Health and Social Care Bill

Lord Elton Excerpts

Wednesday 8th February 2012 Lords Chamber

[Lord Patel]

My Lords, I wish that I did not need to speak at this point because I am really quite torn. I know how sincerely all those who have spoken feel about this amendment, and about emphasising the need to promote mental illness as having the same parity as physical illness. At the same time, I know how sincere the noble Earl is, and therefore it is difficult not to accept what he has said and the promises he has made. None the less, the comment made by my noble friend Lord Walton is the one that has affected me most: what is the key objection to putting these two words at the front of the Bill to signify that mental illness is as important in its management as physical illness?

In my professional life I have dealt with physical illness, but I was always deeply affected whenever I had a patient suffering from postpartum depression or antenatal anxieties and sometimes psychosis; they were the most difficult to deal with. I would then have to seek the assistance of my psychiatrist colleagues.

[Lord Elton]

The noble Lord said that his noble friend was awaiting an answer to his question as to what was the objection? I have understood my noble friend to say that the objection was that it could actually make things more difficult because it would imply that there is a distinction between the two forms of medical treatment, which is exactly what we wish to negate.

[Lord Patel]

I did hear what the noble Earl said and I cannot say that I can accept that it would create difficulties if we included mental illness with physical illness. I do this with a very heavy heart, but I know that if I do not push the amendment, others will do so. On that basis, I think we should resolve the issue by seeking to test the opinion of the House.

Health and Social Care Bill

Lord Elton Excerpts

Monday 28th November 2011 Lords Chamber

[Lord Butler of Brockwell]

My Lords, the problem is not what may be contained in a particular risk register, as the Minister has said, but the precedent that it sets for all other risk registers. There may be nothing in this register that is particularly sensational or has not been released. However, once this case is conceded it will nullify the effect of all risk registers across government. If people think these risk registers are valuable it must be the case, as the Minister has said, that people look at the worst risks and do so frankly, and if they make them anodyne then the purpose of the registers is entirely lost.

[Lord Elton]

My Lords, I hope that the noble Baroness, Lady Thornton, will remember those words when she is considering her next intervention on this matter. Bear in mind that what she says then will be taken as the yardstick of what any Government of her colour are expected to do when they eventually—one hopes at a great distance of time—take our place.

[Lord Campbell-Savours]

My Lords, I understand there is a precedent—a Department of Transport one. Therefore, there is a discretion and the Government are in a position on this occasion and not on a further one. I do not really see that that case is relevant.

Nursing: Elderly and Vulnerable Patients

Lord Elton Excerpts

Wednesday 19th October 2011 Lords Chamber

[Lord Elton]

My Lords, when Florence Nightingale initiated the growth of modern hospitals, the most important thing she did was to insist that nurses should deliver what she called “tender, loving care”, which later became known as TLC, and remained so when I was in hospital in my middle age. Is it not time that the National Health Service assessed the personality of people seeking to embark on nursing careers to see whether it contained enough compassion?

[Earl Howe]

My noble friend is quite right and there is now a renewed emphasis on that very point, with initiatives to help the nursing workforce practise to the highest clinical standards. These include Essence of Care, which outlines quality provision of the fundamentals of care, and Confidence in Caring, which improves nurse interaction with patients. While national initiatives such as those can stimulate thinking and offer guidance on best practice, it is really the local nurse leaders, team leaders, ward sisters and matrons who are key to setting and maintaining standards for quality and safety in their own clinical areas.

Queen's Speech

Lord Elton Excerpts

Thursday 3rd June 2010 Lords Chamber

[Lord Elton]

My noble and right honourable friends, whom I welcome to their respective Front Benches, have inherited the most appalling economic situation. We all realise, perhaps at different rates, that it is necessary to cut many programmes to save money and stop spending money that we have not got. If those programmes are counterproductive, that is a very welcome step to take. My right honourable friend Francis Maude was quite right to say in the election campaign that a system that gives someone more money for staying at home than for going out to work needs to be fixed—and so it does. In saying that, however, he evoked a large and vocal sector of public opinion. With the pressure from that, it now rests on my right honourable friend Iain Duncan Smith and my noble friend Lord Freud to reduce the flow of money going through the welfare system. Indeed, let them do so, but they must be aware that the vocal pressure contains a good many misconceptions. Benefit is not in itself unnecessary or bad; it is in fact very necessary and good when it works as it should, preventing honest people from becoming casualties of circumstances that they cannot control. Yet when it does not work as it should, it not only encourages welfare dependence but can cause the sort of casualties that the system is meant to cure.

