Covid-19: Social Care Services

Baroness McIntosh of Hudnall Excerpts

Thursday 23rd April 2020 Lords Chamber

[Baroness Wheeler]

My Lords, I thank all noble Lords who have participated in this excellent and powerful debate. I thank the Minister for his thoughtful response, but however thoughtful it was it is clear that many questions remain unanswered and that we will need to ensure that they continue to the brought to the fore and be dealt with by the Government in future Questions, Statements, debates and legislation.

Noble Lords have stressed the need to be open and honest about the challenges that social care faces and about the good and bad news. I am sure the Minister will take that message to heart. Despite the challenges, I want to stress that it is truly heartening to know that this terrible disease has at least been a wake-up call for the Government and the public about the importance of adequate social care for millions of adults and children in need of it and about the value, respect and decent pay that the 1.4 million staff deserve and must be given.

[The Deputy Speaker (Baroness McIntosh of Hudnall) (Lab)]

My Lords, it is a privilege to be the first—I think—to put the question in a virtual Chamber that this Motion be agreed.

Motion agreed.

Covid-19 Update

Baroness McIntosh of Hudnall Excerpts

Monday 16th March 2020 Lords Chamber

[Lord Bethell]

My noble friend Lord Barwell is entirely right. The question of deliveries is an acute concern. There are intense conversations going on on a daily basis between Defra and the food retailers. I understand that there are assurances that there are significant stocks of food and that these are going to be made more available. It is not something that we are currently deeply concerned about. The belief is that as people fill their larders, they will reach a certain point when they will begin backing off the kind of stocking up that they are doing at the moment and it will be possible for those who need it to get those deliveries.

[Baroness McIntosh of Hudnall (Lab)]

I am sorry to ask the Minister to return to the issue of closing theatres—and I declare an interest as the deputy chairman of the Royal Shakespeare Company—but reassurance is needed that, by following the instructions or the advice or whatever it is that has been issued, theatres and no doubt other businesses as well are not inadvertently invalidating their insurance arrangements. I understand that the noble Lord finds it difficult to give assurances but I think that one is particularly necessary, not least because it might save the Government some money in the long run.

[Lord Bethell]

The noble Baroness is entirely right. As a trustee of Sadler’s Wells, I understand completely the implications of what she is saying, her point about insurance, and the confusion there might be about what the current status is. I simply cannot answer the question right now. I am not trying to avoid a difficult question; I simply do not have the information. When I do, I will be very happy to write to her and to others who have asked about this.

Eating Disorders: Provision of Care

Baroness McIntosh of Hudnall Excerpts

Tuesday 4th February 2020 Lords Chamber

[Baroness Parminter]

To ask Her Majesty’s Government what steps they are taking to improve the care offered to sufferers of eating disorders.

[The Deputy Chairman of Committees (Baroness McIntosh of Hudnall) (Lab)]

My Lords, since this business is time limited, I draw noble Lords’ attention to the fact that the clocks that normally flash are not doing so, so we have reverted back to the older model which will require noble Lords taking part in the debate to exercise the customary discipline in recognising when their time is up.

Coronavirus

Baroness McIntosh of Hudnall Excerpts

Monday 3rd February 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

There were a few questions there. With regard to transmission, this is an evolving picture, so the best thing would be for me to send the most up-to-date information to the noble Baroness and put a copy in the Library, as I am sure it will be of interest to the whole House.

On ECMO beds, since April 2013, NHS England has commissioned a total of 15 adult respiratory ECMO beds from five providers in England. There is further provision in Scotland. But in periods of high demand, the capacity can be increased. For example, in the winter of 2018-19, when there was a significant risk associated with flu, the capacity was increased to over 30 beds and similar arrangements are in place for paediatric services. In addition, there are eight commissioned high-consequence infectious disease beds and around 500 infectious disease beds, and at the moment NHS England is confident that it has enough capacity, which I hope is reassuring for the noble Baroness. Obviously, we are keeping that under constant review as the situation evolves.

