Adult Social Care: Long-term Workforce Plan

Lord Scriven Excerpts

Monday 13th January 2025 Lords Chamber

[Baroness Merron (Lab)]

My noble friend is right that it is important that we have a workforce built around the needs of patients, rather than patients having to be worked around the needs of the workforce. I certainly hope and intend that, as we go forward, we will see much more of this flexibility. I share her view that time is of the essence and I also know that my noble friend and your Lordships’ House also understand that it is very important that we get this right.

[Lord Scriven (LD)]

My Lords, the turnaround rate for social care staff was about 30% last year, so retention is clearly an important issue. However, the Government have not helped the situation since July by cutting £115 million from the adult social care training budget. What will the Government do to mitigate this cut and try to help retention within such a vital service?

[Baroness Merron (Lab)]

Retention is absolutely crucial. I was looking—as I know the noble Lord also does—at the vacancy rates and they are currently running at some 131,000. However, I was interested to note that they are not actually the best measure of capacity, or lack of it, because those vacancies can reflect new roles and short-term vacancies because of anticipated staff turnover. So I have had to rein myself in when looking at the relevance of vacancy rates.

On retention, there is a whole range of factors. In the immediate, I say to the noble Lord that we are professionalising the workforce by expanding the national career structure and have developed and launched a level 2 adult social care certificate qualification.

Health and Adult Social Care Reform

Lord Scriven Excerpts

Tuesday 7th January 2025 Lords Chamber

[Lord Kamall (Con)]

My Lords, I begin by echoing the comments made by my right honourable friend the shadow Secretary of State in the other place in support of all those who worked in the NHS and social care sectors over the Christmas period. They sacrificed their time, which could have been spent with their friends and families, to care for those most in need.

On the NHS app, we support the digitisation of health and care to modernise the NHS, and support digital patient records to allow joined-up health and social care to deliver better outcomes for patients and to inform patients. However, the NHS app already sends appointments and updates on treatment to some patients, while some GP surgeries prefer patients to use their own website, not the app. I would be grateful if the Minister could expand on how the updated app will differ and offer up further information to your Lordships’ House. Also, where your GP cannot see you, is the plan to allow all patients to book an appointment with another GP without having to deregister from their current practice and reregister with another practice? Will that be allowed with the updated app? One of the problems was always where there were GPs who could not see their patients but other GPs in the same area had spaces on their lists.

In the Statement, the Secretary of State said:

“We are rewarding trusts that cut waiting times fastest”,


and the carrot of “extra capital investment” is used as an incentive. This appears to make sense, but noble Lords will know that I have always been interested in potential unintended consequences. If the Government reward trusts with extra investment if they cut waiting times fastest, what will happen to those trusts that are not able to cut their lists as quickly? Will they see reduced investment, and will that simply lead to them continuing to perform poorly? What is the solution? Will hit squads—in the best possible terms—be sent in to turn them around? What other plans are there to tackle underperforming trusts which do not qualify for these extra incentives? How do the Government and NHS intend to avoid perverse incentives such as trusts prioritising certain patients over others—not necessarily based on medical needs—to cut waiting times to win this extra cash? How do we avoid that?

On social care, I appreciate the candour of the Statement in acknowledging that Governments of all colours, for decades, have not really dealt with this problem of long-term social care. As my right honourable friend the shadow Secretary of State said in the other place, we will work with the Government and the commission. However, I will put a few observations to the Minister. For decades, successive Governments have known about the ageing population, and Governments of all colours have commissioned report after report, which mostly gathered dust on the shelf. Although I have the greatest respect for the noble Baroness, Lady Casey, given that most commentators on social care agree that everything to be written about funding social care has already been written, I am curious to know what the Government expect to achieve by initiating yet another commission.

