Queen’s Speech — House of Lords, 2021-05-12
Topic: Health
Claire Tyler (Liberal Democrats, Centre to centre-left): My Lords, I congratulate the noble Baroness, Lady Blake, on her excellent maiden speech. Like other noble Lords, I must start by registering my profound disappointment that, despite all the promises made, there is nothing of any substance in the gracious Speech on the long-awaited reform of social care. The pandemic has cast a devastating spotlight on this long-neglected, fragile and much underfunded sector. During that time, tens of thousands of care home residents lost their lives. The questions of who pays for social care, how much funding is needed and how it is delivered are not easy but they are urgent. This is the area, above all, where the Prime Minister should be applying his rocket boosters. We owe it to all those who have died and their families to find a workable and sustainable solution Turning now to the health and care Bill, the emphasis in the White Paper on greater collaboration and integration between the NHS, local government and other services is to be welcomed. However, to achieve their ambition of improving the health of the nation, the Government must also prioritise action on the wider determinants of health and address the key public policy challenges largely absent from the White Paper. I have already referred to fixing and reforming social care, one of the biggest policy failures in a generation Secondly, the NHS and social care workforces have been placed under enormous strain during the pandemic and continue to face chronic staff shortages. The proposals in the White Paper to improve workforce planning are simply inadequate. A fully funded workforce strategy that includes mental health is needed to address staff shortages and boost retention by improving working cultures Crucially, the Government must tackle the health inequalities that have been cruelly exposed and exacerbated by Covid-19. If they are serious about their commitment to levelling up, they must address the deep and widening gap in health outcomes between our richest and poorest communities There is a real risk of distraction from tackling the most important issue. The NHS has just faced the most difficult year in its history, and the scale of the challenges facing it after Covid is formidable; those challenges include addressing the growing backlog of unmet health- care needs, as the noble and gallant Lord, Lord Stirrup, pointed out. Creating new organisations is easier on paper than in practice, and the experience of past reorganisations shows that merging and creating new agencies can cause major disruption The proposal to bring the NHS under closer ministerial control will warrant close scrutiny in your Lordships’ House. The Government should articulate clearly why these additional powers are needed and how they will be used, and outline the checks and balances that will be in place to ensure that they are used as intended. I will be watching this area closely The Government should also consider how the new legislation can be used to improve the lives of people with a mental illness. Despite a national commitment to parity of esteem, mental health services still struggle to meet demand—a situation that has only been exacerbated by the pandemic. To ensure that mental health is given an equal focus in the proposed new system, we need to see three things. First, there should be a legal requirement to have on the unitary integrated care board representation from an NHS trust with responsibility for mental health, alongside representation from other types of trusts. Secondly, the ICSs should be legally required to achieve parity of esteem for mental and physical health in their decision-making and to report publicly on this annually. Thirdly, the NHS’s commitment to mental health should be explicitly included in its triple aim I turn briefly to financial exclusion. Although I welcome the focus on skills and education as part of the levelling-up agenda, much more needs to be done to tackle financial exclusion if levelling up is to become a reality and no one is to be left behind. It is deeply disappointing that legislation on protecting access to cash did not feature in the gracious Speech. Despite an overall decline in the use of cash, an estimated 8 million people continue to use and rely on it to budget and make payments. The pandemic has also highlighted the vulnerability of groups that want or need to make cash payments, as they have been affected the most by reduced bank branch opening hours, branch closures and a lower acceptance of cash As chair of the former Financial Exclusion Select Committee, I was closely involved in the Liaison Committee’s follow-up report on financial exclusion, which was published last month. It highlighted the importance to financial inclusion of access to cash. Will the Minister provide an update on the Government’s plans to bring forward measures announced in the 2020 Budget to protect cash and set out a clear timetable for such legislation?