Public Health Grant to Local Authorities

Lord Laming Excerpts

Tuesday 2nd November 2021 Lords Chamber

[Lord Kamall (Con)]

It is true that some of the allocation for the National Health Service is being used for public health spending, but we want to make sure that across the health system the NHS not only focuses on prevention and therapeutics but works in partnership with the public health authorities.

[Lord Laming (CB)]

My Lords, the good news is that in the Budget last week, it was announced that local councils are to receive £1.6 billion in grants for each of the next three years. The bad news is that that does not take them close to what the councils were receiving and spending in 2010. Will the Minister do all that he can to press for adequate funding, especially for the public health services but also to meet today’s needs and not those of a decade ago?

[Lord Kamall (Con)]

There are many bodies tackling public health and raising awareness of some of the worst health problems we have—not only the Office for Health Improvement and Disparities and public health officials in local authorities but the NHS, which wants to move more towards prevention because in the long term that saves money.

NHS England Funding: Announcement to Media

Lord Laming Excerpts

Tuesday 26th October 2021 Lords Chamber

[Lord Kamall (Con)]

The noble Baroness refers to what she sees as the workforce shortage. The Government are fully committed to supporting our health and care professionals and to making sure that we have the right number of people with the right skills to deliver excellent patient care and support the increased elective activity committed to under Build Back Better: Our Plan for Health and Social Care. The Chancellor will confirm to the House our three-year settlement for wider health budgets at the spending review on Wednesday, which will support the NHS to undertake long-term planning for the workforce and elective recovery. I will write to the noble Baroness on specific staff numbers for A&E.

[Lord Laming (CB)]

I wonder whether the Minister would agree that the NHS cannot succeed without adequate social care. In the last seven days we have had two reports that show just how vulnerable the social care system is. Can the Minister sign up to a new agreement to protect the NHS by supporting social care? That was absent in this statement.

[Lord Kamall (Con)]

I thank the noble Lord for that suggestion. We see social care as incredibly important, which is why we will soon have before the House a health and social care Bill to make sure that we look at both health and social care, from birth all the way through one’s life.

Social Care: Family Carers

Lord Laming Excerpts

Monday 13th September 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the maths that my noble friend has done is a little bit premature. The White Paper will come out later this year; it will spell out the precise financial arrangements, and I am looking forward to that.

[Lord Laming (CB)]

My Lords, the Minister has already indicated an understanding that many carers sacrifice a huge part of their lives in trying to care for a loved one. Many of the community support services that used to be available are no longer available. When these arrangements break down and a crisis occurs, it is understandable that the only option left is to call an ambulance, which places increased pressure on the health service. Will the Minister champion a new approach, which is this: “Protect the NHS by supporting carers”?

[Lord Bethell (Con)]

Yes, I would endorse that sentiment. That has been one of the learnings of the pandemic. It is instinctively true in any case, and the evidence base during the pandemic was quite right. They are interlinked; that is one of the reasons we are bringing forward a Health and Social Care Bill that brings both services much closer together and brings a responsibility on the ICSs to combine health and social care at the same time. Our population-wide measures will try to bring those care responsibilities much closer together, as the noble Lord suggested.

Residential Social Care: Staff

Lord Laming Excerpts

Monday 6th September 2021 Lords Chamber

Asked by

[Lord Laming]

To ask Her Majesty’s Government what steps they are taking to improve the (1) training, and (2) remuneration, of staff in social care residential services.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, we are incredibly proud of our health and care staff. As a nation, we are indebted to their selfless dedication, particularly over the last 18 months. The Government fund a range of training opportunities to support the development of care staff, including through a core workforce grant of £23.47 million. However, the vast majority of care workers are employed by private sector providers, who set their pay independently of central government.

