Care of Critically Ill Children

Lord Watts Excerpts

Monday 29th January 2024 Lords Chamber

[Lord Markham (Con)]

Yes, the noble Lord is quite correct. We know that, in many walks of life, so to speak, there are certain sectors of society that do not get the same level of provision and sometimes miss out. We had the debate last week on maternity provision and saw instances in relation to ethnic minorities as well as people with learning difficulties. We need to make sure that all the communications are there and that everyone is armed to provide the right levels of interface and communication in what are some really difficult cases.

[Lord Watts (Lab)]

My Lords, many families with critically ill children find it very difficult to access treatment because often specialist treatment is only available hundreds of miles away from where they live. That puts tremendous pressure on the family financially. Do the Government intend to do any more to help those families?

[Lord Markham (Con)]

Clearly, we would all agree that the families need to be the priority in these terrible cases. What we have tried to do—and I have also done my own research into this—is make available what I call independent funding requests for when there is a new course of treatment which might not be allowed generally by NICE to give opportunities in those instances as well. I will come back to the noble Lord on things such as travel support and other expenses.

Care Home Staffing

Lord Watts Excerpts

Thursday 18th January 2024 Lords Chamber

[Lord Markham (Con)]

Yes. I have seen a number of really good examples of the kind of step-down care that my noble friend is talking about, or intermediate care that can be used as interim measures. We are trying to bring more of them on board, as well as the very good virtual wards. We have set up 11,000 virtual wards, and they are making a difference as well.

[Lord Watts (Lab)]

My Lords, the Government say that they have done an assessment on the effects of the visa changes. Can he tell us how that was done if the Government did not discuss it or consult with the sector?

[Lord Markham (Con)]

It was a Home Office impact assessment, so I freely admit that I do not know exactly who was consulted; I will happily get back to the noble Lord on that. I know that the assessment looked at all the different parts, including the salary cap and the impact on dependants. For instance, it was not thought that the restriction would have much impact on dependants because not many people come with dependants in the care sector. It looked into each bit, but I will happily let the noble Lord know more in writing.

Adult Social Care

Lord Watts Excerpts

Wednesday 22nd November 2023 Lords Chamber

[Lord Markham (Con)]

As I say, we are seeing staff increases. I accept that there is a lot to do in this space, but there has been a 1% increase this year, so we have turned things round quite substantially. Overall, the number of patients being cared for in this way went up by 15,000 in the last year. As the ADASS survey showed, there has been a decrease in the waiting lists, down 13% from the peak, so we have turned a corner and we will see further improvements.

[Lord Watts (Lab)]

My Lords, the Minister said that waiting lists have gone down by 13%. Can he tell us by how much they went up over the previous 12 years?

[Lord Markham (Con)]

I do not have the figures for those 12 years, but I will happily send them to the noble Lord.

NHS Long-term Workforce Plan

Lord Watts Excerpts

Tuesday 4th July 2023 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend. Dentists were pointed out in particular because so many of them go on to work not in the NHS but in private care settings. It is out for consultation, but I think that was the thinking behind it. For instance, even after five years, 93% of doctors are still registered and working in the health service; that is a lot lower in the dentist space. We are putting investment into that group and it is clearly perfectly reasonable to expect a return on that by a certain time.

[Lord Watts (Lab)]

My Lords, the Minister has set out the aims and objectives of the plan, which we all welcome, but does he understand that, unless we fix the care system at the same time, this plan is bound to fail? It could make it even worse, with staff moving from the NHS and away from care services. How will joined-up government address the problem of under- recruitment and low morale in the care service, which will make this plan either succeed or fail?

[Lord Markham (Con)]

I would like to think, as I mentioned before, that increasing the supply and training of the whole medical profession would help the whole sector. This is quite close to my heart; as I have mentioned before, my mum became a nurse later on in life and went through an apprentice-type route, for want of a better phrase. Having different entry points is a very positive thing. I sincerely hope that people going into a social care environment will see that as a building block to onward career progression and that it will set them up to take further qualifications later on in life, if they wish, in the nursing profession. We are looking to expand the whole sector, and the general belief is that that will benefit both social care and the NHS.

NHS GP Surgeries: Purchase by US Companies

Lord Watts Excerpts

Monday 5th June 2023 Lords Chamber

[Lord Markham (Con)]

My noble friend is correct, of course. GPs have always been independent businesses, and that is the backbone of the service. We have managed to increase the number of GPs by 2000 since 2019, but we all accept that more needs to be done to attract them, especially to the key areas that my noble friend mentions. We have a £20,000 bonus in place to recruit GPs to those difficult areas and, most importantly, we have a record 4,000 GPs in training.

