King’s Speech

Baroness Barker Excerpts

Thursday 9th November 2023 Lords Chamber

[Baroness Barker (LD)]

My Lords, a gracious Speech is a helpful indicator of a Government’s position and their intended programme for the coming years. This speech is quite clear: it is a series of individual bits and pieces with not a strategy in sight. That is something we should pay a great deal of attention to when we think about the run-up to the next election because we are desperate for a Government who will take seriously the issues facing all our public services, addressing the growing demands on them and the likelihood that there will be fewer resources in real terms to provide them.

I spent the last two years in various Select Committees of your Lordships’ House—one on social care, one on scrutinising the mental health Bill and one, which is about to conclude, on the integration of community and primary care. Across those three pieces of work, there have been a number of recurrent themes.

The most fundamental to this is the need for an informed public debate about sharing personal data. Our personal data will be the basis on which the future of health and public services is built. At the moment, we have a great deal of confusion, not least on the part of practitioners, about the status of data protection laws and the importance of public health. Time and again in those different committees, we heard frustration on the part of practitioners, service planners and patients at the utter impossibility of getting data on individuals, or even at a community level, in a manner that is timely and makes for the effective and efficient provision of services.

I wonder whether the Minister will take from this the urgent need to revisit the Caldicott principles and update them in the light of technological information advances, and to begin the process of having a public debate about the ethics and principles of sharing data. In that way, we might move quickly towards an improved performance of public services, particularly health and social care, based on the resources that we have at the moment.

It is regrettable and a great shame that the Government have turned their back on the widespread consensus on how mental health law should be reformed that has developed since Sir Simon Wessely produced his report. Nevertheless, a great deal of work has been done, which will be there waiting for an incoming Government to do it.

There are three things that the current Government should do now, which do not require legislative change. First, there should be mandatory training for all mental health professionals in the recognition and diagnosis of autism and learning disabilities. That would stop the inappropriate treatment of people with learning disabilities and autism, which sometimes not only leads to them being inappropriately detained at length under mental health legislation but results in them going into the criminal justice system when they should not.

Secondly, with a number of long-term conditions such as Parkinson’s disease, there is a great incidence of mental illness. I wonder whether the Minister will look at the major conditions strategy and the need to make sure that practitioners, in certain physical conditions, understand the mental health aspects of those conditions.

Finally, when we worked on the mental health Bill, we looked time and again at the disproportionate effect of mental health legislation on people from black and brown communities. They are far more likely to be detained inappropriately than other groups. We were told by all the people to whom we spoke that one thing that would have a direct impact on that is the introduction of an electronic system of advance choice documents. Advanced work is being done on that, based on work done in the field of palliative care by people at South London and Maudsley, the psychiatrists at Guy’s and so on. It needs only the Minister’s department to swing in behind the work already being done for pilots to be rolled out, ready for an incoming change in the legislation.

Let us be honest: none of us can see a time when local authorities will suddenly have new, massive amounts of money to put into social care. It is already underfunded and is subsidised by individuals. The one key thing that the Government could do is make sure that local government retains the requirement to give people assessments of their needs and to tell them what is available to them, wherever they choose to get their help from. Funding those independent assessments, and not leaving it to providers of services, is the one critical thing that might make a difference to the increasing number of people who will be living in the community with long-term conditions and really need help to stay in their homes—which I hope will be built to a lifetime standard in the future, so that people can stay in their home whatever the tenure of the home in which they live, whether rented or private.

I take the opportunity to say one final thing: King’s Speeches are about Governments’ priorities and choices. When the Government can find the time to license pedicabs but cannot be bothered to bring in a ban on conversion therapy, the lesbian and gay community understands the message. We get it: we are not safe while this Government continue to be in office. It is absolutely time that they went.