NHS Digital: Primary Care Medical Records
Lord Bishop of Carlisle Excerpts(3 years, 5 months ago)
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Lord Bethell (Con)
I am enormously grateful for the noble Baroness’s endorsement of our decision to delay the rollout. As the absolute epitome of the patient safety cause, she knows more than anyone the importance of data to that cause. I completely endorse the points she made.
The Lord Bishop of Carlisle
My Lords, informed consent is at the heart of good patient care. Can the Minister tell us what plans Her Majesty’s Government have to inform patients that they have the right to opt out of having their personal medical information collected in this way? How will this be advertised?
Office for Health Promotion
Lord Bishop of Carlisle Excerpts(3 years, 7 months ago)
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Lord Bethell (Con)
My Lords, I absolutely endorse my noble friend’s points. This is an extremely important agenda which we are getting behind in a very big way. I also completely acknowledge and recognise the enormous amount of interest from noble Lords in this agenda; we have taken a number of Questions on this and I celebrate the fact that noble Lords have as much interest as they do. I would be very glad to arrange such a session as my noble friend suggests.
The Lord Bishop of Carlisle [V]
My Lords, I too echo all the appreciative comments made about the Lord Speaker. Does the Minister agree that any interventions to address obesity must take account of the complex relationship between mental health and obesity? For example, people who are obese have a 55% increased risk of developing depression over time, and people living with depression have a 58% increased risk of becoming obese. Can we ensure that attempts to remedy one problem do not exacerbate the other?
Lord Bethell (Con)
The right reverend Prelate makes an extremely valuable point. He is spot on; these comorbidities are related and dealing with them is complex. It is possible to exacerbate one while trying to cope with another. That is one reason why we are putting so much investment into the cross-governmental effort and why this agenda will be led by a cross-departmental ministerial board, to ensure that that kind of co-ordination happens.
Alcohol Harm Commission: Report 2020
Lord Bishop of Carlisle Excerpts(3 years, 7 months ago)
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The Lord Bishop of Carlisle [V]
My Lords, I too congratulate the commission on its work in highlighting the harm caused by the abuse of alcohol. I wish to focus my brief remarks on the relationship between alcohol and domestic violence.
The statistics make this clear. Home Office figures indicate that alcohol is involved in up to 50% of cases of domestic abuse, as we were informed earlier by the noble Baroness, Lady Finlay. Though not necessarily a direct cause, it is frequently a significant contributary factor. What is more, when alcohol is involved, the abuse affecting children, as well as adults, is more likely to be serious, increasing the risk of physical, emotional and psychological harm. This has, of course, been a particular problem during the last year with the various restrictions that have been imposed to counter the coronavirus pandemic. The commission’s findings on this, as well as several other types of harm, must surely cause Her Majesty’s Government to rethink the statement made in January 2020 that they
“are not planning a stand-alone strategy”—[Official Report, 21/1/20; col. 1043.]
for alcohol. It would complement, rather than cut across, proposals made in the NHS Long Term Plan.
The commission strongly recommends a strategic approach that would not only address the link between alcohol abuse and domestic violence but take into account some of the factors that frequently accompany harmful alcohol consumption. These factors include educational exclusion, social deprivation, financial distress, employment worries and psychological pressures. I wholeheartedly commend the commission’s proposal that the domestic abuse commissioner role, which is being created as part of the Domestic Abuse Bill, must have a duty to have regard to the link between alcohol and domestic abuse in its work.
NHS: Staff Numbers after Covid-19
Lord Bishop of Carlisle Excerpts(3 years, 8 months ago)
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The Lord Bishop of Carlisle [V]
My Lords, I am most grateful to the noble Lord, Lord Clark of Windermere, for securing this short but important debate. It is always a pleasure and a privilege to follow the noble Lord, Lord Patel. I do not intend to repeat all the alarming statistics since it is abundantly clear that we are facing a crisis in the NHS workforce that is likely to get worse post Covid and which requires a co-ordinated long-term strategy. The numbers speak for themselves.
Our debate today is not just about the recruitment and retention of front-line NHS and social care staff. It also raises the issue of an ever-growing demand that drives the need for a larger workforce. There are, of course, many reasons for that, not least long lives and multiple morbidities, but alongside those go questions about lifestyle, behaviours and personal responsibility. The recent White Paper Integration and Innovation emphasises the importance of public health. What plans might Her Majesty’s Government have for making prevention a key part of their strategy for workforce development?
