Queen’s Speech

Baroness McIntosh of Hudnall Excerpts

Tuesday 22nd October 2019 Lords Chamber

[Baroness McIntosh of Hudnall (Lab)]

My Lords, it really is a pleasure to contribute to this debate. While I cannot claim to have listened to every single speech, it has been a great pleasure to listen to the many that I have heard, which have been notably well informed. I know that the Minister will have a very difficult task in winding; I can see from her face that she has worked that out already. I also know that she has been listening very carefully and I very much hope that she is not alone.

We have been told several times already what the gracious Speech says about education—which is frankly not very much and certainly nothing that it would be possible greatly to disagree with. In fact, no Government in modern times would really have said anything different, which suggests that this is a largely policy-free area. The real question is not what you say about aspiration but what you do to make sure that that aspiration is achieved. In opening, the noble Baroness, Lady Barran, who is in her place, talked about additional money. That is of course very welcome, but it is not the whole story if there is nothing to say about content.

I will ask the Minister to pick up two recent reference points. One of them, the Durham commission report which was published last week, has already been mentioned several times. The commission was of course graced by the noble Baroness, Lady Kidron, among others and was chaired by Sir Nicholas Serota. Last Saturday, the Guardian summarised the report’s significance rather well. It said:

“The report, put together in collaboration with academics from Durham University, concludes that creativity is not something that should inhabit the school curriculum only as it relates to drama, music, art and other obviously creative subjects, but that creative thinking ought to run through all of school life, infusing the way human and natural sciences are learned”.


The second reference point is a current Science Museum and Radio 4 collaboration which I have been very much intrigued by. It is called “The Art of Innovation” and is co-presented by the director of the Science Museum, Sir Ian Blatchford, and his colleague, the head of collections, Dr Tilly Blyth. It is a whole range of perfect little programmes about how art and science have inspired each other. I highly recommend them to anybody who has not already heard them. Both of these things point in the same direction, as did Sir Ken Robinson’s report, All Our Futures, 20 years ago. Like the Durham commission, he emphasised that creativity can be taught.

Art, science and mathematics all rely on creative thinking, curiosity and imagination—as the noble Baroness, Lady Bull, for example, said earlier. In my view, all start with the same question, which is, “What if?” Asking this question requires the confidence and courage in both students and teachers to challenge, doubt, question and get things wrong. Nothing in current education policy supports this approach, even though many fine teachers try every day to encourage it. The emphasis on testing knowledge has been shown to narrow focus, and to breed caution and anxiety. At this point, I refer to the many contributions that have touched on mental health. Mental ill-health in young people is a serious matter and something that we are not currently dealing with very well in either the NHS or the education system. We could do better quite easily.

The day I hear a government Minister say from the Dispatch Box that he or she understands that education is far more than the acquisition of knowledge; that young people need imaginative reach in all areas of learning; that simply getting more students to take exams in drama, art or music, while very important, is by no means enough; that passing exams is only one measure of educational success, not the be all and end all; and that these things will be reflected in future policy will be a good day for me. I hope that when the noble Baroness comes to wind up she can make my day.

National Health Service: Healthcare Advice

Baroness McIntosh of Hudnall Excerpts

Tuesday 16th July 2019 Lords Chamber

[Baroness McIntosh of Hudnall (Lab)]

The Minister has just given a very eloquent explanation of her view of the relationship with Amazon, but does she agree that it is a bit counterintuitive to assume that a company as big and commercially successful as Amazon is not getting some value from the relationship with the NHS? Can she explain what that value is?

[Baroness Blackwood of North Oxford]

Amazon is seeking to ensure that it provides a service to its customers. In this instance, we have ensured that we have provided an open API: any company that chooses to develop a service linking to the information on the NHS website is able to do so. This is not an exclusive contract with Amazon. As I have already said, other companies are able to do so and some already have done. It is not a specific benefit for Amazon. It is something that other companies have already availed themselves of and is of benefit to the NHS and NHS patients.

