Health: Cancer

Baroness Redfern Excerpts

Wednesday 20th January 2016 Lords Chamber

[Baroness Redfern (Con)]

My Lords, I, too, thank the noble Baroness, Lady Walmsley, for introducing this debate this evening. Unfortunately and as we all know, cancer touches us all. Every year, more than 250,000 people in England are diagnosed with cancer and, sadly, around 130,000 of these die as a result of the disease.

However, more people are now surviving cancer and I take this opportunity to pay tribute to all those healthcare professionals and volunteers—and dentists—who dedicate their lives to finding cures and caring for patients. The sad fact remains though, that our survival rates are still worse than those for other countries that are as wealthy as us. If we want the best for cancer patients, we have to invest in treatment but our priority also needs to be prevention through early diagnosis, as we have heard from earlier speakers.

I welcomed the Government’s strategy on cancer in 2011 and efforts to raise awareness of symptoms, with £750 million allocated to support this. If we take bowel cancer, for example, which is the fourth most common cancer in the UK and where survival rates are closely associated with the stage at diagnosis, it is estimated that up to nine in 10 people could survive if they were diagnosed in the earliest stages of that cancer. There is a huge variation in survival between cancer types and we have the staggering statistic that one in five cancers is not spotted until A&E.

This Government made a manifesto commitment to continue to support tackling cancer through campaigns such as Be Clear on Cancer. Many noble Lords will be familiar with radio and television advertising that encourages people with possible symptoms or concerns to visit their GP and get them checked out. I, for one, would welcome increased media attention, with a possible monthly “focus on cancer” to promote awareness of the symptoms of a different cancer each time and what to look for.

Alongside diagnosis, access to appointments is vital. In May last year, the Prime Minister reiterated a commitment to seven-day general practice and hospital services by 2020. One initiative that I think has been particularly effective is the free NHS “midlife MOTs” for those aged 40 to 74 who do not have a pre-existing condition, which we have delivered in north Lincolnshire with GP support. These health checks mean that residents will be better prepared for the future and able to take steps to maintain or improve their health. However, we still have a stigma attached to seeking advice on health, particularly with older residents and especially men. I would welcome the Minister considering this point and explaining what further assistance may be available to local authorities to increase contact with these target groups to improve survival rates. We also need to look at lifestyles to reduce the risk of cancer, with around a third of cancers being linked to smoking, diet, alcohol and obesity. By running screening programmes, we have the chance to get an earlier diagnosis so that treatment is more likely to work.

We face a massive challenge ahead to do the best we can against the seemingly endless toll that cancer has on people’s lives. I am positive that more can be done to support those with cancer and identify the risks sooner, but at the same time I acknowledge the huge strides that have already been made.

National Health Service

Baroness Redfern Excerpts

Thursday 14th January 2016 Lords Chamber

[Baroness Redfern (Con)]

My Lords, I, too, thank the noble Lord, Lord Turnberg, for bringing this debate to the House. There are demands on our health service, and it is clear that a rapidly ageing society puts great pressure on our NHS in many different ways. My contribution to this debate will focus on local efforts to support these services.

As noble Lords will be aware, responsibility for public health now rests with local authorities, and that is working well. Councils now play a pivotal role in looking at what can be done to care for people in their own community. Integrated care is essential to meet the needs of the ageing population, to transform the way that care is provided for people with long-term conditions and to enable people with complex needs to live healthy, fulfilling and independent lives.

Locally we are delivering the better care fund programme to ensure a transformation in integrated health and social care. For example, in North Lincolnshire, we have joint senior management at clinical commissioning group and local authority level. We recognise that an enhanced out-of-hospital model, enabling health and social care professionals to provide more joined-up services closer to people’s homes and communities, should form the basis of any system-wide model of care. We connect local areas to local GP practices to offer new ways of working with social care, community healthcare, mental health services, voluntary and community organisations and other key stakeholders. We have local teams to enhance existing community services and have already delivered, as I have mentioned before in the House, five well-being hubs, which are fully operational, and are currently developing satellite hubs. These hubs target the most vulnerable people and provide interventions on a one-to-one basis. They actively work with hospital teams to create support links for service users admitted to hospital, helping with discharge. We are also looking at ways to work differently with the intermediate care services. We engage with users to make sure they have the confidence to access services and work, in order to reduce any delays in processing care which could damage that confidence. We are also piloting the healthy and active passport, which will give citizens access to services and schemes aimed at improving health and well-being.

