Covid-19 Update

Baroness Blackstone Excerpts

Monday 14th September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, we have taken huge steps in the domestic production of PPE. In some matters, where the production is relatively straightforward, such as aprons, we have taken huge steps forward and the vast majority of our production is done at home. For some products, such as gloves, that are more complex because of their shape, we are having to work harder. The progress of my noble friend Lord Deighton’s Make strategy for PPE has been profound, and we are looking at making up to half of our PPE requirements in the UK.

[Baroness Blackstone (Ind Lab)]

My Lords, given the intrusive and damaging effects, especially on family life, of the decision to limit social contacts to six people, can the Minister say why it was decided to apply this both inside and outside, rather than to follow the Welsh Government’s position of applying the new ruling only to meetings inside? Does he agree that medical evidence suggests that the chance of contracting the virus outside is tiny in comparison with inside, and that, with regard to his quest for simplicity, nobody is so simple that they cannot tell the difference between inside and outside.

[Lord Bethell (Con)]

My Lords, I agree that everyone can tell the difference between inside and outside, but everyone also has eyes, and may have seen, as I have, how people crowd together in the forecourts and beer gardens of Britain. If they were all standing on draughty hillsides with the wind blowing the disease around, that would be one thing, but the simple fact is that our prevalence has gone up—the evidence speaks for itself—and that is why we need to be clearer about this simple measure.

Medical Teaching and Learning: Ethnic Diversity

Baroness Blackstone Excerpts

Tuesday 14th July 2020 Lords Chamber

[Lord Bethell]

The noble Baroness put her point well, although the broadband deficiencies meant that I did not get all of it. I emphasise that this area of policy work is very much the focus of the drafting of the People Plan, which will put a spotlight on a number of the areas of our human resources, including BAME people, and we look forward to the publication of that plan.

[Baroness Blackstone (Ind Lab) [V]]

My Lords, while the curricula of medical schools are for them to determine, could the Minister tell the House whether any meetings between the Medical Schools Council and Ministers have taken place recently? Will he ensure that a meeting is arranged in the near future to hear from the medical schools what they are doing, first, to improve the representation of Afro-Caribbean staff and students and, secondly, to ensure that teaching and research properly explore those conditions to which the BAME community is especially susceptible? Black lives really do matter.

[Lord Bethell]

The noble Baroness asks a very specific question; I cannot, I am afraid, answer precisely on what meetings there have been with the medical councils, particularly during the busy Covid period. All I can say is that there is ongoing and regular engagement with the medical schools that focuses very much on the key issues that she describes. Diversity and Inclusion: Our Strategic Framework 2018-2022, from Health Education England, is a very explicit and specific programme of works in which we engage all those in health education. As I mentioned, we are working extremely hard on our recruitment campaigns to ensure that they reach communities otherwise not reached.

Covid-19: Mental Health Services

Baroness Blackstone Excerpts

Thursday 2nd July 2020 Lords Chamber

[Lord Bethell [V]]

My Lords, threats of violence under any circumstances are reprehensible, and those aimed at the old and the vulnerable are in a category of their own. It is up to the clinical judgment of those involved in social care to decide whether the involvement of the police is of benefit and worth. I would not want to apply a blanket ruling on that, but the noble Baroness makes an extremely important point, which we are constantly reviewing.

[Baroness Blackstone (Ind Lab) [V]]

My Lords, there is increasing evidence that the mental health of children and young people has been badly affected by the Covid-19 lockdown. Given that the provision of mental health services to this age group was already inadequate, why has progress in implementing plans in the Green Paper on child mental health been so poor, particularly in the rollout of child mental health teams? What steps will the Government now take to rectify that?

[Lord Bethell [V]]

The noble Baroness is likely correct that the epidemic has had a particular effect on children and young people. The evidence on this is not crystal clear, but that is the strong instinct of all those in the field. I personally welcome the reopening of schools, which will have a particularly beneficial effect on those children who at present are stuck at home and do not have the support of the school system. Mental health services for young people are part of our long-term plan, with the additional £2.3 billion of spending on mental health. Our ambitions in that area remain enormous.

Coronavirus Bill

Baroness Blackstone Excerpts

2nd reading & 2nd reading (Hansard) & 2nd reading (Hansard): House of Lords
Tuesday 24th March 2020 Lords Chamber

[Baroness Blackstone (Ind Lab)]

My Lords, like many others in this debate, I pay tribute to the many thousands of people who are working immensely hard to counter the effects of the coronavirus.