Social Care Funding (EAC Report)
Lord Bishop of Carlisle Excerpts(3 years, 10 months ago)
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The Lord Bishop of Carlisle [V]
My Lords, I add my own expression of gratitude to the Economic Affairs Committee for such a clear and coherent report, based as it is on such careful research and presenting us with such direct and forthright conclusions. Its basic principles for reform are eminently sensible. Like others, I applaud the emphasis, pace Dilnot, on a partnership approach to the funding of social care, and the principles of free personal care, with a cap on accommodation costs, and increased funding enabled by general taxation. I will focus my brief contribution on principle (j), which reads:
“Invest in the social care workforce and ensure a more joined up approach to workforce planning with the National Health Service.”
If that is ignored, any increase in funding will run the risk of being wasted.
We are all well aware of the current situation in this country. The number of older people and working-age adults requiring care is increasing rapidly. Some 1.4 million people over 65 have unmet care needs. Covid has reminded us of just how crucial care homes and carers are in our society, alongside NHS workers and social services. Yet, as the noble Baronesses, Lady Kingsmill and Lady Finlay, have pointed out, carers are usually undervalued; they refer to themselves as second-class citizens; they are underpaid, underqualified and under- resourced, with a chronic staffing shortage that is getting steadily worse.
There are too many adjectives there beginning “under”. It is no wonder that there is a turnover rate of nearly a third in such an underregarded profession, with poor levels of both retention and recruitment. As we have already been reminded, what is so obviously needed for carers is a combination of proper status, good and appropriate training, and reasonable pay. The report before us has significant implications for all of those, as pages 24 to 29 make clear.
With regard to status, if the social care workforce of 1.6 million is to be developed and stabilised, there needs to be more parity of esteem with their 1.4 million NHS colleagues. That necessitates a programme of vocational as well as academic training, which will provide social care staff with the qualifications and career structure that are currently lacking.
In its turn, that should prompt levels of pay, especially in publicly funded institutions, that begin to reflect the value to society of the service being offered. None of this can happen without a substantial increase in funding, which is why the report is so important. That is before even considering the possibility of support for the 5 million or so unpaid carers who do such a great job and save us vast sums of money every year.
However, it involves more than just financial commitment, crucial though that is. This report, like so many before it, is about a change of culture, which is why the greater integration of health and social care to which it refers is so vital. We have a renamed department, but the transformation that that implies must go beyond its title. When asked recently about his biggest hope for change, Sir Simon Stevens replied:
“Seeing health and social care as two sides of the same coin.”
The Select Committee on the Long-term Sustainability of the NHS has exactly the same aspiration.
It has already been observed that, despite many positive and encouraging statements over the years, there has so far been a huge political reluctance to grasp this particular nettle, despite the cross-party consensus mentioned by the noble Lord, Lord Forsyth. I appreciate that much time and attention is currently focused elsewhere, but we would be grateful to know from the Minister whether Her Majesty’s Government have any timetable in mind for the sort of reform of our social care system that, as this report makes clear, is so urgently needed.
Social Care
Lord Bishop of Carlisle Excerpts(4 years ago)
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Lord Bethell (Con)
My Lords, I reassure my noble friend that there is absolutely no dilution in the commitment to a long-term solution. No one in the Chamber would deny that the challenges in this question are extremely complex. The Government are also committed to cross-party talks and everyone in the Chamber recognises that we need a generational solution, not a political fix. In terms of finance, it is undoubtedly the case that the social care system has been under pressure during Covid. That why we have put an enormous number of funds—I could list them—into social care in the past six months. The refinancing of the social care system is one of the items that will undoubtedly be on the agenda.
The Lord Bishop of Carlisle
My Lords, given the long delay in the publication of proposals for the reform of social care, the impact of Covid-19 on carers and care homes, and the implications of reform for the future of the NHS—not to mention the political sensitivity and complexity of the subject, which has been referred to—does the Minister agree that the best way to achieve the cross-party consensus to which he just referred would be through an ad hoc Lords Select Committee, as already proposed from these Benches?
Lord Bethell (Con)
My Lords, the development of a cross-party consensus is one of the great challenges that we have for the future. The mechanism that the right reverend Prelate suggests is imaginative, thoughtful and constructive, which I very much welcome and will take back to the department, but it is for the Prime Minister and the Secretary of State for Health and Social Care to define that precise process. But I completely welcome having our feet held to the fire on this issue. It is a massive priority that is at the top of the Government’s agenda.
