Ageing: Public Services and Demographic Change Committee Report

Lord Mawhinney Excerpts

Thursday 17th October 2013 Lords Chamber

[Lord Mawhinney (Con)]

My Lords, I presume to speak on behalf of all the committee colleagues of the noble Lord, Lord Filkin, by thanking him for the leadership which he gave the Select Committee and for his own knowledge and enthusiasm which drove that leadership. The five-minute advisory length of speeches will constrain committee members from dealing in any depth with the multitude of issues that we raised. No doubt that was part of the Government’s thinking when they scheduled this debate at this time.

I will restrict myself to one issue only, which came through regularly and strongly in the evidence that we were given. The report states:

“To meet the needs of our ageing population … the health and social care system needs to work well 24 hours a day, seven days a week”.

The Secretary of State told us that,

“we have to have a 24/7 NHS”.

That is good. Actually, it is vital that we have such a service, but when will we have it? We called on the Secretary of State in our report to,

“within 12 months … set out how this will be made real”.

To date, we have heard nothing. The clock is ticking in an otherwise silent room and we look to my noble friend the Minister to inject a degree of urgency in his colleagues—for I suspect that my noble friend senses that urgency even if at times he, too, is constrained from being as explicit about the issue as some of the rest of us wish to be.

Because there was no indication of timing, I put down a Parliamentary Question in July asking the Government what was the percentage of GPs providing a full weekend service. My noble friend will remember his Answer. He told me that it is all being looked at by NHS England. My heart sank because, first, I was a Minister long enough to know that when Ministers are trying to distance themselves from something difficult, they pass it on to someone else. Secondly, as my noble friend knows, I am not a great admirer of NHS England, particularly of its chief executive Sir David Nicholson—he with the wildly chequered career. He is the one who the previous Secretary of State, Mr Lansley, wanted to be wholly in charge of the NHS, rather than the Secretary of State. I know what the department thinks of Sir David. I know what the health professions and the public think of him. I maintain hope that my noble friend will be persuaded to join me and the majority, and put Sir David on a bicycle as quickly as possible.

On the other hand, the Prime Minister announced just recently that he was going to initiate a pilot study in nine areas about GP surgeries running through the weekend and providing a full service. This is very good. Well done, Prime Minister. I am not sure why there are nine areas. To be honest, as a former health Minister, I am not sure whether this policy needs to be piloted at all, but it is a step in the right direction. On the other hand, after 11 and a half years as a Minister, I have developed a marginally healthy scepticism. I was immediately reminded of that old Chinese proverb that states:

“A journey of a thousand miles starts with a single step”.

I have to say to my noble friend that I think we still have 999 miles and 1,750 yards to go. We need a full-week service.

I tabled another Parliamentary Question to my noble friend. I asked him to tell me what percentage of full social care was available at weekends. My noble friend—perhaps above all of his colleagues on the Front Bench—is too courteous and sophisticated to have given me the Answer that the words yelled out: “Nothing to do with me, guv”. We all know who has the primary responsibility for delivering social care. However, we all also know that it is to do with the Government. It is to do with providing what the Government believe people need. If it is not a matter for the Government, who is it for? While we dicker, duck and dive, there are more elderly people with frailties in mind and body, needs, deprivation, suffering and pain. All are made worse by the absence of a full seven-day-a-week service. Only government can ensure that care, support and treatment are administered effectively—I repeat, effectively—24 hours a day, seven days a week.

I have no vested interest but I have hard-won, emotionally draining experience about the importance of that to which I make reference. Near the end of her life, my mother had to spend two weekends in a local hospital because she had contracted pneumonia. Her care and treatment adversely affected her condition, even though the infection was cured. The hospital wrote a self-satisfied letter telling me how good the standard of care that it provided had been. We, the family, could not wait to get her out of the hospital and back to the residential home. In this day and age, that may sound strange because residential and nursing homes have not always had a very good reputation or appreciation—and some of them should not have, because some of the things that have happened have been horrendous. However, I want to say how grateful I am to Abbott House in Oundle for its professional, sympathetic and focused care for my mother and her well-being, despite the pressures that people are facing and the inadequacies of what the NHS made available at weekends.

Our report’s conclusion was that a radical change and an improvement in health and social care were badly needed to provide a full service. I share the view of the noble Lord, Lord Filkin: radical change will take time, and time in politics means cross-party support or radical change will never happen. Without it, the present scandal of the treatment of our elderly will grow to a point where it is not handleable by politicians who wish to act humanely. That is the size of the challenge and the size of the problem that this Government face.