NHS Update

Debate between Lord Bethell and Baroness Hollins

Thursday 22nd July 2021 Lords Chamber

[Lord Bethell (Con) [V]]

My Lords, I am grateful to my noble friend for highlighting this important development. The cancer drugs fund was a great success, and we are building on it with a substantial investment. The new fund will support patients with any conditions, including those with rare and genetic diseases. Dementia is one area where we are extremely interested in looking at investing further, and I hope that this would be captured, but we are waiting for recommendations from NICE and the data that it will provide before we set the right prioritisations. In terms of the date, I do not have that at my fingertips, but I would be glad to write to my noble friend with the details.

[Baroness Hollins (CB)]

My Lords, the strategy promises millions to prevent mental health crises for autistic people and to help people detained in hospital back into the community. The Written Ministerial Statement responding to my 2020 independent report about people with learning disabilities and autistic people detained in long-term segregation was laid in the other place after the Minister’s Statement had finished. My report emphasised the urgency of these strategy promises. Will the noble Lord commit to meeting me, with the Secretary of State, to discuss the full implementation of my recommendations?

[Lord Bethell (Con) [V]]

My Lords, I am enormously grateful to the noble Baroness for her hard work in this area. We are taking a range of actions to drive further, faster progress on reducing the number of autistic people and those with learning disabilities in in-patient mental health settings, including robust action by the CQC, work on our new cross-government “building the right support” delivery board, and reform of the Mental Health Act. I would be very glad to meet the noble Baroness and her colleagues to discuss these and other measures in more detail.

Social Care Reform

Debate between Lord Bethell and Baroness Hollins

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the point made by my noble friend is entirely thoughtful and persuasive. Indeed, there may well be a role for insurance rather than any other mechanism, and it will be one of the options that those who define the policy will look at extremely carefully. The point that he makes about the desire of homeowners to pass on their homes to future generations is completely understandable and human, and one that will take into close consideration.

[Baroness Hollins (CB) [V]]

My Lords, further to my noble friend Lady Campbell’s question, will the Minister commit to mentioning working-age disabled adults every time social care reform is discussed? The needs of older people living in care homes are important, of course, but that is an easier focus for improvement. The real challenge is to improve care and support for disabled adults living in their own homes, including people with learning disabilities and autistic people.

[Lord Bethell (Con)]

I am extremely aware of the point the noble Baroness is making. A very large proportion of those in care are not elderly at all but the young and adult disabled who need some care for some condition, whether physical or mental. Their needs are paramount in these reforms. We will not forget the people the noble Baroness describes; the financial arrangements for supporting them are one of the things we absolutely want to take on in these reforms.

NHS Digital: Primary Care Medical Records

Debate between Lord Bethell and Baroness Hollins

Tuesday 8th June 2021 Lords Chamber

[Lord Bethell (Con)]

I am grateful for the noble Lord’s anecdote. It is no coincidence that he got the text yesterday. We have energetically promoted this opportunity to patients and we are grateful to those who have engaged. He is entirely right. Patient data played a critical role in the development of the shielding list during Covid, in the recovery clinical trials programme and in the vaccine priority list. Clinical data is essential for patient safety. That is why we are modernising the system by which we access it.

[Baroness Hollins (CB) [V]]

My Lords, the choice on the opt-out preference form is either:

“I do not allow my identifiable patient data to be shared outside of the GP practice for purposes except my own care”,


or:

“I do allow my identifiable patient data to be shared outside of the GP practice for purposes beyond my own care.”


The big question is: what is identifiable? For some people with disability, mental health and/or trauma histories, data might be easily identifiable. I knew nothing of this until last week. I await with interest the noble Lord’s reply.

[Lord Bethell (Con)]

The nature of the data is very explicitly described in the documents that the noble Baroness will have referred to. If she likes, I would be very happy to send her a full set of details. Of course, many patients have engaged with the process and, like the noble Lord, Lord Young, have made the wise decision to remain enrolled in the system.

