Social Care in England: Older People

Lord Cormack Excerpts

Monday 20th March 2017 Lords Chamber

[Lord O'Shaughnessy]

There are two distinct issues here: carers and care workers. To attract more care workers into the system we have introduced the national living wage, which will make a difference in pay for about 900,000 people. The noble Baroness is quite right about carers. There are millions of carers in the country, and we will be bringing forward a carers strategy this year, which will address some of the issues she talks about.

[Lord Cormack (Con)]

Will my noble friend first of all associate this side of the House with the warm tributes to Dame Vera Lynn? Will he also tell the House how many care workers are from other countries within the European Union? What are we doing to ensure that we do not have a haemorrhaging of those upon whom our old people depend?

[Lord O'Shaughnessy]

I of course associate myself with the comments made by the noble Baroness and apologise for not saying so before. However, I am not going to sing in tribute.

Around 17% of the care workforce comes from abroad and some 7% of the total are from the EU. The key is to make sure that we have, as far as possible, a care system that attracts workers domestically. We are doing that through improving the training packages available and through better pay under the national living wage, which I mentioned.

Junior Doctors: Industrial Action

Lord Cormack Excerpts

Monday 5th September 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, the contract that has been offered to the junior doctors is not confidential. It can be made available to the public. Indeed, I think the main terms of that contract have been made available to the public. My noble friend is absolutely right that members of his family—and, indeed, my family and others we know—enter the medical profession as a vocation or a calling. It is an awful shame that that seems to have been lost in the dispute that has been happening over the past few months.

[Lord Cormack (Con)]

My Lords, following on from that point, is there not a case for the presidents of the royal colleges to have a greater leadership role? Is there not a case for the Secretary of State and my noble friend, in whose negotiating skills I have very great confidence, calling in the presidents to discuss this and see whether there is not some opportunity of rebuilding trust between individuals at the head of the profession and those junior doctors who are clearly disenchanted, disaffected and, frankly, behaving in a way that is not compatible with a true vocation?

[Lord Prior of Brampton]

My Lords, I agree with my noble friend. I think there is a huge opportunity here—actually, a necessity—for senior leaders in the profession, in the royal colleges, to play a really serious leadership role. Rather than standing on the touchline, if you like, they need to get on the pitch. There is a role for them. To some extent, they were instrumental in getting the two sides back to work again back in May. They were successful in doing that. Certainly, I know the Secretary of State would be very happy to listen to any thoughts that they have.

NHS (Charitable Trusts Etc) Bill

Lord Cormack Excerpts

Friday 26th February 2016 Lords Chamber

[Lord Cormack (Con)]

My Lords, I would like briefly to pay my tribute in the gap—I have given notice—to the noble Baroness, Lady Massey, and to add my congratulations on what is clearly a double golden day for her. I said that I would like to speak in the gap because I noticed there was no voice from this side of the House on the speakers list other than the Minister’s. I thought it would be appropriate to underline what general support there is for this small but very important and far-reaching measure.

When I came to the House this morning, I thought I knew what being given the bird meant. A new meaning has been brought today by an extraordinary Member, who encapsulates the importance and worth of your Lordships’ House. It is highly unlikely that he would have gone to another place, but here he is, able to contribute from a unique perspective to our deliberations. He is warmly welcomed by us all and we look forward to more hilarious and pertinent speeches, for which I suppose there is only one exclamation, which is GOSH. When the noble Baroness spoke about the charity having that name—a sort of Wodehousian name, rather than a JM Barrie one—I thought, “Oh dear, not another abbreviation that we’ve all got to remember”. But it is a memorable word. I am delighted that the noble Baroness introduced the Bill with her usual quiet skill, and we all pay tribute to a real Wendy in another place for what she did. I am delighted to give my strong support to this small but important measure.

Health and Social Care: State Pension

Lord Cormack Excerpts

Thursday 21st January 2016 Lords Chamber

[Lord Prior of Brampton]

The Government believe that we have a plan—it is the NHS’s plan, which we fully support—and that to set up an alternative commission or other kind of look at the future would be a distraction at this time.

