Queen’s Speech

Baroness Massey of Darwen Excerpts

Tuesday 22nd October 2019 Lords Chamber

[Baroness Massey of Darwen (Lab)]

My Lords, children and health have been mentioned in some very eloquent speeches already. I want to talk about young people’s health, particularly early inequalities in health due to many of the factors expressed so eloquently by my noble friend Lady Sherlock.

The gracious Speech did not refer to the needs of children directly, but it referred to domestic abuse, which affects children and who may be victims in their own right. This will no doubt be considered as we go through the Bill. I am reminded that over the past three years or so we have not considered issues such as children and the elderly; we have been talking about Brexit considerations. I regret this and we should now emphasise issues such as the health and well-being of children and the elderly. We must re-address our priorities and examine what, as a nation, we should urgently consider important, such as children and the elderly.

This is a crisis for young people’s health. Decreasing funding for children’s services and a rising demand and legal requirements to provide statutory services has meant that there is a gap between what local authorities need to spend and the resources available. This is calculated to be £3.1 billion by 2024-25. Between 2010-11 and 2017-18, central government funding for children’s services fell by 29%. The most deprived areas suffered a fall of 37%, compared to 21% in less deprived areas. This makes no sense at all, as pointed out by many in the children’s voluntary sector. It affects social mobility, so emphasised by the Government in recent years, and is an economic nonsense. Early intervention in child health and well-being has been shown to save millions of pounds in the long term.

The Private Member’s Bill of the noble Lord, Lord Bird, on the welfare of future generations is a welcome intervention, which calls for long-term sustainable thinking. Will the Government look at the success of Wales when we consider this Bill?

I shall now refer to an excellent report from the Association for Young People’s Health, of which I am a patron. The report gives key data for young people aged between 10 and 24 in the UK. Sadly, the message is that inequalities are disturbing and on the increase. The gap in health between rich and poor is already apparent in young people aged between 10 and 24. In some cases, health inequalities are widening. Of course, the 10-to-24 age group covers a time of huge change, when many influences coincide. For example, there are the transitions from childhood to adolescence, from adolescence to adulthood, from education to employment, and from reliance on family to—we hope—being independent and peer group interaction becoming more significant. For some young people, without sustained support, life is difficult and leads to vulnerability, including the dangers of poor mental health and anti-social behaviour. I am aware that the Government have promised a greater focus on mental health.

Let me give some examples of the impacts of deprivation. Severe obesity rates for 10 to 11 year-olds in the most deprived areas of England are four times greater than those in the least deprived. That gap rose from 8.5% in 2006-07 to 13.5% in 2017-18. Young people living in the poorest areas are twice as likely to be admitted to hospital with asthma and have much worse diabetic control. There are also inequalities in smoking rates, under-18 conception rates, mental ill-health prevalence and rates of road traffic injuries.

Information on health has consistently pointed out inequalities in health related to income, education and where people live. The problem is that the situation is becoming worse. We need to examine the social determinants of health, such as those pointed out by my noble friend Lady Sherlock. I support Action for Children’s call for a national childhood strategy. I called for a young people’s strategy in another debate and will follow this up with the Department for Digital, Culture, Media and Sport, as recommended by the noble Lord, Lord Agnew. Will the Department for Education and the Department of Health and Social Care also examine the urgent need for such a strategy? Will they call for a cross-government approach to this? Only by combining forces will we serve our children and young people well.

Mental Health of Children and Young Adults

Baroness Massey of Darwen Excerpts

Thursday 16th May 2019 Lords Chamber

[Baroness Massey of Darwen (Lab)]

My Lords, this is an important debate. I thank my noble friend Lady Royall for introducing it with such eloquence and for the information that she has supplied. I have listened to many moving speeches today containing evidence for urgent action on this issue.

I want to focus mainly on what young people themselves and their parents say about mental health services provision in schools. I draw on my experience of working with young people and parents and on evidence from the Association for Young People’s Health, of which I am a patron, and with which parliamentarians have just set up an All-Party Parliamentary Group on Young People’s Health. Our last meeting was on the mental health of students, with eloquent testimonies of some of the problems described by my noble friend.

I start with a quotation from a review by the Association for Young People’s Health, which spoke to parents about their concerns. One parent said about her daughter:

“She’ll come to me and she breaks my heart: ‘help me mum’, and I say, I promise I’ll help you pet, I’ll make sure you get help. And I feel like I’m banging my head against a brick wall because it doesn’t happen, it never happens”.


