(2 years, 5 months ago)
Lords ChamberWe are finding that vaccination is clearly the best way to break the link between catching Covid and hospitalisation. Sadly, a large part of our population still has not been vaccinated. Even with the third booster, 80% of that age group have come forward but 20% of the older age group still have not done so. We are trying to target groups that have not yet been vaccinated to make sure that we offer them the best protection possible.
My Lords, does my noble friend think that an inquiry will be carried out into the Covid pandemic, and if there is one, does he think that it will prove that every mutation has made this virus more transmissible but less lethal?
Undoubtedly there will be an inquiry; in fact, the Government announced that there would be one. There will also be lots of independent inquiries and academics writing about what different countries got right and got wrong. When speaking to my friends who are Health Ministers in other countries, we all say that, looking back, there are things that we could have done differently, in various ways, if we had had that knowledge. But we also have to be very careful about the fallacy of hindsight, and of saying that we would have acted differently had we been in that situation. We can learn from hindsight, and we need to make sure that we do so for future pandemics.
(2 years, 5 months ago)
Lords ChamberI thank the noble Lord for the question and pay tribute to him for his work in this area over many years. He is absolutely right. One of the challenges of this programme is that it is a nine-month course. Clearly, like many things, it was impacted by Covid, with a lack of in-person consultations and appointments. However, the silver lining to the cloud was the digital service. The course was able to move some patients on to digital services and to self-referring. One impact of that has been more people signing up to this programme.
My Lords, is it possible that it is not the course that is at fault but the people who go on it? Has the department not considered charging people a refundable attendance fee to ensure that they roll up?
I thank the noble Lord for his question but what is more important is that we get people who have diabetes on to the programme in the first place. As we adjust the programme to take account of the pandemic, for example, and digital offers, we are also looking at different ways to work with different communities. For example, I was talking to a young girl of Bengali origin in my department the other day. I said, “What do we do about getting to the heart of the communities, given that we are in Westminster and Whitehall?” She said that one of the problems in her community is that, “We love ghee—we love clarified butter, in our curries and our rotis.” We are looking at alternative recipes and menus so that people can still have the same food but it can be healthier.
(2 years, 7 months ago)
Lords ChamberI appreciate the fact that the noble Lord has had his spring booster. I would love to take some credit for it, but that must go to our wonderful health and care staff and how they deal with these issues.
The noble Lord is absolutely right: the waiting list, however big, is too big. However, when we analyse the waiting list on the backlog, we see that 80% of people on it are waiting for diagnosis, not surgery. Of those waiting for surgery, 80% can be seen within a day and do not need to stay overnight. We understand the granularity of the waiting list and are taking targeted action to ensure that it is focused on needs.
Does my noble friend the Minister accept that, last year, the United Kingdom spent, as a percentage of GDP, a higher amount than any other country in the EU? Does he, therefore, also accept that all these internationally poor comparisons cannot be attributed to a lack of money?
My noble friend makes an important point. When you look at the Civitas report, there are a number of statistics where the UK does quite well, but they were not always highlighted. This comes back to the point that this is not only about money; it is about how you spend that money and ensure that you focus on outcomes. One thing we are looking at is better use of the money, for example by using new technology to identify the waiting list and prioritise based on need, as opposed to waiting time.
(2 years, 8 months ago)
Lords ChamberMy Lords, does my noble friend have any idea who the people are who are abusing nurses, how many of them are drunk and how many of them are mentally ill?
I thank my noble friend for his question. When the NHS started investigating and digging deeper into this issue, the assumption was that it was often just members of the public. It is finding that it is individuals who have had a mental health crisis or are suffering from dementia or another neurological condition, rather than the classic perception of members of staff being abused by the public.
(2 years, 9 months ago)
Lords ChamberMy Lords, I begin by thanking the noble Baroness, and the Lord Speaker for allowing us time for this debate. I congratulate my noble friend Lord Lilley on securing the time for Third Reading of the Bill, which proposes a state-backed insurance company for social care. I am sure noble Lords across the House will wish my noble friend a speedy recovery. I thank him for his thoughtful proposal to address the long-standing issue of unpredictable social care costs. As many noble Lords will recognise, there have been many reports over the last few decades and they have just sat there gathering dust on shelves: to date, we still do not have a proper system. The Government wholeheartedly agree with much of the analysis underpinning the Bill and I shall mention but a few of the ideas that stood out for us.
First, we are well aware of the challenges around the private market delivering insurance for social care costs, so we recognise the benefits of delivering insurance through a public not-for-profit company owned and guaranteed by government. I also particularly admired how the proposal addresses affordability by allowing people to pay for the insurance premium through equity on their home. Lastly—this is probably the Bill’s strongest selling point—it would be cost-neutral to the Exchequer. I recognise the opportunity this presents for the savings to be invested in financial support for those not able to access the insurance offer—for example, people who do not own a home.
I reassure my noble friend that his proposal has been carefully considered in the lead up to the announcement of our reform package from October 2023, but I point out that one of the key benefits of the cap and extended means test is that it is a universal offer—universal for everyone, irrespective of age or home ownership. We believe that a universal cap means people can plan ahead for their care from the outset. Knowing that the cap is there will benefit everyone, not just those who own a home. The home ownership landscape is changing over time, and within that context the Government have developed a package of reforms which is future-proof and gives support and certainty to the current generation, as well as future generations.
