Care Quality Commission: Morecambe Bay Hospitals

Lord Bishop of Liverpool Excerpts

Thursday 20th June 2013 Lords Chamber

[Earl Howe]

My Lords, clearly it is a matter for the police to investigate criminal offences and for the Crown Prosecution Service to consider whether the test for prosecuting individuals has been met in this case. It is too early to reach a conclusion about whether this case highlights a gap in the law but if it does, I can assure the noble Lord that we will pursue it. We keep the criminal law under review. It is too early for me to say—I am not a lawyer—whether he is right, but I am sure that his comments will resonate strongly with the House.

[The Lord Bishop of Liverpool]

My Lords, chaplains occupy a unique position in hospitals in relation not just to patients but to staff. Will the Department of Health keep under review the role of the chaplain in relation to both patients and staff, especially when a culture of carelessness and intimidation emerges?

[Earl Howe]

The right reverend Prelate makes an extremely important point. The Government have been very supportive of the concept of hospital chaplains, who play an enormously important role in supporting not just patients but staff. I am concerned because I have heard anecdotally that in some hospitals there are moves to dispense with hospital chaplains. I am in touch with one of his right reverend colleagues about this. Once again, we have a mechanism—if I may call them a mechanism—that could be deployed to good effect in this context.

Social Care

Lord Bishop of Liverpool Excerpts

Thursday 29th November 2012 Lords Chamber

[The Lord Bishop of Liverpool]

My Lords, I begin by declaring that I am not one of the usual suspects in this debate and I hope that the noble Baroness, Lady Pitkeathley, and others will forgive me, as a novice, speaking. I defer, of course, to her experience and expertise and that of other noble Baronesses who have spoken, especially the noble Baroness, Lady Campbell. On behalf of the communities in Liverpool, I thank the noble Baroness for this debate and for the opportunity to consider the impact of the reduced local authority budgets on the welfare of the people of Merseyside, and to localise the debate in that way, if possible.

I do not deny the need to be financially prudent or the need to live within our means. I also understand how difficult it is for the Government to be pressed persistently to fund all the demands on the public purse. The question I want to press in the debate is not whether there should be cuts to the budget but, rather, how assured the Government are that the financial settlement across the nation is fair. In his response to the debate, I would like to hear the Minister say that he is prepared to review the local authority settlement in terms of the provision for social care.

The city of Liverpool is expected to reduce its spending by 52% over the next four years. This cut is more draconian than elsewhere and leaves us asking why the north-west seems to be targeted more severely than, say, places such as London, Bournemouth or Brighton. For people to be able to accept such drastic measures there has to be a sense of fairness across the country. I hesitate to paint the picture of need in Liverpool for fear of giving the wrong impression of the city and of the region. The truth is that Liverpool is a thriving European city, with a vibrant cultural life, three universities and an enterprising business community. The elected mayor is pragmatic politically, seeking every opportunity to gain investment in the city.

However, alongside this cultural and economic renaissance, there are areas of consolidated poverty that demand intervention. We have the highest percentage of people with a history of substance abuse and some of the highest rates of unemployment, cancer and teenage pregnancy. That is why there is genuine fear in the city over the impact of 25% cuts in adult social care over the next four years and 25% cuts in children’s services.

The council knows that throwing money at these problems is not the solution, which is why it is already working in partnerships to maximise the value of the money already invested, and economies are certainly being made through better co-ordination and management. However, save as it tries, there remains an axe hanging over the head of the support services—the home visits and support for the elderly and the mentally ill. If these go under the axe, it will only put more pressure on the front-line services, as we have already heard. To support someone in their own home costs Liverpool City Council up to £250 per week. If you cut these services and the patient ends up in a nursing home, the cost goes from £250 to £550 per week. I would be glad if the Minister could tell us how the Government view this problem and whether they are prepared to be more creative and flexible, channelling between the different silos of policy and funding to avoid the social disaster that might follow. It is demoralising for the city council to analyse the statistics across the country and discover that, far from there being a level playing field, there are staggeringly steep differences in funding across the nation, which makes the pain of applying these cuts even more severe.

I have refrained from anecdotes, although I could give noble Lords many of them. In fact, the cuts and the anecdotes are much greater and more numerous than people are already testifying to, because once these 52% cuts have really kicked in there will be dramatic stories of people who are not cared for in their own homes and further afield. Will the Minister please review the settlement and give us an assurance that these cuts are fair across the country?

NHS: Liverpool Care Pathway

Lord Bishop of Liverpool Excerpts

Wednesday 20th June 2012 Lords Chamber

[Earl Howe]

My Lords, one key feature of the Liverpool care pathway is regular monitoring of the patient—every four hours at a minimum, I believe. That regular monitoring process gives clinicians and nursing staff an opportunity to reassess the patient’s condition to see whether they are in fact responding to treatment, whether they require a different form of treatment or whether the treatment they are being given is unduly burdensome. That regular monitoring should, I think, take care of the point my noble friend raises.

[The Lord Bishop of Liverpool]

My Lords, I have some contact with the Liverpool care pathway in Liverpool. Does the Minister agree that not just palliative care professionals but all healthcare professionals should receive education and training in caring for dying patients? Would he also agree that in the relationship between the two, trust is paramount?

[Earl Howe]

My Lords, the right reverend Prelate is absolutely right. Audits that have been carried out, particularly the recent audit published in December last year, provide us with important information about the current quality of care provision. The recent audit makes a series of recommendations, including mandatory training in the care of the dying for all healthcare staff involved and a seven day, nine to five, face to face palliative care service.

Organ Transplantation

Lord Bishop of Liverpool Excerpts

Monday 27th February 2012 Lords Chamber

[Earl Howe]

My Lords, the report from the BMA was very useful and we are looking at it extremely carefully. It made some useful suggestions about how we might expand the number of donor organs. A number of initiatives have already been taken: for example, there is a prompt when you apply for a driving licence online as to whether you wish to donate an organ. In general, public awareness is being raised in a number of useful ways, which has led to the increase in the number of people donating organs.

[The Lord Bishop of Liverpool]

My Lords, I very much welcome the increase in the number of donors. I have been pastorally involved with the Alder Hey families and seen the devastating effect of the taking of organs without consent, and I have been involved in the burial of 10,000 bodies and body parts. Can the Minister assure the House that in the work towards a more efficient and effective system of harvesting organs, the principle of requiring the consent of next of kin will not be compromised?

[Earl Howe]

The right reverend Prelate is absolutely correct. In England, Wales and Northern Ireland, the Human Tissue Act 2004 requires that appropriate consent be given for the removal, storage and use of material from a deceased person for a range of purposes, including transplantation. Appropriate consent means the deceased person’s consent or that of his or her nominated representative, or of a person who stands in a qualifying relationship to the dead person. There are no plans to change that principle.

NHS: Budget

Lord Bishop of Liverpool Excerpts

Wednesday 23rd June 2010 Lords Chamber

[Earl Howe]

My Lords, that work is ongoing and we have not yet reached any definitive conclusions.

[The Lord Bishop of Liverpool]

My Lords, I declare an interest in that the Church of England is a provider of sessional chaplains in the National Health Service. Given the importance of chaplains to the well-being and recovery of patients and given the value of their work with staff, especially those under stress, will the Minister encourage NHS trust hospitals to resist reducing those services?

[Earl Howe]

My Lords, as I hope was apparent from our debate in the House the other day, the Government attach great importance to chaplaincy in the NHS. The kind of encouragement that the right reverend Prelate speaks of is something that I will consider. I need to be sure in my mind of how best to do that, but his point is well made and I will take it back to the department to see what we can do.