On the question about surfaces, that is one of the specific reasons why advice has been given regarding personal hygiene—washing hands and using tissues when sneezing—to avoid any forms of transmission that may create the kind of risks referred to by the noble Baroness.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, when the Minister repeated the Statement, she referred to the precautionary measures that people are being invited to remember when trying not to pass on infection. If I recall, the Statement said something to the effect of “as you would normally do with flu”. But does the Minister agree that that is not what people normally do with flu? People often do not take the symptoms seriously and transmit it before they have even decided to give into it themselves. I have one germane example in this context. A member of my family contracted flu a couple of months ago which became pneumonia, although fortunately not a serious case. He was advised to go to his GP and the GP referred him to A&E where he waited a long time with a lot of other people in what was clearly a highly infectious state.

Given the stringency of the measures taken to contain coronavirus, can the Minister say what wider public health lessons we might take from this in giving consistent messages to prevent people imagining that flu is a minor illness and it does not matter if you continue going to work or pass it on to other people? It does matter, and the mortality rate among vulnerable groups with flu can be quite high, as the Minister will know.

[Baroness Blackwood of North Oxford]

The noble Baroness has rightly raised this issue with me before. She is quite right that flu can and should be managed much more effectively in the community and by individuals. I think we have had an effective flu campaign this year. The flu vaccine has been offered to 25 million people. We have also extended the flu programme this year to children in year 6 to improve herd immunity and drive up its impact. We are seeing the number of those with flu declining, so we are starting to see some improvement. However, I completely recognise the noble Baroness’s point about public health lessons and improving public education on the management of infectious conditions, which we live with every winter, not just when we have an infectious situation such as this. I thank the noble Baroness for an important question.

National Health Service Infrastructure

Baroness McIntosh of Hudnall Excerpts

Thursday 9th January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

We have been looking at providing additional funding and support to councils to meet the rising demands and to continue to stabilise the social care system. We announced access to an additional £1.5 billion of funding for adults and social care, and we will be considering this further in the spending review.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, the noble Baroness will be aware that there was a spike in the incidence of flu just before Christmas; I do not know whether it has diminished, but it certainly was quite high. As a consequence, a number of people who perhaps would have much preferred not to go to hospital were forced to do so. She might like to know that, in one London hospital to which one of my family was obliged to go, the queue for A&E was out into the street. Many of those people were ill and should not have been outside in the cold. The reason for it was partly to do with availability of staff but more to do with the availability of chairs. Does she understand that hospitals need capacity beyond what their expectation might be of how many people will turn up, precisely to cope when there is a spike of this kind?

[Baroness Blackwood of North Oxford]

The noble Baroness is right that there has been a significant increase in demand over recent years. That is partly why we have secured the significant funding increase from the Treasury of £33.9 billion, which we will be enshrining in law for the first time to give certainty to hospitals. It is why we are increasing the capital investment, which will address some of the challenges that she has raised, and it is also why we have run a vigorous flu vaccination programme to prevent people from getting into that problem in the first place. We recognise that we need to reduce the demand from those going into A&E unnecessarily and to support those very hard-working staff who were in those situations over Christmas and the new year. We thank them for their hard work over that period.

Queen’s Speech

Baroness McIntosh of Hudnall Excerpts

Tuesday 22nd October 2019 Lords Chamber

[Baroness McIntosh of Hudnall (Lab)]

My Lords, it really is a pleasure to contribute to this debate. While I cannot claim to have listened to every single speech, it has been a great pleasure to listen to the many that I have heard, which have been notably well informed. I know that the Minister will have a very difficult task in winding; I can see from her face that she has worked that out already. I also know that she has been listening very carefully and I very much hope that she is not alone.

We have been told several times already what the gracious Speech says about education—which is frankly not very much and certainly nothing that it would be possible greatly to disagree with. In fact, no Government in modern times would really have said anything different, which suggests that this is a largely policy-free area. The real question is not what you say about aspiration but what you do to make sure that that aspiration is achieved. In opening, the noble Baroness, Lady Barran, who is in her place, talked about additional money. That is of course very welcome, but it is not the whole story if there is nothing to say about content.

I will ask the Minister to pick up two recent reference points. One of them, the Durham commission report which was published last week, has already been mentioned several times. The commission was of course graced by the noble Baroness, Lady Kidron, among others and was chaired by Sir Nicholas Serota. Last Saturday, the Guardian summarised the report’s significance rather well. It said:

“The report, put together in collaboration with academics from Durham University, concludes that creativity is not something that should inhabit the school curriculum only as it relates to drama, music, art and other obviously creative subjects, but that creative thinking ought to run through all of school life, infusing the way human and natural sciences are learned”.


