NHS: Electronic Patient Record Systems

Baroness Pitkeathley Excerpts

Wednesday 12th February 2025 Lords Chamber

[Baroness Merron (Lab)]

There are huge gains to be made in digitisation, which I know that the noble Lord shares my view on. It is crucial that we get it right. I assure him that procurement processes are carried out as we would always expect them to be and that we are satisfied that the right provision can be made.

[Baroness Pitkeathley (Lab)]

My Lords, does my noble friend agree that any reluctance to share records or data is very rarely on the part of the patients but instead is usually on the part of the systems and the professionals? Patients are always astonished that the records are not shared between their GP and the hospital, and less still with social care.

[Baroness Merron (Lab)]

My noble friend is quite correct. The report of the committee that my noble friend chaired said that one of carers’ greatest frustrations was repeatedly repeating information to all the various aspects. The point about ensuring that there is digital maturity, and that various parts of the NHS and social care can get up to that and beyond, is crucial. This is the way that we are going and it will produce far better outcomes, not just for patients but for those who care for them.

Care Homes: Safety Ratings

Baroness Pitkeathley Excerpts

Wednesday 5th February 2025 Lords Chamber

Asked by

[Baroness Pitkeathley]

To ask His Majesty’s Government what assessment they have made of the remarks by Sir Julian Hartley, the new chief executive of the Care Quality Commission, that the public can no longer trust the safety ratings given to care homes.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, the CQC has assured the department that Sir Julian Hartley, the new chief executive, did not use the exact words attributed to him in the interview with the Sunday Times recently. However, the chief executive gave a very honest assessment of the Care Quality Commission’s operational failings as a regulator and the challenges that face it in regaining public confidence. We welcome his candour, as well as his actions.

[Baroness Pitkeathley (Lab)]

My Lords, it seems that available reports about care homes, which are needed, may be four years out of date, which is a serious shortcoming. At a time when the pressure is on to discharge people who need social care, as opposed to medical care, does my noble friend agree that the serious problems in the inspection regime are a barrier to any kind of progress with hospital discharge, and that the aim must be to make the CQC the trusted organisation it once was, on which families can rely when arranging care for their loved ones?

[Baroness Merron (Lab)]

My noble friend is quite right in her observations. Indeed, serious shortcomings are at play. As for the age of the assessments, to which she refers, that is of scant help to those who are seeking to make decisions for either themselves or those who they care for. The CQC, under its new leadership, is prioritising tackling the oldest assessments. The first order of priority is to reduce the registration backlog, which at present is over 10 weeks, and address issues with the registration portal. An independent review has been commissioned to look specifically at the technology that will help reduce the backlog and provide the very necessary up-to-date assessments.

Young Disabled People: Social Care Services

Baroness Pitkeathley Excerpts

Tuesday 28th January 2025 Lords Chamber

[Baroness Merron (Lab)]

The noble Lord is correct to reference the committee’s findings. People should not be written off as unable to work. It is about getting the right support in place, with the right provisions and at the right time. I certainly share his view. That is why we are working across government to achieve the very thing that he talks about.

[Baroness Pitkeathley (Lab)]

My Lords, I was with someone this morning who has a son at this stage and was told that the earliest time when they could have a transition interview would be December 2026. In the meantime, the only support they are getting is from the local branch of Mencap. As well as co-operation between health and social care, will the Government commit to supporting the voluntary sector, which provides such important services in this regard?

[Baroness Merron (Lab)]

I have direct experience of the value of charities such as Mencap, and I thank it and all the other third sector organisations involved. I agree with my noble friend about the need to incorporate all sectors. That is the only way that we will provide the right provision in a timely fashion.

Health and Social Care: Winter Update

Baroness Pitkeathley Excerpts

Tuesday 21st January 2025 Lords Chamber

[Baroness Merron (Lab)]

I made a call for creativity, and I compliment the right reverend Prelate on his creativity; I will certainly pass on his comments to my colleagues. I am delighted to agree with him about the importance not just of places of worship but of communities, including faith communities. As the right reverend Prelate said, we can find the finest examples of community provision which support the NHS and social care through churches, synagogues, mosques and other places of worship. I pay tribute to and thank all those that do this. Of course, this is overwhelmingly done by volunteers, and I pay tribute to all of the volunteers in faith communities and beyond.

[Baroness Pitkeathley (Lab)]

My Lords, the Statement mentions 12,000 patients in hospital beds where they do not need to be. The noble Lord, Lord Laming, has rightly drawn attention to the fact that many of those people discharged are dependent on the care provided by their families. In spite of many reports written about the need to plan discharge from hospital—at least one of them written by me 40 years ago—too much discharge still happens at pace and without planning. It is Friday afternoon and suddenly, the consultant needs the bed. Oh, funny that: there is no care available in the local community. Would the Minister agree that all the reports about discharge indicate that you should start planning for discharge the minute the patient is admitted, and that this planning should include those who are going to provide the care, whether that is the voluntary sector or the patient’s own family?

