Pharmacies

Baroness Pitkeathley Excerpts

Monday 20th July 2020 Lords Chamber

[Lord Bethell [V]]

As the noble Baroness is probably aware, the Secretary of State for Health and Social Care spoke at the annual conference of the National Pharmacy Association, at which he reiterated his commitment to the sector. The noble Baroness puts it well: pharmacies have something very special and valuable because of their trusted role. We very much want to see an enhanced role for pharmacies in the delivery of healthcare.

[Baroness Pitkeathley (Lab) [V]]

Does the Minister agree that independent pharmacies are of particular importance in rural areas, where they are often the only source of advice and information, as well as prescriptions and equipment, for people with disabilities and their families? Will the Minister confirm both his support for these rural pharmacies in particular and the Government’s commitment to ensuring that they can continue to provide all these vital services?

Social Care

Baroness Pitkeathley Excerpts

Wednesday 8th July 2020 Lords Chamber

[Lord Bethell]

My Lords, that is very much the policy, but I emphasise the following. No plan can succeed unless it gains the support of a wide number of stakeholders, including cross-party support. Attempts to foist a plan from one group on to another simply will not work. That is why a bridge-building exercise is needed and why the Secretary of State has invited others to cross-party talks. I invite all those players to go into that process with a spirit of collaboration.

[Baroness Pitkeathley (Lab) [V]]

It is good to hear that the Minister now accepts that piecemeal reform of social care will not do. Can he confirm that the Government will consider finally putting social care on the same level as the NHS and creating a national care service in which risks and costs are shared? Sharing costs must apply to the whole population for the whole of their lives, not just when they are in need of care—in fact, from the cradle to the grave.

[Lord Bethell]

My Lords, the Covid epidemic has been a vivid experience for me personally. I have seen how the Department of Health and Social Care prioritises the care for those in social care. I completely endorse the noble Baroness’s view: piecemeal reform is not on the cards. The Government have made it clear that a holistic solution is needed. That is what we are working to achieve.

Nurses: Recruitment

Baroness Pitkeathley Excerpts

Thursday 18th June 2020 Lords Chamber

[Lord Bethell [V]]

The noble Baroness is entirely right about retention: we are battling the leakage of skills and experience from the NHS. In September 2019, the Government announced a £210 million boost for front-line NHS staff, which includes, as she referred to, funding for a £1,000 personal development budget for every nurse, midwife and allied health professional working in the NHS. I would be glad to meet her and her colleagues to discuss what more can be done.

[Baroness Pitkeathley (Lab) [V]]

Among the extra 4 million people who have become carers during the pandemic, 72,000 left the NHS to take on caring responsibilities. Many will eventually want to return to work or training. How will the Government support those who will need to combine caring with employment or training? Are there plans to enable career progression, as the noble Baroness, Lady Verma, suggested, so that skills learned in caring can be translated into professional qualifications?

[Lord Bethell [V]]

My Lords, the Covid epidemic has thrown a spotlight on the essential role of carers, who have clearly played an enormous role in looking after those who are vulnerable. I completely support the sentiments of the noble Baroness that we should do more to help carers in their professional development so that they can convert to different secondary careers. I would be happy to look at any suggestions she has for ways in which we can do that better.

Covid-19: R Rate and Lockdown Measures

Baroness Pitkeathley Excerpts

Tuesday 9th June 2020 Lords Chamber

[Lord Bethell [V]]

I share my noble friend’s frustration that this disease has proved a horrid and at times confusing foe, but I testify to the strength of the scientific advice we have been given. We do not expect scientists to agree. We believe that a degree of conflict is the right approach to trying to find the right answer. The role of the CMO and the Government’s chief scientist is to distil the advice of a great many sources into the best possible advice. We expect there to be a dialectic, with some form of conflict. I do not believe that we have made profound mistakes on the science. In fact, I believe that the scientists have been wise and thoughtful in the advice and recommendations that they have given us.

[Baroness Pitkeathley (Lab) [V]]

The Minister will know from research published yesterday by Carers UK—I declare an interest as a vice-president—that more than 4 million extra people have taken on caring roles at home for family and friends during the pandemic. Following the question asked by the noble Lord, Lord Crisp, I ask: in the event of a second wave, how will the Government ensure that these carers are provided with adequate PPE and access to services?