This huge Bill gives unprecedented power to the Government. Whether all these powers will be needed is uncertain. There are still questions about the severity of the disease and its future trajectory. The CMO has assessed a death rate of 1%. New research from the University of Oxford suggests 0.7%. In Germany, where far more testing has been done, it is 0.3%. We know that in the UK the average age of death from the virus is 78.5 years, and it is a fair assumption that, very regrettably, of those who succumb, quite large numbers would have died anyway. The measures in the Bill and those already taken, exacerbated by last night’s announcement, are leading to massive fear and anxiety in much of the population. More must be done to explain the demographics, reduce unnecessary fear and protect mental health. We in this House might need to worry about our survival but, fortunately, most of the population does not.

The other general point I want to make concerns the economy. A global recession will lead to the death of many children in poor countries, and it is undisputed that the supply of goods and services will be greatly reduced: first, by closing down production with large lay-offs; and, secondly, by restrictions imposed to keep a large part of the workforce at home. At the same time, in the UK, huge amounts of money are being pumped into the economy for understandable reasons. Are the Government assessing the serious implications for high inflation in the medium term? Will they be considering price controls at a later date?

I turn now to my main focus: how we sustain our education system and protect our children and young people from long-term damage as a result of school closures and the cancellation of public exams. History will judge whether or not the wider measures that have been taken to combat the coronavirus were proportionate. My view is that the decision to cancel GCSEs and A-levels was disproportionate and made without sufficient preparation and the requisite advice on what would be put in place instead. While recognising, as I really do, how difficult it is for the Government in these circumstances, answers are desperately sought by teachers, parents and pupils. Many pupils have said that they feel “gutted”; having spent the past two years working hard to reach their potential and get good grades, they feel cheated that they have been denied the opportunity to do so.

The Government have said that alternative assessments will be just and fair. Teachers will have to draw on many sources, including predicted grades, class work and mock exams results. I am sure that they will do their best. Nevertheless, there are bound to be large variations in the judgments they make. Some will be generous, and others tougher, so it will not always be just and fair. Moreover, universities will face difficult decisions about who to admit; at least a collapse in international student numbers could allow them to admit more home students and veer towards a generous admissions policy. But, given that all secondary schools will be open to allow the children of key workers to be looked after, I think it is a pity that 16 to 19 year-olds cannot work at home until the exams begin, and then come to school to take them. I believe that that is what should have happened.

The other concern about many children being forced to remain at home is the likely outcome of increased social inequality. Schools do not just educate children; they also provide them with a safe haven, a structure to their day and a chance to be creative and to learn about sharing. Schools are a leveller, in that they provide a similar environment for all their pupils, in contrast to the huge inequality in their homes. I am not sure how head teachers will define vulnerable children—presumably it will include those with disabilities, those who have been abused and those who are in children’s homes—but it is doubtful that they will be able to embrace the 4 million children who live in poverty and the many children who live in appalling accommodation, with overcrowding and limited resources.

When the schools reopen, will the Government provide extra resources to schools with many disadvantaged pupils, to allow them to give additional help, particularly to those who have suffered most from possibly many months of being unable to go to school? Will PGCE students be able to complete their courses this summer, to ensure an adequate supply of new teachers?

To conclude, ways must be found to ensure that the drastic decision to close our schools indefinitely does not have life-changing consequences for children and young people, such as increasing their vulnerability to gang violence and crime, as well as to mental illness and anxiety, while trashing our hopes for more social mobility.

Queen’s Speech

Baroness Blackstone Excerpts

Tuesday 22nd October 2019 Lords Chamber

[Baroness Blackstone (Ind Lab)]

My Lords, the Minister in opening quoted from the gracious Speech, stating that Ministers would,

“ensure that all young people have access to an excellent education, unlocking their full potential and preparing them for the world of work”.

This is a worthy aim, but given government policy, it is unlikely to be achieved. I expected the Minister to tell us that funding for schools would increase as a result of spending round pledges. She told us about the budget for early years, too, and for universities, but further education, as so often, did not even get a mention.