[Lord Cormack (Con)]

My Lords, it is over 70 years since Beveridge and almost 70 years since the foundation of the National Health Service. In the debate brilliantly introduced by my noble friend Lord Fowler last week, there were many calls for a commission or an inquiry from all parts of the House—from the Cross Benches and all the political parties. Cannot my noble friend give us some hope that he has a chink of an open mind?

[Lord Prior of Brampton]

My Lords, I am afraid that I cannot today give my noble friend that chink or that hope, because we are supporting the NHS’s plan, which was developed and produced by the NHS. We believe that it would be wrong to set up an alternative at this stage.

National Health Service

Lord Cormack Excerpts

Thursday 14th January 2016 Lords Chamber

[Lord Cormack (Con)]

My Lords, I will begin by making an appeal to those who arrange these matters in this House. A three-minute time limit in a debate such as this is absurd, and it is certainly absurd to allow a maiden speaker—we heard a very good one this morning—only three minutes. When times are allocated, a little could be taken off the Front-Benchers to give a little more for a maiden speech. I also endorse the plea made by my noble friend Lord Lansley for a proper annual debate—I do not refer to the Queen’s Speech—on the National Health Service.

Time allows me to make just two points. The National Health Service may indeed be the best in the world. If it is, that is because it is the creation of all political parties, and it is very wrong for any politician to seek to make a political football out of it. Your Lordships’ House sets a much better example than the other place when it comes to debating the NHS.

My second point is very simple. My noble friend Lord Fowler made an eloquent plea for a royal commission. I was privileged to take part in a debate that was instituted by the noble Lord, Lord Turnberg, just over a year ago, when I made for the third time a plea for a commission or an inquiry. I repeat that plea again today and endorse what my noble friend Lord Fowler said. It is important not only that we take the NHS out of the party political arena but, as the noble Baroness, Lady Williams, said in her excellent speech, we have to look to the future because the health service is in crisis. A sticking plaster is not the solution. To lurch from one financial crisis to another does not only the NHS but the whole nation a disservice in the process. As I have said before, we must have a plurality of funding. Whether that comes from taxation—hypothecated or not—compulsory insurance, extra charges such as penalties for those who do not keep appointments or from a combination of all three, we must have a plurality of funding and take away this continual crisis.

We are all beneficiaries of the National Health Service and we will all depend on it in the future. I therefore urge the Minister to give some indication that he has sympathy for the idea of a commission and, at the very least, I should like some sympathy for my noble friend Lord Mawhinney’s plea for a body to be set up in this House, where there is a greater accumulation of expertise on this subject than anywhere else in the country.

Southern Health NHS Foundation Trust

Lord Cormack Excerpts

Thursday 10th December 2015 Lords Chamber

[Lord Prior of Brampton]

My Lords, the noble Lord, Lord Hunt, gave two very important figures: 1% of these incidents involving people with learning difficulties were investigated and 0.3% involved people with learning difficulties who are older. We have not got it right in this country when it comes to people with learning difficulties. We have not fully learnt the lessons of Winterbourne View. However, NHS England has now published this new strategy for people with learning difficulties and mental health problems. We will hold it to account for delivering that. I think that represents a step change in trying to get as many of these people out of hospital settings—“from hospital to home” is the line in the report—which is so important. That is the fundamental issue that we should not lose sight of.

NHS England received the report in September. It has not yet been published because it had to give the trust a chance to comment on it, and the methodology has to be fully sorted before it is published. However, Jane Cummings has given a commitment to the Secretary of State that the report will be published before Christmas. So does NHS England have a grip? I think it does.

On the question of an independent investigation, which the noble Baroness, Lady Walmsley, raised, the trust has to be the first line in this. It is up to the trust to have the right culture within it so that these incidents come to the surface. We now have a much more empowered CQC providing independent inspection, and of course the Secretary of State has agreed to set up an independent investigation branch, on the recommendation of the PASC, which will be operable from March.

[Lord Cormack (Con)]

Will my noble friend institute an emergency review, through the CQC or wherever, to try to establish that this is an isolated incident and that there are not more horrors waiting to be discovered?

[Lord Prior of Brampton]

My Lords, I certainly cannot give a guarantee that this is an isolated incident. Often in the past we have taken these awful events when they happen and tried to say that they are isolated. The fact is that there are many trusts that the CQC has characterised as requiring improvement, so I cannot give my noble friend an assurance that this is an isolated incident. However, I can reassure him that our inspection procedures are much more robust than they used to be.

