Health and Social Care

Baroness Masham of Ilton Excerpts

Thursday 15th December 2016 Lords Chamber

[Baroness Masham of Ilton (CB)]

My Lords, I thank the noble Lord, Lord Harris of Haringey, for having secured this debate, which for some time I have thought needs discussing. I join other noble Lords in sending our thoughts at this time to the noble Lord, Lord Prior. I also congratulate the noble Baroness, Lady Chisholm of Owlpen, for taking on the extra load. As we draw near to Christmas, the ill, disabled, frail elderly people and the vulnerable homeless should be in our thoughts at this time.

We hear a great deal about the patient-centred health service. This should not just be words; patients and patient associations should be part of the system and the patients’ voice should be listened to. They should be part of the team, not just a number to be dealt with. I declare an interest as president and founder of the Spinal Injuries Association. We have a wealth of knowledge collected over the years, which we are only too pleased to share with anyone who may be interested. It is a catastrophic situation if you break your neck and become paralysed. SIA supports members and their families. We have a very complex health system. With so many different bodies it is difficult for even health professionals to know their way around and who is responsible for what.

I support flexibility of care and encouraging health and social services to work in co-operation and communication, which must be the best way. But the fact is, both the National Health Service and social care are in crisis due to pressure and shortage of doctors and other staff, so there are demands on the services and a lack of funds to cover the increasing needs of patients who expect and want a high quality of care.

Growth in the workforce has not kept pace with the growth in patients. The Government ought to do a comparison between the UK and Germany to understand why patients seem to get a better service in Germany. When new life-saving drugs come on stream, German patients get them quickly while our patients have to wait, and sometimes never get them. This debate addresses the effectiveness of the local Healthwatch network and its independence from sponsoring local authorities, and the role of Healthwatch England. Healthwatch England and the local Healthwatch organisations have a number of statutory duties such as promoting and supporting the involvement of local people in the commissioning, provision and scrutiny of local care services.

The health and social care reforms of 2012 set a powerful ambition of putting people at the centre of health and social care. To help realise that ambition the reforms created Healthwatch in every local authority area across England, and Healthwatch England is the national body. Healthwatch is supposed to be unique, in that its sole purpose is to understand the needs, experiences and concerns of people who use services, and to speak out on their behalf. Knowing this debate was to take place, I asked many people if they knew about Healthwatch and what it is supposed to do. Not one of them had heard about it, including my sister-in-law who is Lord Lieutenant of the East Riding of Yorkshire.

North Yorkshire is bigger than the whole of Belgium, and that county has only one local Healthwatch, situated in York. There are many problems at the moment in rural areas, with community hospitals and care homes being closed, but I have never heard a comment from Healthwatch supporting the local communities. If there is an important health issue, it is the Patients Association which is asked to comment by the press. Perhaps this debate will help to expose some of the problems. I feel that Healthwatch bodies do not represent rural areas; they are situated in large towns and cities and are spread too thinly to do the job of helping communities. Last Friday morning, my secretary telephoned the Healthwatch in York to get some information but she got only an answerphone. She left a message but we never got a response.

I want to tell noble Lords about a positive project. Independent Age, a voluntary organisation, has joined with Healthwatch Camden. Independent Age has developed a quality assessment for care homes based on the things that older people and their families want and need. Because Healthwatch Camden has a statutory right to enter care homes on request, it has partnered with Independent Age as part of a pilot programme. This will increase the amount of information available to older people when making decisions about their care, as there is often not enough transparency over which care homes are good and which are not. It is good to hear of bodies working together. So much time and energy is wasted when organisations work in silos.

North Yorkshire’s health watchdog, the county council’s Scrutiny of Health Committee, will hold a high-profile conference on 16 December—tomorrow—in response to NHS England’s plan to reorganise services in the area. The Government are rolling out sustainability and transformation plans—STPs—which cover 44 different areas of the country and are intended to accelerate the implementation of the five-year saving plan. The fear is that plans are being rushed through and modelled around the needs of urban centres, depriving the needs of rural areas.

The county has already seen reductions in health provision, with the closure of the Lambert Memorial Community Hospital in Thirsk and the downgrading of the maternity unit at Northallerton. The distances in rural areas can be immense. People do not mind travelling long distances to specialised expert services, but for respite care and general medical matters they need to be nearer home. Can the Minister give an assurance that the special needs of rural areas will be safeguarded across the country? There is suspicion of STPs, which do not seem to be open and transparent.

Everyone wants a thriving NHS, not a failing service. Many people thought that if they voted for Brexit, the money saved would go to the NHS. They will feel that they were led up the garden path if things do not get better.