Social Care Reform

Lord Bishop of Southwark Excerpts

Monday 2nd September 2024 Lords Chamber

[Baroness Merron (Lab)]

I very much take on board what the noble Baroness has said, and I understand that for many, including her, time is of the essence. I have described the long-term plan but there will be endeavours to improve things in the shorter term; for example, trialling neighbourhood health centres, which will bring together a number of services under one roof to ensure that health and social care are provided close to home, so that people can access the care that they need. We will also develop local partnerships between the NHS and social care so that we can get people home from hospital rather sooner than they have been of late—and, indeed, when they are ready. But it is about patient-centred care, which will always be at the heart of what we do.

[The Lord Bishop of Southwark]

My Lords, I welcome the Minister to her post. Does she recognise that one principal reason why fundamental issues around adult social care have not been addressed in the past 25 years is not only the complexity and cost—it is because adult social care is largely invisible and lacks political priority? Do the Government intend to address this?

[Baroness Merron (Lab)]

I thank the right reverend Prelate for his kind words of welcome. I take the point about invisibility in this area, but it would be fair to say that this Government will want to make this extremely visible. It is an issue that will not go away, and also one that is absolutely crucial, not just for those who rely on social care but for the good functioning and provision of the National Health Service. The two are inextricably linked, and we cannot sort out one without the other.

Queen’s Speech

Lord Bishop of Southwark Excerpts

Thursday 9th January 2020 Lords Chamber

[The Lord Bishop of Southwark]

My Lords, I wish to raise the issue of local services that are likely to have a positive impact on serious youth violence, in particular knife crime. I appreciate that the criminal justice system was key to yesterday’s debate on the gracious Speech, and indeed the right reverend Prelate the Bishop of Rochester touched briefly on knife crime in that context. However, I wish to concentrate not on policing per se, nor on the actions of the courts, prison or probation services, but on those of other local agencies.

Clergy from all churches, and ministers of other religions too, are locally based in the communities affected, as are lay ministers, church youth workers and volunteers. Clergy take the funerals, comfort the bereaved, go into schools and seek to provide safe spaces for people to explore a richer and fuller meaning for their life and an identity that recognises the divine image in the other.

The year 2019 was terrible for knife crime in the capital. I was involved in the funerals of two of the victims. The extinguishing of a life, the grief of those who remain, the criminality of the perpetrators and the pervasive and corrosive insecurity these events create for our young people are all too evident.

It is not possible to demonstrate that cuts in funding inevitably lead to violence, but adequate provision for youth services that stress the value of teamwork, structure, mutual respect as a matter of course, value beyond self and the normality of loss and gain bears fruit that will last. They are the immersion in a positive way of life.

I agree with the right reverend Prelate the Bishop of Rochester that the proposal for the serious violence Bill to mandate multiagency working is very welcome. But as a range of national charities pointed out in February 2019, between 2010-11 and 2017-18 local authority spending on children and young people’s services fell by 16%, from £10.3 billion to £8.6 billion. In comparison, the funding provided to them fell by 29% in the same period. Within that, there has been a shift from early intervention through children’s centres and family support to late intervention in safeguarding and children in care. There is some way more to go beyond the Government’s election promise of an additional £500 million if the desired impact is to be made.

For those deeply involved in our local communities, the efforts of the Mayor of London through his violence reduction unit, Young Londoners Fund, educational toolkits for schools and the London Needs You Alive online campaign all need our support. The Stepping Stones programme supporting at-risk young people in transition from primary to secondary school is the sort of initiative additional funding should support.

For our part, in the diocese of Southwark we are working with the group Oxygen on providing a 10-week anti-crime programme in schools. We are working with Power the Fight to train clergy and youth workers to provide spaces for young people in churches. The Southwark diocesan board for education is piloting training across 10 Church of England schools on adverse childhood experiences and contextual safeguarding, in a programme developed by the Children’s Society and EduCare to raise teachers’ awareness of safeguarding and adverse experiences of young people, to improve their life chances. The diocese of Southwark supports the Ascension Trust’s Synergy Network, and its pioneering CEO, Les Isaac, who founded Street Pastors and will next month launch a dedicated website as a network of resources for those doing youth work across the capital.

I trust that members of the Government will be sensitive to the funding of local government youth services and those who seek to enable our young people to flourish.

NHS: Healthcare Data

Lord Bishop of Southwark Excerpts

Thursday 6th September 2018 Lords Chamber

[The Lord Bishop of Southwark]

My Lords, I too express appreciation to the noble Lord, Lord Freyberg, for securing a debate on a subject so full of possibilities for enriching our knowledge and improving the lives of fellow citizens. In England alone the National Health Service deals with more than 1 million patients every 36 hours. The potential use of data is enormous.

