The Long-term Sustainability of the NHS and Adult Social Care

Baroness Emerton Excerpts

Thursday 26th April 2018 Lords Chamber

[Baroness Emerton (CB)]

My Lords, I thank the noble Lord, Lord Patel, and the committee members for the report. It was like taking a breath of fresh air when I read it. With my experience over some years in the health service, it came alive straightaway. The report states that the,

“biggest internal threat to the sustainability of the NHS”,

is the,

“absence of any comprehensive national long term strategy”,

to secure for the health and care system a workforce which is skilled, well trained and committed.

My personal experience started as a St John Ambulance cadet two years before the NHS started. It was drummed into me as a volunteer and a cadet that the most important thing was the safety of the patient. I joined the NHS as a nursing student in 1952 and worked in the NHS until 2000. Since then, I have done other work concerned with both, all of which is listed in the register.

I would like to take up the point about the workforce. First, every employee and volunteer has an important part to play in the delivery of care, and it is important that they understand their role. That was brought home to me very clearly when I was put in charge of laundries because I complained about the linen being unsatisfactory, with a high incidence of bed-sores. I think that I have related this story before but it is worth repeating. When I talked to the laundry workers, none of them realised that their job had an effect on the patients. My point is that every volunteer and every employee needs a clear job description and a clear understanding of their job, and they should be monitored to see that they understand the importance of patient safety.

Secondly, there is an issue not just in hospitals but in social care. Those with a mental handicap or learning disability and those with a mental illness have to be examined every six or 12 months by a panel to see whether their support allowance can be continued. The panel has set questions but no background information on what caused the injury or on why the money might be taken away. The relation of a personal friend of mine had a brain injury before birth but his allowance was withdrawn. He had a parent who lived some distance away and was living on his own. The point is that social care needs monetary support, and every person involved in it, as well as in the health service, needs knowledge of what the job is about.

Thirdly, the correlation of theory to practice within the professions is very important and we need to ensure that it works well. It was particularly important when producing graduate nursing courses that adequate clinical teaching was linked with educational supply. We need to see a closer relationship between educational provision and the delivery of care. Correlation of theory to practice is vital, and, again, that is important for volunteers as well.

My last point is that, in delivering care, workforce planning is not just a question of numbers. It must include an understanding of the occupations that are being looked at. We must see it as a job not just for administrators but for all aspects of the health service: clinicians, volunteer charities and the users of services must be involved. During the history of the NHS we have had attempts where this has been attained, but recently we have not seen workforce planning being spread across the services and understood by all the clinicians, as was mentioned this morning. This is so important for the future of health and social care.

In summary, my introduction to the NHS was at a time when the Second World War had just ended. There was a fear that medical care was going to be too expensive and worries about how everyone was going to manage. It was a tremendous relief to the population when the NHS was introduced by the Labour Government for the United Kingdom. That relief is being sought now by the public, who fear that health and social care services are in danger. I hope the Government will take on the recommendations from the report and we will see some action. I hope the Minister will be able to confirm that we will see movement, not just in the short term but for the long-term future, as has been mentioned.

My only adverse comment on the report is this. This morning, I was reminded that the Griffiths report mentioned Florence Nightingale looking for the missing nurse. There were no nurses on this panel.