Architecture and the Built Environment

Lord Sawyer Excerpts

Monday 28th July 2014 Lords Chamber

[Lord Sawyer (Lab)]

My Lords, I also thank my noble friend Lady Whitaker for securing this important debate, and Mr Ed Davey, and Sir Terry Farrell and his team for an excellent and ground-breaking report. If it was implemented, it could provide a real cultural change in the way in which we live, and approach our communities, towns and houses.

There are many big ideas in the report. One of the biggest is the embedding of design and place-making in our children’s education. If that was taken up and implemented, it would have an enormous impact on future generations. The concept of place institutions and urban rooms is another big idea. A national conversation between architects, planners, local councils and housing professionals, along with the communities, on a regular, systematic basis is an excellent idea, which will have enormous benefits if implemented.

There are many good ideas in the report, but I want to spend my time on the issue of implementation. That is very important. Without it, the report may as well not have been written, like many similar reports in the past. I understand that the Government will be expected to play their part. It will be interesting tonight to hear what the Minister has to say in that respect. I see in the conclusion the comments about Sir Terry keeping track on what is happening and having regular meetings with Ministers. Sadly, I think that that part of the conclusion is a big hole in the report. It is nowhere near enough.

In its conclusion the report needs a huge commitment from the profession, the big-name architects and others. They need to say that they will make this work. That is what we should be looking for. They need to say that they will fund a not-for-profit organisation—let us call it the “Centre of Place”. This will have the stamp and resources to fund and fulfil the mission of this report. It should be a 10-year-plan.

I expect the Government to take a role but I do not expect them to carry the full responsibility. I look to the profession. This report will not happen unless it lives its own prescription—in other words, from the bottom up. We have heard in these debates over the years names from the past, such as Howard Parker and Unwin Hollanby, who gave without asking for return, who changed the face of architecture and the built environment in our nation and I vote that Sir Terry Farrell’s name eventually goes on this list.

Queen’s Speech

Lord Sawyer Excerpts

Tuesday 14th May 2013 Lords Chamber

[Lord Sawyer]

My Lords, when my noble friend Lord MacKenzie rose to speak, he said that he had had to tear up his original speech because of the speeches made by my noble friend Lady Wheeler and others, and I feel the same about mine. My noble friend made an excellent speech on the health service and on nursing in particular, and I should like to be fully and completely identified with what he said. However, there are a couple of things regarding this issue that I do not think were dealt with in that speech or in others, and I should like briefly to say something about them.

The first concerns nursing and nurses spending more time with patients and more time on the ward. My noble friend Lord MacKenzie implied that it was time to get nurses back to basics. It is part of the current ethos about the problem in the National Health Service that nurses are not spending enough time on the wards. Certainly, given the Francis report and other things, I can understand why that might be thought to be the case. At the same time, in my experience, it is crucial that we do not overlook the importance of high-quality nurse managers. Matrons and charge nurses are managers as well as nurses. Their clinical qualifications and expertise as clinicians are not always matched by their qualifications and expertise as managers and leaders.

Basically, hospitals work in teams. It is only teams that deliver. Anyone who has been a patient or worked in a hospital will understand that nurses do not work in isolation; they work in teams. Skills are needed to build and develop a team, to take it forward, to fill a gap, to look after an absence, and to deal with a crisis. All those important skills have to be learnt and developed by nurse managers. It is important that that is said.

In the past 10 years, developments have taken place in the commercial sector and some parts of the charity sector, and investment has been made in helping people to become high-quality managers and leaders. I am not sure that that same development has taken place in the National Health Service. We need to address that. I do not know whether the Minister would be kind enough to write to me about the ambitions in this respect. I do not expect chapter and verse, but I should like to know the direction of travel in making sure that we have world-class leadership among our nursing staff. It is worth using that word because in order to deal with the problems that we have seen in the Francis report we need that kind of ambition.

Secondly, on what I would call an holistic approach to patient care, again, the drum-beats at the moment are about patients left on trolleys and nurses not caring properly. However, the patient experience is about a lot more than a nurse and a doctor. It is about something much more fundamental and basic. If the first call to a general practitioner’s surgery is badly answered by an inattentive receptionist, it is the first step towards a bad patient experience. In the National Health Service, it is possible to have several bad patient experiences before you ever meet a clinician. It is very important that people who work in all professions—nursing, non-nursing and supporting professions—understand that the patient experience begins with them.

Everyone has responsibility for giving good patient care, including the GP who does not have time to listen properly to a patient, and the consultant who is too busy to explain exactly what the issues are and what might be done to help a patient’s situation. These skills are not taught in medical school or nursing school. I ask: are they taught or are they picked up? It is expected that these skills will be picked up and learnt on the journey from being a clinical practitioner to a manager and a leader. My opinion is that often those skills are not learnt and that they are badly lacking in a lot of health service experiences. We need to do something about that.

The skills required are those of listening, empathy and understanding. Sometimes they would be called soft skills, but they are crucial in the health service. Patients feel vulnerable, worried and anxious about what will happen to them, so it is very important that everyone who works in the health service understands that the patient experience begins with them and that they are responsible in just the same way as doctors and nurses. If it not too much trouble, I would not mind a note from the Minister about how that wider holistic approach to patient care, not just by clinical practitioners, doctors and nurses, is seen. I ask everyone in the health service to be aware of the importance of the patient experience.