We simply cannot ignore the impact of an ageing population and the pressures it puts on healthcare, both local and national. The current efforts to address projected pressures offer a way to a brighter future for older and vulnerable people, and I welcome the Government’s initiatives to support local areas. They are fundamentally about moving away from a sickness service and towards a system that enables people to live independent and healthy lives in their own communities. We must create wellness, not just treat illness. Through hard work, imagination, commitment, and not working in silos but together, we can meet head on the challenges presented by our increasingly elderly population and aspire to make this country the best to grow old in.

Residential Care: Cost Cap

Baroness Redfern Excerpts

Thursday 10th December 2015 Lords Chamber

[Baroness Redfern (Con)]

My Lords, I, too, join other noble Lords in congratulating the noble Baroness, Lady Wheeler, on introducing this very important debate this afternoon.

I know all too well, through my own local authority in North Lincolnshire, the pressures the sector faces, both locally and nationally, in providing high-quality and affordable residential care. As Members of this House are aware, the first stage of the Care Act 2014 came into force last year, providing a single, modern statute that puts an individual at the centre of their own care. The introduction of a cap on care costs is welcomed by many. However, without going over ground already covered this afternoon, concerns were raised regarding the cost to public sector spending of a cap.

As a result, Her Majesty’s Government announced in July that there would be a delay until April 2020, particularly to allow further consideration on the implementation and sustainability of what will perhaps be the biggest reform of the payment of care since 1948. I strongly believe that Her Majesty’s Government wholeheartedly support reforms to assist those requiring care, and I look forward to further announcements on this.

That said, let me turn to my authority and add an important local dimension to this debate. As a local authority we have looked at the best way to implement these reforms to care and support under the new rules of the Care Act 2014. We put people at the heart of what we do and constantly work from that position to help those in need. We work hard to ensure that they remain safe and properly supported. We want to work with those who receive care and, importantly, their families to transform their lives for the better.

I am pleased to inform your Lordship’s House that North Lincolnshire continues to be a high-performing authority and we continue to develop and enhance a vast range of care and support services to meet local needs. Although the changes to the Care Act aim to give greater choice and control to those in need of support, we found that we are already fulfilling some of these duties. We said that we would increase the number of vulnerable people helped to live and receive care in the community, and we achieved this through a number of different routes.

First, we did this by increasing the accessibility to advice and information at the time of choosing a care package. We also carry out regular reviews to check progress with the individual’s care. Access to information of services is incredibly important, and the adult social care outcomes framework measured the percentage of people who found this information about services in North Lincolnshire increased from 77.4% in 2013-14 to 84.4% this year—the joint highest result in England.

Secondly, we established community well-being hubs, which offer access to services for those with more complex care and support needs, helping individuals to identify ways to improve their independence and well-being. I am pleased to say that we now have five of these hubs across North Lincolnshire as well the Sir John Mason intermediate care centre in Winterton, which I mentioned in my maiden speech such is our belief in the excellent facilities on offer there.

By working closely with health colleagues and other organisations, more people are being supported to remain living well—that is really important—for longer in their own homes and community. A great focus has rightly been placed on adult carers, with an increase in the number supported than in previous years. The noble Lord, Lord Lansley, earlier alluded to working with partners to increase the provision of suitable and adapted housing for people with complex needs. More people than in 2013-14 now have control of their own support, through a direct payment which is personal to the individual’s need. A personal budget gives people control to choose how, where and when they will be supported.

Our ultimate intention is to ensure that everyone living in a care home receives good and outstanding services across the area, and we want to work with them to achieve this. We also said that we would increase the number of vulnerable people who have real choice over their care and the support they receive. By undertaking personal assessments, again we support people to remain independent, and we make sure we personalise the approach to their care. Independent living is, I am sure, something that noble Lords would agree that many of us at times take for granted.

Furthermore, I cannot stress enough the significance of the relationships social work teams must have with individuals, their families and carers in order to understand their care and support needs, and how they would like these needs to be met. The better care fund, introduced more than two years ago, creates a single shared budget, which encourages the council and NHS to work together.

The priorities of the partnership agreement were to reduce hospital admissions, lengths of stay in hospital, delays in transfers of care from hospital and also permanent moves into care homes. To end, North Lincolnshire’s social work teams continue to ensure that people are at the heart of what we do. I hope that other local authorities, too, welcomed the reforms to the residential care sector and that they had as much success in implementing them. As we have discussed, for the first time in nearly 70 years we are presented with an opportunity to undertake a proper review of residential care. I welcome Her Majesty’s Government giving proper consideration to designing a means to support and protect vulnerable people from potentially catastrophic care costs, both in North Lincolnshire and across the country.

