King’s Speech

Baroness Pitkeathley Excerpts

Friday 19th July 2024 Lords Chamber

[Baroness Pitkeathley (Lab)]

My Lords, it is a great pleasure to speak again from the Government Benches in this debate, as I did in my first 13 years in your Lordships’ House. I warmly welcome the new Ministers to their posts. However, in the spirit of graciousness which distinguishes our politics, I also want to thank the previous government Ministers, including the noble Lords, Lord Evans, Lord Kamall and Lord Markham, and the noble Viscount, Lord Younger, with whom I worked—especially on issues concerning unpaid carers. They did not always give me what I wanted, but they were always courteous and sympathetic. I too will miss the noble Baroness, Lady Jolly.

First, as others have noticed, there was a big omission in the King’s Speech: anything to do with social care. I know that Ministers understand the urgency of tackling it, and that no reform of health services can be truly effective unless linked with reform of social care, as the Covid inquiry this week has reminded us. It is, though, very welcome news that there is to be an important Bill on mental health, and the mention of prevention in the gracious Speech when it comes to the NHS will be greeted with relief and pleasure. We cannot tackle the ongoing problems of ill health caused by lifestyle unless we address those challenges robustly. The restrictions on smoking and the attacks on fast and ultra-processed foods, especially advertising to children, will be most welcome to those of us serving on the Select Committee on diet and obesity, so ably chaired by the noble Baroness, Lady Walmsley. In a visit to Blackpool, we were shocked to discover that two-thirds of children starting secondary school there are already clinically obese.

As well as prevention, our reforms of the NHS must also focus on integration. I was privileged to chair one of your Lordships’ House’s special inquiries into integration last year, and it was not a comforting picture. Clearly, people are not getting the right care in the right place at the right time. Our recommendations focused on improving structures and organisation which currently limit integration, on revising contracts and funding which limit, or even disincentivise, integration and on devolving far more money away from hospitals towards community-based care. The inadequacy of digital connectivity was a huge source of frustration for our witnesses, and guidance is needed to clarify responsibilities. We saw, for example, people putting the same data into three separate computers because the computers did not talk to each other.

A major barrier to integration is staff shortages and professional divides which indicate that one set of workers, like those from a local authority, are somehow of less value than another, like those from the NHS. I am hopeful that measures in the planned employment rights Bill to increase social care pay and scrap exploitative zero-hours contracts will help retain and attract more staff. It is possible. On Monday this week, I was in Southampton with my 104 year-old aunt. While I was there, four different people visited her: a local authority worker, an OT, a district nurse and a private care company. All of them knew about each other, they all had the same data regarding my aunt and they were all working to the same end. I could not see the joins between them. They were helping a 104 year-old lady to live peacefully, and probably die peacefully, in her own home. We should take these examples and learn from them.

I have not thus far mentioned unpaid carers, which is so often the subject of my interventions in your Lordships’ House. I hope the employment rights Bill, however, will encourage the Government to move more quickly to deliver their review of the Carer’s Leave Act 2023 and to introduce enabling provisions to ensure a right to paid carer’s leave can be introduced during the passage of the Bill. Of course, a commitment by the Government to a national strategy for carers would be welcomed by 6 million people.

In conclusion, I repeat my disappointment thus far that nothing in the gracious Speech will lead us to a reform of social care, but I know that Ministers and others are extremely aware of the urgency of the need and that we shall hear announcements as soon as possible.