Mesothelioma (Amendment) Bill [HL]

Lord Cormack Excerpts

Friday 20th November 2015 Lords Chamber

[Lord Cormack (Con)]

My Lords, exactly what the relevance of that story is to the debate is unknown, but it is one that I have heard in the past and have much enjoyed hearing again. I will begin, as others have, by warmly congratulating the choirboy—not superannuated—because he has a wonderful and youthful enthusiasm, as the noble Lord, Lord McNally, said, and he is doughty campaigner. I am reminded when thinking of campaigners of Sir Walter Raleigh, who made the famous remark that it is not the beginning of a cause for which you should be praised, but for continuing with it to the end, until it is throughly, not thoroughly, finished. I do not think that the noble Lord, Lord Alton, is going to give up his campaign until it is indeed throughly finished.

The noble Lord outlined graphically the need for this modest measure to supplement the Act that is already on the statute book, and we have heard in the debate a number of moving testimonies, not least from the noble Lords, Lord Freyberg and Lord McNally, whose personal family lives have been tragically affected by this ghastly disease. We have also had something of a medical teach-in because the noble Lord, Lord Winston—I am sorry that he is not in his place; oh, he is in his place. I am so sorry. The trouble with the noble Lord is that he moves; he made his speech from the back and now he is sitting elsewhere. He gave us a treat of a lecture. Then the noble Lord, Lord Kakkar, and my noble friend Lord Ribeiro gave us supplements to that lecture. It has been a privilege and is indeed an illustration of the value of your Lordships’ House that we have such expertise in all parts of the Chamber. That has been demonstrated today in a splendid way.

I want to address most of my remarks to my noble friend the Minister. Quite rightly, complimentary things have been said about him. He made his mark before he came into the House when he was chairman of the Care Quality Commission. In a sense we are talking about quality care here, but we are not appealing to the Minister to come to the Dispatch Box and agree to large extra expenditure from public funds. What we are asking him to do is recognise that there is a very real problem that we cannot adequately quantify. In her splendid speech, the noble Baroness, Lady Finlay, talked about schools. How many five year-olds in this country today might already be stricken by this disease, which perhaps will not manifest itself for many years to come? We all know that in our youth—I am sure that I speak for most of your Lordships—asbestos was regarded as a good thing. It was a fire retardant material that brought great benefit. But now we know that it is one of the most lethal of killers. Of course the Minister knows that, but we are asking him to recognise that more must be done to combat this evil within our midst, the full and devastating results of which none of us knows.

That there should be a levy on insurances is a very sensible suggestion, but I would say to the Minister that that should be just the starting point. There are many substances from which we all benefit in some ways—some we regularly imbibe and others we eschew—that damage the health of the nation. Why should there not be a specific levy for medical research on alcohol, tobacco, petrol or diesel?

As my noble friend knows well, I have argued, as have many in your Lordships’ House in various debates on the health service, that we must have a plurality of funding if the National Health Service is going to be the service we need in the years ahead. We have to get away from the sticking-plaster approach that we have often referred to in this Chamber. Here is a wonderful opportunity to begin something by having a specific levy for a particular disease that could then be extended. I commend this to the Minister. When I talk to him about these funding issues, he always indicates the difficulty. Of course we all know there is a difficulty. We all know that there is a degree of cowardice in all political parties when we start talking about charges and compulsory insurance, for example. This is not one of those things the Minister has to fight shy of, because here, we are saying that those who have a degree of culpability should be made to acknowledge that by making a contribution.

Of course, that may not have helped the sisters of the noble Lords, Lord McNally and Lord Freyberg, but there will be others in the future whom it might help. We might be able to avoid some of the tragedies about which they movingly spoke, if only we could grasp this particular nettle. I do not want from the Minister the soft answer that turneth away wrath. I want a determined commitment on the part of the Government to recognise the overriding importance of medical scientific research, and to recognise that this is one way properly to meet the needs that we all acknowledge.

