Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) (No. 2) Regulations 2021
Baroness Chisholm of Owlpen Excerpts(4Â years, 9Â months ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
My Lords, I will make a Statement on measures to make sure that our health and care system is as safe as possible in the battle against Covid-19 by making vaccination a condition of deployment for more health and social care settings.
Across the UK, the overwhelming majority of British people have played their part by getting vaccinated against Covid-19. Over 81% of people over the age of 12 have had two doses, a figure that rises to around 91% when you look at NHS staff. The impact of this outstanding vaccination effort is clear. The UK Health Security Agency estimates that at least 127,000 deaths and 24 million infections have been prevented as a result of the Covid-19 vaccination programme. In addition, around 260,000 hospitalisations have been prevented in those aged 45 years and over.
But we still need to do more. Uptake rates vary between different health and care organisations and across the country, and, despite the incredible effort to boost uptake across the country, over 94,000 NHS staff are still unvaccinated. It is important that our health and care staff get jabbed to protect the vulnerable who are in their care and to protect the NHS workforce in the wake of new variants, such as omicron. We made vaccination against Covid-19 a condition of deployment in care homes from 11 November this year. Contrary to initial fears, we are not aware of any care home closures where vaccination as a condition of deployment has been the primary cause.
Today, we are putting before your Lordships the regulations to extend this requirement to health and other social care settings, including NHS hospitals and GP and dental practices, regardless of whether a provider is publicly or privately funded. Anyone working in health or social care activities regulated by the Care Quality Commission will need to be vaccinated against Covid-19 if they are deployed to roles that have direct contact with patients or service users, apart from a few limited exemptions—for example, for medical reasons.
I hear the concerns that have been expressed or raised about the impact of these measures on the workforce, especially during these winter months. For this reason, we are allowing a 12-week grace period to give people the chance to make the positive choice to get protected. We are committing to enforcement of the requirements by 1 April next year, subject to the will of Parliament.
We are also increasing the number and diversity of opportunities to receive the Covid-19 vaccine, using the booster campaign to make the most of walk-ins, pop-ups and other ways to make sure that people are getting the vaccine as easily as possible. The NHS has already written to all providers providing early guidance, setting out what vaccination as a condition of deployment means for the system, as well as advising on next steps to boost uptake and help to ensure smooth implementation. After consulting on the policy in September, we have seen a net increase of over 55,000 NHS staff vaccinated with a first dose.
These steps complement key interventions that we have made to support services, including bolstering capacity across urgent and emergency care and the wider NHS, including with a ÂŁ250 million investment in general practice, ÂŁ55 million for the ambulance service and ÂŁ75 million for NHS 111, and publishing an adult social care winter plan, including ÂŁ388 million to support infection prevention control and ÂŁ162.5 million for workforce recruitment and retention. In addition, we have invested ÂŁ478 million for support services, rehabilitation and reablement care following discharge from hospital, and we are ensuring that health and social care services are joined up.
Although the Government believe that these measures are a proportionate way of protecting those at greatest risk, we recognise that some noble Lords have asked whether we should or would extend these measures even further. So let me state clearly that although we have seen plans for universal mandatory vaccinations in some countries in Europe, we do not support them here. The Government have no intention of extending condition of deployment to other workforces or introducing mandatory vaccination more widely.
At this point, I would like to address head on some of the concerns your Lordships may have regarding concerns raised by the Regulatory Policy Committee and the Secondary Legislation Scrutiny Committee about these regulations. I sympathise with noble Lords who are concerned with some of the procedural aspects of the passage of this legislation, but in unprecedented times such as these it is right that the Government do everything in their power to protect the vulnerable.
The Government have responded to the concerns raised by the Regulatory Policy Committee and the Secondary Legislation Scrutiny Committee as quickly as possible and have provided further information to your Lordships, including on the actions on workforce capacity—as I have set out—and the steps we are taking in collaboration with the NHS and adult social care sector to mitigate the risks to small business, which is of particular concern to the Regulatory Policy Committee. An updated Explanatory Memorandum has been provided to Parliament, and the department’s consideration of the RPC’s concerns has been published on the government website.
