Covid-19: BAME NHS Staff

Baroness Uddin Excerpts

Tuesday 19th May 2020 Lords Chamber

[Lord Bethell]

The noble Baroness put this very well. We are deeply concerned about genetic differences between groups. This virus is like malaria and other viruses in that it affects different ethnic groups differently. We are concerned about behavioural issues such as diet and environmental issues such as urban versus rural living arrangements. We have already invited health trusts to put in place arrangements to protect our BAME NHS workers. We are also inviting other academic studies, of which there is a large number, to look at the various concerns about how the virus has hit different groups. We will be commissioning a very large amount of medical research into this important area.

[Baroness Uddin (Non-Afl)]

I salute my noble friend for her relentless uphill struggle to combat institutional discrimination in our country. No one can ignore the sobering statistics on front-line deaths among members of minority communities. These have raised the deepest fears about the tragic number of deaths. Leaders in the NHS who are responsible for diversity have also said that the Government have been too slow to act to protect NHS front-line staff. What measures are in place to monitor this situation and to assure BAME staff that they can be confident about continuing to provide their services to the NHS in safety?

[Lord Bethell]

I completely and utterly reject the suggestion by the noble Baroness that there is institutional racism in the NHS. That is a completely inappropriate slur and I invite the noble Baroness to retract it at a future date.

Covid-19: Social Care Services

Baroness Uddin Excerpts

Thursday 23rd April 2020 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, I declare my interests as a former statutory social worker and as the mother of a person living with autism. I express my heartfelt condolences to all those who have lost loved ones during the horrific and tragic past weeks. These are sad times and I thank my noble friend Lady Wheeler for leading this discussion. I agree wholeheartedly with her invaluable and detailed insights and I completely endorse the comments expressed by my noble friends Lady Grey-Thompson, Lady Pitkeathley and Lady Jolly.

Our nation is indebted to all staff at the front line of our NHS and our social care sector. Even at this unprecedented time, we have witnessed exemplary appreciation and respect for their unflinching bravery. In fact, there are infinite numbers of men and women creatively assisting their local services, including care homes, some privately purchasing protective equipment that is rapidly running out. This is reinforced by Excelcare, the national provider of 33 homes, including in my constituency. Indeed, I feel proud of the work being done by many local and national charity organisations based in my area of Tower Hamlets. Despite the lockdown, neighbours are supporting one another and organising food packages for front-line staff. By all accounts, this is being replicated in every part of our communities.

I commend to the House the work of two organisations. One is the Bangladeshi catering industry, which has used restaurant kitchens to supply free food for thousands of vulnerable families at breaking point, as well as NHS and care staff. The other is a satellite TV channel, Channel S, which is providing an outstanding public service in mobilising communities and helping people suffering extreme hardships and those who are finding it difficult to access some of the financial measures in place. The channel has ensured that government messages and instructions reach its vast bilingual audience, in addition to helping charities raise hundreds of thousands of pounds for vulnerable families at home and abroad. Each day is a forbidding challenge for many who are suffering poverty, domestic abuse and multiple frailties. Nevertheless, it has been a privilege to witness the human spirit thriving in communities coming together. As the month of Ramadan begins tomorrow, these collective efforts will intensify unabated to help all sections of the community, regardless of age, ethnicity or faith.

I conclude by asking the Government if they have undertaken an impact assessment of the current pandemic on people at special schools, day-care centres and other residential care institutions that provide services to disabled children and adults with learning disability and autism, in terms of the availability of PPE, staff and adequate resources. What protocol exists for carers accompanying disabled children and adults to hospital should they contract Covid-19? The Children’s Commissioner is concerned about the drop in the number of children on the safeguarding and child protection registers attending schools. What is being done to ensure that local authorities have adequate social work staff and resources to maintain sufficient monitoring of their safety? I thank noble Lords for their co-operation and attendance.

Coronavirus Bill

Baroness Uddin Excerpts

2nd reading & 2nd reading (Hansard - continued) & 2nd reading (Hansard - continued): House of Lords
Tuesday 24th March 2020 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, it is a privilege to follow the noble Lord, Lord Hastings. I agree with the entirety of his contribution. The entire world faces the colossal fear—unimaginable a few weeks ago—of an outbreak of such magnitude; a public health emergency.