Mental Health of Children and Young Adults

Baroness McIntosh of Hudnall Excerpts

Thursday 16th May 2019 Lords Chamber

[Baroness McIntosh of Hudnall (Lab)]

My Lords, at the end of King Lear, where, frankly, the stage is littered with bodies and not much to cheer one up has occurred, the Duke of Albany speaks to the few people who are left standing. He enjoins them thus:

“Speak what we feel, not what we ought to say”.


At this point, I feel that that is all I can do, because, unlike my noble friend Lady Royall who introduced this debate so extraordinarily well, and many others who are speaking, I cannot claim any expertise, whether clinical or in the work I have done in the field of child and adolescent mental health. However, I have some direct personal experience. Many people in my family, including me—I regret having to say it—have suffered from difficulties with their mental health. That includes children and one young child at the moment.

When I put my name down to speak in this debate, I knew that I wanted to speak but I was not sure how I was going to say what I wanted to say. I am still not entirely sure, so if what comes out lacks coherence or is sometimes intemperate, I apologise to the House and in particular to the Minister who has to answer this debate.

Two things have happened in the past 12 hours which have changed the way in which I thought about this subject. One was a television programme, and one was something that happened to a member of my family, a young child. The television programme was shown last night—I do not know whether anybody else saw it—and in it Nadiya Hussain talked about her own anxiety problems. The one thing that emerged from that for me more clearly than anything was that young people whose mental health problems are not diagnosed grow up into adults with mental health problems. That has already been mentioned by others, but we should never forget it. That is the risk we run: if we do not look at children’s mental health early enough, they will grow up into adults who find it much more difficult to deal with the residual problems they have.

This week is Mental Health Awareness Week—many of us are sporting the badges. It may be less widely known in this House that it is also SATs week; if nobody understands what that is, they should look it up. Putting the two together, the few things I want to say are about schools—schools as healthy or, in some cases, unhealthy communities. I want to make it clear that, as I say it, I intend no disrespect whatever to teachers or their students, all of whom in their different ways are trying their best to do a good job in difficult normal circumstances. I say that because I believe it but also because I have quite a lot of teachers in my family, so they would be very cross with me if I did not say it.

Good education must always strike a balance between discipline and freedom; core skills and creative range; learning to be part of a group and learning to be ourselves. Government policy over the past decade has done very little to help schools be healthy communities in that way. It has steadily narrowed the curriculum, reducing choice and imaginative aspiration, and focusing far too much on testing, which is why the SATS point is important. It has downgraded and undervalued arts subjects. I know that this is an old hobby-horse of mine, but I do not mind riding it out again when evidence shows the benefits of these subjects, including to mental health. More than anything else, government policy over the past decade has drained the joy out of education. If you cannot be joyful as a child, it is very hard to be mentally healthy.

I know that the Minister will say, with some good reason, that this is not her area of responsibility, but I ask her to consider that it is the responsibility of the Government as a whole to understand that young people spend a huge amount of their lives in school. Schools are communities, within which adults and young people need to find a way of co-existing such that the education the young people receive is good, enduring, healthy and sustainable. They cannot easily get that from adults who are themselves stressed, overworked and anxious. It is my belief and experience that many teachers in the system at the moment are in exactly that condition.

One way we can prevent our young people from becoming problems and needing mental health interventions is to try to ensure that their experience at school is nurturing, creative, safe and inspiring. That is what schools ought to be. I wish more of them were and I hope that the Minister will understand why I am putting this to her today.

Sexual Health Services

Baroness McIntosh of Hudnall Excerpts

Thursday 29th November 2018 Lords Chamber

[Baroness McIntosh of Hudnall (Lab)]

Following on from the question asked by the noble Baroness, Lady Barker, what is the current assessment of the undiagnosed incidence of HIV? There is usually a quantum that is reckoned to be about where we are with undiagnosed incidence. The Minister says that diagnoses have gone down and that that is a good thing, but it is not necessarily. Can he give us some information on that?