The updated Explanatory Memorandum provides further information on the scientific and clinical rationale for the policy, the exemptions that have been provided and those not provided, and the steps we have taken to further encourage uptake of vaccinations and to mitigate workforce issues. The Secretary of State also wrote to all Peers on 10 December to set this out.
In these difficult times, we have seen the very best of those who work in health and care. We have seen care, compassion and conscience. Noble Lords across the House continue to pay tribute to the heroic responses across the health and care sectors. Today’s Motion is about protecting not only health and care staff but the patients in their care. By protecting patients and staff, we protect the NHS from being overwhelmed. I commend this Statement to the House.
Baroness Chisholm of Owlpen (Con)
My Lords, I just want to make a quick adjustment: we are of course debating the Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) (No. 2) Regulations 2021.
Amendment to the Motion
Health Protection (Coronavirus, Wearing of Face Coverings) (England) Regulations 2021
Baroness Chisholm of Owlpen Excerpts(4Â years, 10Â months ago)
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Lord Kamall (Con)
The UK Health Security Agency continues to monitor the situation closely in partnership with scientific and public health organisations across the world. Covid-19 is not going away and so we are likely to keep seeing new variants emerge. If we want to learn to live with the virus, we must follow the scientific evidence and advice and act in a proportionate and responsible way if a variant has the potential to thwart our progress. As we do this, we are taking a well-rounded view, looking not just at the impact of these measures on the virus, but on the economy, education, and non-Covid health, especially mental health. I am confident that the responses we set out today are balanced and responsible steps that are proportionate to the threat we face.
Covid-19 Vaccinations
Baroness Chisholm of Owlpen Excerpts(4Â years, 11Â months ago)
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Baroness Chisholm of Owlpen (Con)
Will the noble Baroness ask her question and sit down? She is preventing other people from asking questions.
Baroness Uddin (Non-Afl)
My Lords, will the Minister agree that incredibly important environmental safeguards continue to be required to prevent children catching Covid and to empower parents with sufficient information so that they can make informed choices?
Covid-19 Update
Baroness Chisholm of Owlpen Excerpts(4Â years, 11Â months ago)
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Lord Kamall (Con)
My Lords, I thank the noble Lord and noble Baroness for their questions, and I will try to clarify some of the issues. I also thank the noble Lord for his acknowledgement of my newness to the job and for giving me some bandwidth on it, if that is fair enough.
Let me be quite clear on the questions that were asked in terms of threshold. There is no pre-set threshold for considering plan B; we consider a range of evidence and data—as we have done throughout the pandemic—to avoid the risk of placing unsustainable pressure on the NHS. For example, while the number of Covid-19 patients in hospital is an important factor, the interaction with other indicators, such as the rate of increase in hospitalisations and the ratio of cases to hospitalisations, will also be vital. We will need to make a judgment on whether plan B is necessary based on the interaction of all those indicators, and informed by advice from the Government’s scientific and clinical experts—I will come to that question later. As I have said, we have an effective vaccine and much-improved treatments, so we are not where we were last winter.
The Government’s objective is to avoid a rise in Covid-19 hospitalisations that would put unsustainable pressure on the NHS. The Government will monitor all the relevant data on a regular basis to ensure that we can act if there is a substantial likelihood of this happening. The Government monitor a wide range of Covid-19 health data which, to give a taste, includes cases, immunity, the ratio of cases to hospitalisations, the proportion of admissions due to infections, the rate of growth in cases and hospital admissions in the over-65s, vaccine efficacy and the global distribution and characteristics of variants of concern.
In assessing the risk to the NHS, the key metrics include hospital occupancy for Covid-19 and non-Covid-19 patients, intensive care unit capacity, admissions in vaccinated individuals and the rate of growth of admissions. The Government also track the economic and societal impacts of the virus to ensure that any response takes into account these wider effects. We also monitor a range of metrics on other NHS pressures, including winter respiratory hospitalisation rates, influenza, urgent and emergency care pressures, elective activity and ambulance response times.
A number of noble Lords asked, “So what is the plan for autumn and winter?” The Government’s plan includes building our defences through pharmaceutical interventions, including vaccines, antivirals and disease-modifying therapeutics; identifying and isolating positive cases to limit transmission—test, trace and isolate; supporting the NHS and social care, including managing pressures and recovering services; advising people on how to protect themselves and others through clear guidance and communications; and pursuing an international approach, helping to vaccinate the world and managing risks at the border.