Only today Dr Fuad Nahdi’s family laid him to rest as I sat in the Chamber. He lost his battle with several health conditions and finally succumbed to coronavirus. I do not know whether he was able to be resuscitated—whether that facility was available to him. But he was an outstanding community champion and he worked relentlessly—tirelessly—with Government Ministers, churches and the community to keep people safe post 9/11. I express my condolences, heartfelt prayers and good wishes to his family.

Dr Rosena Allin-Khan, an honourable Member of another place, has called for urgent attention to be paid to the shortage of resuscitation units. These are already full, she says, in many hospitals as the numbers of admissions rise. NHS staff face an incredible decision: who will live and who will die? I add my thanks to all those NHS and front-line bravehearts who are putting their own life and well-being aside to take care of us and others.

The country understands that decisions must be made to prevent mass infection and preserve security, with adherence to the norms of a civilised, humane nation. Perhaps liberty is in temporary abeyance—the freedom and privilege that we have enjoyed. Therefore, the Government’s economic measures and responses are welcome, although I have pointed reservations. Since the Bill was published, all parliamentarians have been inundated by constituents and community and business groups alike; they support government measures but are deeply troubled by some aspects of the proposed legislation, and its short- and long-term impact on significant sections of our vulnerable communities. I record my thanks, for their incredible insights, to Toni Meredew at account3; James Lee at the City of London Corporation; Inclusion London; Haji Taslim Funerals; the East London Mosque; and Hasina Zaman from Compassionate Funerals.

I wish to raise two points in particular: first, how the Bill will potentially impact the lives of disabled people such as my noble friend Lady Grey-Thompson. Many fear serious risk to their and thousands of other vulnerable people’s daily care needs, and that they will be abandoned in the emergency situation and left to the discretion of an already overstretched local authority. There are incredible misgivings about measures to suspend provision under the Care Act 2014. The fear is that social care provision is likely to breach the human rights threshold, as has been said, and will be offered only to those in critical and severe need.

We have large numbers of disabled people who require daily care and noble Lords are rightly concerned that the Bill will suspend their right to daily care from a local authority. If, as the legislation proposes, assessment needs are delayed, there will be untold suffering, which will cause lasting mental and physical harm to the well-being of those dependent for their care needs, as well as an unbearable imposition on carers to cope alone.

With regard to mental health services provision, I accept that this is a national emergency and we are being asked to suspend normal freedoms as a new norm. However, we must think carefully about obliterating our social care responsibilities. There is also significant fear about the power of detention by one doctor. I cannot overemphasise caution about that provision, given that many black and minority ethnic citizens experience detention disproportionately, as has been mentioned. Suspending any accountability in the process may leave a generational legacy of damage. Will there be an impact assessment in place to monitor the impact of the proposed legislation?

Equally, I declare an interest as a former social worker. The well-being of those who experience and will continue to experience domestic violence, child sexual and physical abuse, and sexual exploitation depends on social workers, but there is a huge shortage. What are the Government doing to ensure that social workers will also be asked to come back and provide emergency services?

We have worked for decades to advance the rights of people with disabilities, those who live with mental health issues and those who are cared for by social services. I echo the words of my noble friend Lady Grey-Thompson and ask how the Government will adhere to the human rights of people who receive social care and social services support.

I also wish to make a point about the power in the Bill at Schedule 28, which proposes to suspend taking into consideration the preferences of the deceased, regardless of their religious duties and obligations. I apologise to the House for taking a few more minutes to finish this point. The Bill suggests using powers to direct the deceased to be cremated if there is a lack of capacity at storage facilities, thus suspending Section 46(3) of the Public Health (Control of Disease) Act 1984, which prohibits cremation against the wishes of the deceased. This has caused serious panic and anxiety in many parts of our communities and many have written to ask us to raise that matter as Members of Parliament. The honourable Member for Bradford West tabled an amendment to the Bill and has now withdrawn it. I am thankful for her outstanding campaign to mobilise and bring about the Government’s understanding that, even in these times of national existential threat and crisis, we will remain resolute in remaining a society that values freedom of choice, particularly around the dignity of human death.

I spent the whole weekend speaking to various organisations that lead funeral services, including those I mentioned earlier. Will the Minister agree to consult and work with them and with faith-based organisations along the lines that I referred to earlier to ensure—

[Noble Lords]

Oh!