[Lord Laming (CB)]

My Lords, I am grateful, but the Minister will understand that, very often, the impression is given that the only qualification needed by these splendid staff is that of a kind heart. This is despite the fact that they are caring, day by day and hour by hour, for the people in our society with the most profound needs. Does the Minister accept that, in these circumstances, it is remarkable that the median pay for these staff is £8.12 per hour? Is it any wonder that there are 112,000 vacancies in this field? Could the Minister say whether the Government have any plans to support these staff with professional training and give them a fair salary?

[Lord Bethell (Con)]

My Lords, I endorse the noble Lord’s key point, which is that value is seen not through salary but through the skill, love and determination of our social care staff to do a fantastic job. We are extremely proud of the service that they provide. The provision of care in this country is being looked at in the spending review settlement, and the need to support the sector will be addressed in that.

Covid-19: Care Homes

Lord Laming Excerpts

Thursday 17th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, PHE has published a report on that. It calculates that around 1.6% of the deaths in care homes were directly attributable to discharge. That number is very sad, but it is a relatively low proportion. This will, of course, be a subject covered in the government inquiry that the Prime Minister has already announced.

[Lord Laming (CB) [V]]

My Lords, I feel sure that the Minister will agree that it was extraordinary that, when relatives were prevented from visiting their loved ones in residential care, and many of the residents could not understand why they had been abandoned, at that very time patients were being admitted from hospital without having been tested for this virus.

[Lord Bethell (Con)]

My Lords, I completely sympathise with the point on those in care homes receiving a very tough challenge when they have been prevented from seeing loved ones. We have had to take extremely severe infection control measures, many of which are still in place for the reasons that have been discussed in this Chamber before. But I challenge the noble Lord’s point on testing. We brought in testing when asymptomatic infection was recognised and when the capacity was available.

Care Homes: Insurance Indemnity

Lord Laming Excerpts

Wednesday 19th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, in the year from March 2020, the number of patients has in fact increased from 457,000 to 458,000. The CQC is monitoring the situation extremely closely and its data from the insurance industry suggests that, although there has been some pressure on some companies, there have also been new entrants and the amount of support available to the social care sector is resilient.

[Lord Laming (CB) [V]]

The Minister has a very good understanding that many of the residents in residential care homes are unable, because of their condition, to comprehend the significance of the coronavirus. At this stage in their lives, when they are at their most vulnerable, many have felt that they have been abandoned and are now unloved. Can the Minister tell the House, if the insurance indemnity is not acceptable, what other possibilities are being considered by the Government so as to ensure that the awful experiences of some residents in the past year will never be repeated?

[Lord Bethell (Con)]

My Lords, the noble Lord speaks movingly of the plight of many people in care and I agree with his sentiment—it has been a very difficult year indeed—but we cannot blame the insurance industry for the pressures that have been put on residents. On the specific point about residents receiving visitors, which has, I think, been attributed to problems with insurance, I remind the noble Lord that 82.5% of care homes in England are now able to accommodate residents, compared with 40% at the beginning of March—a very large increase.

Social Care: Person-centred Dementia Care

Lord Laming Excerpts

Monday 17th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am afraid it is beyond my reach to define the terms of the inquiry, but I entirely endorse the noble Baroness’s depiction of the very cruel dilemma we have faced over the last year: between safety—the preservation of life—and the care, love and consideration we owe to older people, particularly those with dementia. It has been a horrible and extremely uncomfortable dilemma. I pay tribute to those in social care who have sought to navigate it as thoughtfully as they could, but there is no doubt that it has been a horrible moment.

[Lord Laming (CB) [V]]

My Lords, as we have heard, dementia is a cruel illness because it strips away both individual personality and memory. Does the Minister agree that, learning the lessons of this past year, we must in future do everything possible to reinforce the message to each sufferer that they are loved for who they are, a unique person, rather than for what they are, just another patient with dementia?