[Baroness Merron (Lab)]

I agree with my noble friend about the need to plan sooner. It gives the opportunity to assess what is, is not, and can be made available. I also very much share my noble friend’s comments about involvement—involvement of the patient themselves but also of their loved ones. I know from the reports that my noble friend has done over the years how she has shone a spotlight on the exclusion of the very people who could assist in the discharge procedure and make it go smoothly. I welcome her comments that the discharge is as important as the admission and the care people get while they are in hospital.

Adult Social Care: Long-term Workforce Plan

Baroness Pitkeathley Excerpts

Monday 13th January 2025 Lords Chamber

Asked by

[Baroness Pitkeathley]

To ask His Majesty’s Government what steps they are taking to develop a long-term workforce plan for adult social care, similar to the NHS workforce plan.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, as the social care system in this country is failing, we are therefore launching an independent commission into social care to gain cross-party consensus and lay the foundations for a national care service. The commission will look at how we recruit, retain and recognise the workforce, building on work that is already under way to provide a career structure, to give care professionals greater skills and to legislate for the first ever fair pay agreements.

[Baroness Pitkeathley (Lab)]

I thank my noble friend the Minister for that response and remind her that, when it comes to social care, time really is of the essence. Does she agree that one of the real problems we face is the great difference in status between those who are employed in the NHS and those who are employed in social care? Could next steps, therefore, including the work of the commission, include looking towards developing a workforce that is much more flexible, so that it can actually work across both disciplines—for example, working with a patient in hospital and following them when they are discharged into social care—for the benefit of patients, users and their families?

[Baroness Merron (Lab)]

My noble friend is right that it is important that we have a workforce built around the needs of patients, rather than patients having to be worked around the needs of the workforce. I certainly hope and intend that, as we go forward, we will see much more of this flexibility. I share her view that time is of the essence and I also know that my noble friend and your Lordships’ House also understand that it is very important that we get this right.

Health and Adult Social Care Reform

Baroness Pitkeathley Excerpts

Tuesday 7th January 2025 Lords Chamber

[Baroness Merron (Lab)]

I am pleased to give that assurance and thank the noble Lord for his welcome for these measures. As I mentioned earlier in response to opposition Front-Benchers, we have not waited. In the last six months, we have made a number of immediate changes. He mentioned carers, and it is worth emphasising that, as I said, the increase in carer’s allowance is the largest since the 1970s. It will mean roughly an extra £2,300 a year for family carers. That is extremely significant. This House rightly presses me on the need to recognise carers, in particular unpaid carers, which we have done. The whole range of measures I described earlier will show our direction. I look forward to the noble Baroness, Lady Casey, publishing her first report next year. Those recommendations will also be there straightaway. We are doing this on all timescales.

[Baroness Pitkeathley (Lab)]

My Lords, it is indeed gratifying, as the Minister has mentioned, that many of the health proposals take into account the report of the Committee of your Lordships’ House on integrated care, which I had the privilege of chairing. I am going to take it for granted that the issue of unpaid carers will be the focus of the commission’s report, since the whole edifice of social care depends on unpaid carers.

Does the Minister agree that social care and health care work best when you cannot see the join between them? Therefore, are we able to look at employing people across both disciplines—and indeed across the voluntary sector as well, which provides many of these workers—in order that the focus can be on the patient or the user, and not on the institution?

[Baroness Merron (Lab)]

As the House knows, my noble friend is a great campaigner on this issue. I can certainly assure her that the review will include exploring the needs of the 4.7 million unpaid carers who effectively hold the adult social care system together. On the point about the care workforce, we are already improving career pathways by expanding the national career structure, including new role categories. The suggestions my noble friend makes about a seamless service are quite right. We are a long way from that, but I hope we will be able to get to it, and the workforce will be key in that.

NHS Plan: Consultation

Baroness Pitkeathley Excerpts

Monday 2nd December 2024 Lords Chamber

[Baroness Merron (Lab)]

I can confirm that both the online portal and the “workshop in a box” to which I just referred will be available in easy read and British Sign Language versions, and in other languages. Attention has been given to those for whom English is not their first language; in-person events can be tailored to their needs—for example, by having smaller groups. The staff to whom the noble Baroness refers are a major group being asked to provide input; indeed, they are taking part in online workshops and can respond online.

[Baroness Pitkeathley (Lab)]

My Lords, does my noble friend the Minister agree that one of the groups that sometimes finds it difficult to interact with health service professionals is unpaid carers? Despite the huge contribution that they make, they often have their needs ignored by those providing services. Does she therefore agree that it is very important that the voice of the unpaid carer is heard in the consultation process?