[Lord O’Shaughnessy]

Of course, I am very happy to. In this case, it is good news that diagnoses are going down because 92% of people with HIV in the UK have been diagnosed. The UN target was 90%, and we have exceeded it. That leaves 8% to reach and, clearly, we want everyone diagnosed and on treatment, with their viral loads suppressed, so that no new infections can take place.

--- Later in debate ---

[Lord O’Shaughnessy]

First, we are giving it an extremely high profile. Indeed, Governments have given it a high profile since the noble Lord the Lord Speaker raised the issue in the 1980s. All Governments since have been committed to that and this Government continue to be so. We do that through a mixture of public health campaigns and working with schoolchildren to ensure that there is no stigmatisation or bullying of any groups of young people with HIV.

[Baroness McIntosh of Hudnall]

My Lords, as there is a moment left, I ask the Minister to return to the question I asked him. Forgive me if I misunderstood his answer, but I do not think he said what the current assessment is of undiagnosed HIV in any of the populations. If he has that information, perhaps he could let me have it in writing.

[Lord O’Shaughnessy]

I thought I said that 8% are currently undiagnosed across the country. As to how that is split across different socio-demographic groups, I shall have to write to the noble Baroness with more detail.

Health: Stroke

Baroness McIntosh of Hudnall Excerpts

Wednesday 14th November 2018 Lords Chamber

[Lord O’Shaughnessy]

The noble Lord is quite right that patients with atrial fibrillation have a five times greater risk of stroke. Most patients are diagnosed but about 300,000 are not yet, so finding them is critical. The tests are available now not just in GPs’ surgeries but increasingly in pharmacies. I will write to him with specific details about the rollout.

[Baroness McIntosh of Hudnall (Lab)]

Of course the prevention and treatment of stroke is very important, but unfortunately some people have strokes and are incapacitated by them, sometimes physically but sometimes mentally as well. What work are the Government doing to ensure that as many people as possible register a lasting power of attorney so that, when that bad thing happens to them, a proper care plan is available?

[Lord O’Shaughnessy]

I will need to write to the noble Baroness with specific details on promoting lasting power of attorney. There has been an improvement in the availability of occupational therapy for those who suffer disabilities from stroke, but I do not know whether there is support in terms of planning ahead.

NHS: Staff

Baroness McIntosh of Hudnall Excerpts

Tuesday 13th November 2018 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness will understand that the safety of NHS patients, and the NHS as a whole, is paramount when considering workforce. We are looking at whether additional flexibilities can be explored, but that will only be done if we can assure ourselves and others of that safety. These issues are being considered in the workforce plan.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, the Government have placed great emphasis on mental health recently. Could the Minister tell the House what is the current shortfall of mental health professionals—particularly psychiatrists, and particularly child psychiatrists—in the National Health Service, and how the Government intend to address that shortfall?

[Lord O'Shaughnessy]

The noble Baroness is right to highlight that issue. Only around 30% of those who should be seen for treatable mental health illnesses currently are, which means that we have an important and urgent task to expand mental health places. There simply are not enough mental health staff in any category. This affects all developed countries. A big expenditure is being made, and around 21,000 new posts are being created across all specialties.

Antimicrobial Resistance

Baroness McIntosh of Hudnall Excerpts

Thursday 25th October 2018 Lords Chamber

[Lord O’Shaughnessy]

I join the noble Baroness in congratulating farmers on fantastic action in reducing the use of antibiotics. The specific issue the noble Baroness asked about is in the competence of Defra, so I will have to speak to my colleagues in that department about their opinion on the prophylactic use of antibiotics. On food standards, we have some of the highest food standards and animal welfare standards in the world, as the noble Baroness knows, and we have no intention of lowering them in any trade deal.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, the Minister referred earlier to overprescribing. Will he tell the House what is being done to protect the future of scientific research in this area, particularly post Brexit? Although changing the behaviour of GPs and patients is important, long-term certainty will come from research which is yet to be completed.

