Social care funding in Budget gives sticking plasters a bad name

Norman Lamb, the Liberal Democrat Shadow Health Secretary, has criticised Chancellor Philip Hammond's response to the NHS and Social Care crisis in his Spring Budget. 

Today, the Chancellor announced an extra £2 billion for social care over the next three years. However, independent think tanks and charities including the highly-respected Health Foundation, The King's Fund, and the Nuffield Trust have concluded that the struggling care sector faces a funding shortfall of £2bn next year alone, when only £1bn additional funding will be made available. 

An extra £325m of capital funding has also been released to invest in service capacity and put more family doctors into A&E departments. But this is only a fraction of the £1.2bn cuts to capital spending this year, as the Department of Health slashed capital spending to plug gaps in Trusts' running costs.  

The Liberal Democrats had called for £4 billion of extra NHS and care funding for 2017-18, including £2bn for social care, £1.5bn to improve efficiency in the NHS and £500m dedicated funding for mental health. 

Commenting on the Budget, Norman Lamb said: 

"This announcement gives sticking plasters a bad name. It is a woefully inadequate response to the impossible pressure the NHS and care services are under.

"There will be a £2bn black hole in social care funding next year alone, yet the Government plans to stretch this amount across three years. This will mean more elderly people going without the care they need, more pressure on A&E, and more people stuck in hospital beds due to a lack of care in the community. 

"The Government has refused to give the NHS the extra funding it needs. The percentage of our national income spent on the NHS is still set to fall which makes no sense at a time of rising demand."

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Learning disabilities & autism care ‘shameful’

Norman Lamb MP is demanding urgent action to reduce the number of people with learning disabilities and autism stuck in big institutions, following serious concerns highlighted in last night’s Channel 4 Dispatches documentary about the care given to people with these conditions.

‘Under Lock and Key’, which aired on Channel 4 last night (Weds 1st March at 10pm), revealed that thousands of people with severe learning disabilities and autism are still stuck in hospitals, despite promises to reduce the number of people in these settings. Experts have long called for people with these conditions to receive support from local, personalised care providers in the community, rather than big impersonal institutions which reduce independence and harm recovery.

The programme also discovered serious concerns about the care in one of Britain’s largest mental health centres, St Andrew’s in Northampton, including heavy use of face-down restraint, seclusion, and anti-psychotic medication in both adults and children.

Fauzia Yasmin Hussain, who has autism and Tourette’s, was admitted to St Andrew’s at the age of 15.  She was kept mostly in seclusion, in a room with very little natural daylight, and was given high doses of anti-psychotic drugs including intramuscular injection.  After her family raised concerns about her care with Norman Lamb, who was then Care Minister, he visited St Andrew’s and was appalled at how she was being treated. 

He said in the documentary: “I went to St Andrew’s and saw Fauzia in her room, which in effect was a cell.  A 15-year-old girl was being treated in effect like a prisoner. It was one of the most shocking things that I’ve seen in my time in parliament.  Just as a human being I was horrified.”

Mr Lamb initiated a review of her care, which ultimately led to her being discharged in September 2014 after almost two years in the institution.  She now receives high-quality care at Alderwood Care Home in Colchester, coming home to visit her family once a month. Her condition and quality of life has improved dramatically. 

Norman Lamb has now written to the Chief Executive of NHS England, Simon Stevens, to request a meeting to discuss care for people with learning disabilities and autism, along with Fauzia’s aunt, Dr Shahana Hussain, and Dulwich MP Helen Hayes, who also appeared in the programme.

Commenting, Norman Lamb said:

“It is shameful that there are still so many children, young people and adults with learning disabilities and autism who are stuck in institutions and treated as second class citizens.

“Submitting young people to face-down restraint, seclusion and sedation is unacceptable and has no place in our NHS.  In my view, it is a significant abuse of human rights. I struggle to think of anything less therapeutic or more detrimental to good care and recovery. 