[Lord Watts (Lab)]

My Lords, is it not a national scandal that someone can purchase a building for £1 million, they can locate health services in there, they can get the NHS to pay the mortgage on that building and at the end of that period, that person owns that building? In other words, we have transferred £1 million from the taxpayer to an individual.

[Lord Markham (Con)]

I think it was the noble Lord opposite who introduced patient choice. That looked to the independent sector to increase supply, which is what we care most about. I do not believe that anyone should be fundamentally against who owns a business. What they should care most about is the supply of good-quality services.

Diphtheria

Lord Watts Excerpts

Tuesday 18th April 2023 Lords Chamber

[Lord Markham (Con)]

Clearly, I am always going to support good dialogue—that is common sense, and we should do that. The proof of the pudding is in the eating, and 88% is a very good result. That notwithstanding, clearly it makes sense that they should work closely with local officials as well.

[Lord Watts (Lab)]

My Lords, 88% is very good, but why is it not 100%?

[Lord Markham (Con)]

As I say, compared with 93% in the UK population—who have many bites of the cherry, for want of a better term, because there are many opportunities for them through schools and everything—88% is very good. Is it perfect? No, but it is very good and definitely better than anywhere else in Europe.

Patient Deaths: Ambulance Waiting Times

Lord Watts Excerpts

Tuesday 14th March 2023 Lords Chamber

[Lord Markham (Con)]

I thank the noble Lord for his contribution, as ever. Yes, absolutely; these things always have to be resolved around the table. As I say, I am pleased that we are making good progress with nurses and ambulance workers, and I hope we can get around the table and make more good progress with GPs as well.

[Lord Watts (Lab)]

My Lords, there is a shortage of nurses, a shortage of doctors and a shortage of ambulances. What have the Government been doing for 13 years to let this crisis happen?

[Lord Markham (Con)]

Noble Lords will be aware that this is a situation facing people all around the world. Just today I was being grilled by a Select Committee talking about the problems in Stanford in California, where people were having to wait 48 hours to go from A&E to get to a bed. It is a worldwide issue.

NHS Staff: Food Banks

Lord Watts Excerpts

Tuesday 7th February 2023 Lords Chamber

[Lord Markham (Con)]

As has been mentioned many times, the workforce strategy is key; being able to recruit and retain staff, and pay, are vital elements of it, so I accept the challenges in this space. At the same time, I am mindful that we have sought to protect the lowest paid through these increases, as I mentioned. I am confident that the new pay review body, which is coming up, will seek to take the inflationary pressures into account to make sure that there is a fair settlement for everyone.

[Lord Watts (Lab)]

My Lords, why are the Government hiding behind the pay review body? When it looked at wages for the health service, inflation was running at 4% or 5%. We have just heard that food inflation is now running at 16%. Will the Government think about this again and ask the pay review body to look at the facts now?

[Lord Markham (Con)]

Again, April is very close; the pay review body will be looking at the facts then. The noble Lord is quite correct that the real change is inflation, and that is why the priority for all of us has to be to reduce inflation. It is pernicious in its impact on every single one of our pockets, and most of all on those people with the least money. That has to be the priority, but we will continue to support these people.

Care Homes: Staffing

Lord Watts Excerpts

Wednesday 11th January 2023 Lords Chamber

[Lord Markham (Con)]

Yes, this is absolutely something that we talk to our Home Office colleagues about all the time. I believe that 15,000 people have already come through on this route in the last nine months or so; we are seeing a rate of about 1,500 a month. It is very important and something on which we are focused.

[Lord Watts (Lab)]

My Lords, rather than bringing in people from abroad, would it not be more effective to pay our own people proper wages with proper conditions, so that they want to work in this sector?

NHS Winter Pressures

Lord Watts Excerpts

Tuesday 10th January 2023 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend. The best ICBs that I have seen have the local authority as part of their board and their decision-making on a day in, day out basis. One of the best control systems that I saw in an ICB actually had the local authority social care people in the room making the decisions with them, so they are a key element in all of this. On purchasing and funding, they are very much a strong player.

[Lord Watts (Lab)]

The Government have spent 13 years cutting the number of beds and they are now reversing that and starting to increase it, which is welcome. The other thing that they have done is to constrain pay in the NHS and social care. They have an opportunity to do something about that. Why are they not taking the opportunity to boost pay in both those sectors to address some of the problems that we face?

[Lord Markham (Con)]

I welcome what I hope, over the past few days, has been better mood music—let me put it that way—in this space. I hope from the different things that we see that we will get closer towards a landing zone where we can reach agreement going forward. We know from both sides that neither side wants to be in this dispute. My hope very much is that constructively—with good will on both sides, which we are seeing—we will find a way forward.