Unpaid Carers: Support

Lord Bishop of St Albans Excerpts

Thursday 13th June 2019 Lords Chamber

[The Lord Bishop of St Albans]

My Lords, I am sure that we all want to encourage stronger family and community life, which is the very bedrock of healthy societies, but there is one group in particular that needs help and that is the 166,000 underage carers in England. Research by the Children’s Society suggests that that is just the tip of the iceberg—indeed, a huge underestimate. Many of these young people do not realise that they classify as carers: it is just what they have had to deal with. In many cases it is affecting their schooling and mental health. What are Her Majesty’s Government able to do to help and support underage carers in particular?

[Baroness Blackwood of North Oxford]

The right reverend Prelate is quite right to identify this as a crucial issue. The Government believe that children should be protected from inappropriate and excessive caring responsibilities. We changed the law to improve the way that young carers are identified, and we are supporting schools to support carers and working with the Carers Trust to identify and spread best practice. Just today, working with the Children’s Society, which he rightly says has led this project to identify and disseminate best practice, guidance and resources will be published to enable young adult carers to make positive transitions between the ages of 16 and 24. We hope that this will improve the outcomes that young carers experience.

Mental Health Budget: Domestic and Sexual Violence

Lord Bishop of St Albans Excerpts

Thursday 22nd November 2018 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness is quite right. The strategy, of course, has a focus on women and men. Women are the greater victims of abuse; indeed, the more severe the abuse, the more likely it is that the victim is a woman. However, I can tell her that it is a broad strategy which encompasses both. We still have a problem, in that men are much less likely to come forward if they have been abused than women.

[The Lord Bishop of St Albans]

My Lords, it is much to be welcomed that the Government are allocating this money. I am also glad that the needs of young people have been highlighted, but the Minister will be aware that statistics show that roughly 340,000 elderly people are suffering abuse in the community each year. If we are not tracking how the money is spent, how can we be sure that the mental health needs of the elderly are being properly addressed at a particularly vulnerable point in their lives?

[Lord O'Shaughnessy]

The right reverend Prelate makes an excellent point. The intention is that there will be greater reach into care home settings as well as domestic settings, so that people who experience abuse in those settings are able to come forward and we can provide such protections for people in homes.

Brexit: Risks to NHS Sustainability

Lord Bishop of St Albans Excerpts

Wednesday 12th July 2017 Lords Chamber

[The Lord Bishop of St Albans]

My Lords, I thank the noble Lord, Lord Warner, for introducing this important topic for us this evening and for his helpful and comprehensive opening remarks.

Ensuring the sustainability of the NHS is undoubtedly a significant challenge, even before the potential consequences of Brexit are considered. The uncertainty surrounding the Brexit negotiations has created significant stress for many working in already pressurised health and social care systems. There is no doubt that urgent action must be taken to ensure the stability of the current system. That being said, I wonder whether we might be able at this time of significant pressure to begin to confront some of the deeper challenges that our health system faces. The challenges of Brexit for our health and social care services might only reveal the deeper, long-term problems of these systems as a whole. It would be unfortunate for Brexit to be only the latest in a long line of short-term crises rather than an additional opportunity for reflection.

The report of the Select Committee on the Long-term Sustainability of the NHS, published in April of this year, stressed:

“Whatever short-term measures may be implemented to muddle through today, a better tomorrow is going to require a more radical change”.


I note particularly its recommendation of,

“a new, independent standing body enshrined in statute to safeguard the long-term sustainability of the NHS and social care”.

The nature of the political cycle means that it is difficult for politicians to rise above the fray and consider the long-term sustainability of the system as a whole, and there is substantial room for a body to oversee and scrutinise independently and to report directly to Parliament. National health and social care service provision affects the lives of citizens in profound ways, quite literally from cradle to grave. It is no surprise that it is of paramount importance to both individuals and politicians, and we should consider novel ways to safeguard these systems. Bold leadership is required, but this should be an area where politicians can show courage in finding common ground to make meaningful and lasting change.