[Baroness Uddin]

I have nearly finished. With the leniency of the House I will ask my final question.

I appreciate the fact that the Paymaster-General has given his assurance, but will the Minister assure us that the provisions in Part 4 of Schedule 28 in relation to the wishes of the deceased will be respected? I thank noble Lords for their leniency.

Health: Maternity Care Provisions in East Kent

Baroness Uddin Excerpts

Thursday 13th February 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

People are entitled to free NHS care if they are ordinarily resident in the UK. However, my noble friend’s wider point about the pressure on maternity services was absolutely right. That is why, in February 2018, the Government announced an additional 3,650 training places for midwives. I am pleased to say that the first 650 began their training in September 2019 to ease the pressure, and there will be 1,000 training places for each of the next three years. This should ease the pressure and address some of the concerns my noble friend raised.

[Baroness Uddin (Non-Afl)]

My Lords, I draw the Minister’s attention to one of the first advocacy schemes for maternity care, which still operates in Tower Hamlets 35 or 38 years onwards. When I was working there, I dealt with a number of cases where there were complaints from parents. Will she commend the efforts of the parents, who persisted in taking their complaints so far up? Without their knowledge, persistence and dedication, we would not have come to this point where we are seriously questioning the competence of the staff.

[Baroness Blackwood of North Oxford]

We are obviously very grateful to all those brave enough to bring their stories forward in the midst of extreme tragedy and pain. We know that it is not easy and that within the culture of the NHS, it can sometimes be extremely hard to break through the barriers of not denial, but resistance. We should pay tribute to all those who have campaigned for maternity safety. In particular, I pay tribute to my right honourable friend Jeremy Hunt, who began a lot of the work to improve maternity services when he was Health Secretary, and to James Titcombe, who led a lot of the work relating to Morecambe Bay.

Government Vision on Prevention

Baroness Uddin Excerpts

Tuesday 6th November 2018 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, those of us who have worked in community developments over 40 years have understood and valued the notion of prevention. It has to be recognised that funding has dissipated over the last 10 or 15 years, due to the finance extracted from local government. I welcome the Statement and I particularly welcome the fact that the Secretary of State makes reference to wanting to integrate housing and health and social care. This is very important. More specifically, I want to make a couple of points on learning disability and autism.

The Secretary of State recently came to a meeting of the All-Party Parliamentary Group for Disability and we were really pleased that he stayed and listened throughout. However, the point that is still missing—I would like the Minister to respond—is on how the Government will ensure that organisations that have worked solidly with sterling records on the ground will be part of this discussion, because they know the answers. Minister after Minister and officer after officer will change, but many of these organisations have remained rooted, whether they have been funded or not, and I would like some assurance that they will have their say. Millions have been lost in services over the past decades, particularly in disadvantaged communities, so women and people with disabilities have not been able to access services adequately, either because they do not know that services exist or because government organisations simply fail to connect with them.

[Noble Lords]

Question!

[Baroness Uddin]

With respect, my Lords, I state my objection at being shouted at to move on; many Members would simply carry on.

[Lord O'Shaughnessy]

I am grateful to the noble Baroness for the question. On learning disabilities and autism, I know that the Secretary of State has been very moved by some of the cases that he has become aware of since taking the job in the summer. He has instigated not only serious incident reviews into individual cases but a thematic review by the CQC, with contributions from NHS England, on how to improve the system and ensure that we move more services out of in-patient facilities and into the community. I am absolutely confident—I will confirm this to the noble Baroness—that the best providers, from wherever they are, will be able to contribute to that review.

National Health Service: Mental Health Funding

Baroness Uddin Excerpts

Wednesday 20th June 2018 Lords Chamber

[Lord O’Shaughnessy]

I agree with the noble Lord that we need to increase funding for local mental health services. That has been happening over the past few years; indeed, between 2015-16 and 2018-19 it has gone up by £1 billion. I turn to his point about mental health funding being used for other purposes. I want to be clear that there is NHS England guidance that that should not happen, and from this financial year all CCGs will have to meet what is called the mental health investment standard, which means that they are to increase their spending on mental health at least as much as, if not more than, their spending on physical health.

