Care Homes: Covid-19 Testing

Lord Laming Excerpts

Thursday 14th May 2020 Lords Chamber

[Lord Bethell]

I think the noble Baroness casts the situation unfairly. There are undoubtedly cases where test results have taken longer. Last weekend, a laboratory let us down and we had some delays, but I pay tribute to the team who turned around a very difficult situation. By far the vast majority of tests are turned around within our target time, and we are currently trying to reduce that time by using mobile and satellite units to take the tests to residents. That work is showing great and encouraging signs of improvement.

[Lord Laming (CB)]

My Lords, will the Minister assure us that the department accepts that residential care homes exist for those who suffer from multiple and serious health problems? That being so, can he help us understand better why, when we have known for months that Covid-19 was a severe threat to residents and staff, it is still not possible to guarantee either testing or essential equipment?

[Lord Bethell]

I completely acknowledge that one of the most horrible aspects of this disease is that it targets those who are most vulnerable and live closely to each other. Care homes are therefore a priority. I also acknowledge that we started with a very low base of diagnostic testing and have had to work extremely hard to build that up. But now that that capacity is there, we are focusing it on care homes and using innovative methods to get those tests directly to people. We could not be working harder to get the right people tested in the care home sector.

Covid-19: Care Home Deaths

Lord Laming Excerpts

Wednesday 22nd April 2020 Lords Chamber

[Lord Laming (CB)]

I know that the well-respected Minister recognises that his department is the department not only of health but of social care. Does he agree that there has been an almost total preoccupation in the department with the NHS and a near disregard of social care, resulting in a high price being paid by both individuals and communities? Does he agree that there would be great benefit in a fundamental review of the role of social care, the training and skills of the staff, and a proper regard accorded to those who daily are meeting the needs of the most vulnerable people in our society?

[Lord Bethell]

The noble Lord, Lord Laming, makes a point that I am afraid I cannot agree with. While the press may be more focused on hospitals, we in the department have put an enormous amount of focus on social care. I pay tribute to my colleague Helen Whately, the social care Minister, who does not allow us to spend one minute not thinking about social care. However, the noble Lord is right that social care was deserving of a review in any case, and this epidemic will make that review even more poignant, relevant and important. I very much support his view that a review should take place after the epidemic and that it should be a root and branch look at the social care provision in this country.

Dementia: Accident and Emergency

Lord Laming Excerpts

Wednesday 11th March 2020 Lords Chamber

[Lord Bethell]

The noble Baroness is entirely right to say that this is an important issue. Short-term funding has been put in place for the best possible short-term arrangement, but this is a long-term problem that cannot be solved by any Government on their own. It requires cross-generational and cross-party agreement. That is why an important and well-organised set of engagements has been initiated. It is timetabled, and the Government have committed to action in this area.

[Lord Laming (CB)]

My Lords, does the Minister agree that it is most unfortunate, to say the least, that many of the staff who are caring for patients with Alzheimer’s disease and other forms of dementia have been classified as unskilled? Most people who have experienced those services and met the staff involved recognise their skill and the contribution that they make to their fellow citizens. They should be valued.

[Lord Bethell]

The noble Lord makes an important point. I completely sympathise with it. Low paid does not mean unskilled or unvalued. We are looking at the classification, but I should like to communicate the value that we put on the people who care for those we love and the importance they play in our society.

Mental Health: Weight and Shape-related Bullying

Lord Laming Excerpts

Monday 22nd July 2019 Lords Chamber

[Lord Laming (CB)]

My Lords, does the Minister agree that in recent years there has been a marked reduction in mental health counselling services for young people? Can the Minister tell us anything encouraging about the redevelopment of specialist mental health services for young people?

[Baroness Blackwood of North Oxford]

The noble Lord is absolutely right that we must make sure we invest in the services needed to respond to the increasing reports of mental ill heath in young people. That is why we have focused on increasing mental health funding. I am pleased to report that the amount spent on mental health will be £12 billion in the next year and that all CCGs will meet the mental health investment standard. We are also investing in particular in suicide prevention over the next three years—£25 million to support local suicide prevention plans to make sure that local authorities are able to have a multiagency suicide prevention response, which I think the noble Lord will agree is extremely important.

