Disabled People: Personal Assistants

Debate between Baroness Donaghy and Lord Kamall

Wednesday 7th September 2022 Lords Chamber

[Lord Kamall (Con)]

One issue that I think noble Lords across the House agree on is a suggestion made by the noble Baroness, Lady Thornton. If we want to make sure that we have the right number of workers, we should improve training over here, but there will clearly be a skills gap in this country and therefore we need to look overseas. Sadly, as I said earlier, under the Home Office rules at the moment, individual employers do not count as sponsors. Officials in the department are having conversations with DWP to look at whether that can be rectified, or whether there is a way to find a trusted sponsor.

[Baroness Donaghy (Lab)]

My Lords, working-age people with disabilities are virtually prisoners in their own homes. We are not talking about improving skills or having conversations. When disability is supposed to be a subject where people are treated as normal citizens who want and can go out to work with sufficient support, we are looking for some answers from the Government about how they can do so. Why are the Government only having conversations, after 12 years?

[Lord Kamall (Con)]

The Government have been committed to ensuring that there is equality for disabled people, including plenty of initiatives in other sectors—transport, building new homes and offices, and retrofitting—but the issue of personal assistance is a particularly difficult one in the context of social care having been treated as a Cinderella service for years. Some of the initiatives that we are putting in place, such as the proper qualifications and recruitment from overseas, sadly do not yet apply to personal assistants because of the rules. We are looking at those barriers and hopefully will be able to tackle them.

Integration White Paper

Debate between Baroness Donaghy and Lord Kamall

Thursday 10th February 2022 Lords Chamber

[Lord Kamall (Con)]

I respect my noble friend for his willingness to pass on the benefit of his many years of advice to me.

We do not want to get overly prescriptive. We have talked about health and well-being boards and I know that my noble friend has talked about their importance. In the papers I laid in the Library the other day, where we looked at integrated care boards and integrated care partnerships it was quite clear that, in some places where the health and well-being boards may well completely overlap with the ICPs in a smaller area, that will continue to be the place-based level. Where there is a larger system, we expect the integrated care board and integrated care partnership to work with the local place-based organisations underneath them at a more local level. That is what we have been saying all the way through. We want to make use of existing fora. In some places they will overlap and may well end up as the same thing. We will update the health and well-being board guidance in due course to reflect the implications of policies set out in the White Paper and what comes out of the Health and Care Bill when it passes.

[Baroness Donaghy (Lab)]

My Lords, mine is a simple question. We have two separate pieces of legislation on the same area. How does the Minister guarantee that we will not end up with two contradictory systems?

[Lord Kamall (Con)]

The only legislation I am aware of is the Health and Care Bill; this White Paper complements that, just as the adult social White Paper does. This is not legislation.

NHS England: Waiting Lists

Debate between Baroness Donaghy and Lord Kamall

Tuesday 16th November 2021 Lords Chamber

[Lord Kamall (Con)]

If the noble Baroness looks at the statistics relating to the waiting lists, she will see that 75% of patients do not actually require surgical treatment: they require diagnostics. We have announced an investment in community diagnostic centres— sometimes in shopping centres or sports grounds—to make diagnostics more accessible to the public, rather than having to go to a healthcare setting. Moreover, 80% of patients requiring surgical treatments can be treated without an overnight stay in hospital, so they can do that as day patients. This is where we want to focus, along with making sure that we tackle all the waiting lists right across the board.

[Baroness Donaghy (Lab)]

Nine in 10 NHS chief executives, directors and chairs reported last week that the present system and organisation have become unsustainable. We can only guess at the pain and anxiety of those waiting to be treated. That is really what this is all about. My noble friend Lord Young talked about ambulances and the time wasted waiting outside hospitals. What plan do the Government have to boost the NHS workforce and ensure that there are sufficient numbers to help bring the waiting lists down?

[Lord Kamall (Con)]

The Government are in conversations with the NHS about the workforce plan and the winter plan. We are looking at ways to tackle the waiting list in more creative ways. As I said, 80% of patients requiring surgical treatments can be treated without an overnight stay in hospital. If we take medical care out to the community, especially at diagnostic centres, we can cut down a lot of the waiting list, but also in terms of the Health and Social Care Bill. One of the reasons is that the NHS has been asking the Government for changes to make sure that it meets the challenges of the future.

Health Care and Adult Social Care

Debate between Baroness Donaghy and Lord Kamall

Wednesday 27th October 2021 Lords Chamber

[Lord Kamall (Con)]

I am grateful to the noble Baroness for the specific examples that she gave. The department is constantly monitoring the workforce capacity pressures. We are continuing to gather a range of qualitative and quantitative intelligence in order to have a strong and live picture of how the risk is developing and emerging. In more detail, this includes drawing on evidence gathered by a regional assurance team and regular engagement with key stakeholders, including the Association of Directors of Adult Social Services in England, local authorities and care provider representatives. We are also monitoring data from the capacity tracker, Skills for Care’s monthly workforce reporting and wider market data. To ensure that we are aware of any emerging workforce capacity pressures, we are strongly encouraging providers to continue sharing available capacity and completing the capacity tracker.

[Baroness Donaghy (Lab)]

My Lords, I conveyed my commiserations to the Minister last week. As he said, he is on a hat trick today, but he is no Salah just yet. The noble Lord is obviously not a Liverpool fan. As the report says, over the past year the pandemic has further exposed and exacerbated health inequalities. Case rates and mortality rates were higher in deprived areas—2.4 times higher than in the least deprived areas for mortality. The report stated that

“strategies to identify and tackle health inequalities were not yet well established.”

What is the Government’s strategy for this, given that deprived areas, such as those in London, are often next to the wealthiest?

[Lord Kamall (Con)]

The noble Baroness raises an important point but before I answer that specifically, I reassure her that I am a Liverpool fan, as well as an Enfield Town fan. It so happens that my middle name is Salah. I think that I can wear that name on the back of my shirt with pride. I assure noble Lords that I did not line that question up. One reason why the Office for Health Improvement and Disparities was set up in the first place was to look at disparities across a wide range of issues, not only in social care but in relation to gender inequalities, ethnic minority inequalities and some of the other inequalities and disparities between various areas. As the noble Baroness rightly says, sometimes one can find some of the poorest communities right next to the some of the wealthiest. We are hoping to address those issues through the work of the Office for Health Improvement and Disparities, by first identifying where disparities are and then addressing them.