NHS Long Term Plan

Baroness Browning Excerpts

Thursday 31st January 2019 Lords Chamber

[Baroness Browning (Con)]

My Lords, I too am grateful to the noble Lord, Lord Hunt of Kings Heath, for giving us this opportunity. I pay tribute to the fact that the plan focuses on autism. I declare my interest in the register as a vice-president of the National Autistic Society. The focus on the need to reduce diagnosis waiting times for autistic children and young people is very welcome. Please do not forget the adults in the community who have yet to receive a diagnosis; they are some of the most complex cases for professionals to address accurately.

The need to reduce the number of autistic in-patients in mental health hospitals is something that this House has debated on many occasions, and which I know is a very real problem for many families around the country. The improvement in understanding the needs of people with learning disabilities and autism within the NHS generally has improved, but there is still much to be done. There is also the issue of increasing investment in crisis support: sometimes we deny people small amounts of support and they end up in crisis. That is one of the most expensive ways to address people.

The long-term plan contains a commitment to piloting a new annual health check for autistic people. That is welcome, but I must say to my noble friend on the Front Bench that it is very important that that is done by doctors and professionals who have a good understanding of autism. If parity of esteem is to mean anything, it must be more than just checking blood pressures and weighing people. Checking the mental health of people on the autistic spectrum is probably almost more important than just checking them physically.

In order to do that, it is important that the GP knows who to call. For many years, the National Autistic Society and others, including the Royal College of General Practitioners, have been calling for improved recording of autism in GP registers, so that GPs know more about the needs of their autistic patients. If we do not have a register, and if GPs do not log who their autistic patients are—even if they do not see them very often—will they know who to call for annual check-ups? It is really important that the need to create a database of who is on the autistic spectrum and where they are is included. That requirement is missing from the report. I hope my noble friend will address that; perhaps she will get back to me and put a letter in the Library of the House. The database has been requested for many years.

On dementia, there is much that is very good in this area, but I hope equally that some of the pilot schemes will not be pilot schemes for too long, and that the process will be speeded up—particularly the side-by-side service provided by the Alzheimer’s Society.

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[Viscount Hanworth (Lab)]

My Lords, this debate has been rich in its detailed treatment of particular issues but I shall talk only in general terms. At its inception in 1948, the NHS was an expression of the egalitarian philosophy of the Labour Party. At that time, it had the support of many Conservative politicians, but gradually they changed their opinions. They began to favour a health service in which consumers could exercise their preferences in favour of a more personalised provision, if that is what they wished for and if they were able to afford it.

In 2009 several leading Conservatives who were to become members of David Cameron’s Cabinet put their names to a manifesto criticising the NHS. They were calling in effect for the NHS to be dismantled and replaced by a system based on health insurance in which private providers would play a major part. This worried their leader, who was conscious of the popularity of the NHS and of the damage to the Conservatives’ electoral prospects that might ensue if their adverse attitudes towards it were widely perceived. For that reason, he felt compelled to assert that the NHS would be safe in the hands of the Conservatives. Nevertheless, the covert plans to privatise parts of the NHS proceeded unabated. The Health and Social Care Act 2012 was the precursor to its intended privatisation.

[Baroness Browning]

I advise the noble Viscount from personal experience that David Cameron’s motivation was not political expediency. As I know only too well, he had every reason to be grateful to the NHS because of his son.