Pharmacy Closures
Baroness Janke Excerpts(3 weeks, 5 days ago)
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Baroness Janke
To ask His Majesty’s Government what assessment they have made of the impact of increasing numbers of local pharmacy closures on primary healthcare services.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, pharmacies are an easily accessible front door to the NHS and we understand the impact that closures may have. We have increased the community pharmacy budget by £340 million—a 10% uplift that builds on the 19% increase, which was at the time the largest uplift in the NHS. That was delivered in 2024-25 and 2025-26 in order to support pharmacies’ essential role. Recent data indicates that closures have slowed, with 19 net closures in 2025-26 compared with 112 in 2024-25.
Baroness Janke (LD)
My Lords, I thank the Minister for her response, but 65% of community pharmacies are now operating at a loss; 45% have been forced to rely on personal savings or remortgaging their own homes just to keep their doors open, mainly to vulnerable people with the highest levels of need. What is the Minister’s response to the fact that individual pharmacists are subsidising essential front-line services out of their own pockets? Given that the closures are hitting deprived communities the hardest, what specific measures is the Secretary of State taking to prevent the creation of pharmacy deserts in areas with the greatest health needs?
Baroness Merron (Lab)
We are taking a number of actions on the point that the noble Baroness rightly raises. I have spoken about the uplift on the back of a major uplift in the two years previously. For underserved areas, the pharmacy access scheme provides financial support to pharmacies in areas where there are fewer of them. About 1,400 benefit from the scheme and they receive an average of £1,130 per month. Also on the question that the noble Baroness raised, local authorities have health and well-being boards, which assess whether the local provision of pharmacy services meets the needs of the population. Integrated care boards make decisions on pharmacy openings, and they can directly commission a pharmacy if necessary.
Healthcare Services: Acute, Primary and Community
Baroness Janke Excerpts(1 month ago)
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Baroness Janke
That this House takes note of the relationship between (1) acute, and (2) primary and community, healthcare services.
Baroness Janke (LD)
My Lords, it is a great privilege to open today’s debate on matters that are of such concern to so many people and which lie at the heart of our local communities. As we all know, health services are severely overstretched, whether in a local context or elsewhere. The systems are simply not coping.
Anxiety and fear are facts of life for many, particularly the elderly and vulnerable, who fear they will not have proper access to healthcare—so much so that A&E has become the default destination for desperate patients unable to find care or advice through their local doctor. Some 18% of patients attending A&E did so because there was no GP appointment available to them; this amounted to 4.5 million attendances. Nearly half a million people waited 24 hours or more in A&E last year, an increase of 150,000 patients in just three years. Over 1.1 million patients were stuck in A&E, specifically waiting for an in-patient bed to become available. Even more frightening, according to the Royal College of Emergency Medicine report published in June this year, in 2025 around 15,860 patients died in NHS A&E departments in England while waiting for care that could have saved them. That is roughly 1,300 people every month, nearly 10 times the figure recorded in 2015.
However, the Government’s 10-year primary healthcare plan promises us community-based health services with a focus on illness prevention and promotion of good health. The vision of a well-resourced community-based health service is attractive and powerful. It is what we all want, patients and professionals alike, but it could not be further from everyday experience.
With waiting times for GP appointments at record levels, people’s fears about access to healthcare are well justified, particularly among the vulnerable and elderly. Worse still, the system can be off-putting and daunting, and not everyone is able to navigate it. For example, there is the 8 am scramble: having to phone in by 8 am and then being told you are 20th in the queue; having to explain highly personal matters to the receptionist who answers your call; or having to deal with an online system, only to find that there are no appointments left and you must phone anyway and wait in the queue. There are many questions across the board as to how we get from where we are now to the reassuring and welcoming world of the 10-year vision.
The pillars of community healthcare that so often support the ailing service we have today are the community pharmacies, which offer a local service that is practical, easily available and embedded in local communities. I will use the rest of my time today to speak about the crisis in this essential service and its impact on community healthcare.