The position in further education is dire: its funding has been slashed by £3.3 billion since 2010. At least in the spending round the Government have recognised that FE colleges do need more money, but an extra £400 million is a paltry sum against the magnitude of the cuts. The Chancellor said that he had attended an FE college and knows how important they are. That is good news—he is one of the few Tory politicians who has done so—but come on, Mr Javid, that sum will not be nearly enough for FE to unlock the full potential of young people and prepare them for the world of work.

Before I discuss FE colleges’ resources, I will comment on the curriculum for 16 to 19 year-olds across school sixth forms and colleges. In this country, we have a disastrously overspecialised learning environment for young people taking school-leaving examinations at 18. No other education system has anything like the specialisation associated with A-levels. Like the noble Lord, Lord Storey, I will mention Mr Gove. As Secretary of State for Education, he took a step backwards when he returned to the three-subject A-level norm, dropping AS-levels which have encouraged the study of four subjects in the first year of the sixth form. If only he had made the progressive step of going in the other direction, towards five subjects at AS-level, followed by four at A-level. Even this approach is some way from the hugely preferable international baccalaureate, which allows the study of six subjects. The universities must share some of the blame, because their conservatism in sticking rigidly to offers of three A-levels has discouraged a broader range of subjects.

Many people lament the dramatic decline in the study of foreign languages. In a world where English has become the global language, it is harder to motivate young people who have English as their mother tongue to study them after the age of 16. They are also unlikely to be chosen when competing with a range of science subjects and mathematics, or with English and the humanities, when students are so constrained in their choices. The three-subject straitjacket also means that many able young people are not studying the important subject of mathematics after 16; many others are studying no humanities subjects either. We are forcing young people into a horribly unbalanced education at a time in their lives when they should be learning more broadly. I challenge the Government to do something about this, and I hope to hear about it in the Minister’s reply.

I turn to further education colleges which, as well as providing A-level programmes, are the vitally important institutions for the development of vocational skills for 16 to 19 year-olds—as well as for adults, which I will not touch on today. Many people welcomed the Government’s industrial strategy and their wish to tackle our low levels of productivity with more emphasis on skills training. How are we going to make any inroads into this problem if we starve the institutions with a central role in developing these skills? After cuts averaging 30% per annum between 2009 and 2019, the Institute for Fiscal Studies called FE the “biggest loser” in the austerity programme, and so it was.

To cite another important commentator, the Children’s Commissioner’s recent report showed that, by 2020, real-terms spending per 16 to 18 year-old will drop to the level it was 30 years ago. This means that we are spending the same amount per student aged 16 to 19 as we were in 1990, despite rising costs. It must be remembered that the spending review increase for FE is for one year only, in 2020-21, whereas the schools have a three-year settlement. Why should there be a difference? Why is the promised extra funding for FE so small? I ask this against a background where 16 to 18 year-olds in England get an average of 15 hours of contact time a week, compared with 25 for students of that age in other OECD countries. This amounts to 600 fewer hours over a standard two-year course—hardly the way to improve our relative productivity position and, thereby, our competitive success.

There is also a failure to meet another government priority: to promote greater social mobility. Many of the most disadvantaged young people do not stay at school after 16, and many will never gain a university place. FE colleges can have a vital role in providing a route to the skills needed for a rewarding career and to becoming socially mobile.

In conclusion, funding is a fundamental challenge in FE, as the Augar committee made clear. Will the Government now make a firm commitment to the sector of £5,000 per student per annum? Only then will FE teachers receive the pay they deserve and students get the quality of education and training that they need.

Health and Social Care Act 2012

Baroness Blackstone Excerpts

Thursday 5th July 2018 Lords Chamber

[Lord O'Shaughnessy]

I am sure that the Chancellor will have taken that view on board and he will reveal his decisions in the Budget.

[Baroness Blackstone (Ind Lab)]

My Lords, have the Government made any estimates of the cost of the extensive and in some cases overintrusive regulatory system? The Minister has rightly said that the Government are looking for savings in the NHS. Surely this is an area where savings can be made, as well as that of questionable surgical procedures.

[Lord O'Shaughnessy]

That is one of the areas we need to look at to make sure that there is proper regulatory reform. It does not necessarily require legislation, primary or secondary. There are actually fewer managers in the NHS today than in 2010. We have tried to transfer responsibility to clinical staff. But if the NHS identifies any barriers, we are committed to looking at them.

