NHS England: Waiting Lists

Lord Bishop of Lincoln Excerpts

Tuesday 16th November 2021 Lords Chamber

[Lord Kamall (Con)]

I hope that the noble Baroness will allow me as much time as her question took to answer. The Government have announced at least £500 million over three years to support the workforce and fund various initiatives. One thing that we are looking at in the Health and Care Bill is how we make sure that workers in the social care sector, whether in private or state-funded institutions, make sure that they earn enough. We have also launched a Made with Care programme, a publicity campaign to encourage people into the social care sector. It involves many existing social care workers, who talk about what a rewarding job it is and how they can make a difference in people’s lives.

[The Lord Bishop of Ely]

My Lords, can the Minister confirm the number of children waiting for treatment for speech and language and for physiotherapy and occupational therapy assessments after their initial assessment? Those treatments are vital for supporting educational development of children as we recover from the pandemic. Are those figures included in the published waiting list figures—and, if not, why not?

[Lord Kamall (Con)]

I thank the right reverend Prelate for that question. Unfortunately, I do not have the statistics with me, but I shall write to him.

Adult Social Care

Lord Bishop of Lincoln Excerpts

Thursday 25th July 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

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

[The Lord Bishop of Ely]

My Lords, we have heard, properly, about the needs of the elderly. Will the Minister assure us that the needs of people with learning disabilities will be better addressed in any action the Government are likely to take, particularly since some 41% of the helpline calls to Mencap in April were from people very concerned about the loss of community care?

[Baroness Blackwood of North Oxford]

The right reverend Prelate has pointed out something very important: a significant portion of those accessing adult social services are actually those of working age and those with learning disabilities. It is very important that does not get lost in the debate. Anything that comes forward as part of the social care solution must address the concerns of that part of the community in a much more effective and joined-up way. Integration of social care and NHS budgets, and effective delivery, will be core to that delivery.

Mental Health: Weight and Shape-related Bullying

Lord Bishop of Lincoln Excerpts

Monday 22nd July 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

The noble Lord is absolutely right that we must make sure we invest in the services needed to respond to the increasing reports of mental ill heath in young people. That is why we have focused on increasing mental health funding. I am pleased to report that the amount spent on mental health will be £12 billion in the next year and that all CCGs will meet the mental health investment standard. We are also investing in particular in suicide prevention over the next three years—£25 million to support local suicide prevention plans to make sure that local authorities are able to have a multiagency suicide prevention response, which I think the noble Lord will agree is extremely important.

[The Lord Bishop of Ely]

My Lords, the Children’s Society has done quite a bit of research into the profile of those involved in bullying. Many have had very unhappy lives. Does the Minister agree that it would be a good idea, in policy formation, if we spent more time talking to the children themselves and getting their case put more fully before us? The Children’s Society advocates that the Government systematically measure children’s well-being and use this to inform policy-making. Does the Minister accept the potential merits of measuring children’s well-being?

[Baroness Blackwood of North Oxford]

As usual, the right reverend Prelate raises an important point. The fundamental principle of using lived experience to develop policy is an important principle within the Department of Health and across government. Most particularly, the experience of young people—those who are bullied and those who are bullying—should be taken into account. This is the only way we will get to the bottom of this problem and stamp it out once and for all.

People with Disabilities: Reporting Abuse

Lord Bishop of Lincoln Excerpts

Monday 17th June 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I thank my noble friend for raising this matter and I am very sorry about the experience he highlighted. One of the measures that has been implemented in order to improve this situation is liaison services between police and mental health trusts to ensure that expertise is on the ground should individuals find themselves in situations such as he described. This has dramatically reduced the number of such situations. I would be very happy to write to him giving examples of where this has improved the situation.

[The Lord Bishop of Ely]

My Lords, it is important to consider also that there are various ways in which people with disability might be prevented from reporting abuse in the first place. In particular, some people with learning difficulties might not understand or recognise that they are being abused psychologically or financially. Does the Minister agree that information regarding abuse needs to be produced in accessible formats, such as easy read, and should ideally be produced in conjunction with people with disability themselves?

[Baroness Blackwood of North Oxford]

Absolutely. The right reverend Prelate makes a very sensible, common-sense point: this is exactly why work is going on between the NHS and the ombudsman to ensure that, within the NHS, there is a sensible and consistent complaints process that is accessible to all who try to make a complaint within the system, no matter their circumstances.