We often hear the community pharmacy described as the front door of the National Health Service, yet we are currently watching that door being systematically bolted shut in the communities that need it most. The scale of this crisis is staggering and, frankly, a damning indictment of a decade of financial neglect. Since 2015, England has seen a net loss of 720 pharmacies. Last year, closures reached their second-highest level on record, and current data suggests that the rate of closure this year is nearly 50% higher than at the same stage in 2023. Between January and April alone, 177 pharmacies closed their doors for good.
The root cause of this is a 30% real-terms funding cut since 2015. While the costs of medicines, energy and staffing have surged, core funding has remained stagnant, leading to an annual funding gap of at least £2 billion across the sector, as reported by the NHS. The human cost of this neglect is borne by pharmacy owners, 65% of whom are now operating at a loss. Nearly half—45%—have been forced to rely on personal savings or remortgaging their own homes just to keep their doors open to the public.
Every day, pharmacies facilitate 1.6 million daily visits, providing vital triage and advice that keeps pressure off overstretched GP surgeries. However, when a local pharmacy closes, these daily visits do not simply vanish. Instead, they are forced back into the primary care system, exacerbating the crowding of emergency departments with non-urgent issues that could have been managed in the community. Acute care is designed for rapid intervention in time-sensitive, high-stakes conditions such as heart attacks or severe injuries. By removing the pharmacy buffer, we are forcing patients with minor ailments into acute settings, wasting specialised resources and jeopardising the safety of those with life-threatening needs.
Pharmacies cater for many needs, such as dispensing medicines, vaccinations, medical advice and urgent medical care, as well as provide services to promote health, such as smoking cessation and weight management—and they could do more to ease pressure on other parts of the health service. According to a 2025 Department of Health and Social Care report, 70% of people surveyed would be happy to see a pharmacist for common conditions or prescription reviews if it meant being seen sooner. The same study found that 68% of respondents are comfortable speaking to a healthcare professional in a pharmacy setting rather than a traditional GP surgery.
Pharmacies offer a range of walk-in services and can work in tandem with GPs and other primary care settings to play a greater role in long-term condition management and point-of-care testing, but this has to be with the right investment and support. Pharmacies are small businesses, and like all small businesses, they have difficult issues affecting them, such as increased national insurance charges, increases in the minimum wage and rising business rates. Incidentally, GP practices and pubs are exempt from business rates, so many local pharmacists are asking why pharmacies cannot also be exempt as an essential service. I would like the Minister to consider that in her remarks. Some 95% of pharmacies also told the National Pharmacy Association that they were not in a financial position to be able to support the Government’s ambitions to move care into the community, as outlined in the 10-year plan.
Deprived areas with high health needs saw the highest rates of pharmacy closures between 2022 and 2025, with Liverpool being the nation’s capital for pharmacy closures per head of population, followed by Blackpool, Coventry and Hull. The pharmacy network in England now stands at its smallest since 2006. Some 63% of pharmacies could close this year, with 40% unable to pay the full cost of prescription medicines for patients. The current system of reimbursement for medicines is currently failing pharmacists and patients, and it needs reform.
We are also facing a workforce crisis, where locum costs have risen by 80% in a single year and overall staffing costs have grown by nearly 70% since 2015. Pharmacies simply cannot absorb this scale of increases without a fair and sustainable funding settlement. “Lights Out” is not just a campaign slogan; it is becoming a stark reality for high streets across the country. We cannot move healthcare out of hospitals and into the community if the community infrastructure has been allowed to crumble.
Can the Minister say when the Government will deliver the urgent investment needed to close the £2 billion funding gap and stabilise this sector? What specific protections will be put in place to prevent further closures in deprived areas where health needs are greatest? How do the Government plan to prevent the withdrawal of addiction and delivery services, which will inevitably overwhelm our GPs and A&E departments? The time for warm words has long passed. We need a sustainable road map that reflects the true cost of delivering NHS pharmaceutical care. If we do not act now, the front door of the NHS will be not just bolted but gone for ever.
Baroness Janke (LD)
I thank the Minister for her remarks and her explanation. She is obviously very committed to her plan. I think it is fair to say from what we heard during the debate, which had strong contributions from both professional and patient experience, that people in this Chamber are not convinced and that there is a lot of work to be done to convince people that the plan is going to succeed—not least the people who are working in it.