Of course, we have had to prepare contingency measures for if the various indicators and the range of scientific advice that we receive suggests that we have to move to plan B. The measures include: mandatory vaccine-only Covid status certification in certain riskier settings; legally mandating face coverings in various settings, such as public transport and shops; and communicating clearly and urgently to the public if the risk level increases. The Government may also consider asking people to work from home again, if necessary, but, once again, a final decision on this would be made at the time, dependent on the latest data and recognising the extra disruption this causes to individuals and businesses. The message is clear: we prefer not to go to plan B. We prefer to rely on informed choice, but we might have to go to plan B, if cases rise.
I was asked questions on some statistics. Some 49.5 million people had been given a first dose by the end of 19 October, and almost 45.5 million people had been given a second dose. More than 4 million boosters and third doses have been administered so far, including to one in three health and care workers who are eligible. But there is more to do: 5.5 million people have been invited for their booster so far, and another 1.9 million people will be invited this week, as they have become eligible over the last few days and weeks.
Looking at NHS pressures, we are working with NHS England, which is leading work with NHS providers, regions and stakeholders to ensure that robust operational plans are in place for the winter, including plans to meet potential increases in demand for emergency care driven by seasonal flu and Covid-19. To further protect the NHS this winter, we are also carrying out the largest ever seasonal flu vaccination, alongside Covid-19 booster vaccines for priority groups. The NHS will also receive an extra ÂŁ5.4 billion over the next six months to support its response to Covid-19.
The noble Baroness asked about boosters in care homes. We are committed to ensuring that those who are most vulnerable receive their booster jab as soon as possible after they become eligible. That of course means that care homes are a priority. Vaccination teams have already visited over 40% of all care homes in England, and we expect thousands more to have either received a visit or have a date for a visit scheduled in the coming weeks. The latest figure I have, from a few days ago, is that 40% of care homes—in addition to the 40% where boosters have been received—have booked a visit. That leaves a 20% gap, which we are continuing to look at and work on. Some, for reasons of local outbreaks, cannot yet receive a visit, but we are very clear that 80% are on plan and we are looking at how to narrow that 20% gap.
The noble Lord referred to the NHS booking system. I was not aware of the problem, so I thank him for bringing it to my attention. I will investigate and get back to noble Lords, but I am afraid I do not have the answer at my fingertips. I am sure the noble Lord will appreciate that.
The noble Lord also asked about NHS capacity. The NHS can respond to local surges in demand in several ways, including through expanding surge capacity in existing NHS hospitals, mutual aid between hospitals, and making use of independent sector capacity and accelerated discharge schemes.
I apologise to noble Lords that I am over time. All I will say to finish off, in answer to the question about our scientific advice, is that we have confidence in SAGE. I was also asked who we listen to. Our approach has always been informed by scientific and medical advice, using the latest data. We take advice from the Chief Scientific Adviser, the Chief Medical Officer, the UK Health Security Agency, the NHS and others, which remains valuable. As always, scientific experts have contributed directly to ministerial discussions.
Social Care in England
Baroness Chisholm of Owlpen Excerpts(4Â years, 11Â months ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
My Lords, I thank the noble Baroness, Lady Pitkeathley, for securing a debate on such an important subject. I also thank the noble Baroness, Lady Donaghy, for her commiserations on my having this post. I pay tribute to the noble Baroness, Lady Pitkeathley, for the experience she brings to the debate today, including her contribution to carers as former chief executive of Carers UK and her work in the voluntary sector, being a founding member of the Association of Chief Executives of Voluntary Organisations and chair of the New Opportunities Fund—one of the National Lottery distributors.
I am sure we all wish to recognise and thank the social care workforce, both paid and unpaid, and many noble Lords have done so in their tributes today. We should thank them for the work they do in care homes, in people’s homes and in day services, day after day, week after week and month after month.
