Health Promotion Bill [HL]

Baroness Uddin Excerpts

2nd reading
Friday 2nd December 2022 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, it is a pleasure to follow the noble Lords, Lord Crisp and Lord Lansley. I applaud and thank the noble Lord, Lord Addington, for his leadership in pursuing this debate.

Like many noble Lords, I have spent a lifetime trying to improve health and social care in my backyard, alongside the work we do in this House. It would be remiss of me to not acknowledge the immense results we achieved back in the early and mid-1980s, which saw great improvements, particularly in perinatal and postnatal mortality rates, immunisation and breastfeeding. Most of those changes are under much stress now, adding to the improvements required in maternity services, which need urgent attention, and to the gross disparities we have talked about in this place and elsewhere on health and well-being, as well as air pollution, mental health and long Covid, particularly for those people living with disabilities and from minority communities.

Alongside this, the dissatisfaction rate among the general population for our GPs and much-beloved NHS and A&E services suggests that services have become inadequate. There is a lack of good quality maternity services, with women unable to receive adequate care during pregnancy, childbirth and postnatal care; one can see the trajectory of the health and well-being deficit in the family being set very early on. This is worsened if there are disabilities, mental health and care needs, in addition to the bullying, racism and discrimination within the system and which staff experience. If this is embedded in the services, is it any wonder we are facing this crisis? If noble Lords are minded to underestimating the effect of racism within institutional structures, I ask the Government to speak with Dr Chaand Nagpaul prior to setting up the new office proposed in the Bill to ensure that we do not just consult but involve those who have a track record of achieving changes within communities, even with restricted and constrained resources.

The Health Promotion Bill contains potential and important milestones to achieve better services. However, I would like us to pay the requisite attention to ensure that the issues of workforce balance, leadership in commissioning and senior management, and board representation are given equal attention and support. I welcome this Bill and agree that the national plan must be integrated, as has been said. What it does not explain is how we will set and benchmark standards, how implementation will be monitored, or how this will be embedded within the equality framework. This must be based on an absolute commitment from the Government to address workforce balance and leadership in commissioning and senior management. This must be a perquisite to the changes that are required.

This new office can flourish only with the determination of better collaboration which integrates sufficient resources and a commitment to achieving this, and by placing at the heart of any changes the service users and leadership which reflects all the communities in which these services are based.