I draw the attention of the Minister to the morale and the sense of crisis that there is in many communities. On my point about local pharmacies, there is a crisis, and if we are not careful there will be none left to help to deliver the plan, and I am sure the situation is similar in other parts of primary care. So, while I recognise that the Minister has tried to be helpful, I think there is still a lot of work to be done and I—and, I know, others in this Chamber—will be pursuing the plan, in the hope that we will see it succeed in the future. It will need a lot of commitment and, as we have said, a lot of resource focused on primary care in communities and making sure that that focus is kept and that we remain committed to it.
Motion agreed.
Cost of Living: Public Well-being
Baroness Janke Excerpts(3 years, 9 months ago)
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Baroness Janke (LD)
My Lords, I too add my thanks to the noble Baroness, Lady Drake, for initiating this debate and for comprehensively and analytically setting out the context. My comments concern the education of children, particularly those with special educational needs, as well as the impact of years of underfunding on the morale of teachers, parents and schools.
Having read an article in a local paper by a parent of a child with special educational needs, about the fear they feel at the prospect of more cuts, I made my own inquiries and found a situation that makes me also fear for the future of these children, particularly those from disadvantaged homes, and their education across the country. I found that schools in general feel very undervalued and the lowest priority of Governments. I was told:
“Every year we need to do more with less and it is simply unsustainable”.
I am including direct comments from schools and parents, so I apologise if they sound slightly out of context.
The first thing to say is that not having enough funding encompasses just about every problem in any school, and the effects are: not enough teachers or assistants in the classroom, so schools cannot deliver an individualised education for disabled pupils and those with special educational needs; provisions for personal growth and mental health cannot be met with not enough staff, and neither can early intervention; and alternative provisions for those most in need are not fit for purpose: students have been refused places in schools that are specialised and should be meeting their needs. But, if a specialised school, with all the equipment and funding, deems a child “too difficult”, how is a mainstream school supposed to deliver an effective education and a safe place for that child, with no specialised provisions or training?
There is very limited language provision. When 25% of a school does not speak English, even as a second language, there is no access to or funding for translators. One translator on one morning a week for six weeks does not cover the revolving door of refugees from places such as Afghanistan and Ukraine. Staff work very hard with these children to give them the best possible chance and to provide some stability, only for them to be moved on, with other schools refusing to take them. One refugee child could not get a school to take him because of disabilities, which is of course devastating for the child.
The increase in teaching assistants’ wages of around 10% is very much welcomed, but this now has to be funded by the school’s budget, so the choice is between having fewer teaching assistants or cutting the school’s budget in another way. Having fewer teaching assistants impacts on the quality of teaching and learning. Already, not all classes have a general teaching assistant to support those who need extra help.
Energy cost measures apparently apply only to residential premises, so schools will have to find the funds to meet the increases in energy, or not heat classrooms. One school has estimated increases of 230%.
As the right reverend Prelate the Bishop of Oxford said, feeding children is also extremely important. Free school meals are grossly underfunded, and they struggle to offer a good nutritious meal for the price, including vegetarian, halal and kosher alternatives. Children are not engaged and ready to learn if they are hungry, and this might be their only hot meal of the day. A large proportion of pupils in the school I mentioned—43%—receive free school meals.
Parents too feel that they have been left high and dry and fear that worse is to come. Many of them suffered indignity and encountered rudeness in fighting for their children’s rights. The education, health and care plans which have replaced statements are also a cause of great concern. They are supposed to take 20 weeks to achieve but in some cases it is 50 to 70 weeks, fraught with numerous assessments and shed loads of bureaucracy. Mainstream schools focused on performance are reluctant to make proper provision for children with special educational needs.
Council services are starved of cash, so parent support groups, play groups and social arrangements for children with special needs and learning difficulties are closed due to lack of funding. There is heavy reliance on private provision. This is very expensive and many councils now have enormous debts in their special educational needs departments, which are in crisis. All this is happening now, before anything in the future budgets. It is clear that the system cannot bear any more cuts without threats to the very existence of many schools and services.
The current system clearly needs reform. It already offers woefully inadequate services to the most disadvantaged children, particularly those with special educational needs and those with disabilities. I hope that the Minister might propose some form of in-depth review of what is clearly a failing service.