Social Care: Green Paper

Lord Laming Excerpts

Monday 13th May 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I share the noble Baroness’s impatience for progress on this. She is absolutely right that there is no point in bringing forward the proposals if they are not properly costed and funded. That is exactly why these proposals have been developed in collaboration with the long-term plan and the social care plan. We have to ensure that the right funding for social care is agreed alongside the rest of the local government settlement at the forthcoming spending review. That is partly why this process is taking the route that it is.

[Lord Laming (CB)]

My Lords, I feel sure that the noble Baroness will agree that this has become an embarrassingly long-running saga. I am sure the whole House will agree that the people who depend upon these services are the most vulnerable in our society and have such high-dependency needs that they ought to have the security of knowing that their well-being and safety is being properly attended to. Will the noble Baroness use all her influence to make sure that these people get the security and peace of mind that they deserve?

[Baroness Blackwood of North Oxford]

I am absolutely delighted to offer the noble Lord my assurance that we will work as hard as we can to deliver the most effective and most deliverable Green Paper we can. He is absolutely right that the most vulnerable people within our society depend on the effectiveness not only of social care services but the integration of social care services with our public health services and the long-term plan. That is why it is encouraging that social care sits right at the heart of the long-term plan and why it is well integrated with the other commitments within the plan to improve outcomes for major diseases and including measures to support older people, through more personalised care and stronger community and primary care services. These will improve outcomes and reduce the demand on social care, and that is exactly the kind of holistic approach that we want to see.

Brexit: Health and Social Care Workforce

Lord Laming Excerpts

Thursday 13th December 2018 Lords Chamber

[Lord O'Shaughnessy]

I thank the noble Baroness for her question. First, we want to ensure that EU staff working in Britain are able to do so, and course that is why the EU settlement scheme pilot is so important. The social care workforce in this country has increased a lot, with a mixture of domestic and foreign staff. One of the ways in which we are increasing the attractiveness of that profession is by increasing the living wage, which has benefited so many staff in social care. Of course, many of them are highly skilled, and we want to ensure that we continue to be able to attract such skilled staff. We continue to discuss with the Home Office exactly what the right thresholds are for our future immigration system so that we do not lose out on these kinds of staff.

[Lord Laming (CB)]

My Lords, does the Minister agree that the problem is caused primarily because of the low esteem given to social care staff? This is extraordinary because most people who find themselves dependent on those staff value their contribution enormously. Would it not be helpful if the Government attached greater importance to those staff, not only through reward but through training and proper support?

[Lord O'Shaughnessy]

The noble Lord is absolutely right. The Government certainly do not hold those staff in low esteem—quite the opposite. As we know, we need increasingly to think of health and care staff as one workforce and ensure that professional paths lead through all those professions. I am sure he will be aware of the work being done by Skills for Care, which provides the overarching policy in this area, has made recommendations about pay and helped to inform our increase in the living wage, and is providing better training facilities for those staff.

Domestic Abuse: General Practitioner Charges

Lord Laming Excerpts

Thursday 15th November 2018 Lords Chamber

[Lord O’Shaughnessy]

I do not think that it is an issue of staffing per se, because it is not only doctors but other healthcare professionals who are able to provide letters of this kind. The evidence that has been gathered through consultation and indeed through the progress of the secure tenancies Bill is that the charges for these letters act as a barrier. That is the issue we are trying to address.

[Lord Laming (CB)]

My Lords, does the Minister agree that evidence of domestic abuse is important not only in respect of the adult who is the victim but also in respect of the children? It is the children who are often the most innocent victims in these situations. Given that, GPs have an important role to play in producing evidence of the well-being of children in these households.

[Lord O’Shaughnessy]

The noble Lord speaks with great wisdom on this subject. That is precisely why the domestic abuse Bill is looking to provide stronger sentences where a child has been involved or has witnessed this kind of abuse, and why some of the money I mentioned earlier, around £8 million this year, has been put aside to support children in these situations.

