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.

Adult Social Care

Baroness Pitkeathley Excerpts

Thursday 25th July 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

The noble Baroness is quite right that the better care fund has been considered a great success. It is an important part of the integration proposals between health and social care, which the Government and the NHS are committed to. It is under review to see how it can work better. That will conclude later this year so that certainty can be given to local councils, which I hope she welcomes. On market instability, I reassure her that the overall number of social care beds has remained more or less constant over the past nine years. There are also over 3,700 more home care agencies now—so, while there will inevitably be some exits from the market, we are more reassured than we would otherwise have been.

[Baroness Pitkeathley (Lab)]

May I take the noble Baroness back to her reference to personal responsibility? There is a great deal of agreement across the House and elsewhere that personal responsibility is important as far as social care is concerned, but does personal responsibility extend to subsidies for those on local authority placements in nursing homes? Those paying for themselves privately are actively subsidising those places because local authorities cannot afford adequate rates.

[Baroness Blackwood of North Oxford]

The noble Baroness has got to the nub of the challenge, which is how we get the balance right. This is why we have brought forward the work we have been doing to make sure that, while we have the safety net in place and an element of personal responsibility, it becomes fairer. That is why the Prime Minister and the Secretary of State have made it clear that they are determined to drive this work forward faster and with more urgency than has been done until now. That has been put forward as a key priority of the incoming Cabinet.

Social Care: Free Personal Care

Baroness Pitkeathley Excerpts

Wednesday 26th June 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I thank my noble friend for her question. We should pay tribute to those who work very hard in the social care system under very challenging circumstances. Swindon, for example, has brought in a co-designed service with users and an increase in reablement of 150%, bringing an annual saving of £1.9 million to the health and care economy, while also reducing DTOC. Services and improvements such as these should be spread across the system. That is exactly what the better care fund is designed to do, and it is what the new models of care commitment within the NHS long-term plan will spread across the system so that we can improve social care for all.

[Baroness Pitkeathley (Lab)]

My Lords—

[Baroness Brinton (LD)]

My Lords—

Carers: Support

Baroness Pitkeathley Excerpts

Monday 17th June 2019 Lords Chamber

Asked by

[Baroness Pitkeathley]

To ask Her Majesty’s Government what proposals they have to guarantee support for family carers following the cuts made to local authority and voluntary sector support services.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)]

My Lords, the Government have given councils access to £3.9 billion in dedicated funding for adult social care in 2019-20. Last June, we published the carers’ action plan, a cross-government programme of targeted work to support carers, including a £5 million carers’ innovation fund to encourage new and creative ways of doing so. We are also working with local government to ensure that carers can access the support that they deserve and promote best practice in carer breaks provision.

[Baroness Pitkeathley (Lab)]

I thank the noble Baroness for that Answer, which I listened to with great interest. I am the first to acknowledge that much progress has been made for carers in recent years, especially winning rights for them under the Carers Act. But I wonder how the noble Baroness would respond to the carer I spoke to on Friday. She is 79, recovering from cancer that has left her with severe back pain and caring for her 91 year-old partner, who has vascular dementia. Fourteen times she has asked her local authority for the assessment, to which she knows she is entitled. Fourteen times she has either been ignored or refused. Her local carers’ group, which was a support to her, has closed down because its funding has been cut. “It is no good telling me I have a right to services”, she says. “There are no services. There is only me and I am about to go under”. How does the noble Baroness respond to her?

[Baroness Blackwood of North Oxford]

The noble Baroness has raised an important point, which is that we need to provide carers with the support they need, because they do an amazing job. Unpaid care is a vital part of a sustainable health and social care system. This is why the long-term plan has put in place an ambition to ensure that we provide sustainable support across the public health system, and will ensure that we have a quality mark for primary care to highlight best practice. I am very sorry to hear about the experience of the carer in the case that the noble Baroness highlighted and would be pleased to follow this up with her directly, after today’s Question Time.

NHS Funding: Mental Health Services

Baroness Pitkeathley Excerpts

Wednesday 1st May 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I shall have to write to my noble friend in order to answer her question with the best accuracy possible. However, my understanding is that the ring-fenced funding will be spent on health professionals rather than probation professionals. One of the most effective measures introduced under the five-year forward view, which has delivered very effective outcomes, has been liaison services. I shall investigate the point that she has raised and come back to deliver the response that she deserves.

[Baroness Pitkeathley (Lab)]

My Lords, does the Minister agree that continuity is what is important here? That means continuity of care and of services across the NHS, social care and family support. In the absence of any coherent plan for social care, which is needed by mental health patients almost as much as medical care, have we any hope of achieving this continuity? And if the Minister could say anything about the Green Paper, I am sure the House would be delighted.

[Baroness Blackwood of North Oxford]

The noble Baroness is right to identify the need for continuity of care and the fact that community care is essential to ensuring good mental health outcomes. That is exactly why the focus in the long-term plan is on ensuring prevention and early intervention and on targeting the support of liaison services—for example, support for mental health training in the context of schools as well as for liaison services in policing and other areas. She is right that we must endeavour to deliver on the social care Green Paper. It is imminent, and I look forward to the debates in this House when it is produced.

