Young Disabled People: Social Care Services

Lord Laming Excerpts

Tuesday 28th January 2025 Lords Chamber

[Baroness Merron (Lab)]

It certainly does. The noble Baroness has been positive about the plans that we have for the independent commission, led by the noble Baroness, Lady Casey, to resolve once and for all, on a cross-party basis, adult social care. The noble Baroness makes a very good point about the role of carers. Indeed, when we think of a young carer particularly, it is crucial that their needs are considered and that support is given. It is part of the whole way in which we support someone who needs social care, no matter what their age.

[Lord Laming (CB)]

My Lords, when the Public Services Committee took evidence on the transitional arrangements for young people with disabilities, we experienced two extremes in that evidence. One was that the transfer from education services to social care services was badly handled in a lot of authorities. As the noble Baroness, Lady Monckton, said, it felt like falling off a cliff, with young people then described as unemployable. The second, which was quite inspiring, was where local authorities had established a local hub where employers could meet these young people. They discovered there things that could benefit both sides, and that the young people blossomed in work. Will the Minister do everything possible to encourage the second?

[Baroness Merron (Lab)]

The noble Lord is correct to reference the committee’s findings. People should not be written off as unable to work. It is about getting the right support in place, with the right provisions and at the right time. I certainly share his view. That is why we are working across government to achieve the very thing that he talks about.

Health and Social Care: Winter Update

Lord Laming Excerpts

Tuesday 21st January 2025 Lords Chamber

[Lord Laming (CB)]

The Minister will be pleased to know that the House was glad that she referred to social care. Every day in the winter there are thousands of patients who no longer need to be in hospital; it is not good for them to remain in hospital, and it is not good for the NHS that they remain in hospital. In addition to the considerations of the social care commission, which will take some time to go through, will it be possible to have a proper endeavour to address these issues before next winter? As the Minister said, there always seems to be a winter crisis now. Would it be possible to get local government and the charities together, but also—and this is not difficult to do—to respect the role of unpaid carers and to provide support for people who are, in effect, taking over the care of patients who would otherwise remain in hospital?

[Baroness Merron (Lab)]

The noble Lord is right to remind us of the challenge of having people in the right place, rather than in hospital when they do not need to be there. We have already taken action, so I am pleased to be able to reassure him that, while the noble Baroness, Lady Casey, will look at long-term solutions for social care, she will present a report within a year from her commencement, which will add to the actions that we have already taken.

The noble Lord talked about unpaid carers—and I certainly share the respect that he holds for unpaid carers, so I am very pleased that we have given the biggest boost in income to family carers through eligibility for the carer’s allowance. That has meant an additional —on average, of course—£2,300 a year. That is the biggest boost since carer’s allowance was introduced in the 1970s. We are also legislating for a fair pay agreement, for the first time ever, which will help to tackle the number of vacancies, now standing at 131,000. There will be immediate action, because discharge requires being able to be in the right environment, which might be home but it might need an adaptation. Through the disabled facilities grant there will be a further 7,800 adaptations to homes both this year and next year. So we have taken the immediate action—and, yes, there is a lot more to do.

Adult Social Care: Long-term Workforce Plan

Lord Laming Excerpts

Monday 13th January 2025 Lords Chamber

[Baroness Merron (Lab)]

I myself have seen some tremendous examples of the use of technology in allowing people to be in the right environment for themselves and their situation. I assure the noble Lord that we are continuing to work to develop medical technology, not just getting it rolled out and applicable but developing new medtech where necessary.

Perhaps I could use this opportunity to make an allied point. We have also published new guidance on safe delegation to care staff, which I hope will also help professionalise the workforce. We are working to support that across the country. That includes, for example, having care staff taking blood pressure. These are simple but obvious measures that I think work for everybody.

[Lord Laming (CB)]

My Lords, the Minister will realise that the workforce in social care is not as varied as in the National Health Service. However, that is not to underestimate the fact that there are staff working in clients’ homes, day centres, residential units and office-based organisations. Will she ensure that, when the workforce is being considered in social care, it will be considered in the round and not just in a narrow way?