Covid-19

Debate between Lord Bethell and Baroness Hollins

Wednesday 26th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Baroness alludes to a dilemma that we face. It is not possible to organise surge testing and have pinpoint outbreak management in 120 different areas. That is just too many and our resources do not stretch to that. Many of the outbreaks are substantial clusters. Sorry—let me phrase that better. There is a small number of very substantial clusters in the towns and cities of which noble Lords will be aware. That is where we are focusing the surge testing and surge vaccination. In the other areas, we are working with DPHs to ensure that they know the best way to target the particular behaviours of the India 2. That means that it has very high transmissibility, which requires an extremely quick reaction to school and workplace outbreaks, and within specific communities. That kind of briefing and guidance has been channelled through the Chief Medical Officer’s department and the kinds of infrastructure that I described in my answers to previous questions. The response has been extremely strong and I hope we are making some impact on the spread of the India virus, but we remain extremely vigilant.

[Baroness Hollins (CB)]

My Lords, my question is about the implementation of quarantine regulations. How many travellers have been required to repeat the 10 days required in a designated quarantine hotel for a second 10-day period, with or without a positive Covid test? What appeal arrangements are in place because public guidance does not mention any? Is there any risk of exploitation?

Health and Social Care Update

Debate between Lord Bethell and Baroness Hollins

Monday 22nd March 2021 Lords Chamber

[Lord Bethell (Con)]

My noble friend is entirely right: this is a considerable dilemma not just for the Government, but for everyone. We in the UK have an enormously valuable project in our vaccination programme. Who does not relish the potential freedom from this horrible disease that it gives us? Yet we need only look overseas to see infection rates rising and the variants of concern spreading. The bottom line is that we do not know the impact of the variants of concern on the vaccine. Anyone who says they do for sure is simply not representing the truth. We have to be patient and figure out and fully understand the threat from the variants of concern. When we have that information, we can make a pragmatic, sensible and informed decision on foreign travel, as the Prime Minister has promised.

[Baroness Hollins (CB) [V]]

My Lords, I am so pleased that all people with learning disabilities who are known to their GP are now in either group 4 or 6 for vaccination. Will the noble Lord commit to reporting on the take-up of Covid immunisation for people on the register, both nationally and locally? Will he also report on the implementation of visiting policies for people with learning disabilities in both supported living and residential settings, and whether those residents are able to choose their one visitor?

[Lord Bethell (Con)]

Those were two extremely thoughtful and well-informed questions. I do not have the statistics at my fingertips, but I would be glad to go back to the department and write to the noble Baroness with the information she has asked for.

Covid-19: Vaccination Programme

Debate between Lord Bethell and Baroness Hollins

Wednesday 24th February 2021 Lords Chamber

[Baroness Hollins (CB) [V]]

My Lords, I welcome today’s announcement that all people with a learning disability on their GP learning disability register will now be included in group 6. However, we know that these registers are incomplete. How will the Government and the NHS ensure that those in England not currently on the register can be added so that they can be offered a vaccine too? Will the Minister confirm that family carers and home carers will be offered vaccination at the same time?

[Lord Bethell (Con)]

We have to work with what we have. The existing register, while not perfect, is the tool that we have for our task. GPs had been encouraged to update registers in advance of the vaccine, as we had several months of knowing that it was coming. I understand that considerable work has gone into that. With regard to carers, my understanding is that they are not currently included in the clarification that came out today, but I am happy to confirm that point with her.

Covid-19 Update

Debate between Lord Bethell and Baroness Hollins

Thursday 4th February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am grateful for the reminder from the noble Baroness. The analysis we have done of the Pfizer vaccine, and indeed of all vaccines, is extremely encouraging and the impact it has on the body’s antibody production rate is profound. In fact, for many vaccines it might be that a longer delay, of 12 weeks, to the second dose might have an improved impact on the body. The second dose is really important for longevity rather than for efficacy, and therefore, with the data we have at the moment, we do not have any plans to change the pace of the rollout, but we are making sure in absolute terms that the second dose is delivered to all those who have had a first dose, promptly and on time.

