Veterans: Mental Health

Baroness Brinton Excerpts

Tuesday 7th November 2017 Lords Chamber

[Lord O'Shaughnessy]

On the first point, there have been reviews at European level to improve the packaging and the patient information leaflets about any risk that might attend taking this drug or indeed any others. Status as a veteran is now recorded in the NHS and goes into the patient record.

[Baroness Brinton (LD)]

My Lords, the mefloquine help page for veterans and current serving officers is very good at explaining the signposting, but there is no mention in Meeting the Healthcare Needs of Veterans, which has not been updated since 2011. Only 2,000 GPs out of more than 50,000 have attended the day training course on working with veterans. Can the Minister ensure that at least one GP from every surgery has training, so that he or she can advise other GPs when they are helping to serve our veterans once they are back in the civilian workforce?

[Lord O'Shaughnessy]

The noble Baroness makes a good point. As I mentioned, that training is now in the curriculum, but of course that deals with the flow of new GPs as opposed to the stock of existing GPs. I shall certainly look at that and see what more can be done to make sure that GPs have up-to-date training.

Care Homes: Hospital Discharges

Baroness Brinton Excerpts

Monday 16th October 2017 Lords Chamber

[Lord O'Shaughnessy]

The point about integration is critical. The CQC’s report from last week, which we were discussing, is all about collaboration and integration. Someone in their 80s who is experiencing care does not distinguish between different bits of it as we do bureaucratically. They want to know that there is seamless care. That is what the sustainability and transformation process is attempting to do.

[Baroness Brinton (LD)]

My Lords, I am grateful for the right reverend Prelate’s comment about the National Audit Office’s report from February, which makes it clear that 43% of the multidisciplinary team meetings in acute hospitals began immediately, which is to be encouraged, but only 20% of local authorities were invited to those early meetings. What are the Government doing to ensure that the advice from NHS Improvement about getting that earliest intervention will actually happen?

[Lord O'Shaughnessy]

The noble Baroness raises an excellent point. She may know that the better care fund—the route by which the additional money goes into social care—reviews and holds accountable local authorities and the NHS for interacting with one another to deal with delayed transfers of care. There is something called the high-impact change model, which is designed precisely to bring people together to ensure that the number of delayed transfers in care are reduced. That is compulsory as part of the funding provided.

Health and Social Care

Baroness Brinton Excerpts

Thursday 12th October 2017 Lords Chamber

[Lord O'Shaughnessy]

I join the noble Baroness in paying tribute to voluntary sector providers and volunteers, whether family members or others, who support care throughout the NHS and social care. There need to be more paid staff to meet the needs of our growing and ageing population, which is why the Secretary of State announced a 25% increase in the number of training places and more nursing associates. That is being put in place to make sure that the system, which is described in the report as stretched, has the capacity it needs to meet patients’ needs.

[Baroness Brinton (LD)]

My Lords—

[Lord Davies of Stamford (Lab)]

I shall give the Minister another chance. He did not even begin to answer the question from my noble friend Lord Hunt. Why did the Government drop Dilnot?

--- Later in debate ---

[Baroness Brinton]

My Lords, the CQC report has shown that over the past two years there has been a reduction in beds in nursing and care homes, while the Lancet published the results of a research project in the summer showing that we will need an extra 9,000 beds per annum by 2025—that is more than 70,000 beds. What are the Government proposing to do to make it easier for more homes to be set up and run and to fund the beds we clearly need urgently, not just in 2025 but from now on?

[Lord O'Shaughnessy]

The noble Baroness will know that there has been a small reduction in the total number of residential nursing home beds, although it is a fairly flat picture over a long period of time. We have also seen an increase in the amount of domiciliary care. One of the things we need to get to the bottom of, and this is what the consultation will look at, is the imbalances that exist between the funding regimes for residential and domiciliary care. We have to get to the bottom of it, because it creates an imbalance on the provider side as well, so that we can have proper funding for the kind of care that people need regardless of whether it is in a residential nursing setting or at home.

