Queen’s Speech

Baroness Browning Excerpts

Thursday 29th June 2017 Lords Chamber

[Baroness Browning (Con)]

My Lords, I refer to my various interests in the register. Following on from the noble Lord, Lord Warner, I begin with mental health. As I think others in this Chamber did, I worked on pre-legislative scrutiny of the last set of changes to mental health legislation, before the Bill itself came before Parliament. Although this is a two-year Parliament, I would urge pre-legislative scrutiny, as this is such a complex and very diverse area.

There are two things at the heart of mental health services. The first is the quality and appropriateness of the services that are provided, and the second, perhaps much more important, is accessibility. At the moment, that is patchy, as has been mentioned. I think my noble friend Lady Cumberlege said this, and it is not just in maternity services but right across the piece. But there is good practice, and I hope we do not feel we have to reinvent the wheel every time we look at these subjects, but identify where good practice is, take it up and implement it as quickly as possible. That of course means resources, and accessibility is about nothing if it is not about resources. Some GP practices have community psychiatric nurses attached to them, who can identify, when a patient comes in out of the blue, that the patient needs a much longer time for diagnosis and for a plan to be put in place. No GP can do that in a few minutes. Where they have a CPN attached to the practice, and that happens, you see the results and it is very good. These are the sorts of examples we should be lifting up and encouraging throughout the country.

I hope we will look at where mental health needs are most prevalent, not least in prisons. I am not talking about people who are in secure units, but our general prison population. We have talked so many times about the need for more mental health service inputs there. It is so important before people leave prison, as is continuity when they come out. I recently visited Feltham prison, which has an exemplary practice in the way it manages people on the autistic spectrum. Autism is not a mental health condition, but I like to talk about autism as often as I can, and people will not be surprised to hear me say that people on the autistic spectrum who go without the appropriate support and package of care—both children and adults—very often spiral downwards into very serious mental health problems. The suicide rate is high. The suicide rate in this country, particularly among young men, is too high per se, and we should be looking very critically at what works and what does not. I will just say to my noble friend on the Front Bench that we produced an Autism Act in 2009, which had an autism strategy. The Government have dragged their feet somewhat in making sure that every local authority is implementing that strategy to make sure that people on the autistic spectrum have that support.

I turn now to social care. The guidance produced by the Government says that the number of people aged 75 and over is expected to increase by 70% between 2015 and 2035, so I declare a personal interest here. I am what is euphemistically described as a baby boomer—looking around the Chamber, I suspect I am not alone. Originally baby boomers were those people born either during or in the decade immediately after the Second World War. The noble Lord, Lord Whitty, referred to the way the younger generation now see our generation of baby boomers, and I must say that I am very concerned at some of the divisive language used—not by the noble Lord, Lord Whitty—to describe the difference between the younger and older generations. Back in the 1950s, if your Lordships can imagine that far back, only 10% of young people went to university. We are not talking about the 50% who go now. There is this idea that it was somehow free for 50% of the population, but it was not. The school leaving age was 15, and many people left school and went straight to work without any training, or further or higher education at all. But we made it none the less.

That age group is very important. If you were to ask people of that age today what they would like most, they would say, “To die and be cared for at home”, but the practicalities of that are very difficult. The noble Baroness, Lady Jolly, has drawn to my attention the concern, which I am sure she will raise later, about people living at home who have carers who need to sleep in, for whom the national minimum wage has become a big issue.

I am a vice-president of the Alzheimer’s Society and conclude with the problem of dementia, because deciding how we shall take this forward is quite a serious matter for the country. The Alzheimer’s Society says that dementia has,

“long been the most discriminated against condition, dismissed as ‘social’ rather than ‘medical’. Unlike many other conditions such as cancer or heart disease, where assistance will be provided free of charge through the NHS, dementia care is social care. The current system demands that anyone with even limited assets is forced to pay for their social care. This is unfair and can lead to astronomical costs for the person and their family. It should not be the case that because you develop one condition over another, you can be left bankrupted by care costs”.

I personally feel that we should all make provision for our old age and contribute towards our care costs but, as the Alzheimer’s Society says, dementia can take virtually every penny you have. I am very glad that the Government are to carry out an in-depth study into how we find some action to go with this challenge.