Unpaid Carers: Patient Hospital Discharge

Lord Kirkhope of Harrogate Excerpts

Thursday 19th March 2026 Lords Chamber

[Baroness Merron (Lab)]

I can see the pressure and difficulties that can bring. There is a range of reasons why discharges do not take place in a timely fashion—not just processes but the interface between health and social care, and capacity. As we look at how we involve carers and improve discharge rates, matters of funding will be key.

[Lord Kirkhope of Harrogate (Con)]

My Lords, we live in a world where we have constant criticism, both of government—rightly, quite often—and of many individuals for their behaviour. But here we have a situation where the health service and, indeed, society are being saved many billions of pounds as a result of the work of people who volunteer to care for their relatives and others—those in the voluntary sector, in our hospice movement and all over the health service. Without these people, we would be in real trouble. Is it not marvellous, and can we perhaps commend them and approve of what they are doing both to save us resources and to show that people are basically good?

[Baroness Merron (Lab)]

I am very grateful to the noble Lord. I and the Government are certainly cognisant of the role that unpaid carers play. That is why, last year, we increased the carer’s allowance weekly earnings limit. This was the largest cash increase ever and means that 60,000 additional carers will qualify. That is part of our recognition, but I share the views the noble Lord has given and the comments about my noble friend Lady Pitkeathley and Carers UK—I am grateful to all.

NHS: In-house Software Capabilities

Lord Kirkhope of Harrogate Excerpts

Monday 16th March 2026 Lords Chamber

[Baroness Merron (Lab)]

The straightforward answer is that we are doing exactly that. It is important to say that our front-line digitisation—our move from analogue to digital—is not something for the sake of it; we are doing it because it is improving efficiency and outcomes. For example, a 94% coverage of electronic patient records is expected by the end of this month, and the digitally mature trusts show a 13% lower cost per admission. That is a prize worth having, but we can do it only through the systems and training that the noble Baroness seeks.

[Lord Kirkhope of Harrogate (Con)]

My Lords, I support what the noble Viscount said. The history of software in the National Health Service is nothing less than a disaster. Coupled with that is a very unfortunate situation where some of the companies that have been responsible for these messes in the NHS are still on the Government’s procurement lists and are still getting contracts from the Government. Surely more attention should be paid to that, and we should curb that as soon as possible.

[Baroness Merron (Lab)]

If the noble Lord has particular companies in mind, he is most welcome to raise them with me. It is important that we look at what NHS teams have done: they have designed, built and maintained national platforms. The NHS app is an example; I am sure that many noble Lords will be familiar with it. That is going to be our digital front door to the NHS. In addition, there is the NHS login and core national infrastructure. All these mean full NHS ownership, governance and control. Supported by £2.5 billion of investment in 2025-26, we are, as the noble Lord seeks, expanding NHS in-house digital capability to reduce the reliance on large suppliers.

MBRRACE-UK Report 2025

Lord Kirkhope of Harrogate Excerpts

Thursday 23rd October 2025 Lords Chamber

[Baroness Merron (Lab)]

This Government are committed to closing the black and Asian maternal mortality gap. It is unacceptable that, in 2025, black women are twice as likely to die in childbirth. I was speaking yesterday with a clinician who said that for every woman who dies, 100 women experience a severe maternal morbidity event, such as stroke, kidney failure or acute psychosis, which can lead to lifelong health implications, as the noble Lord has referred to. The maternal care bundle, which we have developed in partnership with MBRRACE, proposes intervention on the issue of blood clots, which are three times as likely to occur in black women and can have tragic consequences.

[Lord Kirkhope of Harrogate (Con)]

My Lords, there are considerable concerns in Leeds about the maternity services in the Leeds Teaching Hospitals Trust, including that the investigations that are now beginning will take a considerable amount of time. Can the Minister confirm that, in the ongoing inquiry into general services, a conclusion will be brought to the investigations in Leeds as soon as possible?

[Baroness Merron (Lab)]

I can give that assurance in respect of services across the country. The independent maternity and neonatal investigation will act at pace. It is an independent investigation and will be chaired by the noble Baroness, Lady Amos. In addition, the Secretary of State, Wes Streeting, is showing how high a priority it is for us to provide urgent action on this by chairing the maternity and neonatal task force himself. These projects will work at pace to bring about the change we need to see.

