Queen’s Speech

Baroness Walmsley Excerpts

Wednesday 12th May 2021 Lords Chamber

[Baroness Walmsley (LD) [V]]

My Lords, the gracious Speech made a very brief mention of the Government’s intentions on health and care, but the recent White Paper was a little more helpful. Today I ask: why this and why now? There are three key reasons why I would rather have seen a draft Bill for consultation than the immediate introduction of the forthcoming health and care Bill.

First, to integrate health and care, desirable although that is, without previously carrying out the long-awaited reform of social care is partial and unwise. It is like refurbishing one wheel of a bicycle while the other wheel is bent and rusty. For years, we have had a social care crisis. Provision is fragmented between public, private and third-sector providers, which makes consistency of standards and access to information difficult. It has been chronically underfunded for years, which makes for a lack of confidence on the part of both those who invest in it and those who need its services. Meanwhile, self-funders overpay to cover the shortfall in fees from cash-strapped local councils. This is unfair.

Worst of all, because many settings have closed, there are fewer services available for those who need them. Those who may need services in future fear, as the noble Lord, Lord Rooker, put it—yes, really fear—what might happen to them, especially if they get dementia. About a million older or disabled people are already unable to get all the support they need. There have been many opportunities to work cross-party to correct this, sort out the funding and give a decent living wage to those who work in social care, but successive Governments have failed to grasp that nettle. In the gracious Speech, we were given nothing more than another promise to deliver what the Prime Minister told us two years ago was a ready plan.

Secondly, a Bill that plans to reform a health and care system that is struggling to recover from a pandemic, without considering what state it is in and what lessons can be learned, is precipitate. One of the biggest issues, as I see it, is the staff. They are stressed and exhausted, yet they face an uphill struggle to deal with the backlog of treatment needs. The number of people now waiting more than a year for treatment has risen from 1,600 before the pandemic to almost 390,000. I welcome the recent NHS announcement of upfront money for a few integrated care services that present a cogent plan to increase their elective treatments to 120% of pre-Covid levels. This will help a few ICSs, but it is not universal.

We started this pandemic with too few beds, too few doctors and too few nurses, and no more than a five-year staffing plan for the NHS. No wonder the staff struggled. Today, on International Nurses Day, I welcome the record number of students joining the nursing profession and those returning, but we now need an independent 10-year staffing plan for NHS and social care. Will the Minister please consider the necessity for that?

Thirdly, we have a crisis in mental health. Demand was not being met before the pandemic; there were long waiting lists, especially for young people. Because of the pandemic, the situation is now much worse. I hope that, when deciding on the policy to reform and fairly fund social care, the Government will consult the sector, users and across parties.

Implementation is another challenge, but here I think we have a good example. People have rightly praised the vaccine rollout. The Vaccine Taskforce and the thousands of NHS workers and volunteers who have delivered the vaccines so brilliantly invented by Oxford University and other scientists have done a wonderful job. I believe the vaccine rollout has been a success because of two things from which we can learn: mission focus and a “whatever it takes and whatever it costs” attitude from government. That focus and that investment are needed to sort out the three crises of social care, mental health and the waiting lists. It will be cost-effective in the end, because it will reduce the pressure on acute hospitals. We need this before we try to implement the reforms in the Bill, many of which I would probably happily support at the right time. I ask the Minister whether the Government will withdraw the Bill for consultation and bring it back when they have sorted out the crises in social care, mental health and NHS and social care staffing.