Health: Parity of Esteem

Baroness Brinton Excerpts

Tuesday 20th October 2015 Lords Chamber

[Lord Prior of Brampton]

My noble friend makes a very good point: reaching for medication is often not the right way forward. I am not sure how much time in the undergraduate syllabus is reserved for mental health training. However, I know that a considerable amount of time is set aside for it, so that people who decide to become GPs will have had some training in mental health before they qualify. Only last week, I was talking to Clare Gerada, who was the president of the Royal College of General Practitioners. She said that she thought the best combination of all was for a GP to have studied psychiatry as well.

[Baroness Brinton (LD)]

My Lords, it is encouraging to hear the new Government continue the priority that the coalition Government gave to improving mental health access for everyone, and specifically for children. I am also encouraged to hear the Minister talk about waiting time targets. However, surely true parity of esteem will be reached when we have targets for CCGs and, if they miss them due to lack of funding and the appointment targets are missed, that is publicised in the same way as missed A&E targets.

[Lord Prior of Brampton]

That is a very interesting point. We have three principal targets for mental health: two relate to IAPT and the other to access for those who have their first psychotic episode. Clearly, we do not yet have the range of targets for mental health that we have for physical health, although the introduction of those three targets this year is a big step forward. It is important that the targets should be based around outcomes rather than funding.

Social Care and Support: Funding

Baroness Brinton Excerpts

Monday 19th October 2015 Lords Chamber

[Lord Prior of Brampton]

As regards the position of the social care sector, “fragile” is putting it kindly. It is very difficult; there is no point making any bones about that. The increase in the living wage, which is long overdue and very welcome, will add to pressures on the sector. It was made very clear in the Five Year Forward View that the future of the healthcare system is very much tied up with the future of the social care sector. The noble Baroness can be assured that we have brought that to the attention of the Treasury and we are waiting for a favourable result in November.

[Baroness Brinton (LD)]

My Lords, the social care sector is in a perfect storm, with councils having faced a 30% cut in their social care budgets as well as the increase in the national living wage which—much as it is welcomed—it is estimated will cost an extra £1 billion. I ask the Minister once again: will the Government commit to spending the extra £6 billion that they are saving by not implementing Dilnot and ring-fence that money to support the social care sector through this very difficult time?

Social Care

Baroness Brinton Excerpts

Thursday 15th October 2015 Lords Chamber

[Lord Prior of Brampton]

I thank my noble friend for that important observation, with which I agree completely.

[Baroness Brinton (LD)]

My Lords, the better care fund was a good starting point for the integration of health and social care, but the Government deferring the integration of the spending limits in the Dilnot review means, we are told, that there are £6 billion of savings. Will the Government ensure that that saving of £6 billion from not fully implementing the integration of health and social care is put towards the new minimum wage and the new contracts ensuring that staff are paid for travel between appointments?

[Lord Prior of Brampton]

The position on the savings from deferring the introduction of the Dilnot proposals is that they are being taken into account under the spending round and I cannot comment further today.

National Institute for Health and Care Excellence

Baroness Brinton Excerpts

Monday 13th July 2015 Lords Chamber

[Lord Prior of Brampton]

I am not entirely convinced by the argument about regulation when it comes to managing wards. My own observation is that when you have strong leadership from strong ward sisters, ward managers or charge nurses, many of the problems that we identify seem to disappear and there is very high staff morale, low absenteeism and little use of agency staffing. So much comes down to local leadership, and sometimes regulation is used as a scapegoat.

[Baroness Brinton (LD)]

My Lords, given that everyone accepts that the new safer staffing guidelines will require more nurses, what will the Government and Health Education England do to reduce the number of nurses who do not qualify from their training, which is currently running at about 20%?

[Lord Prior of Brampton]

That is a very high figure. It is quite revealing that most of the people drop out in their first placement, and it behoves universities and Health Education England to ensure that they are recruiting new nurses who have done some work in a care home or hospital so that they know what the realities and practicalities of being a nurse are.

NHS: Whistleblowing

Baroness Brinton Excerpts

Tuesday 30th June 2015 Lords Chamber

[Lord Prior of Brampton]

There are a number of organisations that the noble Baroness might wish to contact, but most important is to raise the matter first in the local organisation. All organisations should have their own whistleblowing procedures, and that is the right way to raise concerns. If any individual finds that not to be satisfactory, the right way to proceed is through the Care Quality Commission, which has a dedicated hotline in its service centre in Newcastle.

[Baroness Brinton (LD)]

My Lords, which takes priority: duty of candour or an employee’s contract with their NHS trust where they are gagged?

[Lord Prior of Brampton]

The duty of candour should clearly take precedence. It should be seen in the context of an agenda to improve patient safety in hospitals; if we are not open about our mistakes, we will not learn from them.