Declining Birth Rates

Baroness Thornton Excerpts

Thursday 4th June 2026 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, I congratulate my noble friend Lady Nargund on securing this debate, and I note how busy she seems to have been today. I have a strange feeling that she is only just getting started in your Lordships’ House—let us see what happens next. This debate is a veritable banquet of related policy issues. I intend to address those which are to do with the ageing demographic.

I declare an interest as the chair elect of SCIE, the Social Care Institute for Excellence, founded by your Lordships’ House around 2003. I follow distinguished Members of your Lordships’ House in chairing this organisation. I am also a non-executive director of Whittington Health, where I am the maternity lead. I am going to talk about the demographic impact of our ageing population. It is important to say, as other noble Lords have said, that having a population of so many people living longer is a matter for rejoicing. It creates issues, but it is something for which I think we should all be grateful.

It is indeed the case that 14.2 million of us will be living longer by 2034, and 9.1 million of that number will have a serious illness. So, I am very pleased that the NHS 10-year plan addresses the UK’s ageing population by shifting the health service’s focus from reactive hospital treatment to proactive integrated care in local communities and tackling the unsustainable rise in demand from major illness by promoting preventive care, better digital access and stronger social care.

The plan has various elements. On neighbourhood health services, it will decentralise care by expanding multidisciplinary teams in our local communities. On digital integration, it will enhance the NHS app to empower patients to manage their own care. I appreciate that raises issues of digital exclusion, but those are issues we need to tackle. We should not underestimate the fact that those of us who are older are perfectly digitally capable given the chance to be so—although I have to say the phone on my desk has stopped working again, but I promise I will solve that problem. On preventive healthcare, the NHS will shift from reactive to predictive care by leveraging genomics and health risk scores to intervene earlier.

The plan also envisages social care alignment, which I will spend my last couple of minutes talking about. It emphasises the urgent need to accelerate social care reform to ensure smooth hospital discharges and, more importantly, sustained support at home. It emphasises shifting care closer to home and building a neighbourhood health service. That is not achievable unless we can really place social care on an equal footing with healthcare.

Social care’s role is vital in effectively delivering neighbourhood health and early support. That is why the Casey report is very important. However, I ask my noble friend the Minister whether the interim report expected this year will address the necessary transition to equal status for social care fast enough to allow this delivery to happen. Will the plan also fulfil the commitment to incorporating lived experience in the design of neighbourhood healthcare development? Will the voluntary sector, social enterprises and community organisations also be involved in the delivery of the neighbourhood healthcare we need to develop and build to ensure a soft landing for the future?