Mental Health Services: Young People
Lord Bishop of Carlisle Excerpts(4 years, 2 months ago)
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Lord Bethell (Con)
My Lords, we are greatly concerned about the human and financial costs, as the noble Baroness rightly points out, which is why we put in place the Wellbeing for Education Return fund. It is training the trainers, working through the Anna Freud centre, the well-respected child mental health charity, and it is already having a huge impact. Some 95% of the attendees in a recent session said that they were extremely or somewhat pleased with the programme, and we are expecting it to be rolled out across schools.
The Lord Bishop of Carlisle
My Lords, I spoke last week with a young person whose father, sadly, died recently of Covid-19, and she told me about the impact that experience has had on her own mental health. I am therefore grateful for the reassurance from the Minister that Her Majesty’s Government will be strengthening access to mental health services in our schools and, I hope, in our colleges and universities. Are there any plans for bereavement support and counselling to form part of that provision?
Lord Bethell (Con)
The right reverend Prelate the Bishop of Carlisle is right to emphasise bereavement support. We all remember well the difficulties faced by family or friends who were bereaved in the terrible circumstances that we were put under during Covid. We have put £9.2 million of additional funding into mental health charities, which includes charities that provide bereavement support. However, I will take away the well-made points of the right reverend Prelate and will look into whether more could or should be done.
Covid-19: NHS Long-term Plan
Lord Bishop of Carlisle Excerpts(4 years, 2 months ago)
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Lord Bethell (Con)
I thank the noble Lord for his generous comments towards the NHS. Undoubtedly it is true that, after a massive epidemic such as the one we are living through, we will have to rethink some of our priorities and learn from Covid, but I will add a few comments about the restart. The focus on getting patients back into hospital is having a huge impact on cancer waiting lists. Attendance at GP surgeries is increasing all the time, and waiting lists are coming down dramatically. I pay tribute to NHS staff for their hard work on this matter.
The Lord Bishop of Carlisle
My Lords, given that the health protection remit of Public Health England is to be subsumed into the new national institute for health protection, can the Minister tell us what steps Her Majesty’s Government will take to ensure that health inequalities are robustly addressed through programmes of health education and promotion, as envisaged in chapter 2 of the NHS Long Term Plan?
Lord Bethell (Con)
My Lords, the right reverend Prelate is right; health inequalities are a massive priority for the Government. Covid has demonstrated how health inequalities play out when an epidemic such as this one hits the country. That is why we put education and levelling-up on health generally as major government priorities, why we are investing in 50,000 new nurses and 40 new hospitals, and why health remains a number one priority for this Government.
Social Care
Lord Bishop of Carlisle Excerpts(4 years, 4 months ago)
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Lord Bethell
My Lords, the Covid epidemic has been a vivid experience for me personally. I have seen how the Department of Health and Social Care prioritises the care for those in social care. I completely endorse the noble Baroness’s view: piecemeal reform is not on the cards. The Government have made it clear that a holistic solution is needed. That is what we are working to achieve.
The Lord Bishop of Carlisle
My Lords, following on from the previous question, given that a long-term settlement for social care is one of this Government’s top priorities, and that there is general agreement that this should involve cross-party consensus and a significant measure of integration with the NHS, does the Minister agree that, in the continuing absence of a White Paper, the time has come to establish a Select Committee or perhaps a parliamentary commission with a specific timescale to make recommendations that might finally resolve this complex issue?
Lord Bethell
The right reverend Prelate is entirely right that we will need some kind of formal structure to go about cross-party talks and achieve a solution. That formal structure will need to be agreed in cross-party conversations. Those conversations have been ongoing during the epidemic and are now very much the focus of the Government’s attention.
Covid-19: Cancelled Medical Operations
Lord Bishop of Carlisle Excerpts(4 years, 5 months ago)
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Lord Bethell [V]
My Lords, I do not have the precise figures which the noble Baroness asked for. However, I reassure the Chamber that the NHS is working hard to ensure that those who need urgent surgery, such as cancer patients, have it, and we have committed a substantial amount to the Help Us, Help You media campaign, which is having an impact in restoring confidence in returning to hospitals.
The Lord Bishop of Carlisle [V]
My Lords, given the disproportionate effect of Covid-19 on those aged over 75 and the likely knock-on effects of cancelled operations, will the Minister take steps to encourage the reintroduction of routine GP health checks among people in this age group which, understandably, have been largely suspended during the pandemic?
Lord Bethell [V]
My Lords, the impact on the over-75s is, as has been described, profound. We have worked hard to try to protect those who are shielding. The reopening of GPs’ surgeries is a priority but, at the moment, we are not encouraging those who are over 75 to make the journey to surgeries that are a potential source of infection. Therefore, we will not be taking the steps the right reverend Prelate described.