Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2026

Lord Addington Excerpts

Wednesday 15th April 2026 Grand Committee

[Lord Herbert of South Downs (Con)]

My Lords, I want to add to the comments and questions made by my noble friend Lady Harding about the potential impact of this regulatory change on horseracing. It is a very important sport, as the Minister responsible knows, and a sport that is already under considerable financial pressure, despite its tremendous popularity. There is concern about what the unintended consequences of this significant change may be, the bureaucratic burden that could be created by the extension of the CQC’s jurisdiction into event medicine and the cost, so I seek reassurance that Ministers are alive to these issues.

I want to raise a particular issue, which has also been raised by other noble Lords, about the possibility of exempting from registration the healthcare that is provided to athletes, performers and officials, as opposed to the healthcare provided to the public. I understand that that exemption exists already for treatment provided under arrangements between employers and employees, but not more widely. However, much medical provision might not be on an employer-employee basis and therefore would not be covered by the exemption. That would create an anomaly.

Ministers are of course right to draw attention to the importance of this issue, given the terrible events in the Manchester Arena nearly a decade ago, the awful loss of life and the very large numbers of people injured. But the extension of the CQC’s remit, as a consequence of the inquiry’s recommendation, was precisely to improve healthcare provision for the public. I am not aware that there was any perceived problem with healthcare provided for athletes and competitors—a much narrower group of people. That was not, of course, what the inquiry was thinking about when it proposed this extension, but the extension at the moment covers them, so there may be significant unintended consequences.

We know that one survey suggests that over a third of the doctors who currently provide medical cover for racing may not continue if required to register, because of the bureaucratic burden. There is obviously a tremendous reassurance job that has to be done, at the very least, but it seems that we also need to address the fundamental issue. I wonder whether the Minister would accept that there is a difference between the care that is provided for the public, which is what the inquiry was all about, and the arrangements for athletes and competitors, which are different and where there was not a problem that needed to be addressed. However, accepting that an event healthcare standard is a good thing, and that Ministers will look at the potential for exempting from registration healthcare provided for athletes, performers and officials on that basis, this instrument would seem to be commonsensical.

[Lord Addington (LD)]

My Lords, this is one of those debates where you think, “Who do I disagree with?” I am afraid that I have not disagreed with anything from anybody. As I speak for my party, it is important for me to restate that things went wrong with the treatment of the Manchester Arena disaster. We should do something about it—that would be great.

The problem here is that we seem to have gone far too wide. As the noble Baroness, Lady Finlay, asked, how far down do you go when covering an event? For instance, for small rugby union clubs—my own sporting background—you are lucky if there are three men and a dog watching. That is your crowd, but a local cup game could have a couple of thousand. Where does that support structure kick in? That is something that all amateur sport will confront from time to time. This is merely the first opportunity for the Minister to correct these perceptions. We need to have some cut-off points, going from when it is enough simply to have a first-aider within earshot to when we need better medical support and structure. When that changes and how they interact is really what the discussion here is about.

When it comes to sport, please let us not do anything that stops sporting events happening. There is a fear that we will do so inadvertently by providing a greater bureaucratic burden on providing help. We hope that the Government will not do that. I hope that the Department of Health will not do something that will make the country intrinsically less healthy. That is really what we are looking at.

Let us look at other specialist events. This is not an interest, but I live in the village of Lambourn so, even if I did not want to be, I am very aware of things to do with equestrian sport and particularly races. Anything to do with horses is intrinsically dangerous; indeed, we have a rehabilitation centre for neck and back injuries in Lambourn. When it comes to racing, as my wife has often pointed out to me, there are not many events when an ambulance follows you down the course as you are taking part—so there are structures there. If something that organised is raising concerns—it is not because they want it to be there but because it has to be there—there might well be something worth listening to. We must make sure, when we deliver this, that we do not throw the baby out with the bathwater and that good intentions are erased out. We should go through all those things.