A solution was proposed in the Health and Care Act 2022. Noble Lords welcomed that we finally had a solution but disagreed on some of the details. But we had a solution to which the Treasury agreed. I remember the Opposition criticising the Government not for introducing the social care cap but for not doing it earlier, and they also suggested a number of tweaks. The incoming Government could have tweaked the numbers to address the concerns that they expressed at the time, and they could have grasped the nettle, but I am afraid that the announcement looks like yet another Government kicking the can down the road. So will the Minister write to noble Lords with the terms for the commission led by the noble Baroness, Lady Casey? This time, will the Department of Health and Social Care continue to work with the Treasury to ensure that whatever solution is finally proposed, even if it is likely not to be a new solution, has the agreement of the Department of Health and Social Care, other government departments and the Treasury? If not, it will simply find itself kicking the can down the road yet again when it comes to 2028.

My final point is on how to cut the backlog. These Benches welcome the Government continuing the policy of the last Government in opening new surgical hubs and community diagnostic centres at weekends and evenings. But, when we were in government, we found a potential workforce issue in opening community diagnostic centres at weekends and evenings. Of course, there are only so many staff who can be employed to keep these services open for longer, so have the Government made an assessment of how many staff they envisage will be available to keep these centres open for longer hours? What is the plan? Will it be a redeployment of existing staff, will existing staff be asked to work longer hours and overtime, or will they recruit new staff?

[Lord Scriven (LD)]

My Lords, we on these Benches welcome the Statement and can see some positives in the way forward, but we have some reservations about timescales and unintended consequences in the implementation that I would like to explore with the Minister.

On social care, we have already called for cross-party talks, as many noble Lords will know. Social care is in crisis and at a tipping point, and it is an unbearable pressure for many families. But we cannot understand why the review will take until 2028 and full implementation will probably not happen until 2029-30. It is a bit like calling the fire service when your house is on fire and asking it to attend once it is out. So what specific components of this review that are not already in the public domain have the Government already determined will take until 2028 to be dealt with? Will the review tackle all forms of social care, including continuing care and young people’s services?

The NHS elective reform plan marks a significant initiative for reducing waiting times and enhancing patient access to elective care. The plan introduces some welcome measures, but many are not new, such as the expansion of the diagnostic and surgical hubs, increased utilisation of digital platforms such as the NHS app and a commitment to meeting the 18-week referral to treatment standard by the end of this Parliament. Although these proposals are commendable, I have been of the view for many years that elective and emergency care need to be provided in different, and probably separate, ways. Several critical concerns warrant attention to ensure the plan’s success and sustainability.

A primary concern is that the plan focuses predominantly on elective care, potentially overlooking the broader health and social care ecosystem. The Nuffield Trust emphasises that, for the plan to be sustainable, there need to be concurrent reforms in social care, significant investment in community services and attention paid to the determinants of ill health, such as housing and education. The focus on throughput measures will mean that it will be focused purely on those. What outcome measures will be put in place, not just for the quantity and speed of care but for the clinical outcomes for patients?

The emphasis on meeting elective care targets should not overshadow other clinical priorities. It is critical to ensure that resources allocated to elective procedures do not detract from urgent and complex care needs. Indeed, the financial model set out in the plan on tariffs will create incentives to focus on elective cases when budgets are stretched. What measures will be put in place so that the expanded diagnostic and surgical hubs, along with the extra reported 3.5 million procedures in the independent sector, will avoid pulling staff away from urgent care and complicated patient needs? This must be based on a fully costed workforce plan, so when will that be presented?

The plan has been announced with little firm detail on funding, especially considering that the £3 billion ring-fenced for cutting waiting times this financial year will not be available from April. Will this ring-fenced scheme be reintroduced? While we welcome the thrust of this plan, there will be some unintended consequences, and we really need to see a detailed implementation plan to ensure that elective care does not overshadow emergency care and those seeking social care.

