Queen’s Speech

Lord Ribeiro Excerpts

Wednesday 12th May 2021 Lords Chamber

[Lord Ribeiro (Con) [V]]

My Lords, it is a pleasure to take part in this debate on the humble Address to Her Majesty. I wish to cover issues around social care, alcohol abuse and the Healthcare Safety Investigation Branch.

During my 10 years in your Lordships’ House, the issue of social care and how it should be provided and funded has been debated continuously. It started with the Dilnot commission’s report in July 2011, of which the noble Lord, Lord Warner, a co-chairman, was a formidable champion in this Chamber. Now, 10 years on, we are still waiting for concrete proposals, and the Queen’s Speech was relatively silent on this, merely noting:

“Proposals on social care reform will be brought forward.”


The pandemic has taught us that good public health systems are key to developing confidence in the public to follow government guidelines. The successful vaccination programme is testament to that approach. We should draw on the lessons learned from the vaccination programme, including the ability to cut through red tape and to create joined-up services, where all disciplines in hospitals rolled up their sleeves to take on new roles. The creation of new intensive care beds and high-dependency unit beds with ventilators, both in hospitals and on other sites, was a revelation in peacetime and a tribute to the leadership of the NHS during the pandemic.

One sentence jumped out at me from the Queen’s Speech:

“My Ministers will bring forward legislation to empower the NHS to innovate and embrace technology. Patients will receive more tailored and preventative care, closer to home.”


For that we need a truly integrated system of care, and the lessons of the pandemic must act as a catalyst. The Bill aims to remove bureaucratic and transactional processes that do not add value, thus freeing up the NHS to focus on what really matters to patients. The health and care Bill should provide the legislative basis for establishing integrated care systems as statutory bodies. Integrated care systems will include health and care partnerships, thus bringing multiple patients from the NHS, public health, social care and other stakeholders together, rather than having them work in silos.

I welcome the banning of junk-food adverts before the 9 pm watershed on television, and the total ban online, but I would like to see the Government take the same tough line on alcohol advertising. Remarkably, just 9% of people with alcohol dependency account for the 59% of in-patient alcohol-dependent admissions. These 54,349 patients account for some 365,000 admissions, and have more than 1.4 million bed days, at an estimated cost to the NHS of £858 million. According to Public Health England, alcohol treatment is cost effective. Every £1 invested in alcohol treatment yields an immediate £3 of social return, rising to £26 over 10 years.

There has been significant pressure on the workforce during the pandemic, and, while it was reassuring to read in the Times today that recruitment numbers in nursing and midwifery and for health visitors are expected to rise, the Royal College of Psychiatrists has warned that the future of addiction psychiatry may be put at risk through the shortage of trainees in that specialty—a point made by the noble Lord, Lord Owen.

The Government must ensure that the Bill provides a mechanism for alcohol treatment and a workforce to sustain it in the long term. The purpose of the Bill is to prevent illness, tackle health inequalities and enhance patient safety: something that the charity that I chair, CORESS—Confidential Reporting System for Surgery—tries to do by reporting incidents of near misses in surgical practice. Through these reports, surgeons can learn from others and avoid repeating the same mistakes. I am delighted that the Health Service Safety Investigations Bill, to which I drew attention in the Queen’s Speech debate of October 2019, has finally been put on a statutory footing as the Healthcare Safety Investigation Branch, with the power to investigate patient safety risks and to support a learning culture—something that we can all benefit from.