Hospitals: Delayed Discharges
Debate between Baroness Blake of Leeds and Lord Laming
Baroness Blake of Leeds (Lab)
I reassure the noble Lord that the Department of Health recognises the issues that he raises. That is why £2 billion is being put into NHS digital transformation to modernise systems, expand the use of electronic patient records and improve productivity across the service. It simply is not good enough that the reasons he outlines are causing delays. We are determined to improve these areas to speed up the process and ensure that people do not fall through the gaps, as we have seen too often.
Lord Laming (CB)
My Lords, the report in the Question is most welcome, but I am sad to say that it is the latest in a long line of similar reports, all recognising that the NHS will continue to be at risk until social care is sorted out, not least because the NHS is free at the point of delivery whereas social care is means-tested. When will the Government—of any kind—agree to tackle this issue of social care? It is serious and will get worse.
Baroness Blake of Leeds (Lab)
The noble Lord raises the importance of the Casey review, but we are not standing still waiting for the noble Baroness, Lady Casey, to report. We are making progress towards building a national care service, with around £4.6 billion of additional funding available for adult social care by 2028-29 compared with 2025-26. All of us in this Chamber know how important improving social care is. We are not going to improve the system until we move forward on this and make sure that we get the best services for our frail and elderly in particular.
Best Start Family Hubs
Debate between Baroness Blake of Leeds and Lord Laming
Baroness Blake of Leeds (Lab)
The noble Baroness touches on an important point: we need to build on the good things from the Sure Start model and the good things that came out of the family hub model, bring them together and analyse the way forward. On working with parents, the model has proved that parents coming in will often get confidence from other parents in the hub helping them with support. Working with professional support in the hub, they can then be signposted to special services to give them the support they need. I cannot be more precise than that because things will develop in different ways in different areas, but there is a real determination to take advantage of all the cross-cutting themes that can come out of this. Parental relationships are one of those areas.
Lord Laming (CB)
My Lords, the House will have been surprised by recent reports about the number of children who start school and are not fully toilet trained and have very poor command of language. Does that not illustrate how we must invest more in parental skills to help people who are not natural parents learn how to be good parents and provide this essential development at that stage in the child’s early life?
Baroness Blake of Leeds (Lab)
I completely agree with the noble Lord. We recently had a whole Question devoted to the issue of toilet training and preparedness for life in school. Talking to reception teachers, I think that some of the examples they give are really disturbing. We have been through a very difficult time with Covid, but bringing families together and sharing experience is a very good substitute, particularly in areas where the natural community support and support from extended family might not exist anymore. That is one of the reasons why this development is so important.
Early Years Education
Debate between Baroness Blake of Leeds and Lord Laming
Baroness Blake of Leeds (Lab)
The whole purpose of investing in this area is to increase access for families generally. It is crucial that the information that the noble Baroness raises is disseminated to as wide a number of people as possible. Evidence suggests that it is not just about the young people and children themselves; it is about the use of devices by the adults in their lives too. There is a huge amount to do, and a lot of emerging evidence, but increasing access and coming up with programmes of work has to be the way forward.
Lord Laming (CB)
My Lords, does the Minister agree that the mastery and development of language, spoken and written, needs to begin very early and be sustained through the early years? Children will not get that from a tablet. What they need is interaction with adults in order to develop learning skills—listening to stories being read, and the like. Will the Government ensure that parents are reminded that keeping a child occupied and quiet is not the main task, but rather it is to encourage the proper development of the child?
Baroness Blake of Leeds (Lab)
The evidence shows that children’s language skills at the age of five are the biggest indicator of later attainment and one of the strongest predictors of children’s overall school achievement and success on entering the workforce. It is about bringing parents together, whether through hubs or other means, and sharing experience of how you can have fun with children and young people—we have forgotten how to have fun, in many cases—and learning through play. In all of these things, we need to get back to the emphasis being on how children learn, what inspires them, and how they can go on to thrive.
Unpaid Carers
Debate between Baroness Blake of Leeds and Lord Laming(3 months, 4 weeks ago)
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Baroness Blake of Leeds (Lab)
I thank my noble friend for her long-standing commitment to the cause of unpaid carers and for contributing to strengthening their rights under the Health and Care Act 2022. I reassure her and the House that the Government recognise the concerns raised in the recent Carers UK report. The Hospital Discharge and Community Support Guidance states that NHS bodies and local authorities have a duty to involve parents and carers, including young carers, at the earliest opportunity in discharge planning for adults who are likely to need care and support. The Care Quality Commission is assessing local authority performance against the Care Act 2014. If the CQC identifies that a local authority has failed or is failing to involve carers in discharge planning, the Secretary of State can intervene.
Lord Laming (CB)
My Lords, I was told in a discussion with a carer coping with the day-by-day, hour-by-hour demands of looking after someone with severe dementia that when they got a hospital appointment, the doctor spent a great deal of time looking at the screen and firing off questions to the patient. Frankly, the patient did not recognise where she was, and when the carer intervened to help, they were made to feel that their only job was to act as chauffeur to get the patient to hospital. Surely the time has come to recognise the tremendous contribution of unpaid carers in our society, and to support them, value them and help them to feel valued.
