Prioritising Early Childhood: Academy of Medical Sciences Report

Lord Sterling of Plaistow Excerpts

Monday 11th March 2024 Lords Chamber

[Lord Markham (Con)]

I agree with the noble Baroness and my noble friend Lady Cumberlege about the importance of continuity of care in the maternity space. We are investing resources as part of the long-term workforce plan to increase the number of people trained in maternity and in this area generally. To give another example, we are investing in family nurses by increasing the number of training places by 74%, because it is understood that we need the workforce to provide all these services in an ever more complex world.

[Lord Sterling of Plaistow (Con)]

My Lords, is not one of the problems that children today do not get anything like the exercise we used to do in the old days?

[Lord Markham (Con)]

Wearing the tie I was awarded for being man of the match in the rugby against the Irish parliament this weekend, which we won, I totally agree about the importance of exercise in all walks of life. Social prescribing is vital. We are expanding the number of PE services available for children, because exercise is vital.

Polio

Lord Sterling of Plaistow Excerpts

Thursday 23rd June 2022 Lords Chamber

[Lord Kamall (Con)]

As it happens, I was at an event yesterday at which a GP from east London was present; we were talking about the whole range of issues, not just this specific issue. Let us be clear: no one has got polio and no cases have been identified. We have found it in the sewage, and it probably came from someone who had the oral vaccine overseas, came to the UK and excreted it into the system. there are no cases of polio at the moment—we should be absolutely clear about that—but we are saying that this is a warning that people should ensure that they get vaccinated and check their records.

The noble Baroness makes a really important point about health disparities and there are lots of issues we must tackle. I have said many times that we must see how we can work on a community-led solution, rather than having someone in Westminster or Whitehall who thinks they have all the answers. To be honest, we have to show due humility and say that people sitting in this House can sometimes be out of touch with those communities.

[Lord Sterling of Plaistow (Con)]

My Lords, as my noble friend has said, the polio disease still exists in other parts of the world. When immigrants come from different parts of the world—not just from Europe—are they examined, checked and given polio injections immediately, or does it take time?

[Lord Kamall (Con)]

I thank my noble friend for that question. I am not sure of the exact details on when they are informed but let me go back to the department and ask. What I do know is that, when immigrants come to this country and register with their local GP, there is a health check and, quite often, a questionnaire to raise awareness about what vaccines or treatments they may have had and to ensure that they are as up to date with their vaccinations as the existing populations.

Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 6) Regulations 2021

Lord Sterling of Plaistow Excerpts

Wednesday 15th December 2021 Lords Chamber

[Lord Sterling of Plaistow (Con)]

My Lords, I suggest that, if it were not for omicron, we would not be sitting here today. It is only because of omicron that we are all debating this. I have to say this. Could the messages have been better? Yes. Could the NHS have been better prepared? Possibly. But that does not matter. I completely support what my dear noble friend Lord Fowler said.

Decisions have to be made and I will finish on this point. The sooner we are able to be free—truly free—I want the opportunity for us all to get everybody back to creating wealth in this country, because that will be the real challenge before us. Unless we manage to do it, the rest, sadly, will become unnecessary.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I commend the 126 MPs in the other place who voted on their principles and conscience, despite heavy whipping, in yesterday’s rebellion. They formed an ad hoc Official Opposition while the formal Official Opposition did their—what did Keir Starmer call it?—“patriotic duty” in not opposing but endorsing every single one of the Government’s proposals.

Despite having previously opposed vaccine passports, now renamed by Ministers—as though that were convincing—and despite all the talk of preventing the NHS toppling over and lauding NHS workers as heroes, Labour voted for discriminatory employment practices and the brute force of job losses to coerce NHS staff into complying with a medical intervention or getting sacked.

In every wing of the Conservative Party there was a significant minority of MPs who, despite personal appeals from the Prime Minister, defied the Whip—and that means something important that this House might note.

This legislation has already been passed, so detailed scrutiny of each aspect of it is largely formal, with little meaning, but there are broader issues worth raising. One is trust. I am concerned that the Government’s response to omicron is eating away at trust in political institutions, and objective statistics and data have been misused recently, with examples of regular contradictions and different figures coming from Ministers with quick contradictions afterwards. We worry about misinformation on the web, but there has been a fair amount of it from official sources.

