Young Carers
Baroness Finlay of Llandaff Excerpts(7 years, 8 months ago)
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Baroness Finlay of Llandaff (CB)
My Lords, I declare my interest as chair of Dying Matters. Do the Government accept the figure that approximately 10% of schoolchildren are bereaved, a third of those of a parent or sibling, and that many of them have cared for that person during their final illness and, after death, often provide care and support for the other bereaved members of the family? Will the whole House join me in expressing the most sincere condolences to the two children who were bereaved because their mother was killed yesterday on Westminster Bridge?
Schools: Access to Defibrillators
Baroness Finlay of Llandaff Excerpts(7 years, 9 months ago)
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Lord Nash
We leave it to schools to decide precisely how much they teach their pupils about first aid. Some very good resources are available from the British Heart Foundation, the Red Cross and others. The defibrillator we provide comes with audio instructions which make it very easy to use, but of course, training for staff and others is important.
Baroness Finlay of Llandaff (CB)
Do the Government recognise that it is essential to have emergency action first-aid training in primary and secondary schools, so that children can recognise cardiac arrest in another child, respond appropriately, call for help and know where a defibrillator is? Simply purchasing a defibrillator is inadequate.
Higher Education and Research Bill
Baroness Finlay of Llandaff ExcerptsTuesday 6th December 2016
(7 years, 11 months ago)
Lords ChamberRead Full debate Higher Education and Research Act 2017 View all Higher Education and Research Act 2017 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Consideration of Bill Amendments as at 21 November 2016 - (21 Nov 2016)
Baroness Finlay of Llandaff (CB)
My Lords, I declare my interests in Cardiff University, Cardiff Metropolitan University and the Medical Schools Council.
I start by welcoming the noble Baroness, Lady Sugg, and congratulate her. I agree with what she said about teaching. Indeed, teaching has for too long been a poor relation, and so the concepts in the TEF are to be welcomed. The problem is that teaching excellence has to be at course level. It cannot be just across the board. In one institution there can be both excellence and appalling teaching. Often, some of the best teachers turn out to be very unconventional role models, but they have a huge influence on the lives of the students with whom they interact. The problem we had with the REF was the game-playing and the problem that we might have with the TEF will again be the game-playing that can occur, and the REF is being revised.
As so many noble Lords have already said, buried in the Bill are massive constitutional changes that appear to undermine the autonomy and vigour of Britain’s universities and its research base. The current balance of power, democracy, expertise and academic freedom can seem intangible to many outside academia, but those inside do not feel that their autonomy is adequately safeguarded in the Bill.
We have heard from many speakers already how the universities here punch above their weight with very high-impact research per pound—more than any other country. If their autonomy is eroded, support for spontaneous, innovative endeavours is put at risk. Let us not forget that some major breakthroughs have appeared almost by chance. They cannot be directed; they cannot be predicted. They are wonderful products often of the cross-fertilisation of ideas, as researchers learn through interesting conversations with others and through debate with other academics. Postgraduate students, in particular, but also undergraduates benefit from being part of and observing this interchange.
I want to focus on the new super-research council—UKRI—in the few minutes that I have. Its powerful chair and chief executive—the power will be with the chief executive—will oversee the near-totality of publicly funded research in the UK. Never before in the history of British science have so few individuals been responsible for so much spending. Although the revamp of the research councils was envisaged in the Nurse review, the Bill in its present form threatens to undermine our research base and our universities, which are vital parts of the economic, political and cultural life of this country.
It was said in the briefing meetings which many of us have attended and appreciated that there would be no political involvement in individual research decisions, but what about the overall direction? It feels too dangerous to have interference even in that. To safeguard the search for evidence and academic freedom, the researchers of the future need to be developed through keeping education and research linked and integrated.
On a global scale, we must remain friendly to overseas scholars and students, continue to win research funding from outside the UK, and foster our vibrant collaborations. I hope the Government will listen to the wise words of the noble Baroness, Lady Chakrabarti, when she addressed the problem for refugees who have lived through absolute living hell and want to study here, who are extremely bright yet find yet another hurdle in front of them. That has to go.
Among universities, there is disquiet about the proposed governance of the UK research base, which appears significantly more top-down than before. Research councils will become committees and lose the protection of their autonomy that comes from their royal charters. They will not have an ex-officio seat on the board of the powerful overarching council, although the Department for Business, Energy and Industrial Strategy is going to create some kind of forum, so research communities’ views can be fed in.
Sir Paul Nurse intends the new arrangement to create a powerful voice for science at the heart of government. To date, heads of autonomous funding councils, Whitehall chief scientists and even campaign groups have often worked with, and sometimes against, government to protect the research base. Now this creative tension seems to be the task of very few individuals, with a great deal of power in the chair and chief executive. UKRI can create a strategic view of promoting interdisciplinary research, but will the autonomy of research councils remain intact, not just free from politicisation but free to self-govern? The Secretary of State will have great control, approving board appointments. I know that a lot will come through in statutory instruments placed before Parliament, but they probably will not get much scrutiny as we are bowed under with the post-Brexit legislative timetable.
Research is a fast-moving endeavour. As the noble Lord, Lord Kakkar, said, we have to make sure that it is supported, providing stability through the dual support system. The Bill needs to be amended to maintain the autonomy of those determining research funding and to ensure adequate consultation.
