Adult Social Care: Long-term Workforce Plan
Debate between Baroness Pitkeathley and Baroness Merron(2 days, 11 hours ago)
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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
Debate between Baroness Pitkeathley and Baroness Merron(1 week, 1 day ago)
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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
Debate between Baroness Pitkeathley and Baroness Merron(1 month, 1 week ago)
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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
Debate between Baroness Pitkeathley and Baroness Merron(1 month, 3 weeks ago)
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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
Debate between Baroness Pitkeathley and Baroness Merron(1 month, 3 weeks ago)
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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
Debate between Baroness Pitkeathley and Baroness Merron(1 month, 3 weeks ago)
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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.
NHS: Independent Investigation
Debate between Baroness Pitkeathley and Baroness Merron(3 months, 1 week ago)
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Baroness Merron (Lab)
I am very pleased to see the noble Lord in the rudest of health and to hear of his positive experience. Of course, there are many positive experiences every single day, and the noble Lord is quite right to remind us of that and of the need to thank the whole NHS staff team who make that happen.
On the point about the NHS being broken, I understand the noble Lord’s view. However, I think it is important that we lay it bare and say what we have found. Having read the report by the noble Lord, Lord Darzi, I find it hard not to conclude that there are fundamental points within the National Health Service that are just not working. Of course there is good practice and there are brilliant outcomes in some areas, but it is not universal and that is what drives us to make that point. I hear what the noble Lord says. However, it is important to be honest, and that is what we have said we will be, uncomfortable though it might be at times.
Baroness Pitkeathley (Lab)
Does the Minister agree that integration between the different branches of the NHS, or rather a lack of it, is one of the problems? It is particularly a problem for patients. It works best when you cannot see the joins between various branches—when you cannot tell who the community nurse is working for, whether it is the hospital nurse and so on. Those are the things that puzzle patients. In thinking about the workforce, therefore, will the Government look at ways—for example, joint training—in which we can better integrate the staff, so that they work less in professional silos and much more across various branches of the NHS?
Baroness Merron (Lab)
Yes, I certainly agree with my noble friend about the need for better integration. Joint training is a very practical example and will be part of how we develop the workforce, because silo working clearly is not working, as we can see in the current state of affairs, particularly if we look at the relationship between the National Health Service and the social care service. It is not seamless, and individuals are suffering for that, so I very much agree with my noble friend.
Palliative and End-of-life Care: Funding
Debate between Baroness Pitkeathley and Baroness Merron(4 months, 1 week ago)
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Baroness Merron (Lab)
I certainly take on board the point that the right reverend Prelate makes. It is the case that the amount of funding that charitable hospices receive varies by ICB area. That, in part, is dependent on the breadth of a range of palliative and end-of-life care provision within the ICB area. I can assure your Lordships’ House that my colleague, Minister Kinnock, the Minister of State for Care, has recently met with NHS England, and discussions have started on how to reduce inequalities and variation in access to services and their quality.
Baroness Pitkeathley (Lab)
My Lords, does my noble friend agree that when end-of-life or palliative care is delivered at home, the principal deliverers are usually the family—the unpaid carers—of the patient? Does she agree, therefore, that they must be considered in this equation to get them as much support as possible, and that they ought to be given as much information as possible about the patient’s prognosis and the treatment plan, bearing in mind the sensitivities associated with such information?
NHS Continuing Healthcare
Debate between Baroness Pitkeathley and Baroness Merron(4 months, 1 week ago)
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Baroness Merron (Lab)
It is crucial that we provide the right support to children and young people. NHS England’s regional teams are working with local systems to explore the delivery of continuing care to that younger group. It is important to say to your Lordships’ House that we do not currently collect data on, for example, children and young people, but we will be doing so from April next year. That will help us capture evidence, which will enable us to improve things in the way the noble Lord and his all-party group want to do. We continue to welcome views from stakeholders and partners in this regard.
Baroness Pitkeathley (Lab)
My Lords, I wonder if other noble Lords share my experience of people who should have continuing care never even being told about its existence. As the noble Lord, Lord Crisp, said, the criteria are obscure, but they are even more obscure if nobody tells you that you could be eligible. Would the noble Baroness be sympathetic to the idea of being much more open about the existence of this facility to both patients and their families?
Baroness Merron (Lab)
I thank my noble friend for that observation and certainly agree that, in all these areas, it is very important that people understand what might be available and how they might best apply. As I said to the noble Lord, Lord Crisp, the assessment is potentially a gateway to other NHS funding. I feel quite strongly that that needs to be clarified, so that people know what they are going into. I will take my noble friend’s comments on board and discuss this within the department.