That sums up the situation described by many here today. We know that the situation is worrying. We know the Government have expressed concern in many ways and are putting money into their concern. However, there are problems of funding and of timing. This is an urgent issue. I feel that the situation is fraying around the edges, as described by some of my colleagues today.

I want to mention the aspect that concerns me most, as highlighted by the Local Government Association. Funding reductions to local authorities mean that many councils are being forced to reduce intervention work to support children and young people. The early intervention grant has been reduced by almost £600 million since 2013. Children’s services will have a projected funding gap of £3 billion by 2025. Youth clubs are closing, mental health services are overwhelmed and Sure Start centres are disappearing. I do not understand the logic of putting money into children and young people’s mental health, as this Government intend to do, when so many services are being eroded by these devastating cuts.

I turn to what young people and parents think about the state of mental health services and what might be done about it. I was involved in a seminar in Parliament in November 2016 at which young people, NGOs, academics and service deliverers met interactively and equally to discuss child mental health and child-friendly justice. Young people constituted half the group. One young woman said at the beginning of the seminar, “We are experts by experience”. That is why I make a strong plea for involving young people in defining problems and suggesting solutions.

Young people require protection and good services, but they also require empowerment to speak out and help themselves. Some points that the young people made in the seminar were about the stigma attached to mental health; the importance of cultural awareness in dealing with young people’s mental health issues; problems around consent and consensus for treatment; access to treatment, including waiting lists; there not being enough counsellors in schools; schools being too focused on academic results to note early warning signs—for example, eating disorders; a lack of sensitivity to vulnerable groups, such as BME and LGBT youngsters and those in the criminal justice system; and the negative impact of social media, which can also be a force for good—for example, with helpline support groups. They emphasised the need for campaigns of positive information about mental health. They suggested that good interventions include buddy systems in schools and youth services; committed, informed professionals; and awareness being raised by well-known, high-profile people speaking out.

I turn to what parents have said in surveys, and in particular to a project to support young people with mental health problems carried out two years ago by the Association for Young People’s Health. Some 41% of them said that agencies involved in mental health issues for children do not include or consult them. These parents created a network for parents, which snowballed into other networks. Things they found helpful were: the development of parent support groups; provision of more practical advice for parents; provision of mentors, support groups, helplines or advocates for parents; more consistency in how schools operate as intermediaries in involving parents; easier access to early intervention; crisis support; and acknowledgement that parents are important partners in helping young people recover. One sad and worrying thing that 36% of parents said is that they had had to resort to private treatment, because there was no access to CAMHS. I hope the Government will listen to this, and strengthen these services.

I do not have time to dwell on the local and national cost savings of tackling mental health problems, which are huge. Millions could be saved on this annually. However, the life chances of young people are being affected and the key to all this is the welfare and happiness of young people and families.

Breast Scans

Baroness Massey of Darwen Excerpts

Monday 19th November 2018 Lords Chamber

Asked by

[Baroness Massey of Darwen]

To ask Her Majesty’s Government how many facilities which conduct mammograms offer breast cushions in order to relieve the pain of breast scans.

[Baroness Massey of Darwen (Lab)]

I beg leave to ask the Question in my name on the Order Paper. In doing so, I declare an interest as the vice-chair of the All-Party Group on Breast Cancer.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord O'Shaughnessy) (Con)]

My Lords, the use of cushions in mammography has not been formally evaluated. Therefore, information on centres that might offer them is not collated, although we know that some hospitals use cushions non-routinely after surgery or radiography. Use of cushions had been trialled but was discontinued because of interference with the reading of the mammogram. However, I have asked the advisory committee on breast cancer screening to advise on this issue.

[Baroness Massey of Darwen]

I thank the Minister for that concerned reply. Many women suffer intense pain during mammograms and are therefore put off returning for examination. The use of breast pads is not conclusive, but they do not seem to interfere much with the results of the mammogram. We also do not track how women react to mammograms. We do not hear the voices of women to say how they feel. Therefore, they do not inform good practice. Could the Minister say whether these issues will be addressed during any investigation or advice that he may be seeking?

