My Lords, this gracious Speech was interesting in part for what it did not contain, despite containing a large number of Bills. The noble Baronesses, Lady Jolly and Lady Pitkeathley, have focused comprehensively on social care. I will address issues for the workforce in health, including the impact of the war in Ukraine, preparation for adulthood of children and young people with learning difficulties or autism, and the importance of kinship care and our need for an alcohol strategy.
The Government have stated an intention to build 14 new hospitals by 2030 and upgrade another 70, including by providing new beds, equipment and technology, and they plan to set tight targets for elective recovery. We have just passed the Health and Care Act, and each statutory instrument for its 160 delegated powers will need to be debated. But the Government rejected legislated workforce planning, despite the deficits in staff at every level, including in social care.
Our intensive care bed capacity must expand, with highly trained staff to manage complex elective surgery and recovery from life-threatening illness, as well as increasing organ donation by those who have lost their lives in catastrophic circumstances, usually accidents. Our high-quality ethical transplant programme is hampered by a shortage of facilities. Here I should declare my interest as chair of the Commonwealth Tribute to Life UK committee, which has produced a memorandum of understanding for shared learning as a legacy from the Commonwealth Games.
My Lords, the war in Ukraine has resulted in many UK students returning to this country. Some 600 of these are medical students who had been unable to secure places in British medical schools originally and therefore went to study medicine, taught in English, in Ukraine. Most planned to return to practice medicine here, having secured GMC registration. Yet we have a fixed number of places in our medical schools and the current thinking is that these students will have to go back to the beginning and reapply through UCAS if they cannot continue their courses in Ukraine. Surely the Government can find a negotiated agreement between the General Medical Council and our universities’ medical schools to assess the learning needs of these students, who are at different stages of the course, and find a way to integrate many of them. We need new medical graduates; these are motivated students whose life experience from the war will have undoubtedly broadened their vision.
Just as the gracious Speech was silent on workforce planning, so it was also silent on tackling the problems that alcohol is causing in our society. I declare that I chair the Commission on Alcohol Harm. Alcohol is linked to 27 types of cancer, suicide, abuse and obesity. The Government have ducked developing a comprehensive alcohol strategy to tackle harm by addressing the affordability, promotion and inappropriate availability of alcohol. Alcohol causes more working days of life to be lost then the 10 most common cancers combined, yet where is the strategy on alcohol? Without tackling alcohol, the Government’s strategy on mental health, on crime, on obesity and on increased pressures on the NHS are, I fear, doomed to fail.
Drugs and alcohol are frequent antecedents to crises and trauma in children who enter care long term. There is good evidence that kinship care has better outcomes overall for those 180,000 children who would otherwise enter the care system and be cared for by strangers, but over half these children have additional educational needs or disabilities. Kinship care needs to be defined in legislation so that carers are properly recognised and can access the support needed, particularly in education for all ages and support for legal costs. This could result in far better outcomes for these children.
I turn briefly to the draft Mental Health Act reform Bill, in which much remains to be worked through and debated. The detention of those with learning disabilities and autism in mental health institutions has not supported people to live their lives as well as possible and has denied them opportunities, particularly as they transition from teenage years to adulthood. I had the honour of chairing the National Mental Capacity Forum until recently and I welcome the Government’s recognition that people need support to empower them to make decisions for themselves and avoid the inappropriate detention of those with unaddressed needs.
We recently had the shocking Ockenden report into maternity services, and the Government’s recognition of an urgent need for maternal mental health services is welcome, but I return to the important question of the workforce and where these teams will be drawn from.