[Baroness Uddin (Non-Afl)]

My Lords, regardless of what the Minister says, does he accept that there has been a systematic destruction of voluntary organisations providing many mental health services? This has had a particular impact on survivors of domestic violence. What are the Government doing to ensure that Women’s Aid and other organisations that provide support for women suffering from and the survivors of domestic violence have funding available through the means to which he has referred?

[Lord O’Shaughnessy]

Although the particular funding the noble Baroness is talking about is a Home Office issue, I can say that £100 million is available until 2020 to support the victims of domestic violence. From the health service perspective, obviously we are increasing the amount of money spent on treating those with mental illness, regardless of the cause that gave them their illness in the first place.

Social Care

Baroness Uddin Excerpts

Thursday 7th December 2017 Lords Chamber

[Lord O'Shaughnessy]

I am happy to provide that assurance. Inevitably, there is economic modelling that will need to be updated from previous reviews. It is the reason that, in particular, Dame Kate Barker and Sir Andrew Dilnot have been invited to play a role as well as others, as I am sure the noble Baroness knows. We do not want to have to reinvent the wheel and we know what we want to achieve. The difficulty is that, as Governments have found throughout the years, it is easier to say that than to do it. We all want to get through that process and hopefully achieve it this time.

[Baroness Uddin (Non-Afl)]

My Lords, in the light of all the previous comments I want to raise a couple of issues. I welcome having another look at social care in general and the fact that the Minister says that the Government are looking at integrated care. That is not the experience of men, women and children on the ground; I declare an interest in that I have a son with autism but I receive no service, so I do not really need to declare that. I think an awful lot of parents are like me and my husband: their families manage it themselves. The level of support for social care for adults with autism or a learning disability has been decimated over the last 10 years in various ways. How will this new approach to social care ensure that there is some reverse, so that there is dignity and honour for those individuals who go through the social care process and system?

Does the Minister agree that it is really important to ensure that there will be some reparation, almost, for the loss of services in the past so that adults, particularly those with a learning disability and autism, have access to services such as simply going to the library? My noble friend Lord Howarth mentioned the arts earlier but there is also music, as was pointed out earlier in the Chamber. There is a variety of ways in which social care is now more innovative, and that access should be available to service receivers in all parts.

My final point is about the communities that do not automatically understand the new approach or the latest fads and reports. They do not follow the system. How will we ensure that all kinds of communities understand that there is an approach to integrated social care, and that they will not be left behind simply because they do not understand the system or are not au fait with it, or if they are not politically correct and shouting the loudest?

[Lord O'Shaughnessy]

The noble Baroness put it beautifully in saying that the people we are talking about, who are on the receiving end of care, need to be treated with dignity and honour. I wholeheartedly agree with her.

I will separate integrated care into older people and working-age adults, as the noble Baroness did. On older people—and on health and care in general—I encourage her again to look at the five-year forward view and the plan for integration. In the recent Budget, we funded more than £200 million of capital programmes to help move a handful of local areas to what are called accountable care systems. That is where you look at the health of a population, which is quite an important step forward towards integrated care. I agree with her that that is not necessarily the everyday experience.

On disabled working-age adults, we may talk about the ageing and growing population but I believe that they are the fastest-growing group of care users. There is of course excellent work going on at the local authority level; I had the privilege many years ago to chair a special school in Wandsworth and saw the fantastic work it did with a peripatetic autism service there. But I know that there is huge variation, which is why the parallel programme of work that I talked about is so important.

Finally, the noble Baroness talked about hard-to-reach communities, and I could not agree more on that. One of the ways of reaching them is to engage with those who give voice to those communities. I would be delighted to discuss that with her, to make sure that we are listening to every voice we can as we move ahead.

Children: Oral Health

Baroness Uddin Excerpts

Monday 31st October 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, I think that I have already answered my noble friend’s question on fluoridation. On his second point about regular tooth-brushing, Scotland has a scheme called Childsmile, where there is supervised tooth-brushing in primary schools and nurseries, as well as a fluoride varnish twice a year. We can learn something from Scotland in that regard. It is expensive, but Public Health England is nevertheless looking at it and we may adopt it in our country soon.

[Baroness Uddin (Non-Afl)]

My Lords, do the nine categories of food to which the Minister referred also include baby foods, which are packed with sugar? I declare an interest, having a granddaughter, Imaan, who has allowed me to taste the enormous amount of harmful sugar contained even in organic baby food. Will the Minister consider adding baby food to his basket list of things to look at?

