People with Learning Disabilities: Acute Illness
Lord Scriven Excerpts(1 week ago)
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Lord Scriven
To ask His Majesty’s Government what assessment they have made of the recommendations in the National Confidential Enquiry into Patient Outcome and Death report Acute illness in people with a learning disability, published on 11 June; and whether they intend to ensure those recommendations are implemented by NHS Trusts.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, we welcome the National Confidential Enquiry into Patient Outcome and Death’s report and its recommendations. NHS England has circulated learning from the report across the health and care system for regional teams to share it with integrated care boards. NHS accountability arrangements are in place, and immediate improvement actions are under way, including the reasonable adjustment digital flag. The Government are committed to high-quality care for people with a learning disability.
Lord Scriven (LD)
My Lords, enough is enough. Currently, with everything in place, people living with a learning disability still die on average 20 years earlier than their non-learning disabled peers. The key missing part of the jigsaw is a statutory independent review of every such death, legally compelling NHS trusts and other providers to implement the improvements identified. Why are this Government content to rely on the toothless, non-statutory reviews that have changed nearly nothing, and allow this 20-year life expectancy gap to continue?
Baroness Merron (Lab)
I certainly accept the point, and I am not quibbling about the number, because 19 years, which is where we are now, is totally unacceptable. In addition, there is the high percentage of avoidable deaths, which I know the noble Lord is very alive to. While I share the view that this is unacceptable, I would not put it all down to reports. I can say that there are strong expectations of ICBs. As I have mentioned, they are kept to account, and we are continually ensuring that the death of every autistic person and those with a learning disability that is notified is reviewed. The new national-level patient dataset will certainly provide what I would call a single point of truth, which has not been there in the past.
Baroness Merron (Lab)
That is the reason for the accountability measures that I have outlined. I should add that transparency is absolutely key to that. The guidance that we have issued about supporting the identification of people with learning disability is important; we are at that basic level. That is where we have started, but it will push this forward. Further to my answer to the noble Baroness, Lady Finlay, the guidance for acute hospital staff, for example, included standardised mental capacity assessment forms; they were not in place previously. Each ICB is required, via statutory guidance, to have an executive lead on learning disability and autism.
Lord Scriven (LD)
My Lords, every question that has been asked has shown that the system is failing: people are still dying. The key point is that the accountability mechanism is missing or is too diluted to work. Why do the Government allow this system, which kills people early, to continue? What has the Minister not heard in this debate that assures her that the system is working and that it will somehow change for the better? Evidence and history tell us that the system is broken.
Baroness Merron (Lab)
I hope that I have already agreed with the noble Lord and others about the progress that needs to be made in this area. I have certainly not said that it is acceptable—it is far from acceptable—and the questions have been very helpful in identifying that. The learning disability improvement standards support NHS trusts to measure the quality of care that they provide. All the areas that I have suggested and more are taking us forward. I gave the commitment —and I mean it—to keep these things under review and to seek to improve wherever we can. We look forward to working with the noble Lord in doing so.
Pharmacy Closures
Lord Scriven Excerpts(3 weeks, 5 days ago)
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Baroness Merron (Lab)
That comes into the category of underserved areas, particularly if there are fewer pharmacies. I disagree with my noble friend about the overall picture in terms of pharmacies; we are supporting them to do more work, and a bigger range of work strengthens their position. It is not necessary to live right near a pharmacy, because of provision by online pharmacies. Finally, I repeat that local authorities can also seek to open pharmacies where there are underserved areas.
Lord Scriven (LD)
My Lords, community pharmacy has lost thousands of full-time pharmacists in recent years, and many have been recruited directly to other parts of the NHS that can afford to pay more. What more can the Government do to support community pharmacists to minimise this internal displacement and help keep vital local pharmacies open?