The Government need to start doing something to get better information out there about exactly what they are doing, where the barriers are and what will happen. A series of meetings might help—possibly with parliamentarians and certainly with larger groups—and they should get the information out quickly. It will dramatically help to let the information out in dribs and drabs—as and when they see fit as they go forward—setting out their intentions, and we will bring in stuff behind it. That way, if there is a real fault-line here, as opposed to a fear of one, we will find out. Then we can start to do something about it.

Can the Government give us something that reassures us on our worries about the extra bureaucratic burden, given that people are terrified? They are one newspaper report and a few tweets away from people having a panic about everybody being sued every time anybody gets cuts in an amateur football game. What are they doing? Where are the structures going? That is what is required here.

We all want the big events to be safer, but they will have got it wrong if they apply this to an open mic night at a pub and a Sunday league football game at the same time. We must make sure that people know where those fault-lines are. The exemption for people taking part in sports events is a no-brainer. Can we make sure that this happens and that people know about it? It is clear that they do not, at the moment, and that is a fundamental flaw in the Government’s approach.

[Lord Kamall (Con)]

My Lords, as other noble Lords were declaring their interests, I thought, “Oh, that’s good; I have no relevant interests”. But, the last time I thought that, a number of people tweeted at me for not declaring my interests, so I will bore all noble Lords with them. I am a professor of politics and international relations at St Mary’s University, Twickenham. I teach an MBA module on healthcare policy and strategy. I also work with the medical school that it is starting and have started co-operating with colleagues in the Faculty of Sport, Technology and Health Sciences. I also teach at the University of Buckingham, but I have no contact with its medical school. I just wanted to touch all the bases.

I thank the Minister for setting out these draft regulations in her usual clear manner. Obviously, they arise from the tragic events of the Manchester Arena attack and the subsequent inquiry. Like other noble Lords, my heart goes out to those who were affected; we offer our condolences to the victims and their families, some of whom are probably still in a state of bereavement. Clearly, that inquiry called for a review of healthcare provision at events, as well as clearer standards for public safety, which I think everyone who has spoken is in favour of.

Most of the people who have contacted us said that they support the principle that those attending sporting and cultural events should have access to safe, high-quality medical care—there is no disagreement there—but the question before your Lordships is one not of principle but of implementation and delivery. It is right, therefore, that the detail be scrutinised carefully.

In removing the previous exemption and requiring providers of event healthcare to register with the CQC, the SI clearly extends the CQC’s regulatory remit to a sector that is complex and, in many cases, heavily reliant on volunteers and small providers. You cannot just transplant knowledge from the hospital or mental health sectors into sports events; noble Lords have referred to the range of events that would be covered. This removal, while understandable, has given rise a number of concerns—I am sure that the Minister has heard them—among, but not limited to, small organisations and volunteer-run sports clubs. Like the noble Lord, Lord Addington, I share the concerns of the noble Lords on different Benches who have spoken. There is no disagreement here.

The department’s own impact assessment acknowledges the increased costs associated with registration and ongoing compliance, but one of my concerns arose when I saw the estimate for the registration fee. It said that, for newly regulated providers, it will be between—

Learning Disabilities: Health and Social Care Access

Lord Addington Excerpts

Thursday 26th March 2026 Grand Committee

[Lord Addington (LD)]

My Lords, the most depressing thing about this debate is that it has been decades since I first spoke in a debate that pointed out that anybody with a learning disability or autism will have very bad health results and die early. That is an established fact. My noble friend said that you cannot change the past, but let us at least learn from it. We have been doing this for a long time with various Governments.

It turns out that our medical system is based on somebody telling a medical professional what the matter with them is by responding to certain, usually verbal, stimuli. Any group that has not been able to do that has always suffered badly. For example, it is an established fact that people using sign language have suffered badly. If we are going to do something about that, we will have to make some reasonable adjustments—that is the expression we are using here. If we do not do that, we will continue to get bad results because the medical profession will get involved only when something becomes obvious. We have all been told, again and again, “You should have seen a medical practitioner sooner”. We are guaranteeing that that will happen here if we do not find a way to assess those needs and get in earlier.