The second reference point is a current Science Museum and Radio 4 collaboration which I have been very much intrigued by. It is called “The Art of Innovation” and is co-presented by the director of the Science Museum, Sir Ian Blatchford, and his colleague, the head of collections, Dr Tilly Blyth. It is a whole range of perfect little programmes about how art and science have inspired each other. I highly recommend them to anybody who has not already heard them. Both of these things point in the same direction, as did Sir Ken Robinson’s report, All Our Futures, 20 years ago. Like the Durham commission, he emphasised that creativity can be taught.

Art, science and mathematics all rely on creative thinking, curiosity and imagination—as the noble Baroness, Lady Bull, for example, said earlier. In my view, all start with the same question, which is, “What if?” Asking this question requires the confidence and courage in both students and teachers to challenge, doubt, question and get things wrong. Nothing in current education policy supports this approach, even though many fine teachers try every day to encourage it. The emphasis on testing knowledge has been shown to narrow focus, and to breed caution and anxiety. At this point, I refer to the many contributions that have touched on mental health. Mental ill-health in young people is a serious matter and something that we are not currently dealing with very well in either the NHS or the education system. We could do better quite easily.

The day I hear a government Minister say from the Dispatch Box that he or she understands that education is far more than the acquisition of knowledge; that young people need imaginative reach in all areas of learning; that simply getting more students to take exams in drama, art or music, while very important, is by no means enough; that passing exams is only one measure of educational success, not the be all and end all; and that these things will be reflected in future policy will be a good day for me. I hope that when the noble Baroness comes to wind up she can make my day.

National Health Service: Healthcare Advice

Baroness McIntosh of Hudnall Excerpts

Tuesday 16th July 2019 Lords Chamber

[Baroness McIntosh of Hudnall (Lab)]

The Minister has just given a very eloquent explanation of her view of the relationship with Amazon, but does she agree that it is a bit counterintuitive to assume that a company as big and commercially successful as Amazon is not getting some value from the relationship with the NHS? Can she explain what that value is?

[Baroness Blackwood of North Oxford]

Amazon is seeking to ensure that it provides a service to its customers. In this instance, we have ensured that we have provided an open API: any company that chooses to develop a service linking to the information on the NHS website is able to do so. This is not an exclusive contract with Amazon. As I have already said, other companies are able to do so and some already have done. It is not a specific benefit for Amazon. It is something that other companies have already availed themselves of and is of benefit to the NHS and NHS patients.

Mental Health of Children and Young Adults

Baroness McIntosh of Hudnall Excerpts

Thursday 16th May 2019 Lords Chamber

[Baroness McIntosh of Hudnall (Lab)]

My Lords, at the end of King Lear, where, frankly, the stage is littered with bodies and not much to cheer one up has occurred, the Duke of Albany speaks to the few people who are left standing. He enjoins them thus:

“Speak what we feel, not what we ought to say”.


At this point, I feel that that is all I can do, because, unlike my noble friend Lady Royall who introduced this debate so extraordinarily well, and many others who are speaking, I cannot claim any expertise, whether clinical or in the work I have done in the field of child and adolescent mental health. However, I have some direct personal experience. Many people in my family, including me—I regret having to say it—have suffered from difficulties with their mental health. That includes children and one young child at the moment.

When I put my name down to speak in this debate, I knew that I wanted to speak but I was not sure how I was going to say what I wanted to say. I am still not entirely sure, so if what comes out lacks coherence or is sometimes intemperate, I apologise to the House and in particular to the Minister who has to answer this debate.

Two things have happened in the past 12 hours which have changed the way in which I thought about this subject. One was a television programme, and one was something that happened to a member of my family, a young child. The television programme was shown last night—I do not know whether anybody else saw it—and in it Nadiya Hussain talked about her own anxiety problems. The one thing that emerged from that for me more clearly than anything was that young people whose mental health problems are not diagnosed grow up into adults with mental health problems. That has already been mentioned by others, but we should never forget it. That is the risk we run: if we do not look at children’s mental health early enough, they will grow up into adults who find it much more difficult to deal with the residual problems they have.