Also, can we remind ourselves that the Prime Minister, Boris Johnson, declared an “irreversible” road map out of lockdown? But that irreversible moment has now screeched to a halt and is reversing at rapid speed. Then we get shrill warnings that the UK is facing a “tidal wave” of omicron. Is that a bit like “one minute to midnight”? I am worried that there is overhype and too much hyperbole.

This is all in the real context that 95% of the population have antibodies. There has been a phenomenally successful vaccine take-up and, in the real-world international evidence—not speculative modelling—we are thankfully shown that, while this variant is highly transmissible, it is not as yet seen as a widespread, lethal threat by medics and scientists. And hyping up the potential threat can do real damage in other ways. If everything is an emergency, nothing is an emergency, and there is always a danger in crying wolf.

The speed of omicron is not the only danger. More worrying is the dangerous speed with which the Government immediately have recourse to invasive restrictions. This is no longer a last resort. It is almost the first policy idea at which they grab. It is not based on weighing up the broad social pros and cons. We are not presented with a detailed cost-benefit analysis; it is deployed just in case there is a worst-case scenario. There is always a hint of worse to come. It might be vaccine passports now, but in the new year there will be three-dose vaccine passports.

The Prime Minister offered a rare opportunity for a national debate. I was quite excited. A national debate is sorely needed on the whole question of the balance of risk and the priorities which society wants to take. But, no, the Prime Minister’s offer of a national debate was to discuss mandatory vaccination, of all things.

This Government have made national sovereignty a byword and sovereignty something which people understand. I remind them that this direction of travel is in danger of trashing the Enlightenment ideals of individual sovereignty and bodily autonomy. John Locke’s A Letter Concerning Toleration says,

“no man can be forced to be … healthful”

Vaccine passes are not inconvenient or a bother. I have one in my bag in the unlikely event that I might go to a nightclub. What does it mean? Most people will say, “I do not know what the fuss is about”, but there are far greater implications. Everyone’s freedom is limited if the state determines that it is contingent on accepting a medical treatment or providing medical information, or on a submission to public health priorities above all else. It is limited if we need a licence to go about our lives freely.

The noble Lord, Lord Scriven, has asked us to put our political philosophies to one side, as though noble Lords are raising matters of principle as if we are in some sort of sixth-form debating chamber. I understand that this is a caricatured view. If society is to be completely reorganised around public health, and dangerous, illiberal principles are to be set, debate should at least be encouraged. I should have thought that liberals and democrats—as in Liberal Democrats—might be quite keen on that kind of a debate.

I quote from a new document which the Government has brought forward in the last few days. It is a modern Bill of Rights. In the foreword, we are told,

“The United Kingdom has a long, proud, and diverse history of freedom. This stretches from Magna Carta in 1215”.


It then details all the proud freedom movements. It continues,

“Our proposals, which form the basis of this consultation, reflect the Government’s enduring commitment to liberty under the rule of law.”


What is the point of having documents declaring a commitment to liberty under the rule of law if liberty can be so easily dispensed with in the name of public health?

State power works. Of course it does. You can scare and threaten people into changing their behaviour, but is that what we want in our society? Many of my extended family have disagreed with my more liberal views on this question, throughout this pandemic, and have been enthusiastic adherents of lockdown. At the moment, they are not so much scared of the virus as of the next government press conference. They have become cynical about a lot of what they are being told. They are fearful that their way of life is being disrupted, rather than being immediately frightened of death.

In a recent pamphlet, Toxic Sociality: Reflections on a Pandemic, Josie Appleton makes the point that every pandemic has a social dynamic, as well as an epidemiological cause which structures the way the disease is seen and responded to. In many ways, my extended family has noticed that there is more to life than epidemiology. There has been a period when they have been able to meet publicly and socially to discuss what kind of priorities they want. It is important not to dismiss that social side. It seems to me that one clear and present danger is that social cohesion is now threatened by the kind of messaging that we are getting around the virus. Human interaction is presented as a contagion. All the unregulated examples of free conviviality and spontaneous social gatherings, such as going to a nightclub without showing a pass, are presented as toxic. Free association is being replaced by state-authorised association.

We are encouraged to view the unvaccinated as “the other”, as lesser, to be excluded from aspects of society and employment and discriminated against—not there to be encouraged or persuaded into the vaccine, but threatened. This is not making a positive case for the wonders of the vaccine and it promises to backfire.

The noble Lord, Lord Fowler, made a point about what he considered to be the role of this House. I thought that its role was to scrutinise and be critical. I hope that in the new year this House gives a lead, not just by going along with whatever we are told but by asking questions and potentially prioritising the importance of a free society, without having to apologise for it.