Baroness Merron (Lab)
This is an important point and why the refreshed 10-year workforce plan, which we will soon see, will deliver the transformation of the health service, which pharmacists are very much part of. We are also looking to support employers in offering a range of national training opportunities for pharmacists and pharmacy technicians. We need to train and upskill the current workforce, and invest in community pharmacy staff. Pharmacists are very important, but there is a whole team with them. Training will include independent prescriber training, clinical examination skills and training the next generation of education supervisors.
Healthcare Services: Acute, Primary and Community
Lord Scriven Excerpts(1 month ago)
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Lord Scriven (LD)
My Lords, it is always a pleasure to follow my noble friend Lady Walmsley; I will pick up on her final theme. I thank my noble friend Lady Janke for initiating this important debate. As the vice-chair of the APPG on Pharmacy, I think the case for extra investment has been made by both her and my noble friend Lady Leaman.
When the Government took office nearly two years ago, they came with a narrative of transformation. They promised people a fundamental shift away from the expensive, reactive walls of acute hospitals and toward a proactive, preventative “neighbourhood health service”. But looking at the NHS ledger of the 2026-27 financial year, they are forced to confront a recurring theme: the Government’s policy is built on hope while the NHS is living a different reality.
The Government stated their hope that primary and community care would finally receive the financial engine required to keep people well for as long as possible at home. The reality under their watch is that the gravitational pull of the acute sector is still as strong as ever, accounting for between 75% to 80% of total NHS spend.
The data from integrated care boards for the year ahead show this. Out of a combined £139 billion allocation, the total identified for neighbourhood health transformation activity is a measly 0.25%—and this is to fund the flagship policy of the Government’s health strategy. The reality is that local efforts to invest in community, primary and preventive services have been actively crushed by top-down directives prioritising acute hospital performance.
The Derbyshire, Lincolnshire, and Nottinghamshire ICB cluster tried to deliver the Government’s vision, with a £33 million fund dedicated to community transformation. Yet, within days of launching it, national performance directives forced it to withdraw the whole funding and redirect it to acute services.
The Government’s financial priorities are also written clearly in their capital budgets. They have earmarked £2 billion this year for acute emergency care, yet allocated only £200 million for their flagship neighbourhood health centres. When you contrast £2 billion for the emergency machine against the £200 million for new community infrastructure, their true priority is laid bare.
Nowhere is the gap between the Government’s rhetoric and reality more damning than in community support for learning disabilities. Over the past 24 months, we have witnessed the continuation of the systematic hollowing out of the infrastructure that keeps these people safe and alive. Evidence published only last week by the Royal College of Nursing exposes what is happening right now under this Government’s watch. In its report, Safety, Equity and Expertise, the RCN warned that the specialist learning disability nursing workforce is in absolute crisis. In autumn 2025—the first academic intake under this Government—we see a catastrophic collapse in the pipeline. Fewer than 500 student learning disability nurses enrolled across the entire UK. In the south-east, the intake was exactly zero.
The workforce is evaporating because community budgets are being raided. What is the human cost? For someone with a learning disability, there remains a shocking 20-year life expectancy gap compared with the general public. When the Government force ICBs to pull transformation funds and look the other way as the specialist nursing pipeline dries up, they engage in a false economy of the highest order. When a vulnerable young person loses their community safety net, they land, eventually, in an acute crisis bed. The taxpayer pays a premium for this systematic failure. This is not just a policy failure but a profound human failure which is all too real for my family.
Why have the Government spent the last two years forcing local health systems to continue to feed the acute vacuum? When will they finally align the reality of NHS budgets with the hope of their rhetoric?
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, I congratulate the noble Baroness, Lady Janke, on securing a very important debate. I am also grateful to all noble Lords for their contributions. I recognise many of the challenges raised, which is exactly why we are taking the action that we are. I am glad that the noble Lord, Lord Evans, in particular welcomed the direction of movement, as have so many noble Lords, including the noble Baroness, Lady Pidgeon.
