Prioritising Early Childhood: Academy of Medical Sciences Report
Lord Bird Excerpts(9 months, 1 week ago)
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Lord Markham (Con)
I think we all agree that it is a very serious problem, so I do not want to diminish that. I was trying to demonstrate that the steps we are taking—there is a lot to do in this space—are having an effect. Noble Lords have heard me say before that our reformulation efforts mean that everything from Mars Bars and Snickers to all sorts of other foods are having the sugar content taken out, so we can make sure they are healthier for people to enjoy.
Lord Bird (CB)
My Lords, have the Government looked at the idea of bringing back something like Sure Start? I was involved in Sure Start, and I saw people breaking down poverty in their lives because of children coming in and mixing with other healthy children. It was wonderful. Can we look again at Sure Start?
National Health Service: Key Targets
Lord Bird Excerpts(11 months ago)
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Lord Markham (Con)
I agree with the basic point, as I am sure all noble Lords will, that ambulances are on the front line and are the most important service in all of this. That is why we have invested in 800 new ambulances, with over £200 million of funding. It is early days, but that is starting to take effect. Regarding the category 2 issue, we have managed to halve the time it takes since last year, but it is still too long and we absolutely need to make more progress in this area.
Lord Bird (CB)
Does the Minister agree with me that, if you really want to hit the targets for the NHS, you need to deal with the fact that 50% of people who present themselves at the NHS are suffering from food poverty? Why do we not concentrate on lifting the great weight on the NHS by doing serious work on getting rid of poverty?
Lord Markham (Con)
I agree with the noble Lord that prevention is key. About half the number of people who turn up at A&E do not need to go to A&E and can be seen in other settings. I completely agree that all the elements in terms of prevention and getting ahead of the problem are key, including where there are issues around food.
King’s Speech
Lord Bird Excerpts(1 year, 1 month ago)
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Lord Bird (CB)
That was a very interesting speech about cigarettes—good. It is interesting, because what you are going to try to do is stop people smoking. What I know about smoking is that most of the people who smoke—and I work with homeless people—are great smokers. Most of the other people I know who live in poverty are great smokers. I am interested in looking at it another way: what about getting rid of poverty? If we get rid of poverty, we can get rid of the driving force that turns people into addictive persons.
I am addicted to red wine. I gave up the addiction to cigarettes 30 years ago, but I still find I need to have a few drinks every now and then, and I do not always stick to two glasses. That is largely because I come from poverty. I know those addictive powers. I know the way that you almost feel that you need to hide somewhere, and the palliatives provide one of the best ways. Virtually all the homeless people I have worked with have been smokers and users of drugs and all sorts of things. I always tell people that one reason I came into the House of Lords was to get rid of poverty.
When I look at the King’s Speech, I feel sorry for the guy. He had to say that he wants to do things such as hand out licences to extend the amount of oil that we are getting, and so on. There was not an awful lot to encourage us that, in this year before the election, the Government would say, “Okay, let’s do something original and new; let’s inspire the electorate”, thinking that they might be voted in for another four or five years.
This week, I had a run-in with Suella Braverman after she came up with the incredibly mad idea—I do not think anyone in the Government would agree with her—that people who are homeless and sleeping in tents, the street homeless, have made a lifestyle decision to become a part of the homeless fraternity because they want to give up on paying taxes and live off begging and so on. I find this really difficult and I have written about this; I do not know of any piece of research that I or any other people have been involved in over the past 30 years—or 32 years since the Big Issue started—that shows the kind of data that the Home Office must have turned up to find this out. Why would you talk like that without the data? But the data is not there. If you talk to most people who are caught in the trap—the bastille—of homelessness, they will talk to you about all the reasons why they ended up homeless. They will not say that they simply decided it at some stage.
What Suella may have done wrong is to have got a number of people around her who said, “Yes, we talked to a homeless person the other day; they said they like to be on the streets”. I know those people. I have met a few of them. Some of them are ex-members of the Armed Forces who have been caught in bivouacking and all those things—I knew three or four of them who used to live on Wimbledon Common, up there with the Wombles, for years, even decades. Most of the people who say “I want to be on the streets” do not want to be in the hostels; they do not want to be controlled. Unfortunately, hostels—even those run by the best charities—are very hostile places to be. They are not places of safety. Quite a number of people who move away from them end up on the streets, because it is the less bad choice.
What I am worried about when I see the Queen’s Speech—I mean the King’s Speech, the gracious, what do you call it?