[Baroness Hollins (CB) [V]]

My Lords, the Minister repeated the statement earlier that said that all care home residents and staff have been offered vaccination, but this is not true for homes for people with learning disabilities. I was pleased to hear in the Minister’s reply to the noble Baroness, Lady Andrews, that the JCVI is still considering priorities for groups 5 and 6. Is the Minister aware that 80% of the deaths of people with learning disabilities in England were Covid-19 related in the week ending 22 January, compared with 45% of the general population? Does he anticipate that all people with learning disabilities will be included in group 5 or 6?

[Lord Bethell (Con)]

My Lords, I have taken the noble Baroness’s insight on this to the department where it is being plugged into the Vaccine Taskforce and the JCVI. Her championship of this cause is to be lauded. The statistic she just cited is heart-rending, and I will definitely return to the department this afternoon and follow up, to ensure that it is being taken seriously.

Vaccine Rollout

Debate between Lord Bethell and Baroness Hollins

Monday 25th January 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I assure the noble Baroness that it is communicated on the front line immediately. I did not have a valid NHS number until a week ago: it took me a couple of days to get one, but it was provided extremely promptly. I am hopeful that anyone who is lacking an NHS number can get one extremely quickly when they apply.

[Baroness Hollins (CB) [V]]

My Lords, I am grateful to the Minister for all his hard work on this subject. As he says, the vaccination rollout rightly aims to prioritise the people who are most vulnerable to Covid, but this mainly focuses on age. On the BBC news yesterday, we heard directly from several people with learning disabilities about their well-founded worries concerning the Public Health England data, which shows that they are six times more likely to die from Covid. Given this, and the fact that only 40% of people with learning disabilities reach the age of 65, does the Minister agree that relying on a strategy of vaccinating them at the same age as other people magnifies their existing health inequalities and discriminates by failing to recognise their increased risk?

[Lord Bethell (Con)]

My Lords, the JCVI looked at this very question in great detail. It is very conscious of discrimination, but its focus is on morbidity. Its judgment, which I entirely back, is that age, more than anything else, is the driver of morbidity. That is why the prioritisation is structured in the way that it is. Those who are CEV are also prioritised. Many of those who are most vulnerable and who also have learning difficulties will qualify under the CEV threshold. However, I have passed her arithmetic to the vaccine taskforce. She makes a very good point that those with learning difficulties and autism have a different life profile and die at an earlier age. I have asked the system to ensure that this arithmetic has been considered in the prioritisation list. I will be glad to reply to her when I have the answer.

Mental Health Act Reform

Debate between Lord Bethell and Baroness Hollins

Monday 18th January 2021 Lords Chamber

[Baroness Hollins (CB) [V]]

My Lords, I welcome the focus of the consultation and the White Paper on prevention, along with the new duties on local commissioners to ensure that they understand and monitor the risk of crisis for individuals—for example, when a family member dies—and to ensure an adequate supply of community services for people with learning disabilities and autistic people as an alternative to admission. Does the Minister agree that for these duties to have teeth, the descriptor “adequate” will have to be defined and subject to legal enforcement?

[Lord Bethell (Con)]

The noble Baroness asks a very perceptive question. I pay tribute to her work in this area and the challenge and scrutiny that she has given to the Government, which have helped lead to the position we are in at the moment. This is exactly the kind of area that we will be presenting for consultation, and I very much look forward to the noble Baroness’s contribution to that consultation.

