Health and Care Bill

Debate between Earl Howe and Baroness Uddin

2nd reading
Tuesday 7th December 2021 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, I spent some decades of my personal and professional life trying to improve health and social care through the statutory and voluntary sector. I welcome the prospect of refining the Bill in the interest of service users and staff alike, to whom I pay my deepest respects in the light of what has been an impossible and worsening situation for the health of our nation.

I recently witnessed two contrasting events: a patient in an acute ward for mental health, and another progressing though intensive care and then a surgical ward. The staff shortage and lack of adequate care support is indeed grave at every level, and I know my family will not be the first or last to share these harrowing experiences. Therefore, my principal reaction to the many aspects of this ambitious legislation and the report on adult social care is that they ring hollow as wishful prayers.

The Government have said that the Bill is driven by NHS demand. I fear that most frontline staff across the service do not agree; nor have they asked for the inevitable fragmentation and the huge structural upheaval which may result, given the existing shortage of staff and funding within the NHS and care sector as it struggles with Covid.

Of course, I hope that the panacea on the written papers will improve service users’ actual experience. Given the glaring lack of any meaningful references to workforce development and, ominously, of any indication that the long-standing consequences of inequalities and discrimination are being addressed, my confidence is rather low at this point.

We are asked to respond to a 10-year plan fit enough to address a massive, long-standing crisis where people are waiting to receive the urgent care to which they are entitled: 1.5 million hours of commissioned care is not being delivered and at least 400,000 adults and families are waiting for formal assessment. This gravely undermines the human rights of those who may already be experiencing a great deal of indignity, pain and desperation. Does the Minister accept that the new proposed boards and commissioning structures may create an even greater backlog of unmet needs?

How do the Government propose to address these anomalies while introducing the new challenges of means-tested personal care and private care companies into an already frail NHS, which struggles to manage current demands? According to the Royal College of Nursing, the Bill as it stands does not address nursing staff concerns, ensure patient safety or give adequate weight to staffing shortfalls in the NHS and the social care sector.

According to other leading experts, including ADASS, £1 billion for the social care sector, while extremely welcome, is not aligned to the reality of the £7 billion investment required to meet urgent needs, and is unlikely to remedy the current crisis in social care. The fear is that the prolonged and chronic historical underfunding—the insufficient resources allocated for social care in the community, which is a disjointed system at local level—will exert even more pressure and cause untold misery and suffering for individuals and families who are among the most vulnerable: the elderly, the disabled with learning disabilities and autism, and people needing mental health support. Integrated care will therefore remain dysfunctional locally, regardless of the fact that half the available social care budget is spent on working-age adults with learning and physical disabilities and the elderly to empower care in the community.

We know that supported housing is seen as a critical linchpin of independent living and is projected to increase by 2030. With only £300 million for these options, does the Minister accept that the Government will have to broaden their reach to widen the network of providers, including specialist and BAME providers, to provide comprehensive and equal care across all communities?

How will these proposals affect the lives of black and Muslim men experiencing mental health crisis who are festering in hospital wards without adequate support, counselling and rehabilitative programmes, and with next to nothing on prevention? I am pleased to hear the new announcement for funding for drug and alcohol treatment. As an experienced leader in the field of dealing with substance misuse at local and national level, I can assure the House that adequate funding for resources and social work support is indeed effective in preventing revolving doors, which can save the NHS and the justice system millions. As the distinguished noble Lord, Lord Ramsbotham, clearly and eloquently said, the Bill should be the right place to consider this service.

Caring institutions and organisations are often run by poorly paid and undertrained staff, including social workers, who are once again in our sight for scrutiny. I declare my interest as one. I have worked in child protection and with domestic violence victims and survivors, as well as those with disabilities and substance misuse problems. I understand the horrendous pressures at the front line.

I have two final points. The APPG on Children, alongside many leading NGOs, is anxious that the Bill does not do enough to bring the benefits of integrated working to children and families. I support its asking the Government to commit to assess the Bill’s impact on children within two years of its implementation. Lack of investment in social work, police and education has once again led us to a tragic death, that of Arthur Labinjo-Hughes. As a social worker, I have witnessed the demeaning and catastrophic effect of child abuse. Heartbreakingly, it is a fact that lessons learned from what happened to diminish the hope, the smiles and Arthur’s last breath may not prevent the last cry of a child unless we empower staff at the front line of managing complex violence and abuse in our midst.

Finally, I draw the House’s attention to the points raised by the Inter-Collegiate and Agency Domestic Violence Abuse coalition. It views the Bill as an opportunity to deliver the health needs of survivors of domestic abuse. It rightly asks that the guidance for integrated care systems and partnership boards be placed on a statutory footing to ensure that it is adhered to across the health service. I agree with the noble Lord, Lord Shinkwin, that this guidance should also apply to those with learning disabilities and communication needs.

I welcome and congratulate noble Lords—

[Earl Howe (Con)]

My Lords, contrary to the clock, the noble Baroness has been speaking for nearly eight minutes. Perhaps she could bring her remarks to a conclusion.

[Baroness Uddin (Non-Afl)]

I welcome and congratulate the noble Lord, Lord Stevens of Birmingham. I hope that we will all work together to enhance this Government’s efforts for better regulation. I hope that we can safeguard the needs of the most vulnerable in our society.

Business and Planning Bill

Debate between Earl Howe and Baroness Uddin

Committee stage & Committee: 2nd sitting (Hansard) & Committee: 2nd sitting (Hansard): House of Lords
Tuesday 14th July 2020 Lords Chamber

[The Deputy Chairman of Committees]

I have received a request from the noble Baroness, Lady Uddin, to speak briefly after the Minister.