Baroness Blake of Leeds (Lab)
The noble Lord, as always, goes right to the heart of the issue. I reassure him that, through the 10-year plan, all the issues that he has raised are recognised. Through all the aspects, enhancing the position of carers is paramount. It cannot be right to have the situation he outlined whereby the carer’s wishes, understanding and insights are not taken seriously. The golden thread running through all the planned improvements is that the rights of carers will be recognised. Through the My Carer app, for example, no medical professional can have any excuse for not recognising the vital role that they play.
Independent Commission on Adult Social Care
Debate between Baroness Blake of Leeds and Lord Laming(4 months, 4 weeks ago)
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Baroness Blake of Leeds (Lab)
I agree, and I would broaden that out to the whole emphasis on housing generally. Housing is a critical factor in the ability to thrive, to live independently and to move forward, but it is also about place and making sure that everyone has the opportunity to live near their supporters around them. This is a huge area of work. I hope that our commitment to improving housing in this country is known and understood, and this is a very important element of that.
Lord Laming (CB)
My Lords, it is a pleasure to follow the noble Baroness, Lady Monckton. Does the Minister agree that we are still writing off too many young people as unemployable because the focus has been on what they cannot do, rather than concentrating on what they would be enabled to do with the right kind of support and help? Does the Minister agree that we really need to change our attitude to be altogether more positive, creative and supportive, especially of these young people?
Baroness Blake of Leeds (Lab)
The noble Lord, as always, raises a fundamental point. One area that I have most concern about is that of transition. Some young people could be getting very valuable and profound support while they are of school age, but the transition into adulthood is where the gaps occur. We recognise this, and are working on a whole range of issues to make sure that they have opportunities. We need to make sure that every young person has the opportunity to thrive, whatever their background, whatever their health needs, and this Government are committed to do just that.
Independent Commission on Adult Social Care
Debate between Baroness Blake of Leeds and Lord Laming
Baroness Blake of Leeds (Lab)
My Lords, I think the answer is partly in the question. There have been so many reviews and inquiries, but none of them has come forward and got total ownership from across the House; that is part of the problem. All the work that has been done through those reports will be built on. I would never underestimate the noble Baroness, Lady Casey. It has been my great privilege to work with her for decades. She was responsible for introducing ASBOs for troubled families, as noble Lords may recall. This situation is complex. It needs to be tackled in depth. There are things that can been done quickly, which she will address, but it is critical that we let her do the work and use her skills to reach consensus, which, frankly, has been so plainly missing in all the work that has been attempted in the past.
Lord Laming (CB)
My Lords, the Minister will know that, as many more people are, thankfully, surviving longer despite having severe disabilities or illnesses, and as we are all ageing, there are more people living in the community than in hospitals who need continuing medical care and social support. The department is not just the Department of Health; it is the Department of Health and Social Care. In the light of what the noble Lord, Lord Young, just set out, can the Minister assure the House that, until the noble Baroness, Lady Casey, reports, health and social care will be given equal weight, and that social care will not be treated as a mere add-on to the health service?
Baroness Blake of Leeds (Lab)
The noble Baroness, Lady Casey, is working towards setting up a national care service that can work alongside the National Health Service. The noble Lord raises critical points. Given that so many people live with frailty and need in the community, it is essential that not only the NHS and social care but the voluntary sector and the wider community are involved. We have seen incredible benefits for our most vulnerable in areas that have managed this successfully. There is an enormous amount to do, as the noble Lord suggests, but we are up for the job.
Social Care
Debate between Baroness Blake of Leeds and Lord Laming
Baroness Blake of Leeds (Lab)
It will come as no surprise to the noble Baroness that we are looking at the recommendations of the Health and Social Care Select Committee report and will come forward with our responses. It is of course vital to look at the impact of the model that we have now on society, on the people involved and on the economy. The various debates we have had in this House in the time I have been here have picked that up and recognised the valuable contribution that carers make to the economy. We have to start taking the holistic view moving forward. That is why we have the commission: to look at all the different aspects, improve the situation and make progress.
Lord Laming (CB)
Does the Minister agree that the Government will not achieve their ambitions for the National Health Service without also having a well-developed and successful plan of development to make social care services easily accessible, properly trained and well respected? Do the Government have a development plan in mind for social care?
Baroness Blake of Leeds (Lab)
The noble Lord raises such an important point. I am sure he will also be thinking about the vexed issue of hospital discharge and all the issues that are creating such difficulties in the system. I emphasise that adult social care is part of our vision for a neighbourhood health service, shifting care from hospitals to communities, with the NHS working alongside local authorities, social care providers and the voluntary sector. I am sure we are all looking forward to the announcement of the 10-year health plan, looking at how we can move healthcare from hospitals to the community but recognising that all agencies out in the community have a vital part to play to make this story successful.