Covid-19 Update

Debate between Lord Bethell and Baroness Hollins

Tuesday 15th December 2020 Lords Chamber

[Lord Bethell (Con) [V]]

I am grateful for the noble Lord’s insight. He is right that travel is the friend of the virus. Many of the growths in transmission have been associated with it; one thinks of the ski resort holidays at the beginning, the spring break migrations in America and other examples. I reassure him that, while he is right to question the arrangements around our airports and transport hubs, we have brought in a much more strenuous test to release programme which is much more realistic than the previous isolation programme. The procedures around the passenger location ports have been tightened up and the enforcement and tracking arrangements for passengers have been supplemented. There is now a very strong body of evidence to suggest that passengers are abiding by the testing programme. As he may know, private tests were launched yesterday, and their uptake has been incredibly impressive.

[Baroness Hollins (CB) [V]]

My Lords, 200,000 people are on their GP’s learning disability register and get the flu jab on the same terms as over-65s, but only one in 10 of this group has been prioritised for vaccination. My research 25 years ago found that these people were 58 times more likely to die before the age of 50 in ordinary times, and PHE research found a death rate 30 times higher for 18 to 34 year-olds with learning disabilities than for others of the same age during the first wave. To require them to wait until their chronological age group is eligible seems discriminatory. Will the Minister commit to look at this again?

[Lord Bethell (Con) [V]]

I completely acknowledge the correlation between mortality and learning difficulties that the noble Baroness alludes to. PHE has looked at this in respect of Covid very closely. That evidence played into the JCVI prioritisation process; it landed on age as the main determinant for that process but continues to review this based on evidence. The noble Baroness makes a good case, but I reassure her that the JCVI has looked at all this evidence very closely.

Covid-19: Transparency and Accuracy of Statistics

Debate between Lord Bethell and Baroness Hollins

Monday 9th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, my noble friend is entirely right: statistics are critical and very important to public trust. No one takes them more seriously than this Government. However, I remind him that it was not the statistics that the Office for Statistics Regulation expressed concern about; it was about material being used in press conferences that has not been published at the press conferences as they happened. That was a function of the speed at which that press conference was turned around, but he is entirely right that that chart had a presentational error in it, which was corrected. It was published as a result of the publication of the data behind it. I reassure him that the data upon which decisions were made and the data that went into the central case of that chart was correct, and the fact that we have changed it demonstrates that we are committed to transparency in all these matters.

[Baroness Hollins (CB) [V]]

My Lords, my question is about when Her Majesty’s Government will make accessible communication a priority. The Prime Minister’s press conference was like a scientific symposium, except that the slides were presented too quickly, with too much information. It felt as if we were being blinded by science. Does the Minister agree that providing information that is accessible to all viewers would be a more effective public education strategy, and that that means using everyday language?

[Lord Bethell (Con)]

On the manner in which the information was delivered, I take the noble Baroness’s comments completely on board. While it is not my role to be in charge of the presentation of No. 10 presentations, I think a lot of people would agree with her that there were a lot of slides, which were very detailed and not all formatted for the TV screen. However, we are trying our hardest to share with the public as much of the insight and science as we possibly can, and we are trying to hit that balance between too little and too much information. We are trying to publish data as soon as it can be reasonably verified. There will be some scratchiness around the edges on that, and I take the noble Baroness’s points about last Saturday completely on board. However, the commitment to transparency and open debate on these issues is sincere.

Covid-19: People with Learning Difficulties and Autism

Debate between Lord Bethell and Baroness Hollins

Monday 5th October 2020 Lords Chamber

[Lord Bethell (Con)]

My noble friend Lady Stroud speaks very movingly of the tough figures around the prevalence of disability among those in poverty. I completely take on board her recommendations about training in education. The Prime Minister spoke last week about the opportunity that Covid presents for a reboot around skills. That reboot will include provisions for those with learning difficulties and disabilities. I would be glad to inquire at the department exactly how developed those plans are and to update the noble Baroness with the information that I have back at the department.

[Baroness Hollins (CB) [V]]

My Lords, a ministerial response in the other place last week stated that only some supported living settings would be able to access asymptomatic testing. People with learning disabilities have had excess death rates higher than over-65 year-old care home residents, and many live in supported living settings. When do the Government intend to extend regular asymptomatic testing to all supported living settings, where the majority are still effectively shielding, and thus perhaps also enable day centres to open?