“I was absolutely horrified by what I witnessed when I visited St Andrews.  Fauzia was a young, vulnerable girl who was in care funded by the state and was being badly let down. She was being robbed of her dignity and independence.  Fortunately I was in a position to initiate a review which led to her discharge but there are too many people who are treated in this way. 

“We set a new ambition to reduce the number of people stuck in institutional settings by providing better support in the community. We also published a Green Paper before the election proposing new legal rights for people to challenge decisions about their care and to have more control over the resources available for their care. But progress has been far too slow and the Government has not legislated to give people these rights. I have asked for a meeting with Simon Stevens to discuss how we can end this scandalous situation.”

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Norman Lamb swears to take on mental illness

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Norman Lamb, the Liberal Democrat former health minister, has pledged to take on the unacceptable lack of progress in tackling young people’s mental ill health.

He joined MPs from all parties in swearing to tackle mental illness at an event in Parliament last week, sponsored by the mental health research charity MQ.

New figures from MQ show that four in 10 (42%) people in the UK have come to believe that mental illnesses such as anxiety and depression are now an inevitable part of life, such is the lack of understanding and action around mental health.

84% say that not enough is being done to tackle mental illness for the future, and more than two-thirds of parents (68%) believe that having more education about mental illnesses could prevent suffering for future generations.

Three children in an average class are affected by a diagnosable mental illness.  However, many wait for a decade between experiencing their first symptoms and getting help, and only a quarter of young people referred to services receive appropriate care.

Overall only £8 is spent on research per person affected on mental health in the UK, which is 22 times less than per person for cancer (£178) and 14 times less than dementia spend (£110).  And despite 75% of mental illness starting before the age of 18, less than 30% of the total mental health research spend is focused on children and young people. As a result, the majority of mental healthcare resources are not designed or developed for young people, leading to poor treatment outcomes in young people and hindering prevention efforts.

Norman Lamb said:

“Mental illness should not be seen as an inevitable part of life.  The current state of mental health treatment would simply never be accepted for a physical condition.

“MQ’s ‘We Swear’ campaign aims to make it clear that radical change is needed right now, and asks the public to show they ‘give a s**t’ by swearing to take on mental illness.

“Through research we can get to grips with this growing crisis in young people’s mental health – and build progress towards much-needed hope for everyone affected.” 

 

Swear to take on mental health. Search #WeSwear on social media or visit www.mqmentalhealth.org/we-swear for further information as to how you can help.

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North Norfolk flood wardens celebrated in Parliament

Norman Lamb has tabled a motion in Parliament to celebrate the work of Flood Wardens on the North Norfolk coast.

Community flood wardens are volunteers who monitor tide levels and weather conditions for potential risk of flooding.  They play a crucial role in ensuring that local residents are aware of flood warnings and, when evacuations are necessary, support vulnerable people to reach a place of safety and provide assistance at evacuation centres.

During the extreme weather conditions in January, flood wardens were out working with North Norfolk District Council officers in areas at high risk of flooding such as Bacton, Walcott, and Wells-next-the-Sea.

Commenting after tabling the motion, North Norfolk MP Norman Lamb said: 

“Flood wardens are some of the unsung heroes of our county.

“We often hear of the excellent work of the emergency services and the army during flood warnings, and rightly so, but much less is said about the vital role of flood wardens.

“I tabled this motion in Parliament to place on record our gratitude to those who selflessly give up their own time, often in the most horrendous weather conditions, to protect the local community and keep people safe during floods.”

 

EARLY DAY MOTION 962: FLOOD WARDENS  

That this House recognises the important work done by flood wardens in protecting their local communities from flooding; notes that these wardens are local volunteers who turn out, day and night, in often the most appalling weather conditions; further recognises that residents of small coastal towns and villages, in places such as Bacton, Walcott and Wells-next-the-Sea on the North Norfolk Coast, rely almost exclusively on flood wardens to ensure that residents are aware of flood warnings, provide vital advice and information during floods, identify and assist vulnerable residents to seek a place of safety, advise local authorities on whether an evacuation is necessary and provide assistance and facilities at evacuation centres; regrets that this often goes unnoticed in the national media; and celebrates the essential work of flood wardens in the communities they serve.