Hospice Funding

Lord Scriven Excerpts

Monday 6th January 2025 Lords Chamber

[Baroness Merron (Lab)]

I associate myself with the tributes paid to the great contribution that the late Lady Randerson made to this House. She will be sorely missed. In addition to Minister Kinnock meeting major stakeholders, including Macmillan, Together for Short Lives and a number of other organisations and charities to discuss sustainability of funding, Ministers will continue to have discussions with NHS England, because the other area is about getting the money promptly, which has not happened to date. Again, that has caused huge difficulties. We very much look forward to seeing the commission’s findings and recommendations and will look at how we can work to support it.

[Lord Scriven (LD)]

My Lords, I add my tributes to Lady Randerson and wish the Minister a happy new year. As welcome as the £100 million in capital is, it will not pay for staff, drugs, heating, lighting, meals or day-to-day services. What are the Minister and the Government going to do to add extra revenue funding to deal with the costs that the hospices are dealing with now?

[Baroness Merron (Lab)]

As I mentioned, it has been confirmed that there will be funding for children and young people’s hospices for the forthcoming year, which I know had been hoped for but not actually delivered. I am very glad that the Secretary of State was able to confirm that. On long-term sustainability, Minister Kinnock is very much looking forward to meeting major stakeholders and is working with NHS England to find the best funding mechanism, in respect of the £100 million capital grant and more generally.

NHS: Patients with Allergies

Lord Scriven Excerpts

Thursday 12th December 2024 Grand Committee

[Lord Scriven (LD)]

My Lords, I thank the noble Baroness, Lady Ramsey of Wall Heath, for introducing this debate. I also thank the noble Lord, Lord Mendelsohn, and the noble Baroness, Lady Keeley, whom it is a pleasure to follow, for bringing this issue to life with personal stories that go beyond the statistics and bring home exactly what we are talking about today.

Allergy services in the UK are at a critical juncture. As my noble friend Lady Burt said, with more than 21 million people affected, allergies are no longer a niche issue. They represent a public health issue, from life-threatening anaphylaxis to chronic conditions such as allergic eczema. These conditions profoundly impact individuals, families and the NHS yet, despite this growing prevalence, the UK’s allergy care system remains inadequate. The Government must act to bridge these gaps and create a robust, equitable allergy care framework, with the Government and the NHS at the helm of these reforms.

Let us acknowledge the scale of the problem. Hospital admissions for allergic reactions have increased by 615% in the past 20 years. As other noble Lords have said, shockingly, there are only 40 specialist allergists; that is one for every 525,000 patients. For patients, this translates into a postcode lottery of care, with many waiting more than 18 months for appointments. Primary care also faces significant challenges, with most GPs lacking adequate allergy training. This leads to unnecessary referrals, misdiagnosis and poorly managed conditions. The strain is particularly acute for children and young adults. Food allergies, which can be fatal, are rising sharply in children, yet there is a severe lack of specialist support during the critical transition from paediatric to adult services, as other noble Lords have said. What priority will the Government put on these transition services?

The gaps in care are not just a human tragedy; they are an economic burden as well. Allergy care costs the NHS more than £1 billion annually in emergency admissions, prescription costs and referrals. Addressing this crisis requires systematic change, not piecemeal change, with the Government and NHS having to play pivotal roles. I ask the Minister: what will the NHS do urgently to expand the workforce? This includes increasing the number of specialist allergists and immunologists, as well as training GPs and nurses in allergy management.

A promising model was demonstrated in a pilot project by Allergy UK, where nurse-led clinics reduced waiting times from 18 months to just four to eight weeks. Some 95% of cases were managed successfully in primary care, saving not just lives but costs. What is the Government’s view on this pilot being rolled out nationally? Additionally, the Government should allocate targeted funding to recruit and train more allergy specialists.

Investing in allergen immunotherapy services is also critical. Although they are costly up front, these treatments prevent severe reactions and reduce long-term healthcare expenses. As many other noble Lords have said, we need to appoint a national allergies tsar or clinical director to lead a co-ordinated strategy. This role would oversee data collection, resource allocation and policy implementation—and, to put it bluntly, it would knock heads together to make sure that action happens. What is the Government’s view on appointing such a clinical director, and is there a timeframe for doing that?

