My Lords, I declare my interests as outlined in the register. It is a pleasure to follow the speech of the noble Baroness, Lady Tyler, because I have had to cut my own considerably so that I might contribute to this debate on the gracious Speech not only on my own account but to some
extent on behalf of my noble friend Lady Emerton, of Tunbridge Wells, who has given notice of her retirement from 1 November. I am glad that I might be given a few extra seconds as a result. She very much wanted to be here today but is unable to be so. I want to acknowledge her extensive contributions to the nursing profession over the past six decades, and particularly the distinction with which she has served this House for the past 20 years.
On a more personal note, her encouragement, mentorship and support to me as a “fellow nurse” has been exemplary since my appointment to this House four years ago. I wish my noble friend a happy retirement and I am fully aware, having spoken to her on the phone this afternoon, that she is following my contributions in the House now and will do so in future. I can only hope that, with further experience, I will live up to at least some of her high expectations.
I welcome the new laws that the Government intend to bring forward to assist in the implementation of the NHS plan in England, in particular the £33.9 million per annum increase in the budget by 2023-24. However, how do they intend to ensure that the appropriate workforce will be available to deliver the plan? The recent NHS people strategy outlines the challenges that we face in this domain. Is it not time for the Government seriously to consider writing off student debt for healthcare professionals who work in the NHS and state-funded social care roles for three to five years after graduating from university? Providing “golden hellos” to recruit to hard-to-fill roles, including learning disability and mental health nursing, podiatry and some areas of medicine, should be seriously considered. Having investigated the Army support structure for attracting nurses, it is clear to me that there are established successful schemes of this kind in the UK public sector. Why cannot this approach be adopted more widely? We will not be able to provide safe staffing in the NHS unless we recruit and retain excellent healthcare professionals.
I was a member of the pre-legislation scrutiny committee for the Health Service Safety Investigations Bill, ably chaired by Sir Bernard Jenkin MP, a strong advocate for the Bill. As others have outlined, the Bill will transform the way in which patient safety incidents in the NHS are investigated. Investigations would be for the purpose of learning and not to attribute blame or fault, thus improving patient safety by encouraging staff to identify areas of concern and to be candid in the information they provide to the investigatory body. I fully support this approach, while recognising that the Bill requires proper debate and amendment, as other noble Lords have outlined. I hope that we might be able to do this in what might be a very short term after what has happened today.
My noble friend Lady Emerton has been a champion in promoting high standards of community-based, individualised care for people with a learning disability. On behalf of us both, I ask what the Government’s plans are for finally replacing inappropriate, institutionally-based services with more suitable provision. This issue appears notably absent from the gracious Speech.
It is essential that the proposed Mental Health Act reforms are initiated. This will require additional investment in mental health services, as others have outlined, yet the NHS long-term plan, with investments relating to 40 new hospitals, makes no mention of new community mental health facilities. The Royal Colleges of Nursing and Psychiatrists call for an end to dormitory provision in mental health wards; a fleet of vehicles to transport people having a mental health crisis to a care facility, rather than using police vehicles; and the provision of more appropriate assessment space in emergency departments, in particular therapeutic calming spaces. Can the Minister outline whether any such investment is planned?
It is acknowledged by the King’s Fund that the NHS plan will not be achieved without further investment in social care, as was far more ably outlined by the right reverend Prelate the Bishop of London. The Government intend to bring forward the Green Paper proposals to reform adult social care to ensure dignity in old age. This is urgent. What is the planned timetable for this legislation? It is unacceptable in 2019 that dignity in old age should be a vision for the future rather than a right today.
Health is adversely affected by poverty. Barnardo’s, the Trussell Trust and many other bodies estimate that Brexit will create inflationary pressures that will hit the poorest in our society the hardest. Will the Government commit to providing a hardship fund for those on universal credit if there are sudden increases in food prices? If so, can they guarantee that such a fund would provide grants and not loans? Reducing food poverty and investing in public health measures, including health visiting services, particularly for children, may do more to improve the nation’s health than the proposed hospital building programme. We need a rounded approach.
It has been a pleasure to contribute to this debate. I look forward to the Minster’s responses to the issues that I have raised. Finally, I wish on behalf of the nursing profession to thank other noble Lords for their appreciation of my noble friend Lady Audrey Emerton’s public service contributions and her long and distinguished service in nursing, the NHS and this House.