[Baroness Uddin (Non-Afl) [V]]

My Lords, I wanted to speak in support of the noble Lord, Lord Kennedy of Southwark. I was not able to do so because I was muted from the other side; I therefore seek the leniency of the House in making my points.

In the past few months, we have become accustomed to approving measures retrospectively. Our debates have become mostly redundant because of the need to accommodate the next set of schedules and amendments. It has been important for me to put forward my views on this Bill.

Given the significant role of local authorities in the recovery of our communities, the reporting requirement in this amendment must detail the extra cost of how measures in this Bill will have an impact on local communities, as it is not clear. As a former councillor, I fear that the inevitable result will be a greater workload and higher cost for most authorities, including planning services. Many local authorities have been put on the back foot by some of the proposed measures and, by all accounts, feel sidelined.

As the noble Lord, Lord Paddick, and other noble Lords passionately detailed, it is local authorities and local police forces who will have to manage the fallout and environmental impact of any breaches or disputes and mop up after anti-social behaviour. I am in complete agreement with the points made yesterday by the noble Lords, Lord Paddick and Lord Sheikh, about the result and detrimental impact of increasing the availability of alcohol. Therefore, this House requires more than assurances on reducing closing times. The impact can be felt by local residents—as well as the police and health services, of course—long into the night.

I am also concerned about the planning aspects of the Bill coming into this emergency process. The three-monthly review required by this amendment is of the highest imperative in warranting the necessary transparency in, and safeguarding of, local consideration of public interests. The Bill would worryingly enable planned development delayed by the Covid-19 outbreak to go ahead, forgoing the usual standards, such as requirement of local public consent, as eloquently detailed by the noble Lord, Lord Balfe, and others.

I appreciate that responding to housing need is of the utmost urgency. As a former deputy leader of Tower Hamlets Council, I am also fully conscious of the central role of local authorities in the planning process, and their duties and obligations to meet the needs of local residents and communities. This is equally significant when considering the environmental and health effects of long working hours on residents, particularly children. What provision will be made for environmental standards in the proposed local government emergency planning reforms?

It is worth reflecting on the Government’s own recent deluge of impositions, usurping the local planning process, which would have obvious detrimental consequences, incurring significant financial loss to the community benefits available from a number of local planning permissions granted. For decades, this has been a creative partnership route, allowing local authorities to build a fairer and more balanced mix of social and private housing and community facilities. The delay to accessing the community interest levy suggested in the Bill is deeply unsatisfactory. What consideration will be given to working with housing associations to ensure that good-quality family housing will also be built through permitted development rights —not just expensive housing creating segregated communities and further exacerbating social division? If the Minister is not able to answer, I would appreciate it if he would write to me and other interested Members.

No matter the political expediency, I see no value in, or justification for, management or planning decisions falling under emergency measures. I agree with my noble friend Lord Hain and the noble Baroness, Lady Wilcox, who have cited justified concerns and questions about land banking and other tensions within local authorities that they have to deal with. Local authorities should be at the heart of planning consent, and the Government should not persist in allowing fast-tracking for developers, which will inevitably compromise community housing needs.

The Bill would amend existing requirements concerning appeals to the Planning Inspectorate and would be a permanent change to the appeal procedure; it is a fundamental shift in local democratic accountability. Therefore, will the Minister assure the Committee that the quarterly review will encompass independent and local oversight of all planning applications granted for housing under this emergency legislation? Will he also make public any objections raised by local residents to safeguard due process in all planning consent while this emergency legislation is in place? I am extremely grateful to all Members for their patience.

[Earl Howe]

My Lords, with the leave of the Committee, I will reply very briefly to the noble Baroness. I was sorry to hear her questions because it appeared from what she said that she is fundamentally against the purposes—or most of the provisions—of the Bill. I hope that is not the case and will of course consider the questions she has asked. I simply remind her that extensive consultation has taken place with the Local Government Association, voluntary bodies and local associations of various kinds, and we have not encountered hostility to the purposes of the Bill, which are of course to enable the economy—and businesses in the economy —to get going again after the dreadful pandemic that we have all endured.

We have, in fact, been over most of the points raised by the noble Baroness at some length already, whether at Second Reading or in these Committee proceedings. I also remind her that these are, with two exceptions, temporary provisions. The noble Baroness made as if to say that we were setting in stone forever provisions that she had considerable concerns about. This is not the case and I hope that, on reflection, she will feel that this is a Bill that the country wants and needs. I will look at her questions and respond in writing as appropriate.

Coronavirus Bill

Debate between Earl Howe and Baroness Uddin

Committee stage & Committee: 1st sitting (Hansard) & Committee: 1st sitting (Hansard): House of Lords
Wednesday 25th March 2020 Lords Chamber

[Earl Howe]

All I can do is assure the noble Baroness that the points she has made will be taken back to the department and considered.

[Baroness Uddin]

My Lords, I too regret another intervention, but how will people know what is going on if they are number 30,000 in the queue? How will they communicate with the Government or the necessary department? What are the Government doing to ensure that they communicate to these people how they should react and respond? Is everything being done that can be? Maybe some of those working in the gig economy who have nothing to do will be asked to join some of these telephone contact centres as paid employees. That might be of additional assistance to the Government.

[Earl Howe]

My Lords, as the noble Baroness knows, there are various avenues for individuals to utilise. One might be contacting their local Citizens Advice to enable it to make representations. They can contact their Member of Parliament to enable him or her to make representations on their behalf. They are not without the means to communicate if something does not work as it should.

BBC Charter Review

Debate between Earl Howe and Baroness Uddin

Wednesday 22nd January 2020 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords—

[Earl Howe (Con)]

My Lords, it is the turn of the Liberal Democrats.