacks. It is important that we move forward from thinking that our defence consists of sailing a battleship round the Black Sea to a point where we accept that there is a much wider area in which public good can be interrupted for malicious reasons.

We have heard a fair bit about the number of people who have been vaccinated and the various plans that have come forward. I am an occasional subscriber to and regular reader of the Daily Sceptic, which I receive by email. It has put another view on some of the material that has been released about Covid. For instance, we hear very little about the Oxford group and a group of people who have looked carefully at all the evidence and concluded very similarly to the noble Viscount, Lord Ridley, on matters such as face masks. Not all the evidence is being presented; indeed, some outlets take great pride in saying that they are Covid-friendly and, basically, supply you only with government propaganda.

So I welcome the new Minister and the new Secretary of State, because they have an opportunity to move us forward towards a better situation. I have mentioned the problem of GPs in the past, but that situation also covers the rest of the National Health Service. I live in Cambridge, which could probably claim to be the medical capital of Britain. I live in a street that is packed full of doctors, because only doctors and former MEPs can afford the houses there. Some of my best friends are doctors, as they say, and some of their stories about what has been going on are, shall we say, not in line with what we have been led to believe is going on. One of them said to me, “I don’t know what the GPs are doing. We haven’t seen any of them in our hospital, I can tell you that”.

So we must get the health service and private hospitals back to work. Our local private hospital was bought out by the NHS and basically stood empty for the best part of a year, with the consultants doing their consultations at home. It was absolutely ridiculous. The way to get a consultation with your specialist relied on knowing their home phone number and getting on to them and going to see them at home. So they were finding a way round the regulations, and the hospitals were closed but still earning large amounts of money from the NHS.

So the Minister is going to find that there are a lot of themes to unravel. On the subject of vaccination, I counsel the Government not to take on battles that they are probably going to lose. If they take on this battle of trying to get vaccination certificates and vaccination approvals before people can do certain things, they will end up in a morass of bureaucracy and in the end they will lose. Leave it to the market. If a venue wishes to say it requires proof of vaccination to enter—as, for instance, some restaurants in France require—let it administer it and look at the certificate. All I would do is say, “Please put a notice on the door”. Do not get involved in what could turn out to be a terribly authoritarian effort.

There is one question I would like to ask the Minister. We are constantly urged to get lateral flow tests. How much do these cost? I was asked to get a lateral flow test before I went to David Amess’s memorial service. Why? I also question whether they should be free and whether it is our priority as a health service to carry on spending this amount of money. How much does it cost and, more importantly, what plans does the Minister have to wind it down or at least make it a paid-for service, which seems a quite reasonable thing to do?

My final words are that I am pleased that we are moving forward. I hope this will be the last SI we have to debate that is laid in this way, and I hope we will move forward, end this image of a terrified country and continue getting back to normal, so that we can start to get back to where we were some years ago, as normal human beings in a normal society.

[The Deputy Chairman of Committees (Baroness Pitkeathley) (Lab)]

My Lords, before the noble Baroness, Lady Brinton, joins us remotely, the noble Lord, Lord Naseby, will speak briefly in the gap.

GPs: In-person Appointments

Baroness Pitkeathley Excerpts

Tuesday 19th October 2021 Lords Chamber

[Lord Kamall (Con)]

My Lords, I am happy to agree with the sentiment in the question from my noble friend, but it is important to make sure that we are not overly prescriptive. Patients sometimes want face-to-face consultation, but they may also be happy with a telephone call or an online consultation. At the heart of this should be patient choice.

[Baroness Pitkeathley (Lab)]

My Lords, has the Minister heard GPs say, as I have, that the most important question a patient asks is the one as they are leaving—the one as they are walking out of the door? Will the training of GPs be amended to cover the different listening techniques that may be required for online consultations, so that these important questions are not missed?

[Lord Kamall (Con)]

I thank the noble Baroness for sharing her expertise in this area, and absolutely agree with the question she asked. I do not have the details of the training of GPs to make sure that they are best prepared for online consultations, but I will write to her.