For anybody who has a communication problem or is communicating through one person that is going to be worse still. An example is the fear of an individual, usually a parent, who thinks, “What happens to my child with a disability when I’m not around?” The emphasis on that has been made very clear. It might be another relative who is doing the caring or somebody else. According to everything that we have heard today, they are quite right to be frightened when they are going through that.

We also have a system that has a series of flags coming up. As my noble friend pointed out to me, it is great having a flag, but what do we do when we see it? Until we get that ingrained in the training and structure—indeed, until somebody’s life is made more than a little unpleasant if they are not doing it—we will not get change. Every time we have a system that works in a certain way and we want to deviate slightly, what is required is to play the system and get around it.

I will repeat another bit of black humour. It is often said that the first thing a disabled child who wants to do well should do is to choose their parents carefully in order to give them that advantage. I am afraid that that still applies. What are we doing to make sure that when we have a system in place, action is taken? Then, if we have a system in place, are medical professionals told—even if they are not trained to do it themselves—how to communicate with somebody with autism who takes things very literally? How do we get that information out to them? If the patient has certain types of learning difficulties, how do they get in touch with somebody to receive health checks? Those checks normally depend on tick boxes, so how do we avoid that? How do medical professionals extract information from that person, given that we depend on their assessment of their health? If they cannot do it, a prolonged examination will be needed. All of that is clear. If you follow it through, there is an iron logic to it, and it has not changed. It is an accepted system.

I will ask the Minister a few questions. On the flagging system, what is the process to make sure that people react to flags? Where would a medical professional go to get help interpreting and extracting information from a person who has certain types of communication or perceptual difficulties? That is particularly the case if the parent or carer is not readily available. Is there a process? If not, there should be because we are guaranteeing more failure if we do not have one.

These are the things that we have come back to over and over again for years. They have been said with more eloquence and knowledge than I can manage today. Unless the Government can start to address this, we will come back to this subject again in a new form because nothing will have fundamentally changed. I hope this Government will at least move this project on because, let us face it, it is well overdue and needs to be given a good hard push, or even a kick.

Learning Disabilities Mortality Review Reports

Lord Addington Excerpts

Thursday 13th November 2025 Lords Chamber

[Baroness Merron (Lab)]

I understand the point that the noble Baroness makes—it is quite right. We will continue to take account of and work to support parents and those they care for in the way that she describes. Certainly, I will also discuss with the Minister continuing the work with the organisation to which she refers.

[Lord Addington (LD)]

My Lords, to slightly widen the Question, would the Minister look at the fact that anybody who has a communication problem has historically had very bad results, compared with the rest of the population, when dealing with the National Health Service? Those with a hearing impairment would be a classic example. Will the Government have a good look across the whole spectrum of those who have some form of communication difficulty and try to get those medical professionals briefed in different forms of communication for that very important interview?

[Baroness Merron (Lab)]

Again, I certainly accept the important points that the noble Lord is making. It is unacceptable that there are health inequalities and poorer life outcomes. Indeed, action could be taken. That is why our 10-year health plan recognises these inequalities and identifies particularly those with disabilities as a priority group for more of that holistic, ongoing support. Key to that will be the development of neighbourhood services, where such groups will be prioritised.

Support for Infants and Parents etc (Information) Bill [HL]

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2nd reading
Friday 6th September 2024 Lords Chamber

[Lord Addington (LD)]

My Lords, sometimes, when you deal with a certain piece of legislation, you get the feel that it is very close to a finished and polished article, and that is what I get here. Thought has clearly gone into it. It is not trying to reinvent the wheel. Although all politicians have that Christmas tree urge to ask, “What can we stick on this?”, I encourage noble Lords to resist on this occasion; the decorations are fine. We must make sure that we can get this through. If the Government are willing to accept this, which I hope they will be, they will be doing a good thing, and they are not doing something that costs a lot. The Bill is merely bringing together everything the Government are doing and letting those who should access them know.

