Long-term Plan for the NHS

Debate between Lord O'Shaughnessy and Lord Mackay of Clashfern

Tuesday 19th June 2018 Lords Chamber

[Lord O’Shaughnessy]

The noble Lord makes excellent points. It is right at this moment to applaud the wisdom and far-sightedness of the Lords Select Committee on the long-term sustainability of the health and social care system. It called for, among other things, funding of growth in line with GDP, delivering integration, a 10-year workforce strategy, a commitment to reduce variation and a joined-up Department of Health and Social Care, all of which, if we were not able to deliver it in time for our response to the report, we are delivering in short order afterwards.

One of the first ways in which we shall do it is to draw on the wisdom that resides in the NHS, in Parliament and elsewhere in the profession. In the Statement given by my right honourable friend, I point again to the commitment to take on integrated care, that being one of the tests of success. Equally, there is the commitment to transformation of the workforce, to make sure not just that we have enough people but that we have enough flexibility and digital skills, for example.

The final point, on innovation, is very close to my heart—and indeed the Secretary of State’s. We know that doing things in the same way will not deliver the standards we need. We really need a transformation in how we deliver healthcare, much greater digitalisation of the entire sector and the ability to take the amazing innovations that we develop in our laboratories and universities, such as the noble Lord’s own, and get them into use across the NHS. That is one reason why I was so delighted that we were able to announce today that the noble Lord, Lord Darzi, will be chairing our Accelerated Access Collaborative. It is hard to think of anybody more committed to this agenda than him.

[Lord Mackay of Clashfern (Con)]

My Lords, I seem to recollect that some years ago there was a royal commission on social care. Is there any wisdom to be gained from it? I do not think much action was taken on it when it reported.

[Lord O’Shaughnessy]

My noble and learned friend is quite right: these commissions do not always produce action. I realise that there is some frustration in the House over the delay to the social care Green Paper. I hope noble Lords will respect the fact that it is sometimes difficult to fight battles on many fronts. We have made some progress on the NHS and the army moves on to win the war on social care as well.

Carers: Health and Well-being

Debate between Lord O'Shaughnessy and Lord Mackay of Clashfern

Tuesday 12th June 2018 Lords Chamber

[Lord O’Shaughnessy]

I thank the noble Baroness for her question and for her tenacity in pursuing me on this topic. I am glad that we were able to publish the action plan. It is appropriate during Carers Week to pay tribute to the amazing work that carers do. Yesterday, I had the opportunity to meet carers who were struggling, often against their own health needs, to care for those they love.

The action plan that we published is a two-year plan. It has some immediate actions but is not purely short-term and contains some actions for the medium term. I highlight one of those, which is important, particularly given these concerns about carers’ health and well-being: a commitment to creating equality standards for carer-friendly GPs. Carers mentioned to me yesterday how important it is for GPs to validate the fact that they are carers and signpost them in the direction of care. I can confirm that carers and support for carers will have prominence in the Green Paper.

[Lord Mackay of Clashfern (Con)]

My Lords, one of the most exciting experiences I ever had in my life was to go to a children’s hospice providing respite care for the parents of children facing an early death as a result of the onset of permanent illness. What sort of provision do we make for that?

[Lord O’Shaughnessy]

The importance of respite care is agreed by everybody. I point my noble friend to the better care fund, which provides around £130 million a year to support respite care and carers’ breaks, building on the commitment made in the Care Act 2014.

Children and Social Work Bill [HL]

Debate between Lord O'Shaughnessy and Lord Mackay of Clashfern

Report: 2nd sitting (Hansard): House of Lords
Tuesday 8th November 2016 Lords Chamber

[Lord Mackay of Clashfern (Con)]

I listened to this debate in Grand Committee in considerable detail and I certainly have a vested interest in securing our social work and the Children’s Act statutory provisions. I think that the provision made in the Bill is misunderstood in some quarters. As I listened to the debate today and on the last occasion, I formed a view that some of those contributing may not have fully understood the purpose of this provision. It is not about allowing local authorities to innovate at their whim; what it does is to ask local authorities that if they have an innovation that they think will improve the lot of children, and they find that that innovation is inhibited or prohibited by some statutory regulation or provision, they should be able to ask the Secretary of State to use the powers—which are strictly limited by the amendments that have been put in—to authorise that amendment for a limited time.

The noble Baroness, Lady Pinnock, quoted what my noble friend the Minister said in Grand Committee about there being no limit to this. Of course, it depends what you are looking for. There is a terrific limit to it but it has to be for the benefit of the children. It is not limited in the sense that it may be about a statute or a statutory regulation, or indeed some form of guidance issued by the department, but it is very limited by the necessity to demonstrate that you want to improve. The noble Lord, Lord Low, for whom I have the greatest possible respect, asked what prevents innovation as it is. There is nothing to prevent innovation except that some innovations which you may want to make run counter to a statute or statutory provision. If you are faced with that, you cannot make that innovation unless there is some way of dealing with the statutory prohibition. That is what the Bill intends to do. Having listened to the debate in the summer, I suggested to the Bill team that there might be a slightly better way of framing this to make it a little plainer that that is exactly what it does, but that has not happened—as yet, anyway.