Health: Learning Disability and Autism Training

Lord Sterling of Plaistow Excerpts

Monday 10th February 2020 Lords Chamber

[Lord Sterling of Plaistow (Con)]

My Lords, my involvement in autism over a number of years has been on two fronts. One is through Motability, where we are getting ever more people with an autistic background coming to us for mobility. Then, of course, as some noble Lords are aware, my grandson is on the spectrum but, pleasurably for me and all of us, at a low level. I can only emphasise what I have said so many times. I asked myself: is there anything new about what we want to do? Frankly, there is not.

I was very pleased indeed that the manifestos of all political parties—I am not getting partisan at all—all agreed that greater support for the disadvantaged and disabled are critical for everybody. I also want to say, from our experience and from my own experience, that the earlier you can identify autism, the better. That is the key. We were very fortunate that our little lad was identified at the age of three. Why? Because in the school he was at, the headteacher had actually studied and been trained and she identified it.

I deliberately thought, “I am not going to look at the old speeches I have made before. They are all there.” What I want to say specifically is that I have discussed many times with a lady many of you know, Professor Vivian Hill, the fact that, sadly, until we have many more educational psychologists who are in a position to make it quite clear and agree that somebody is on the spectrum, diagnosis will take too long.

Many of us here have chatted, individually, separately and together. People say, “Let us do some more analysis—let us wait another five years to see what we can understand”. We know what needs to be done. I have seen it myself in action. Fortunately, in the state school in West Sussex where he is at now, the headteacher has had training, and that makes a huge difference to how a school is run. It is a marvellous school, one of the finest state schools in the country, and they are so conscious of the training.

In practice, when you think about the identification of what we are talking about, a young teacher of 21 who might be in her first job, if she has had some training, it could well be that she can actually identify certain things. She can make a note and then ask the headteacher whether it should be looked at, so that autism is identified at a much earlier age. The opportunities then are immense. When people are trained and given the support they need, the children stand a much greater chance of going into mainstream schools and then, in due course, being able to get on in general life and society.

Having said that, I am afraid that people say that, somehow or other, those who are autistic should be made normal, like the rest of us. It is we who have to change. I have seen the autism figures and in actual fact, as they get older, only 16% of those on the spectrum have been able to have jobs. That is a problem of the employers. I have seen it myself in business. In practice, people are nervous handling somebody who they are told is autistic. We are the ones who have got to change.

On the need for training, I feel quite strongly about that—including for the public at large. My daughter’s little boy had a meltdown in a major store. It was terrible. He ran off and she ran after him. She got him to the floor and people surrounded them. She is quite strong, but she was so embarrassed that she picked him up to get him out, because she also had her little girl with her, and was thinking about what would happen to her if she ran away and left her. Did anybody come to support her at all?

The following day she had two policemen at her door saying, “We understand that you’ve abused your child”, and so she went on to the list. That is a shocking outcome. People did not volunteer to help. It is not just about educating teachers, which should be mandatory—no one should become a headmaster or headmistress until they are educated on this—but we should also find ways and means to educate the public, so that if they see something, they help and it registers with them that this person needs some support: “I’ll look after the little girl while you look after him”, et cetera.

I thank the noble Baroness, Lady Hollins, so much for introducing this debate. I should have thanked her at the start. I have very strong feelings on it.

Anxiety is a key factor in mental health. People are starting to understand, but it should become law that every headmaster and headmistress in the country, and anyone in a teaching role, should have compulsory education on this, so that they have the opportunity of picking up one or two points which can give a kid a chance early on.

Noble Lords probably know better than I do that the available support money in these areas is quite uneven in different parts of the country. In some, it is very high; in some, it is very low. Some do not have any support for people at all, or any understanding of what it is about. That must be addressed.

Now that we have got all of last year out of the way, I would like to think that, going forward, all political parties agree on this; it is totally non-partisan. I hope the Minister recognises that it would be a pleasure for all of us if things happened sooner. We do not need more analysis; we know what is needed and we need to get on with it.

People with Disabilities: Reporting Abuse

Lord Sterling of Plaistow Excerpts

Monday 17th June 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I am happy to give the noble Baroness that commitment. Domestic abuse in any situation is absolutely unacceptable and we are happy to commit to supporting her.