[Lord Prior of Brampton]

My Lords, I cannot recall whether baby food is one of those nine categories that have been identified in the obesity strategy, but I will look into that and write to the noble Baroness.

Mental Health Services

Baroness Uddin Excerpts

Wednesday 25th February 2015 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, the commitment to ensuring equity between mental and physical health services is in disarray. The NHS has undoubtedly hit mental health provision hardest, according to a BBC report, with as many as 1,700 beds being cut and patients having to travel huge distances to access care, putting patients and families through significant distress and displacement. Despite the promise of guarantees of parity in funding, the overall proportion of funding going to mental health has been falling, compounding the long-standing underfunding of mental health services which is so costly to human lives and our society at large.

The impact of these cuts on children and adolescents has often been lost in the furore about mental health. I thank the noble Earl, Lord Listowel, for highlighting this issue, not only through this debate but also through his involvement in Young Minds, which has campaigned so effectively to highlight cuts and freezes to mental health services across most local authorities.

Only yesterday, I and colleagues in this and the other place, heard Sally Burke describe her family’s plight when her daughter Maisie, now aged 13, went into crisis. Suicidal and distressed at the age of 12, Maisie had to be taken by the police—because no GP was available to tend to her—and was eventually hospitalised in Stafford, 130 miles from her home in Hull. Sally Burke has had to fight tooth and nail for her daughter to get appropriate care, including getting her MP, Alan Johnson, to intervene with Norman Lamb and the health commissioner in order to get Maisie moved closer to home. However, she still remained 60 miles away in Sheffield due to the removal of mental health beds for children in Hull.

One of the many distressing features of Maisie Shaw’s case is that she was only aged 13, after being hospitalised, when she was diagnosed with autism. As a high-functioning autistic child, at no point had the health or education practitioners she had come into contact with pushed her towards a diagnosis. Instead, Sally Burke says that she was made to feel responsible for Maisie’s irregular behaviour as a small child. She has had to develop huge resilience to withstand battle after battle with atomised public services. She describes the experience as fundamentally “cruel”. This is one example among many that has come to our attention, particularly from carers struggling to manage their loved ones with mental health and autism as an added dimension.

The figures are stark. NHS England reports that as many as 70% of children and young people with autism have at least one mental health disorder. Some 40% have two or more mental health disorders. The Minister will acknowledge that the condition of autism is associated with significant mental health needs. At present, however, specialist child and adolescent mental health services—CAMHS—for autism are few and far between. As NHS England has acknowledged,

“there is a scarcity of professionals with the necessary levels of expertise to provide this highly specialist service across the country”.

Professionals working within CAMHS say that children are not adequately supported while waiting for psychological therapies and that support for parents and carers is negligible.

Can the Minister assure the House that, to address these challenges, the Government will address autism specifically in their work on mental health, for example through the task force on children and young people’s mental health and via the mental health system board and the ministerial advisory group? Given the complexity of autism, will he agree that this group requires specialised attention?

Autism

Baroness Uddin Excerpts

Wednesday 4th February 2015 Lords Chamber

Asked by

[Baroness Uddin]

To ask Her Majesty’s Government what steps they are taking to understand the causes of autism spectrum disorders and speed up diagnosis.

[Baroness Uddin (Non-Afl)]

My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I draw the House’s attention to my declared interest.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con)]

My Lords, there are a number of current government-funded research projects linked to autism. These include a Medical Research Council study to identify why certain genetic mutations can cause problems during brain development. By following the National Institute for Health and Care Excellence’s guidelines and toolkits, autism diagnosis can be speeded up. NHS England also has plans to use its local audit teams to provide assurance that people’s experiences of the diagnostic process are acceptable.

[Baroness Uddin]

My Lords, I thank the Minister for that thoughtful reply. He and I agree completely that there have been massive improvements in diagnosis over past decades. However, according to the Government’s Think Autism document, reports by the National Autistic Society and the BME organisation Include Me TOO, the experience of many parents seems to be that there are significant disparities and underdiagnosis, particularly among the BME communities. Given the crucial importance of timely diagnosis to the future prospects of someone with autism, how does the Minister’s department intend to address this currently patchy and inconsistent assessment service for all those who are identified as needing a full diagnosis on time and according to the Government’s own standards, and how does it intend to monitor progress?