I also thank the noble Baroness for her thoughtful comments and the well-argued case she has put before the House. We have heard many moving testimonies from across the Chamber. As noble Baronesses have said, this pandemic has provided a once-in-a-generation challenge for this country. There is no getting away from the fact that the past 18 months have been incredibly tough for social care. The challenges have been unprecedented—what Nassim Nicholas Taleb would describe as a black swan event. Many people, not only in the UK but in many other countries, have lost loved ones because of the virus. Our hearts go out to each and every one of them. It demonstrates the importance of this debate today.
I thank the noble Baroness for summing up the numbers that we should all be aware of: 9 million unpaid carers before Covid, 4.5 million new carers, totalling 13.5 million—including 2.5 million who are holding down jobs. I also thank the right reverend Prelate the Bishop of Oxford for his quote from one of the 10 commandments. I am sure he will agree that people of many other faiths and no faith also agree very strongly with the importance of parents and looking after our loved ones as they get older.
Many have said that it has been a real challenge, and we agree. As the Prime Minister said,
“we are … committed to learning lessons”—[Official Report, Commons, 12/5/21; col. 138.]
from the pandemic. When the pandemic hit, the Government worked hard to ensure that the sector got the support it needed as quickly as possible. The Government published guidance tailored to care homes and care providers, domiciliary care, unpaid workers and local authorities on how to continue to safely provide care during the Covid-19 outbreak. We rolled out regular testing for the sector and have sent more than 42 million PCR swab test kits and 117 million lateral flow devices to care homes to date. We set up a massive PPE supply chain from scratch and, through the PPE portal, have provided over 3.6 billion items of free PPE for providers’ Covid-19 needs, and, since April 2020, more than 478 million items through local resilience forums and local authorities.
The Government also moved as quickly as possible to provide financial support to the sector, making available almost ÂŁ2.4 billion in specific funding for adult social care throughout the pandemic. This is in addition to over ÂŁ6 billion that has been made available to local authorities to address pressures on their services. Many noble Lords spoke about the importance of local authority funding.
Crucially, we have provided health and care workers and older residents with vaccines. From 11 November, vaccinations will be a condition of deployment for care home staff. I know many will want to reflect on this point. It is worth noting that many staff—the vast majority of care home staff—have been vaccinated. It is our responsibility to do as much as we can to encourage others to be vaccinated to reduce the risk in our care homes. I know if I had a relative in a care home, I would feel much better if they were cared for by someone who had been vaccinated. I hope that across the House we can encourage more care workers to be vaccinated. Of course, there are some who are unable to be vaccinated for medical reasons and we should address their concerns too. Those people should call 119 to apply for a medical exemption.
As noble Lords can see, the Government have provided a huge number of resources to the sector to deliver better care. Of course there will always be a debate on whether the spending is enough. I have heard from across the House how many have responded to the numbers suggested. Looking to the future, the Government will maintain support, both in the short term to address the impact of Covid-19 and, more crucially, in the longer term through the social care reforms. In the short term, the sector will be supported by continuing to be provided with free PPE to protect against Covid-19 until the end of March 2022. This is also extended in designated settings, backed by the extension of the designated settings indemnity support scheme, to March 2022, so that no patient who has tested positive for Covid in the past 14 days is discharged from hospital to a care home.
In addition, in September, the Government announced an additional £388 million to prevent the spread of infection in social care settings. This package includes funding for infection control measures, as some have spoken about, £25 million to support care workers to access Covid-19 and flu vaccines over the winter months, and funding for testing costs, allowing testing to continue for staff, residents and visitors, to ensure that residents can see their loved ones as safely as possible. As part of the preparations for winter, plans are being developed in conjunction with the NHS and social care sector stakeholders. This will draw on the recommendations of Sir David Pearson’s review of last year’s winter plan, advice from SAGE and UK HSE, and—more importantly—on the lessons learned so far in the pandemic.
Our country’s social healthcare system has never been under such pressure as it has been over the past year. Many noble Lords have spoken about the pressure. The coronavirus pandemic posed unprecedented challenges to the sector, so we all agree that we must address the long-term future of social care in this country.