It is important that we look at where we started, because I think it reminds us of the scale of the challenge. It was the noble Lord, Lord Darzi, who made the point that we inherited an NHS facing the worst crisis in its history. We all know of people stuck on waiting lists for many years, staff who have felt let down by bureaucracy and little support, and patients who have had to navigate a system that all too often felt complex, disjointed and fragmented—the noble Baroness, Lady Brinton, spoke about literal navigation, which I thought was a key point. Not only was that the situation but we recognise that, while we are making improvements, there is some way to go, and I want to set that out at the outset.
I am grateful to the noble Baroness, Lady Lane-Fox, for talking of her own personal experience, and I can say to her that, yes, the patient is at the centre of all the reforms that we are making.
The noble Lord, Lord Darzi, found that society is getting sicker. People are living longer but in poorer health and with more complex needs. I should emphasise that that burden is not shared equally. The gap in healthy life expectancy has grown between the richest and poorest areas, and the model of care that was in place, which we are still seeking to change, while making progress, is working least well for those with greatest disadvantage, who are most likely to have complex needs. I agree that the system we inherited and are changing has been too hospital-centric, too detached from communities and too organised into silos. To the noble Baroness, Lady Lane-Fox, I say, yes, modern technology has transformed everyday life, and the scale of change certainly had not reached the National Health Service. We had a stark choice, as noble Lords know, and our response is reform
We also heard from staff and patients that they do not want the status quo. To agree with the noble Lord, Lord Scriven, people said that they wanted radical reform, and we have embraced that. I believe that the 10-year health plan responds to that, setting out the three fundamental shifts—hospital to community, analogue to digital, and sickness to prevention—with neighbourhood health at its very core. Our neighbourhood health framework, which was published in March, gives partners the clarity to develop locally led plans.
What is at the core of this debate is how to make that shift real. For the first time, the medium-term planning framework sets a target to reduce long waits in community health services, with at least 80% of activity to take place within 18 weeks by 2028-29. We are restoring GP access; to some of the points made about the important role, which we acknowledge, of the GP, more than 76% of people are now saying that it is easy to contact their GP, which is up from 61% when we came into office.
The noble Baronesses, Lady Brinton and Lady Gerada, and the noble Lord, Lord Scriven, all spoke of the importance of GPs. We are training thousands more GPs, and we are boosting capacity. From July 2024 to April 2026, we had more than 2,000 additional GPs; in total, we now have over 30,000, which is the highest number since 2015. This has meant that we have delivered 12.7 million additional GP appointments this year compared with last year, and I am grateful to GPs.
We are investing directly in the services that will make neighbourhood health possible, which was raised, quite rightly, by the noble Baroness, Lady Cass. I totally agree with her about young people having that voice, and we ensure that that is the case, but I know where to come should we need further assistance.
We have invested an additional £601 million in general practice, taking total GP contract investment to nearly £14 billion in 2026-27. A number of noble Lords, including the noble Baronesses, Lady Janke and Lady Leaman, spoke about the importance of community pharmacy, which I totally align myself with. That is why, to recognise that key role, we have given a 10% uplift, which translates to £340 million. Further on funding, as a number of noble Lords have raised, including the noble Lord, Lord Scriven, over £9 billion is being invested through the better care fund, and there is a commitment to deliver 250 neighbourhood health centres, for which the first 27 sites have already been selected.
This is not just a vision, but vision is important: one of continuous, accessible and integrated care, centred around the patient, which prevents ill health, intervenes earlier and gives people more control, by 2035. I understand the wish for pace, and I share it, but we also have to be realistic. There is a reason it is a 10-year health plan: it is not so we wait but so we have a plan that will transform the model of elective care.
Many interactions will no longer take place in a hospital building, but they will be able to take place. The noble Baroness, Lady Lane-Fox, asked whether we are using technology to the best advantage; the NHS was certainly way behind where it should have been, but we are moving towards that, because interactions will be able to take place virtually or through neighbourhood services closer to home. We will see the first NHS online hospital, the development of the NHS app—which has already greatly improved, as many of us know, as patients access care, information and appointments more responsively through their phones—and, by 2035, two-thirds of out-patient care will take place digitally or in the community. Central to that will be the single patient record, which I look forward to coming to when we receive the Health Bill.
