(2 years, 5 months ago)
Lords ChamberWhen we look at the 500,000 number, we are talking about an assessment of any kind. These are not people who are outside the system; sometimes they may be in the system but waiting for another assessment within the system. For example, they could be waiting for Care Act deprivation of liberty safeguards, occupational therapy assessments, the beginning of direct payments or a review of their care. It means they are in the system but just waiting for another part of the system to work. The other thing about the report was that there was a 61% response rate, and it was extrapolated from that. Anyone who has read behavioural economists Daniel Ariely or Daniel Kahneman will know that people are more likely to focus on losses rather than gains and, similarly, in surveys people are more likely to report bad things than things that are going well.
My Lords, does my noble friend accept that what these figures show is that local authorities with insufficient resources are introducing rationing of services to some of the most vulnerable people in the country? Why did we pay more in national insurance if the money was not to be made available to social care until three years down the line and the crisis is now?
I wonder if I could correct my noble friend. The Government implemented a comprehensive review of the programme on adult social care with a £5.4 billion investment over three years from April 2022, of which £1.7 billion will be used to begin major improvements across adult social care in England, including but not limited to £500 million investment in the workforce and £150 million to improve technology. As many noble Lords recognise, for too long this sector has been neglected. In some cases, there is a lack of understanding about the breadth of the sector. We are trying to understand it and get people to register, and then we can improve it.
(2 years, 8 months ago)
Lords ChamberIf I was aware of any scientific advice that had not yet been published, I am not sure whether I would be unaware of it. I will try to find out. The Government have laid out the terms of the inquiry; only last week I sent the link to some people, which I am very happy to send to the noble Viscount, for the points that should be considered by the inquiry. During the pandemic, and even now, we continue to receive a wide range of scientific advice. The wonderful thing about scientists is that they continue to debate with and contest each other. Some say that we should never have had these measures, some that we lifted them too early, and some that you can never get the timing right, whatever you do.
My Lords, as we enter an economic war, are the Government not absolutely right to balance the scientific advice with the economic consequences, and that by pursuing the policies which they have since before Christmas, they have put the economy in a strong position which guarantees that we can do as much as we can to help the most vulnerable people in our country?
I thank my noble friend for making that point. It is incredibly important, not only within the medical community, where we were asked, for example, to lift some restrictions so that we could start tackling the backlog. We were asked `by mental health experts to ensure that people were getting access to mental health care who had been unable to because of the pandemic. We have also balanced this against economic and social considerations—sometimes these things affect each other. Being unable to work and facing uncertainty can be one of the most destabilising things and can affect people’s mental health. My noble friend is right that we have had to balance a number of issues in the round.
(2 years, 9 months ago)
Lords ChamberMy Lords, does my noble friend not recognise that some people have very short memories? If we look back, there was huge demand globally for PPE. The press and the public were screaming for supplies to be provided. People worked round the clock, and of course they ended up paying over the odds in such a situation. Politics is fine, but to try to score points against people who did their best in the interests of public health and who were not bean-counters is really unworthy.
My noble friend makes a very important point. We should completely pay tribute to all those who worked as hard as they could during a time of panic. I remember that the leader of the British Medical Association said:
“This really is a matter of life and death. In what is an incredibly challenging time, doctors and healthcare staff should feel as equipped and supported as they need to be able to deliver care for patients.”
You cannot put a price on that. We had to buy equipment from wherever we could to help make sure that we kept our staff safe.
(2 years, 10 months ago)
Lords ChamberMy Lords, this has been a fascinating discussion and debate. I recall watching the debate on the Private Member’s Bill of the noble Baroness, Lady Meacher, a few weeks ago; I remember thinking that that was Parliament at its best. The arguments on both sides are fascinating—thank goodness I was not the Minister responding.
I thank my noble friend Lord Forsyth for assuring me today that we were not going to re-open the whole issue but talk only about the merits of the noble Lord’s amendment. Before I turn to his amendment, I will start with Amendment 203 tabled by the noble Baroness, Lady Meacher.
It is incredibly important that everyone at the end of their life, whether or not they have been diagnosed with a terminal illness, has the opportunity to discuss their needs, wishes and preferences for future care, so that these can be taken fully into account. There is ongoing work across the health and care system, as the noble Baroness, Lady Finlay, alluded to, to support this aim, including a commitment within the NHS Long Term Plan to provide more personalised care at end of life, and a recently updated quality statement from NICE on advanced care planning. In addition, we have established the ministerial oversight group on Do Not Attempt Cardiopulmonary Resuscitation, following the CQC’s review of this during the Covid-19 pandemic. This group is developing a set of universal principles for advance care planning to further support health and care professionals in having appropriate and timely discussions with individuals at the end of life. We believe that patient choice is a powerful tool for improving patients’ experience of care, and we intend to ensure that effective provisions to promote patient choice remain. However, I do not feel it is appropriate to specify the level of detail included in Amendment 203 in the Bill, and I hope the noble Baroness, Lady Meacher, will consider withdrawing her amendment.
