Older Persons: Care and Human Rights

Lord O'Shaughnessy Excerpts

Tuesday 11th July 2017 Lords Chamber

[Lord Foulkes of Cumnock (Lab)]

My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I refer noble Lords to my entry in the register of interests.

[The Parliamentary Under-Secretary of State, Department of Health (Lord O'Shaughnessy) (Con)]

My Lords, first, I congratulate the noble Lord on leading the production of this report. The Government are pleased to note its publication and look forward to contributing to the response. This Government’s ambition is to make the UK a good place for everyone to grow old, and we have put in place a programme of reforms across health, care, housing and other services to support older people to live independent and fulfilling lives.

[Lord Foulkes of Cumnock]

My Lords, I have no doubt at all about the Minister’s sincerity on this, but he will know that in the last few weeks Age UK, the Care Quality Commission, the King’s Fund and the Local Government Association have all produced reports showing problems and failings in the provision of services for older people in the United Kingdom. Will Her Majesty’s Government now discuss with civil society the implementation of the recommendations contained in the report?

[Lord O'Shaughnessy]

I certainly pay tribute, as the noble Lord does in the foreword of the report, to the growing trend towards strengthening the protection of older persons’ human rights. He is also right to highlight today and in the report that there are still widespread negative stereotypes. The Government are proud to lead the world in tackling age discrimination, and we published in February a strategy called Fuller Working Lives on that purpose. We are taking many actions to fulfil the requests in his report; one particular one that I would focus on from a health perspective is the fact that, by 2020, all medical curricula will include training for geriatrics, so there will be that additional support throughout the entire NHS.

[Lord Clark of Windermere (Lab)]

My Lords, I, too, congratulate my noble friend on producing such a brilliant report. One theme running right through the report is that ageism, like sexism and racism, is simply wrong. Does the Minister agree with that? In his response to the report, will he make it clear that the Government will not support ageism in general legislation or in any rules affecting this House?

[Lord O'Shaughnessy]

Rules affecting this House will, of course, be decided by its Members, who are probably the least likely group in the entire country to be ageist. The noble Lord is quite right to highlight this incredibly serious point. Any form of negative stereotyping or discrimination is, of course, wrong. I mentioned a couple of things that the Government are already doing and a lot is going on to counter any kind of discrimination. This Government have got more older workers into employment and are tackling the discrimination in the workplace that, unfortunately, still takes place.

[Baroness Barker (LD)]

My Lords, given the salutary experience of the general election, does the Minister now agree that the previous Conservative Government were wrong to kick the Dilnot commission recommendations into touch and that now would be the time to get that report back off the shelf, dust it down and hold proper discussions about the funding of long-term care?

[Lord O'Shaughnessy]

The noble Baroness is quite right that this is a nut we have to crack. The Government are going to begin consulting widely on proposals at the end of the year and this consultation will be on specific proposals rather than being open ended. As we have discussed in this House before, it is important that we do that in a spirit of consensus, because I do believe that there is a way forward which all parties can support.

[Lord Spicer (Con)]

My Lords, I declare an interest in the old and decrepit—I am one of them. Will the Minister confirm that much of what the noble Lord, Lord Foulkes, is saying is already standard practice in this country? Does that not bode well for the Brexit legislation when it comes forward?

[Lord O'Shaughnessy]

I do not know if we can relate this to Brexit, but we can always try. The UK has a good record in this area. There are 14 specific recommendations in the report authored by the noble Lord. We are doing good things on personal budgets and on encouraging volunteering for the over-50s—so there is a lot of work going on in this country that we can be proud of.

[Baroness Howe of Idlicote (CB)]

My Lords, given that in future we will be looking at older people being very old indeed—up to about 150—what are we doing to think about their lives and about care for them beyond that age?

[Lord O'Shaughnessy]

There is a prospect to look forward to. If we will be living to 150, there are a lot of middle-aged people in this Chamber. The noble Baroness is right. There is a particular issue around frailty as people move into old age. That is why the GP contract introduces responsibility to look out for frailty, as well as making sure that there are named GPs for the over-75s and, if necessary, annual health checks, to make sure that there is both health and social care provision for older people.

[Baroness Wheeler (Lab)]

My Lords, my noble friend is to be congratulated on his excellent report, bringing together key issues that would enable older people to maintain their independence, dignity and quality of life and to receive the care that they need. The report underlines the importance of countries having an enabling legal framework for the provision of integrated health and social care. What action will the Government therefore take in the light of the conclusions of last week’s IPPR report, which calls for our existing national legislation to be amended to enable pooled budgets and integration, and also says that if everybody has to carry on working round the 2012 Act, as at present, STPs and accountable care systems could both be blocked?

[Lord O'Shaughnessy]

I will read the report that the noble Baroness mentioned. She is quite right that integration of health and care budgets is the way forward, particularly as the burden of disease changes away from infectious diseases towards lifestyle and complex diseases of old age. The better care fund is beginning to start the kind of integration she is talking about, but of course we need STPs and accountable care systems, as set out in the five-year forward view. We feel there is, at the moment, the legislative freedom we need to move ahead with that.

[Lord Laming (CB)]

My Lords, the Minister will recall that last week there was a question about the number of residential homes for older people that were failing to provide adequate care. The temptation in some circles is simply to say that these homes should be closed down. The human rights of these very vulnerable people are bad enough when they are getting inadequate care; it is even worse when they are threatened with homelessness at this advanced stage in their lives. Will the Minister and his department give some thought to how failing homes could be tackled more effectively without creating homelessness for very vulnerable residents?

[Lord O'Shaughnessy]

The noble Lord makes an excellent point—and with great authority, as ever. The CQC report published last week indicated an improving picture, but clearly too much care is not up to scratch. One of its more heartening findings was that 80% of settings that had been deemed inadequate had improved by the time of the next inspection. It is clearly not right just to go in and start closing these homes: they need support to improve. As we are talking about care, it is worth bearing in mind also that the CQC report indicated that 98% of settings were deemed good or outstanding on caring. That goes to the heart of the fact that the people working in the care sector really do care and have been found to do so.