Noble Lords
Lord Bird (CB)
Forgive me; I will get it right by next year, I promise. One thing that worries me is the talk of giving tenants a better ride. The Government say they are going to protect tenants. Earlier this year, they said that they were not going ahead with the banning of Section 21, but I hear from the noble Lord, Lord Markham, that they will in fact do something about it. What does that mean though? This has been in the manifesto since 2019 and there has been no movement in the last four years.
Yet if we look at the reasons people end up on the streets, Suella is right about one thing. I checked with a friend of mine who runs a church in Hounslow only the other day and said, “Who is coming to you who is most desperate?” I will tell you who it is: a new cohort of homeless people who have been given asylum and then told to leave their hostels or their hotels within a matter of a week or two. Actually, Suella is right: there is a new group of people coming on the streets, but driven there by the Home Office. At the same time, there are people on the streets who are there because they are not getting the correct social help that would address their mental health and all the other problems.
I wanted to talk about other things but I just say, lastly, that I came into this world to do something about homelessness; I came into this House to do something about homelessness. What is happening in Gaza really frightens me. Everywhere I go and whoever I talk to—and I speak at many places—I do not meet people who are siding with His Majesty’s Government and siding with Israel. Most of them are saying, “A ceasefire, please”. If I am walking around and I go to a meeting in Norwich and there are 100 people, most of them say to me, “John, we’ve got to stop the bombing”. It may not make military sense to stop the bombing, but what worries me is the possible outburst of anti-Semitism—the most evil thing, that I as a child was taught to embrace, because I came from an anti-Semitic Catholic family. I am seeing it. I want to head off that anti-Semitism and I think we may be walking into a trap. I am sorry; I might be the only person in the House who believes this, but I worry about the homelessness that is being created and I worry about the long-term effect on Jewish people in this country, because people are turning away, and that really worries me.
Children’s Health: Ultra-processed Foods
Lord Bird Excerpts(1 year, 1 month ago)
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Lord Bird (CB)
My Lords, it is interesting that the noble Baroness, Lady Jenkin of Kennington, has got this discussion going. I am a bit confused about who we are talking about. I can imagine people who eat poor food—I know them. I come from those people, and they are therefore familiar to me. I have a large extended family where people eat all sorts of muck. I just cannot see where any of the advice I have heard today would fit in.
For instance, I do not know many people, particularly poor people, who would read the back of a packet and make a decision. The reason why they are eating poor-quality food is largely because they are stuck in poverty. The Government could, for instance, invest an enormous amount of money in good food, which could be distributed or made available, a bit like what used to be done after the Second World War—to give people milk, which is what I was brought up on, and capsules and orange juice, which was imposed while you were at school. However, I cannot really see the poor going down the road and picking up their food, unless of course it was cheaper or there were other things that made them think.
What we are always missing, not just in this House or in the other place, is the fact that we do not know how to bring all the elements together to dismantle poverty. One day we have a discussion about the impact of food on poverty, and a discussion about the impact of obesity and where it comes from. That is really interesting. Then another discussion would be about the fact that we know that if your education system is not working then you produce poor people, because you do not skill people away from poverty. The fact is that 80% of all the money spent on poverty in the world is actually to maintain people in the crisis of poverty and make them cope. Very little is spent on prevention or on cure.
If you really think about it, you need a different view of poverty and people who are the victims of poverty. Across the road, for instance, 50% of the people who use St Thomas’ Hospital, if it is an average hospital, will suffer from food poverty. The British Medical Association says that 50% of people who present with cardiac arrest actually suffer from food poverty. I am really glad to be a part of this discussion, but I cannot see how the fracturing down and breaking d will work unless there is unity around getting rid of poverty. That is why I will have a Bill in the next Session calling for a ministry of poverty that will bring everything together: education, housing, food, et cetera.
NHS and Social Care Workers
Lord Bird Excerpts(2 years ago)
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Lord Bird (CB)
It is wonderful that we get the chance to discuss this very serious matter. I agree with the noble Lord, Lord Davies, that it is pity that so few Peers wanted to participate in the debate. I am sure they are all busy because it is Christmas and there are lots of things to do; God bless them all, whatever they are doing.
About five years ago, after I first came into the House, I really cheesed off a number of doctors. I know that because, in response to a Question on the lack of doctors, I made the observation that the problem was not that we did not have enough doctors, but that we had too many patients. My noble friend Lord Crisp, who is a mate of mine now, said that he does not go for those supply-side arguments—I did not even know what he meant, but I could understand that he was cheesed off with me. One of the big problems is that we have a health service—which includes nurses, in particular; a subject I would like to talk about, because I have known loads of them—that is always finding it very difficult to make ends meet.