Children: Gaming

Lord Bishop of Lincoln Excerpts

Thursday 23rd May 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

My Lords, the noble Baroness is absolutely right, as ever, on this point. There is a challenge for parents and young people to be more educated and more critically engaged with online harms. The Online Harms White Paper is out for consultation until 1 July and I encourage all Members of this House to engage with that consultation. It is about setting clear responsibilities for tech companies to keep UK citizens safe but also about thinking about how teachers, parents and young people can get the best out of their engagement with the internet. To encourage the noble Baroness, our children and young people’s mental health Green Paper addresses these issues and we shall make sure that we drive that agenda forward.

[The Lord Bishop of Ely]

My Lords, there has been much conversation already about research into gaming addiction among young people. My right reverend friend the Bishop of St Albans raised the issue of a mandatory pause function following calls from healthcare providers. As that was raised again in conversation and discussion around the Online Harms White Paper, will the Minister confirm that the Government are assessing the value of this function?

Children and Young People: Mental Health

Lord Bishop of Lincoln Excerpts

Wednesday 28th March 2018 Lords Chamber

[Lord O'Shaughnessy]

It absolutely is, and the Green Paper covers some of these issues, both in terms of providing resilience for young people themselves and getting social media to act more responsibly.

[The Lord Bishop of Ely]

My Lords, in my area, the diocese of Ely, which covers Cambridgeshire, some young people wait for up to 12 months for effective treatment, and the referral rejection rates are at the highest they have ever been—over 50% in Cambridgeshire. In many cases, voluntary sector organisations are working with us to mitigate the amount of time that children and young people have to wait. Does the Minister agree that 2025 is too long to wait until the changes proposed in the Green Paper are fully rolled out?

[Lord O'Shaughnessy]

I recognise the right reverend Prelate’s point about the rising demand for services. We are trying to increase the proportion of children and young people who are helped from a quarter to a third, but obviously that leaves two-thirds who will not be helped. So there is a long way to go. We are unfortunately starting from a low base; we have to bring together many new staff and teams. I agree with the right reverend Prelate that speed is of the essence, but we must also be realistic about what we can achieve.

Health and Social Care

Lord Bishop of Lincoln Excerpts

Thursday 24th November 2016 Lords Chamber

[The Lord Bishop of Ely]

My Lords, I am grateful to the noble Baroness, Lady Finlay, for bringing this important matter before the House today. The right reverend Prelate the Bishop of Carlisle, our lead bishop on health and social care, cannot be in his place today, but I am glad to contribute from these Benches on his behalf.

The debate brings to mind two principles central to Christian faith and practice: justice for the stranger in our midst and care for the vulnerable. Mosaic law enjoins us not to withhold justice from the outsider. Only yesterday, in conversation, the Secretary of State for Communities and Local Government sought to check that I had heard the words of Jesus, “Love thy neighbour as thyself”. I am grateful to him. This reminds us that the words of Jesus tell us that every care and service given to others is a service given to God.

In the context of the present debate, I want to explore how those principles might be applied to care workers. I trust that the first of these will be upheld in line with the Government’s statement, recorded in the Guardian on 21 September, that the Prime Minister has been clear that she wants to protect the status of EU nationals already living here. In excess of 84,000 EU citizens do the demanding and essential job of caring for vulnerable people in our society, day in, day out. They deserve both our gratitude and support. For their sake, as well as the sake of those they care for, I trust they will continue to be welcome.

As we all know, social care in this country faces a challenging future. Only last week, Age UK and the Alzheimer’s Society reported that some 300,000-plus elderly people are in need of social care but are not receiving any assistance; indeed, my own mother is one of these. With an ageing population, this problem is likely to get worse unless the recruitment of care workers increases notably. It is difficult to see how this can be achieved if immigration policy is changed post-Brexit. According to modelling by the charities Independent Age and the International Longevity Centre UK, if all immigration from the EU were halted there would be a shortage of care workers in excess of 1 million by 2037. A low-migration scenario would still mean a 750,000 shortfall. Even under current migration conditions, the care sector will face a workforce shortage of 350,000 because of the likely dramatic increase in the population needing care.

I cannot stress or praise highly enough the role played by care workers, whether in care homes or through domiciliary care. Care workers play an indispensable role in promoting the health and well-being of millions, mostly elderly or disabled people. Without their intervention, the needs of many vulnerable people would go unmet. Some might go for days on end without any meaningful contact with their families or other human beings. The economic cost to the nation would be immense.