Let us now turn to the amendment that has been much discussed. As many noble Lords have rightly said, it is a long-standing position that any change to the law on assisted dying is a matter for Parliament to decide, rather than one for government policy. Assisted dying remains a matter of individual conscience, on which there are deeply held and very sincere views on all sides. Sometimes these are informed by one’s own experience of family members; other times, these are informed by one’s faith. You can rationalise it, or argue, but people have very strong feelings on both sides.
Noble Lords are aware of the Private Member’s Bill of the noble Baroness, Lady Meacher, on this subject, and we look forward to further debate in Committee when parliamentary time allows. I will commit to discussing this with the Chief Whip, given the request that was made. But as this matter is so important and is a matter of conscience, we cannot take a partisan position. If the will of Parliament is that the law on assisted suicide should change, the Government would not stand in the way of such change but would seek to ensure that the law could be enforced in the way that Parliament intended.
I am most grateful to my noble friend. Could he just clarify what he said? Did he say that there was a possibility that time would be made available for the Bill of the noble Baroness, Lady Meacher?
I am afraid that I cannot give that guarantee. I will commit to speak to the Chief Whip about whether time could be made available.
(2 years, 10 months ago)
Lords ChamberI thank the noble Baroness for giving me the opportunity to say what the Government are doing right now. We are working closely with ambulance services, NHS England and the Association of Ambulance Chief Executives to reduce the handover delays. The 10-point plan I referred to earlier goes into detail about how we handle this, both in handling calls at call centres—some calls are not emergencies, for example, and patients are directed elsewhere—and in making sure that the wider system is available to make sure that patients are unloaded within the 15-minute target and that ambulances are turned around as quickly as possible. Where we have spotted disproportionate pressures in the system, as in the 29 hospital trusts across 35 sites, we have focused more resources there.
My Lords, I appreciate that my noble friend has to read out what he has in his brief, but would he take time to read the report on social care published by the Economic Affairs Committee of this House, which received pretty well universal endorsement? Will he then discuss with his colleagues whether we really have fixed social care and whether the resources he is claiming are sufficient to meet the problem?
I thank my noble friend for drawing my attention to the report and the work of that committee. I will commit to reading the report and look forward to future discussions with my noble friend and many noble Lords across the House.
(2 years, 10 months ago)
Lords ChamberAs the noble Lord says, pay is one of the important issues when people consider what career to take, but also how much that career is valued. One of the reasons we are looking at this voluntary register, but also the skills passport, is to understand the current layout of the sector. There are a number of different qualifications at the moment and before we consider what should be mandatory and make sure that everybody is aligned in terms of qualifications, we want to understand the care force out there. Some 56% of those in the care sector, for example, do not have any qualifications and we want to make sure that we address that.
My Lords, the Economic Affairs Committee report of some two years ago estimated that £8.6 billion was needed just to get back to where we were 10 years ago. This money, which the Government are promising, is not available now. The need is now and the Government themselves have said that they want to deal with the problem of beds that are blocked in the NHS. That can happen only if the care workers are there and encouraged to be so, and that is about training and pay. At the moment, really good, wonderful people get paid more for stacking shelves in Tesco than they get for carrying out this work. Will my noble friend persuade the Treasury that this money needs to be made available now?
My noble friend makes a very important point that we need to make sure that this is an attractive career and that people feel valued. One of the reasons we launched the Made with Care campaign in November, which is running over five months, is to attract more people to the sector. Some of the money we have made available is to make sure that the sector is more attractive to people who want to work in it and that people in local authorities push the care home owners to pay their staff more.
(2 years, 10 months ago)
Lords ChamberI begin by wishing the noble Lord and all your Lordships a happy new year. We have started the national discharge task force, with membership from local government, the NHS and national government, and we have looked at the different pathways. There are four pathways: one is direct discharge, one is interim discharge, and one is for those who need a bit more support. But then sometimes individual cases are quite different; sometimes a place is offered, but the family may not be happy, so we have to find other ways. One thing that the national discharge task force has been doing is to look for spaces, wherever they may be, across the health and social care system to see whether they would be suitable for interim—but we are looking at all sorts of solutions in partnership with local authorities.
My Lords, while I welcome the very substantial additional resources given to the health service, will my noble friend revisit the decision to delay making money available for social care purposes? That money is needed now to finance the care workers and finance those places in care homes. Without it, we will continue to see bed-blocking, so it is a policy that is self-defeating.
My noble friend makes an important point. In the White Paper, People at the Heart of Care, we have set out our vision for adult social care and outlined our priorities. Throughout the pandemic, we made available nearly £2.9 billion in specific funding for adult social care—£1.75 billion for infection prevention and control, £523 million for testing and £583 million to support workforce capacity and recruitment, as well as all the other measures that I have previously referred to as part of the task force.