Many people have said that this issue has been live for a number of years. The noble Baroness, Lady Tyler, spoke of social care having been “in the shadows” for many years; the noble Baroness, Lady Warwick, said that people have been talking about this for years; the noble Lord, Lord Lipsey, spoke of the 1999 minority report. However, this debate has been going on for much longer. It has been decades—I think someone said 50 years. If we are honest about it, various experts have warned for decades that the combination of an ageing population and increased life expectancy poses a real challenge to social care. What happened? The debate continued, more think tank reports were produced, other reports were produced, and parties published suggestions in their manifestos. But in reality, all of these were placed on the shelf and just gathered dust, while successive Governments, of all colours, kicked the proverbial can down the road.
The Prime Minister decided that his Government would not shirk the responsibility and stepped up to publish a plan, Build Back Better: Our Plan for Health and Social Care, pledging an extra ÂŁ5.4 billion over three years for social care. I also thank my noble friend Lord Astor for his comments on a bolder programme of reform. We need to make sure that, whatever additional funds are provided, there is reform, so that the public can have confidence that the additional funds will be well spent.
The Prime Minister’s September announcement was an important step on the journey to reforming adult social care. Of course there will be debate—any reform or change leads to debate. I worked for many years in organisational change and know that any change always generates a large debate. There are some short-term winners and losers—many people will clearly claim that they have lost out and others will gain, but, quite often, the gainers are not as vocal as those who have lost out, and rightly so. We should address those who have genuine concerns. It is really important that we learn from many of the concerns across the House today.
The Prime Minister’s announcement showed a real commitment to delivering world-leading health and social care across the whole of the UK. As we speak, details are being discussed in preparation for a White Paper on reforming adult social care, to be published later this year, as the noble Baroness, Lady Wheeler, pointed out in her intervention. We hope that the reforms will make a real difference to front-line adult social care. This includes both care users and the dedicated care workforce, who have been so brilliant throughout the pandemic.
We also know that there has been a debate over whether funding should come from general taxation or national insurance contributions. Having looked at this debate when I was head of research at a think tank, I have seen a range of views across the political spectrum—there are even some who have asked why people should not sell their homes to fund their care. So you can imagine the range of views that we have heard and read over many years. We really hope that these reforms will make a difference. While there is a range of views, I will outline some of the proposed reforms that we hope will deliver better care for adults of all ages.
First, the ÂŁ86,000 cap on care costs, funded by a health and care levy, means that, for the first time, everyone will have protection from unlimited costs. There are those who have prudently saved for their old age and who have been hit hard by the unpredictable costs associated with their health and care needs; currently, one in seven faces fees of over ÂŁ100,000.
Secondly, individuals with limited or no savings will be safeguarded by a more generous means test. The increase in the upper capital limit from ÂŁ23,250 to ÂŁ100,000, and in the lower capital limit from ÂŁ14,250 to ÂŁ20,000, means that the number of adults receiving some state support will increase from around half to two-thirds. In short, some people who need care, and their loved ones, will have the certainty of support when it is needed and will not have to live in fear of unpredictable costs.
In wanting to propose the fairest reforms possible, the Government decided to fund these measures with a new UK-wide health and social care levy. The Government are absolutely clear that we should not pass on the costs to future generations and increase public debt even further. There is much debate over this, but, by using national insurance contributions, the Government are ensuring that both businesses and individuals contribute. Those who are earning more will pay more. It has a clear UK-wide approach, meaning that everyone pays the same, wherever they live in the UK. In addition, by extending the levy to those working over the state pension age from April 2023—many will of course complain, and I understand that—the Government have listened to those concerns and balanced them with intergenerational justice. Many young people have asked why they are being asked to pay for people. We need to make sure that individuals of all ages play their part.
However, we should also recognise that this is not just about the over-65s. In adult social care currently, over half of all state spending goes towards under-65s—so working-age people will also benefit from limits on what they have to pay if they need care for themselves in later life. This was considered consistent with the contributory principle for national insurance contributions, whereby working-age employees pay these NICs and this gives them access to contributory benefits when out of work, including the state pension.
