Social Care in England: Older People

Lord Watts Excerpts

Monday 20th March 2017 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness is quite right that there is a growing need for care for older people because of our ageing and growing population. I am sure she welcomes the additional funding announced in the Budget. It brings to over £9 billion the additional funding announced since 2015 for social care for the next three years, and that will make a big difference to meeting the kinds of care needs that she is talking about. She talked about the difference between the short term and the long term. That is why the other crucial part of the Budget announcement concerned the Green Paper. This will be ambitious in scope, with the intention of creating a fairer and more sustainable system of the kind I am sure she wants to see.

[Lord Watts (Lab)]

My Lords, does the Minister agree that the Government’s decision to cut spending to local authorities’ care services has created this crisis?

[Lord O'Shaughnessy]

Much more funding is now going into the social care system to reflect the additional needs of the ageing population. I am looking forwards in thinking about the extra £9 billion that will be provided. We also have over 150,000 more care workers helping people in the system, whether in residential care homes and nursing homes or at home through domiciliary care.

Mental Health: Children’s Services

Lord Watts Excerpts

Thursday 19th January 2017 Lords Chamber

[Lord O'Shaughnessy]

I could not agree more with those points, in the sense that money must get through to the front line. However, we have an NHS that is set up so that clinical decisions are made by clinicians rather than politicians, and that must be right, because the needs vary from area to area and different areas have different priorities. They have different historic legacies in terms of delivering their services. As for the direction that we give to schools and colleges, clearly the thematic review that the CQC and Ofsted are carrying out will provide advice on what works. We are also introducing some randomised control trials to look at interventions that work, so we have a proper evidence-based system. The commitment is to get 70,000 more young people having evidence-based treatments by 2021.

[Lord Watts (Lab)]

My Lords, is it not clear that the present system of “hands off” is not working? People working in this service are desperate to make sure that the Government take action to ring-fence this funding so that vulnerable children are not put at risk.

Young People: Self-Harm

Lord Watts Excerpts

Tuesday 6th December 2016 Lords Chamber

[Lord Prior of Brampton]

I think the right reverend Prelate has raised an incredibly important issue. Around 300,000 young people go to A&E every year through self-harm, after cutting or burning themselves very badly. The right reverend Prelate asked about advice and guidance. In 2004, NICE put out explicit guidance that all those people should receive, at the very least, a psychosocial assessment; today, only 53% of those people—young people in the main—receive such an assessment. That means that 100,000-plus people are going to A&E with this very nasty self-harm and are really being sent home with very little. That is quite an indictment of our system and the words that we have about parity of esteem. I entirely take on board exactly what the right reverend Prelate said. There is a lot more we can do, and perhaps in response to subsequent questions I shall try to say what we are doing.

[Lord Watts (Lab)]

The Minister will know that the mental health service is in crisis. He says on a regular basis that the Government are putting more resources into the area of mental health for young people. He also knows that that money is not getting spent by the trusts. When is he going to sack the trusts, or sack the chief executives of the trusts, for failing to spend that money on vital services for young people?

[Lord Prior of Brampton]

Last year, the rate of spend by CCGs on mental health went up by 8.6%, compared to 3.7% across the board, so the money is starting to get through. The fact is, though, that there are nooks and crannies in our NHS—which we all love—where we have fundamentally let people down for many years. The issue of self-harm and the suicide risk that derives from self-harm is a very black hole at the heart of the NHS.

Children: Oral Health

Lord Watts Excerpts

Monday 31st October 2016 Lords Chamber

[Lord Prior of Brampton]

The noble Baroness is right to say that childhood oral health is very poor, but it is getting better. Some 75% of children no longer have tooth decay compared with 69% in only 2008, but it is still not good enough. The Government’s policy is very much around prevention rather than treatment. The new contract being discussed with dentists will put this work on to more of a capitated basis rather than an activity basis. NHS England has identified 10 areas of deprivation for special treatment and we are looking at a new programme with Public Health England to improve education in this area. Quite a lot is happening.

[Lord Watts (Lab)]

My Lords, surely the way to prevent this is by introducing fluoride into the water supply and to ignore those people who think it is a bad thing. Does not all the evidence seem to suggest that it would be very good, especially for deprived communities?

[Lord Prior of Brampton]

My Lords, the evidence for fluoride is incontrovertible: it is good for teeth. There may be other issues attached to fluoride, but in terms of dental health it is unquestionably a good thing. It is interesting to note that in Birmingham, which has been adding fluoride to its water for many years, the incidence of child tooth decay is 29% whereas in Blackburn it is 57% and in Hull, which is considering fluoridation, it is 37.8%. The evidence is very strong, but it is up to local authorities to decide.