This week is Mental Health Awareness Week—many of us are sporting the badges. It may be less widely known in this House that it is also SATs week; if nobody understands what that is, they should look it up. Putting the two together, the few things I want to say are about schools—schools as healthy or, in some cases, unhealthy communities. I want to make it clear that, as I say it, I intend no disrespect whatever to teachers or their students, all of whom in their different ways are trying their best to do a good job in difficult normal circumstances. I say that because I believe it but also because I have quite a lot of teachers in my family, so they would be very cross with me if I did not say it.

Good education must always strike a balance between discipline and freedom; core skills and creative range; learning to be part of a group and learning to be ourselves. Government policy over the past decade has done very little to help schools be healthy communities in that way. It has steadily narrowed the curriculum, reducing choice and imaginative aspiration, and focusing far too much on testing, which is why the SATS point is important. It has downgraded and undervalued arts subjects. I know that this is an old hobby-horse of mine, but I do not mind riding it out again when evidence shows the benefits of these subjects, including to mental health. More than anything else, government policy over the past decade has drained the joy out of education. If you cannot be joyful as a child, it is very hard to be mentally healthy.

I know that the Minister will say, with some good reason, that this is not her area of responsibility, but I ask her to consider that it is the responsibility of the Government as a whole to understand that young people spend a huge amount of their lives in school. Schools are communities, within which adults and young people need to find a way of co-existing such that the education the young people receive is good, enduring, healthy and sustainable. They cannot easily get that from adults who are themselves stressed, overworked and anxious. It is my belief and experience that many teachers in the system at the moment are in exactly that condition.

One way we can prevent our young people from becoming problems and needing mental health interventions is to try to ensure that their experience at school is nurturing, creative, safe and inspiring. That is what schools ought to be. I wish more of them were and I hope that the Minister will understand why I am putting this to her today.

Sexual Health Services

Baroness McIntosh of Hudnall Excerpts

Thursday 29th November 2018 Lords Chamber

[Baroness McIntosh of Hudnall (Lab)]

Following on from the question asked by the noble Baroness, Lady Barker, what is the current assessment of the undiagnosed incidence of HIV? There is usually a quantum that is reckoned to be about where we are with undiagnosed incidence. The Minister says that diagnoses have gone down and that that is a good thing, but it is not necessarily. Can he give us some information on that?

[Lord O’Shaughnessy]

Of course, I am very happy to. In this case, it is good news that diagnoses are going down because 92% of people with HIV in the UK have been diagnosed. The UN target was 90%, and we have exceeded it. That leaves 8% to reach and, clearly, we want everyone diagnosed and on treatment, with their viral loads suppressed, so that no new infections can take place.

--- Later in debate ---

[Lord O’Shaughnessy]

First, we are giving it an extremely high profile. Indeed, Governments have given it a high profile since the noble Lord the Lord Speaker raised the issue in the 1980s. All Governments since have been committed to that and this Government continue to be so. We do that through a mixture of public health campaigns and working with schoolchildren to ensure that there is no stigmatisation or bullying of any groups of young people with HIV.

[Baroness McIntosh of Hudnall]

My Lords, as there is a moment left, I ask the Minister to return to the question I asked him. Forgive me if I misunderstood his answer, but I do not think he said what the current assessment is of undiagnosed HIV in any of the populations. If he has that information, perhaps he could let me have it in writing.

[Lord O’Shaughnessy]

I thought I said that 8% are currently undiagnosed across the country. As to how that is split across different socio-demographic groups, I shall have to write to the noble Baroness with more detail.

Health: Stroke

Baroness McIntosh of Hudnall Excerpts

Wednesday 14th November 2018 Lords Chamber

[Lord O’Shaughnessy]

The noble Lord is quite right that patients with atrial fibrillation have a five times greater risk of stroke. Most patients are diagnosed but about 300,000 are not yet, so finding them is critical. The tests are available now not just in GPs’ surgeries but increasingly in pharmacies. I will write to him with specific details about the rollout.

[Baroness McIntosh of Hudnall (Lab)]

Of course the prevention and treatment of stroke is very important, but unfortunately some people have strokes and are incapacitated by them, sometimes physically but sometimes mentally as well. What work are the Government doing to ensure that as many people as possible register a lasting power of attorney so that, when that bad thing happens to them, a proper care plan is available?

[Lord O’Shaughnessy]

I will need to write to the noble Baroness with specific details on promoting lasting power of attorney. There has been an improvement in the availability of occupational therapy for those who suffer disabilities from stroke, but I do not know whether there is support in terms of planning ahead.