My Lords, I, too, congratulate the noble Lord, Lord Darzi, on opening the debate and thank him for being such a breath of fresh air, as he always is when he speaks in this House. I also thank the right reverend Prelate the Bishop of Carlisle for his words. It reminds me to confess my qualifications in the register as a retired nurse and midwife who started 65 years ago. I started in 1946 as a volunteer in the order of St John as a cadet, and learned the basics of life-saving and care. I have always been grateful for that background and the privilege that I had as a registered nurse.
In one of my jobs, as the youngest member of a consensus management team, I was asked to close two large hospitals and move mentally handicapped patients into the community. The first hospital had 1,500 patients and the second had 1,200 patients. It was my job to find a team that would work with me, with the money coming from the health service. I learned a tremendous amount about social services, working with two county councils and five London districts. It taught me one very large lesson: we have tremendous barriers that have to be broken down when we are concerned with delivering care. It is not a question of care in hospital and care in the community being different; we are looking at the whole person and their whole life. One thing I hoped, as I travelled through this task of 10 years, was that we were on the verge of reaching where we are today: considering bringing together health and social care.
I have always valued that experience, because I learned three things. One was that we needed the money, but that it needed to be spent cost-effectively and that we had to look at the way in which people were trained for this new model of care. The second was the high quality of care, which was different from that in an institution. The last was the culture in which people were cared for. I hope that, as a result of today’s debate and all that we have heard from the Government, we will be able to move forward, get rid of the barriers between health and social care and become one caring service.