Empowering primary care is vital to reduce pressure on specialist services. This can be achieved by embedding allergy-trained nurses and dieticians in every integrated care system, as other noble Lords have said. These professionals would manage routine cases, leaving specialists to handle the more complex ones. Where will the move from hospital care to community care fit in within the 10-year plan?

The absence of robust reporting systems for allergic reactions is another glaring gap. A mandatory near-miss reporting system for anaphylaxis, akin to the system in place in Australia, would allow us to identify emerging risks and act upstream. Will the Government look at such a mandatory near-miss reporting system?

Lastly, we must focus on prevention. Early allergen introduction and proactive eczema management in children have been proven to reduce lifelong allergy risks, yet these strategies remain underutilised. Will the Government prioritise funding for education campaigns and preventive measures? Improving allergy services is not just about saving lives; it is about improving the quality of life for millions of people. By investing in specialist care, empowering primary care and adopting preventive strategies, we can take important steps to transform allergy care.

Health: Quad-demic

Lord Scriven Excerpts

Tuesday 10th December 2024 Lords Chamber

[Baroness Merron (Lab)]

We are aiming communications —I know the noble Lord will be familiar with this from his previous role—particularly at groups that are less represented in terms of vaccinations. From my discussions with the national medical director, I do not recognise the reference that the noble Lord made to hospitalisations; they are as I set out in the Answer to my noble friend. However, we are far from complacent and continue to push vaccination. We will get vaccination rates up because they are the best line of defence against infectious diseases.

[Lord Scriven (LD)]

My Lords, the chief medical officer at the UK Health Security Agency stated last week that NHS staff should get the flu vaccination. The Government’s own statistics show that last week, in the largest trust in the country, only 7.9% of those eligible had had flu jabs, and on average the number is in the lower 20%. Why has this happened? What are the Government doing urgently to improve the take-up of the flu vaccine by NHS staff?

[Baroness Merron (Lab)]

I must be honest: I cannot explain here the exact reasons why NHS staff are not taking it up, but I assure the noble Lord, as I have assured other noble Lords, that our focus is on getting vaccination rates up. That is why the national medical director made the comments that he did, as well as assuring me that we are not nearing a pandemic.

Physician and Anaesthetist Associate Roles: Review

Lord Scriven Excerpts

Thursday 5th December 2024 Lords Chamber

[Lord Scriven (LD)]

My Lords, this has been a short but useful debate introduced by the noble Baroness, Lady Bennett. The Question that she laid before the House underlines the lack of balance that she opened with. She asked

“what the review, announced by the Secretary of State for Health and Social Care on 20 November, of the physician associate and anaesthetist associate roles will cover, and what actions they plan to take in advance of the outcome”.

I would hope that if a review of this controversial issue was taking place, it would be considered wise to wait for the evidence and recommendations, not just do something on instinct or limited evidence. Therefore, it is welcome that the Government have opened the Leng review into how physician associates and anaesthetic associates are deployed as part of a team to improve patient outcomes working under the supervision of doctors to support the delivery of medical care.

I thank the approximately 5,000 physician associates and 300 anaesthetist associates who are registered or practising for the professional and dedicated work they do, and the thousands of doctors, nurses and other allied medical professionals of all levels who quietly but professionally and supportively work alongside PAs and AAs as part of the medical team to improve the health of patients.

If I were to think back to when other health professional roles were introduced into healthcare settings when I was managing in the NHS, the issues raised about the work that these healthcare professionals do, and the potential issues that arise, are no different. This is not anything new. What is new is the level of unprofessionalism and hostility that has been shown to these roles.

The lack of respect and the bullying behaviour that some medical leaders within the BMA have decided to adopt when dealing with the issues around the use and deployment of these professionals are not only unacceptable but go against the very GMC regulations that govern you as a doctor. On collaborative working, the regulations say:

“Work effectively … with colleagues in the multidisciplinary team”


and

“respect the skills and contributions”

of all healthcare professionals. Some of the examples of ostracisation, making false claims and bullying at work fall far below what doctors are expected to do and the standards that they are expected to uphold. To that small minority of doctors, I say, “Stop”.