In addition to the cap, from October 2023, anyone with assets of less than £20,000 will not have to make any contribution for their care from their savings or the value of their home, ensuring that those with the least are protected. Anyone with assets below £100,000 will be eligible for some means-tested support, helping people without substantial assets and ensuring that many more people benefit from funded support earlier in their care journey. We believe that our reforms significantly improve the current system. In developing the reforms, we had to make tough choices, balancing the generosity of the reforms with how much extra we ask taxpayers to contribute and pay for them. My noble friend may disagree with our current formulation of the cap, but we believe the plan is credible, deliverable and affordable. Therefore, while the Government are not convinced that the Bill is the right course of action, we agree with his intelligent analysis that underpins it and, as the noble Baroness, Lady Merron, said, we will debate this further.
I again thank my noble friend Lord Lilley for putting forward this proposed Bill, and for his engagement in discussing our reforms after this debate.
My Lords, I know that my noble friend Lord Lilley will be very grateful for the compliments from both Front Benches and he will be glad that he stimulated so much thought in the minds of the Government, judging by the remarks of my noble friend the Minister. He will probably be watching this from his sick bed but if not, I am sure he will read it tomorrow in the Official Report.
(2 years, 10 months ago)
Lords ChamberWe do not think we should just have a protectionist view on staff. It is important that we recruit British staff from the UK, but we should not have a policy of British jobs for British workers. There are very good staff across the world. Indeed, in some countries they train more staff than they have places for in their health system so that they become a foreign revenue earner. Many people who have looked at the statistics say that remittances quite often are more effective than foreign aid.
Could the Minister say how many agency nurses are being employed by the NHS? Is he not concerned that so many are being employed when they are so much more expensive?
My noble friend makes a valuable point about the cost of agency nurses, which is why we have the goal of recruiting 50,000 nurses. We are looking at completely different pathways to ensure that we can encourage people into nursing. I do not have the statistics with me, but I will write to my noble friend.
(2 years, 11 months ago)
Lords ChamberIssues such as the way private care home owners treat their staff are all part of the consultation that we launched on 6 January. We are working across government and with the devolved Administrations to seek views on the proposed criteria on which the profession should be regulated, whether there are regulated professions that no longer require statutory regulation, and whether there are unregulated professions that should be brought into statutory regulation. The consultation will run for 12 weeks until 31 March, when we will look at the results before taking further action.
My Lords, was the Spectator right when it said that 25% of people over 65 were worth more than £1 million, and is it right that these people should have capped care costs of £86,000, which means that taxpayers on much lower incomes have to pitch in and support them?
As my noble friend will appreciate and probably anticipate, there will be debate on the Health and Care Bill for the next few weeks. I am sure that that is one of the issues that will come up.
(2 years, 11 months ago)
Lords ChamberOne of the issues of technology is how it has changed the nature of work. We have seen over time how older jobs have disappeared and new types of jobs and industries and different working practices have appeared. It is really important to make sure that workers, wherever and whatever times they work, get the best facilities and conditions possible. Sometimes that is done directly by unions, which work with employers and companies, and other times it is done directly, but it is important. One of the things we are looking at in the review is how deprivation of sleep affects many people, especially those who work at night.
My Lords, I totally accept that night work may affect the health of many night workers, but the noble Baroness, Lady Bennett, said that it is bad for the economy. Surely if night work increases, this should increase productivity.
It depends on why people are working at night—it really ranges. For example, when I was a student, I did a night shift from 10 pm to 8 am to pack the shelves for the next day. Sometimes drivers decide to work at night; some Uber or Bolt drivers tell me that they prefer night-time working because the roads are clearer then. There are different reasons—as the noble Lord indicated, sometimes it is the only job available to some people. It is really important to make sure both that customers and others are getting the services they want and that workers are treated decently and with dignity.
(3 years ago)
Lords ChamberIn June 2019 the NHS published a people plan that would improve the NHS workforce, including a dedication to recruit more nurses. We continue to work hard to deliver that commitment. Latest workforce figures show that there are 5,100 more doctors and more than 9,700 more nurses.
My Lords, I will follow on from the question from the noble Lord, Lord Kakkar. Unlike the noble Lord, Lord Rooker, I believe that the Government have ploughed ever increasing amounts of taxpayers’ money into the NHS. Does the Minister think that the Government have got good value for money?
My noble friend makes an important point. What matters is not just the amount that you put in but the way that you spend it. This is why the Government announced the NHS long-term plan to look at where we should tackle issues and the nature of waiting lists and, given that much of the waiting list is for diagnostics, roll out diagnostic centres to meet that challenge.
(3 years ago)
Lords ChamberThe noble Lord makes the very important point that unpaid carers save the state billions of pounds a year with all the work that they do and the love and attention that they give. Sometimes, they do have a choice, but they choose to be carers because they are worried about putting their relative into a home and are not quite sure about that—I understand that. But the fact is that, if they are unpaid, we are looking at how we can support them better. Unpaid carers are very different, and you cannot lump them all into one group: they have different needs and are at different stages of their lives. I emphasise the importance of making sure that we understand how we can personalise that journey for everyone—the cared- for person and the carer. But, if you have given up work, a range of other benefits may be available, and we want to make sure that unpaid carers are equally valued and not penalised for looking after a loved one.
My Lords, following on from my noble friend Lord Lilley’s remark, what percentage of people in need of care will be covered by the £86,000 cap?