[Lord Bethell (Con)]

We are seeking to extend asymptomatic testing as widely as we possibly can and as soon as we possibly can. At the moment, our focus for testing is on residential social care, where we have committed to 100,000 tests a day. That is where the greatest threat comes from. But as the number and range of tests increase, we hope to be able to roll out asymptomatic testing to a much broader set of user cases, and the kind of care centres that she describes will surely be near the top of the list.

Independent Residential Care

Debate between Lord Bethell and Baroness Hollins

Tuesday 7th July 2020 Lords Chamber

[Lord Bethell [V]]

My Lords, the money that my noble friend refers to is not currently ring-fenced. Local authorities have been written to, to explain that the money should be prioritised for Covid—but, at the request of the local authorities themselves, the money was not ring-fenced.

[Baroness Hollins (CB) [V]]

My Lords, the Vivaldi project found that, in care homes where staff received sick pay, there were lower levels of infection in residents. During the next pandemic, will our priority to be to save the NCS—the new national care service—as well as the NHS, or will we have an integrated NHCS national health and care service, or, what other urgent measures are Her Majesty’s Government considering to protect care?

[Lord Bethell [V]]

The noble Baroness puts her question extremely well, but I am afraid it is beyond my ability to predict as she asks exactly what the shape of the national care provisions will be. What I can say is that the role of agency staff was always, from the very earliest stage, one of the gravest concerns we had. The CMO flagged it very early, and we moved as quickly as we could to tackle the difficult issue of itinerant staff, and to put in place both the funding and the procedures to anticipate problems of infection around staff who move from one home to the next.

Covid-19 Update

Debate between Lord Bethell and Baroness Hollins

Wednesday 1st July 2020 Lords Chamber

[Lord Bethell]

The noble Baroness asks a sensible question. It is, however, an unfortunate truth that, by the time someone tests positive, it is likely that they may have infected other members of their household. So, our current guidelines are that anyone who tests positive should isolate themselves with all other members of their household for 14 days, thereby containing the virus and breaking the chain of transmission.

[Baroness Hollins (CB) [V]]

My Lords, are services that care for people with learning disabilities—a group with an even higher death rate than the over-65s—being provided with home testing kits? I hear of services that are having difficulty getting access to them. Secondly, what proportion of people completing a home test fail to register their test online and therefore do not receive their test result?

[Lord Bethell]

My Lords, home testing by those with learning difficulties should be a straightforward matter. Anyone seeking a home testing kit can apply for one online; we have a large supply and there is no capacity issue. The registration of home testing kits is improving all the time; we are working through a checklist of things to get that rate higher. At-home testing is a hugely valuable resource for specifically the reason that the noble Baroness alluded to, and to get the geographical spread we need if we are to make testing available to everyone in the country.

Covid-19: Response

Debate between Lord Bethell and Baroness Hollins

Wednesday 3rd June 2020 Lords Chamber

[Lord Bethell]

I deeply regret that my noble friend had to drive from Cambridge to Stansted. We are working hard to address that and are looking at alternatives. We have now put up more than 100 sites, and I hope very much indeed that there would now be a site nearer him. We have also pioneered at-home testing, which we believe will address his key point, and we are trialling walk-in centres for city centres such as Cambridge.

My noble friend’s last point is entirely right. You should have a test when you show symptoms, but defining the symptoms of any disease, and in particular this disease, is very difficult. We do miss some people who do not show any symptoms, and some people who think that they have the symptoms actually have the symptoms of something else. It is a real dilemma and part of the battle we face against Covid.

[Baroness Hollins (CB)]

My Lords, the Statement does not address yesterday’s report from the CQC showing more than double the expected number of deaths of people with learning disabilities during lockdown—something we were warned to expect by colleagues in Italy. Will the noble Lord explain what is being done to better protect everyone in this group, including those living in residential care, but also people made vulnerable because of visits by support staff, who often visit more than one person living in the community?