It is clear that PAs and AAs have not had the introduction or supervision that has led to some care being optimal. However, to quote individual cases and then equate the lack of patient safety with all PAs or AAs is neither useful nor correct. The very nature of healthcare is that risk is there and can and does lead to problems. This happens across all professional groups involved in healthcare provision. The issue at hand is whether PAs and AAs have more never events or near misses than other medical and healthcare professionals. Surely, that should be a key line of inquiry to work out the safety of these professions.

Physician associates are mid-level healthcare professionals trained under a medical model to support doctors in diagnosis, treatment planning and patient care. They have a science degree, predominantly, and two years of postgraduate training. PAs can enter the workforce sooner than fully qualified doctors, and, as some evidence suggests, they can make a real difference in relieving pressure on overstretched health services.

The NHS has been using a model of PAs since 2003, and their role has expanded over the years. Yet, despite 20 years of valuable contributions, their integration remains controversial. Some doctors have rightly voiced concerns about their short training period, lack of regulatory authority and potential competition for roles. These concerns deserve thoughtful consideration, which is why the investigation will take place, but they should not overshadow the evidence demonstrating the benefits that PAs and AAs can bring to our healthcare system.

Research led by Professor Vari Drennan and colleagues has provided compelling insights into the effectiveness of PAs across various settings. For instance, an observational study comparing PAs and GPs in primary care found that consultations with PAs resulted in no significant differences in re-consultation rates, diagnostic testing, referrals or patient satisfaction, while maintaining comparable patient outcomes. In secondary care, a BMJ Open study evaluated PAs working in emergency departments alongside doctors in training. It concluded that PAs were equally effective and safe, with no significant differences in clinical adequacy or unplanned re-attendances. What is more, PAs were praised for improving team continuity and efficiency, allowing doctors to focus on more complex cases. These findings demonstrate that PAs can provide high-quality care while addressing staffing mix issues in primary and secondary care settings.

To address the concerns, the new GMC regulation regime will help to deal with some of the genuine issues raised around the scope of practice. I need to be clear, as people keep talking about a national scope of practice. The scope of practice—that people are working within their competence—is down to the individual. That is exactly what the GMC does now with individual doctors. Individuals have to work within their scope of practice, and standards will be laid down by the GMC, which then allows the scope of practice and revalidation to take place. We need to be clear what we are talking about. Along with this new regulatory scheme, there will be professional accountability for education, training and conduct, and it will ensure that individuals undertaking these roles are safe to practise.

Secondly, it would be useful for the NHS to undertake a refreshed national public campaign to raise awareness of PAs and what they do. Some patients still mistake PAs for doctors or nurses, which can lead to confusion and undermine trust and satisfaction. Research conducted in 2021 revealed that a simple information leaflet, co-designed with patients, significantly improved patient understanding of and confidence in PAs. Expanding such initiatives across the NHS would enhance public confidence and empower patients to make informed decisions about their care.

As we move forward, and when the Leng review reports, we must ensure that PAs and AAs are regulated to the highest standards and adequately equipped to perform their roles. Furthermore, improving public understanding of PAs will help their role to be understood more widely by the public.

With these measures in place and other recommendations that will emanate from the review, PAs and AAs will not only help, as part of a modern medical team, to address the future demands of patients but, if the review identifies the key changes required and the Government act on them, become a vital part of a resilient NHS. I hope we can all embrace the opportunity to support our health service and improve patient care.

NHS Plan: Consultation

Lord Scriven Excerpts

Monday 2nd December 2024 Lords Chamber

[Baroness Merron (Lab)]

I agree with my noble friend: we have to hear from unpaid carers, because that will strengthen the exercise. We are constantly monitoring which groups are responding and which are not, and that allows us to tailor our approach to the underrepresented groups who are not coming forward. If that includes unpaid carers, the consultation absolutely will make special, tailored efforts to reach them.