We have heard ample evidence throughout the debate that current services cannot sustain future cuts. Indeed, they are in danger of collapse already. The noble Baroness, Lady Sherlock, spoke about indexing and the link to reality, and proper systems to protect us all. The noble Baroness, Lady Tyler, mentioned the effect of poverty on anxiety and mental health, and fear and insecurity and the need for reassurance with health and advice. The noble Lord, Lord Layard, underlined the importance of services to all sectors of the population and providing for their enduring needs. The noble Lord, Lord Howarth, mentioned inequality and how that leads to poor physical and mental health as well as social problems. The noble Lord, Lord O’Donnell, talked about well-being and the importance of targeting, as well as energy efficiency and labour shortages. All these concern different departments of state. It seems to me that one of the most important messages from this debate is that poverty concerns all the services; it certainly should not be left as being led by the concerns of the Treasury. I hope that message will hit home.
I urge the Government to protect our children, particularly those who are already disadvantaged, from any further attempt to cut essential services. As the right reverend Prelate the Bishop of Oxford said, children’s futures are on the line. Our country will pay the price if we do not face up to our responsibilities and make sure that children are fully protected in these difficult times.
Eating Disorders
Baroness Janke Excerpts(4 years, 4 months ago)
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Lord Kamall (Con)
As a result of the work that has been undertaken in response to the report, and in conjunction with Beat and many other stakeholders, we are looking at the issues. First, we are making sure that people are trained to understand the issues as part of their education. Secondly, we are looking at what we can do retrospectively for those who have already qualified. We are working with various bodies—the royal colleges and others—to see how we can make sure there is more awareness and training available, including e-learning resources.
Baroness Janke (LD)
My Lords, there is a need for urgency on this issue. We do not get the impression that the Government are treating this very urgently, but anorexia has the highest mortality rate of any mental illness. If it is not treated early, it becomes worse, much harder to treat and puts lives at risk. In view of the unprecedented growth in sufferers, what will the Government do to accelerate access to treatment for those in urgent need and prevent more needless deaths?
Lord Kamall (Con)
I think the noble Baroness is being unfair in suggesting that the Government are not taking this issue seriously. In the conversations that I have had in the lead-up to this Question, it has been quite clear that they are taking it very seriously. They recognise its granularity and the differences in types of eating disorder. As the noble Baroness rightly said, people quite often associate eating disorders with adolescents or young females and young men, but binge eating disorders in particular can occur among adults who are 30 or 40 years old. The Government are looking, first, at education. Secondly, they have made a number of investments in adult and children’s services relating to mental health, including eating disorders.
Eating Disorders
Baroness Janke Excerpts(4 years, 6 months ago)
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Lord Kamall (Con)
As noble Lords can imagine, because of the pandemic, sadly, waiting times have gone up, but we are making sure that we are doing as much as we can to address that. Longer term, we are focusing on prevention, not only cure. We are also making sure that we are able to understand the various forms of eating disorder better. It is very simple to lump them all together, but there are different elements and you can distinguish between them. Then we will, I hope, be able to tackle that as much as possible.
Baroness Janke (LD)
My Lords, given that many young people with eating disorders find it very difficult to seek help and identify themselves, what specific additional resources have been provided for schools to help and support young people with this actually life- threatening illness?
Lord Kamall (Con)
The noble Baroness raises a very important point about how we identify children and young people who are suffering from these disorders or may be a few steps away from it. We know that there are programmes from the Department for Education and our department to tackle mental health issues in schools, identifying pupils and encouraging them to come forward, to talk to a counsellor in the school, and making sure that there is signposting in the right place to ensure that we can tackle their issues.
Eating Disorders: Provision of Care
Baroness Janke Excerpts(6 years, 5 months ago)
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Baroness Janke (LD)
My Lords, I too am grateful to my noble friend Lady Parminter for the debate today. I will speak particularly about anorexia, a killer disease that frequently affects young girls and women between 14 and 25. That is the area I have had most experience of, although, as other noble Lords have said, anorexia also affects adults.
As other noble Lords have said, anorexia has the highest mortality rate of any psychiatric disorder. The death rate associated with anorexia nervosa is 12 times higher than the rate for all other causes of death for females aged 15 to 24. Yet, as other noble Lords have said, there is much to be grateful for in that there can be a recovery, with enough support and treatment. Research suggests that 46% of anorexia patients fully recover, 33% improve and 20% suffer chronically. I am grateful that my daughter was one of the 46% who recovered.
