The Long-term Sustainability of the NHS and Adult Social Care

Lord Loomba Excerpts

Thursday 26th April 2018 Lords Chamber

[Lord Loomba (CB)]

My Lords, I thank the noble Lord, Lord Patel, for initiating this debate on the report, which comes at a crucial time for the NHS and for adult social care. It is widely recognised by many that there is a need for immediate action to sort out the main difficulties that plague both the NHS and adult social care, and especially to look at better long-term sustainable funding so that the NHS can get on with its work in a more secure way than at present.

It is becoming increasingly clear that, as the report recommends, the NHS and adult social care should be brought together to tackle the problems in tandem so that the most apt solutions for both sides are put forward. The report recommended that the Department of Health should have budgetary responsibility at national level for adult social care and should be renamed the Department of Health and Care, and it appears that there has been some movement on this front as the department has now been renamed the Department of Health and Social Care. Confusingly, though, Jeremy Hunt said in his evidence to the House of Commons Health Committee in March that while he now has responsibility for adult social care, funding would continue to flow through local government, which delivers adult social care. Additionally, the Secretary of State for Health and Social Care now has responsibility for the proposed Green Paper on adult social care, but at the moment it will not cover the NHS.

Age UK’s briefing for the debate highlights the interconnectedness of the problem. It should not be forgotten that problems with the care system in turn create further pressure on the NHS. Delayed discharges are a good example of this, where older people are unable to be safely discharged from hospital because adequate social care plans are not in place.

Clearly, no business can run without an eye to the future, and an organisation as vital as the NHS needs a clear strategy of where we are, what the problems are, what needs to be achieved and the steps needed to achieve it. It is not insurmountable, but it will take willpower on all sides and agreements to be reached that allow for the patients who need assistance to be at the forefront of the change, so that they are given the best health and social care possible.

As the noble Baroness, Lady Pitkeathley, pointed out in this House last year, numerous commissions and consultations over many years have not resolved the issues. The bottom line is that while all this prevarication continues, the people who need help are suffering the most, as they are let down by a system that is not fit for purpose. With this comes low morale and a depleted workforce that needs uplifting, for without them it would be a much bleaker picture.

I am aware that waiting times in A&E are coming down. However, we need to reduce them further so that no one is forced to wait for more than four hours to be seen, and especially to improve matters so that there is not a repeat of this winter’s acute problems, when ambulances at some hospitals were forced to wait outside and unable to deliver their patients due to lack of capacity.

What actions are the Government taking to increase the number of doctors and nurses working in the NHS, and how can immigration policies be amended to accommodate more doctors and nurses from overseas to help to fill the shortfall in staffing levels?

Finally, I am pleased to hear that the Government have committed extra funding to the NHS in the five-year forward view. Can the Minister identify how, when and where the extra money will be allocated?