[Lord Sterling of Plaistow (Con)]

My Lords, a reverse of the abuse that the noble Baroness commented on was highlighted at a meeting in this House only two or three weeks ago, when we had a whole load of international psychologists around. A couple were there who said that their son, who is a lawyer but is on the spectrum, had a meltdown one Friday night. He was arrested and stayed in prison until Monday night/Tuesday morning because there was absolutely nobody around who was able to verify that he had this problem. I suggest to the Minister that one of our biggest problems is that there is not enough knowledge, by the police or by others, about how to handle such occasions.

[Baroness Blackwood of North Oxford]

I thank my noble friend for raising this matter and I am very sorry about the experience he highlighted. One of the measures that has been implemented in order to improve this situation is liaison services between police and mental health trusts to ensure that expertise is on the ground should individuals find themselves in situations such as he described. This has dramatically reduced the number of such situations. I would be very happy to write to him giving examples of where this has improved the situation.

Health Inequality: Autism and Learning Disabilities

Lord Sterling of Plaistow Excerpts

Thursday 10th May 2018 Grand Committee

[Lord Sterling of Plaistow (Con)]

My Lords, we are very fortunate to have such a powerful advocate for the way in which to deal with this. On my own front, I have a young grandson who is on the autistic spectrum. We are also getting many more people with autism coming into the Motability scheme, so I am interested on two fronts. In advance of today’s gathering I spoke to the chair of the British Psychological Society’s Division of Educational and Child Psychology, Dr Vivian Hill. She also looks after our little boy. We have talked about the child, but it is the stress on the family that is immense. I see despair and sadness in my daughter—she says to me sometimes, “What is going to happen to him if I am not alive? Who’s going to look after him?” She brought up one issue on the health side, in particular. There is a lady—I will not give her name—who is now 35; she has a university degree, and works with Vivian at University College London interviewing people for the educational course. She has been in and out of hospital this year with various problems, to say the least. She said yesterday that she calculated that, for the first six months of the year, it has probably cost the health service £50,000—but they stopped the welfare attention that she used to have once a fortnight, which could have made a huge difference in understanding what the situation is. She was saying that there should be a way—in the same way that there is in collecting tax, for example—that a name flashes up immediately, in any ward anywhere throughout the country, if somebody is on the spectrum.

I also spoke yesterday to two fascinating headmasters in the Horsham area about money and so on. Many noble Lords have talked about how early it is possible to identify children on the spectrum. Everybody here feels that if you can get a child into a mainstream school, they have a chance of making it in life—a chance of acquiring self-esteem and of getting somewhere. We have not talked about money but really we are talking about money being made available to achieve that. If one looks at this from a taxpayer’s point of view, it is reckoned that if things were handled differently on the health service side, we would save a huge amount of money, although there is no point in my trying to guess the figures. Our little boy was diagnosed at the age of three. He was very fortunate and is getting through it very strongly. From the perspective of the taxpayer, the savings from early diagnosis—as a long-term investment—are immense.

In conclusion, as has been said, most of us in this Room are very fortunate. We must help these people, many of whom have brilliant minds and want to play their part in society. There has been enough talk.

The Long-term Sustainability of the NHS and Adult Social Care

Lord Sterling of Plaistow Excerpts

Thursday 26th April 2018 Lords Chamber

[Lord Sterling of Plaistow (Con)]

My Lords, it is with some trepidation that I take part in this debate. The professionalism of the report of the noble Lord, Lord Patel, together with everything that has been produced with all-party support, shows this House at its best.

Many years ago, I was at the Grosvenor Hotel attending a ball. The lady with me, who was beautiful and was wonderfully dressed in a long gown, was a senior nursing sister at St George’s Hospital at Hyde Park Corner. The music was suddenly stopped and it was announced that an IRA bomb had just hit the Hilton Hotel. As noble Lords may remember, there were a very large number of casualties. My companion grabbed her bag and we rushed out. Everything had stopped. Police cars were all over the place. She ran into the middle of the road and stopped a police car. The bloke yelled out, “What the hell do you think you’re doing?” She said, “I’m a nursing sister. Get me down there fast”. I followed along. When we got inside, there were a couple of house doctors standing at the side. She said, “If you can’t do anything better, get out of the way”. As noble Lords can imagine, it was a pretty awful evening. At about 1 am, she came over to me with a white coat, covered in blood, over her gown, and said to me, “Jeffrey, I’m starving. Where can we eat?”