As has already been mentioned, there are different groups of people. Those who most need to know what support is there are those least likely to look for it or to understand it. I am afraid that that is a circle we have not yet squared, but it is true. However, if you have it in one place, you stand an infinitely better chance of doing it, or allowing those who are trying to support them to do it. This is something that this Bill addresses, so that people have a chance of finding the support that is out there.

The noble Lord, Lord Meston, added necessary cold water in saying that there is a group of people who have persistent problems. The noble Lord, Lord Bird, used the word “concatenation”; I had no idea it existed, so it has expanded my knowledge. Everything he said was right. He described this as a brick in the wall to build something better. Although I would have said that it is a bit of the foundations, I agree that it is a good thing.

I could go on at considerable length on this, but I will resist that temptation. Anything that has guidance coming out to deliver it and the Secretary of State reporting back afterwards in order to make an asset to be used in all these things has to be positive. I think that anybody who has been involved in any part of politics or government knows that we have bits of government going off at tangents and not talking to each other.

I hope that the Government will give a positive response to this and tell us the timetable so that we can all cheer it on the way through, because it is good. It will not solve all the problems of the world, but it might be that little bit of foundation of doing things a bit better. I wish the Bill well and look forward to the Government’s response and to the assurance that they will make sure that it becomes law.

Learning Disabilities and Autism: Solitary Confinement in Hospital

Lord Addington Excerpts

Thursday 23rd November 2023 Lords Chamber

[Lord Addington (LD)]

My Lords, when you have been here a while and suddenly see a pairing of people coming up in front of you on a certain subject—and it is the noble Baroness, Lady Browning, and the noble Lord, Lord Touhig, on autism—the first thing you do is to listen hard. When you get a report that has been written with such authority, inspired by this subject, that is doubly the case.

Every time we hear about confinement and control—physical restraint, chemical coshes on groups—we are basically saying, “You have got a failure”. Why have we got to that? Often because in getting to that point, people have not understood this bit of their client base; the report refers to that. The noble Lord, Lord Touhig, just put his finger on it but from what I know of autism, that would be one person’s experience of it. There will be a series of traits gathered together that are complicated and different—never the same twice, so it is not easy.

It is difficult to tell a health professional, or any professional in any sphere, “By the way, your training doesn’t cover this properly”. We all have a series of reflex reactions which we go back to. We have to make sure that people on the way up to this point—or down, depending on how you want to look at it—have ideas about where they should have better interventions, or know whether they should make them or back off. If, as a mental health professional, you are confronted with somebody in an institution or in that process, unless you know not to behave as normal you will go into a pattern of behaviour because everybody does. You have put a reflex or bureaucratic pattern in place, so why would you break it? The only answer will be from the information about what you are dealing with.

Lots of things can go wrong in this process of identification and self-identification. I remember that once I managed to get myself into a totally unnecessary row with somebody who was on the autistic spectrum, because they accused me of not doing something in very aggressive terms. They probably did not mean to. I said, “Wait a minute—this is public”, and started to defend myself. Then they had a minor meltdown and left. I know more about this than most people but still do not know anywhere near enough to understand what that person was going through. Everybody can make these series of mistakes.

My question to the Government is: what are you doing to ensure that everybody in that process better understands that normal responses will get negative results on many occasions? How can we get that idea into the system quickly? Long training programmes, the fact that we are making progress through them and the fact that we have targets: those will all come out because they will be in the Minister’s brief—they always are. However, we need to know that an awareness that something will not respond correctly is required here.

Every time I have dealt with anything to do with autism, there has been this pattern of behaviour in the criminal justice system. To put it bluntly, autism is one of the most over-represented groups in society within the prison system. It can go horribly wrong everywhere. I take the example of the noble Lord, Lord Touhig, on the process of responding: when somebody is confronted with authority, suddenly there is a conflict there, without even trying.