Much of the difficulty for social workers is that there are sometimes a lot of misunderstandings and misrepresentations over what this is about. It is not about destroying the system. I would certainly not support it for a minute if it was. It is to improve the way that the system works and, where you find something in it that constrains you not to do it in the best possible way, you would have a way of dealing with that.

[Lord O'Shaughnessy (Con)]

My Lords, I rise to speak in favour of the power to test new ways of working and am therefore against those amendments which seek to remove the relevant clauses from the Bill. In doing so, I strongly associate myself with the comments of my noble friends. I have reflected carefully on the arguments made by the proposers of these amendments and I know that they are motivated by the best wishes for very vulnerable children. I take their warnings seriously. Noble Lords may know of my own involvement in running schools, so I am deeply aware that the duty of safeguarding young people and children lies heavily on the shoulders of those who look after them. Our first responsibility is to keep children safe; even more so when the home life of a child does not offer sanctuary. It is right to move cautiously before we put any of this at risk.

Education and Adoption Bill

Debate between Lord O'Shaughnessy and Lord Mackay of Clashfern

Wednesday 16th December 2015 Lords Chamber

[Lord Mackay of Clashfern (Con)]

Having read over the amendments, I wonder about one small technical point in Amendment 24. Proposed new Section 2B says:

“An Academy agreement in respect of an Academy school … must include provision allowing the Secretary of State to terminate the agreement if … the Academy is coasting”.

Proposed new subsection (6) says the definition of coasting will be put forward in regulations, and I am just wondering about the date at which that applies. As I understand it, there is provision in the definition of coasting, and in the system to be used for setting it up, which allows the definition to be changed. If that is so, will it have an effect on the agreements retrospectively? How will it work? This is a very technical kind of point but quite an important one, because it is an essential of the agreement to have this definition of coasting in it.

[Lord O'Shaughnessy (Con)]

My Lords, I am grateful for the opportunity to speak to this group of amendments. I apologise that I was not present and did not speak at Second Reading, but I had not yet been introduced to the House.

I warmly welcome the amendments that have been put forward by the Government. The fact that they have come forward in response to amendments from all over the House demonstrates what I believe to be a great truth of education reform, which is its bipartisan nature. It has been put forward by many Governments over many years, and accelerated by this one. We see that in action today.

In 2012, I wrote a paper for Policy Exchange which called for a level playing field and a single regulatory regime, and for coasting schools to be intervened on, so I am especially delighted to see that the Government have put forward the extension of this regime to academies. It is incredibly important for the reputation of academies that this is the case. I declare my interest as the managing director of an academy trust which will now be within the clutches of this—so my noble friend is making my life more difficult for me, which I am very grateful for. The idea in Amendment 24 of this detailed process for intervening in academies is incredibly important. It is important for academies to know that they are within the single regime and that the expectations that apply to all other schools also apply to them. I know the retrospective nature is uncomfortable for many but it is incredibly important.

The noble Baroness, Lady Hughes of Stretford, asked in particular about what happens when an academy is intervened on. There have been plenty of examples already of academies that have had to be—in the horrible terminology—rebrokered, because they have not performed. Although they are a rare exception, there are instances already of this happening, so we are not entering into new territory here with coasting schools. It must be right that, as time goes on, we raise the bar of what we expect in terms of performance in all our schools—maintained, academy or other—so I welcome that. There are around 300 inadequate schools at the moment and there may be around 1,000 coasting schools, so we are continuing to raise the bar for all school providers, which must be the correct thing to do.

I will talk very briefly about Amendment 15, in the name of the noble Lord, Lord Addington, about whether to include non-academic measures into the definition of coasting. Some other noble Lords mentioned this as well. The schools that I run have a very big focus on character education, so I absolutely believe that there is more to education than passing exams, but you get into some very difficult territory if you want to exclude schools that perhaps have good extra-curricular activity but poor standards. There is a problem of measurement. Any definition which is going to be workable and not challengeable has to be based on objective data. It is very difficult to get objective measurements of the quality of schools other than their academic standards.

I also happen to think that, in the end, schools are responsible for providing a great education. If they can do the other bits, fantastic, but if they are not providing a good academic education, they should be intervened in. What is more, any sensible or wise sponsor would want, as they always do, to keep what is excellent and change what is not good. Although I understand the impulse behind the amendment, in practice it is not workable. In any case, first and foremost, the department and anyone else who is intervening in a school should be worried about standards. I very much welcome my noble friend’s amendments and commend him on his determination and on listening to opinion from across the House.