Southern Cross

Lord Brooke of Alverthorpe Excerpts

Thursday 16th June 2011 Lords Chamber

[Earl Howe]

My Lords, I fear that I am unable to answer the noble Lord’s questions, for which I apologise, but I understand why he has asked them. If I have some concise answers that I can send him, I will certainly do so by way of a letter.

I think that the noble Lord and I agree that we are looking at a fundamentally unsound business model. As I understand it, it is a unique business model in the care home sector, where a deliberate decision was taken for the company not to own its own care homes but rather to pay the rent on them. The market clearly moved against it in more than one sense. The company’s problems are partly attributable to the occupancy levels of some of their care homes. Southern Cross occupancy levels have gone down, I understand, more than those of other care homes. It is not about fee levels; other providers of residential care are not in the same position as Southern Cross. I believe that Southern Cross’s problems relate to the rental agreements—the leases—that they entered into. It is those things that the restructuring aims to fix.

[Lord Brooke of Alverthorpe]

My Lords, I thank the noble Earl for his Statement. I listened carefully to what he said about the need for clarity on where responsibility lay. He also stated that there were lessons to be learnt. Will he say when the Government will conclude their review of these lessons, and when and how they will make them public? With the imminent privatisation of the Royal Mail, which has a lot of property worth quite a lot of money, will the Minister say whether some lessons learnt in this exercise might be useful in the context of ensuring that we do not run into similar problems there?

[Earl Howe]

My Lords, I would love to be able to comment on the Royal Mail, but noble Lords will be sorry to hear that I have not received the necessary briefing. On the timescale of our review, as I indicated to my noble friend Lady Barker, there are a number of elements to our review of social care policy. One is the Dilnot report, which we are expecting at the beginning of July. Another is the Law Commission report. However, a third is undoubtedly the lessons learnt from this episode. It is fair to say that it would be rash of me to give the noble Lord a date on which we will conclude all three strands of that review. It is likely that we will be able to be more definite later on this summer.

Health: Alcohol Minimum Pricing

Lord Brooke of Alverthorpe Excerpts

Tuesday 1st March 2011 Lords Chamber

[Earl Howe]

My noble friend makes an extremely important point. We estimate that alcohol harm costs the NHS around £2.7 billion a year. Forty per cent of all accident and emergency admissions are in some way connected with alcohol—I think a higher percentage on Friday and Saturday nights—and 7 per cent of all hospital admissions are accounted for in some way by alcohol. This is a very serious problem: 8,500 people die from alcohol in the UK every year and there are over 1 million hospital admissions relating to alcohol.

[Lord Brooke of Alverthorpe]

My Lords—

[Baroness Jolly]

My Lords—

[Lord Brooke of Alverthorpe]

My Lords, now that the Minister and the Government have accepted that raising the price of alcohol is one of the ways in which we can minimise harm to those who are abusing alcohol, why have the Government’s recent proposals been so minimal? The cost of a can of lager will be increased, or minimised, to 38p under the new arrangements. This is hardly going to make any change whatsoever. We have to wait for the White Paper in the summer, but in the mean time why could a more positive approach to raising the cost of alcohol not have been taken and more fundamental changes made to the ever increasing easy access to alcohol, which is another problem that needs addressing?

[Earl Howe]

My Lords, we view the decision to ban below-cost sales of alcohol as very much a first step. We have announced a number of other measures, as the noble Lord may know, particularly a rise in the rate of alcohol duty by 2 per cent above inflation over each of the next four years, additional duty on high-strength beers and greater powers for local authorities over local licensing decisions. As I mentioned, there is no single solution to this problem, but we are looking at a number of additional measures.

Healthcare: Costs

Lord Brooke of Alverthorpe Excerpts

Monday 15th November 2010 Lords Chamber

[Earl Howe]

My Lords, my noble friend is quite right to identify dementia as a particular cost pressure over the next few years. The coalition Government signalled in their programme our intention to prioritise funding for dementia research. The spending review confirmed that and committed to real-terms increases in spending on health research. This investment is indeed essential if we are to increase the quality, productivity and cost-effectiveness of the NHS.