Perhaps I may illustrate this, and ask your Lordships to put yourselves in the place of a friend of mine whom I shall report as accurately as I can. You are a retired soldier in latish middle age. Your pension is not yet in payment. Your former wife and her children have long lived in a different continent. You have a number of things wrong with you and are assessed as unfit to work. Your entire income consists of your benefits for long-term disability, housing and council tax. You live alone in a one-bedroom council flat. A good deal of your time is given to helping a solitary, handicapped neighbour to manage his dog, his flat and his shopping. You are, not unnaturally, already somewhat depressed. Suddenly, your whole benefit package—your entire income—ceases. In the past you would have asked why, but you are deeply depressed so you live off the favours from people for whom you will do small services, while brown envelopes accumulate and are binned unopened—until Tuesday, 21 May 2009, when, by the grace of God, you open one envelope. The letter inside tells you that in 10 days’ time, at 9 am on Friday 1 June, the bailiffs will remove you and your possessions from your flat, breaking down the door if necessary.

My first question to Her Majesty’s Government is: why, for heaven’s sake, when a tenant does not reply to their letters for month after month, does a housing authority not do what an ordinary person would, in common decency, and send someone round to see if he is all right? That would have saved a huge amount of money let alone anxiety. Of course, computers do not have common decency unless it is programmed into them—we are talking of institutionalisation here.

Your first reaction to the eviction notice is to go round to St Mungo’s to see whether it will find room for you and to make a small pile of essential belongings to take with you—but at last, and with encouragement, you go to your local authority customer advice centre. The lady at the desk is kind, knowledgeable and patient. Your benefit has stopped because the system shows that you are getting working tax credit. You reply that you would not qualify for it and are not getting it in any case. You are asked to prove it. Nobody explains how you can do that, even if your Post Office account had not already been closed. A second lady, equally kind and knowledgeable, joins the first and rings the Department for Work and Pensions, which says that it can only discuss it with you in person, so you speak to it directly, giving your correct address and correct date of birth. “No”, it says, “That is not what we’ve got on our records”, and cuts you off.

The ladies now agree that it looks as if somebody else is getting the money. They advise you to apply again for benefit and to apply to the court for a stay of execution of the warrant. Close to tears, you take the ladies’ advice and go to the local police station to report a suspected crime. You aren’t very welcome. The person receiving you, who is not in uniform, tells you from behind a plate-glass window that if there was a crime you are not the victim and sends you to an airless waiting room, furnished only with a bench. The door, which can only be opened remotely by someone else, closes behind you—and there you wait with nothing but anger and depression to occupy you for one hour and 52 minutes while other, later arrivals are called forward to interviews ahead of you.

Eventually two courteous policemen, having taken lengthy advice, confirm that you cannot be recorded as a victim of a suspected crime. This has taken a total of two hours and 40 minutes. Is that normal? Or could it be that this treatment is because you are black and your obvious accomplice, a do-gooder who wants to see what treatment you get, does not declare himself as a Member of your Lordships’ House? I leave the question in the air, perhaps to be picked up by the Metropolitan Police.

With the welcome help, which I acknowledge, of the then Minister, the noble Lord, Lord McKenzie of Luton, a senior official in DWP agrees to take an interest, accepting the probability of identity theft. Meanwhile, you get and complete the application for a stay of execution and, on Thursday the 30th, less than 24 hours before eviction is due, you get it, somewhat out of breath, into the court office. It costs you £35 and, for someone with feet like yours, it is a £2 bus ride away from home. You, too, are expected to spend money you have not got.

The bailiffs are now temporarily in baulk, but tomorrow you have to persuade the court to leave them there. On that day you learn that DWP’s involvement has enabled your local authority to resume paying your housing benefit. This does not give you spending money but it does pay your rent and offer the prospect of payment of arrears in due course. That is not enough for them, though—they still want you out. Luckily, unlike many, you have been able to obtain the loan of a substantial amount, interest-free, as a subordinate debt. Offered this, the local authority agrees not to object to your application for delay. That afternoon, the court gives you six weeks in which to get things sorted out. Long enough, you think.

How wrong you are. It takes all of that to get from HMRC, which pays WTC, a letter for the court admitting that it had been paying WTC to someone else. Unfortunately HMRC compounds the difficulty by confusing your identity with that of the man who stole it. Eventually, in mid-August, the court orders payment of arrears at £3.25 a week, which in your circumstances is a significant amount, and suspends the warrant. It still hangs over your head today.

I skip a whole nine-month rollercoaster ride of other difficulties till we get to May this year when, reassessed and transferred to ESA benefit, your housing and community tax benefits are automatically stopped. That is how it works. It ought to take six weeks to get them restored but, although you fill the form in at once and it is taken in over the counter at the Jobcentre where you fill it in, it somehow gets lost and the money is not there in six weeks. The suspended warrant is threatened and you are again told that you are going to be evicted.

In fact that friend of mine is still in place, and is now in receipt of benefit, but I ask my noble friend only my second question: can the Government possibly do anything about this, and will they accept any help that I can give them to get it done? I am talking not about that individual case but about the system that allows these things to happen.