[Lord O'Shaughnessy]

I am grateful to the noble Baroness for the Question and the spur to ask the advisory committee to look at this issue. She is quite right about the experience. It can be painful. As she pointed out, it is the experience of pain that puts some women off taking up their appointments. Around half a million each year do not take up the appointments they are invited to. That is obviously a problem if we want a comprehensive screening programme. I will make sure that the advisory committee not just considers the evidence for use of them, but looks at how we can get qualitative evidence from women to inform their use across the country.

Mental Health Units (Use of Force) Bill

Baroness Massey of Darwen Excerpts

3rd reading (Handard): House of Lords
Tuesday 30th October 2018 Lords Chamber

Moved by

[Baroness Massey of Darwen]

That the Bill do now pass.

[Baroness Massey of Darwen (Lab)]

My Lords, in moving that the Bill do now pass, I should like to sincerely thank several people, including the Minister and his counterpart in the other place, Jackie Doyle-Price MP, who have been so supportive and helpful on the Bill. I also thank the voluntary sector, which has been incredibly vigorous and thorough in making sure that the Bill is as close to perfect as it can be. Will the Minister confirm that there will be other, informal, meetings on the Bill, which will look at the guidance to the Bill, particularly on statistics, impact and measurements? I wish to say that the Bill should now pass.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord O’Shaughnessy) (Con)]

I am very grateful to the noble Baroness for her question and, more importantly, for her steering the Bill to this point. I offer my thanks to her, her colleague Steve Reed in the other place and everybody who has been involved in this important piece of legislation. As she will know, my honourable friend Jackie Doyle-Price, the Minister for Mental Health, committed to the Government publishing statutory guidance within 12 months of the Bill being passed. I am happy to confirm to the noble Baroness that, in developing this guidance, the department will establish and consult an expert reference group, which will include experts on restrictive intervention as well as people with lived experience and, furthermore, that public consultation will take place before the publication of the final guidance. So I can absolutely reassure the noble Baroness and all noble Lords that we will consult widely with a broad set of stakeholders, as well as reflecting discussions in this House and the other place, to make sure that all those contributions are included in the guidance.

Mental Health Units (Use of Force) Bill

Baroness Massey of Darwen Excerpts

2nd reading (Hansard): House of Lords
Friday 7th September 2018 Lords Chamber

Moved by

[Baroness Massey of Darwen]

That the Bill be now read a second time.

Relevant document: 31st Report from the Delegated Powers Committee

[Baroness Massey of Darwen (Lab)]

My Lords, it is an honour to speak on this short but important Bill, and I am glad to see that the speakers here today all have experience of and commitment to mental health, young people, police systems and making systems better.

I shall illustrate why this short Bill is so important. In 2010, a young man, Olaseni Lewis, known as Seni, was a patient at the Bethlem Royal Hospital in Croydon. There was an incident in which Seni attempted to leave the hospital’s mental health unit and he was restrained face down by police officers. He suffered a heart attack and died four days later. He was a constituent of Steve Reed MP, who originally took this Bill through another place.

I thank Steve Reed and congratulate him on introducing the Bill with such passion and clarity. As he said at Third Reading, which was completed in July this year,

“the Bill in its current state will, if passed, give the United Kingdom some of the best legislation in the world to protect mental health patients from abusive or excessive restraint”.—[Official Report, Commons, 15/6/18; col. 1266.]

That is what we all want. It is not a party-political issue—all parties supported the Bill in another place. It is a matter of human rights and human dignity, and of how vulnerable people are treated in a system that should be there to protect them.

I thank Steve Reed for holding meetings with me, and I also thank Jackie Doyle-Price, the Minister for Public Health, and the noble Lord, Lord O’Shaughnessy, our Minister here today, for attending a very helpful meeting earlier this week. Both Ministers recognise the vital role that this Bill would play in getting more order into a system that is subject to so much criticism. In another place, Ms Doyle-Price stated that,

“the existing guidance is not having the impact that the Government expected, and … we must do more”.—[Official Report, Commons, 15/6/18; col. 1267.]

She has shown her determination and passion to make things better, and our deliberations today will, I know, contribute to that.

I also thank the numerous NGOs that have focused on this Bill with briefings and discussions—NGOs from mental health and disability organisations, the Restraint Reduction Network, the Crisis Prevention Institute and children’s organisations. Their work is, as ever, much appreciated. As we know, the voluntary sector is a highly respected force in our society for its critical judgments and for advocating change when needed.