[Lord Bethell [V]]

I share the noble Baroness’s tribute to the nation’s carers. This week is Carers Week, and it is quite right that the House pays tribute to the contribution of all those who have looked after loved ones and neighbours in the manner she described so well. Support for carers has been at the front of our minds, but she rightly reminds us that we could do more in a second wave, and we are looking hard at ways of developing that support in the months to come.

Covid-19: Government Response

Baroness Pitkeathley Excerpts

Wednesday 6th May 2020 Lords Chamber

The Statement was considered in a Virtual Proceeding via video call.

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

Good evening, my Lords. The Virtual Proceeding on the repeat of the Urgent Question will now commence. I will call the Minister, who will repeat the Statement in the usual way. There will then be 10 minutes for questions, led by the Opposition Front Bench. The Minister will respond to each question in turn. I will call each Back-Bench Member on the speakers’ list to ask a supplementary question and the Minister will answer. I ask noble Lords to ask brief questions and give brief answers. Each speaker’s microphone will be unmuted prior to them asking a supplementary question and returned to mute once their question has finished.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, with leave I shall repeat the Answer given to an Urgent Question asked in the other place yesterday. In the repeat, I will use the most up-to-date figures, which have changed since yesterday. The Answer is as follows:

“Mr Speaker, we have flattened the curve of this epidemic, ensured that the NHS is not overwhelmed and expanded testing capacity to over 100,000 tests a day. As a Government, we are working resolutely to defeat the coronavirus. There are two important areas where I want to update the House today.

First, on the expansion of our work to test, track and trace, we have now built a national testing infrastructure of scale. Because we have this extra capacity, we will be delivering up to 30,000 tests a day to residents and staff in elderly care homes, making sure that symptomatic and asymptomatic staff and residents can all be tested. Our care system represents the best of us, supporting our loved ones with tenderness and dedication at their time of greatest need. Through this unprecedented expansion of testing capacity, we can give them the certainty and confidence that high-quality testing can provide.

Secondly, we are working to strengthen the resilience of the NHS. We currently have 3,382 spare critical care beds in the NHS, and that does not include the capacity provided by our Nightingale hospitals, including the 460-bed Sunderland Nightingale, which opened earlier today. We should all be very proud that we have built up the NHS so fast and that our collective national effort has helped to protect the NHS and flatten the curve. As a result, not only have we been able to restore some NHS services; we are in a position to be able to place the London Nightingale on standby. This is good news, because our NHS has not been overwhelmed by this crisis and remains open to those who need care, which means that this nation’s shared sacrifice is having an impact.

Throughout its time, this Chamber has borne witness to so much, and it has borne witness to the nation’s resolve once more. I am delighted that the British people are well and truly rising to this incredibly difficult challenge.”

My Lords, that concludes the Statement.

--- Later in debate ---

[Lord Bethell]

I completely acknowledge the situation and the testimony of the noble Lord. The response by British companies to the ventilator challenge was incredible and, at times, overwhelming. No discourtesy was meant to the firm that he mentioned and I completely take on board his comments about the importance of courtesy, respect and a proper feedback mechanism in such circumstances.

[The Deputy Speaker]

Lord Dobbs. As Lord Dobbs is not responding, we will go to Lord Liddle.

[Lord Liddle (Lab)]

Following up on the question from my noble friend Lady Thornton, when the number of deaths in Britain is now the highest in Europe and the second highest in the world, do the Government really believe that their level of accountability to Parliament matches the scale of the crisis? If they can manage a press conference every day, can they not manage a regular parliamentary session which allows for proper questioning of what is going on?

--- Later in debate ---

[Lord Bethell]

I return to my comments to the noble Baroness, Lady Thornton. In the Lords at least, Ministers have been on the Front Bench answering questions on Covid every day since the Lords reopened. Subjects have ranged from social security and housing to, in my case, the Department of Health and Social Care. We remain accountable for the measures that we have put in place. The media also have a huge role in that scrutiny. We remain committed to keeping Parliament open, despite the lockdown regime, and completely respect the importance of parliamentary scrutiny.

