Advertising Restrictions on Less Healthy Food
Debate between Lord Kamall and Baroness Blake of Leeds
Baroness Blake of Leeds (Lab)
The noble Baroness is right, and I have alluded to this in my previous answers. The issue of tackling obesity is multilayered and complex. We have the evidence based on experience that working with families and creating excitement around healthy food is incredibly important. One of the most important things we have done, just in the last week or so, is announce mandatory healthy food sales reporting, making sure that shops take responsibility. It is heartbreaking walking into big supermarkets and seeing the amount of shelving space dedicated to attracting young people that, quite frankly, does not live up to healthy eating standards.
Lord Kamall (Con)
My Lords, as a number of noble Lords have said during this Question, there have been many top-down efforts over the years to reduce unhealthy eating and obesity, but they have all had variable levels of success. Noble Lords have said that it is important that we work with local families. Some of the best organisations, such as BRITE Box or FEAST With Us, which work with local families to help them eat healthily on a budget, are doing fantastic work in our local communities. Rather than always top-down solutions and bans, what are the Government doing to work with local community organisations to ensure that they get to families to help them to budget and eat healthily?
Baroness Blake of Leeds (Lab)
I completely agree with the noble Lord and I have personal experience from my background. It is empowering when a parent presents at a community organisation with a child who has an eating disorder or who is becoming obese, and they work together through cooking, education and shopping. All those things are fundamental and they need to be reinforced in schools, and I agree with the noble Lord that we need to tackle this on all levels. We obviously have to have the top-down measures that we were talking about earlier, but changing habits is going to be transformational.
NHS 10-Year Plan
Debate between Lord Kamall and Baroness Blake of Leeds(6 days, 14 hours ago)
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Lord Scriven (LD)
My Lords, we on these Benches welcome the Minister to her place. I know that, when I say that we hope that she is not too long in her place and that the noble Baroness, Lady Merron, is with us again soon, she will understand that I say it in the nicest possible way.
From these Liberal Democrat Benches, our unwavering commitment to the NHS remains absolute. We welcome any stated ambition to improve the health service, particularly with a focus on prevention, leveraging technology and moving care closer to people’s homes. However, our support is contingent on plans being genuinely deliverable, properly funded and, crucially, addressing the interconnected crisis in social care. We have long championed that you cannot fix the NHS without fixing social care.
I confess that, as I read the Government’s new 10-year plan, a familiar echo resonated through my mind. Having started my career in the early 1990s as a manager in the health service, much of what is proposed sounds eerily familiar. This plan speaks of a network of new neighbourhood-based care that provides services between general practice and traditional general hospitals. This mirrors strikingly similar initiatives from previous governments—echoing, for example, the advocacy of the noble Lord, Lord Darzi, for polyclinics in 2007.
What does history teach us about such wholesale shifts of care from hospital? It tells us that this inevitably involves running the old and new systems simultaneously, which is, without exception, expensive. Hospitals will continue to perform their essential functions, and their fixed costs will remain. The new community service demands significant new investment in buildings, staff and technology, and there are no immediate savings to fund the shift. Let us not forget the stark reality: we currently lack the capital simply to repair our existing crumbling health estate, let alone build numerous new hubs.
Crucially, for any plan that speaks of shifting care out of hospitals, the most frequent users of the NHS are our elderly population. Keeping them well and out of acute settings profoundly depends on effective social care, yet this essential pillar remains largely absent from this new plan. We search in vain for a decade-long funding and development road map for social care, or for a stand-alone, fully resourced social care strategy. This is a crucial strategic failure, undermining the very foundation upon which this shift to community is based.
Moreover, while the enthusiasm for digital transformation is understandable, the detailed implementation plan of how to do it is absent. The app is a diagnostic tool; it does not provide direct care, it does not give the jabs and it does not provide the treatment. The King’s Fund has shared its concern on this:
“AI scribes can only transform the productivity of the NHS if staff don’t need to spend 30 minutes every morning logging into multiple out-of-date IT systems”.
The fundamental question remains unanswered: how will this be delivered? The plan is ambitious, but it has been launched into an incredibly chaotic delivery environment marked by significant structural change within the health system bureaucracy. The key question for the Government is how this will be delivered. I therefore have a few questions for the Minister.
What precise funding strategy is embedded within the 10-year plan to deliver the necessary reform and integration of adult social care? Given the dual running costs of new neighbourhood health facilities, can the Minister provide a year-by-year financial breakdown of expenditure and demonstrate how these investments will lead to overall system efficiencies and net savings? Will the Minister commit to publishing within the next four months a comprehensive, independently overseen delivery road map for this 10-year plan that details specific year-by-year objectives and names leads and mechanisms for public reporting on progress? While we wish the ambitions well, the key challenge for this Government is how they will deliver and being open and transparent on that.
Baroness Blake of Leeds (Lab)
My Lords, I also start by sending my very best wishes to my noble friend Lady Merron. No one more than me is looking forward to her making a very speedy recovery. I am very pleased to hear from her that she is making good progress, so we look forward to her return. I think it is appropriate that I declare an interest: my son is a GP, which I think is perhaps slightly relevant to the debate before us today.
