NHS: Hospital Visiting
Debate between Lord Bethell and Baroness Greengross(3 years, 2 months ago)
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Lord Bethell (Con)
My Lords, the noble Lord makes an incredibly powerful point. I agree with him. The point about visitors to the dying was one of the most poignant and hurtful aspects of the pandemic. The stories I have heard personally and in the Chamber on that point have been some of the most moving I have heard in the entire year. He is right that being ill is horrible; being ill and away from the people you love is doubly horrible. We are trying our hardest. Infections in hospitals cost a lot of lives last year. We are mindful of that damage. Another area where we are very mindful is maternity units, where to prevent post-birth depression it is really important that partners are there. We have put in allowances for all partners to be at scans and at the birth, but we are working to try to balance these two competing difficulties.
Baroness Greengross (CB)
My Lords, have the Government considered using vacant hospital land owned by the NHS or unused buildings near NHS hospitals for patient accommodation while rehabilitating, rather than having long stays in medical wards? Have the Government considered the benefits for patients and families? Visiting may be safer and more suitable in this type of accommodation compared with visiting medical wards.
Lord Bethell (Con)
The noble Baroness’s point is entirely right. The focus on hospitals puts huge pressure on hospital administrators to have safe, contagion-free environments. That makes visiting extremely difficult. That is why we are trying to move as much care and diagnostics as we can back into the community, where we have smaller hubs and visiting is much more accessible. Some of that can be done on vacant NHS land. There are also opportunities on the high street, which is not as occupied as it used to be, for those kinds of services. We have £3.3 billion available for discharge. If we have safe, quick discharge, that also achieves the same objective.
Covid-19 Update
Debate between Lord Bethell and Baroness Greengross(3 years, 4 months ago)
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Lord Bethell (Con)
I am extremely sympathetic to the situation that my noble friend and a large number of other people find themselves in. I reassure him that we are seeking a solution to this issue with the EMA, and I am hopeful that we will get there some time soon.
Baroness Greengross (CB) [V]
My Lords, given the significant increase in Covid-19 infection rates in the UK in recent weeks, what assurances can the Government give to people in the social care sector that there will not be a repeat of what happened in early 2020, when 30,000 people in care homes died of Covid-19? What is the difference between making people wear a seatbelt in a car and a face mask on a train? Both are in the interests of health and safety and are surely in the spirit of community consideration.
Lord Bethell (Con)
My Lords, I completely understand the noble Baroness’s concerns about those in social care. In the provisions that we have put in place for the vaccine, I reassure her that we have those who are elderly and vulnerable absolutely at the top of our minds. As she knows, we are putting in place arrangements for a third shot for those who were early on the prioritisation lists, and we are working on booster shots, should those prove to be necessary. The vaccine is our absolute front line in the battle against the virus. We are seeking to protect most those who are in social care, the elderly and the vulnerable, which is why the vaccine arrangements have been prioritised in that way.
Care Homes: Insurance Indemnity
Debate between Lord Bethell and Baroness Greengross(3 years, 6 months ago)
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Lord Bethell (Con)
My Lords, in terms of monitoring, Care Quality Commission data indicates that pressures are being felt by the insurance industry, but these are not translating into reduced capacity, service closures or quality concerns. There is, in fact, a growth in the number of home care agencies since March 2020; for instance, in the east Midlands, there has been a growth in capacity of 9.4%. These are reassuring figures and we are monitoring the situation extremely closely.
Baroness Greengross (CB) [V]
My Lords, there are still many inconsistencies between the NHS and social care. Specifically, will the Government ensure that there is a level playing field between the two in terms of insurance and indemnity?
Lord Bethell (Con)
My Lords, I do not need to remind the noble Baroness that there are profound inconsistencies between the NHS and social care. They are organised completely differently, and the insurance arrangements reflect that. The noble Baroness is right that we are looking for parity of outcome between the two. That is very much our commitment and this is one area in which we are striving to achieve that.
Care Home Occupancy Rate
Debate between Lord Bethell and Baroness Greengross(3 years, 6 months ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, occupancy levels are hard to measure precisely. However, data from providers indicate that occupancy rates in care homes for older people have been adversely affected by the pandemic. We have made over £6 billion available, through grants that are not ring-fenced, to help councils tackle the impact of Covid-19 on services, including adult social care. We have made it clear to councils that this funding can be used to help offset the impact of temporary reductions in occupancy.