How can people be trained and be made aware generally in society so that they can avoid getting as far as the medical facilities, and how can we make medical facilities aware that a different type of response will be required? I would like that big question to start to be answered. If we do not address that, we do not stand a chance of addressing it in the round because even if we train all the medical practitioners, they will still have a great flood of people coming to them—people who should not have been there.

The police in certain places have had a little more training, but usually after very bad episodes: some degree of conflict has taken place or somebody has been traumatised. We are asking the Government to give us a serious plan about building up a pattern of awareness within the institutions that people bump into. If there is a certain specialist pattern, you only get x number of people going into it. Somebody who is a high- functioning autistic or functions well with learning difficulties may bump into the system only occasionally. But if they do not have support and guidance, with somebody to say, “Yes, there is a different type of response required here”, those incidents will get bigger and more frequent, and we will have to deal with them at the acute level.

The same will apply to those who are discharged from hospital. There must be an entrance and a way down. Sometimes it will be specialist provision and sometimes it will be specially trained people, particularly when you are discharged having had some damage—let us face it, we have all had some damage. I would hope the Minister can give us some pattern for the first steps in making the institutions of government aware that a different way of responding is required. That is a necessary first step, meaning that people should at least ask others, “What do we do?”. If you have that, you will have a bit of hope, which is the least that we should take away from this debate.

Paediatric Care: Wating Times

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Monday 16th October 2023 Lords Chamber

[Lord Markham (Con)]

The role of the GP is clearly vital. That is what I was trying to get behind in the Start for Life initiative and clear early warning indicators. Clearly, that needs to go right through the development of a child at different key stages along the way. On digital treatments, I was at Boston children’s hospital last week, and it has early indicators for dyslexia—for example, looking at pattern recognition via an app, as it is not until children are older that they can see letters. Similarly, early signs of neurodiversity can be seen in the way that children play online on certain apps. I think we can add some of these digital support tools, but clearly the GP has a primary role.

[Lord Addington (LD)]

My Lords, following on from his last comment, can the Minister give us some idea of what contact there has been on this with the Department for Education? We are supposed to talk to each other, but it becomes increasingly apparent that we do not do so.

[Lord Markham (Con)]

I like to think that we have good contact on this, centred around, as I said, Start for Life, which is a £300 million joint programme between ourselves and the Department for Education. There are also other things; for example, noble Lords might remember me mentioning the Bradford pilot previously, where we are looking at children’s scores in test environments and using those where there may be early indicators of ADHD or other neurodiverse needs. There is quite a bit of work going on in this space. No doubt we could always work more closely, but there is some promising work being done.

NHS: Performance and Innovation

Lord Addington Excerpts

Thursday 15th June 2023 Lords Chamber

[Lord Addington (LD)]

My Lords, this is one of those debates where we all think we know what is going to be said, but hopefully we are all mildly surprised. My noble friend started this process by hitting the nail straight on the head, saying—I paraphrase, but I formed this impression—that we are dealing with everybody after they have fallen over, not making sure there is not something to slip on. We have a system which seems to be in almost terminal crisis, according to many politicians—it is always the politicians who are not in power—and we are always sitting in here trying to rescue it.

I have a bit of a track record on this issue. I think the first debate I spoke in when the Minister who will reply today was here was about trying to change the nature of what we do with health, and to improve the surrounding structure. It was on a Private Member’s Bill that was a wonderful thing, but the Government have decided otherwise. Health promotion has far greater potential than does the pharmaceutical industry for making sure we have a healthier society. Clean water and clean air have saved more lives than all the drugs piled up together. You put that together with a decent diet, and people survive.

But we have the health service in a box. How do we make sure that the health service influences the rest of society? We do not do it from behind a Chinese wall in Westminster, the punching through of which requires a huge act of will, either way. You can tell the Ministers who take that on: they have metaphorically bandaged hands from doing it. They are always trying to get through, and everybody thinks it is down something else. The priority is always the emergencies and no one has the authority to say, “No, we have got to carry on with this and other departments must change their activity and talk to us”. This strikes me all the time: those little battles you have constantly.