[Baroness Merron (Lab)]

I can give that assurance to the noble Lord, and I am glad he has identified to your Lordships’ House the wide range of circumstances in which the workforce might be. For the benefit of your Lordships’ House, I should add that, in their manifesto, the Government made a commitment to

“ensure the publication of regular, independent workforce planning, across health and social care”.

We are currently developing advice on the options about how to fulfil this commitment for adult social care, which will take account of the point the noble Lord made.

Health and Adult Social Care Reform

Lord Laming Excerpts

Tuesday 7th January 2025 Lords Chamber

[Lord Laming (CB)]

My Lords, the Statement is most welcome, not least the attention given to social care services. I congratulate the Minister and the Government on striking that proper balance between health and social care. The issues are hugely challenging, very expensive and important for the whole of society, especially if the National Health Service is to survive and prosper, for reasons that the Minister has touched on. The issues in social care range from recognition of the very important contribution of unpaid carers to the fact that a large number of local authorities face financial problems which place their future in a degree of jeopardy. The commission to be chaired by the noble Baroness, Lady Casey, will tackle these and many other issues, but we have to get through the immediate situation. Can the Minister assure the House that, in taking the social care agenda forward, from today these matters will be kept in sharp focus and handled with great vigour and determination?

[Baroness Merron (Lab)]

I am pleased to give that assurance and thank the noble Lord for his welcome for these measures. As I mentioned earlier in response to opposition Front-Benchers, we have not waited. In the last six months, we have made a number of immediate changes. He mentioned carers, and it is worth emphasising that, as I said, the increase in carer’s allowance is the largest since the 1970s. It will mean roughly an extra £2,300 a year for family carers. That is extremely significant. This House rightly presses me on the need to recognise carers, in particular unpaid carers, which we have done. The whole range of measures I described earlier will show our direction. I look forward to the noble Baroness, Lady Casey, publishing her first report next year. Those recommendations will also be there straightaway. We are doing this on all timescales.

National Carers Strategy

Lord Laming Excerpts

Tuesday 19th November 2024 Lords Chamber

[Baroness Merron (Lab)]

I certainly agree with the emphasis that my noble friend is putting on the need for cross-government working. I know she has been a champion of that for many years in the other place and that she will continue in your Lordships’ House to ensure that unpaid carers are properly supported and recognised. I can tell my noble friend that Minister Kinnock, as the lead Minister for unpaid carers, regularly engages with those with lived experience, the organisations that represent them and—importantly to the point my noble friend is making—with Ministers from other government departments, most recently the Department for Work and Pensions. We will be formalising our cross-government working with relevant departments and NHS England.

[Lord Laming (CB)]

My Lords, if the Government are going to achieve their ambition to delay admissions to hospital and get people out of hospital more quickly, does the Minister agree that we have got to have proper support for carers? In particular, we should enable them to feel valued for what they are doing on behalf of their family and society as a whole.

[Baroness Merron (Lab)]

I agree with the comments and observations of the noble Lord. I would like to put on record, as I know many Members of your Lordships’ House would want to do, my thanks for and acknowledgement of the role that unpaid, as well as paid, carers play. They are the difference between quality care and less than optimal care. Their support is greatly valued, so I thank the noble Lord for making that point.

NHS Continuing Healthcare

Lord Laming Excerpts

Monday 2nd September 2024 Lords Chamber

[Baroness Merron (Lab)]

I thank the noble Lord for his welcome, and I welcome him; I hope we have set the standard on this first Question on the first day. What matters is that people are getting the right care in the right place, and that it is provided near to where they want it. We think that continuing healthcare is one means of doing that; of course, care homes are another. It is about getting in place what is right. I will be very pleased to speak to the noble Lord outside the Chamber on this matter.

