Health and Social Care in England

Baroness Emerton Excerpts

Thursday 11th July 2013 Lords Chamber

[Baroness Emerton]

My Lords, I thank my noble friend Lord Patel for the way in which he introduced this debate and other noble Lords for their very valuable contributions. Like my noble friend Lord Crisp, I have had to change what I was going to say in terms of the range of things. I declare an interest in that I am a nurse by background, a long-retired nurse who had 60 years’ experience, in one way or another, connected with the NHS. It is true to say that there is evidence of brilliant care being given within the NHS and social care. However, there are also many deficits.

We have talked about a seamless service. Is there a seamless service today? A model needs to be developed from the previous Government’s introduction of the patient pathways. I hope that we will not forget that patient pathways are the most cost-effective and care-effective way of treating people in the future. However, we need to think about prevention being better than cure, as was said by the noble Baroness, Lady Tyler. Public health is defined as the science and art of preventing disease, prolonging life and promoting health through the organised efforts and informed choices of society, public and private organisations, communities and individuals. This requires a change in the culture of the population served to a health and well-being approach to life and a personal commitment to living a healthy lifestyle from birth to the grave. This picks up some of the points made by the noble Lord, Lord McColl.

Changing the culture of the NHS is an even more important issue. The prime focus must be on the principle that all aspects of public health are centred on the personal pathways of the population and the provision of health and social care given through those pathways to a healthy population. Changes must be made to the culture of the delivery of health and social care towards those who live independently, supported where necessary by expert professional teams that are educated in the delivery of holistic care to meet mental, physical and emotional needs within the community. Hospitals should be required only for the diagnostics, treatment and research that cannot be delivered in the community. To make all these changes, outstanding leadership skills are required. This can be achieved only by an open and honest approach to the population which helps them to understand that to live longer, healthier lives, changes have to be applied through a much more active and aggressive approach to the prevention of disease and the promotion of health. These changes must be assisted and supported by expert clinicians from all health and social care professions who utilise the good of what is in place while identifying the large gaps that exist. They must make those good not only by correcting the education and training of the workforce but by engaging the assistance of families and communities.

The education and training needs of the NHS social care workforce need to be radically examined to ensure that the overarching focus of care delivery in this country is public health-supported by the treatment of disease. This strategy requires a refocusing of the distribution of funding towards these aims. Florence Nightingale once said that hospital beds should be reduced in London. Perhaps we should look at the way in which our hospital beds are used and ensure that hospital services are cost-effective and care-effective within the framework of the patient pathways determined by the health and social care teams. This should be done to support patient pathways in a seamless way from diagnosis through to treatment. In turn, we must utilise the support of families and communities towards the future health and well-being of the individual on discharge to the community, where high-class care is delivered by professional health and social care teams, families and communities.

I hope that the Minister will be able to look at the point raised about the need for a cross-party multiprofessional group. However, I stress that it needs to be multiprofessional.