Social Care in England

Baroness Pitkeathley Excerpts

Thursday 14th October 2021 Lords Chamber

Moved by

[Baroness Pitkeathley]

To move that (1) this House takes note of the challenges facing Social Care in England following the pandemic, and (2) further notes the effect that (a) the Health and Social Care Levy, and (b) Her Majesty’s Government’s Social Care plans, may have.

[Baroness Pitkeathley (Lab)]

Well, my Lords, here we are again. In the 24 years I have been in your Lordships’ House, I have lost count of the number of debates on social care in which I have participated, joined by the intrepid band to whom I usually refer as the “usual suspects”. In fact, at times we have found it difficult to fill a debate, so unpopular was the topic. I am glad to note that it is very different this time; many want to speak. Of course, the Minister is very much not a usual suspect, so we welcome him and hope he will be accommodating and bold in answering this debate, as I have always asked Ministers from all sides to be.

The debate, like Gaul, is in three parts and reflects the new situation in which we find ourselves since our last debate in April 2020. We have come through a pandemic and at long last—at very long last, many of us would say—have some government proposals addressing the crisis in social care which in the past we all agreed—the degree of consensus on this was remarkable—was bad for everyone concerned.

The Public Services Committee, of which I am a member, concluded that while the crisis in acute care during the pandemic was dealt with relatively successfully it was followed by a devastating crisis in adult social care. Older people and working-age disabled people with care needs were left particularly vulnerable. The large number of deaths in this group may have been the most significant public service failing in the pandemic. These were due to the pre-existing weaknesses to which we have been pointing for years, including the lack of integration between health and social care, and successive Governments prioritising the NHS while neglecting to fund social care adequately.

These problems are far from new. Many inquiries, including parliamentary inquiries such as that by the Economic Affairs Committee, have focused on the need to fund adult social care properly, put more focus on prevention and address the poor integration between health and care services. The Covid crisis highlighted the effects of all these long-standing problems between health and social care and, as Age UK put it, “laid bare” the stark inequalities of the current social care system and

“revealed the true extent of the impact underfunding, structural issues and market instability have had on the system’s ability to respond and protect … people at a time of crisis.”

The initial pandemic response made protection of the NHS a priority, which had a detrimental effect on social care. The rapid clearing of hospital beds revealed too little consideration of the fragility of care settings and resulted in too many deaths.

Inevitably, I must focus on the effect on unpaid carers—as your Lordships know, I always emphasise them—who are propping up whatever system of care we have. Let us be clear about the numbers, which are provided by Carers UK. There were 9 million unpaid carers across the UK before the Covid pandemic, providing everything from a few hours of support a week to intensive and complex round-the-clock care. The pandemic has resulted in about 4.5 million new carers, 2.5 million of whom are trying to juggle paid work with caring. This takes the estimated total number of carers to 13.5 million and the annual value of what they contribute is now estimated to be £193 billion every year.

Carers have been particularly hard-hit by Covid and many have had to make extremely difficult decisions about work and family. Some 81% say they are providing more care because services were closed or not available due to lack of PPE and care staff self-isolating or having caring responsibilities themselves. Yet the Build Back Better plan hardly mentions unpaid carers or how they will be supported. The Government have assured us that the forthcoming White Paper will address this, but when the Secretary of State for Health and Social Care said in his speech to the Conservative Party conference that care “begins at home” and people should turn to family first, it was hard to believe that the Government understand that this is precisely why there are 13.5 million carers. They do turn to their families first. His remarks were seen as uncaring and disrespectful to the millions of carers who never questioned their duty to their family.

Let us try to be positive and thankful that at least the pandemic has made us focus on social care more than ever before. The government proposals for which we have been calling for years have now come out, so I will turn to those.

That the social care sector needs more money and that this money should be found from taxation is never in doubt. However, there is puzzlement, even bewilderment, in most agencies about the Government’s chosen method of raising these taxes, using a levy on national insurance. Let us face the stark fact that not a single penny of the money raised by this method will go to front-line social care. We know that it will initially go to the NHS, for at least two years. I do not begrudge the NHS the money. Having just been told that I have to wait 42 weeks for a telephone conversation with a consultant, of course I do not begrudge it. I just do not want anyone to be conned into thinking that the tax raised by the levy will solve social care problems.