[The Deputy Speaker]

My Lords, the time allotted for the Statement is now up. The day’s Virtual Proceedings are now complete and are adjourned. Good evening.

Virtual Proceeding adjourned at 8.16 pm.

Covid-19: Social Care Services

Baroness Pitkeathley Excerpts

Thursday 23rd April 2020 Lords Chamber

[Baroness Pitkeathley (Lab)]

My Lords, as my noble friend Lady Wheeler indicated in her powerful opening speech, there are many shocking statistics about the care sector when it comes to delays. Like others, I was duly shocked—but in all conscience I cannot say I was surprised. When has the care sector ever been at the forefront of the news? When has it ever been top of anyone’s agenda? How many years did it take for the Department of Health to change its name to the Department of Health and Social Care?

The notion that the social care sector is somehow second class probably goes back as far as 1948 and the founding of the NHS. Back then, men died at 66 and women at 69, so why bother setting up a fail-safe care system when it would not be needed? We reckoned without the wonderful success of the NHS in extending our lives so that we see not only our monarch, but many of our most successful fundraisers, playing important roles well into their 90s.

The Government’s recent bailout plan is extremely welcome, and much needed as local authorities are pushed into insolvency by the extra demands of this crisis. At best, though, the £1 billion

“buys us a month or two”,

as one council leader said. It is now more than four years since the CQC told us that the social care sector was at “a tipping point”. If that was the case in 2016, how much more is it the case now?

We must always remember too, when we celebrate caring, the contribution of the unpaid army of at least 6.5 million family carers—rising, we think, to more than 8 million according to the latest statistics. These families and friends are holding the social care system together by providing support for the most vulnerable in society, saving billions of pounds for all of us—the cost of another complete National Health Service. Many carers were at breaking point before, and the current crisis has further exacerbated their situation. Many now say that they are sick with worry. We are asking more of these carers than ever before and they too urgently need to be supported and recognised. They need to know how to keep themselves and the person they care for safe. Many are worried that the care workers who previously supported them are bringing the virus in, so they are doing more themselves.

Many services that previously supported carers are now closed—day centres for example. Even before the virus, 40% of carers providing substantial care had not had a day’s break in more than a year, so there was already considerable unmet need. We should be concerned at the local authority and charity sectors being under such pressure. As we have heard, there is a worry that these services may never be resumed. Some carers are even finding it difficult to get food and supplies. Not all supermarkets class them as vulnerable and not all carers are as tech-savvy as we are all learning to be. When someone needs care 24/7, it is hard to find the time to learn a new skill, even if you can afford to buy a computer.

Carers UK has conducted research with carers, looking at their experiences of Covid-19. It had a large response in a very short period. If I send the Minister a copy as soon as it is published, will he undertake to provide me with the Government’s response to the issues the research raises?

It is clear that, coming out of the pandemic, we will need to have short-term funding for care to stabilise the system, but beyond that we must finally commit to a bold solution for the future funding of social care. Many of us have been calling for a such a commitment for many years. Do we dare hope that a positive outcome to what we are now experiencing will be that we finally get such a commitment?

NHS: Targets

Baroness Pitkeathley Excerpts

Thursday 6th February 2020 Lords Chamber

[Baroness Pitkeathley (Lab)]

My Lords, do not be confused, I am not my noble friend Lord Brooke; I am grateful to him for swapping places with me—noble Lords will be hearing from him later.

I am grateful to my noble friend Lord Hunt for securing this debate; nobody knows more about this than he does. I am particularly pleased with the wide range of his topic: we can focus on the performance of the NHS in relation to its targets but also recognise the impact of adult social care pressures on those targets and that performance—I am glad that so many noble Lords who have spoken realise this.

My noble friend draws attention to a whole-system failure, and we can see evidence of that in the shocking statistic that shows how life expectancy in the United Kingdom is falling, contrary to what the noble Lord, Lord Bates, said to us. Life expectancy had been rising for decades, but has now started to decline, with the elderly, poor and newborn worst affected. Life expectancy for those over 65 has dropped by more than six months. Why? Academics have said that it is a direct result of the austerity measures imposed by the coalition Government in 2010. These cuts, which removed more than £30 billion from welfare payments, housing subsidies and social services, were some of the severest made by any nation after the 2008 financial crisis. They triggered dramatic reductions in social care, meals on wheels, rural transport, health visitors and district nursing services.

