Queen’s Speech

Baroness Walmsley Excerpts

Thursday 19th May 2016 Lords Chamber

[Baroness Walmsley (LD)]

My Lords, before turning to the gracious Speech, I first echo the thanks of the Lord Speaker to the noble Baroness, Lady Thomas of Walliswood, and the other three colleagues who have ceased to be Members of this House today. To my personal knowledge, the noble Baroness was an excellent and very hard-working Peer in this House when she was in full health. She made an enormous contribution to the work of these Benches, and I am quite sure that the other noble Lords mentioned had a similar track record. I would not have felt it necessary to make these remarks had it not been for the rather unfortunate laughter after the announcement earlier, which our ex-colleagues and their families may have found somewhat hurtful. I am sure that the House did not mean any disrespect.

On these Benches, we welcome much of what was in the gracious Speech, especially those items that have been Liberal Democrat policy for some time. Of course, we will scrutinise the measures very carefully when they are put before us. Noble Lords will hear from my noble friends on these Benches about various topics today. My own remarks will be addressed to health and social care, although my noble friend Lady Brinton will say more about the latter.

When I heard the gracious Speech, I did not know whether to be astonished that there was hardly a mention of the NHS or glad that the Government were not planning another disruptive top-down reorganisation. This morning, there is a Statement in the other place about progress at last with the junior doctors’ contracts but we have no Health Minister in this debate in your Lordships’ House. I asked for the Statement to be taken in this House, but I was refused by the Chief Whip. The noble Lord, Lord Prior, has been such a trooper, patiently standing at that Dispatch Box week after week reporting that there was nothing to report. Then, on the very day when there actually is something to report, the noble Lord is not allowed to answer our questions. That is treating your Lordships’ House with contempt and it is treating the health service with contempt.

I hope that the Minister, when winding up, tells us what will happen next and why, when it is now possible to make arrangements to protect women doctors who wish to take maternity leave or take time out for training or research, it was not possible to do that a long time ago. Why, if it is possible now to make some small concessions to the quality of life of doctors and their families, was it not possible to do that before? Why, if it is not just about money, did we have the Secretary of State telling us this morning on the BBC that it will cost hospitals one-third less to roster doctors at the weekend? At least the gracious Speech contained a further commitment to mental health, but my noble friend Lady Tyler of Enfield will express our concerns that the commitments made during the coalition Government have not been followed through.

As to the proposals to charge non-resident visitors to the UK for health services, we will wait for the details before we comment further. However, our main concern will be that no one in the UK should go without the healthcare they need.

It has to be said that the past 12 months have not been the NHS’s finest hour, and certainly not the finest hour of the Secretary of State. This is not because NHS staff are not working hard or because they are not working at weekends, because they have been, but rather it is the failure on the part of the Government to be realistic about the legitimate health and social care needs of our population and the right of those who work in these services to be properly paid and have a reasonable work-life balance. While I accept Jeremy Hunt’s personal commitment to patient safety, he has not gone about it in the best way. The industrial action taken by junior doctors over the past year is only one, although a very serious one, of the indications that health and social care services are at full stretch. The whole debacle has been damaging to the morale of the health workforce, and the Government will have to work hard to regain its confidence.

It never was just about money, it was about being constantly asked to do more with less, or at least the same amount. While I do not deny the right of the Government to make a commitment in their manifesto and then try to implement it, I believe that the way they have gone about it has been a disaster. Governments should be very careful about the factual basis on which to build their policies. There have been several expert reports, including a recent one by a health economist in Manchester, which have questioned the weekend death rates quoted by the Government as being the basis for what they are trying to do. We shall see how the members of the BMA vote, but I hope very much that this matter can now be settled in the interests of patients and doctors.

The pressure does not apply only to junior doctors in hospitals. GPs are also hard pressed. I shall quote from an email I received recently from a GP known to a friend of mine: “I was working from home last Sunday night going through results, patient records and letters. Tim was also on the system from home and Dan was in the surgery doing administration. We are working 12-hour days in the surgery as it is and we really do not have the capacity to do seven days on top of what we are doing now and remain healthy. We are also working on our frailty project, plus looking to see if we can expand the premises. As you can see, I am juggling lots in addition to the daily seeing of patients. These other bits do not get registered: talking to social services, carers, families and patients, looking at the systems in place for clinical safety, multi-disciplinary meetings, emails, keeping up to date and more”. That could be echoed by GPs all over the country. I am lucky that I live in an area where my GP is able to give me a good service, but in some places, especially in London, patients have to wait weeks to get an appointment.

This is the result of bad planning. It takes eight years to train a GP, so today’s needs should have been planned for years ago. Unfortunately, the planning of training for health professionals has been fragmented and everyone blames everyone else for shortages. Now the Government even want to charge a £1,000 skills levy on visas for health workers from overseas. That is crazy and it certainly is not joined-up government. Sadly, the system is playing catch-up all the time. Targets are being missed, deficits have skyrocketed and will swallow up most of the new money announced last year. The Government will not recognise the real black hole in funding and believe that the hard-pressed workforce can make £22 billion of savings in the next few years when it is struggling just to stay afloat.

Then, of course, there is the equally serious shortfall in social care funding. The recent NHS ombudsman’s report on unsafe discharges from hospital with non-existent or inadequate social care packages made for very sad reading. Frail, elderly people are being discharged to cold homes, left alone at night and their families not informed. This should not be happening in this country in this century, and it is no good saying that guidelines were not followed. No one in the NHS would do something like that deliberately, but the pressure on beds through delayed discharges sometimes causes people to make mistakes—fatal mistakes in some cases.

The pressure on the NHS could, of course, be lessened in future if we paid more attention to prevention, yet the Government had to be led kicking and screaming into agreeing some kind of sugar tax to reduce child obesity. The measures announced lack ambition. They should be broader and introduced sooner, but at least they are something. But where is the long-promised child obesity strategy? And what about putting fluoride in all our drinking water to prevent children getting tooth decay and having to go into hospital for extraction? What about fortifying flour with vitamin B to prevent neural tube disease? What is being done about the quality of the air we breathe? Why did Boris Johnson suppress the report about the terrible state of air pollution in London? We need to be told. Then there was the further cut in public health spending, attacking the very local services that help people to stop smoking, get active, avoid unwanted pregnancy and all the other things that local authorities try to do for their residents. This is all so short-sighted, but, if it were reversed, what a difference all these measures would make to rates of heart disease, stroke, diabetes and the sustainability of the NHS.

Savings could also be made on the drugs Bill. I wonder whether the Minister will tell us what progress is being made with the recommendations of the noble Lord, Lord Carter, on that. Will she also assure us that the Government will take notice of the recommendations in the report from the noble Lord, Lord O’Neill, published today, on the actions that must be taken nationally and internationally to combat the over- prescribing of antibiotics and the consequent rise of antibiotic-resistant micro-organisms—a global disaster waiting to happen?

What else should happen? We need some straight talking about the funding and capacity challenges our NHS faces and the steps needed for positive change. So although much of what needs to be done in health does not require the signature of Her Majesty, the Liberal Democrats propose a future of healthcare Bill to find solutions to these challenges, independent of interference from political parties, so that the NHS can continue to deliver health and care for future generations without detriment to its hard-working staff.