[Lord Bethell]

I thank the noble Baroness for her question, which I think I understood. If I understand correctly, she is asking about those who live in social care and residential care. I commend the work of Helen Whately, the Social Care Minister, who has been an amazing champion for social and residential care. She holds our feet to the flames daily to ensure that more work is being done. Testing is one area where we have made huge progress. The provision of PPE, raised by the noble Baroness, Lady Brinton, is another, despite everything noble Lords might have read. I pay tribute to my noble friend Lord Deighton, who has brought about a huge amount of manufacturing in the UK. There is, however, more that we can do and we are working as hard as we can.

Mental Health Services

Debate between Lord Bethell and Baroness Hollins

Tuesday 19th May 2020 Lords Chamber

[Lord Bethell]

My Lords, I understand that it is a firm “yes”, but I will check that answer and revert to the noble Baroness if there is any different information.

[Baroness Hollins (CB)]

My Lords, yesterday the Guardian reported a study by Public Health England which showed that agency staff working between multiple care homes in London were unwittingly spreading Covid-19 during the surge of the pandemic. Given the evidence of the vulnerability of those receiving care, which includes working-age adults with mental health needs, is there really a commitment to parity of esteem between physical and mental healthcare? Why has the testing strategy not been amended properly to cover these groups?

[Lord Bethell]

The noble Baroness rightly points to one of the most difficult aspects of the Covid epidemic—the itinerant staff who pass from one vulnerable person to the next. We recognised this issue at the beginning and put money in to try to ameliorate it. When testing was expanded weeks ago to key workers, it was deliberately targeted at these staff and this continues to be prioritised.

Covid-19: Care Home Deaths

Debate between Lord Bethell and Baroness Hollins

Wednesday 22nd April 2020 Lords Chamber

[Lord Bethell]

The right reverend Prelate makes the completely fair point that this disease is utterly unfair and cruel in the way that it targets the old and the vulnerable, and those who are in the front line of our care system are carrying the greatest burden of all. Huge resources have been put in place, both financially and in terms of seeking to recruit more staff, but undoubtedly more can be done. Guidelines are evolving at great pace regarding both PPE and other care arrangements, and we are constantly reviewing and updating both the arrangements and guidelines for care home staff, as she suggests.

[Baroness Hollins (CB)]

My Lords, many people with a learning disability share their home with others, with support from social care providers. If a housemate dies from Covid-19, this will be extremely upsetting. Also, many people were taken back to their family home, often by elderly parents, from care settings at the beginning of lockdown. Some will have died there or their elderly parent may have died, leaving them with no familiar support or advocacy. I am concerned about the availability of skills support to people with learning disabilities at such times of traumatic loss. There are accessible resources; I declare an interest as co-author of some that have been developed by Books Beyond Words. How are local authorities supporting providers and families to ensure that those receiving care are supported when someone dies, especially given the easements to the Care Act and the inability of family and friends to visit?

[Lord Bethell]

The noble Baroness raises what is probably the cruellest and most unkind aspect of this awful epidemic: the circumstances of death where those who love and care cannot necessarily be with those who have died or attend the funeral or mark the moment in the way that they would like. It is a cruel and horrible part of this epidemic.

We have put considerable resources into supporting charities that provide care, particularly around bereavement. If the noble Baroness has any charities that she would like to recommend, I ask her to write to me. I would be glad to make sure that they have the resources they need.

Coronavirus (COVID-19)

Debate between Lord Bethell and Baroness Hollins

Tuesday 3rd March 2020 Lords Chamber

[Baroness Hollins (CB)]

My Lords, the coronavirus action plan emphasises that risk increases in elderly people and those with underlying health conditions, particularly men. The Secretary of State emphasised handwashing but he also mentioned social distancing. Given the demography here in a self-regulating House, might it be advisable for us to model a kind of social distancing and make behavioural choices? I understand the Minister saying that maybe one should not adopt behavioural change too early because it might discourage people. But I wonder whether it is necessary for people who have no intention to speak to come here at a time when perhaps a little more space might keep Members of the House safer, and the work of the House safer so that it continues. Have the House authorities considered the possibility of engagement through web-based debate or digital voting, in the event that attendance at the House really needs to be minimised?