For instance, let us take one of my favourite subjects, sport. Good sporting activity means you are generally healthier and in contact with the rest of humanity, which is good for your mental health. In fact, the mental health benefits of sport and social interaction may outweigh the physical ones. We know that if you have good mental health, you are more likely to undertake physical activity. It is a virtuous circle. What is required? It might be making sure that we have a tax regime and a minor support structure that allows our voluntary-inspired amateur sports teams to continue more easily, being as generous and helpful as we can and not leaving them constantly struggling for finance.

We are very lucky in this country: we went first for amateur sport and did it by people doing it for themselves, outside the state system. The state does not have to do it. In France, you play your rugby, football or tennis at the stades municipaux.

In Germany—this is an example I have used before—I remember that, whereas the FA said, “We spend X number of million pounds on improving the number of pitches we have”, the Bundesliga turned round and said, “What are you talking about? That’s a local government job”. We need support for those structures; the Government must have some way of saying, “This is something for more than just local government or the Department for Education. It is more than just money taken from the lottery. It is something that the health service and the public health environment have an active interest in”.

Some of this will be purely bureaucratic, such as making sure that these structures are always available; part of it might concern planning. How many amateur sports teams have done the wonderful thing of killing off their junior sides by getting a deal on their ground and moving out of town to somewhere where there is no bus service? That is a great way to destroy a junior team. I bet that most people do not even take that into account when they do it. I bet that most sporting bodies are not advised when these people move; they all work in structures. Do not do it: you are going to damage your junior structure. There will always be a developer waving a chequebook at you, but you have to make sure that you can actually get there.

That is just for the amateur sports structures; we can then go on to say, “We have done things like, under the Agriculture Act”, as I remember being told, “farmers will get support to create footpaths”. Great—but who is telling those farmers to link in with existing footpaths and public service networks, or at least to have good car parking, so that there is a structure where everything can be used together? I have not seen that. I have not heard of somebody doing that, for instance by telling the Ramblers’ Association or others, “Please talk to each other and create better networks”—so that, for instance, if you are going for a walk or going somewhere else, you can either get public transport or get back to where you parked your car. That might allow the local community to have a better chance of sustaining a café, a shop or a pub. All these things come together; we have to think slightly more holistically on this. When it comes to encouraging people to walk casually to and from work, we all know the answer: make sure that the streets are comparatively clean and well lit. All these things come back into creating a healthier society.

We can even go further than that; I was going to save this point for a little while longer, but my party has been, quite rightly, raising awareness of water quality and sewage discharges. If you want people to do things such as wild swimming and boating, making sure that they do not come face to face with a turd is a good idea, to be perfectly honest. Can we make sure that the weight of public opinion on public health—indeed, the public’s reverence for the health service—is used to influence the rest of this structure? If we do, we will have something that can get in there. We will not do this by standing behind Chinese walls. We need something that will go beyond and talk. If we do this, we stand a chance of making these improvements that mean that the acute services are called on later and less frequently. The huge bureaucracy, which may or may not be dealt with at some point in the future, will at least be called into action less often. However, this will require somebody to go in there and annoy people and say, “Please talk to each other”.

I have been in Parliament more than long enough to know that, if you want to make a speech on anything, talking about getting two government departments to work together and how they do not do it is probably good for five minutes; let us face it, it always has been. However, in this instance, we already have cases of it. We have the first steps. I hope that, in future, a Government will be brave enough to take this issue on—that is, to turn round and say, “We need better sports education and a structure to get people involved”. That may well lead to something like a good social hub, which, if they are at all sensible, will be able to be accessed by people from outside the sporting community. We have to maintain buildings where any activity can take place.