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Ambulance service must tackle bullying and harassment

Norman Lamb, MP for North Norfolk, has urged the leadership of the East of England Ambulance Service to act on the findings of an independent review into bullying, harassment and discrimination at the Trust. 

The review was commissioned by UNISON and was conducted by the Andrea Adams Consultancy, which specialises in issues of workplace bullying and harassment. 

Some of the key findings were:

  • There are significant delays in dealing with staff grievances and complaints;
  • Concerns are mainly ignored, dismissed or are dealt with in an unnecessarily protracted way;
  • A ‘Speak Out’ culture is not promoted, and there is a fear of retaliatory action if an individual raises concerns;
  • Investigation processes are not secure and cannot be relied upon to robustly test allegations made;
  • The Trust appears to tolerate a bullying culture and managers adopt, in the main, a bullish approach to people management;
  • There is a strong perception that many issues that should be dealt with are swept under the carpet;
  • The Trust is not perceived to be a listening and learning organisation and this presents high levels of risk to patient and staff safety.

The full report can be read here.

Commenting, Norman Lamb said:

“This independent review found worrying evidence of a bullying culture at the trust, with a lack of robust processes to deal with allegations of bullying and harassment.

“Ambulance staff must have the confidence to speak out against bad practice without fearing for their careers.  It is unacceptable to allow such concerns to be dismissed, swept under the carpet, or met with retribution.

“Failure to eliminate wrongdoing not only has a damaging impact on the wellbeing of staff, but it ultimately puts patients at risk.

“The leadership at the trust must respond positively to the findings of the report and take immediate steps to act on its recommendations.”

Fraer Stevenson, UNISON Branch Secretary for the East of England Ambulance Branch, said:

“It’s vital that staff at every level feel able to speak out freely without fear of retaliation. It’s clear from the report that hundreds of our staff do not feel able to do that.

“We have some very good managers in our Trust and their voices need to be heard and empowered. Some of the poor behaviours we continue to see appears to go unchallenged and this must change.

“It’s important the Trust Board hear the concerns of their staff from across the Trust, support the recommendations in this report and commit to genuine change. This change needs to be modelled through their own behaviours and will require strong leadership.”

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Lamb hits out at North Norfolk bed closures

Norman Lamb MP has hit out at plans to cut the number of local patient beds without any consultation, after North Norfolk CCG served notice on the beds it commissions at Benjamin Court in Cromer and Cranmer House in Fakenham.

Mr Lamb believes that the CCG may be in breach of its legal obligations and has asked to meet with CCG leaders urgently.

In November, the Norfolk Health Overview and Scrutiny Committee (NHOSC) was notified that the closure of beds at Cranmer House, to be replaced with a new ‘supported care’ model, was no longer being considered after strong local opposition.  However, the CCG this week announced that beds in Cranmer House and Benjamin Court would be decommissioned without any consultation with the local authority.

Under the Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013, CCGs have a duty to consult the local authority about any proposal they have ‘under consideration’ for a substantial development of or variation in the provision of health services.  As part of the consultation process, the CCG is required to notify the local authority of the date by which a final decision will be taken as to whether to proceed with the proposal.

Commenting, Norman Lamb said:

“It seems extraordinary to serve notice that these beds will be de-commissioned without any prior consultation.  I strongly suspect that the CCG is in breach of its statutory duty to consult on the plans before they were finalised, given that it amounts to a significant change in the provision of local healthcare services.

“The apparent view that there is no requirement to consult because the closures apply to the beds, rather than the units themselves, is hard to justify, especially when the loss of beds could reduce support for frail elderly people for whom care in the home is not appropriate. The CCG itself states that it is introducing a new model of care. This is the sort of change that should involve consultation with the local community.

