Government Vision on Prevention

Baroness Uddin Excerpts

Tuesday 6th November 2018 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, those of us who have worked in community developments over 40 years have understood and valued the notion of prevention. It has to be recognised that funding has dissipated over the last 10 or 15 years, due to the finance extracted from local government. I welcome the Statement and I particularly welcome the fact that the Secretary of State makes reference to wanting to integrate housing and health and social care. This is very important. More specifically, I want to make a couple of points on learning disability and autism.

The Secretary of State recently came to a meeting of the All-Party Parliamentary Group for Disability and we were really pleased that he stayed and listened throughout. However, the point that is still missing—I would like the Minister to respond—is on how the Government will ensure that organisations that have worked solidly with sterling records on the ground will be part of this discussion, because they know the answers. Minister after Minister and officer after officer will change, but many of these organisations have remained rooted, whether they have been funded or not, and I would like some assurance that they will have their say. Millions have been lost in services over the past decades, particularly in disadvantaged communities, so women and people with disabilities have not been able to access services adequately, either because they do not know that services exist or because government organisations simply fail to connect with them.

[Noble Lords]

Question!

[Baroness Uddin]

With respect, my Lords, I state my objection at being shouted at to move on; many Members would simply carry on.

[Lord O'Shaughnessy]

I am grateful to the noble Baroness for the question. On learning disabilities and autism, I know that the Secretary of State has been very moved by some of the cases that he has become aware of since taking the job in the summer. He has instigated not only serious incident reviews into individual cases but a thematic review by the CQC, with contributions from NHS England, on how to improve the system and ensure that we move more services out of in-patient facilities and into the community. I am absolutely confident—I will confirm this to the noble Baroness—that the best providers, from wherever they are, will be able to contribute to that review.

National Health Service: Mental Health Funding

Baroness Uddin Excerpts

Wednesday 20th June 2018 Lords Chamber

[Lord O’Shaughnessy]

I agree with the noble Lord that we need to increase funding for local mental health services. That has been happening over the past few years; indeed, between 2015-16 and 2018-19 it has gone up by £1 billion. I turn to his point about mental health funding being used for other purposes. I want to be clear that there is NHS England guidance that that should not happen, and from this financial year all CCGs will have to meet what is called the mental health investment standard, which means that they are to increase their spending on mental health at least as much as, if not more than, their spending on physical health.

[Baroness Uddin (Non-Afl)]

My Lords, regardless of what the Minister says, does he accept that there has been a systematic destruction of voluntary organisations providing many mental health services? This has had a particular impact on survivors of domestic violence. What are the Government doing to ensure that Women’s Aid and other organisations that provide support for women suffering from and the survivors of domestic violence have funding available through the means to which he has referred?

[Lord O’Shaughnessy]

Although the particular funding the noble Baroness is talking about is a Home Office issue, I can say that £100 million is available until 2020 to support the victims of domestic violence. From the health service perspective, obviously we are increasing the amount of money spent on treating those with mental illness, regardless of the cause that gave them their illness in the first place.

Social Care

Baroness Uddin Excerpts

Thursday 7th December 2017 Lords Chamber

[Lord O'Shaughnessy]

I am happy to provide that assurance. Inevitably, there is economic modelling that will need to be updated from previous reviews. It is the reason that, in particular, Dame Kate Barker and Sir Andrew Dilnot have been invited to play a role as well as others, as I am sure the noble Baroness knows. We do not want to have to reinvent the wheel and we know what we want to achieve. The difficulty is that, as Governments have found throughout the years, it is easier to say that than to do it. We all want to get through that process and hopefully achieve it this time.

[Baroness Uddin (Non-Afl)]

My Lords, in the light of all the previous comments I want to raise a couple of issues. I welcome having another look at social care in general and the fact that the Minister says that the Government are looking at integrated care. That is not the experience of men, women and children on the ground; I declare an interest in that I have a son with autism but I receive no service, so I do not really need to declare that. I think an awful lot of parents are like me and my husband: their families manage it themselves. The level of support for social care for adults with autism or a learning disability has been decimated over the last 10 years in various ways. How will this new approach to social care ensure that there is some reverse, so that there is dignity and honour for those individuals who go through the social care process and system?

Does the Minister agree that it is really important to ensure that there will be some reparation, almost, for the loss of services in the past so that adults, particularly those with a learning disability and autism, have access to services such as simply going to the library? My noble friend Lord Howarth mentioned the arts earlier but there is also music, as was pointed out earlier in the Chamber. There is a variety of ways in which social care is now more innovative, and that access should be available to service receivers in all parts.

My final point is about the communities that do not automatically understand the new approach or the latest fads and reports. They do not follow the system. How will we ensure that all kinds of communities understand that there is an approach to integrated social care, and that they will not be left behind simply because they do not understand the system or are not au fait with it, or if they are not politically correct and shouting the loudest?

[Lord O'Shaughnessy]

The noble Baroness put it beautifully in saying that the people we are talking about, who are on the receiving end of care, need to be treated with dignity and honour. I wholeheartedly agree with her.

I will separate integrated care into older people and working-age adults, as the noble Baroness did. On older people—and on health and care in general—I encourage her again to look at the five-year forward view and the plan for integration. In the recent Budget, we funded more than £200 million of capital programmes to help move a handful of local areas to what are called accountable care systems. That is where you look at the health of a population, which is quite an important step forward towards integrated care. I agree with her that that is not necessarily the everyday experience.

On disabled working-age adults, we may talk about the ageing and growing population but I believe that they are the fastest-growing group of care users. There is of course excellent work going on at the local authority level; I had the privilege many years ago to chair a special school in Wandsworth and saw the fantastic work it did with a peripatetic autism service there. But I know that there is huge variation, which is why the parallel programme of work that I talked about is so important.

Finally, the noble Baroness talked about hard-to-reach communities, and I could not agree more on that. One of the ways of reaching them is to engage with those who give voice to those communities. I would be delighted to discuss that with her, to make sure that we are listening to every voice we can as we move ahead.