Even after social care—endlessly the poor relation whenever reforms are discussed—gets any of the money, it will go to helping a small number of families be relieved of care costs and the need to sell their houses. How will this stop the 15-minute visits by overworked and underpaid care staff, or give them even slightly better pay? Indeed, those overworked and underpaid staff will be paying towards this levy in their wage packet, as will their employers, largely in the private sector, whose profits—the only thing which keeps them in business—will be further eroded.

It is now 10 years since this House passed the legislation for the Dilnot review. Many of us spoke in favour of it at the time. However, the cap has been set so much higher than recommended that it is far from clear whether many people will actually benefit. I must point out—few people understand this—that the cap applies to the cost of nursing in residential homes only and does not include the so-called hotel costs. It will help a few better-off families, leaving most to pick up the bill, or subject to the vagaries of local authority funding.

In addition, it will add to the complexities of an already far too complicated funding system and add to the danger that any money coming to social care will be spent on bureaucracy, making assessments, testing eligibility and explaining to bewildered families why care costs so much, and why the picture in the social care sector is very different from that in the health care sector. Moreover, it will do nothing to improve the standards of care received by older people or those working-age adults with disabilities who make up at least one-third of those needing care, a fact which often seems to be overlooked in the emphasis on older people.

The debate in your Lordships’ House on 11 October makes interesting reading regarding how the levy proposals are viewed. It is hard to find any support for the proposals and there is great disappointment in the failure to address the promises which have been made about “fixing” social care. Surely fixing requires two things above all: enough money and better integration.

As to the former, the Institute for Fiscal Studies, quoted by my noble friend Lord Eatwell in Monday’s debate, says that

“it is clear that the extra funding will not be sufficient to reverse the cuts in the numbers receiving care seen during the 2010s.”

The IFS also points out that

“many people with care needs not considered severe enough will continue to miss out.”

Moreover, the latest IFS report published this week says that the £12 billion which will be raised annually by the tax rise is sufficient only to fix the immediate shortfall faced by the NHS and would need to double by 2025 to have any hope of keeping up with NHS, let alone social care, needs.

Integration with the NHS is seen as a vital need. There has always been political agreement across the board on this, yet I am mystified as to how these proposals will address it. At a time when waiting lists for the NHS are growing longer by the minute, should it not be a priority to ensure that no one stays in hospital longer than they have to by having discharge procedures which provide a seamless transition and making sure that the all too frequent readmission because of inadequate co-operation between the NHS and local authorities is guarded against?

We heard again only yesterday that care jobs are unfilled and requests for care are being turned down because of staff shortages. Local authorities are struggling terribly to recruit enough workers to meet increasing demands. That is no wonder when you can earn far more by filling shelves in Sainsbury’s.

The minute someone is admitted to hospital, health services, social care and the often ignored but very significant voluntary services should plan between them for what will happen on discharge. Sadly, the usual pattern is for a conflict to emerge, on a Friday afternoon, between a hospital ward desperate to empty beds and social care services inadequately prepared or even informed. The Government’s plans should include commitment to such planning and co-operation. Thus far, they do not.

As I turn to the third part of the Motion, the effect that Her Majesty’s Government’s plan for social care will have, I feel more regret than anger, because these proposals represent such a failed opportunity and once again see social care as the poor relation—the Cinderella, as some have called it. Social care could be at the heart of a levelling-up agenda, if we had a vision for its workforce and for the impact it has on the health of a community in its broadest sense. Care providers could be encouraged to diversify their businesses and to reach out creatively into the community by providing tax incentives, for example, or a reduction in business rates.