“The Overview and Scrutiny Committee should have had the opportunity to consider and feedback on these plans before any final decision was taken. Instead, the bed closures are being pushed through without any local scrutiny.

“After the original plans to close beds at Cranmer House seemed to have been shelved just three months ago, this u-turn by the CCG doesn’t inspire confidence.

“I am asking for an urgent meeting with the CCG to explore alternatives to these closures.  As well as a reduction in beds, it seems inevitable that jobs will be lost and I am happy to meet with staff who will be affected by these plans.”

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Time to back breathing space for families in debt

Norman Lamb, MP for North Norfolk, has backed calls for a new scheme to help thousands of families regain control of their finances as data from the Bank of England shows unsecured household debt rising at its fastest rate since the financial crisis.

Debt often strikes when people experience sudden changes in circumstances such as job loss or ill health.  Aggressive action from creditors and pressure to repay debts at an unaffordable rate can lead families to cut back on everyday essentials like food, take out other, expensive loans or fall further behind on essential bills. The rise in personal borrowing has led to mounting concern that households who get into debt need safer ways to manage financial difficulties.

In the constituency of North Norfolk, an estimated 2,069 families with 3,604 children are living with problem debt. Analysis from The Children’s Society shows that children in low-income families with multiple debts are more likely to suffer from mental health problems than equivalent families with fewer debts. 

Norman has joined calls in parliament to introduce a ‘Breathing Space’ scheme – supported by The Children’s Society and StepChange Debt Charity - that would offer people seeking debt advice a 12-month legal protection from mounting interest, charges and enforcement action. It would build on protections offered under the Debt Arrangement Scheme in Scotland, which has made sure that families sticking to an affordable repayment plan agreed with their creditors are not harried or hassled for the duration of that plan. 

Commenting, Norman said:

“It can't be right that children's mental health and happiness is suffering as a result of creditors unfairly escalating people’s debt problems.

“Families in problem debt need time and space to get back on their feet. By providing a period free from additional interest, charges and enforcement action, a new Breathing Space scheme would help families recover their financial situation and put in place a plan to affordably repay their debts.

“I’m pleased that the Breathing Space proposal has widespread cross-party support, including from the Work and Pensions Select Committee and the APPG on Debt and Personal Finance. The Government now needs to act by putting a comprehensive Breathing Space scheme in place.”

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Norman Lamb pledges support for the 49,000

Norman Lamb, MP for North Norfolk, has committed to support the charity Together for Short Lives’ call to provide better support for children and young people who need palliative care and their families.

The charity, which speaks out for the 49,000 children and young people in the UK who are expected to have short lives, held a special Westminster reception on Tuesday 7th February to highlight the devastating impact that life-limiting and life-threatening conditions can have on children and their families.

MPs heard about the action that the charity would like the Chancellor to take to help these vulnerable families when he delivers his Budget next month, including adequate funding for children’s palliative care services and investment in community nursing teams. The reception also saw the launch of the new All-Party Parliamentary Group for Children Who Need Palliative Care – a forum for MPs and Peers to discuss issues facing seriously ill children and possible action they can take in Parliament to help. 

Children with life-limiting conditions require a wide range of professionals working together across different health and care services to support them. Unfortunately, Together for Short Lives’ commissioning maps show that there is a postcode lottery of support for children and their families. Many cannot access the care they need, because it is not available in their area or there are not enough professionals with the right skills and experience.

NHS England is currently undertaking a review of the Children’s Hospice Grant, and Mr Lamb has written to the Health Secretary and the Chief Executive of NHS England urging them to increase the value of the grant so that every seriously ill child receives the care they need.

Commenting after the event, Mr Lamb said:

“I really appreciated having the opportunity to learn about the wonderful support that children with life-shortening conditions receive from a range of services, including local children’s hospices and palliative care services.