Brexit: Health and Social Care Workforce

Baroness Pitkeathley Excerpts

Thursday 13th December 2018 Lords Chamber

[Lord O'Shaughnessy]

I recognise the picture that my noble friend paints. It is of course incredibly important that money gets to the front line. I am sure that she is aware of this, but I would point out the operation of the Better Care Fund, which brings together local authority and NHS funding specifically to support social care provision. The amounts of money going through that have been increasing over recent years.

[Baroness Pitkeathley (Lab)]

My Lords, the statistics quoted by my noble friend on the Front Bench are pretty frightening, but the knock-on effects on the 6.5 million unpaid carers upon whom our health and social care system depends are even more alarming. In a recent survey, 70% of them doubted their ability to continue caring if more support, much of which comes from these care workers, is not available to them. Will the Minister assure the House that the forthcoming Green Paper, which we know is imminent, and the NHS plan, will take full account of the needs of carers?

[Lord O'Shaughnessy]

I am grateful to the noble Baroness for raising the matter and for her persistence in doing so; she is quite right to. We were pleased to publish the action plan earlier in the year and I can tell her that the Green Paper, as I have said before at the Dispatch Box, will contain more policy on supporting carers.

Domestic Abuse: General Practitioner Charges

Baroness Pitkeathley Excerpts

Thursday 15th November 2018 Lords Chamber

[Lord O’Shaughnessy]

My noble friend is right to say that domestic abuse can affect anyone, although of course it happens predominantly to women. The police, local authorities and the third sector are there to provide support for both men and women when they are abused.

[Baroness Pitkeathley (Lab)]

My Lords, further to the question put by the noble Baroness, Lady Greengross, I understand that it is becoming more common for some general practitioners to see older people with a similar illness in groups. Would this not be quite prejudicial to the idea of having a confidential interview with one’s GP if abuse has been threatened?

[Lord O’Shaughnessy]

This would be for the discretion of the GP. I would be amazed if any GP would want to see someone who has come to them with a confidential matter, such as saying that they have been the victim of domestic abuse, in a group situation. That seems to be quite wrong. There is a role for group GP appointments for totally different issues, and indeed some of the emerging evidence shows that, for certain illnesses, they can be quite successful.

General Practitioners

Baroness Pitkeathley Excerpts

Wednesday 17th October 2018 Lords Chamber

[Lord O'Shaughnessy]

I agree with that recommendation. It is certainly being considered as part of the long-term plan, for which workforce is clearly critical. That is one reason why it is significant that there are 3,000 more clinical staff in general practice who are not doctors—nurses, pharmacists and others. Clearly the nature of general practice is changing. Doctors do not have to do everything, and other well-qualified professionals can carry out essential roles.

[Baroness Pitkeathley (Lab)]

My Lords, when the Government launched their loneliness strategy last week, we learned that one in five people at GP surgeries is there for reasons caused by loneliness. Can the Minister expand on what is being done to change GPs’ training so that they can deal with such problems, or—following his answer to the previous question— on what other clinicians and associated professionals will be brought into the mix to help solve the loneliness issue?

Personal Social Care: Funding

Baroness Pitkeathley Excerpts

Tuesday 16th October 2018 Lords Chamber

[Lord O'Shaughnessy]

I thank the noble Baroness for raising this important issue. She is quite right that extra funding is needed, which is why we have pledged £20 billion extra for the NHS and want to get this long-term funding settlement for social care. There are many proposals in the Independent Age document—nine, I think—and we are looking at a range of different options. As I said, there needs to be a fair balance between those who are working today and those who need care today, an issue that has evaded a number of Governments and which we sincerely hope to solve. On how the two plans will work together, the intention is that the long-term plan and the Green Paper will be published together around the same time and will therefore be complementary in trying to achieve the goal of integrated health and care.

[Baroness Pitkeathley (Lab)]

May I press the Minister further on his Answer to my noble friend about the consideration of free personal care? Those of us who were at the memorial for Lord Sutherland earlier today remember that he chaired a Royal Commission that came up with a proposal for free personal care. Sadly it was not implemented then, nor has it been implemented by any of the endless reports we have had on this issue in the ensuing 20 years. We need to consider free personal care as one of the options. I ask the Minister again: will it be considered?

[Lord O'Shaughnessy]

I shall have to disappoint the noble Baroness: the proposals will be set out in the Green Paper and I will not give a sneak preview today.

Adult Social Care

Baroness Pitkeathley Excerpts

Wednesday 11th July 2018 Lords Chamber

[Lord O’Shaughnessy]

That sounds like an excellent idea, and I would be delighted to consider it, as well as any other ideas that the noble Baroness has.

[Baroness Pitkeathley (Lab)]

I welcome the Green Paper but it is only a Green Paper. Does the Minister have any assessment of how long it will be before legislative changes can be brought in to make new initiatives a reality?

[Lord O’Shaughnessy]

I do not have that information, but it will be set out in the Green Paper.