NHS: Staff

Lord Laming Excerpts

Tuesday 13th November 2018 Lords Chamber

[Lord O'Shaughnessy]

I am grateful to my noble friend, who set the foundation for this long-term workforce plan—indeed, the long-term plan for the NHS. He is right. It is not just a workforce plan for health workers but also looks at care workers. We need more staff, and that decision will be taken at the spending review, but it does have the highest priority.

[Lord Laming (CB)]

My Lords, does the Minister agree that the concerns expressed in this Question apply equally or even more to social care services? Unless social care is adequately staffed, the rebound on the health service will be enormous. I hope that, in future, social care will be given priority along with the health service.

[Lord O'Shaughnessy]

I agree. Indeed, my Secretary of State has made workforce one of his top priorities. We are responsible for health and social care, and the Green Paper we will publish this autumn will contain more detail on the social care workforce plan.

NHS and Social Care Services: Parity of Esteem

Lord Laming Excerpts

Thursday 5th July 2018 Lords Chamber

[Lord O'Shaughnessy]

I join the noble Baroness in paying tribute to staff, not just across the NHS of course but across all the caring professions. We published the draft strategy and will publish a joint strategy for the health and care workforce precisely for the reasons that she set out. We need to make sure that there is joined-up care across all sectors. That means that we need extra funding—a sustainable funding solution—for the social care sector. We have put in an extra £9 billion over the course of this spending review since 2015 to provide a short-term solution. The Green Paper is about providing a long-term solution. Some of the principles in the Green Paper emphasise the importance of this integration, delivering quality and integration, a valued workforce and sustainable funding. Those are the conditions necessary for what she wants to achieve.

[Lord Laming (CB)]

The Minister will know that in the social care field there are now numerous independent providers. What mechanism is there to ensure parity across the whole sector, including all aspects of social care?

[Lord O'Shaughnessy]

The noble Lord is right to point out that there are differences between the two workforces: clearly the NHS has a largely publicly employed workforce and social care has a largely privately employed one, so there will inevitably be some differences in form. We need to make sure that those workforces work together and are as attractive as one another, which is why finding a sustainable funding solution is so important so that those private contractors have the ability to pay what is necessary to attract the right staff.

Domiciliary Home Care Support

Lord Laming Excerpts

Wednesday 25th April 2018 Lords Chamber

[Lord O'Shaughnessy]

I thank the noble Baroness for the opportunity to provide that reassurance for people using and benefiting from the care provided by Allied Healthcare. I want to reassure them that the Care Act 2014, passed by the coalition Government, gives local authorities responsibility for continuity of care if a business were to fail. Of course, we are not in that position with Allied Healthcare, because it still has to go through the CVA process. I can reassure people that the LGA has said that councils have “robust”—its word—plans in place to ensure continuity of care if that is required. I put that on record for those who may be worried about it.

We know that extra funding is needed in the sector. Over three years, through a number of means including extra money through the precept and direct funding to local authorities, the Government have increased by about £9 billion the funding available for social care, which we know is required. I also point out that, if you look at domiciliary care provider numbers, you will see that there are 50% more than there were eight years ago. We know that markets have entrants and that providers are exiting, but we have more providers in the market and more packages being delivered than ever before. Ultimately, the backstop is that local authorities have that responsibility to provide continuity of care.

[Lord Laming (CB)]

My Lords, does the Minister understand the importance of this Question? Imagine being a very vulnerable person living in a residential home with no alternative to go to or being dependent on a home help for the basics of daily living. Now imagine living under the shadow that the company that provides that service is going to go out of business at any time. Nothing could be more anxiety-provoking for these residents. The Care Quality Commission telling the local authority that there is a problem here is of no comfort. I hope that he will take this Question rather more seriously.

[Lord O'Shaughnessy]

I have huge respect for the noble Lord and his expertise in this area. I take this issue very seriously, which is why I used the opportunity in answering the noble Baroness to provide the reassurance that is in law. Local authorities need to step in to provide continuity of care with notice from the CQC, which now has a new responsibility to monitor the financial sustainability of providers and to make sure that that care is provided, whether it is delivered in-house or through contracts with other providers. That reassurance did not exist before it was introduced in the 2014 Act. It ought to provide a degree of reassurance among vulnerable people, who I accept will be anxious. That responsibility is in law.