[Lord Laming (CB)]

My Lords, I too welcome the noble Baroness to her post. Does she agree that our society would benefit greatly if we gave more recognition to the load that carers carry in these situations? According to the evidence they gave to our committee, unpaid carers sometimes feel that they are regarded by the health service simply as the chauffeur getting the person to hospital, whereas they are actually providing a huge amount of care. Can the noble Baroness assure the House that recognition will be given to unpaid carers?

[Baroness Merron (Lab)]

I am pleased to take this opportunity to give great recognition to the role that unpaid carers play; they are absolutely crucial to ensuring that people get the care they need, either directly or perhaps by being advocates. I also thank the noble Lord for his kind comments. While unpaid carers are very busy looking after those they care for, they need to be able to look after themselves and their own health needs. We will apply ourselves to this issue.

Mental Health: Children and Young People

Lord Laming Excerpts

Thursday 23rd November 2023 Lords Chamber

[Lord Laming (CB)]

My Lords, I add my welcome to the most distinguished noble and learned Baroness and congratulate her on an outstanding maiden speech. The House is the richer for having her, and I hope she visits us much more frequently in the future.

We are indebted to the noble Earl, Lord Russell, for enabling the House to debate this subject, which, as previous speakers have said, is of great importance not only to children but to our wider society. It is generally agreed that this generation of young people have had, and are still having, a rather hard time. While many of these young people are able to rise to the challenge and are inspiring, both in their values and achievements, we must nevertheless recognise that the development of many has been badly affected in recent years and that they now need considerable help.

This generation of youngsters has unexpectedly experienced many changes. For example, in the decade following 2010, there were cuts in local government finances. As a result, many of the programmes that were designed to support young people and their families were cut and some, sadly, disappeared altogether, especially in the preventive and support services. We have not recovered from that situation. While the recent increase in funding is most welcome, I am advised that, in many areas, today’s budgets have not returned to where they were a decade ago, in real terms.

What had an even bigger impact on the well-being of young people, however, were the decisions related to Covid. The lockdown of schools and all other related activities not only interrupted their education but, in its wake, created their isolation, which had a marked impact on their intellectual, social and emotional development. As a result, very many young people became anxious, withdrawn and lacking in self-confidence. Here, we are not referring to just a small number of children and young people but, as has already been said, to many thousands.

The Children’s Commissioner’s recently published excellent report on school absences in England supports this. She says that absence figures have risen to “crisis levels” and are not recovering quickly enough. In Spring 2022, the last term for which we have data, 2% of all children were not just occasionally but severely absent. This is equivalent to 140,700 children. Her briefing goes on to say that:

“For some, the pandemic has led to disengagement. Schools and families have said that they feel like the … contract between parents and schools has been broken”.


That is a serious matter.

The fact that these issues are persisting into adolescence is well illustrated in the very helpful report by the Prince’s Trust from 2022 entitled The Power of Potential. That report makes it clear that:

“Young people were hit especially hard by the economic impact of the pandemic. In March 2021, young people accounted for around two thirds of the total fall in employment since the start of the pandemic, and youth unemployment was almost four times higher than the rest of the working-age population”.


Sometimes these children who are seriously absent from school are referred to as “ghost children”. What a terrible expression—and what a terrible situation they find themselves in: they are basically lost to the system and no longer known.

The difficulties of these young people taking these problems into adolescence means that the number who are not in employment, education or training continues to increase to an alarming degree. That is despite the increase in job vacancies. To reinforce this situation, the recently published report by several childcare charities, entitled Children at the Table, makes it clear that:

“Babies, children and young people have been overlooked by policy makers for too long and the impact is clear: more children are living in poverty, they face a growing mental health crisis, and are waiting too long to receive urgently needed support.”


This is what this debate is about: among young people, we are facing a growing number who have mental health problems now but are waiting far too long for the help that they need to be delivered.