I shall not go through the Bill in detail; I shall bring forward specific concerns and questions for the Minister later. I shall simply say that, as we know, Clause 1 deals with definitions such as “patient”; Clauses 2, 3, 4 and 5 discuss the duties of the responsible person in a mental health unit, including training; Clauses 6 to 9 relate to reporting incidents of the use of force and the investigation of deaths and record-keeping; and Clauses 7 and 8 require the Secretary of State to publish an annual report and to conduct a review of reports. Clause 9 refers to the investigations of death and serious injury in mental health units; Clauses 10 and 11 speak of the duties of the responsible person and of delegation; Clause 12 makes provisions related to wearing and operating body cameras when police attend a mental health unit; and Clauses 13 to 16 make provisions on the interpretation of the Bill and its financial implications. Finally, Clause 17 applies the extent of the Bill to England and Wales.

How big is the problem of the use of force in mental health units? The Crisis Prevention Institute found, from a series of information requests sent to mental health trusts in England in 2016-17, that 3,652 patients were injured while being restrained during NHS treatment, that 13% of trusts did not have a policy in place to reduce the use of restraint, that 97,000 restraints took place, with more than 2,600 staff assaulted by patients during interventions, and that 46 people have died. This is simply not good enough.

I want to probe five issues in relation to the Bill: guidance to the Bill, the issue of training of personnel working with people in mental health units, patient involvement, the treatment of children in mental health units and the disproportionate use of restraint.

First, guidance will be crucial to the success of the measures suggested. There is already statutory guidance but it is not working well enough. Guidance is essential because every nitty-gritty definition cannot be included in the Bill. Guidance must be clear and firm and must be monitored to check that it is actually working. Will the Minister tell us when new guidance will be issued? Will contributions from NGOs, parliamentarians, and staff and clients from mental health institutions be taken into account? How will that consultation work? I do not intend to move amendments to the Bill, but I hope we can be assured that the guidance will be detailed and strong.

The second issue is training, which is vital to deliver the outcomes that we all want. What kind of training are we talking about? Those of us who have delivered training know that it is not just about giving lectures and telling people what to do. It is about exploring feelings about issues; sharing experiences; getting below the surface of deep and fundamental problems that might exist; and using client groups to suggest recommendations about behaviour. In relation to the Bill, will a training manual be produced that includes case studies of good practice or will all this go into the guidance?

Thirdly, how will the views of patients be sought? Patients need to understand their rights and be able to contribute to decision-making about their treatment. If people feel respected, they are more likely to understand the issues and contribute to solving problems.

I come now to the fourth issue: disproportionate restraint. Among patients admitted to mental health units, there may be people of different races and faiths, and different ages and abilities, both physical and mental. Today, I received a letter from someone who works with people with Alzheimer’s who have suffered in these institutions. At the Second Reading of the Bill in another place, Steve Reed said:

“If we look at the faces of the people who have died after severe restraint in a mental health hospital, we see many more young black faces than in the population as a whole”.—[Official Report, Commons, 3/11/17; col. 1090.]


The same is of course true of the youth justice system. There is a huge need for training to understand and deal with the issue of bias and lack of recognition of race, culture and special needs. Units seem to act independently, and therefore standardisation on recording data is needed. How will guidance address this issue?

Finally, I have a particular concern about the treatment of children and young people in both the youth justice system and mental health units. Children are children first, and anyone under 18 is a child according to the United Nations Convention on the Rights of the Child, which we have signed. Children on the cusp of 18 are at particular risk: in institutions they are frequently treated as adults and are placed with adults. This is inappropriate and can place them in danger. How will guidance deal with the issue of children?

This is an excellent and much-needed Bill. I look forward to contributions from all colleagues and I hope to hear a satisfactory and positive response from the Minister. I beg to move.

--- Later in debate ---

[Baroness Massey of Darwen]

My Lords, I thank all noble Lords who have taken part in the Second Reading of this Bill. I have found the debate most moving, which cannot often be said about debates in your Lordships’ House. It has been both interesting and moving, and it is a pleasure to be in the midst of people who are so concerned about vulnerable people—children and adults. I hope that the family of Seni will consider this debate something of a tribute to him and to themselves for all their work in bringing this to our attention and the development of a Bill that could be a very significant piece of progress.