To recap before I go into more of the details, I emphasise that this plan is different in so many ways to the NHS plans that have come before it. As we have heard, it is a road map for radical reform that is built on three fundamental shifts. Those of us that have been around the health agenda for a while recognise the past aspiration for some of these measures, but there was never a bold, innovative, collaborative plan to take our ambitions forward.
From hospital to community care, bringing care closer to home and making access to GPs faster and simpler is absolutely fundamental, particularly in the current climate—and from analogue to digital, giving staff modern tools and patients the kind of convenience and control they expect elsewhere in their lives. All of us have heard heartbreaking stories of patients who go from one specialist to another, and there is not that join-up. This has to be changed. There is no reason why this cannot apply across all the experiences the public have, regardless of where they are seeking services.
Many of us have been talking about the need to move to prevention in so many areas of life. Where better than people’s health, looking at the root causes of poor health and making healthy choices? It is the easy choice, but at the moment it is not that easy.
The new NHS has patients at its heart, will deliver equity and quality, is devolved and decentralised so that we are more responsive to local community needs and the front line is freed up to harness innovations, and the rules and incentives in the system support clinicians and lead us locally to be able to make the right decisions. This means that there is no simple chapter or section within the plan for individual conditions or groups setting top-down actions. The impact on particular services and outcomes will be through successfully transforming how our health ecosystem works. As we will come on to with the more specific questions, this is very much a work in progress. I am delighted by the reach the consultation has had over the last year. That has informed the debate and the outcome that is seen in the plan, so there have been no surprises. Many people who have been involved recognise what is in the plan.
The plan is backed by £29 billion per annum of extra investment by the end of the review period and, crucially, by a drive to cut unnecessary bureaucracy and empower front-line staff, giving them the tools to do what they do best: caring for patients.
I thank the noble Lord, Lord Kamall, for his very constructive comments; they were exceptionally helpful. Across the House, we all look forward to taking this extremely seriously and moving forward.
Turning to the comments of the noble Lord, Lord Scriven, on social care, he and I share a very positive background in local government, and nothing could be closer to our hearts than working out how we are going to bring the two together. That is fundamental. Both noble Lords made the point very clearly, and we welcome that.
Over the next three years, we will focus on the neighbourhood health approach to those most let down by the current system. That includes older people with frailty and those in care homes. Social care professionals will work alongside NHS staff in local teams, supporting recovery, rehabilitation and independence. We have examples from around the country where this is already happening: services are joined up and the cultural differences between the NHS and local government have been successfully broken down. We need to make sure this is replicated and spread to every part of the country. We need to enable care professionals to take on many more health-related responsibilities, such as blood pressure checks and reducing avoidable hospital administrations. Of course, pay terms and conditions have to be improved through fair pay agreements.
In the longer term, the noble Baroness, Lady Casey, will produce an interim report next week, but it is very much a work in progress.
Baroness Blake of Leeds (Lab)
Sorry, I meant next year—I was just testing that everyone was still with us—in anticipation of the in-depth work she is already involved with. There will be cross-party discussions and a real engagement with stakeholders.
On the single patient record, I will have to write to the noble Lord about how the merging of the different systems will be achieved, but it will very much be about the patient being in control and giving a full picture for staff moving forward. The digital red book for children is absolutely fantastic.
On the shift to the community, as we have made clear, we will initially prioritise those living in areas of greatest deprivation. We will be opening neighbourhood health centres in places where life expectancy is low. There will be principles that we will follow, bringing all the multidisciplinary teams together.
On the fracture liaison service, I will have to respond in writing. I am sorry but I do not have the specific details in front of me.
Returning to the noble Lord, Lord Scriven, and his comments about social care, it is critical that we get this right and make sure that local leaders are right in there, responsible for delivery, proactive, providing a co-ordinated response and building on the work already being done.
On the funding, £29 billion is quite a significant amount of resource to work from. We recognise that there are challenges, and it would be wrong of me to pre-empt the work of the noble Baroness, Lady Casey. But I know she has been encouraged to work with the best of the best, and I look forward to the outcomes.
I have to finish—I am sorry; there is never enough time. Our health system is in crisis, and we need to act now. We must make sure that the NHS continues as a publicly funded service free at the point of use. We need to seize the opportunities provided by all the new technologies and medicines outlined in the plan, go forward with innovation and make sure that the patients are at the heart of everything we do.
Covid-19 Update
Debate between Lord Kamall and Baroness Blake of Leeds(3 years, 7 months ago)
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Lord Kamall (Con)
I understand the frustration of the noble Baroness and a number of civil libertarians, but we have always been clear that we have to have a balance between keeping the British people safe by being cautious and making sure that we follow the data. We have always looked at a number of different factors, including hospitalisations, the proportion of admissions due to infection, the rate of growth in cases, vaccine efficacy and many others—but, quite clearly, when we see this doubling rate of the omicron variant and do not yet have enough data, we are being cautious. By doing this now, we could prevent a worse situation later.
Baroness Blake of Leeds (Lab)
My Lords, when you go on to your app, you do indeed get a message that says, “There are currently issues with accessing the Covid pass on the NHS app and the website”. Given that the advice is that this mandatory certification will be required from Friday, this is an issue not only for the individuals trying to access the certification but for the venues. Can the Minister assure us that, if the problem continues, there will be clear advice to venues as well? Otherwise, there will be untold chaos when this comes in on Friday.