If we want a high-skill, high-wage economy, as we are increasingly told we do, what better place to start than social care, with its huge workforce, badly paid but certainly not unskilled? Those skills could be developed by providing training, and retention could be dealt with by better career progression and recognition of qualifications. If you provide more support to unpaid carers, you get the very best out of that huge but unrecognised workforce, and if you help them combine paid work with caring responsibilities, you not only help them financially now but save them from poverty in future. Surely that makes good economic sense, as well as being morally imperative.

It is possible that the Government intend to address those issues in the forthcoming White Paper, and I hope that the Minister can assure us about that. I also hope that he can assure the House that integration between health and social care will be seen as a priority, as there is a sad lack of any such incentive in the current proposals. Has he considered an integrated workforce with cross-discipline skills? How about integrated budgets and data sharing? Will all those failed opportunities be addressed in future policies? If they were, I really do not think it would be difficult to get the cross-party agreement and support that Ministers say they are aiming for.

Above all, I regret that there seems to be no attempt anywhere to address the causes of the difficulty in both health and social care, leaving the Government open to the charge of a sticking-plaster solution. Levelling up must surely include addressing the health inequalities which are the result of poverty and inadequate services, and which, sadly, have increased after a decade of public spending cuts.

The most efficient way to ensure that our health and social care services are not overwhelmed by demand is to make sure people do not need them as much. As Sir Michael Marmot has said:

“We need to adopt a health and social care system which prioritises not just the treatment of illness but how it can be prevented in the first place. The pandemic has made it crystal clear over the last 18 months why public health and … the social determinants of health, are so important. The health and social care agenda must be re-balanced … towards prevention”.


That, surely, is the sort of vision we should have for social care.

We eagerly await the White Paper, but I must tell your Lordships that the current proposals, with their inadequacies and lack of understanding and vision, do not fill me with hope. I beg to move.

--- Later in debate ---

[Baroness Pitkeathley (Lab)]

My Lords, I am sure that your Lordships’ House would like me to thank the new boy on your behalf for his tour de force in answering his first debate. We do not doubt his commitment to this issue and we can promise him that this will not be the last time that he replies to a debate of this kind.

Far be it from me to try to sum up all the things that have been said today. There has been much consensus—consensus that we have reached before—that social care is a mess and does not provide to vulnerable people who need it, who work in it or who participate as carers or volunteers, services which allow them dignity or satisfactory and adequate care. Resources are completely inadequate and funding systems far too complex—we have heard quite a lot about that today.

We have heard concerns from all over about the workforce and the lack of integration between health and social care and a lack of understanding of the reality of people’s experience of what it is really like on the front line. I am afraid that that consensus also extends to our opinion of the reforms proposed so far. They will not do—they are not the promised fix. However, this debate has also thrown up something else. Here I echo what others have said about your Lordships’ experience. This debate has thrown up a wealth of constructive ideas about what is needed for that fix if we have not got there yet. The Minister has talked about listening, so I hope that those preparing the White Paper and the next steps in this reform will take into account the wisdom and experience expressed by your Lordships today.

Motion agreed.

Health: Chronic Fatigue Syndrome

Baroness Pitkeathley Excerpts

Tuesday 12th October 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness for her warm welcome. I am new to this and, as you can imagine, I am still learning the ropes and learning about NICE and its processes. However, I agree with the noble Baroness: it is really important that we address the issues she raises and if she writes to me, I will ask for some advice and respond to her.

[Baroness Pitkeathley (Lab)]

Does the Minister agree that patient groups and charities are key in providing support to these patients? They are very concerned about the absence of guidelines, particularly as they have been involved in their production. Could the Minister offer them any reassurance about the timing of the guidelines?

[Lord Kamall (Con)]

I understand that NICE wants to publish these guidelines as quickly as possible. It is very aware that there have been two delays: first, to make sure that it took on board the various comments; and secondly, the current delay because of issues raised by some clinician groups. As noble Lords will understand, NICE is independent from the Government. It hopes to progress this issue by having the roundtable, hearing all the different views and seeing if some consensus can be reached before the guidelines are published.