I shall just make a few comments about speeches that noble Lords have made. I liked the very incisive comments of my noble friend Lord Harris and his clarity in talking about the investigation of deaths in custody, based of course on his own vast experience of this. I learned a lot from his speech and I hope that the Minister will take that up further, as there was a lot in there that needs to be looked at again in writing, assessing how it could contribute to any possible future guidance. The noble Lord, Lord Adebowale, also has huge experience of working with vulnerable young people and with mental health issues. He emphasised the need to take account in the guidance of the work of NGOs, which I—and I think all of us—totally support. The noble Baroness, Lady Tyler, and I have worked for years on the issues relating to children and young people and I am glad that she reinforced comments on that, as did other noble Lords, and that she gave her support to the Bill. Her point about consultation with parents is important, as was the issue also raised by my noble friend Lady Thornton about the traumatisation of women who may have been subjected already to violence and be in distress. She also mentioned training in the prevention of the use of restraint.

My noble friend Lady Thornton raised many good points about equality. I think she said that it was “unthinkable and cruel” that people who have problems should be subject to more, and sometimes regular, violence. She recalled the amendments tabled in the other place and said that we should take account of them, and I agree. I am trying not to use the word “negligible” here. At least I can say it. I thank my noble friend for her comments in winding up.

The Minister made some helpful points about the importance of cross-party collaboration in the Bill, and said that more needs to be done. He covered many issues that have been raised today, and I know that he is passionate about this, because we have talked about it. It would be a good idea if we had a full meeting after this debate. Things have come up that we need to tease out the meanings of, like that terrible word “negligible”, and the word “patient” itself, including children in that. What is a child? We need a definition. Is a child someone under 18? In fact, some organisations use “child” to cover up to age 24. Let us get some correct definitions. Let us listen to what my noble friend Lord Harris said, to what all other noble Lords said, and to the NGOs. The Minister is generous to suggest a meeting, and it would be useful, just to tidy up some of the things we have talked about and to reinforce some of the issues. I would appreciate that, and perhaps we can talk about it afterwards.

Having said all that, I thank all noble Lords. I said I was moved by the debate, and I was. We have done justice to a serious and important issue here, and I hope that we will see it move forward a bit more rapidly than I heard the Minister say. I do not know whether that is possible, but we need guidance as quickly as possible, although not rushed guidance. However, with consideration, we can make this into good guidance that will have some impact on the ground where people work and are in mental health units. I also take the point that the people administering this violence may also be suffering somewhat. I am of the view that violence never solves anything at all; we need a different approach to this, which can come only from training, discussion and sympathetic listening to people who are in this position. I ask the House to give the Bill a Second Reading.

Bill read a second time and committed to a Committee of the Whole House.

Obesity

Baroness Massey of Darwen Excerpts

Wednesday 18th July 2018 Lords Chamber

[Baroness Massey of Darwen (Lab)]

My Lords, I thank the noble Lord, Lord McColl, for introducing this debate with his usual clarity and passion. I also congratulate the noble Baroness, Lady Boycott, on her invigorating maiden speech. I loved Spare Rib.

We know a lot about obesity. We know its side effects, which include illnesses such as cancer and diabetes. However, there is a warning. Our experience of public health shows that just giving people of any age the facts about the health detriments caused by smoking, alcohol and poor diet is not enough to change their behaviour. We also need to examine the more complex aspects of these issues.

Like many other countries, we have an obesity crisis. I am currently writing a report on adolescent health for the Council of Europe, where I chair the sub-committee on children. Our report will focus on three aspects of adolescence: mental health, sexual health and obesity. Those topics might seem diverse and unconnected but I think that they have some points in common, chief among which is the development of self-esteem in young people. As we know, young people who have high self-esteem are more likely to have better social skills, better decision-making skills and better resilience, enabling them to resist pressure and seek help when needed.

The same things tend to influence young people’s mental health as influence their sexual health and possible obesity, namely their parents and family, social and other media, advertising, gender, laws and policies, friends, school, and so on. Surely we need to focus on what those influences are doing to children rather than on one simple issue, even if it is a health issue. For example, we know that children from lower-income backgrounds tend to be more obese, so poverty is the driver, and we need to look at poverty. Surely we also need to look at how the media is influencing children and works to their detriment.