[Lord Scriven (LD)]

My Lords, the life expectancy of people with learning disabilities is, on average, 20 years less than the general population’s. Research has shown that a major contributor to this is a lack of access to appropriate healthcare. What will the Minister do to ensure that this group of people will be not only consulted but listened to, and that the 10-year plan will provide appropriate services tailored to them?

[Baroness Merron (Lab)]

This is indeed one of the groups for whom we need to ensure absolute inclusion. As I mentioned, the work with integrated care systems will be particularly helpful in running the workshop. We train organisations to work with it, and it is designed so that it is easy to use. It can be used in events to reach the seldom-heard voices in communities, including those with learning disabilities. It is vital that we hear from them as we design an NHS fit for everybody for the future.

NHS: Dentistry Provision

Lord Scriven Excerpts

Monday 25th November 2024 Lords Chamber

[Baroness Merron (Lab)]

I commend the noble Lord for raising his long experience of facing and dealing with these problems locally in Norfolk. I note the report in September that the Norfolk and Waveney area has the worst ratio of NHS dentists to patients in England, with 1,000-plus people having to attend Norfolk’s casualty department last year due to serious dental issues, so this is a serious point. We are aware of the University of East Anglia’s interest in this area, and my colleague Stephen Kinnock, the Minister responsible for this area, recently met with east of England MPs to discuss this matter. However, as I have said, it is not the Government who make these decisions, although we encourage those new dental schools to be in areas of particular need. I encourage the University of East Anglia to take its proposals to the General Dental Council.

[Lord Scriven (LD)]

My Lords, has any extra allocation been made in-year—this year—from the Budget’s NHS allocation for the extra appointments the Government wish to see in dentistry, or is this expected to be bought from existing ring-fenced dentistry budgets?

[Baroness Merron (Lab)]

My Lords, the Government are investing around £3 billion in dentistry each year. As the noble Lord will be aware, I cannot yet confirm 2025-26 dentistry budgets, but they will be confirmed in planning guidance published by NHS England in due course. I know that the noble Lord will be aware that, despite the tough fiscal circumstances the Government have inherited, the Budget set out a big increase in day-to-day spending for health and social care. Regarding the process, and our planning, it is entirely normal that we set out matters in planning guidance. We are, of course, keen to reform the dental contract with a shift to focusing on prevention and the retention of NHS dentists. That work is immediately under way.

Mental Health Bill [HL]

Lord Scriven Excerpts

2nd reading
Monday 25th November 2024 Lords Chamber

[Lord Scriven (LD)]

My Lords, it is a pleasure to follow the noble Lord, Lord Bradley, who was the MP for the constituency I lived in when I was a student. In those days, I campaigned against him, but, from listening to his speech today, I am sure that we will campaign together in Committee on some of the reforms that may be required in the Bill.

This Bill is a welcome direction of travel for mental health legislation in the United Kingdom, but it is only an extra stop. As other noble Lords have said, sometimes we have to look at the bus we are on—the underlying legislation. That bus was built when I was 17 years old, if we go back to the 1983 legislation, and it had its last MOT 17 years ago, in terms of its amendments. I believe that, although these measures are welcome, there is still a fundamental issue in terms of the basis of what we are traveling on. I understand the problems with that.

The questions we are really asking in this Bill are quite limited in the sense of the balance between individual freedoms and public protection when it comes to the detention of individuals. Because we look at such legislation infrequently, we must do our best in Committee to ensure that the balance is at its best and that, wherever we can, we take a person-centred, rights-based approach to this legislation. Having said that, there are some pleasing points in the Bill, including the tightening of the criteria for the detention and compulsory treatment of individuals. It is welcome that the four key principles are mentioned but it is a shame that they are not on the face of the Bill and are down as guidance only. It is important that those of us who really support the principles fight for them to be on the face of the Bill in Committee.