The right reverend Prelate the Bishop of Carlisle, who takes a special interest in health matters, is particularly sorry not to be able to participate in this debate. I also congratulate the noble Lord, Lord Bethell, on the quality of his maiden speech. I was, furthermore, particularly grateful for the wisdom of the noble Lord, Lord Kakkar, who spoke from his great expertise in this field. My focus is on mental healthcare data, which was recently highlighted in the Church of England’s toolkit on minority ethnic mental health issues, launched at our General Synod in July.

We know from the Adult Psychiatric Morbidity Survey, conducted every seven years, that one adult in six has a common mental disorder. By gender this breaks down to one woman in five and one man in eight, with the rate for women increasing since 2000 and the rate for men largely static. It is important to know why this is the case. Most mental disorders are more common among those living alone, in poor physical health or unemployed. One should avoid simple remedies, but esteem, living in a community, relational contact, activity and purpose seem to correlate with better mental health.

It is also important to note that there are wider demographic inequalities in who receives treatment for common mental disorders. According to the 2014 survey, after controlling for need, people who were white British, female or in mid-life, which in this instance means 35 to 54—rather younger than the average of fellow Peers—were more likely to receive treatment. Black ethnic groups had particularly low treatment rates. That is a serious matter. Analysing the data by socioeconomic variables demonstrates fewer inequalities in treatment, although people in low-income households were more likely to request a particular treatment but not to receive it.

I appreciate that even a debate as lengthy and as valuable as this is not going to solve systemic issues. It is clear, however, that there are discrepancies in how people are served. In a very different arena from this one—criminal justice—the Lammy report, addressing disproportionality, proposed a standing order of “explain or change”: if the disproportionality cannot be justified, action must be taken to remedy it. In this instance it would be good to know what action will address the failure to treat a category of citizens on the basis of ethnicity.

One of the outworkings of the gospel is the creation of a new society where distinctions do not matter. That is no easy thing, since so much of our security, identity and understanding is based on distinction and difference. Ultimately, however, this is not healthy, and in an area of pathology and treatment where provision is as sadly lacking as in mental health, to make less treatment available where the key variable is ethnicity is not a justifiable way to ration the system.

I have said before, in respect of public service reform, that a failure to include a clear relational element is a great deficit in any programme. I trust that in the wake of the Windrush scandal we may yet be learning that lesson.

Alcohol: Minimum Unit Pricing

Lord Bishop of Southwark Excerpts

Wednesday 28th February 2018 Lords Chamber

[Lord O’Shaughnessy]

As I have said, and reiterate to the noble Baroness, we will look at the impact of minimum unit pricing. We must not just take into account any revenue that we generate and the health benefits that could accrue, but make sure that it provides a fair deal for those who drink sensibly.

[The Lord Bishop of Southwark]

My Lords, the report of the University of Sheffield referred to earlier said that the top 30% of drinkers consume 80% of all alcohol consumed, as measured in pure ethanol; and that, of the beer sold in supermarkets, a disproportionately high amount is sold on promotion—and much of that well below 50p per unit. Does the Minister agree that a floor in the unit price of alcohol would help to yield a more orderly, content and healthy society by bearing down on demand?

[Lord O’Shaughnessy]

The statistic mentioned by the right reverend Prelate is in a way even more alarming because 4.4% of the heaviest drinkers account for a third of all alcohol drunk. A lot of people are drinking sensibly, within the guidelines. We need a system capable of targeting those who are sensitive to both price and health interventions, among those drinking in a way that is very deleterious to their health. We are doing that for a range of interventions—public health and taxation. As I said, we will look at the progress of minimum unit pricing in Scotland as it takes place.

End of Life Care

Lord Bishop of Southwark Excerpts

Tuesday 5th September 2017 Lords Chamber

[Lord O'Shaughnessy]

I agree that there is more to do but progress has been made since the first national framework was published a couple of years ago, building on the work of successive Governments. Staffing is important. There are more early-life nurses than there were seven years ago. More than that, additional training is also going on. This is a really important part of this. Health Education England’s mandate now includes end-of-life care training within various care packages. Indeed, through the Nursing and Midwifery Council, midwives are starting to get systematic end-of-life care training. Given that, unfortunately, 40% of these child deaths happen in the neonatal and newborn setting, that is incredibly important. But I take the noble Lord’s point.

[The Lord Bishop of Southwark]

My Lords, as the Minister has already intimated, the key to delivery of end-of-life care to children and young people is the work of our children’s hospices. Given the 22% figure, will Her Majesty’s Government follow the lead of the Scottish Government and agree to work towards funding 50% of children’s hospices’ charitable costs, to the benefit of the patients concerned, rather than allow the proportion to decrease?

[Lord O'Shaughnessy]

I thank the right reverend Prelate for making that point. In Scotland there are different funding environments. I am aware of the 50% funding commitment from the Scottish Government. We are trying to make sure that CCGs in England not only have the funding they need by increasing NHS funding in real terms but that they understand how to spend it well for end-of-life care, and topping that up where necessary with central funds. So there is a big spending commitment there and with the new accountability framework we have a way of holding those CCGs to account for their performance.