[Lord O’Shaughnessy]

The noble Baroness is quite right. A key part of the strategy to date has been a £350 million investment in R&D specifically on AMR. On what will happen after Brexit, as she will know, our intention, as set out in the White Paper, is to be part of the successor programme to Horizon 2020, which you do not need to belong to the EU to be part of.

Child and Adolescent Mental Health Services

Baroness McIntosh of Hudnall Excerpts

Wednesday 24th October 2018 Lords Chamber

[Lord O’Shaughnessy]

As I hope the noble Lord will know, refugee children have as much right to access these services as other children. I should also point out that a new mental health assessment trial is being funded by the Department for Education specifically to design mental health assessments for looked-after children of all kinds, including refugee children.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, can the Minister say what work his department is doing with the Department for Education in making consistent the level of pastoral care available in schools, particularly for young people who have experienced mental health problems and may not be in an acute stage but need ongoing monitoring?

[Lord O’Shaughnessy]

I am pleased to tell the noble Baroness that extensive work is being done. It was summed up in the plans outlined in the Green Paper last December and revolves around two things: every school having a designated senior lead for mental health and the recruitment of mental health support teams that will sit in and around schools. It is precisely about joining up education workers and health workers in the community to provide that kind of support.

National Health Service: Mental Health Funding

Baroness McIntosh of Hudnall Excerpts

Wednesday 20th June 2018 Lords Chamber

[Lord O’Shaughnessy]

My noble friend is absolutely right to highlight this issue. Individually, our emergency workers did extraordinary deeds of bravery, for which we are all deeply grateful, during the Grenfell fire. In the aftermath of that fire, the north-west London mental health service was the lead trust in providing mental health support for not just the families and individuals who were victims of the fire but emergency service workers who had been through that very traumatic experience. I strongly encourage any emergency service workers who are experiencing trauma—of course, that can happen many months, indeed years, afterwards—to get in contact with mental health services.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, does the Minister agree that £1 spent today on child and adolescent mental health services is likely to save the NHS a considerable number of pounds in the future? What proportion of the money spent on mental health services is going to child and adolescent services? Will that proportion increase in the future?

[Lord O’Shaughnessy]

The noble Baroness makes an excellent point. The emerging science tells us that heading off mental illness in adolescence is critical to ensuring that it does not deepen and become more severe in later life, with great human as well as economic cost. At the moment, the mental health budget for children and young people does not reflect the burden that children and young people have, which is why the Prime Minister announced an extra £1.4 billion for children and young peoples’ services, as well as £300 million on top of that to support the plans set out in the child mental health Green Paper.

Health: Cancer Nurses

Baroness McIntosh of Hudnall Excerpts

Wednesday 2nd May 2018 Lords Chamber

[Lord O'Shaughnessy]

My Lords, regarding the Statement made by my right honourable friend the Secretary of State earlier today about the errors in the breast cancer screening programme, I take this opportunity to apologise wholeheartedly and unreservedly on behalf of the Government, Public Health England and the NHS for the suffering and distress that has been caused to women by this flaw in the screening service. We will have an opportunity to discuss this at greater length tomorrow, when I will repeat the Statement.

The shortage that has been described is based on an analysis of vacancy rates. The number of cancer nurse specialists has actually increased by 1,000—that is 30%—in the last three years alone. That is a huge increase. Of course we know that we need to do more, but it is worth recognising the great steps forward that we have made in cancer treatment in this country.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, can I take the Minister back to the question from the noble Baroness, Lady Hayman? In his answer, he made the rather odd observation that it was in the long-term interest of the service that we should recruit our workforce domestically, and no doubt that is at least an arguable position. However, we are not talking about the long term here: we are talking about the immediate term. In the interest of joined-up government, could he go back to his colleagues at the Home Office and ask them to look again at whether they have made the right decisions in this case?

[Lord O'Shaughnessy]

I reassure the noble Baroness that we have lots of discussions with the Home Office about the recruitment of international doctors and nurses. I reiterate the point, however, that it is our intention to increase the number of training places for doctors and nurses from this country.