Health and Care Bill

Jess Phillips Excerpts

2nd reading
Wednesday 14th July 2021 Commons Chamber

[Joy Morrissey (Beaconsfield) (Con)]

May I thank Neil from Buckinghamshire Healthcare NHS Trust, Buckinghamshire County Council, the local Bucks clinical commissioning group, local GP surgeries, REACH care homes and care workers across South Buckinghamshire, Thames Hospice and Jayne from the Care Campaign for the Vulnerable? They are all already modelling integrated care, which is promised and promoted through this Bill, and I just want to thank them for their tireless service.

I also need to declare an interest: I am now a carer for a very disabled relative, who became disabled through the pandemic and now requires 24-hour care. So I am fully aware of how broken the care pathways are. I want to speak on behalf of disabled adults and their access to care, and the carers who struggle with the demands of finding ways of advocating for their loved one in the current system. I welcome any changes to integrated care because of that. I want to share examples from my personal experience, not because it is important; it just chimes with what I keep hearing from patient advocacy groups, Age Concern, Mencap and other charities. The problem we see is: when a patient is discharged from hospital, who then takes up the duty of care? I have countless examples of my relative being discharged with open bleeding wounds or bed sores, of waiting four days for a nurse to come to attend to them, of being given the wrong medication, of being unable to access—

[Jess Phillips (Birmingham, Yardley) (Lab)]

I just wanted to give the hon. Lady a bit more time. Does she agree that we would want to see more in this Bill on how social care is going to be accounted for? Currently, I feel that is lacking.

[Joy Morrissey]

I thank the hon. Lady for the point she has raised. I have had reassurances from the Minister that we are going to address the social care issues, but I agree that we need parity of esteem between health and adult social care. We need to see those who are delivering those care pathways—local authorities—given the parity of esteem that the NHS and other care providers now have. I hope that we will look at this further as the Bill progresses.

Parity of esteem is very important because there is a difficulty with collaboration and co-ordination of care, and it is the major driver of health inequality and avoidable deaths for people with learning disabilities. Many people with learning disabilities have very complex health needs that require healthcare professionals to collaborate and to co-ordinate interventions. On top of that, healthcare staff need to work together to deliver the healthcare that those vulnerable patients need, which requires effective communication and understanding, as well as resource. How those funding streams are co-ordinated and improved in future is something that should be looked at.

I have seen at first hand, particularly with stroke victims who leave hospital with varying levels of cognitive and physical impairment, the need for critical rehabilitation services to be co-ordinated and put in place the moment people leave hospital, but that is often difficult. Many Members have raised the issue of workforce capability—I echo that. We need to look at how we can work together collaboratively to put patients first and deliver the vital services that many disabled adults need. We have an ageing population, and we face a crisis in adult social care that will eclipse all other things in healthcare. If we work to deliver solutions now—I welcome what is in the Bill—to the hard problems that we face in integrated social care, we can find the solutions that we need for the future.

--- Later in debate ---

[Rob Roberts (Delyn) (Ind)]

Today’s Bill will help our healthcare system to become more accountable and less bureaucratic, allowing our brilliant healthcare professionals to focus on their job of providing world-renowned care to patients, rather than filling in unnecessary paperwork. It allows our healthcare system to be flexible, adapting to meet future and local needs.

As my hon. Friend the Member for Meriden (Saqib Bhatti) said earlier, a one-size-fits-all approach is rarely the most effective, and today’s Bill will mean local areas can develop practices that best suit their needs.

[Jess Phillips]

Will the hon. Gentleman give way?

[Rob Roberts]

No.

This is something we are acutely aware of in Delyn, as we have a much higher proportion of over-65s than the national average. Sadly, the Welsh Government’s funding to the north Wales health board is significantly lower per capita than that enjoyed by the health board in south-east Wales, but that is a debate for another time and place.

[Jess Phillips]

Will the hon. Gentleman give way?

[Rob Roberts]

No.

Sadly, one of the major elements of today’s Bill that should be praised falls a little short for my constituents in Wales. The Bill will lead to greater collaboration and integration between the NHS, local authorities and care providers in England, and ultimately this will deliver more joined-up working and the best outcomes for patients, yet this move towards greater collaboration needs to go further. We need to see collaboration in healthcare across all the constituent parts of the United Kingdom.

The NHS is not limited to one part of our country; it is nationwide. When someone is treated in their local hospital, they are treated by the NHS—not NHS England, or NHS Wales but the national health service. People do not see that there should be a difference and, frankly, they do not care.

Just as we should be united in our response to covid-19, it is now time for our healthcare system to work together across borders for the good of all UK residents. Despite holidaying within the same country, as so many people are doing this year, if a constituent from Delyn holidays in Cornwall and needs NHS treatment, their medical records will not be on file and will be difficult to access. Without immediate access to those medical records, I cannot help but worry that it could affect the outcome and care they receive, demonstrating the need to share records between all four nations. This issue is one of many that could be resolved through greater collaboration between the UK Government and the devolved Administrations on healthcare, just as we saw with the fantastic vaccine roll-out.

I urge the Government to remember that they are the Government of the whole United Kingdom, which should come with an overarching responsibility to care for and look after all their UK citizens, regardless of the nation in which they reside. As this Bill progresses through the House, I hope the Government draw on the lessons they learned from working together on the covid-19 vaccine programme to consider how greater collaboration in healthcare can be achieved between all four constituent parts of the UK to tackle the public health issues that we collectively face.