In the past I have been a trustee of a Christian care home and domiciliary care service, and I have seen at first hand the extraordinary work undertaken by care workers over and above what they are paid to do. In spite of that, care workers are seldom given the recognition they deserve, with few attempts being made to make care work a recognised and valued profession. It is therefore no surprise that there is a growing shortfall in the number of care workers from within the resident UK population. Unless underlying issues are addressed, the disparity between care provision and need will continue to grow even if Brexit’s efforts prove to be less damaging than many fear.

The UK care sector is indebted to EU workers, in part because it is difficult to recruit and retain care workers from the existing population, given the poor wages, inadequate training and low esteem in which many care workers perceive themselves to be held. The jobs of current care workers from the EU ought not to be at risk if the Prime Minister’s undertaking is adhered to, but it is really important that the UK does not continue to rely on EU workers solely because care work is attributed such a low status. The pathway to sustaining and developing the care workforce lies in improving the profession, rather than relying on others to do the jobs that many UK citizens are not prepared to do.

The Social Care Institute for Excellence, in its Dignity for Care Workers initiative, set out a series of recommendations for commissioners and providers of social care that would enable workers to enjoy the esteem in which they deserve to be held. These go beyond addressing the persistent problems of low pay and zero-hours contracts, calling on commissioners and providers to offer support and training, proper career pathways and the involvement of care workers in day-to-day decision-making and service improvement.

It is essential that Her Majesty’s Government take effective action to address the concerns of care workers, rather than continuing to rely on low-paid, unqualified positions that offer little job security or chance of advancement. Providing care for an ageing population requires a professional care force that enjoys decent pay, job satisfaction and prospects for personal and career advancement. The current question of admission of care workers from the EU ought not to mask these crucial concerns.

NHS: Accident and Emergency Services

Lord Bishop of Lincoln Excerpts

Thursday 15th January 2015 Lords Chamber

[The Lord Bishop of Ely]

My Lords, I am very grateful to the noble Lord, Lord McColl, for reminding me how pleased I was to be off my trolley in February 2013, when I was admitted as an emergency patient to Addenbrooke’s Hospital in Cambridge. Were it not for the skill and dedication of the surgeons and nurses—and the grace of God—I would not be here now. Like the right reverend Prelate the Bishop of St Albans, I pay tribute to the dedication of staff in our hospitals, not least Addenbrooke’s, from which no one needing emergency treatment is turned away.

I support the thrust of what the right reverend Prelate has already said. The immediate problem for Addenbrooke’s recently, in its critical incident over accident and emergency, was the high intake of unusually frail elderly patients in December. They took up more than 300 of the 700 adult beds available. The number of elderly admissions is bound to double—so the chief executive tells me—in the next 20 years. The only immediate resolution was provided by a release of funding and access to beds in social care by the county council.

I am pleased to commend the even closer co-operation of trusts and social care providers to ease the pressure on A&E and to provide even more joined-up care for the frail and elderly, both in their homes and in nursing environments. The new frailty assessment unit at Addenbrooke’s seems to me a way ahead in offering an overhaul of how hospitals care for the physically and mentally frail patients, and how to keep patients in hospital for the shortest possible time by having such units next to A&E with a resident multidisciplinary team.

I am also very concerned about the CQC’s report on Hinchingbrooke Hospital in Huntingdon. Without wanting to support poor performance, Hinchingbrooke’s best asset is its dedicated staff. The chaplaincy was one department that was praised in the report. I shall visit staff at the weekend with the chaplain. I mention the Hinchingbrooke situation because a longer-term response to this debate needs to be an urgent approach to even closer synchronicity between regional hubs and district hospitals. This will be one such opportunity.

Very importantly, alongside having GP services available in hospitals, we need to rethink how we recruit younger GPs to market towns and semi-rural settings, such as most of my diocese. In Ely itself, an older profile of GP practice is desperately seeking younger colleagues to take on the profoundly important and complex care needs of the very elderly. The experience of Ely is that recruits are not easy to find. When they are found, they do not often stay, because they are not prepared for the multiple and heavy demands placed on GPs providing clinical, social and pastoral care for elderly patients who are desperate to stay in their own homes, which is much to be commended. We need to support our GPs, as I know Simon Stevens plans to do in his proposed strategy for the future of the NHS. However, this needs to be rooted on the ground in how younger people are formed and prepared for the reality of GP ministry among the elderly in our communities.

In December, the chief executive of Addenbrooke’s, the clinical commissioning groups and the county council presented improvement plans to Simon Stevens and the chief executive of Monitor. Here was an opportunity to pool together the most effective joint services and investment in a lively, real and continuous approach, beyond any change of government, to how we unite our health services properly to get beyond immediate crises to a careful and thoughtful response, particularly for the most elderly members of our communities.