[Baroness Merron (Lab)]

I agree with my noble friend: we have to hear from unpaid carers, because that will strengthen the exercise. We are constantly monitoring which groups are responding and which are not, and that allows us to tailor our approach to the underrepresented groups who are not coming forward. If that includes unpaid carers, the consultation absolutely will make special, tailored efforts to reach them.

Carers and Poverty: Carers UK Report

Baroness Pitkeathley Excerpts

Thursday 21st November 2024 Lords Chamber

Asked by

[Baroness Pitkeathley]

To ask His Majesty’s Government how they plan to respond to the Carers UK report Poverty and financial hardship of unpaid carers in the UK, published on 12 September, and in particular its findings that 1.2 million carers live in poverty and that the poverty rate for unpaid carers is 50 per cent higher than for those who do not provide care.

[Baroness Pitkeathley (Lab)]

I beg leave to ask the Question in my name on the Order Paper and remind your Lordships that today is Carers Rights Day.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, from these Benches I pay tribute to the memory of our dear and noble friend Lord Prescott.

I thank Carers UK for its report, which, importantly, as my noble friend said, is raised on Carers Rights Day. We will take the findings into account as we continue to support unpaid carers, whose major contribution I pay tribute to. We have announced an increase to the carer’s allowance earnings limit. Carers can earn around an additional £2,000 per year. This is the biggest uplift since the allowance was introduced in 1976. Furthermore, we will review the implementation of carers’ leave.

[Baroness Pitkeathley (Lab)]

My Lords, I readily acknowledge the welcome concessions by the Chancellor in the Budget and thank my noble friend for her response. There is never any difficulty in getting recognition for our moral obligation to carers, but figures published this morning by Carers UK remind us of their contribution to the economy. They show that the value of their support is worth £184 billion per year in the UK—directly comparable to the spending on the NHS in the four nations, which is £189 billion. I hope my noble friend understands that it is against this background of their huge economic contribution that we ask for entitlements for carers and for recognition of their rights to lead an ordinary life, to combine paid work with caring, and to not to be condemned to a life of poverty because of their caring responsibilities.

Cancer: Older People

Baroness Pitkeathley Excerpts

Tuesday 19th November 2024 Lords Chamber

[Baroness Merron (Lab)]

I am glad that the noble Lord is, as he describes himself, a happy statistic. We are all grateful for that. I certainly share the view that there are a number of ongoing chronic conditions and impacts on other aspects, such as people’s mental health. The cancer strategy needs to look at this in its development, and I am grateful to him for highlighting it.

[Baroness Pitkeathley (Lab)]

My Lords, as another happy statistic, I ask whether my noble friend thinks that older people are perhaps more reluctant than our younger friends to mention symptoms and are more inclined to say, “Oh, it’s nothing; I’ll get over it”. Would more public education programmes be useful in this regard?

[Baroness Merron (Lab)]

I am glad that my noble friend is also a happy statistic—although I see all noble Lords as more than just statistics. She makes a very good point but it is not just about those who are older; many people are reluctant to consider taking action when they have symptoms. My request to them is that they do not wait and that they act. That is how we get things diagnosed earlier, to provide the right support and care. There is a lot of embarrassment about certain symptoms and I make the plea that people should not be embarrassed. Certainly, as she suggests, the new cancer strategy will take account of how we educate people as well as diagnose and treat them.

National Carers Strategy

Baroness Pitkeathley Excerpts

Tuesday 19th November 2024 Lords Chamber

[Baroness Merron (Lab)]

I do have to say to the noble Baroness that I have not committed to a national carers strategy. However, in our joined-up approach, we will certainly be looking at what is needed. That will be very much part of our considerations on the workforce strategy, which Minister Karin Smyth will be leading on. It is crucial to the delivery of services.

[Baroness Pitkeathley (Lab)]

My Lords, would my noble friend agree that one of the major problems suffered by carers is recognition, not just by other people but by themselves? They say, “I am a wife”, “I am a husband”, “I am a mother”, “I am a daughter” or “I am a son”, not “I am a carer”. Therefore, a very high-profile national strategy led from the very top—previously, two Prime Ministers took this on board—would be extremely useful in helping carers recognise themselves and therefore putting them in touch with services that could support them.

[Baroness Merron (Lab)]

My noble friend, who is a very impressive campaigner on the rights of carers, is right to talk about recognition. Of course, if one does not understand that one is a carer, it is hard to access support. I certainly agree on that point. There is guidance, for example, to support GPs in recording which of their patients are unpaid carers, to ensure that they get access to the support they need. Importantly—this has been raised a number of times in this House—in respect of young carers, there is guidance for GPs and it has recently been added to the school census, so young carers can be identified in order that there can be an assessment of needs. So it is true that we need to identify in order to support. Part of that is people recognising themselves as carers.