Neurological Conditions

Baroness Wheeler Excerpts

Thursday 9th June 2022 Grand Committee

[Baroness Wheeler (Lab)]

I am very pleased that my noble friend Lord Dubs secured this important debate and grateful for his excellent speech. We know that he values every opportunity to underline the urgent need to improve services in social care for all people with neurological conditions. We have often spoken about MS, the impact the disease is having on his son and the experience of his whole family in caring for and supporting him. We also heard from my noble friend Lord Monks of his experience of the care of his son. He also spoke very movingly today.

One in three people with MS does not get the social care or rehabilitation they need to cope with the disease and be able to lead as independent a life as possible. The experience of both my noble friends over many years, sadly, reflects that. The noble Baroness, Lady Thomas, also made a compelling plea for muscle-wasting and other neurological conditions to be better and more effectively managed through timely treatment and access to rehabilitation services and specialist support, with regular access to specialist teams.

I also pay tribute to the work of the 80 charities within the Neurological Alliance. I hope yesterday’s Westminster Hall launch of its excellent survey—which I was, sadly, unable to attend—went well and received the attention and support it deserves. Noble Lords’ contributions have drawn heavily on the survey results in respect of a range of neurological conditions, including MS, dementia, migraine and Parkinson’s. My noble friend Lady Gale is always a great advocate of the work of Parkinson’s UK, but was, sadly, unable to be here today.

My special focus is on stroke, as a carer for a disabled adult stroke recoverer. Stroke strikes every five minutes in the UK and 100,000 people have strokes each year. It is a leading cause of death and adult disability in the UK, with more than two-thirds of people who have had a stroke leaving hospital with a disability. To underline the neuro survey key data highlighted by noble Lords, the one in six people in the UK who have a neurological condition have the lowest health-related quality of life of any long-term condition. One in five adults waited more than 12 months between seeing a GP and then a neurologist, and 55% experienced referral delays in routine neurologist appointments—all of which needs to change, as we have heard. The Chartered Society of Physiotherapy estimates that only 40% of people receive essential neurorehabilitation.

Workforce shortages are the biggest reason behind delays, and I look forward to the Minister explaining the Government’s specific plans to address the chronic neurological staff shortages across all key conditions. How do they account for the UK having only two neurologists for each seven that France and Germany have, and how is this situation being addressed? Does this not reinforce the urgent need for the long-term workforce plan to tackle these and other acute staff shortages, as we have been calling for? In Parliament yesterday, almost as an aside, the Secretary of State referred to work being undertaken “on a 15-year strategy”. That is the first time we have heard mention of any timeframe, so perhaps the Minister could tell us more about who is leading the strategy’s development and when it is expected to be published.

Specifically on MS, last year, NHS England’s Getting it Right First Time adult neurology report recommended that all MS teams have enough administrative staff to carry out non-clinical duties and free up clinicians’ time to treat patients. Can the Minister update the Committee on what progress has been made?

The Government’s acceptance of the alliance’s call for a UK-wide neurological task force of key stakeholders from Governments, departments, professional bodies and the voluntary sector must be a key factor in identifying how treatment, rehabilitation and social care support can be provided and improved, running alongside the strategy, resources, front-line specialist workforce and other clinicians that are vitally needed where shortages are most acute. I hope that the Minister will recognise this as a key way forward.

I have a few further points. The My Neuro Survey rightly makes much of the impact on unpaid carers and families of the lack of support available for the people they care for; a number of speakers mentioned this. In this national Carers Week, it is important that carers feature strongly in today’s debate. According to the Alzheimer’s Society, unpaid carers supporting someone with dementia save the economy £11 billion every year. On Tuesday, the Minister promised that the Government want to help carers to make sure that they are looked after while they provide a service for their loved ones. Can he say what specific immediate steps are being taken to do this?

Specifically on social care, NHS data shows that only 14% of the total social care budget is spent on people living with neurological conditions. Living well with neurological disease means getting the right home support and equipment, regular occupational and physio therapy, and eating, washing, dressing and other essential social care help. But as the latest social care directors’ ADASS survey showed, more than 500,000 people in England are waiting for a social care assessment, for care to begin or for a review of their care. Can the Minister explain how this immediate situation is to be addressed, given that the existing resources pledged for social care at best just shore up existing wholly inadequate services?

Finally, what research is being undertaken by the Government into the impact of long Covid on neurological conditions, following the two studies by Mater Hospital in Dublin that found “significant evidence” of it leading to new neurological conditions? Have the Government any further information on or assessment of this? How is this troubling link being monitored? I look forward to the Minister’s response on all these issues.