I will turn to the paid social care workforce, which many of us have paid tribute to. We have listened to the sector and prioritised the adult social care workforce, recognising their tireless commitment and dedication during the pandemic. The noble Baroness, Lady Finlay, spoke movingly about the hospice movement and the work/life balance that we want to see. Many people have asked what is being done to ensure that working carers can balance their caring responsibilities with work. The Government are committed to promoting the benefits of retaining unpaid carers in the workforce, for both the carer and the employer. The Government’s response to the consultation on carers’ leave confirms their intention to deliver on the manifesto commitment to introduce a new entitlement to one week of leave for unpaid carers. This will be a day 1 right, available to all employees who are providing care to a dependant with long-term care needs. I will obviously send more details to any noble Lords who would like them.
The noble Baronesses, Lady Pitkeathley and Lady Finlay, and my noble friend Lord Astor and others mentioned spending. We need to make sure that the Build Back Better plan for health and social care sets out an intention to make care work a more rewarding vocation. Many noble Lords have spoken about this. We need to offer a career where people can develop new skills and take on new challenges as they become more experienced. The Government are committed to spending at least ÂŁ500 million over three years to deliver hundreds and thousands of training places and certifications, pathways, and well-being and mental health support. This workforce package is a significant investment that will support the development and well-being of the workforce. I hope that that partly answers some of the questions of the noble Lords, Lord Bichard and Lord Sikka, and the noble Baroness, Lady Pitkeathley.
We will continue to support the social work fast-track programmes Step Up to Social Work and Think Ahead, designed to support those wanting to change specialism to become a social worker and make a real difference to people’s lives. As one noble Lord said today, this is an incredibly noble profession. We will continue to introduce further reforms to improve recruiting and support for social care, with more details in the forthcoming White Paper. I am as eager as anyone in this House to see that paper, so that we can have a proper cross-party discussion on the reforms that are much needed.
Speaking as Minister for Technology, I will touch on one of the points that many have raised. I have made digitisation and data sharing one of my key priorities, as Minister for Technology, Innovation and Life Sciences. I hope that digital technology will play a key role in helping adult social care workers to do their jobs even more effectively.
However, we should also recognise the vital role of unpaid carers, as many have said, including the noble Baronesses, Lady Warwick and Lady Tyler. We want to build a system of care to better support unpaid carers, as well as helping recipients of care to have more choice and control over their lives, what they do and how they choose to live. Throughout the pandemic, the Government have taken a number of steps to support unpaid carers, such as funding charities that support carers, producing Covid-19 guidance tailored for carers, helping carers self-identify and ensuring access to and priority for PPE and vaccinations. The Government will work with representatives across the sector, including those who represent carers, to develop more detailed plans for social care reform together, ensuring that unpaid carers receive the support, advice and respite that they need.
As the noble Baroness, Lady Wheeler, said, there is an incredible amount of expertise in this House, and that has come through in the many contributions to today’s debate. I will work with noble Lords across the House as the health and social care Bill goes through it.
I am not sure how much longer I have.
Lord Kamall (Con)
Thank you. Noble Lords will have to forgive the new boy. Now someone is saying I have two minutes—there we are.
There are many questions I wanted to go through in detail, so I hope noble Lords will accept my apologies for being too verbose in many ways and not answering the detailed issues. I will write to noble Lords on any particular points. Clearly, I do not have a realistic estimate of my speaking time—let us put it that way.
Once again, I thank the noble Baroness, Lady Pitkeathley—
Health Protection (Coronavirus, Restrictions) (Steps etc.) (England) (Revocation and Amendment) Regulations 2021
Baroness Chisholm of Owlpen Excerpts(5Â years ago)
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Lord Bethell
That the Regulations laid before the House on 15 July and 19 July be approved.
Relevant document: 11th Report from the Secondary Legislation Scrutiny Committee. Considered in Grand Committee on 14 September.
Baroness Chisholm of Owlpen (Con)
My Lords, on behalf of my noble friend Lord Bethell and with the leave of the House, I beg to move the three statutory instruments in his name en bloc.
Covid-19: Obesity
Baroness Chisholm of Owlpen Excerpts(5Â years, 5Â months ago)
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Lord Bethell (Con)
The right reverend Prelate puts the case extremely well. The community kitchen measures she describes are beyond my brief. I do not have the details to hand, but I should be glad to follow this up and write to her.