It is clear from the number of young people who are not in school, employment or training that they are vulnerable to exploitation from organisations such as county lines and other disturbing influences. We owe it to these children and young people to have them properly supported and protected at this critical stage in their development. This picture emerges at a time when children’s mental health services have never been so overwhelmed and ill-equipped to meet the needs of these children and young people. I recently heard that one family had been told that the gap between referral to those services and the beginning of assessment was longer than a year and could even be much longer in reality. Just imagine what it is like for the child with these problems: a year in this child’s life at a very formative stage is of immense importance. What is it like for their parents, because what can they do? I am told that they just said, “We are waiting. There is nothing that can be done.” That is a sad situation.

The charity Beat said that a report on the mental health of children and young people in England found large increases in the number suffering from eating disorders, which have already been mentioned. The Times reported:

“Between 2017 and this year … Among 11 to 16-year-olds, the prevalence had jumped from 0.5 per cent to 2.6 per cent, and among 17 to 19-year-olds from 0.8 per cent to 12.5 per cent”.


This clearly represents a huge increase. This is not about fads but recognised and serious eating problems.

Whatever standpoint we take to approach this serious subject, the evidence is starkly clear—and the evidence we have heard from each contributor to the debate so far is in one direction. There is no conflict about this. The number of children in need of the mental health services is seriously increasing, while the service is less able to respond. These children did not invite lockdown or the disruption to their education and their normal social development. They should not be left behind. If we do not respond to their needs now, they will take these problems into adulthood and society will be the poorer for it. So, let us do all we can together to ensure that these children and young people get the help that they need from the specialist mental health services when they need it. We will all be the better for that.

Paediatric Care: Wating Times

Lord Laming Excerpts

Monday 16th October 2023 Lords Chamber

[Lord Markham (Con)]

It is now the legal responsibility of the ICBs to appoint an executive lead in this area, but I think the point generally is a good one. As I said, as a result of this Question I have managed to spend some time looking into this and we clearly need to make sure it is a priority. One of the other things I have been talking about with the executive team of the NHS is how we can introduce this to the tiering measures so that hospitals are given special help in making sure that children’s wait time is one of the key priority areas, and we can put more resources and support towards that and more support where hospitals are not performing well in that area. I agree with the noble Lord.

[Lord Laming (CB)]

My Lords, does the Minister agree that all staff in the front line of these services need to be aware of the dangers of child abuse or child neglect, because the developmental needs of very young children can also be indicators of serious neglect in the home?

[Lord Markham (Con)]

Yes. That is where our colleagues in the Department for Education have a key part to play. Start for Life is a joint initiative with DfE which is trying to look at early diagnosis. At the same time, often some of those issues can manifest themselves in anxieties and mental health issues. That is why we have done a lot of work to expand the number of mental health-aware teachers and assessors in schools, so that we can have early detection.

Mental Health Services: Huntington’s Disease

Lord Laming Excerpts

Monday 12th June 2023 Lords Chamber

[Lord Markham (Con)]

The noble Baroness is correct that they have complex needs and I know from personal experience, with both my mother and my father, the importance of end-of-life palliative care. I thank the noble Baroness for the warning of the question and have been assured that the integrated whole person care approach that the major conditions strategy sets out will include palliative care measures.

[Lord Laming (CB)]

My Lords, the Minister will know that many of the people who suffer from this disease depend very heavily on the support of unpaid carers. I note that his fellow Minister is going to hold a cross-government round table on the needs of carers. Might that lead to the development of a national carers’ strategy?

NHS: Allocation of Financial Resources

Lord Laming Excerpts

Thursday 11th May 2023 Lords Chamber

[Lord Laming (CB)]

My Lords, does the Minister agree that one of the best ways to help the health service would be if the Government would allocate money dedicated to social care services? This would relieve the pressure on beds. Many beds would be relieved—thousands of beds—and it would prevent people having to go into hospital. Is that possible?

[Lord Markham (Con)]

Yes, and we are doing it. We have committed to an up to £7.5 billion increase in funding over the next two years. We announced last month a social care plan which is addressing this and reforming the sector, and we are starting to see the changes.