If that is going on and people are interacting with each other across the whole of government, we stand a chance of making this better. This will make it easier for the other bits of government, including local government, to work. The whole of civil society can benefit. However, if we are talking about healthcare, the thing that gives someone a chance of enjoying their life is much easier if they have good health; it is much more difficult if they do not. We are going to have to take more positive steps. As has already been said, if we are obsessed with handing out pills in a certain way and concentrate totally on the overly high demand for acute services, we are never going to get there. I hope that, today, we will start to see this Government’s thinking on this subject, as well as that of others who are not in power at the moment.

Autism: Diagnosis Targets

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Tuesday 16th May 2023 Lords Chamber

[Lord Markham (Con)]

Yes, absolutely, we need to look at all areas where we can increase and expand supply, including use of the private sector. I am sure I will be asked about ADHD later on and the “Panorama” programme, which shows that there are some pitfalls in all that, but provided they are assessing according to the NICE guidelines, it clearly has to be sensible to use as much supply as possible.

[Lord Addington (LD)]

My Lords, would the Minister agree that when you delay an assessment, you delay support from the entire structure of government, which we have said should be helping? What help is his department getting from the Department for Education and the Department for Work and Pensions to ensure people are getting to these assessments? If they cannot get the full assessment, can some intermediate steps be taken to ensure that people actually get the help they are entitled to?

[Lord Markham (Con)]

We are working closely with the Department for Education. The Bradford pilot scheme I mentioned takes the early years foundation stage profile scores of children. It knows that if you have a low score, you are far more likely to have autism. That triggers a multidisciplinary team to come in and inspect. That is a way that we can use that as an early warning indicator and then follow it up with volume. I hope that working very closely with the DfE in this space will be a real way forward.

Stroke Rehabilitation and Community Services

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Wednesday 22nd March 2023 Lords Chamber

[Lord Markham (Con)]

We are very much believers in the importance of social prescribing. I was at a reception just yesterday given by the Alliance of Sport, talking about the importance of active lifestyles for people’s mental health and recovery, and in the criminal justice system. It is something that we agree on the importance of. I will come back in more detail on the arts.

[Lord Addington (LD)]

My Lords, can the Minister expand upon the encouragement that the Government are giving to people in secondary services, to encourage people to fulfil the exercise programmes that are given to them by the experts? Without that encouragement from GPs and practice nurses, such programmes may seem very difficult and may not happen.

[Lord Markham (Con)]

My Lords, that is a very important point. Two things have really struck me. When people are in hospital, they lose 10% of their muscle mass per week, which is clearly key in their ability to have an active lifestyle and look after themselves outside. At the same time, they need constant support and reminders to keep up that active lifestyle. It is very much at the front of our mind.

Physiotherapy: Rehabilitation Services

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Thursday 23rd February 2023 Lords Chamber

[Lord Markham (Con)]

I thank the noble Baroness for bringing this to our attention; again, I believe that the advantage of these Questions is that they shine the spotlight on particular areas. As the survey pointed out, there are a lot of places which, for very understandable reasons, were swapped over to Covid uses during the pandemic and which now need to be brought back into physio use. That was one of the main recommendations from the society, and we will now write to all the NHS chief executives on the back of that. As the House will be aware, I am doing some work anyway to make more space available as part of the capital programme, so this is very much on my list to make sure that we expand that space and provision.

[Lord Addington (LD)]

My Lords, does the Minister agree that physiotherapists do very little of their work in the actual appointment, and that it is the supervised exercise patterns they give patients afterwards that are probably the most important for all forms of rehabilitative structure? Bearing that in mind, what is the Department of Health doing to make sure that local government has facilities such as swimming pools and gyms that remain open under the financial squeeze?

[Lord Markham (Con)]

I agree with the noble Lord’s point; our estimate is that over half of all physiotherapy takes place outside the hospital environment. Clearly, all sorts of settings, including swimming pools and gyms, are vital for that. The work we have done with the Energy Bill and the caps has been a vital help to those leisure centres, and, thankfully, we are now starting to see bills come done and so these places are on a better financial footing.