Health and Care Bill

Lord Bishop of Carlisle Excerpts

2nd reading
Tuesday 7th December 2021 Lords Chamber

[The Lord Bishop of Carlisle]

My Lords, this is a health and care Bill. I will address certain specific aspects of that care that deserve further attention.

First, on integrated care, like the noble Lord, Lord Kakkar, I welcome the clear desire for integration, collaboration and local flexibility, and the placing of integrated care systems on a statutory footing. But can the Minister assure us that, in ICBs and ICPs working together to ensure co-ordination in the design and delivery of integrated care, there will be an adequate focus on prevention rather than just cure, especially in mental health needs, not least among young people with learning disabilities?

Secondly, there is pastoral, spiritual and religious care, which, as Covid has reminded us and NICE guidelines recognise, are essential aspects of care, especially at the end of life. In Clause 16, mention is made of commissioning “other services and facilities” in addition to the medical, dental, ophthalmic, obstetric, nursing and ambulance services previously mentioned. It is probably not practicable to list all 14 allied health professions in the Bill, but perhaps it could be made clear that these cover important aspects of care that ICBs should be expected, not just encouraged, to commission. That would certainly provide some reassurance for, for example, healthcare chaplains, who, among so many others, have done such valuable work during the pandemic.

Thirdly, there is palliative care. We need no reminder of the fact that we are an ageing population. A significant proportion of those with palliative care needs already do not receive the care they need. By 2040, the number of people who have such needs will have increased by up to 42%. One of the stated aims of this Bill is to reduce inequalities in the provision of care across the country. Therefore, I find it strange that there is no direct reference to palliative care services or the need for integrated care wards to commission such services in their areas.

Fourthly, there is social care. As the Minister has already reminded us, one of the biggest challenges facing social care, as with the NHS, is workforce planning and supply. We are all aware of the alarming statistics regarding vacancies, as well as morale. I am grateful that the Bill aims to improve this situation but, as almost all the briefings that we have received have emphasised, we need greater accountability, transparency and reporting on this issue. So I was disappointed to learn that a proposed amendment to Clause 34 in the other place was not accepted by Her Majesty’s Government. I am equally disappointed that no mention is made in the Bill of the pay of carers, which is obviously an indication of the extent to which they are valued in our society.

Finally, my right reverend friend the Bishop of St Albans much regrets that he is unfortunately unable to speak in this debate. He has therefore asked me to pass on his congratulations to the Government on bringing forward this important legislation, and to ask the Minister whether the aspiration to reduce inequalities between patients in respect of their ability to access healthcare includes inequalities between rural and urban areas.