The following article, jointly authored by the Bishop of London and Pat Cullen, appeared in The Times Red Box on Monday May 22 2023
Nursing has come a long way since we both entered the profession for the first time in the 1980s. But the values that underpin it have remained constant: compassion, selflessness, dignity, and integrity.
Nurses will stop at nothing to look after their patients. The nursing profession is the beating heart of this country’s health and care system.
Ministers stood on their doorsteps during the pandemic clapping the heroic efforts of nurses. Now that seems like a distant memory.
The Bishop of Carlisle also spoke in the debate on the future of social care on 30th March 2023, highlighting the central themes of the Archbishops’ Commission on Reimagining Care, and the need for change in the approach to social care:
The Lord Bishop of Carlisle: My Lords, I have had the great privilege of sitting on both the Adult Social Care Committee and the Archbishops’ Commission on Reimagining Care. I also pay tribute to the outstanding work of their respective chairs, the noble Baroness, Lady Andrews, and Dr Anna Dixon.
When the two reports were published, it came as no great surprise that there were huge areas of overlap. In fact, a careful analysis has revealed at least 17 different points of congruence, ranging from providing everyone with the opportunity to lead a full life, through to appointing a commissioner for care and support and properly implementing the Care Act 2014—all of which have already been mentioned.
As we have heard, the role of unpaid carers, including children, was highlighted in particular by both reports. Because that became such a central feature of the Select Committee’s investigation and report, it is being fully addressed by many noble Lords speaking in this important debate. Rather than repeating their valuable contributions, I, like the noble Lord, Lord Polak, and the noble Baroness, Lady Shephard, want to focus on another area of concern raised by both reports, namely the current difficulty experienced by those who try to navigate the statutory care and support system. Phrases such as a “baffling range of organisations” and a “fog of confusion” abound. As we heard from the noble Baroness, Lady Pitkeathley, whose long-term contribution to this debate we so value, dealing with the complex and circular bureaucracy is time-consuming and frustrating.
The Archbishop of Canterbury: My Lords, I am very grateful to the noble Baroness, Lady Andrews, for securing this important debate, for her Select Committee’s outstanding report on adult social care and for including the recent report of the Archbishops’ Commission on Reimagining Care in the debate title. I am also very grateful to my noble friend the right reverend Prelate the Bishop of Carlisle, who co-chaired the commission. He will be addressing some of its specific recommendations later. I would like to speak about the motivation for its commissioning by the most reverend Prelate the Archbishop of York and myself.
The Bishop of London spoke to a group of amendments related to health services during a debate on the Strikes (Minimum Service Levels) Bill on 9th March 2023, raising concerns of the effect of the bill on individual health service staff, pressure on staff levels, and low morale in the healthcare service:
The Lord Bishop of London: My Lords, I rise to speak to this group of amendments on the inclusion of health services in the Bill. I am sorry that I have not been able to speak before. I declare my interests as set out in the register.
I have been a union member. I joined as a nurse—and as an NHS manager and a civil servant in the Department of Health—because I wanted protection. The relationship with unions was critical; it was the way in which we improved patient care. One of my overall concerns about the Bill is that it has the potential to break down the relationship which is so vital for patient care, as the noble Baroness, Lady Noakes, said.
I am grateful to the Royal College of Nursing, which has helped me in considering the Bill. I am sure that it will not surprise noble Lords to know that it does not support the Bill, for what I see as some good reasons: not least because it curtails the freedom to participate in what otherwise is lawful action.
My right reverend friend the Bishop of Manchester regrets that he cannot be here, but he shares my concern that far too much power is given to the Secretary of State in what we have already heard is only a skeleton Bill, and that there is a complete lack of clarity about how it could be used. It is open to abuse. I am surprised that, as many others have said, the detailed policy that becomes legislation is not there. I am concerned that those who work in the health service probably cannot see whether they are in there or not.
The Bishop of St Albans asked about government support for health, social care, and CAMHS services in response to the announcement of a new special educational needs plan on 9th March 2023:
The Lord Bishop of St Albans: My Lords, I too thank His Majesty’s Government for the improvement plan. I commend what they are doing to try to get a much more integrated approach and some of the resources mentioned in the plan. However, I share the concern raised by the noble Baroness, Lady Twycross, about implementation. The stories I pick up from grass-roots situations in Bedfordshire and Hertfordshire, where I serve, show that there are still some very serious problems, and some children are now being failed immediately.
The Bishop of Exeter received the following written answer on 23rd February 2023:
The Lord Bishop of Exeter asked His Majesty’s Government how many deaths were attributed to antimicrobial resistance in England in (1) 2017, (2) 2018, (3) 2019, (4) 2020, and (5) 2021.
Lord Markham (Con): The UK Health Security Agency runs national surveillance programmes to collect and analyse data on antimicrobial use and antimicrobial resistance (AMR). Data is reported in the annual English surveillance programme for antimicrobial utilisation and resistance report.
On Wednesday 22nd February 2023, the House of Lords debated the Levelling Up and Regeneration Bill in the second day of committee. The Bishop of Leeds spoke in the debate, supporting amendments by the Bishop of London and other peers relating to health disparities:
The Lord Bishop of Leeds: My Lords, at Second Reading, I remember applauding, broadly speaking, the ambitions of the White Paper. However, I share the concerns of the right reverend Prelate the Bishop of London, who of course brings to this much more experience than I do.
I am pleased that, already, the noble Baroness, Lady Hayman, has alluded to the interconnectivity of all these different missions; they cannot be seen in silos or in isolation. For example, if you have children who are turning up at school unfed or living in poor housing, you can try teaching them what you will but it may not be very successful, and that has an impact not only on individuals but on communities and their flourishing.
The Bishop of London received the following written answer on 3rd February 2023:
The Lord Bishop of London asked His Majesty’s Government whether their new Major Conditions Strategy will include the content of their unpublished Health Disparities White Paper.
Lord Markham (Con): The Major Conditions Strategy will consider major conditions in the round, including disparities due to geography and other factors. Many stakeholders have already responded to government consultations on mental health, dementia, health disparities and cancer. We will draw on the insights and evidence provided through these processes and the Department will set out opportunities to contribute further in due course.
The House of Lords debated the Levelling Up Bill in its second reading on 17th January 2023. The Bishop of Carlisle spoke in the debate, focusing on health inequalities between the North and South of England:
The Lord Bishop of Carlisle: My Lords, in the brief time available, I will address health inequalities between the north of England, where I live, and the south, and their implications for levelling up and regeneration. Health inequalities are defined as avoidable, unfair and systematic differences in health between different groups of people. In 2010, Sir Michael Marmot conducted his celebrated review into such inequalities, in the hope that this might lead to some improvement. Instead, we have seen an increase, rather than a reduction, of such inequalities over the last 12 years. For instance, life expectancy in deprived areas of the north-east is at least five years lower than it is in similar areas here in London. A baby boy born in Blackpool today can expect an additional 17 years of poor health compared with a baby born in Richmond upon Thames. People in all social groups in the north of England, male and female, are consistently less healthy than those in the south, and premature death rates are about 20% higher across all age groups in the north, due not least to lower lifetime chances.
These statistics—there are many more—are a stark reminder that inequalities in health are often closely linked to people’s socioeconomic circumstances. This has been forcefully illustrated by the Covid pandemic, which, in the words of one commentator, exposed “deep fractures of inequality” running across our society. During the first year of the pandemic, the mortality rate was 17% higher in the north than in the south, unemployment was 19% higher and there were significant differences in mental well-being between the north and the south. It is now reckoned that health issues account for about 30% of the gap in productivity between the north and the south.
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