Health and Social Care: Winter Update

Lord Bichard Excerpts

Tuesday 21st January 2025 Lords Chamber

[Baroness Merron (Lab)]

I agree with my noble friend about the need to plan sooner. It gives the opportunity to assess what is, is not, and can be made available. I also very much share my noble friend’s comments about involvement—involvement of the patient themselves but also of their loved ones. I know from the reports that my noble friend has done over the years how she has shone a spotlight on the exclusion of the very people who could assist in the discharge procedure and make it go smoothly. I welcome her comments that the discharge is as important as the admission and the care people get while they are in hospital.

[Lord Bichard (CB)]

I too acknowledge the commitment and effort being made, and also, of course, the commitment on the front line. I am not a health professional—and I feel particularly conscious of that, given some of the people in the Chamber this afternoon—but I have spent too much time in the last 12 months as a client and had much time to reflect upon the fact that the problems with the health service are much the same as the problems in most other public services. First of all, we do not design the service around the client and the patient, and, whatever I am told, that still seems to me to be so obvious. We do not join up the various services: pharmacies, GPs and district nurses, who I have got to know quite well. We do not make effective use of digital or AI, and we do not make good use of the community and voluntary sector and charities. Sometimes, we resent them, or they are resented. Of course, there is the issue of social care.

I think we all know this, and I am hearing the right things coming out of government at the moment, but, actually, these things have been there for 20 years. They have been said about and talked about for 20 years, yet things have not really changed. I really want to be convinced that they are going to change, but I want to be convinced that we are learning from the lessons of past failures and that we are focusing on owning up to those failures, because that is the only way in which we will move on. Can the Minister reassure me that we are looking at why it has taken so long and that we are really determined to take on the barriers?

[Baroness Merron (Lab)]

I am grateful to the noble Lord. These things do not just happen; we are here because of a failure to reform, a failure to invest and a failure to get the right productivity and results that we need. Indeed, there has been a failure over a number of years to do exactly what the noble Lord spoke about. I could not have put it better myself. The noble Lord came up with the most marvellous advert in his comments for the central pillars, to which I referred, of the 10-year plan, which will soon be available, following the biggest ever consultation in the history of the NHS.

The noble Lord talked about community. One of the things that we will be ensuring will happen in the NHS is a movement of focus from hospital into community. The noble Lord talked about digital. We will move from analogue to digital. He also talked about services being around the patient. I have frequently said that we need to get the services around the patient, not the patient around the services. There is also the move from sickness to prevention. All these three pillars will completely transform the National Health Service.

The noble Lord also referred to the third sector, including charities. We could not deliver much of what we deliver without them, and charities often are extremely well-placed to do things that statutory services cannot, so they are part of the equation and I offer all respect to them.