Queen’s Speech

Baroness Brinton Excerpts

Thursday 29th June 2017 Lords Chamber

[Baroness Brinton (LD)]

My Lords, in my contribution to the humble Address to the gracious Speech I will focus on health and social care, mainly the latter, and some of the overlapping and invisible problems facing the most vulnerable.

There was much debate during the general election about the funding of our NHS. The Government’s additional funding, announced earlier in the spring, is vital but, as many people, not just politicians, have expressed, it is just not enough. I am proud that my party was brave enough to suggest we should have one penny on income tax for health and social care. I also applaud Labour’s very specific proposals to provide the necessary funding for health and social care. Over recent weeks, with some of the crises and emergencies that we have faced, we have rightly praised the response by the emergency NHS workers, but I praise in particular the invisible unsung heroes who make the NHS, our social care and many people’s lives work without our being aware of it.

Reforming the NHS is vital, but to do so at a time when funding is not just scarce but in some areas—mental health, primary care and for those with long-term conditions—in total crisis sets up these reforms to fail. I congratulate the 50 charities that have recently come together to form the Disabled Children’s Partnership. It has just launched its thought-provoking campaign, the Secret Life of Us. It is those disabled children on whom I want to focus my remarks. Nine out of 10 of the parents surveyed by those charities say that the needs of their disabled children would not be met if they, the parents, could not care for them, and only 10% of the families believe that health and social care services in their area meet the needs of their disabled child. More than four in five of parents of a disabled child face problems accessing the services they need, and over half of them see that this has a negative impact on their child’s health, well-being and ability to make friends. Three-quarters of parents with a disabled child have personally experienced mental health issues, compared with just one in five in the general population.

One example very close to my heart at the moment illustrates all these points and more. I live on the same road as Nascot Lawn, an outstanding facility run by the NHS for disabled children with extremely complex needs. It is in Hertfordshire but it is so good that it is used by other areas as well. Friends of ours have survived—I choose my words carefully—because of the respite care offered by Nascot Lawn. You can get help there only if your child requires hourly attention night and day and their medical needs are complex. They may have tracheotomies, colostomies or regular seizures, or may require feeding by IV tube directly into their stomachs. These children are so sick that they cannot even go to children’s hospices for care. One mum said on television the other day that she could not leave her child on the ward at Great Ormond Street Hospital because that specialist hospital does not have the staffing levels needed to look after her child.

The local CCG has just announced that it will close Nascot Lawn because its work is discretionary. Given that respite and other care provided by Nascot Lawn is specified in most of the children’s education and healthcare plans, and their continuing care plans, some of us think that the CCG has got that wrong. Accountants have decided this without any reference to any of the children’s individual cases.

I am in awe of the commitment, love and dedication of the parents and families of these children. Unless you have seen it first-hand, you cannot understand what living with children this sick and disabled is like. Now imagine if that occasional lifeline is arbitrarily removed by the NHS. Parents say, and I am sure they are right, that it is likely to cost the NHS much more money in the longer run. I also believe that it breaches their child’s rights and, what is more, their rights as carers, working all day and all night, and nursing their children all their lives.

There is something else here, too. A nation’s commitment to its people should be judged by the way it treats its most vulnerable. These children represent the most vulnerable and they are easy targets because they are invisible. My question to the Minister is: will he please meet me and some of the parents involved to discuss why on earth this sort of care could be deemed discretionary?

My noble friend Lady Jolly raised the crisis in social care as a result of employment tribunals and sleep-in shifts. I echo her concerns and agree that that funding must be found to help this problem, but I also want to highlight a further problem. There are now more than 108,000 disabled people with care needs who receive no social care support at all. This is just not acceptable, and the practical problem seems to be that the better care fund is for those who are in hospital and come out, and completely misses out those people living in the community who require long-term continuing care. I ask the Minister: when will there be extra funds for this group?

In conclusion, the Government propose a new consultation on social care. We do not need a new consultation on social care; we need an update on the Dilnot commission and for that to be introduced as soon as possible.