National Health Service Regulations

Lord Kirkhope of Harrogate Excerpts

Tuesday 16th September 2025 Lords Chamber

[Baroness Merron (Lab)]

My noble friend does himself credit with his honesty, which I too will take example from .

[Lord Kirkhope of Harrogate (Con)]

My Lords, there are concerns about the use of physician associates in many general practices. They are not of course doctors but are now on the front line of giving advice and assistance. Is the Minister satisfied about the way in which these people are deployed? Is she happy that the security of patients is completely safe with the use of these people?

[Baroness Merron (Lab)]

Physician associates often work in hospitals and are there to develop the availability of care. The noble Lord is right to say that there are concerns around physician associates. That is why my right honourable friend the Secretary of State for Health and Social Care announced an independent review to work out where there are problems and what we need to do to make sure that there is no confusion among patients about who is treating them, and also that patient safety standards are upheld.

Mental Health Patients: Discharge

Lord Kirkhope of Harrogate Excerpts

Tuesday 5th March 2024 Lords Chamber

[Lord Markham (Con)]

In a word, yes. We had the rapid review of data in mental health settings. Not surprisingly, in mental health, as in a lot of other settings, ensuring that there is the flow of information so that carers get the right information is paramount.

[Lord Kirkhope of Harrogate (Con)]

My Lords, as a former mental health commissioner, I know that the default position regarding long-term in-patients back in the 1980s and 1990s was to ensure they were given a place in the community. As a result, successive Governments closed down many of our institutions. Can my noble friend comment on the balance between present institutional care and its desirability for many in-patients, and in-patients who are regarded as being in the community but are not necessarily protected sufficiently when they are?

[Lord Markham (Con)]

There is, quite rightly, a balance to be struck. For people with learning difficulties and autism, which noble Lords have debated before, we set a 50% target for that reduction—not 100% because, as has been mentioned, it is not always appropriate as a number of people in those situations need additional support. However, as a general sense of direction I think we all agree that, where we can put support into communities, that is the right thing to do. That is what the £1 billion extra investment is about.

Ultra-processed Food

Lord Kirkhope of Harrogate Excerpts

Thursday 26th October 2023 Lords Chamber

[Lord Markham (Con)]

The noble Lord makes a very good point. A healthy start to life is vital, which is why I am very pleased to say that we have the highest level of free school meals ever, with every infant school kid and a third of children overall having a free school meal. On the composition of those foods, I know that this was planned but was stopped due to Covid. The timing is now being reviewed again, because things move on in terms of the content and healthy foods.

[Lord Kirkhope of Harrogate (Con)]

My Lords, most people would be very concerned to know what ultra-processed food means. People who rely on staples such as bread, cereals, sausages, gravy, fruit juice, baked beans and biscuits would be very surprised to hear us talking about those as ultra-processed food and how bad it is for you. Some people say that five ingredients or more puts food into this category. While we should encourage vegetables, fruit and fresh food of various kinds being eaten, does my noble friend not agree that we are alarming the public too much if we deny them the staples that they are used to?

[Lord Markham (Con)]

That is absolutely correct. My understanding is that ultra-processed foods make up, on average, 60% of a person’s diet. If you were to try a blanket ban, it would have a massive impact. I think we all agree that it is important that we try to discourage things that are bad in ultra-processed food, not ultra-processed food per se. As I have said many times, there are many types of ultra-processed food that we encourage, such as wholemeal bread and many of the cereals.

MMR Vaccine

Lord Kirkhope of Harrogate Excerpts

Thursday 20th July 2023 Lords Chamber

[Lord Markham (Con)]

The noble Lord is correct about trying to make sure that we learn the lessons from all these areas. The approach that they have been responding to so far is very much “horses for courses”. In the last six months alone, they have had four different types of campaign. We do not have the results from those campaigns yet, but the point is a very good one and I will make sure that we get those results from the research and share them.

[Lord Kirkhope of Harrogate (Con)]

My Lords, as my noble friend has referred to, it is very important that young people, children, get vaccinations when they are due, but the current government campaign to encourage adults to have a shingles jab, and indeed other areas, seems to point out—I have heard this from GPs—that the fact that adults are not now taking boosters for things such as tetanus, and other areas where vaccination is so important, means that there is a gap. Does my noble friend not think that we ought to do more to encourage adults to take up vaccinations, renewals and boosters where appropriate to safeguard their health?