According to Beat, the eating disorders charity, the average duration of the illness is eight years, but it can become severe and enduring, lasting for many years and having a hugely debilitating effect on the sufferer and their family. Thinking about people at the younger end of that age group, we know that the teenage period is a time of such emotional development as well as physical growth. It is a time of intellectual development and moving into the adult world. For sufferers of anorexia, isolated not only in their body but socially, the illness brings this growth and development to a halt. Cognitive development at this age is of huge importance, as it is often much more difficult to catch up afterwards, even if there is a full recovery. Eight years is the average time it takes to recover. Eight years in the life of a 14 year-old is a lifetime, and a huge loss of a key period in anyone's life.
The disease is sometimes considered not so much a disease as a life choice. There is perhaps a lack of awareness that the obsession with weight and body is so compulsive; that there is an overwhelming fear of gaining weight, and a distorted body image. Sufferers will do anything to get thinner, and the thinner they get, the more they think they need to become even thinner.
Sufferers also change personality. If somebody in your house is suffering from anorexia, you will find that your cheerful, open teenager can become aggressive, abusive, deceitful and manipulative, and an expert in inflicting pain on their loved ones. It is very hard for anyone who has not had first-hand experience of this debilitating and vicious disease to imagine what it is like to have to keep up surveillance and constant care just to keep your precious child alive. It is a deadly disease but, as the noble Lord, Lord Lexden, said, it is often seen as an extension of vanity—the obsession with image and appearance. It is far more complex than that, as other noble Lords have said in the debate.
It is alarming that the January NHS figures show that hospital admissions for eating disorders have risen by 37% across all age groups in the last two years. Hospital admissions are only for those who have to be prevented from starving themselves to death, so this is just the tip of the iceberg. It is a huge issue, and sufferers need intensive support and early intervention. As other noble Lords have said, the sooner they get the treatment they need, the more likely they are to make a full recovery. Prompt access to high-quality treatment and support can prevent people getting to the point where hospital admission is the only course of action that will keep them alive.
I agree with what has already been said: research has been starved of funding. My experience was quite some time ago, but there was very much a feeling that this was not really an illness but the teenage behaviour of adolescent girls, and a failure to recognise the results that could occur when people did not get the care that they needed.
I was interested to hear that research has proposed the idea that there may be a hereditary aspect, for example, and also that people are now looking into a metabolic dimension. As has been said, the relation to obesity is something that appears to be being looked into more. Certain individuals may be much more likely to suffer from anorexia when they experience stress, bullying or very severe pressure. I feel that we need to raise awareness of this as a disease that kills people, not a lifestyle choice, affectation or folly of teenage girls.
I hope that treatment and support will be made available consistently across the country. Whether you survive this disease should not be a matter for a postcode lottery. In my opinion, eating disorders have for many years been a Cinderella service within mental health, which is itself a Cinderella service. I hope, from the information we have had, that the Minister will reassure us that this will not continue to be the case. If not, there will be more and more tragic and unnecessary deaths, as sufferers’ lives continue to be at risk. Again, families and carers live with that risk of death every day. I hope that we are to get assurances from the Minister, as more and more families will be torn apart if there is not very prompt and urgent action to provide support and treatment for people suffering from all eating disorders. However, I make a special plea for anorexia.
Health: Vaping
Baroness Janke Excerpts(6 years, 6 months ago)
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Baroness Blackwood of North Oxford
My noble friend has asked a comprehensive and pointed question. It is notable that e-cigarette use among young people in the United States has increased dramatically— 78% in high-school students and 48% in middle-school students. We have not seen that in the UK because of the very effective and tightly regulated methods we have brought in around advertising and access for under-18s, which have borne fruit. I am proud of the way in which we have managed that in the United Kingdom.
Baroness Janke (LD)
My Lords, is the Minister aware that smoking has again become much more normal, and indeed quite fashionable—particularly in the form of e-cigarettes, among not just smokers but young people and people who have never smoked? Does she consider that this risks growing nicotine use and dependence? If so, what is being done to monitor and evaluate in health terms the increased use of e-cigarettes?