NHS and Adult Social Care

Baroness Blackstone Excerpts

Wednesday 5th April 2017 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness makes an incredibly important point. Despite the ageing population, the fastest-growing part of the adult social care budget is, I think, for adults with learning difficulties. She is quite right that there needs to be a comprehensive approach. That is why additional funding is going in to support not just older people but working-age adults too.

[Baroness Blackstone (Lab)]

My Lords, I declare an interest as the chair of the board of Great Ormond Street Hospital. I was also a member of the Select Committee. I want to pick up on what the Minister said just now about public health—which, if I may say so, I thought was rather complacent. The public health budget has been cut year after year over the past decade. Will he give the House an assurance that this budget will not only be protected but enhanced? Unless that is done, the terrible crisis we have in obesity will not be prevented, and many other areas of public health such as smoking, drugs and alcohol will not be addressed properly.

[Lord O'Shaughnessy]

The budget for all health services has been set out now for the spending review period until 2021. I completely agree with the noble Baroness about the importance of these kinds of activities. We are, of course, moving to a system where local authorities are able to retain their business rates. They have primary responsibility for the delivery of much of the public health services and we are trying to put them on a long-term financial basis so that they will be able to continue with the kind of work she has highlighted.

NHS (Charitable Trusts Etc) Bill

Baroness Blackstone Excerpts

Friday 26th February 2016 Lords Chamber

[Baroness Blackstone (Lab)]

My Lords, I declare an interest as the chairman of the Great Ormond Street Hospital board, and I want to give the reassurance that I am not Captain Hook in disguise.

I thank my noble friend Lady Massey of Darwen for taking forward this Private Member’s Bill in this House. I especially thank Wendy Morton, the Member of Parliament for Aldridge-Brownhills, for introducing the Bill in the House of Commons and for her very hard work in helping the passage of the Bill through the other place.

In advance of what the Minister is to say, I also thank him and the Government for their support for the Bill. I say that in particular since, as my noble friend Lady Massey of Darwen has already said, back in 2014 I attempted to make an amendment to the Copyright, Designs and Patents Act 1988, but without success. So it is a great pleasure that it looks as though as we are going to be successful today.

I want to say a little bit—I feel that I am obliged to do so and I want to do so—about the enormous value of the charity to the hospital’s work. It cannot be overstated. I thank the charity and its special trustees for the enormous amount of hard work that they put in to raise funds. Its current strategy is to try to raise £500 million over the next five years, and I want to say a bit about how vital this is by giving a few examples of the support that the charity gives the hospital.

We are now working to complete what will be called the Premier Inn Clinical Building. It will fit seamlessly with the Morgan Stanley Clinical Building, which was opened in June 2012, to complete what we call our Mittal Children’s Medical Centre. It is truly state of the art. It houses a new surgery centre, a high-specification respiratory ward and a high-dependency area, where the most unwell children can be carefully helped back to better health. The cost to deliver this is scheduled to be around £300 million, and the charity is still working to raise the final amount to make that happen.

Research is absolutely fundamental to everything that a hospital like Great Ormond Street does. If we have to be innovative, we have to be not just the hospital that does research but a research hospital. I shall give one example, which had some publicity last year, of a world first. One year-old Layla was cured of her leukaemia thanks to a gene editing technique developed and used by Professor Waseem Qasim. He designed a new treatment that uses what are called molecular scissors to edit genes and create designer immune cells programmed to hunt out and kill drug-resistant leukaemia. Research like this is made possible only thanks to charity-funded specialist laboratories dedicated to gene therapy research. Our new centre for research into rare diseases, which will be completed in 2018, will take forward a lot of that really innovative, life-changing research. Again, the money for that is being raised through the charity.

The charity also helps the hospital by securing extremely expensive equipment, such as a 3T magnetic resonance imaging machine and scanners that allow us to take much clearer and more detailed pictures of children’s bodies than was ever possible before. That allows faster and more accurate diagnosis, followed by better treatments for the children.

Treating children at home is something that we are also trying to develop at the hospital. Every parent with a very sick child longs for that child to go home, and every very sick child longs to go home. If we can release them from hospital and get them home faster, that makes a huge difference to them. One example of this is that we are now able to allow home dialysis to take place—again, thanks to charity funding. We have been the first hospital in Europe to offer home dialysis for children with serious kidney conditions. Before that, children had to come into the hospital a minimum of three times a week, spending four hours having dialysis. Home dialysis allows them hugely greater freedom and has dramatically improved their quality of life. Those are just a few examples.