One in five children in this country is already overweight or obese before starting school. That is not a child’s problem; it is a parental and societal responsibility. In particular, it is the responsibility of the food industry to make its labelling of sugars more accurate. Interestingly, and the noble Lord, Lord McColl, mentioned this, I have not seen much reference to the importance of breastfeeding in relation to its impact on future obesity. I know that I have read evidence of this but it was many years ago. I wonder if the Minister has any advice on breastfeeding and its impact on obesity.

I know there is more demand generally for healthy food and that this has had an impact on sugar content in food, and that many schools have taken very seriously their attack on sugary drinks and healthier school meals. I know some schools are encouraging children to walk to school and do more exercise. Exercise, as the noble Lord, Lord McColl, was saying, is good for us, and perhaps the feeling of well-being from doing exercise can help to raise self-esteem and the wish to look good. Yes, exercise eats up some calories but, as the noble Lord says, the crucial thing is undoubtedly diet.

What can the Government do? This would be my list, for a start: stop making people poorer so that they do not have to rely on food banks for family food; educate parents about obesity; start now with a firm strategy on school meals; insist immediately on child-friendly watersheds on advertising food that is high in fat, sugar and salt; involve local communities in decisions about reducing obesity; help schools to develop personal, social and health education programmes that increase self-esteem and decision-making skills and to provide consistently healthy food; and set clear goals and targets for reducing obesity, with measures which can be evaluated and learned from. Does the Minister agree?

As I said at the beginning, we know what and where the problems are. Now is the time for swift and breath-taking action to combat obesity. The NHS cannot afford such a problem. Apart from financial concerns, society, and especially children, cannot be allowed to suffer the side effects of obesity. There is much to do, and I shall be most interested in the Minister’s response to this important debate.

Breast Cancer Screening

Baroness Massey of Darwen Excerpts

Thursday 3rd May 2018 Lords Chamber

[Lord O'Shaughnessy]

We must be absolutely cautious in our dealings with technology. Of course, technology is part of the health and care service now. It is in everything. Making sure that there is good quality assurance is critical to that. Clearly, we have uncovered a problem but we do not think that the problem is in other screening processes. We have had reassurance from Public Health England that that is the case, but we clearly need to investigate further. We also need to be alive to the fact that these systems are often under attack from other actors, and to provide that cyber resilience. So I am afraid that it is an ongoing process to provide that kind of resilience and quality assurance. It is a job that never ends.

[Baroness Massey of Darwen (Lab)]

My Lords, I declare an interest as vice-chair of the All-Party Parliamentary Group on Breast Cancer. The Minister may be aware—I hope that he is—of a report, Good Enough?, about capacity issues within the breast cancer screening service. The report expresses very forcefully that there is regional variation. What is the answer to this and how can it be improved so that wherever you are you can get excellent service and screening?

[Lord O'Shaughnessy]

The noble Baroness asks an extremely good question. It is important in this instance to distinguish between the very correct questions that she is asking and the particular problem in this case. In this case the problem is not one of resource but of, unfortunately, an IT flaw in the interaction between the national screening programme database and its AgeX trial. I want to make that clear. But in response to her question, we had an opportunity to debate these issues in the House yesterday in an Oral Question from the noble Baroness, Lady Thornton. We are increasing and have increased the number of specialist cancer nurses, for example, by 1,000. Health Education England, in its cancer workforce strategy, has outlined a plan to recruit more radiologists, radiotherapists and so forth. Having more staff and higher-trained staff with the proper competency frameworks is clearly one way in which we can deal with the variations that she rightly highlights.

Children and Young People: Mental Health Services

Baroness Massey of Darwen Excerpts

Thursday 8th March 2018 Lords Chamber

[Baroness Massey of Darwen (Lab)]

My Lords, I too welcome the Green Paper. Last November I conducted a seminar in Portcullis House of European parliamentarians, children, NGOs and academics. The most important thing there was the voice of the young people. Their concerns have been expressed already—joined-up thinking, early intervention and well-trained professionals. Does the Minister agree that these are important? Does he further agree that the voice of the child in all this is absolutely paramount?

[Lord O’Shaughnessy]

I know that the noble Baroness speaks with deep experience and passion on this subject and I completely agree; it is about making sure that those children’s voices are heard. We recognise that the picture of fragmentation described in the CQC report is not good enough and that is one of things we are trying to fix. It is a historic issue and it cannot be done overnight but we are working on it.