Baroness Blackwood of North Oxford
I am not quite sure I agree with the fundamental hypothesis of the noble Baroness’s question. If the normalisation hypothesis were true, we would not have expected to see smoking rates continue to decline as they have. Since 2013 smoking rates have fallen from 18.4% to 14.4%, and among young people regular use is very small. It is at 2% for those who have never smoked and is very rare or less, at 0.5%, for 11 to 15 year-olds.
Queen’s Speech
Baroness Janke Excerpts(6 years, 6 months ago)
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Baroness Janke (LD)
My Lords, when thinking about the debate today, I wondered what will change for the poorest and most vulnerable as a result of the new government agenda. For example, how will the 4.1 million children in poverty—referred to by the noble Baroness, Lady Blower, in her excellent maiden speech—benefit? Will food banks become redundant? Is the number of rough sleepers likely to go down? The answer seems rather depressing: that very little will change, particularly in the short term.
The hope is, however, that the rise in the minimum wage, which we welcome, will in time help some of those in most dire need. But we should not underestimate the scale and misery of poverty across the country. With low unemployment rates, 4 million workers live in poverty, an increase of 500,000 in the last five years. In-work poverty is rising faster than employment and is higher than at any time during the last 20 years. Some 60% of people in poverty live in a household where at least one person works, and 2.8 million people in poverty are in a household where both adults work. So the rise will be welcomed by many and seen as long overdue.
Policies such as the benefit cap and freeze, the two-child limit and the introduction of full job-seeking requirements for single parents of children as young as three have had a stark impact. In August 2018, two-thirds of those who had benefits capped were single parents. Single parents in the bottom 20% of income will have lost 25% of their 2010 income by 2021-22. As a result of tax and benefits changes, the poverty rate for children will jump to 62% by then if nothing changes.
Women earn, on average, 17.9% per hour less than men and make up 60% of workers receiving low pay. Reductions in social care services place a greater burden on primary care givers, who are also disproportionately women. Single-parent families, of whom 90% are women, are twice as likely to be in poverty as any other social group. Nearly half of those in poverty—6.9 million—are from families where someone has a disability. They have also been some of the hardest hit by austerity measures. Changes to taxes and benefits will mean that some families are projected to lose £11,000 by 2021-22—more than 30% of their income.
It is shocking to British people in the 21st century that we should have 14 million people in poverty. The UK has the fifth-largest economy in the world, a leading centre of global finance and record low levels of employment, yet one-fifth of the population is in poverty, with 4 million people more than 50% below the poverty line. Historically, the UK has had a proud record in terms of a strong social safety net, yet this has been systematically removed over recent years. People who, in former times, found a resource base to support them when they were afflicted by a major catastrophe now find that there are only volunteers and charities with limited resources providing for their most basic needs. How can a country such as ours not be shamed by such a state of affairs, with our benefit service likened to the 19th-century workhouse made infamous by Dickens?
Worse still, the support services that used to be a lifeline for those in poverty have been almost completely removed: youth and community services, social care, debt counselling and libraries have all been closed in record numbers. Surely the Prime Minister’s new golden age must see tackle the record levels of poverty. There must be not just a commitment but a plan to actually do this: to rebuild an effective social safety net national and locally, to address the issues that lead to low pay and insecure employment and to ensure that disadvantaged and vulnerable people are not driven into the deepening despair, humiliation and desperation that poverty brings, as victims of a system with a safety net full of holes.
Health and Social Care: Malnutrition
Baroness Janke Excerpts(6 years, 8 months ago)
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Baroness Blackwood of North Oxford
The noble Baroness is absolutely right that it is critical that people have good and healthy food in hospitals. That is exactly why there are very strict food standards in hospitals and health and care settings which are already enforced by the CQC. It is also why we appointed the former head of the Hospital Caterers Association, Philip Shelley, to look at what more could be done to improve the situation with the hospital foods review, to look at the safety of food available to patients, visitors and staff, improve nutrition and make available healthier choices, and ensure that we can improve the expertise of caterers, suppliers, staff and those who work in hospitals, to ensure that we raise standards and reduce the incidence of malnutrition across the system.