Much has been said in this Chamber about the deep feeling of division in this country in the light of the Brexit referendum. Nevertheless, the NHS, and the importance we place on caring for one another, is at the core of the “British values” discussed in the Queen’s Speech. Indeed, these values are a part of many faiths, including Christianity. Part of what it means to be British is to care for one another, even when it comes at significant cost. We must acknowledge, however, that that cost is increasing, and adjustments must be made at both an individual and societal level. We have a duty to one another and to future generations to ensure that necessary resources are in place and are safeguarded in order for care to be maintained.

It is unfortunate that the NHS is not in a better position to be able to respond to the challenge of Brexit; we are still suffering the consequences of short-term thinking and acting. The waiting list for elective treatment has risen to 3.78 million, which is 5% higher than a year ago, and the number of delayed discharges from hospital caused by waits for home care rose by 45% in 2016-17. Even within my own diocese, two wards in St Albans hospital are scheduled to be closed to cut costs despite the clear demand for beds. By taking a more long-term approach to healthcare, even in the light of Brexit, we may be able to address the issues that have weakened the system substantially and prepare for the additional challenge of our ageing population. If we can work towards preventing weakness in the system, we will be far better placed to respond to sudden challenges.

The potential loss of EU personnel in both the health and social care systems will be an enormous short-term challenge. More than 60,000 people from EU countries outside the UK work in the English NHS and around 90,000 work in adult social care. Support must be provided for these individuals, many of whom work long hours in difficult circumstances and have made significant sacrifices to make the UK their home. We need to take account of them, not just in negotiated discussions but also in any plans, after we leave the EU, to alter immigration policy.

It should never be overlooked that the NHS is heavily reliant on workers from outside the UK. Despite this, the Royal College of Physicians describes our hospitals as chronically understaffed, almost half of community mental health teams had staffing levels judged as less than adequate in 2013-14, and the Royal College of Midwives believes that in England we need 3,500 more midwives to ensure that every woman can receive one-to-one midwifery care in labour.

Not only must we have sufficient numbers of personnel, we must ensure that they have the correct skills and training that the service needs. This means that we need to invest in those currently serving in the NHS, as well as making sure that we train enough doctors and nurses here in the UK. However, in 2016 there were unfilled nursing places in UK universities, and we know that care homes would collapse without their non-UK workforce. This is in part because these roles are not sufficiently valued and hence do not attract UK applicants. Sustainability of the workforce cannot be achieved, even if all EU workers remain, unless attitudes to some health and social care roles change significantly.

As we seek to manage the staff of the NHS wisely—that staff is undoubtedly one of our greatest assets—prudent financial planning will also be required. The quality of care which we have come to expect and demand comes at a significant cost. Some 86% of the NHS’s sustainability and transformation fund of £2.1 billion has been set aside to sustain current services and meet expected deficits. As deficits increase year on year, a radical rethink of healthcare funding is required. We need a broader social dialogue about funding for health and social care, one to which the Church and other faith communities can contribute.

Along with the right to healthcare, which we are undoubtedly privileged to enjoy, as users of health and social care services we have associated responsibilities. In remembering that we both benefit from and contribute to the NHS, we must consider the impact of our own lifestyles on our ability to care for others. In treating others as we wish to be treated, we must be prepared to think creatively and make sacrifices for all to enjoy a good standard of care.

Health: Medically Unexplained Symptoms

Lord Bishop of St Albans Excerpts

Tuesday 4th July 2017 Lords Chamber

[Lord O'Shaughnessy]

Of course, a suite of training is available for those treating illnesses such as this one, which affects about 220,000 people in England. It is not a rare disease; unfortunately, it is far too common. That treatment is there and also a number of networks exist, such as the Academic Health Science Networks, to spread innovation and best practice for treatments around the NHS.

[The Lord Bishop of St Albans]

My Lords, many of us are glad to have this report published by the Joint Commissioning Panel for Mental Health on services for people with medically unexplained symptoms. There is a welcome stress in it on trying to get integrated care—a both physical and mental approach. Would the Minister comment on the need to have an integrated approach to the spiritual dimension of this as an essential aspect of addressing these medically unexplained symptoms?

[Lord O'Shaughnessy]

Of course, the difficulty for sufferers of these illnesses is precisely the unknown origins of them. There are obviously physical aspects—that is the whole point of this being a neurological condition—as well as mental health aspects in terms of dealing with it. No doubt, spiritual guidance and uplift can help those dealing with these awful conditions.