Community and voluntary services, which have always been so important in the care of the elderly and isolated especially, suffered similar reductions. If no one visits an isolated older person, no one notices if they have stopped eating or are having trouble moving about. They fall over, are finally discovered, and are then admitted to hospital where they have to be given more serious interventions than would have been the case if services had been available earlier. Then there is difficulty in discharging them because social care services are not available or are inadequate, and so the whole sorry cycle starts again, inevitably leading to shorter lives.

The cancelled operations, the ambulances queueing outside A&E and the patients dying in corridors are in fact a crisis in social care. NHS budgets may have been ring-fenced, but social care has lost £6 billion from its total spend and the 50% rise in elderly people and others stuck in hospital is because there is nowhere for them to go in the community. Thousands of care homes have closed and more than 30,000 places have been lost because providers can no longer afford to operate on the money they receive from the state. Even those homes that keep going—and there are many of high quality—face a constant battle to keep staff, since the starting wage for a care assistant is about £2,000 a year less than you could earn if you went to work in Asda or Aldi.

I mentioned a whole-system failure, and part of that whole system is of course the huge contribution of unpaid carers to our health and social care system—many noble Lords have mentioned this. Noble Lords would expect me to remind them that this contribution is worth £132 billion a year, or the cost of another whole NHS. But let us not forget the cost to the carers themselves, in terms of their own physical and mental health and the financial strain on them, which is not just the extra costs associated with providing care but the loss of future income because of lost earnings and pension provisions. I acknowledge with pleasure the commitment to carers’ leave in the gracious Speech, but it is to be unpaid so, frankly, it will not help much.

Your Lordships will be familiar with all the arguments about social care that some of us have been making ad nauseam for many years. I will not call that group the “usual suspects”, but after her wonderful maiden speech today I am delighted to welcome my noble friend Lady Wilcox to that group. We are familiar with reports followed by endless delay and indecision about how to tackle the complete unpredictability of the cost of care so that we pray we will die of cancer quickly rather than dementia slowly.

The Minister will quote the £1.5 billion given to local authorities for adult social care. That is a sticking plaster on an open wound, as I have said before in this House. I urge political consensus, as others have done, but we cannot get away from the fact that a very large chunk of money is required immediately to prevent more deaths in a situation which is surely the most pressing problem facing our nation. I have urged the Government before to be honest and bold about tackling this problem. I do so again. I ask the Minister to confirm that we will have an honest and bold proposal before the end of this year.

Young Carers: Health and Well-being

Baroness Pitkeathley Excerpts

Monday 13th January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

I thank my noble and learned friend for his question. The Government changed the law to improve how young carers and their families are identified and supported, to simplify the legislation relating to this. In addition, in 2016 we funded the Carers Trust to develop and run the Making a Step Change project for young carers and their families. It was designed to embed best practice to champion and identify support for young carers and their families and to provide an effective and integrated way for voluntary and statutory sector partners to identify young carers. We are working even harder to make sure that GPs and other professionals do the best for young carers. NHS England has recently introduced a new framework of quality markers in when identifying carers for GP practices so that they can improve both their health and their well-being throughout the care pathway.

[Baroness Pitkeathley (Lab)]

My Lords, the noble Baroness will remember from her previous role at the Department for Health and Social Care that, when carers were consulted prior to the Carers Action Plan, 67% of young carers said that they were not receiving any support at all. Does she have any statistics to show that this situation is improving?

[Baroness Blackwood of North Oxford]

We have now delivered all 12 of the commitments and recommendations in the Carers Action Plan to improve the situation for young carers, but the noble Baroness is absolutely right that the way we will improve on that is by improving identification. As I have said, with support from the Carers Trust and the Children’s Society, we are focusing on making sure that we embed not only early identification but also the right support throughout our work with young carers. We know that we have further to go but we are determined to do so.

Queen’s Speech

Baroness Pitkeathley Excerpts

Thursday 9th January 2020 Lords Chamber

[Baroness Pitkeathley (Lab)]

My Lords, I had a bit of a waiting-for-a-bus moment when I listened to the Queen’s Speech, because I felt I had waited 30 years for a mention in the gracious Speech, and then two came along at once. I refer to the two issues on which I contribute most in your Lordships’ House: social care and carers.

