On 22nd October 2019 Parliament continued to debate the Queen’s Speech, including scrutiny of measures relating to Health and Social Care. The Bishop of London, Rt Revd Sarah Mullally (and formerly Chief Nursing Officer for England), contributed to the debate:
Lord Bishop of London: My Lords, many noble Lords will know that I have a background in health, and I continue to be a great supporter of the National Health Service, so they will not be surprised when I address my comments to health and social care. In doing so, I recognise the contribution of the noble Baroness, Lady Emerton, to nursing and to this House.
I thank the Government for their work to support and strengthen the National Health Service, its workforce and its resources. However, increased investment and reform does not guarantee getting to the root of the problem. Our health and social care issue is what you might call a “village problem”. Our flourishing, mentally, physically and emotionally, occurs best in community. More than that, as Sir Michael Marmot’s research from the Institute of Health Equity indicated, our economic, social and emotional circumstances all play a part in our health and well-being.
As a Christian, I believe that every human being is created in the image of God. We are not made in isolation. We belong together in creation, which should be cherished and not simply used and consumed. This is the starting point for the Church of England’s engagement in society, nation and the world. We are most human when we know ourselves to be dependent on each other. It is therefore no surprise that when communities mobilise and environments are improved, it benefits everyone and reduces the strain on our National Health Service. Here lies, in part, the power of social prescribing. Churches have an integral part to play. The Church is a builder of and a presence in communities, and is well placed to support people as they journey through life, and in fact towards death.
Within the diocese of London, the work of the Posh Club run by St Paul’s in West Hackney is just one example. A weekly cabaret-style party for the over-60s, it combats isolation and loneliness in the community. It provides a unique way to experience connection, laughter and physical activity. Father Niall Weir, rector of St Paul’s, says:
“If there was a Posh Club in every town in the UK, I’m certain the numbers of elderly on GP waiting lists would go down hugely”.
In other words, this kind of community partnership can potentially be used to ease some of the unsustainable pressure on our National Health Service. I would be grateful to hear from the Minister what steps are being taken to ensure the deployment and distribution of social prescribing link workers, as outlined in the NHS Long Term Plan, to ensure that there is a level playing field right across all parts of this country.
What of the social care system? Some 1.3 million children—10% of all children—in England have needed a social worker in the past six years, and their prospects are not always good. For example, just 17% of them get GCSEs in maths and English. The social and economic cost of failing to help children is immense. In addition, as we heard from the noble Baroness, Lady Bakewell, the elderly are being burdened with the huge cost of their care homes, while parents struggle to pay for essential care services for their disabled children.
A great deal of thinking has been undertaken about how we might best improve adult social care funding. The Church of England has been consistent in its advocacy of integrating health and social care to ensure the most efficient and effective use of people and resources; we need to see effective integration taking place on the ground in all the communities of this country. The King’s Fund has pointed out that the NHS long-term plan is fundamentally flawed precisely because it isolates the NHS from both social care and public health. Once again, this is not merely a social care problem but a village problem.
While we are waiting for the Green Paper on reform of social care to be released, we still have the Dilnot report, published almost a decade ago. It had cross-party consensus and tackled the very issues that we still face today. It understood the value of community and the importance of shared responsibility. What plans do the Government have to revisit the Dilnot report and its recommendations?
Although I welcome the Government’s commitment to reforming the Mental Health Act, and despite the commitment made five years ago to closing the gap and the crisis care concordat, there continue to be alarming disparities in minority ethnic mental health provision. I welcome the change in legislation, but it needs to be supported by policies and practices that increase cultural competence among professionals and are developed in partnership with minority ethnic communities.
In conclusion, I remind noble Lords that health and social care depend on the wider collaboration of the community as well as internal change. To tackle the deep-seated inequalities that we face in this sector, we need to work together in partnership. Although I welcome the Government’s commitment to do more, I hope that the Minister will bear in mind the role of communities in delivering positive health outcomes and say something about how that can be done.
Lord Wakeham (Con): [extract] My Lords, first, I say to the right reverend Prelate how much we appreciated her speech today and on other occasions. It takes me back 25 years, to when I was Leader of the House and invited the then Archbishop of Canterbury to have dinner with me, because I thought the Bishops were very good at saying Prayers but never made much of a contribution afterwards. I felt that many of them had a lot of useful things to say, if only we could persuade them to do it. I must say that it is vastly different today, and the right reverend Prelate is a fine example of someone who has something to say worth listening to. …
Baroness Watkins of Tavistock (CB): [extract] …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. …
Lord Smith of Leigh (Lab): [extract] …As the right reverend Prelate the Bishop of London said, Sir Michael Marmot’s report in 2010 identified all these wider links to health outcomes which we need to think about. …
Baroness Jolly (LD): [extract] …I also echo the words of the right reverend Prelate the Bishop of London in applauding the work of faith groups and local charities in health and social care delivery. …
Baroness Blackwood of North Oxford (Con): [extract] …The noble Baronesses, Lady Greengross, Lady Meacher, Lady Hollins, Lady Watkins, Lady Sherlock, Lady Campbell, Lady Wheeler and Lady Bakewell, along with my noble friend Lord Young, the noble Lord, Lord Hunt, and the right reverend Prelate the Bishop of London also raised the critical issue of social care. …