Baroness Janke (LD)
My Lords, in the light of the very real pressures on care services in communities, could the Minister say what steps the Government are taking to ensure that the elderly and vulnerable living in their own homes are not suffering from malnutrition due to poverty and neglect?
Baroness Blackwood of North Oxford
The noble Baroness is right to raise the important issue of malnutrition in the community. We have put together a malnutrition task force, which has published a series of guides of expert advice on prevention and early identification of malnutrition in later life. These guides draw together principles of good practice and offer a framework for making sure that the situation which the noble Baroness has identified does not arise. We have also published a guide for care homes on integrating good nutrition into daily practice. This includes screening, initiating nutritional care plans and considering fortifying food and using oral nutritional supplements when appropriate.
Queen’s Speech
Baroness Janke Excerpts(6 years, 9 months ago)
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Baroness Janke (LD)
It is a great pleasure to follow the noble Baroness, Lady Bakewell. As a former council leader, I am very familiar with some of the issues she raised here today, but I shall confine my remarks to the worsening conditions of the least well off in our country. They deserve consideration, although sadly they are not a priority of the Government in the gracious Speech. There is ample evidence that conditions are getting worse for the poorest, whether in the form of research and reports, or in the daily experiences of children, families and individuals. Reports from the UN rapporteur, the Joseph Rowntree Trust, the Children’s Commissioner, the Child Poverty Action Group and a host of others provide shaming testimony in a country that once led the world in the social welfare of its citizens.
The gracious Speech makes reference to unlocking the full potential of children, yet we hear that teachers are buying food, clothing and equipment out of their own pockets for children who are too ashamed to come to school because their families cannot afford clothes and basic needs. The number of children attending food banks in the last year has doubled. Some 4.1 million children are in poverty, and 70% of them are from families where at least one parent works. Single parents, of whom 90% are women, are twice as likely to be in poverty as married couples. Half the children in one-parent families are in poverty. Furthermore, as far as housing is concerned, there has been a surge in homelessness, which was up by 320,000 in November 2017. Rough sleeping has shot up by 15% in a year; this is because of the paring back of housing benefit and the freezing of local housing allowance.
Nearly 50% of those in poverty—6.9 million—are from families where someone has a disability. On this I support the speech of the noble Baroness, Lady Campbell, and some of the examples she gave us. The crisis in PIP assessments whereby 75% of appeals are upheld requires attention. Even if the Government were concerned only with finance it would be sensible to look at a better way of doing this; in terms of the suffering it inflicts on people who already have to face financial penalties in various forms, it is just unforgivable. Families with disabilities are projected to lose £11,000 a year by 2021-22, more than a third of their income.
Indications also show that the worst off and most vulnerable will suffer more under Brexit. I understand from talking to those involved that very little assessment of this has been done, yet already the depreciation of the pound, rising prices and inflation are making things very difficult for those on fixed income. Unless the full uprating of benefits and low incomes takes place, there will be a crisis and the poorest and most vulnerable will not be protected. Indebtedness has already reached pre-2008 levels, yet little appears to have been done in terms of emergency support.
The gracious Speech states:
“My government will bring forward measures to protect individuals, families and their homes”.
The Government really need to look at the evidence of how they are protecting families and their homes. The two-child limit and the four-year benefits freeze both directly affect children. If what people are saying about the effect of Brexit is right, emergency payments would be indispensable, but they are going to be lost. In the past they have prevented families falling into destitution; they need to be reinstated. The sanctions imposed by the Government are a source of destitution and debt and are particularly damaging to people with disabilities or health conditions such as heart disease.
Payments to young people of £250 per month are not enough to live on for those who do not have supportive homes. Split payments need to be made so that abused women are not kept under the control of their abuser. As the noble Lord, Lord Willetts, has already mentioned, the disincentives to work, the effect of sanctions and flexible working need to be thoroughly investigated and action needs to be taken.
There is ample evidence of the worsening lives of the poor and vulnerable. Our priorities must be to build an effective social safety net nationally and locally, to address the issues that lead to low pay and insecure employment and to ensure that measures are in place for the least well-off, the least protected and the most vulnerable so that they do not slip through the holes of an insufficient safety net and drift into destitution and poverty.