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

Lord Sterling of Plaistow Excerpts

Thursday 26th April 2018 Lords Chamber

[Lord Sterling of Plaistow (Con)]

My Lords, it is with some trepidation that I take part in this debate. The professionalism of the report of the noble Lord, Lord Patel, together with everything that has been produced with all-party support, shows this House at its best.

Many years ago, I was at the Grosvenor Hotel attending a ball. The lady with me, who was beautiful and was wonderfully dressed in a long gown, was a senior nursing sister at St George’s Hospital at Hyde Park Corner. The music was suddenly stopped and it was announced that an IRA bomb had just hit the Hilton Hotel. As noble Lords may remember, there were a very large number of casualties. My companion grabbed her bag and we rushed out. Everything had stopped. Police cars were all over the place. She ran into the middle of the road and stopped a police car. The bloke yelled out, “What the hell do you think you’re doing?” She said, “I’m a nursing sister. Get me down there fast”. I followed along. When we got inside, there were a couple of house doctors standing at the side. She said, “If you can’t do anything better, get out of the way”. As noble Lords can imagine, it was a pretty awful evening. At about 1 am, she came over to me with a white coat, covered in blood, over her gown, and said to me, “Jeffrey, I’m starving. Where can we eat?”

Another personal experience occurred at St George’s Hospital, Tooting, 11 years ago. I was taken there from where I was in the country when I had a heart attack, and it was quite an experience, although it is something that you know can happen. It was the first time that I had ever been in an ambulance. I had seen many ambulances but had never been in one. Because the driver had taken the wrong route, the advice given by the doctors who were waiting was that I had better have a clot-buster. I said to the guy looking after me in the ambulance, “What the hell’s that?” He said, “I’ve only done it once but I’m told that you had better have it. But you must read a form first because of the chance that you won’t make it”. So I had it and I made it, and my experience of the National Health Service on those two occasions is that its staff must be the most trusted people in our society and, if I may say so, the most loved.

Years ago, the late Lord Goodman, with whom I founded Motability, was asked by Barbara Castle to examine the funding position of the National Health Service. He carried out that report and I saw it at the time. At its conclusion, he said, “My strong advice is that you should charge £5 a night for every hospital bed”. If you looked at the figures, you would have seen that that was meaningful. Sadly, it was turned down.

One of my companies built hospitals, and one knows, sadly, the way in which the management change the plans so many times so that the overruns and costs become extraordinary. It is my view that, on the management side, a great deal can be done.

Nearly 20 years ago, when Labour was in power, I was asked whether I would be prepared to look into the health service. I said that I would do it only if it was not a royal commission that would be kicked into the long grass but was done on an all-party basis and I could choose the members of the committee. Sadly, it was turned down and so I never had that experience.

The noble Baroness, Lady Meacher, mentioned the blame culture. Having wandered around the health profession and mixed with a lot of people there, I know that that culture is having a devastating adverse effect on morale and inhibits positive progress and action being taken by managers.

At the start of the debate, the noble Lord, Lord Patel, said that the National Health Service should be free at the point of need. I agree with that, but what I do not agree with is the misuse of the health service and it being taken for granted. Let me give an example. I have talked to people about the number of no-shows in out-patients and those wasting time by turning up at the emergency ward. I have spoken about this with senior registrars in three hospitals and my noble friend Lord Bridgeman will talk later about the views and role of GPs and doctors themselves. In practice, one-third of people who turn up have no need of any medical help and should have stayed at home and one-third should have been treated by a nurse or gone to a chemist. Others will go into this in much greater detail, but in my view the GP is the key factor for what will happen in the future.

My final point is on the NAO. I am not sure that the views of the NAO are right. Putting the care of the elderly under one umbrella may not be the right answer. I am particularly interested in what happens because I am heavily involved in this area and that of the mentally disabled. I find that people want time and they suffer from loneliness. It is not just about care: loneliness must come into the thinking on this.

I will finish by telling the Minister about one aspect of charging. When people get things totally for free—I have found this myself in the past—they do not value them in the same way as when they have put something into it themselves. You should pay £10 a visit to go to the doctor and if you do not turn up at out-patients you should pay £10. That would help enormously. The important point is that people need to value things, and they will do so if they have put in something themselves.