Baroness Greengross (CB) [V]
My Lords, I thank the Minister for that Answer. The Alzheimer’s Society is reporting that because of care home deaths and restrictions on visits during the pandemic, some families have had to defer placing their loved ones into care homes. Given this, how will the Government support the sector to ensure that occupancy rates rise again, other than by what he just said? How will this be monitored, given that I recently received an Answer to a Written Question that said the occupancy rates in care homes were not held by central government?
Lord Bethell (Con)
My Lords, I note the intelligence from the Alzheimer’s Society, but I emphasise it is not the responsibility of central government to raise the occupancy rates of care homes. This area is supplied mainly by the private market. Players may choose to leave the market if occupancy rates fall, and local councils have been provided with more than £6 billion that should be drawn on to support the sector.
Crohn’s Disease and Ulcerative Colitis
Debate between Lord Bethell and Baroness Greengross(3 years, 7 months ago)
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Lord Bethell (Con)
My Lords, Covid-19 has hit all services in the NHS. I pay tribute to those involved in the IBD area who have moved extremely fast to anticipate these problems. Rapid guidelines for gastrointestinal and liver conditions treated with drugs have been made available over telephone, email and text messaging services. NICE issued new guidance in August 2020 to advise healthcare professionals on gastrointestinal and liver conditions.
Baroness Greengross (CB) [V]
My Lords, what plans do Her Majesty’s Government have to introduce sanitary bins in public toilets for men? There is a terrible shortage of these, and many men need somewhere to put items such as pads when they have a disease.
Lord Bethell (Con)
I am afraid that the management of public toilets is outside the reach of the department, but I will take that idea back to the department and write to the person responsible.
Health and Social Care Update
Debate between Lord Bethell and Baroness Greengross(3 years, 8 months ago)
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Lord Bethell (Con)
My Lords, from the beginning, we have put in place arrangements for the UK manufacture of vaccines, which, in the light of events, has proved to be a pragmatic and sensible move. We are hopeful that the EU will continue in the spirit of partnership and will respect contract law. I stand by the statement I made on our expectations on the supply of the vaccine to cohorts one to nine and all adults that I articulated earlier.
Baroness Greengross (CB) [V]
My Lords, what is the Government’s response to the 2020 report from Amnesty International which suggests that the Government, while knowing the vulnerability of many older people, failed completely to protect care home residents? People were discharged into care homes without testing, which, according to Amnesty, breached their human rights and contributed to the fact that the UK had the highest death toll in Europe at the time.
Lord Bethell (Con)
My Lords, I simply do not recognise the characterisation that the noble Baroness has just presented. The view of our treatment of the elderly and vulnerable taken by Amnesty during the pandemic is completely inappropriate and inaccurate. Huge steps have been taken to protect those who are vulnerable and elderly. I cannot think of a country that could have done more under the circumstances. I therefore reject its analysis.
Covid-19: Adult Social Care Complaints
Debate between Lord Bethell and Baroness Greengross(4 years, 1 month ago)
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Baroness Greengross
To ask Her Majesty’s Government, following the suspension of all casework by the Local Government and Social Care Ombudsman between 26 March and 29 June due to the COVID-19 pandemic, what steps they have taken to ensure that complaints made during that period were handled in line with the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009; and what steps they are now taking to ensure that complaints about adult social care are handled appropriately.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, it is essential that people can voice concerns about their care and have complaints properly investigated. The ombudsman is a vital part of that process. The ombudsman temporarily suspended its usual procedures to protect front-line services. It has now fully reopened and is working through complaints received during that pause. No one has lost their access to justice because of the pandemic and usual time limits on complaints have been eased to allow for this.
Baroness Greengross (CB)
My Lords, I thank the Minister for his reply. Can the Government confirm that they still intend to introduce a statutory appeal system for adult social care, as originally planned for in April 2020? If so, do they intend to reopen consultation on that process, given that this was last undertaken more than five years ago, and no response was published?