General practice will remain at the heart of neighbourhood health. I heard what the noble Baroness, Lady Gerada, said. We are introducing two new at-scale contracts—the single neighbourhood provider and the multi-neighbourhood provider—to support GPs and partners to work against larger geographies. I recognise the pressure on GPs. We are working with GPs to assist them in their effectiveness and in the way in which they serve patients. Integrated health organisations will take responsibility for local population budgets. They will support integration and move resources to where they have the greatest impact.
Key within this debate, and raised in particular by the noble Baronesses, Lady Pidgeon and Lady Gerada, the noble Lord, Lord Scriven, and other noble Lords, is funding. We know the importance of ensuring that investment supports the shift from hospitals to communities—and I say to the noble Lord, Lord Evans, that that will include mental health as well as primary care and neighbourhood care. The 10-year health plan sets out an operating model that shifts power from the centre to local commissioners and providers. As I mentioned, ICBs and providers are developing medium-term and multiyear plans through the medium-term planning framework to show how they will use funding in line with the priorities.
I assure noble Lords that ICB allocations give greater growth to community rather than acute services to support the community transformation that noble Lords and I seek and to support neighbourhood health. We will continue to set those national expectations, and we will support that by changes to system incentives, such as financial flows. I hear the call for ring-fences, which is often made. It is a legitimate challenge, but they do not by themselves guarantee better outcomes. Our approach is to set national priorities and accountability, as well as enabling ICBs to use funding flexibly, because they are best placed, as we know, to meet local need and secure best value.
Lord Scriven (LD)
My point was that flexibility is taken away when national directives come down, forcing ICBs to spend money on acute and emergency care.
Baroness Merron (Lab)
I always appreciate the expertise of the noble Lord, but I have set out our approach. We are focusing on outcomes and the best way to achieve them. We keep them constantly under review and discussion, so it is not top-down but how we are going to get to the place that all noble Lords want us to get to.
I know that I will be able to refer to only a limited number of questions, and I hope noble Lords will forgive me. The noble Baroness, Lady Walmsley, raised dental deserts. We are offering incentives to attract dentists under the golden hello scheme, which is what it says on the tin. Importantly, we are also increasing the supply of dentists. We have just announced the first sustained expansion of dental school places since 2007. The noble Baroness, Lady Walmsley, also asked about progress being made on publishing health food standards and the consultation. I acknowledge her particular interest and expertise. We will soon be consulting on the proposals for healthier foods targets and reporting. Importantly, we remain on track for delivering on this 10-year health plan commitment in this Parliament. If the noble Baroness would like further information, I would be very happy to obtain it for her.
The noble Lord, Lord Evans, asked about milestones that will be used to ensure that the shift from hospital to community is taking place, which is important. That is why we have published the Neighbourhood Health Framework, which will ensure that accountability. I am very alive to the points he made about mental health services, and I am sure that he welcomes the mental health strategy that will bring together all the points. I am very enthusiastic about the fact that we are piloting community-based mental health centres. I was glad to visit the one in Birmingham, which totally persuaded me of their value, but we must of course wait for the evidence.
I know that noble Lords know that the NHS that we inherited was under intolerable pressure. We have chosen reform, we have invested, we are rebuilding access, we are enhancing digital tools and we will deliver an NHS closer to home that is more preventive, joined-up and equal. That is the way we will take the NHS into the future.
Puberty Blockers Trial: Consent
Lord Scriven Excerpts(1 month ago)
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Captain of the King’s Bodyguard of the Yeomen of the Guard and Deputy Chief Whip (Baroness Wheeler) (Lab)
My Lords, we will hear from the Liberal Democrats.
Lord Scriven (LD)
My Lords, the review from the noble Baroness, Lady Cass, warned that having no formal medical routes risks driving families towards unregulated online pharmacies and private clinics abroad. Given that an indefinite pause of the trial left some highly vulnerable young people in a state of clinical limbo, does the Minister agree that getting an evidence-gathering trial under way would be an effective way to protect them from the dangers of these unregulated and unmonitored markets?
