NHS and Social Care: Winter Service Delivery

Lord Brooke of Alverthorpe Excerpts

Thursday 25th January 2018 Lords Chamber

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I too am grateful to the noble Baroness, Lady Wheeler, for initiating this debate and to everyone who has participated in producing a set of solutions which, if they were brought together, would solve the problem. I feel sorry for the Minister, who has had little support from any quarter today for his problem.

Everyone knows that much more money is needed. There is a 2% gap that needs to be filled and one way or another we have to find measures—basically through taxation—to meet that need. We also need to look for other ways in which funds can be raised in which we might involve the wider public so that, in turn, we get a greater recognition—to pick up the point of the right reverend Prelate the Bishop of Carlisle—that there has to be more responsibility for the NHS across a broader front. It is not only an issue of the Government providing the money but of how we care for ourselves and each other, of how families care—or do not care—for the elderly, and of how families pay for the elderly or refuse to do so because they want to keep the house for themselves in due course. When these issues are raised, there is a row and people run for cover because they are far too difficult to address.

As the noble Lord, Lord Smith, said, I hope we can spend some time addressing the winter problems, but we see these problems all year round. I bore the House to death when I go on about alcohol and A&E and the costs involved. When the Minister took his job, he said that he was going to stamp down on drunkenness in A&Es. I would like to see some evidence of that because the papers were full of such issues over the Christmas period.

Substantial numbers of people go to hospitals and A&E when they should not be there. I am probably the only Peer here today who was in an A&E department on Christmas day, when we had a family incident. I was there at 10 o’clock through until three o’clock in the morning before the family member was moved into an acute assessment ward and kept in for five days. We were not overrun, to my surprise, by the number of people I had anticipated being in A&E. However, given the relatively small number of patients there, we were, to a degree, overrun by the number of friends and relatives who went along with them. There were four or five people with each patient, creating noise on mobiles, causing confusion and making it much more difficult to manage the A&E. Some simple things need to be addressed. Why do we need so many people going into A&E when it causes a delay in patients being dealt with?

Similarly, when we got to the ward there was very little management and it was difficult to determine who was in charge. People were coming in, shouting and screaming down their mobile phones, and patients were surrounded by four, five or six people spending three, four or five hours in there. If people wanted to make a complaint about it, there was nobody around who was able to address the issue and slow it down. Hospitals used to be about patients, peace, calm, serenity and recovery. During that week, I was in that hospital every day—my Christmas was lost—and my experience, in many respects, was that I was in a place of riot and chaos. It should not be like that in a hospital. It would cost very little money to put this right, but it needs addressing. I know it is a minor issue compared with what we have debated today.

I return to the topic of alcohol. Cheap booze is a source of many of the problems within A&E—not only at Christmas but throughout the year, from Thursday evenings through to Sunday—and that has to be addressed. It is amazing that the Chancellor is struggling to find money for the NHS and yet, on the other hand, he is freezing the regulator in terms of increasing the cost of alcohol duties. He is making alcohol cheaper on the one hand and on the other is struggling to find the cash to keep people well. We now have more people drinking less but certain categories of people drinking more. More people are now going into hospital with less alcohol being drunk, and the price of alcohol, in the main, is going down rather than up. Fairly simple action could be taken on that by adjusting taxes. This would put it right and we would have a good response all the way round. We should apply it across the board—for example, with sugar and a range of other issues. We should look at the polluters who cause the problem to see whether they could make a greater contribution.

At the end of the day, much of this comes back to public health campaigning and how we look after ourselves and each other. Regrettably, the amount of money which has been spent on public health has been cut over recent years. We need to review that and start looking at ways in which we can help people to look after themselves better in the future, live longer and lead better and happier lives than they are doing at the moment. That requires bold decisions, frankness and honesty, which, regrettably, so far the Government have not been prepared to engage in.