Lord Bethell (Con)
The noble Baroness is entirely right that in April 2016 we committed, in fact sheets about the Care Act, to introduce an appeals process. That is still on the horizon, but this is best placed as an overall reform of the social care system that puts it on a sustainable footing where everyone is treated with dignity and respect. We have, therefore, delayed the implementation of this appeal system until we can make it part of a larger commitment to reforming social care.
Covid-19: Medical and Funeral Expenses
Debate between Lord Bethell and Baroness Greengross(4 years, 1 month ago)
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Lord Bethell (Con)
My Lords, the noble Baroness is correct that the calculation is dependent on close relatives being on social benefit. It is a sliding scale, but it is applied in an open-hearted and generous-minded way, and there are relatively discretionary payments, of up to £1,000 for ancillary costs that go beyond the funeral parlour costs, to try to create the kind of funeral that marks the passing of a loved one. We are keeping this payment under very close review, given its sensitivity, and will review it if there are concerns.
Baroness Greengross (CB)
My Lords, given that the number of deaths in the UK has increased by 60,000 on last year, do the Government have up-to-date figures for the number of public health funeral claims being made to local authorities?
Lord Bethell (Con)
My Lords, I do not have up-to-date figures for the claims up to this month, but the number is expected to have risen. We published refreshed non-statutory good practice guidance this month, for all local authorities, to ensure that public health funerals are delivered respectfully and with care, both for the individuals and their families.
Mental Health Services: Young People
Debate between Lord Bethell and Baroness Greengross(4 years, 1 month ago)
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Lord Bethell (Con)
My Lords, face-to-face appointments are incredibly important for some people, which is why we have emphasised the return to work, particularly in GP surgeries. However, I would like to make the case for internet or telephone services. They have proved to be extremely popular among some mental health patients, who find the direct intimacy of face-to-face too overwhelming and prefer instead to do Zoom or telephone consultations. We are supporting analysis of where these rightfully work and in the meantime are supporting face-to-face when preferred or necessary.
Baroness Greengross (CB) [V]
My Lords, I declare my interests as in the register. Like young people, many older people have suffered a significant deterioration of their mental health during the pandemic. Due to social distancing restrictions, many counselling and other mental health services can be accessed only online. Recent research by the International Longevity Centre found that 11.9 million people in the UK lack the digital skills they need for everyday life, and ONS figures published in May show that only 47% of adults aged 75 and over use the internet. What support will the Government give vulnerable older people experiencing mental health issues, and how will they support those who are digitally excluded so that they can still have access to mental and other important health services?
Lord Bethell (Con)
My Lords, the digital gap in social care, particularly for older people, is enormous, and the noble Baroness is entirely right. NHSX has a large programme called Joined up Care, which is seeking to help bridge that gap. It includes, for instance, the provision of a large number of iPads to social care homes. However, the noble Baroness is right that that will not be enough to provide the care for those for whom digital access is simply too challenging or unavailable, which is why we will continue to support face-to-face and direct forms of care when necessary.
Covid-19: Mental Health Services
Debate between Lord Bethell and Baroness Greengross(4 years, 4 months ago)
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Lord Bethell [V]
I pay tribute to charities and other community projects which have contributed to a wide range of projects across mental health, learning disabilities, dementia, isolation, befriending, domestic abuse, women’s issues and BAME groups. As I mentioned earlier, the Mind and mental health consortia are making recommendations about the progress of the fund. I look forward to their recommendations and we will act on them wherever we can.
Baroness Greengross (CB) [V]
My Lords, one consequence of the pandemic has been increased rates of violence or harm against old, young and other vulnerable people. Increased pressure on people’s mental health during the lockdown will likely have contributed to that. Should the Government make it obligatory for threats of violence, which could be bravado but which could also be dangerous, to be reported to the police as well as to social services, and would such measures help reduce domestic and other forms of abuse and ensure early intervention when someone is having a serious mental health episode?
Lord Bethell [V]
My Lords, threats of violence under any circumstances are reprehensible, and those aimed at the old and the vulnerable are in a category of their own. It is up to the clinical judgment of those involved in social care to decide whether the involvement of the police is of benefit and worth. I would not want to apply a blanket ruling on that, but the noble Baroness makes an extremely important point, which we are constantly reviewing.