Schools: Health and Well-being
Baroness Finlay of Llandaff Excerpts(9 years, 5 months ago)
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Baroness Finlay of Llandaff (CB)
What are the Government doing about vitamin deficiency among children, given that the CMO’s report recommended the Healthy Start vitamin programme and that 40% of young children are thought to be vitamin D deficient, particularly as the deficiency may be linked to the metabolic syndrome and high blood pressure? It has even been suggested that a vitamin D supplement may improve some of the core symptoms of autism, which can create major behavioural issues in a classroom.
Queen’s Speech
Baroness Finlay of Llandaff Excerpts(9 years, 5 months ago)
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Baroness Finlay of Llandaff (CB)
My Lords, in the gracious Speech it was welcome to see a commitment to seven-day working. Indeed, in my own Access to Palliative Care Bill, which has now been introduced, I have included a requirement for seven-day services. Like the noble Lord, Lord Sharkey, I welcome the noble Lord, Lord Prior of Brampton, to his position and look forward to working with him closely on this matter.
However, when we talk about seven-day services, we must not forget the nights, because disease does not respect the clock or the calendar. When patients are at home, it is the family who carry the full responsibility for whether to phone somebody and what to do, and that burden of responsibility on them can be huge, particularly if they do not have adequate social care support.
In its report, What’s Important to Me, the National Council for Palliative Care—I must declare an interest because I am taking over as its next chair—has shown just how many patients recognise that they need seven-day services. The appalling findings in the report, Dying Without Dignity, from the Parliamentary and Health Service Ombudsman demonstrate what happens when you do not have seven-day services.
In 2010, the Royal College of Physicians called for such services, with 68% of physicians supporting the move, but physicians are already working on average 50 hours a week. So there is a need for a remodelling of what they do, decreasing bureaucratic burdens on them and ensuring that there are proper roster reviews, otherwise they will not be able to cope and the system will collapse.
An analysis from the Manchester Centre for Health Economics, published last week, looked at the additional risk of death from weekend admissions—it is not just greater on a Saturday but it is even greater on a Sunday. It costs the move to seven-day services at between £1.07 billion and £1.43 billion. Why are those deaths happening? Fewer senior staff are on duty at weekends, with fewer support services, especially in pathology, radiology and pharmacy, and there are fewer allied health professionals, who are so important. There is a higher disease burden in those admitted at the weekends as an emergency, making them less likely to respond well to treatment. The NHS was founded on a principle of equitable care. Failure to provide equity across each day of the week must be considered a failure in one of its fundamental obligations.
For patients who are at home, the need for community support becomes the mainstay of their being able to stay at home. However, they need not only carers but physiotherapy and occupational therapy to maintain their independence. Fortunately, the number of physiotherapy training places has gone back up, having dipped previously, but is not keeping pace with the demand for physiotherapy.
Social care integration is to be welcomed if we are going to use our resources widely. The emergency services, of course, already provide 24/7 cover but the winter funding put in by the previous Government did not reach front-line emergency departments. Only just over 1% of the £700 million went into those departments. The remainder was meant to cut back the pressure on the departments but that seems to have failed. There was an increase in attendances by 500,000, an increase in admissions by 7% and a doubling of delayed discharges.
In its document prescribing the remedy, the Royal College of Emergency Medicine has solutions. Through its future hospital programme, the Royal College of Physicians wants to help the Government to achieve better equitable care, and the Royal College of Surgeons is supportive. However, we must take the administrative pressures off front-line staff to free them up to do the clinical work that we need them to do.
There is a commitment to increasing GP numbers and the Prime Minister, I believe, has said that he wants one in two medical graduates to go into general practice—but how? It will not happen quickly. The time from entry to medical school to being fully trained as a GP is, on average, nine years. However, the shortfall of GPs is already 3,300 and estimated to go up to 8,000 by 2020. Sixty per cent are already providing extended opening hours and 17% are open at weekends.
A Citizens Advice report, Registering Frustration—which was issued after the start of this debate—shows that GP registration is so complex that one in 10 patients finds that it takes them more than two weeks to register; when they cannot register they are directed to walk-in centres; and one in seven GPs has felt that their only option has been to redirect patients to A&E. We should look again at the skill set of those people noble Lords might feel are the least trained and the least qualified—the care assistants and social carers—because, with better training, we will be able to empower them to provide better care.
The UK has a low doctor-to-patient ratio. We are 24th out of the 27 European nations. The Government must re-engage with those who will bring about change— including re-engaging in negotiations with the BMA—to find solutions to work patterns and to the ways that people work.
The noble Lord, Lord Giddens, is right to say that IT must be used imaginatively. We cannot just transfer lengthy paper records on to IT systems and expect that that will do anything other than increase the bureaucratic burden.
As to the threat that comes from the Transatlantic Trade and Investment Partnership, on 28 May the European Parliament’s trade committee agreed a resolution backing the TTIP for the full Parliament to vote on this month. This controversial initiative reintroduced investor state dispute settlements. It would allow corporations to sue the UK for laws protecting public health and represent a destructive force to our NHS. Can the Minister clarify what the Government’s position was in the trade committee and what it will be in a future vote on TTIP? It would be tragic if we undermined our NHS by such a move.