[Lord Bethell (Con)]

My Lords, I entirely agree with the extremely touching way the noble Lord put that. To take a glass-half-full approach for a moment, I have been struck in the pandemic by the huge amount of public support for the protection of those who are older and vulnerable, including those with dementia. It has been a very touching feature of the national response to the pandemic that the country has come together to protect the most vulnerable, and I think there has been a national rethink about how we relate to those in that condition.

Covid-19: Over-75s

Lord Laming Excerpts

Tuesday 9th February 2021 Lords Chamber

[Lord Bethell (Con)]

I completely recognise the concern of my noble friend and of many in the Chamber on this point, so I shall provide concrete reassurance. Everyone will receive their second dose within 12 weeks of the first one. All those booked in at vaccination centres will have an appointment, made at the same time, to receive their second dose, and those who do not have a date today will receive one from their GP.

[Lord Laming (CB) [V]]

My Lords, the Minister will know that six out of 10 people with dementia live in their own home, so they depend on a range of care workers coming into their home—sad to say, often without PPE and some even without face masks. In contrast, those living in residential care have now gone almost a year without being allowed a visit from a loved one—they are not able even to hold their hand. Does the Minister agree that now is the time to set up a formal review in order for us to learn the lessons of the impact of Covid-19 on the over-75s suffering from dementia?

[Lord Bethell (Con)]

The noble Lord explains the situation of those who have been in care homes and separated from their loved ones extremely well. We all feel extremely heartbroken by the stories of people who have been separated from their loved ones, but we need to put the saving of life as the first priority. Visits have been allowed outdoors, behind screens and in safe environments. I appreciate that that is not the same as an intimate face-to-face meeting but, where we can, we have put in place guidelines to ensure that people are protected. A review of the guidelines will happen on 22 February, and that seems the right moment to review these procedures.

Covid-19 Update

Lord Laming Excerpts

Monday 14th September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I sympathise with my noble friend’s point, but I remind him that the regulations come into force later today. It is up to the Metropolitan Police to implement crowd dispersal but the sentiments he expresses are ones that I share.

[Lord Laming (CB) [V]]

My Lords, will the Minister please accept that while there may be good reason for the Government to ratchet up further the restrictions on social distancing, it is surely unreasonable to at the same time pressure people to return to their offices? These two objectives are incompatible, as was shown by government officers last week. Surely the Government should accept that they can press either greater social distancing or a return to offices, but not both?

[Lord Bethell (Con)]

My Lords, I do not think that this Government are pressuring anyone into doing anything. We are keen to give those who have a reason to, whether personal or professional, the confidence to return to their workplace. I pay tribute to the very large number of employers who have invested a huge amount in making those workplaces socially distanced and safe for employees.

Independent Residential Care

Lord Laming Excerpts

Tuesday 7th July 2020 Lords Chamber

Asked by

[Lord Laming]

To ask Her Majesty’s Government, further to the remarks made by the Chief Executive of NHS England on 5 July, what measures they plan to put in place to assist independent residential care providers should any such provider face (1) financial, or (2) operational, difficulties.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con) [V]]

My Lords, this disease has targeted the vulnerable, and those working and living in social care have faced daunting threats. The Government have intervened with £3.7 billion for local authorities, including specific funds such as the £600 million infection control fund and the £500 million announced on 2 July. Delivery is being supported by our social care Covid-19 task force.

[Lord Laming (CB) [V]]

My Lords, I am grateful to the Minister for that reply, but he will know that, nowadays, residential care homes are provided not by local authorities but by thousands of independent organisations. It is now thought that some of these organisations may be in financial difficulties. Can the Minister tell the House what plans are in place to protect the residents of a home which ceases to operate, especially as these residents are not only very vulnerable but, frankly, have nowhere else to go?

[Lord Bethell [V]]

My Lords, the noble Lord is entirely right. The protection of residents is our number one priority and our responsibilities under the Care Act 2014 remain in place. The care home economy is mixed. We are looking very carefully at the financial resilience of all the providers involved. We are providing the funds necessary to see them through this epidemic and we will do whatever it takes to protect residents.