Baroness Chisholm of Owlpen (Con)
My Lords, as we know, there are no real redeeming features to Covid but, my goodness, it has managed to magnify the obesity problem in this country. As my noble friend said, it is a real wake-up call. Does the Minister feel, like me, that we have had enough initiatives that last for a period and then disappear without any real success? Is it time to put someone in charge of this serious health problem who has time and real clout to take on the food industry, tackle the root causes and work with all government departments to deliver change?
Lord Bethell (Con)
I do agree with my noble friend that the answer to this issue is sustained action. This is not something where snazzy initiatives are going to have the necessary impact. But the key to our efforts is creating cross-governmental co-ordination—that very difficult thing to achieve. We are working extremely hard with other departments, particularly with DCMS and DCLG, in order to address the kind of housing, cultural, advertising and nutritional issues at the heart of this problem.
Social Care
Baroness Chisholm of Owlpen Excerpts(5Â years, 11Â months ago)
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Baroness Chisholm of Owlpen (Con)
My Lords, technology innovations have been used by healthcare professionals in the community during the pandemic. Really, they have flourished and have been shown to be of great benefit to social care. Will the Minister reassure the House that, during the reform of social care, funding is put forward for those innovations to carry on and indeed grow to their full potential?
Lord Bethell (Con)
My noble friend is entirely right. One of the experiences of Covid has been the mobilisation of technology to help those in social care. That has ranged from very basic implementation, such as sending iPads to people in social care so that they can message and video their loved ones when in some form of lockdown, to the work done with broadband providers to ensure that those without it can have access to it, all the way through to the use of the most complex artificial intelligence and big data, to help with diagnosis in social care, and the management of care itself. That commitment to technology will continue and will form an important part of improving the commitment to social care as part of the new regime.
Hospitals and Nursing Homes: Do Not Resuscitate Notices
Baroness Chisholm of Owlpen Excerpts(6Â years ago)
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Lord Bethell (Con)
My Lords, I completely agree with the noble Baroness’s sentiments—so does the department and so do the Government. We have noted what happened during the Covid epidemic. The CQC is investigating potential lapses at that time. We have reinforced guidance in the winter plan and the CQC continues to review the situation. New training and guidance provisions are being put in place. We take the situation extremely seriously and are putting in the procedures and investment necessary to ensure the right outcome.
Baroness Chisholm of Owlpen (Con)
What training is being given to physicians and healthcare workers for when they discuss DNR with patients and next of kin?
Lord Bethell (Con)
The department is aware of the Queen’s Nursing Institute report on training and, although the majority of responses were positive, it raised questions about the training of, in particular, care home staff on the instruction to change resuscitation orders for patients without discussion. We are looking at that report very carefully. We cannot comment on individual cases but the report raises important questions. In the meantime, the General Medical Council is providing additional support and guidance to clinicians and the Resuscitation Council is creating a large range of resources for clinicians to help guide them and provide training.
Childhood Obesity
Baroness Chisholm of Owlpen Excerpts(6Â years, 1Â month ago)
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Lord Bethell (Con)
My Lords, I welcome the IPPR report, but it is not true that the Government do not have a whole-society approach. Our approach to obesity involves physical education, supporting underprivileged families, addressing issues with marketing and a whole range of different issues. As for the noble Baroness’s points on profit, this Government are not against profit, but we are for healthy outcomes for young people.
Baroness Chisholm of Owlpen (Con)
My Lords, clearly prevention is better than cure and there is no panacea. However, there seems to be some evidence that, where families are brought together in family programmes to help them bring about behavioural change, there is more likelihood of them sticking to a healthier lifestyle. I ask my noble friend the Minister whether these programmes are ongoing and, if not, whether they can be started again and rolled out countrywide? It seems that, if families are brought together to help them think about behavioural change, this could be one way of tackling the obesity crisis.
Lord Bethell (Con)
My Lords, I pay tribute to the noble Baroness, Lady Chisholm, for her expertise in this matter. She is entirely right that decisions made by families together are more powerful than those made by individuals. The obesity campaign launched in July seeks to achieve exactly that by having a campaign on better health targeted at the whole population. I also emphasise the Healthy Start vouchers, a scheme to provide a nutritional safety net to hundreds of thousands of pregnant women and families with children aged under four, which is one way of bringing families together around healthy food.