National Child Obesity Strategy

Baroness Massey of Darwen Excerpts

Monday 26th February 2018 Lords Chamber

[Lord O’Shaughnessy]

My noble friend is absolutely right and as the noble Baroness, Lady Benjamin, said, it is about getting into families when children are young. My noble friend will I think be reassured, as I hope the House will, to know that not only are there more health visitors than ever but, as part of that, we have a healthy child programme looking at the prevention and identification of obesity. Health visitors are trained in critical elements such as promoting breastfeeding, nutrition and physical activity to encourage healthy babies.

[Baroness Massey of Darwen (Lab)]

My Lords, have geographical variations been taken into account in the strategy? For example, London has much higher levels of child obesity than the rest of the country.

[Lord O’Shaughnessy]

Health inequalities and their reduction are a core part of it and in talking about them I would focus, to pick one example, on breakfast clubs. We know that having a good-quality breakfast—indeed, having any breakfast as some children go without it, which causes problems, too—is important. About £26 million is being spent on extra breakfast clubs in 1,500 schools in opportunity areas and disadvantaged areas.

Older Persons: Human Rights and Care

Baroness Massey of Darwen Excerpts

Thursday 16th November 2017 Lords Chamber

[Baroness Massey of Darwen (Lab)]

My Lords, I thank my noble friend Lord Foulkes for introducing this important debate with his usual vigour and enthusiasm. He and I are members of the UK delegation to the Council of Europe, so I have had the pleasure of following the development of this report on the human rights of older people over the last year. My noble friend has done a most thorough job of exploring many angles of the issue of ageing. I shall touch briefly on three of them today: legal and policy frameworks, the concept of “active ageing” and end-of-life care.

I remember seeing some years ago what was once a familiar road sign warning: “elderly people crossing”. Noble Lords clearly remember it. The man was bent double with a walking stick, with a helpless-looking woman at his side. It was criticised for being stereotypical. My noble friend’s report tries to counteract such stereotypes, which, like all stereotypes, are damaging and oppressive. Indeed, they may contribute to older people’s views of themselves—how they should look and behave, and so on. It must be damaging for their mental health, to say the least.

In your Lordships’ House and elsewhere, I usually discuss the other end of the age spectrum: children. Whether we are talking about children or older people, though, policy frameworks are important. Those of us involved in children’s issues have the Convention on the Rights of the Child to draw on. We use it as a kind of touchstone—a charter, to use my noble friend’s word. As my noble friend points out in section 2 of his report, there is no international legally binding instrument devoted to the rights of older persons. Many of us have called for one, including the UN independent expert on the enjoyment of human rights by older people. The European Convention on Human Rights applies to older persons, even though it is not explicit. The European Social Charter contains several articles relevant to older persons. The Council of Europe and its Parliamentary Assembly have promoted the rights of older people. The UN is actively working on this. There is concern: it needs to be pulled together.

When I talk about children’s rights, I always say that it is not only about protecting children: it is about empowering them. My noble friend is supportive of this concept for older people. A growing proportion of the population that is inactive and dependent is not only expensive for the state, but it is a waste of energy and talent. I am a great believer in prevention: we could improve systems to educate people when younger to help themselves through diet, exercise and ongoing mental activity. We should do more to support people through social systems. We know that many older people experience infringements of their human rights in later life. A recent Care Quality Commission report reveals inadequate and inappropriate levels of care and safety concerns. The noble Baroness, Lady Greengross, referred to this earlier.

Inevitably, of course, people die, and many are by no means elderly. I witnessed a dignified death when my brother died of cancer last year. Dying can be dignified for the person and, importantly, for the relatives and friends. My brother died in a beautiful hospice in Cheshire surrounded by flowers and cheerful, dedicated people after wonderful care. Some of his last words to me were: “You’ve got to sort out this hospice funding situation”. It is a situation that I was unaware of and I ask the Minister to clarify it. It seems that, if a person at the end of life goes into a care home, the money follows the patient. If they go into a hospice, however, the money does not follow the patient. Hospices are funded through their fundraising and bequests. I do not know why this should be. Hospices seem to me to be an excellent model for end-of-life care. Perhaps the Minister can explain.

Again, I thank my noble friend for raising the issue of the human rights of older people. We are talking about human dignity, support and empowerment, which are all absolutely key to any human rights.