Health and Adult Social Care Reform

Lord Patel Excerpts

Tuesday 7th January 2025 Lords Chamber

[Baroness Merron (Lab)]

The independent review by the noble Baroness, Lady Casey—in addition, as I mentioned, to producing recommendations that can be implemented straight away next year—is focusing on completing its final report later in this Parliament, so we are looking at the longer term. I cannot give an exact timetable, although I am hopeful that we will be able to update your Lordships’ House with further information, as the noble Baroness quite rightly asked. The matter of discharge requires there being suitable facilities in the community, but we are not in that place, so this will take some time. But I am very hopeful that all of the measures here, and the measures we have taken already, take us further to that point. We will continue to strive on the matter of discharge, because it is a problem not only for the NHS but for patients and their carers and for social care. We are carrying, as we know, a lot of vacancies and a social care system that is creaking at the seams: we must be honest about that.

[Lord Patel (CB)]

My Lords, I welcome the Statement and many of the proposals in it. We have learned from past experience that all reforms to, and any proposal to change things in, the NHS—and, for that matter, social care, but more so with the NHS—lead to increased bureaucracy but not the benefits that we thought they might deliver. One of the waiting list initiatives is that GPs will have a consultation with hospital staff to try to reduce waiting times and avoid unnecessary duplication. There is some financial incentive attached to that, but it certainly will increase bureaucracy. What modelling has been done to find out whether it will work, whether it will increase bureaucracy and by how much it will increase costs?

[Baroness Merron (Lab)]

I am grateful to the noble Lord for welcoming many of the measures in this announcement. He referred to the £20 fee that will be paid to GPs to call the consultant where necessary. I understand the concern about increasing bureaucracy, but all these reforms are intended to work the other way. We will very closely monitor them and have very carefully considered them with all those who will be dealing with them. I am actually more than hopeful, because the intention is that allowing the GP, for example, to get further advice, and making sure that people are being seen in the right place, will save money. It will mean that people are not taking up a referral place and that they will be referred for the necessary tests, scans, et cetera without the middle bit, which is a very backward-facing way of dealing with things. We will continue to monitor that to ensure that we are reducing what is currently wasted clinical time, while also preventing unnecessary out-patient appointments. The monitoring should show all of that and I will be very happy to update the House on that. The fee is to ensure that it can happen and is an incentive to do so. Of course, the greatest prize is an increased and speedier service for patients.