I want to finish by asking a question of the Minister. I wonder whether he can clarify the details of the commencement of the provisions of the Bill. As I understand it, a number of NHS charities are still in the process of converting to independent charities. How long will it take for these conversions to be completed, and is it or is it not correct that they have to be completed before Clauses 1 and 2 and Schedule 1 can come into force? I would be really grateful if he could clarify that.

I end by thanking the many supporters of the charity—some of whom, indeed, are probably in this House—from the corporate sponsors to the big celebrity donors, but, above all, the many, many members of the public who support us by giving regular donations over many years.

Last of all, in his absence, I should thank JM Barrie for his extraordinary legacy when he donated the copyright to the hospital in 1929. “Peter Pan” has raised large sums of money, which has been put to wonderful use. It is now important that this legacy is safeguarded by passing this Peter Pan and Wendy Bill.

NHS: Reform

Baroness Blackstone Excerpts

Thursday 16th July 2015 Lords Chamber

[Baroness Blackstone (Lab)]

My Lords, I declare an interest as the chairman of the Great Ormond Street Hospital Foundation Trust. Before I put my questions to the Minister, I will just make one brief comment on his remarks about the Opposition. I have no idea what the shadow Secretary of State for Health said in another place, but I will defend what my noble friend Lord Hunt has just said. He said that he agreed in principle with a great deal of the Statement, but it is legitimate for the Opposition to ask questions about how a Statement of this sort might be implemented, which is what he was doing.

I have two questions, the first about bureaucracy. The Minister said that he wished to see a reduction in bureaucracy. As a chairman of a trust, I entirely identify with that. However, some of the bureaucracy is in the regulators, and I hope that his attack on bureaucracy will cover the regulators. The Government are about to set up another outside agency, which will put further bureaucratic pressure on those who are delivering services upfront. Anything he can do to try to reduce that would be helpful.

My other question concerns seven-day services. Again, I entirely endorse what the Government wish to do with respect to seven-day services—if anything, they are overdue—but there are questions to be asked. What is the timetable for this, if it is only going to apply to new consultants? It will take a very long time to introduce seven-day services if only new consultants are going to go on to the new contract requiring them to work at weekends. I understand why the Government are doing that, but it will make for a very long delay. What steps will the Government take to try to encourage existing consultants, who will be far greater in number than the flow of new consultants, to adjust to a new approach where seven-day services are introduced in the interests of patients?

[Lord Prior of Brampton]

I can only agree with the noble Baroness on bureaucracy. The new body that we are setting up to look at incident reporting, as recommended by the PAC, will only look at big incidents so will not be an added bureaucracy for the day-to-day running of a trust. I am always struck by the figure that nurses spend only between 70% and 80% of their time dealing directly with patients because they are dealing with bureaucracy. The bureaucracy argument falls into two parts: it is partly about the way hospitals run their affairs and partly about external regulators. We believe fundamentally in intelligent transparency. I see the CQC, for example, as less a regulator and more a means of providing intelligent information to boards of hospitals and to patients. But I take on board what the noble Baroness says. We will do everything we can to reduce the level of bureaucracy.

As far as the timetable is concerned, junior doctors will switch over much more quickly than consultants, because they turn over much more quickly. It will take time for consultants to move over to the new contract, but we hope that we can make it more attractive to consultants and that it will be more of what I would call a professional contract, so that existing consultants will switch over to it as well as new consultants. We will have to watch that very carefully.

NHS: Five Year Forward View

Baroness Blackstone Excerpts

Thursday 23rd October 2014 Lords Chamber

[Baroness Blackstone (Lab)]

My Lords, on the subject of the prevention of obesity, can the Minister say what steps the Government are taking to introduce a tougher regulatory environment for food companies whose products are damaging the health of many thousands of people in this country?

[Earl Howe]

Many food companies—not all, but many of the larger ones—have already taken steps, for example, to reduce the levels of salt and saturated fat in their products. We need to go further. This has been done by the previous Administration and the current Government on a voluntary basis. We think that that has worked well. Nevertheless, we have never excluded the possibility of regulation, where we think that it is justified. At present, we believe that there is sufficient scope to make progress without regulation, but that is a matter we will keep under review.