Social Care: Family Carers

Baroness Pitkeathley Excerpts

Monday 13th September 2021 Lords Chamber

Tabled by

[Baroness Pitkeathley]

To ask Her Majesty’s Government what consideration they have given to providing extra support for family carers given the delay to social care reforms.

[Baroness Wheeler (Lab)]

On behalf of my noble friend, and with her permission, I beg leave to ask the Question standing in her name on the Order Paper.

Covid-19 Update

Baroness Pitkeathley Excerpts

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness is quite right to ask the question, but I would say to her that it is not actually the regime that has changed, although the regime has changed; it is that the data has changed. Last Tuesday, I sat through Covid Gold, which is our big set-piece data session—a two-hour deep dive into national and local data. Every week for the past 70 weeks, that has been a very chilling experience where we have looked at the progress of and tactics of this awful virus, and I have often left it with a very heavy heart. Last week, I genuinely felt that we had reached some kind of turning point and, on Friday, when I sat in my kitchen, I felt a great weight beginning to lift off my shoulders for the first time in a very long time. I cannot disguise from your Lordships that there may well be more surprises left in this virus. I cannot promise that I will not be standing at this Dispatch Box giving bad news at some point in future, but, right now, I am more optimistic than I have ever been, and I think that the Statement by my right honourable friend the Secretary of State reflected that.

[The Deputy Speaker (Baroness Pitkeathley) (Lab)]

My Lords, the time for questions has now elapsed and, with regrets and apologies to those noble Lords whom I was unable to call, we must move to the next business.

Social Care and the Role of Carers

Baroness Pitkeathley Excerpts

Thursday 24th June 2021 Lords Chamber

[Baroness Pitkeathley (Lab)]

My Lords, in the olden days when I was first in your Lordships’ House, it was very difficult to get anyone to be interested in a debate on social care, still less on the role of carers. I used to call the valiant Peers who turned up the usual suspects, and we tried to bring the problems of social care and the difficulties of carers to the attention of your Lordships. Today, however, so many of us want to speak that our time is very limited and there is an agreement on the social care situation on all sides of the House. I am sure that we shall hear that the Minister himself is in agreement that the situation is bad for everyone: it is bad for councils, because local authorities cannot meet their obligations; it is bad for the NHS, because hospital beds are filled with people who should and could be treated at home; it is bad for care homes, which even before all the problems brought about by Covid were finding it increasingly difficult to balance the books; and it is very bad for family carers.

We all now know that families and friends are holding the social care system together by providing support for the most vulnerable in society. Many were at breaking point before and the Covid crisis has further exacerbated that: many are now saying that they are sick with worry. We are asking even more of these carers than ever before, and they urgently need to be supported and recognised. A recent ADASS survey said that there was now greater awareness of carers among local authorities, which is very good news; but a majority of directors are pointing to increased carer breakdown and requests for more complex support, a result of carers having gone without support for so long.

In all the years I have been banging on about this issue in your Lordships’ House, I have always been amazed that the economic case for supporting carers has not been more acknowledged. I have regaled your Lordships often with the billions saved for the Exchequer by carers, whose care is given willingly and with love. During the pandemic, carers are estimated to have provided care worth £530 million per day. It dwarfs any funding the Government could contemplate. Many carers have given up paid jobs to care, and want to return to work, but the services are not yet there to help them. That, of course, results in a loss of tax returns to the Exchequer. We now estimate that there are 13 million unpaid carers of every age, and they are by far the most cost-effective way of providing care, so it must make sound economic sense to support them and prevent the breakdowns that are going to happen.

Let me tell you about Shelly, who I spoke to during Carers Week. She is caring for both her parents, one with dementia, and her 30 year-old son who has severe learning disabilities. Before Covid, she was just about managing—a bit of respite here, a daycare place there, provided by the voluntary sector. All those services have now gone and she is going to break down. When she does, four people will need state support. Surely the Treasury, naturally concerned about the cost of social care reform, will take note of this. If Covid and what followed brought anything to the party, it is that we will finally be forced to take bold decisions about the funding and provision of social care. That is what I want to hear from the Minister: that “bold” is the watchword when we finally see the reforms.