Baroness Campbell of Surbiton debates involving the Department of Health and Social Care during the 2015-2017 Parliament

Thu 26th Nov 2015

NHS and Adult Social Care

Baroness Campbell of Surbiton Excerpts
Wednesday 5th April 2017

(7 years, 6 months ago)

Lords Chamber
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Lord O'Shaughnessy Portrait Lord O'Shaughnessy
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I thank my noble friend for that and for her contribution to the work of the committee. She speaks with great experience and authority from her role in running a local authority. She is quite right that technology offers huge opportunities. The key is to make sure that the NHS and social care systems see technology as an opportunity to improve productivity rather than as providing an additional cost. That is why we are taking a variety of actions through the life sciences industrial strategy, the accelerated access review and other routes to make sure that technology is improving outcomes.

Baroness Campbell of Surbiton Portrait Baroness Campbell of Surbiton (CB)
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My Lords, the current social care narrative is dominated by the lack of residential homes and home care services for older people. Given that working-age disabled adults make up one-third of those reliant on social care, is it not time that we had a more comprehensive government social care strategy that reflects the diverse needs of all service users, and to work with disabled people to produce it?

Lord O'Shaughnessy Portrait Lord O'Shaughnessy
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The noble Baroness makes an incredibly important point. Despite the ageing population, the fastest-growing part of the adult social care budget is, I think, for adults with learning difficulties. She is quite right that there needs to be a comprehensive approach. That is why additional funding is going in to support not just older people but working-age adults too.

Health

Baroness Campbell of Surbiton Excerpts
Thursday 26th November 2015

(8 years, 11 months ago)

Lords Chamber
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Baroness Campbell of Surbiton Portrait Baroness Campbell of Surbiton (CB)
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My Lords, I thank my noble friend Lord Crisp for tabling this very timely debate. Over the years, my noble friend and I have often exchanged ideas on what I like to refer to as the empowerment model of health and social care well-being. That was the model that drove my leadership of the charities the National Centre for Independent Living and, after that, the Social Care Institute for Excellence, where I was privileged to be founding chair from 2001 to 2006.

Michael Marmot, in his book The Health Gap, argues that not health services but the social determinants of health are more important in determining the health of the population. Like Marmot, I believe it is more important to change the conditions in which people live—to empower people holistically—than simply to address their medical condition or their care need, which disabled people have described to me as the medical model.

It is more important to empower people in health and social care than simply to address their immediate medical conditions. Therefore, the National Centre for Independent Living used the empowerment model to support disabled people to move from dependency-creating care provision to independent living support. Our work was born out of the Community Care (Direct Payments) Act, legislation that was conceived and largely implemented by disabled people. For the first time in our lives we had direct control over our social care budgets. I have to say that traditional care providers were very opposed at the time but, with the assistance of enlightened directors of social services, civil servants and a very enlightened politician, the tectonic plates of power shifted from “the professional knows best” to “the client knows better”.

This care revolution could not have been achieved without the national infrastructure of local centres for independent living. These local centres are largely run and controlled by disabled people, who provide advocacy, advice, buddying, volunteering and jobs. Over 15 years, I saw people society had written off come out of residential care, long-stay hospital wards or their parents’ homes and begin to live as rounded human beings. Relationships were formed, families were made and children born.

Things have rightly progressed over the years, and now people with learning disabilities also enjoy the same right to choice and control over the way their support is delivered and experienced. So, too, do people with enduring mental health challenges, who developed their own empowerment model, the recovery model, which demands greater focus on life chances rather than more psychiatrists, more treatment and more loneliness, pushing a culture shift in the provision of mental health services.

There is rich evidence that the independent living movement drove a culture shift that has led to a wider personalisation approach and now, at last, it is beginning to catch on with personal health budgets. But I remind noble Lords that this was conceived by the people who have the condition and not the experts.

It really baffles me why, when the economy shrank, local and national politicians decided to cut first the independent living infrastructure that is necessary for progressive personalisation. I remember campaigning for a national independent living scheme, which became the Independent Living Fund, over 21 years ago. It was the epitome of the independent living empowerment approach, yet again it was sadly cast aside without a government strategy to ensure its principle and outcomes were not lost when transferred to local authorities.

Independent living pays for itself again and again. It is well evidenced that people who live independently in the community with the right support lead healthier and more cost-effective lives. It is the very basis of health and well-being creation, where professionals enable, facilitate and inform, and the service user learns, takes control and lives—not just survives.

Finally, I congratulate the Government on the Chancellor’s spending review statement yesterday, allowing as it does local authorities to levy a new social care precept of up to 2% on council tax. This is good news. But a word of caution: let the £2 billion investment be directed at social care that enables the service user to become an active, empowered citizen.

Winston Churchill said of scientists that they need to be,

“on tap, not on top”.

We need their expertise, but for God’s sake, do not let them run the country. I would argue that the same applies to health and social care professionals: we need their expertise, but for God’s sake, do not let them run people’s lives. I suggest that legislators, policymakers, economists and politicians should seriously reach out to disabled people and the service users and let them be part of the solution, not a problem to be dealt with. Perhaps we could give leadership to my noble friend’s health-creating society and not simply be the users of it.