Baroness Merron (Lab)
I certainly do agree. As I have said, having put a ban in place, we will take action against those who seek to transgress and benefit from it by seeking to sell drugs that are not permitted. That is a totally unacceptable route for them to follow. They risk the safety and well-being of children.
PATHWAYS Study: Puberty Suppression
Lord Scriven Excerpts(1 month ago)
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Baroness Merron (Lab)
I will approach this in the most straightforward way I know. Obviously, if there are other matters, I would be very happy to talk to the noble Baroness, as I have before. From my point of view, the number one safeguard is not an either/or. Participation can occur only with the consent of a parent or guardian and—not or—the child themselves. In some of the circumstances the noble Baroness raised, that will not be an issue. Clearly, if there is any doubt about consent, assent or suitability, the child or young person will not be included in the trial; it is only where it can be shown that all the safeguards apply.
Lord Scriven (LD)
My Lords, I listened very carefully to both sides of the argument, which is very emotional and charged because people hold strict views on the trans community or the risks to children. Without the clinical trial, where will we be? Is not the clinical trial needed to answer some of the very questions that have been asked?
Baroness Merron (Lab)
The noble Lord takes me back to where I started. This Government, any Government, have a choice, but there is no neutral option here. We know that the status quo—which the last Government accepted and the noble Baroness, Lady Cass, clearly identified—is totally unacceptable and young people are not being protected. It would not be responsible to do nothing about that. We can discuss and disagree or agree about what the right thing is to do, but in his Statement, the Secretary of State made it clear that he has a responsibility to look at evidence and take clinical advice. That is the right thing to do.
Resistant Hypertension
Lord Scriven Excerpts(1 month ago)
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Baroness Merron (Lab)
As my noble friend says, we have had great success, and it has really helped us to have pilot projects in other areas such as mental health services. I ask my noble friend warmly to anticipate the modern service framework, because that will set out how we are to go forward in this regard.
Lord Scriven (LD)
My Lords, following on from my noble friend’s question and the Minister’s answer, there is no definition in the department of preventable spending. Will the new modern service framework determine a definition of what preventable spending is so that it can be tracked over time to see whether prevention is becoming the norm?
Baroness Merron (Lab)
The modern service framework will focus on the cardiovascular disease pathway. I take the point that the noble Lord is making and assure him that, as he and the House will be aware, one of the three main pillars in the 10-year health plan is the move from sickness to prevention. Therefore, we will be looking at how we ensure that it delivers the results that we need. The modern service framework will be focused on consistent high quality and equitable care—in other words, on outcomes.
Integrated Care Boards: Budgets
Lord Scriven Excerpts(1 month, 1 week ago)
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Lord Scriven
To ask His Majesty’s Government whether they intend to mandate a statutory minimum ring-fenced allocation within Integrated Care Board budgets for community-based transformation.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, integrated care boards are responsible for commissioning health services to meet local need. We do not intend to mandate a statutory minimum ring-fence for community-based transformation. Through the medium-term planning framework and the neighbourhood health framework we are requiring systems to set out how they will shift activity from hospital to community. They need to provide clarity and consistency in order that we scale neighbourhood services and teams and develop locally led neighbourhood health plans.
Lord Scriven (LD)
My Lords, that is all well and good, but financial transparency is the bedrock of accountability. Yet in the answer to a recent FoI request, 80% of ICBs indicated that they could not identify their spending on learning disability services. Will the Minister acknowledge that without the basic financial data, the current system provides a perfect screen for ICBs to quietly raid learning disability budgets to cover acute deficits?
Baroness Merron (Lab)
The noble Lord raises a good point about data. Indeed, one of the pieces of work we are doing with ICBs on how they commission services is requiring better data and data analysis. I hope the noble Lord will see the improvements, but I very much take to heart the point he makes.