Mental Health: Young People

Lord Watts Excerpts

Tuesday 11th October 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, I do not think I can answer the question about who will fund the training; I will write to the noble Baroness to answer it. She is absolutely right that a huge proportion of people who are in the criminal justice system, in prison, also suffer from mental health problems. Tackling the mental health problems of people in prison is just as important as tackling them outside. If I may, I shall write to the noble Baroness on this matter.

[Lord Watts (Lab)]

I must tell the Minister that there is very little sign of any investment in mental health services taking place in Merseyside. Will he investigate what is happening to that investment strategy and why Merseyside is failing our children and failing to invest in this vital service?

[Lord Prior of Brampton]

My Lords, I am obviously disappointed to hear what the noble Lord says about Merseyside; I cannot answer specifically on Merseyside today. We have the Future in Mind strategy, which pledged £1.4 billion of extra spending over the lifetime of this Parliament for children and young people. If it is not reaching the front line in Merseyside, we should look at that.

NHS: Junior Doctors’ Contract

Lord Watts Excerpts

Wednesday 6th July 2016 Lords Chamber

[Lord Prior of Brampton]

No, I do not agree with that. Where I do agree with the noble Baroness is that this has gone on for far too long. We have been in discussion on this issue for nearly four years. It has got to come to a resolution, so the Secretary of State is absolutely right to introduce this new contract.

[Lord Watts (Lab)]

My Lords, what would the Government do if large numbers of junior doctors decided to resign rather than accept the new contract?

[Lord Prior of Brampton]

There is no indication that large numbers of junior doctors are resigning because of the introduction of this new contract. If it does happen, we will have to address that issue when it occurs.

Health: Diabetes and Obesity

Lord Watts Excerpts

Thursday 30th June 2016 Lords Chamber

[Lord Prior of Brampton]

I entirely endorse the words of the noble Baroness, which I am sure will be reiterated in the obesity strategy when it is announced later in the summer.

[Lord Watts (Lab)]

My Lords, does the Minister agree with me that far too much attention has been given to sugary drinks, the consumption of which has been in decline for the past 10 years, and not enough attention given to other unhealthy foods that are causing the problems?

[Lord Prior of Brampton]

I think that the levy on sugary drinks has been universally welcomed as a start. That the proceeds of the levy will be put into the sport premium in primary schools and lengthening the school day in secondary schools is all for the good. If we are to address obesity, it has be across a very wide front.

Carers over 80: Support

Lord Watts Excerpts

Monday 13th June 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, under the Care Act there is an assessment, eligibility criteria and a support plan. Clearly there is no point having a plan without the support.

[Lord Watts (Lab)]

My Lords, will the Government consider setting up an independent review to look at the sorts of budgets that local authorities will require to provide a decent service?

[Lord Prior of Brampton]

As part of the consultation that is being conducted in preparation for the publication of the strategy at the end of the year, the Government have called for evidence, looking at international comparisons as well as an economic review, which I am sure will take into account the issues the noble Lord raises.

Health: Alcohol

Lord Watts Excerpts

Thursday 12th May 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, traffic accidents caused by alcohol have been costed. I cannot give the noble Baroness that figure today but I will write to her with it. I do not believe that we are currently reviewing the alcohol limit for driving, although I know that in Scotland it has recently been reduced.

[Lord Watts (Lab)]

My Lords, have the Government considered using the tax system to encourage people to drink lower-alcohol drinks?

[Lord Prior of Brampton]

That is a very good question. I do not have the answer to hand but I would like to think about that and write to the noble Lord. As part of the responsibility deal that was done with the industry in 2010, there has been a significant increase in lower-alcohol drinks, but I will have to come back to the noble Lord on that issue.

Junior Doctors: Contract

Lord Watts Excerpts

Thursday 5th May 2016 Lords Chamber

[Lord Prior of Brampton]

No; the noble Lord has misunderstood the contract. The number of hours are coming down, not going up.

[Lord Watts (Lab)]

My Lords, the Government are pursuing a policy which is not evidence-based and is driven by dogma. Would it not be better to seek arbitration to get us out of the mess they have got us into?

[Lord Prior of Brampton]

My Lords, we now have a pause for five days. This is not dogma; we have two parties who have different views about a small part—about 10%—of the existing contract. Over the next five days we have a chance to resolve that.