(1 year, 5 months ago)
Lords ChamberPerhaps I may take issue with my noble friend about the export of animals for slaughter, which has been a concern of mine for more years than I now care to remember. This is a good time to do it when nothing much is happening; that could change overnight. What is more, countries such as Australia are seriously considering operating such a ban. Here, we could give a good lead, and if the Government want to be at the forefront, now is the time to do it.
(2 years, 6 months ago)
Lords ChamberMy Lords, I thank the noble Baronesses for their questions and for their general welcome for the tone of the Messenger report. I also pay tribute, as did the noble Baronesses, to Sir Gordon Messenger and Dame Linda Pollard for their combination of leadership skills as well as clinical and medical knowledge. I pay tribute too to the number of people who were consulted across the system who fed into the report.
I shall try to address some of the questions that were asked. The Messenger report looked at both health and social care. It was interesting that reference was made to reports being published but nothing being acted on. I think we can be proud that, for the first time, we are now aiming, as is set in law following the passing of the Health and Care Act, for a properly integrated health and care system. We can now work to that properly across the system.
In December 2021, the Government published their strategy for the adult social care workforce in the People at the Heart of Care: Adult Social Care Reform White Paper. Our strategy aims to create a well-trained and developed workforce, a healthy and supported workforce, and a sustainable and recognised workforce. Work that has already started includes the review of the existing workforce and the voluntary register to look at the workforce landscape and the various qualifications. We also want to look at how we make sure that the workforce is professionalised and that people feel attracted to it as a career. The strategy is backed up by an historic investment of at least £500 million for new measures over three years—noble Lords will be aware of that.
Both noble Baronesses raised workforce planning. During the debates on the Health and Care Bill, I made it quite clear that where we disagreed with some of the amendments was on the frequency of the reports that was called for. Let me be quite clear about what we are doing in terms of workforce. First, we have the Health Education England strategic framework to support long-term planning. The department commissioned HEE to review and renew the long-term strategic framework for the health and regulated social care workforce—the right skills and the right values and behaviours to deliver world-leading services. The work is nearing its final stages and will be published before the Summer Recess.
Building on this, we have also commissioned NHS England and NHS Improvement to develop a long-term plan for the workforce for the next 15 years, including long-term supply projections. We will share the key conclusions of this work as soon as it is ready. Section 41 of the Health and Care Act 2022 gives the Secretary of State a duty to publish a report at a minimum of every five years describing the NHS workforce planning and supply system. The report provided for in that section will increase the transparency and accountability of the workforce planning process. On top of this, rather than everything simply being top down—the person in Whitehall or Westminster telling local services what to do—there is also the bottom-up planning, at trust level and ICS level, looking at the right workforce and skills mixes required on the boards and in the services to deliver the right services to patients.
The noble Baroness referred to the North East Ambulance Service. This highlights why this report was so badly needed. My right honourable friend the Secretary of State for Health and Social Care said yesterday in the other place that he was very concerned by what he has heard about the ambulance service and that he is not satisfied with the review that has already been done. He said that we need a much broader and more powerful review; he will have more to say about this very shortly.
We welcome the report. We have rightly said, as both noble Baronesses have said, that we welcome all the recommendations. To ensure that these are delivered as quickly as possible and with the right impact, an implementation plan co-created across the whole health and social sector is required. This report will therefore be followed by a plan with clear timelines and deadlines for delivery.
I am grateful to both noble Baronesses for raising the issue of discrimination and lack of diversity. It is interesting that our public services post war were rescued by immigrants from Commonwealth countries—from Africa, Asia and the Caribbean—yet, amazingly, we do not see them at the top of these organisations. Why is that? Frankly, we must move away from this position of white people stopping black and Asian people from being promoted and fobbing them off as “diversity officers”. They do not want to be diversity officers. We are good enough to be leaders and we must ensure that this is instilled right through our health and social care system, not just at the bottom level but all the way up. That will be the test of true diversity and true openness to equality.
There has been some positive movement towards tackling discrimination. The NHS people plan established a set of robust and comprehensive initiatives thought to imbed equality, diversity and inclusion. The recruitment and promotion practices have been overhauled and there will be named equality champions, but we must ensure that this is not just fobbing off. We need to see more diversity right at the top of our health and care system.
If I have not answered the noble Baronesses, I will write to them.
My Lords, the noble Baroness, Lady Masham of Ilton, wishes to take part remotely, and this seems a convenient moment to call her.
(3 years ago)
Lords ChamberAs the noble Baroness will acknowledge, the MHRA and NICE are independent, but I can, of course, raise the issue with them.
My Lords, can my noble friend confirm that the incidence of breast cancer increases with age? If I am right in that, what plans do the Government have to help older women?
The statistics we have show that four out of five breast cancers tend to develop in women over 50. Therefore, screening is really for women between 50 and 71, which will catch most of them. The 2012 review of breast cancer screening, the Marmot review, estimated that inviting women between the ages of 50 and 70 reduces mortality in the population invited by 20%. It also found concerns about screening women outside those ages and overdiagnosis.