Health

Baroness Redfern Excerpts

Thursday 26th November 2015 Lords Chamber

[Baroness Redfern (Con) (Maiden Speech)]

My Lords, it is with a great source of pride, having spent more than 28 years in continuous service to the Isle of Axholme as an elected councillor and now leader, to be able to stand among you today as a Member of your Lordships’ House.

Preparing for today—I am sure many noble Lords are acquainted with this—I realised my predicament in speaking before so many learned and talented individuals from all sides of the House. Now that I am a Member of your Lordships’ House, I should like to say what a delight it is to observe the wealth of knowledge that this House provides, and the great kindness and warmth shown to me not only by noble Lords but by all the staff who I have encountered since I took my seat here. I would also like to register my eternal thanks to my family and long-standing colleagues. I also thank my two sponsors, my noble friends Lord Taylor of Holbeach and Lady Eaton, both of whom have aided me and provided helpful guidance in my initial few weeks here.

I will, if I may, briefly take this opportunity to share with noble Lords the historic origins of the Isle of Axholme and how the isle came into being. I moved to the isle following marriage and we started our businesses here, enabling us to integrate into what continues to be a close-knit and very friendly community.

The isle is dominated by marshland and peat, with many of the original communities, including Crowle, Epworth and Haxey, all built on what was previously the only high and dry land available. Indeed, the isle is known to many by the early influences of the Dutchman, Cornelius Vermuyden, an engineer whose work at Windsor brought him to the notice of Charles I. The King subsequently commissioned him in 1626 to drain Hatfield Chase.

The isle is known as an isle as it was previously separated by four rivers—the Idle, Don, Trent and Torn—which created a unique and strong identity. A number of notable individuals hail from the isle, and Epworth is the birthplace of Wesleyan Methodism. We have a strong appreciation of agricultural activity and the beautiful watercourses that the isle has to offer, which have produced, among other things, high-quality beetroot and celery. That said, the isle and our area more widely are very susceptible to flooding, and securing funding for proper flood defences is something that I have already championed and will continue to pursue.

It might seem appropriate to speak on health, considering my heart rate in delivering this maiden speech, and I welcome the debate secured by the noble Lord, Lord Crisp, today. Across North Lincolnshire, we have worked hard to engage all of the community and provide opportunities to improve health prospects—both physically and mentally. North Lincolnshire Council has invested in a successful programme of community well-being hubs, which provide advice and support for a wide range of individuals and groups, including vulnerable adults. This is against a backdrop of declining local government budgets and I am proud that we have achieved this by making necessary savings elsewhere to secure and improve front-line services.

The hubs work with and support older people, young adults and also carers; recognising the wide mix of people involved in healthcare. They work neatly with the national health agenda by integrating services for the benefit of both patients and the broader health economy. Indeed, the regulation of health and social care professionals not only impacts on the lives of registered and aspiring professionals but affects the lives of all those who use these services. The community hubs also provide a base for well-being checks which, among other aims, address poor nutrition and raise awareness of healthy eating and choice. Poor nutrition, which manifests itself very much in older people, is estimated to cost the NHS £13 billion a year. Looking at ways of addressing this and creating health aspirations locally is something that I am passionate about.

The latest addition to our commitment to develop health opportunities in North Lincolnshire is the Sir John Mason House intermediate care facility in Winterton, the town where I was born, and this brand-new facility was launched this year. Those using this service may stay there for a period of rehabilitation and reablement, for example following a hospital stay. With an ever-increasing older population, loneliness and isolation are key challenges for all local authorities, and North Lincolnshire Council is working hard to combat this. Like many areas, memory cafes are held across North Lincolnshire and help link residents with health services. These are shining examples of co-operation between the community and different agencies. However, we must look at ways to further integrate services and at the wider health debate as social isolation is known to increase the chances of premature death by up to a third.

Finally, the Isle of Axholme is blessed with some outstanding scenery and is a very special place. I am passionate about encouraging and assisting local residents to access this shared space with opportunities such as Walking the Way to Health, which is a project to organise walking activities. While my walking days are nowhere near behind me, I look forward to spending plenty of time sitting in on the many future debates regarding health and sharing the positive achievements across North Lincolnshire, and particularly on the isle, with this House.