Urgent and Emergency Care Recovery Plan

Debate between Lord Porter of Spalding and Lord Markham

Thursday 2nd February 2023 Lords Chamber

[Lord Markham (Con)]

I agree with the noble Lord. We have a manifesto pledge about five years of healthier living. I am keen to do exactly that, to say, “Okay, let’s unpack this—how can we make that realistic?”. We have all talked about being realistic. What are the causes of death or ill health that we need to get on top of? I mentioned cardiovascular disease earlier. We need to quickly address that because there is a cohort of people of my age who have missed out. Obesity is a clear thing. It is not just the treatments but everything we talk about in terms of supermarkets. I know that there is some discussion in the House on whether we have gone far enough on some of those things, but the action we have taken is hitting the big numbers. It is hitting about 95% of the planned reduction in calorific intake; we are seeing that have an impact already. There is also anti-smoking; I am keen to make that into a coherent plan. We all know that we can spend more and more money on hospitals and the health service, but we will have healthier lifestyles only if we can get up stream on the problem and talk about protection.

[Lord Porter of Spalding (Con)]

My Lords, I declare my interest as a non-executive director of a care company and lead Peer for the Local Government Association.

It is great that politicians are trying to sort out problems with the health service, because those problems have largely been created by politicians—national politicians from both sides of the other Chamber. Clearly, the last Labour Government’s disastrous changes to GP contracts exacerbated the situation we are living in now. The even worse contracts for construction companies to build new hospitals at exorbitant prices were bizarre and are currently impacting the health service.

The coalition Government and this Government are responsible for the chronic underfunding of social care services. We have all contributed to people not being able to see the right GP or whatever at the start of the process, and we are now contributing to people not being able to get out of hospital.

That is not really what I wanted to say, even though I have just said it. I live in Lincolnshire. If a member of staff somewhere in the Lincolnshire health network has suggested, contrary to the Government’s position of increasing hospital beds, that they have to reduce their hospital beds, one way they could save some money is by deleting the post of the person who suggested that. That is probably a good place to start, because a lot of people want to use acute services but cannot because some of the budget is being diverted away to people dressed like me rather than to somebody dressed in those suits they wear in hospitals.

I am quite simple and do not understand why I saw a picture on the news the other day of 40 ambulances queueing up outside a hospital with 80 members of staff and only 40 patients inside the ambulances. Why can we not put up a big inflatable building of some description, offload the 40 people from the ambulances with 40 of the staff, and let the other 40 staff drive 20 ambulances back out again? Nobody seems to be controlling the resources that are being used, even though we all admit that they are scarce.

[Lord Markham (Con)]

I will take it in reverse order. We do have the ability to stand up that capacity quickly so that the ambulances can discharge. I have already ordered a number of those, and some are ready to go, to provide exactly that capacity. Others are coming on stream in the coming weeks, so we are rapidly responding to the exact point that my noble friend raises.

Just as important—I am glad to have the opportunity to talk a bit more about this—is that a lot of the time ambulances do not need to bring the person to A&E. The mental health ambulances we are introducing, or the falls service ambulances that every ICB now has to introduce and have running every day, are critical. They can go there, right the person who has fallen and set them back up again. That needs only one person, not a big ambulance. That sort of care in the community—solving those problems and the right access—is critical in this situation.

On Lincolnshire, I will find out. The key thing here is making sure that we are expanding capacity in terms of beds.

Children in Care: CAMHS Waiting Times

Debate between Lord Porter of Spalding and Lord Markham

Monday 5th December 2022 Lords Chamber

[Lord Markham (Con)]

I would agree. In any case, especially where there is high demand in an area, we need a form of triaging so that we can agree the clearest areas of priority, such as those mentioned.

[Lord Porter of Spalding (Con)]

My Lords, my noble friend has quite rightly mentioned the amount of money that the current Government are finding to attach to this issue, and predecessors of his at the Dispatch Box would have all said similar things. The country is investing billions of pounds in children’s mental health, quite rightly—that has a huge effect on people’s lives, and it also has a huge knock-on cost to other parts of the Government’s spend if it is not done properly. What assurance can my noble friend give to the House that those billions of pounds are being spent properly on the services they are being given for, and are not being used to subsidise bad management decisions such as PFI contracts?