The advance choice documents are a welcome provision but, as many noble Lords have said, they need to be fully accessible 24 hours a day, 365 days a year to those who care for people who have given an advance choice document. I question why they are only for people aged 18 and over. If we are looking at Gillick competence, there are issues around those who are younger, who should be able to provide an advance choice document. I worry that they are not a right or a duty but are only to be given as a consideration.

I welcome the right to a nominated trusted individual but many people who have been involved in healthcare will know that it is not just about having that person as a right; it is about the way in which professionals listen to them and carry out the advocacy that they provide. I am not sure, as we start with this Bill, that the balance is correct; I believe that certain issues will have to be addressed in Committee.

I have also looked at the potential implementation of the Bill. It is always good to start with the impact assessment. It has in it some quite startling issues that I think we will want to look at in Committee. For example, community treatment orders are not meant to change for at least another seven years, but the implementation start is in seven years. The existing CTO regime will last for another seven years and, from the Government’s impact assessment, it looks as though the new regime will start in seven years at the earliest.

I will come back to people with learning difficulties and autism in a second, but the implementation of the measures for them not to be held for more than 28 days and for other provision in the community to have to be available will be in three years’ time, according to the impact assessment. However, there is no money in the next two years to start to provide for those community facilities. It is as though they will come on stream the second the implementation date is reached; I question the Government’s planning on that and whether it is a realistic adaptation for people with learning difficulties and autism.

My passion and focus in Committee will probably be learning disabilities and autism, because they are personal to me. I have close family members who are loving and warm but very misunderstood by those who do not have a close relationship with them. It is scandalous that, in 2024, having those labels attached to you means that you could be detained under the Mental Health Act for more than 28 days. I welcome the fact that the Bill’s provisions will move away from Section 3 and towards Section 2 detention, but I worry that it will not stop detention of people with learning disabilities or autism. For example, DoLS will be used, because these people are misunderstood. The legislation in itself will not change what happens to them. Individuals who are seen not as a threat but as difficult will be detained. As other noble Lords have said, fused legislation needs to be used to ensure that those individuals are not detained using different pieces of legislation.

As other noble Lords have said, it is also worrying that people with learning disabilities or autism who are under a Section 2 detention or detained under the Mental Capacity Act will not have access to Section 117 community facilities. It is quite fascinating that the very things under Section 117 that need to be in place to ensure that these people are not detained are the very facilities that they do not have a statutory right to. That needs to be looked at in this legislation.

There are many things to welcome, but many further questions need to be asked and drawn out, particularly regarding some of the contradictions in different parts of the legislative process on mental health provision within the UK and around the rights-based approach, which the Government seem not to have in place. We will want to explore that as we go forward.

NHS: Treatment of Children from Other Countries

Lord Scriven Excerpts

Thursday 21st November 2024 Lords Chamber

[Baroness Merron (Lab)]

I will be glad to take back to the department the comments of the noble Baroness and the noble Lord, but I reiterate that it is individual expert centres that are responsible for liaising with referring clinicians. By definition this has to be done on a case-by-case basis because we are talking about highly specialised treatments for rare diseases. Again, there is no set nationwide policy for local implementation because of the very nature of the challenge and the specialism to which the noble Baroness refers.

[Lord Scriven (LD)]

My Lords, maybe a good place to start would be to be bolder and more ambitious with the rare diseases framework that already supports international collaboration as part of the Government’s policy. As part of this framework, will the Minister investigate setting up an international centre of excellence in the UK that could be funded by both the UK and international partners for procedures and R&D to be carried out here, which would deal with some of the problems that both noble Lords have mentioned?

[Baroness Merron (Lab)]

The noble Lord is right to make reference to the UK rare diseases framework. The intention of that is to improve the lives of those with rare diseases—for example, by helping to get a faster diagnosis, increasing awareness of rare diseases, better co-ordination and care, and improving access to care, treatment and drugs for those in this country. I will add his suggestion to the list of matters to raise with the department.