Another personal experience occurred at St George’s Hospital, Tooting, 11 years ago. I was taken there from where I was in the country when I had a heart attack, and it was quite an experience, although it is something that you know can happen. It was the first time that I had ever been in an ambulance. I had seen many ambulances but had never been in one. Because the driver had taken the wrong route, the advice given by the doctors who were waiting was that I had better have a clot-buster. I said to the guy looking after me in the ambulance, “What the hell’s that?” He said, “I’ve only done it once but I’m told that you had better have it. But you must read a form first because of the chance that you won’t make it”. So I had it and I made it, and my experience of the National Health Service on those two occasions is that its staff must be the most trusted people in our society and, if I may say so, the most loved.

Years ago, the late Lord Goodman, with whom I founded Motability, was asked by Barbara Castle to examine the funding position of the National Health Service. He carried out that report and I saw it at the time. At its conclusion, he said, “My strong advice is that you should charge £5 a night for every hospital bed”. If you looked at the figures, you would have seen that that was meaningful. Sadly, it was turned down.

One of my companies built hospitals, and one knows, sadly, the way in which the management change the plans so many times so that the overruns and costs become extraordinary. It is my view that, on the management side, a great deal can be done.

Nearly 20 years ago, when Labour was in power, I was asked whether I would be prepared to look into the health service. I said that I would do it only if it was not a royal commission that would be kicked into the long grass but was done on an all-party basis and I could choose the members of the committee. Sadly, it was turned down and so I never had that experience.

The noble Baroness, Lady Meacher, mentioned the blame culture. Having wandered around the health profession and mixed with a lot of people there, I know that that culture is having a devastating adverse effect on morale and inhibits positive progress and action being taken by managers.

At the start of the debate, the noble Lord, Lord Patel, said that the National Health Service should be free at the point of need. I agree with that, but what I do not agree with is the misuse of the health service and it being taken for granted. Let me give an example. I have talked to people about the number of no-shows in out-patients and those wasting time by turning up at the emergency ward. I have spoken about this with senior registrars in three hospitals and my noble friend Lord Bridgeman will talk later about the views and role of GPs and doctors themselves. In practice, one-third of people who turn up have no need of any medical help and should have stayed at home and one-third should have been treated by a nurse or gone to a chemist. Others will go into this in much greater detail, but in my view the GP is the key factor for what will happen in the future.

My final point is on the NAO. I am not sure that the views of the NAO are right. Putting the care of the elderly under one umbrella may not be the right answer. I am particularly interested in what happens because I am heavily involved in this area and that of the mentally disabled. I find that people want time and they suffer from loneliness. It is not just about care: loneliness must come into the thinking on this.

I will finish by telling the Minister about one aspect of charging. When people get things totally for free—I have found this myself in the past—they do not value them in the same way as when they have put something into it themselves. You should pay £10 a visit to go to the doctor and if you do not turn up at out-patients you should pay £10. That would help enormously. The important point is that people need to value things, and they will do so if they have put in something themselves.

Children and Young People: Mental Health Services

Lord Sterling of Plaistow Excerpts

Thursday 8th March 2018 Lords Chamber

[Lord O’Shaughnessy]

I agree that that is a challenge. There is a plan to create 21,000 new medical and allied posts by 2021, which would be the biggest expansion in mental health services that has ever taken place—certainly in this country but even in Europe. How we are going to achieve that is set out in the draft workforce strategy that Health Education England has published. A big part of that is the creation of mental health support teams in schools. That will take time—we need to be realistic—but it is an ambitious goal and we know that that support is wanted and needed.

[Lord Sterling of Plaistow (Con)]

My Lords, I am interested on two fronts. Motability over the next three years will be getting a quarter of a million people coming into the scheme and a large number of them will be children. This will put a major strain on the service they require. I am interested also on a personal front. I have a marvellous young grandson who is on the upper end of autism, so I take a deep interest in both. I thank the Minister for what he has read out from the other place but I disagree. I am afraid that we are lacking hugely in this country. Basically, we are short of educational psychologists. I am no expert but, as any doctor will tell you, the earlier you can identify mental health problems—at three, four or five—gives an opportunity of treating them generally. The Green Paper is interesting but could the Minister do some more work on the ground to find out whether what he is being told is actually happening in practice in local authorities?

[Lord O'Shaughnessy]

I thank my noble friend for that. I think it is a fair challenge. I hope he will be reassured that of the 21,000 more mental health professionals we intend to recruit, 1,700 are therapists—including psychotherapists, educational therapists and others.