Before I talk about that, I will address prevention. In fact, the noble Baroness, Lady Barran, who sits on the Front Bench as Education Minister, made a very interesting point in an Oral Question on Tuesday: she said that she visited a school where they had taken the kitchen and moved it into the classroom. I thought that that was absolutely brilliant, because most of the young people I know—I have five children, so I have been through this—eat crap. By eating rubbish, they are laying down problems for later life. I have eaten more crap than anybody, but, for some strange reason, I am still here at 76 and everything seems to be working, so I might be the exception that proves the rule.
The idea of moving food, in a revolutionary way, into the classroom so that children can see the science of eating and of making and keeping themselves happy was great to news to me, because I am a preventionist. I came into the House of Lords to get rid of poverty, not to make the poor a little more comfortable. I keep telling people that, some of whom have said that they are irritated by it, but I will keep saying it. Unfortunately, there are too many people in the system who are concerned with keeping the poor more comfortable. I will return to the point: the idea of educating our children so that they know the importance of food and what food does to the body is of incredible importance. I would like the National Health Service to live up to its actual name, rather than becoming a national “I’ll get you back to health” service.
I was around in the early days of the NHS. I remember all the exercises we had to do in the playground, organised by public health bodies, and the capsules and the milk. I also remember that about 20% of the NHS budget in that post-war period was for prevention, because it did not have enough money. So I am very interested in the idea of prevention and will stick with it again and again.
What has happened to the NHS, more than at any other time in its history, since 2010 onwards, when we had to pay off the bankers’ mistakes by buying the banks and passing the cost on to the poorest among us? The NHS has become an even bigger social sponge, soaking up the contradiction thrown up by people in poverty. The BMA admits that 50% of the people who present themselves with cardiac arrest are suffering from food poverty. So what happened during the 2010 to 2016 coalition—sorry about that, mates—was that the nature of the NHS changed, and more and more parts of it were about trying to keep alive people who were eating poor and living poor. If we look at the facts and figures, when we entered the Covid crisis, hospitals were 85% full. That is almost full, because you need 10% to play around with. A lot of that was because more and more poor people were making their way to the hospital and the doctor’s surgery. They were trying to make up for the fact that they had become ill and could not maintain their lifestyle, because they were on the edge of poverty.
There is another big issue, which is the problem with the Treasury. No Treasury since the Second World War has got behind nurses in the way it should have got behind them—and hospital cleaners, porters and all the other people who make a hospital run. The principal reason for that is this myopia in the absolute middle of the Treasury. It divides the world between the public good and the people who contribute, and the contributors are the fintech people in the City of London who put money into the Treasury. Then there are the people who work for the public good and public life, and they are always going to be treated in a cheaper way, because the Government will not stand up and say that there is an enormous value that echoes throughout the whole of society if we pay our nurses, hospital cleaners and workers as well as doctors. We must embrace the idea that public service, whether that is driving a train, climbing up a ladder when there is a fire or working in a hospital—all these people are in public life. They are not takers, they are givers. I find it very difficult when I see the way we divide the world between those who take and those who give. It is not true at all.
We know that one of the big problems with the NHS is that it is too full. What if we had made the investment, if Governments of all political persuasions after the Second World War had said, “We are going to have a war on poverty. We are going to destroy poverty.”? Some 40% of all the money spent by government is spent on trying to get away from the problems thrown up by poverty. Our poor nurses are at the sharp end and are underappreciated; they are unable to pay their own way; they cannot breathe. The Royal College of Nursing said recently that nurses are suffering because their heating and food bills are rising, and they are being hit in the same way as everybody else.
I would like the Government to stop and to look at what works and what does not work. I have been saying this to Governments since I came here. I want them to stop, look and say, “How can we change this?”, rather than giving us a very small amount here and there. I want them to end this situation where the heroines of our hospitals are now being described as antisocial, whereas once they were social.
NHS Dental Contract
Lord Bird Excerpts(2 years ago)
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Lord Markham (Con)
It is a good question. I will take the noble Lord’s compliment of being exceptionally helpful; I hope I can give another helpful answer. We need to look at everything we can do to attract dentists. The contract is fundamental to that, because, unless it is attractive for them financially, it will not help.
Lord Bird (CB)
Is it possible also to look at some of the innovations that are done socially, especially for homelessness? We have brought back travelling dentists, and maybe they can go to Cornwall and other places. We have invested in a business in Plymouth that goes around hostels, and it has been remarkably successful.
Lord Markham (Con)
As mentioned before, we are open to all ideas to try to tackle this problem. As we all know, it has been going on for a long time—probably decades. A 360-degree solution is needed; we are open to looking at everything.