[Lord Markham (Con)]

Yes. That is where we really see UKHSA coming into its own in terms of taking an intelligence-led approach. The concern came from its modelling: its epidemiologists brought this up as a concern, which led to the alert going out on 14 July. Likewise, it is looking into other categories and, where there are those concerns, it will come out and suggest such outreach programmes.

Mental Health Services: Huntington’s Disease

Lord Kirkhope of Harrogate Excerpts

Monday 12th June 2023 Lords Chamber

[Lord Markham (Con)]

Yes. The noble Lord has heard me say many times that I have really come to appreciate the Questions format for looking into areas that might otherwise not be seen. I thank the noble Lord and the Huntington’s Disease Association for bringing this to our attention. We have the steps in place but that is a good point about the training.

[Lord Kirkhope of Harrogate (Con)]

I declare an interest as a former Mental Health Act commissioner. Mental health seems to be very much the poor relative when it comes to resources and definitions in our health service. Does my noble friend not feel that we perhaps need to readdress matters such as guidelines for determining mental health? Many issues which arise are about pressures on people in their lives but do not necessarily come within the category of mental health. Would we not be better off having some clearer approach to this in future?

[Lord Markham (Con)]

Our commitment is very much that mental health should be treated just as seriously as physical health conditions. I was delighted to announce today that on the NHS app we are launching mental health digital therapeutics, which are available for everyone to use. I recommend everyone tries them. The idea behind it all is that it is accessible to everyone at any time in their life.

Hospital Beds: Social Care

Lord Kirkhope of Harrogate Excerpts

Monday 19th December 2022 Lords Chamber

[Lord Markham (Con)]

Clearly, if we are going to retain and recruit the key staff in this area, it has got to be a good career, and that means that we must listen to their concerns. I know that Minister Whately is talking to and visiting them all, so it is a key part of the plan. As I say, the fact that we are managing to grow the workforce again shows, I think, that we getting on top of it—but absolutely we need to keep close and make sure it is a good place to work.

[Lord Kirkhope of Harrogate (Con)]

Does my noble friend agree that there are main concerns in some hospitals that dialysis patients are having to be retained in hospital over the Christmas period because of their deep concerns about transport arrangements, partly through the threatened ambulance strikes but also in other ways? Is this not another problem with regard to the bed blocking that we are looking at at the moment?

[Lord Markham (Con)]

The best hospital trusts I have seen have got that absolutely organised. We see a difference in different trusts between as low as 6% bed blocking for social care and over 30%. That depends somewhat on local demography and the amount of care homes, but also on how quickly they can arrange transport, and that is what the best ones are doing, so that cases such as the ones brought up by my noble friend do not exist.

Adult Social Care

Lord Kirkhope of Harrogate Excerpts

Thursday 24th November 2022 Lords Chamber

[Lord Markham (Con)]

I agree with the noble Lord that we need to make this an appealing profession and, as the noble Lord says, that involves more than just pay. We know that retention is vital, so I agree that having it properly recognised professionally is the direction of travel. At the same time, I am very glad to say that, for a lot of the money we are talking about—the £2.8 billion next year, for instance—some 70% will trickle down into wages, so I am pleased that it will actually be felt in the pockets of the carers, which again will help with recruitment and retention.

[Lord Kirkhope of Harrogate (Con)]

Can my noble friend advise us what is in place from the Government to look into the necessary social care of those mental patients who have had to be discharged from institutions and elsewhere, where the history is a very poor one. I speak as a former mental health commissioner. I feel that it is very sad that the community is not able to take care of people who should not be in institutions but in the community. What are the Government doing about this?

[Lord Markham (Con)]

I thank my noble friend. I think we agree that, where care can be considered and put in place in the community, that has to be the best place to do it. These funds are not just limited to care homes. The whole reason that they are allocated through local authorities is that it allows them to put the money where it is most needed in their local area. I have to say at this point that, despite all the issues we talk about, 89% of people are satisfied with the care they receive and 64% or so are very or extremely satisfied. In the context of all this, we have to recognise that the numbers are showing us that this is a service that people are satisfied with.