Healthy Life Expectancy: England
Lord Scriven Excerpts(2 months, 1 week ago)
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Baroness Merron (Lab)
I definitely agree. That is why data, particularly that which drives us to make funding decisions to get funding to where it is needed most, is absolutely crucial. I find the term “healthy life expectancy” more useful than what used to be called “life expectancy”. That, to me, was always only one side of the coin. However, I take on board the point that the noble Lord makes.
Lord Scriven (LD)
My Lords, people with a learning disability enter periods of multimorbidity and chronic illness 20 to 30 years earlier than those without a learning disability. What are the Government going to do to stop this national scandal?
Baroness Merron (Lab)
I accept that this is completely unacceptable. There are groups, including those the noble Lord rightly raises, which have an even worse healthy life expectancy. As I mentioned, we will be redesigning the system and making the shifts in the 10-year plan, in order that we target the areas and the groups that need it most. I can certainly tell the noble Lord that the most recent prevalence review on mental health will include those who have ADHD, those with autism and those with learning disability. That will take us forward, too.
Learning Disabilities: Health and Social Care Access
Lord Scriven Excerpts(4 months ago)
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Lord Scriven
To ask His Majesty’s Government what assessment they have made of (1) the use of reasonable adjustments for, and (2) the safety of, people living with learning disabilities when accessing health and social care.
Lord Scriven (LD)
My Lords, I thank all noble Lords who put their names down to speak in this important short debate, which for me is rather a raw one. This debate is not to ask for more of the same; to do so would be to sign death sentences for thousands more individuals with a learning disability. The system does more than fail. It facilitates what Professor Sara Ryan describes as “social murder”. As both a researcher and the mother of Connor Sparrowhawk, whose preventable death occurred a decade ago, she uses this term to describe a state-sanctioned erasure whereby those very institutions aware of the risks to life choose to maintain the status quo rather than dismantle it. People with a learning disability die, on average, 20 years earlier than the general population, and 40% of these deaths are preventable. At current trends, it will take 102 years to close this life expectancy gap. I therefore ask the Minister: does she accept that this century-long wait is a human rights failure?
Saying that tweaks will be made to a fundamentally broken system is an acceptance of the status quo that killed Connor a decade ago, and it is the same status quo that killed my nephew. My nephew, Myles Scriven, died in 2023 at the age of 31. The coroner delivered a devastating judgment of the evidential reality of today’s health and care system. He found a culture stuck in another era where clinicians had only a superficial grasp of regulations and communication was unsafe. Most tellingly, the reasonable adjustments were laid out in Myles’s medical notes: advocates required; mental capacity tests required; a hospital passport required; communication support required. Yet this was ignored by all healthcare staff, despite the trust telling us at the inquest that 98% of staff had been trained. Safeguards existed on paper only; they did not exist for Myles.
Since Myles’s death, hundreds of families have contacted me, confirming that his experience was not an isolated incident. They have shared identical accounts of systemic failure. Reasonable adjustments are being bypassed, parental expertise is being dismissed, and regulators are failing to enforce the very standards that they are sworn uphold. Despite repeated warnings, some providers continue to ignore the very changes necessary to prevent further avoidable tragedy. Myles’s case was no outlier, but a systemic norm.
We see the grim reality of this failure in the superb journalism of Daniel Hewitt of ITV News, whose investigations have exposed a trail of preventable deaths where life-saving laws are treated as optional. We also see it in the timeless reporting of Dr George Julian, who spent a decade at inquests documenting the fatal consequences of diagnostic overshadowing. Her work reveals an ingrained culture that refuses to see the person behind the disability and a culture that sometimes weaponises the Mental Capacity Act, while completely abandoning the legal duty to provide reasonable adjustments.