[Lord Brooke of Alverthorpe]

My Lords, I return to a question which I posed previously to the Minister and which remains unanswered. Does he not agree that if patients in the health service knew what the costs of their treatment, care and drugs were, as they do in the private sector, this would create a downward pressure, which would reduce costs overall?

[Earl Howe]

My Lords, I know that this is a question to which the noble Lord and other noble Lords regularly return, and it has a superficial attraction. The problem with it, I am advised, is that patients who are informed of the cost of their treatment—some patients, at any rate—take that as a deterrent to accepting the treatment in the first place. That is something we need to avoid. Nevertheless, there is an underlying point here; there is a need to provide better information to patients about their treatment so that they can take ownership of their state of health.

Healthcare

Lord Brooke of Alverthorpe Excerpts

Thursday 28th October 2010 Lords Chamber

[Lord Brooke of Alverthorpe]

I am grateful to the noble Lord, Lord Hunt of Wirral, for promoting the debate and express my gratitude to the several professional organisations that have provided me with briefings. I make a contribution today simply as an NHS patient who has no private medical care or back-up whatever. I am also a former cancer patient; I hope that that continues to be so, but I have been waiting nearly three months for an appointment to deal with a spot on my hip. I finally managed to get one this week at the Chelsea and Westminster Hospital, where, within seven days, staff will do a local operation on it. They hope that it will not be the start of skin cancer.

I was spitting blood the other day when I listened to the Minister defending the Government’s position on cancer timetabling and how treatment was taking place. In my case, it had nothing whatever to do with commissioning or the hospital. The problem arose with what has been happening within my GP practice. I know that people in GP practices in many areas are under a great deal of stress and strain and I greatly sympathise with them, but it is extraordinarily difficult when so many patients cannot get through on the phone to their GPs and so cannot get an early appointment with a GP of their choice. They cannot get a meeting with their GP out of hours—it must be at the convenience of the doctors—and certainly cannot get GPs to come out at the weekend or at night. These are issues that my Government were responsible for; they tried to put them right and did not get them put right, so the new Government should be putting them right and not moving on into other areas.

As far as I can ascertain from how things are moving at the moment, there will be little change on these fronts, or indeed on many other issues that have been raised on the Government’s side of the House when there have been complaints. The White Paper and the programme in front of us will not address those problems. I speak with a degree of anger when I see that we are now moving into an entirely new arena, which was not forecast in the run-up to the general election. There was no debate on it and it was barely mentioned. It was not in the Conservative Party manifesto or the coalition agreement, which just said that nothing was going on. I am sorry that we do not have many Lib Dem contributions today because, in the past when we have had debates on the NHS, we have been chased all over the place by them. Today they are missing and they should be ashamed that they are not standing up and taking a firm stand on these issues.

[Lord Alderdice]

I am grateful to the noble Lord for giving way, but I have to point out to him that he is incorrect on almost everything that he has said in the last few minutes about those speaking from the Lib Dem Benches, as well as about the coalition agreement and the manifestos.

[Lord Brooke of Alverthorpe]

I shall not go into that—I shall move on. If we are faced with this, we need greater openness and transparency and greater access to the economic factors behind it all. If I was in the private sector, all the issues that I have just complained about, with a private GP looking after me, would have been solved. I would have had access to the information and to the costs. We should move to a position where, if people are given choices, they should know what the cost is. Equally, we should be given the opportunity under the changes to know what is being paid into the GP consortia, what profits they will make and what the private sector providers will get out of it. At the moment, this area is all within the public service, but it is likely to be privatised under the coming arrangements. Those are the points that I put to the Minister—there should be greater openness on the economic side of the operation.