Social Care

Lord Cormack Excerpts

Thursday 15th October 2015 Lords Chamber

[Lord Prior of Brampton]

—any place! I look forward to that. We will be accompanied by officials. There is no doubt that the local authority-funded care sector is under considerable pressure at the moment and that the increase in the national living wage will add to that pressure. Those pressures are well recognised by the Government. To some extent they have been addressed by the better care fund. I think that pooling budgets between health and social care is a way forward but we have to await the out-turn of the spending round before we can be more definitive.

[Lord Cormack (Con)]

My Lords, might I express the hope that the meeting with the noble Baroness is not only productive but chaperoned properly? I ask my noble friend to take on board the very important point she made about travel time. It really is very wrong indeed that people should not be paid for travel time, especially in rural areas.

[Lord Prior of Brampton]

I thank my noble friend for that important observation, with which I agree completely.

National Health Service: Sustainability

Lord Cormack Excerpts

Thursday 9th July 2015 Lords Chamber

[Lord Cormack (Con)]

My Lords, it is a great pleasure to take part in this debate, which was so splendidly introduced by my friend, the noble Lord, Lord Patel. We have had many conversations about this in the early morning in the Truro Room, so I was very confident that he would make a splendid speech, which he did. This is a refreshing debate because it has been marked by consensus. I single out the speeches of the noble Lord, Lord Warner, and my noble friend Lord Mawhinney, both of whom, in slightly different words, made the case for saying, “The time for using this as a political football is over”. We need to work from both sides of the House. No substantial difference of opinion has been expressed so far during this debate, and I hope that I will not depart from that.

When I first entered another place 45 years ago I was a very humble PPS in the Department of Health and Social Security, where a very few Ministers—one in this House, three in the other place—looked after the whole of health and social security. When I reflect on that, I reflect on how far we have moved away from that tight-knit and rather efficiently run pattern. Of course, we now have a much larger population and a much larger surviving population. When I entered the other place I did not have a single constituent with artificial knees or hips, or with a transplant. I even wrote to those who attained the age of 80, which would not be possible now. We have moved on.

As the noble Baroness, Lady Emerton, reminded us, it is well over 70 years since Beveridge, and 67 years since the NHS came into being. The sort of commission or inquiry which has been called for today is therefore desperately overdue. It is not the first time that a commission has been called for in your Lordships’ House. I made the call in earlier debates introduced by the noble Lord, Lord Turnberg, in which the noble Lord, Lord Patel, participated. We need an inquiry or a commission, and I would favour the latter. It must be an open-ended inquiry, with an open agenda. Nothing must be off-limits. My noble friend Lord Fowler made that plain in his speech. All forms of funding must be looked at. We have to have a plurality of funding if we are to have a sustainable NHS. Whether the extra funding comes from compulsory insurances or certain charges matters not, but it has to come—we have to have a quality service that does not lurch from crisis to crisis, from one application of sticking plaster to the next. It is crucial that we attain that.

I have a great deal of confidence because my noble friend Lord Prior, who will answer this debate, was himself very recently a notable and innovative chairman of the Care Quality Commission. I hope that he will bring the experience he acquired in that important role to his role as a Minister in the department. He succeeds a greatly loved Minister in our noble friend Lord Howe. Let us now, freed from the constraints of coalition government, have the sort of boldness that the Chancellor expressed in the Budget speech yesterday. Let us have a commission or an inquiry that will look at every aspect of the NHS and of care, and which will in particular look at funding.

All of us here believe in the NHS. There is not a politician of sense or sensitivity in any party who does not believe that. However, we must not be constrained by outmoded philosophies. We must look at the NHS and at the society it serves, and see what we can do to give it the quality service that will take us through this century and into the next. Today we heard the statistics; we know how many people will develop difficult conditions that need very sensitive treatment, sometimes for years. Many of the problems we talk about today were not problems when I was elected to the other place, because not only did some of the drugs and techniques not exist, but people then would have died long before they needed the attention we are now calling for.

I hope that we will have a positive response from my noble friend on the Government Front Bench and that at the very least he will tell us that he will have serious conversations with the Secretary of State on this. However, if it comes to naught, which I hope it does not, we in your Lordships’ House should establish one of our special committees to look at these issues. I know, looking across and around the Chamber, that we have enough expertise; many of the people who could contribute to such a committee have spoken today. This problem will not go away. It must be addressed, and we must make sure that it is. A commission and inquiry is an idea whose time has come, and we must ensure that it happens.