So why has the machinery of oversight failed so spectacularly? The CQC has become a regulator of process. It audits the existence of policy, not the efficacy of its application at the bedside. With only one prosecution in this area by the CQC, despite hundreds of preventable deaths, I ask the Minister: does she not agree that the regulatory framework is fundamentally broken and requires urgent statutory reform? Similarly, LeDeR is a toothless archive of tragedy. It is a system of learning without much doing. It produces a report with no legal powers to compel change. Can the Minister say what the Government’s plan is to transform LeDeR from an archive of tragedy into a tool for change? Specifically, will they commit to a statutory requirement that makes LeDeR’s findings legally binding on providers?
The system is obsessed with inputs. It measures how many staff attend training, not whether they have learned and changed. It measures the number of annual health checks, yet senior clinicians say that these are frequently tick-box exercises. The quality is dangerously variable, leaving serious underlying health needs entirely unaddressed. A tweak will not save lives. We need a systematic reform of the implementation, accountability and regulatory framework that moves beyond paper policy and puts the actual safety and survival of human beings at the very heart of the system.
First, we need a statutory review of all deaths, ensuring legal accountability for implementing recommendations. Can the Minister explain the Government’s ongoing refusal to support this call and why they believe the current voluntary arrangements are sufficient, when the death toll suggests otherwise?
Secondly, the Government must look to the Netherlands, where a dedicated medical specialty for learning disabilities has transformed outcomes and extended life expectancy. We need senior clinical leaders—consultants who can navigate multiple overlapping health issues with the same authority that we see from clinicians in paediatrics. This is about providing the expert clinical leadership required to break through systematic inertia. Will the Government commit to the establishment of these senior clinical leadership roles across the system? Will they provide the recurrent funding required to ensure that this model delivers the improvement and accountability that are so desperately missing?
Thirdly, we need real leadership accountability. The era of moving on from tragedy to tragedy must end. If a provider fails, the responsibility for reform must personally be held right at the top. Accountability must be triggered where a leader presides over safety breaches and fails to implement documented remedial actions—then they should face a lifetime ban from holding any senior management or board-level position in the health and social care sectors. Government responses to my Written Questions reveal a startling vacuum of oversight. They currently lack the basic data required to identify where the system is failing. How can the Government claim to enforce accountability when they do not even track which safety actions are being ignored?
The Minister cannot change the past, but the Government can be the architect of a new era of robust, safe services, accountability and regulatory action that works—or do we continue to defend a system that oversees social murder by another name? Systemic change is more than a tweak; it is a fundamental shift in how we value these human lives. It is the transition from viewing my nephew as a tragic case to seeing him as a citizen, with an inalienable right to safe care and an equal right to long life.
If we do not move to a legally binding new model of improvement, accountability and effective regulation, the Government are effectively saying that a 20-year life expectancy gap is the cost of doing business. Families deserve more than a sympathetic nod. They deserve more than a system that does not work in practice and they deserve a guarantee that “never again” starts today. I look forward to the Minister’s response, not just as a Member of your Lordships’ House, but as an uncle who will not allow his nephew’s preventable death and those of others to be in vain.
Migraine Care: 10-year Health Plan
Lord Scriven Excerpts(4 months ago)
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Baroness Merron (Lab)
I can indeed say to my noble friend that a holistic approach is exactly at the core of the 10-year plan, as is the enhancement of care through expanded community diagnostics, better prevention and the use of personalised digital tools, including the NHS app. All these will be helpful in the way my noble friend seeks. The workforce plan, which we will see shortly to support the 10-year health plan, will also acknowledge the need to see people holistically and to staff up accordingly.
Lord Scriven (LD)
My Lords, there has been a more than 20% increase in the number of emergency hospital admissions since 2021 due to this condition. Will the Government include and fund migraine in the Pharmacy First scheme and empower pharmacists to prescribe for this high-volume condition?
Baroness Merron (Lab)
We constantly review and discuss with pharmacists the range of conditions they cover. It has been one of the highly successful ways of making community-based care available, and we certainly want to continue to work with pharmacists. It is also important to note that more modern treatments are available now on prescription, which will all also support people to manage their condition and will reduce unnecessary A&E admissions.