NHS: Abuse of Nurses
Lord Bird Excerpts(2 years, 8 months ago)
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Lord Kamall (Con)
As well as various programmes such as the NHS violence prevention and reduction standard, against which trusts are measured and held accountable, there are a number of different local initiatives to see what works and what does not in different places. There are a number of innovative ones, and I will give one example, rather than take up too much time. The No Force First initiative at Mersey Care NHS Foundation Trust has resulted in a 46% reduction in physical assaults against staff. There are a number of other examples that I could lay out in detail.
Lord Bird (CB)
There are many opportunities to stop the violence. My nephew is involved in security in a major hospital, and he says the pressure they are under is enormous. They have to work very long hours to make the necessary money. We must look at those kinds of policing operations within our major hospitals.
Lord Kamall (Con)
The noble Lord is absolutely right: it is not a simple issue, and people abuse for lots of different reasons. We are looking at different ways to deal with this, including training staff to deal with violence from patients with dementia or mental illness. We are also looking at various security measures. Money is being made available for trusts and primary care to take security measures, including the installation of cameras and screens for receptionists.
Ambulance Queues: Health Outcomes
Lord Bird Excerpts(2 years, 11 months ago)
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Lord Kamall (Con)
I thank my noble friend for drawing my attention to the report and the work of that committee. I will commit to reading the report and look forward to future discussions with my noble friend and many noble Lords across the House.
Lord Bird (CB)
Would it be possible at this time to talk also about preventing the next crisis and the crisis after that? Are we not always chasing something? The NHS, which does not spend a large amount of money on prevention, is now being hoist by its own petard,
Lord Kamall (Con)
The noble Lord raises a very important point. One of the things the NHS is looking at in more detail, and something we will discuss in forthcoming debates on the Health and Social Care Bill, is how we move a system culturally to not only treat patients once they are ill or need treatment, and work in terms of prevention and encouraging healthier lifestyles. When patients are kept too long in hospital, they can lose certain facilities such as muscle function, so we need to look at prevention as opposed to just treatment. Getting the right balance is something that the NHS and the Department of Health and Social Care are looking at closely.
Covid-19: Poverty
Lord Bird Excerpts(3 years, 6 months ago)
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Lord Bethell (Con)
I feel inspired by the noble Lord’s passion for the subject, but it is not fair or reasonable to suggest that death rates in the country are driven by the electoral cycle. Far from it—this Government have been extremely committed to the obesity strategy, not least because of the personal story of the Prime Minister. We have not abolished Public Health England; we have redefined it as two organisations, UKHSA and the OHP. The impact of those will be profound.
Lord Bird (CB)
Is the Minister aware of the social mobility pledge, which is trying to remove impediments to people applying for highly skilled jobs so that they do not follow the route that their families may have followed into underpaid jobs, where they remain in poverty for ever? I would very much like him to look at this. I support the pledge and many hundreds of businesses are following that example and removing these impediments.
Lord Bethell (Con)
The noble Lord speaks movingly about this important issue and social mobility is itself a massive issue for the country. It does not fall directly within the remit of the Department of Health, but the NHS itself can be an enlightened employer in this respect. Many families have seen great advances in their personal development there, and I hope that it has a spirit of meritocracy and opportunity. I would be glad to write to the noble Lord to share with him the kinds of initiatives designed to increase social mobility that there are within the NHS.
Covid-19: Obesity
Lord Bird Excerpts(3 years, 8 months ago)
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Lord Bethell (Con)
I thank my noble friend for his question. It is for others in the post-mortem process to pronounce on the exact cause of deaths during Covid, but it is an unavoidable fact that, of the 2.5 million Covid deaths reported by the end of February, 2.2 million were in countries where more than half of the population is classified as overweight; that includes Britain. This is a stark fact that, as my noble friend rightly points out, is sinking in among the British public. We want to use this fact as an inflection point—it is an opportunity —to give people the inspiration they need to take the necessary steps towards healthy and fit living.
Lord Bird (CB)
Is it not important to bear in mind the fact that people who are poor and obese are living in a permanent emergency? That emergency starts in the early years of their lives and carries on; they take food and do many short-term things. We must break this emergency and remove the poor from it through education, social opportunity and giving people jobs that raise their wages. Also, social security is often used as a way of saying, “Go over there and we’ll forget about you for a certain period of time.” It is the emergency that they live in that we have to challenge.
Lord Bethell (Con)
My Lords, I defer to the noble Lord’s expertise and authority in speaking on behalf of those who live in deprivation. He is a valued spokesman for people in such conditions. However, on his analysis, I do not think that poor people cannot lead healthy and fit lives. I do not believe that they cannot make the right decisions for their futures. I have the utmost respect for those who live in poverty; it is for us to give them the inspiration and knowledge that they need to make the right decisions.