I hope that a mention in the Queen’s Speech, even if only a fleeting one, about ensuring that everybody has the dignity and security they deserve and that no one has to sell their home to fund care, means that the crisis in social care may finally be given the attention it needs so urgently. We have had five independent commissions, four White Papers, two Green Papers and endless other reports, yet no progress has been made, even though, as my noble friend Lord Hunt referred to, we have proposals agreed on the statute book in the form of the Dilnot commission. I hope that the noble Lord, Lord Warner, will say more about that.

I was heartened when the Prime Minister told us, when he became Prime Minister, that he had a “clear plan” to fix the problem. There was no plan. Instead, he pledged an extra £1 billion a year—the equivalent of yet another sticking plaster on an open wound of the kind we have seen before. The Local Government Association estimates that there will be a £3.6 billion gap in adult social care funding by 2024. Now the Prime Minister says that he will seek cross-party consensus. I hope that all parties will treat this with an open mind. We have had enough of the type of politicking that led to talk of the Labour death tax in 2010 and the Tory dementia tax in 2017. Such talk betrays the people who are vulnerable, lonely and in dire need. While Parliament has endlessly put this issue into the too-difficult box, tens of thousands of people have died waiting for a care package and tens of thousands of carers have sacrificed their own health and finances on the altar of the prevarication of legislators.

Carers contribute £132 billion to our economy, yet too many are burning out while they prop up an underfunded system. We must stop this now. The crisis is acute and growing worse by the day. The consensus that the Prime Minister says he is seeking is largely already there. There is broad agreement that public funding for social care needs must be significantly increased and that a balance needs to be struck between individual and collective responsibility for care costs. I draw your Lordships’ attention to the excellent report by the noble Lord, Lord Forsyth, to which I hope he will refer.

When will the Government publish their plans for long-term reform? How will carers and those they care for be consulted? How will the Government seek this political consensus that they are talking about? This will of course take time and, as an urgent priority, the Government must invest the funding required to keep the social care system afloat until longer-term reforms are implemented. Will the Government meet the short-term funding gap for social care?

I turn to the welcome mention in the Queen’s Speech of the employment Bill and measures to support working carers. Carers UK—I declare an interest as a vice-president—welcomed the announcement of the introduction of a new entitlement to one week’s leave for unpaid carers. To be most effective, this entitlement must be paid and should be for up to 10 days per year. For the 5 million people in the United Kingdom who juggle working and unpaid caring, combining these responsibilities can be a real challenge, as is shown by the fact that 2.6 million people have already left their job to care for a loved one. Carers’ leave would be beneficial for both carers, by helping them to stay in work, and for employers, by helping to improve staff well-being. Of course, this has a very good economic knock-on effect, by enabling carers to maintain their incomes, so as not to build up poverty for the future and therefore have another generation of poor pensioners. Do the Government agree that the new entitlement to carers’ leave should be paid, and that the ability to have flexible working for carers makes very sound economic—as well as moral—good sense?

Healthcare: Brain Tumours

Baroness Pitkeathley Excerpts

Thursday 24th October 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

The noble and learned Baroness is quite right that people should have a choice in end-of-life care. The long-term plan recognises that we need to improve that choice and the quality of discussions around it. That is at the heart of the drive to improve personal health budgets and help staff identify personalised care planning for end-of-life care. I hope that reassures the noble and learned Baroness that this is seen as a top priority in end-of-life care planning.

[Baroness Pitkeathley (Lab)]

My Lords, the Minister has mentioned NHS support, but she will know that by far the majority of support for carers in these circumstances comes from local authorities. How does she react to all the current research showing that not only are services diminishing for carers in local authority areas but also the number of assessments, in contradiction to obligations under the Care Act and the carers action plan?

[Baroness Blackwood of North Oxford]

The noble Baroness will know that this has been identified as a priority, not only from the call to action from carers themselves that services and systems that work for them should be improved, but also because it is one of the 64 actions in the carers action plan. It is something the Government are determined to take action on. We are concerned by the reports and taking action to improve it.