[Lord Bethell]

My Lords, it is not the role of the Department of Health and Social Care to lead on this matter, but I am aware that the House authorities are very sensitive to the points made by the noble Baroness. Ultimately, it will be up to the Leader’s Office, working with the House authorities, to make decisions on the matters she describes.

NHS Funding Bill (Money Bill)

Debate between Lord Bethell and Baroness Hollins

3rd reading & 2nd reading & Committee negatived & 2nd reading (Hansard) & 2nd reading (Hansard): House of Lords & 3rd reading (Hansard) & 3rd reading (Hansard): House of Lords & Committee negatived (Hansard) & Committee negatived (Hansard): House of Lords
Wednesday 26th February 2020 Lords Chamber

[Lord Bethell]

The noble Lord asks a very good question. The answer is not in my mega briefing pack, but I will be very glad to get back to him if I find an answer.

The noble Lords, Lord Hunt and Lord Warner, asked, quite rightly, about maintenance, which is brought up during every hospital visit I make. We recognise the challenge that maintenance presents to the existing estate and the Government have recognised the need for further capital investment in the NHS by announcing, over the summer of 2019, a £1.8 billion increase in NHS capital spending, including £850 million for 20 more hospital upgrades. We know that more capital funding will be needed and this will be dealt with in the near future.

The noble Lord, Lord Bradley, asked about capital for North Manchester General Hospital and the prospects for a green light for the project. As part of our health infrastructure plan, 21 new-build projects across 34 hospitals are receiving £100 million seed funding to help plan their schemes and move on to the next stage. I am delighted that Manchester NHS will benefit from £4.6 million seed funding to help plan and redevelop North Manchester General Hospital.

I move from the Bill to the central thrust of the debate, which was not about the Bill itself, but about what was not in it. I start with mental health, because Peer after Peer addressed this subject. I reassure the House that spending on mental health in the NHS long-term plan is an absolutely massive priority for the Government. This historic level of investment—£2.3 billion by 2023-24—will ensure that this Government can drive forward one of the most ambitious mental health reform programmes anywhere in Europe. It will ensure that 380,000 more people per year will have access to psychological therapies; that 370,000 adults and older adults with severe mental illness can access better support; and that 345,000 children and young people will be able to access services.

I cannot say exactly how many of the nurses that we will recruit will be mental health nurses. That data is not available, but I can say that we are transforming community-based mental health support so that more people can be treated closer to home. We are ensuring that the NHS is delivering the commitment to increasing investment in mental health provision. As a result, we have required all clinical commissioning groups to meet the mental health investment standard. The noble Baroness, Lady Hollins, had some detailed and significant questions about how the mental health investment standard was being applied. Rather than try to give a half answer now, I suggest that we meet to discuss her data in detail. I should be glad to understand more about her concerns.

[Baroness Hollins]

I am grateful to the noble Lord for his response. He mentioned increased access to mental health services for many more people but, in my experience, people with learning disabilities and autism are often left out of those services and seen as requiring something different, whereas they need to be included in all services. Can he confirm and reassure me that that is the case in, for example, psychological therapies?

[Lord Bethell]

The noble Baroness makes an important point and her work in this area is well known. It would be, however, slightly outside the remit of the Bill to go into that in great detail. I do not have the answer she is looking for but should be glad to meet her to discuss this important matter. I share her concerns and my interests in the area are entirely aligned with hers.

My noble friend Lady Penn put us all on the rack regarding the mental health White Paper. I would very much like to give her the absolute date and concrete publication arrangements for it but that is slightly beyond me. However, I reassure her that it will be within the next few months; spring is the hoped-for arrival time.