“There is evidently much more to do to help families overcome the serious challenges they face on a day-to-day basis. I support the charity's call to make the mobility component of the Disability Living Allowance available to children under three who are dependent on heavy and bulky life support equipment.  Currently this benefit is only available to children aged three or over.

“I have written on behalf of East Anglia’s Children’s Hospices to the Health Secretary and to Simon Stevens, urging them to respond to the growing demand for services and the increasing complexity of care required by increasing the value of the Children’s Hospice Grant. Every child with a serious, life-shortening illness deserves high-quality compassionate care, and the Government must make sure that local services have the resources they need to deliver this

“I look forward to working with Together for Short Lives in Parliament to support children with life-limiting and life-threatening conditions and their families.”

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North Norfolk stroke treatment delays ‘deeply worrying’

Fewer than one in five stroke victims in North Norfolk reach a specialist treatment centre within the ‘golden hour’, putting many of them at serious risk, according to official figures obtained by local MP Norman Lamb.

Under national standards, stroke patients who are potentially eligible for thrombolysis – a treatment to dissolve blood clots and restore the flow of blood to the brain – should arrive at a specialist ‘hyper acute stroke unit’ (HASU) within 60 minutes of an emergency call.

However, this target has been met for just 18% of stroke patients in North Norfolk CCG this year (2016/17) – far below the national standard of 56%.

Figures obtained via a Freedom of Information request show that 27 out of 149 patients who were eligible for thrombolysis arrived at a HASU centre within 60 minutes between April and November 2016.  In November, the latest month for which figures are available, the target was reached for only 13% of patients.

In the East Anglia region, 50% of stroke patients served by the East of England Ambulance Service have reached a specialist unit within an hour this year.  August was the only month where the 56% target was met, while just 44% of patients arrived at the HASU centre within the hour in November – the trust’s worst performance since April. 

Commenting, Norman Lamb MP said:

“These are unacceptable and deeply worrying figures, which show the extent of the disadvantage people in remote rural areas face in receiving emergency treatment.

“Early treatment of stroke is critically important and can prevent long-term disability and death. But in North Norfolk, there will inevitably be people who have suffered life-changing consequences or worse as a result of delays in getting to these specialist units.

“This is not the fault of the paramedics, who are doing brilliant work despite being under immense strain. However, we must review some of the perverse national targets for responding to 999 calls which are not time critical, and other incentives in the system which pull ambulances away from rural areas and into the more heavily populated towns and cities like Norwich.

“People should have an equal right to receive life-saving treatment on time, regardless of where they live.”

 

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Norman Lamb: Norfolk and Waveney health plan lacks funding

Plans to integrate health and care services in Norfolk and Waveney will not be achieved unless additional funding is made available, Norman Lamb has warned.

Responding to the publication of the Sustainability and Transformation Plan (STP) for the region, the North Norfolk MP welcomed proposals to ensure a greater focus on the prevention of ill health, better integration between health and social care, and embedding mental health support more effectively into primary care.

However, in a letter to Dr Wendy Thomson, Managing Director of Norfolk County Council, he said that the plans are “very high level with no detail at all about how these good aspirations can be achieved”

He also suggested that the plan would require “substantial investment in new ways of providing more coordinated and integrated services”, and “does not appear to be grounded in reality in terms of what is achievable” within the current financial constraints in health and care.

Mr Lamb stressed the importance of working towards a single pooled budget and joint commissioning between health and social care in the region. He also outlined the need for a clear plan for digitising the health and care system, linking up primary care, acute and mental health services, social services, the ambulance trust, and patients themselves.

Commenting on the STP, Mr Lamb said:

“Despite the horror stories emerging from STPs in some parts of the country, I am broadly encouraged by direction of travel in the Norfolk and Waveney plan. However, the work is at a very early stage and little detail currently exists.

“The focus on bringing the different parts of the system together more effectively – physical health, mental health and social care – is welcome.

“But these proposals will have very clear cost implications, which I fear will prove fatal to its objectives at a time when the local health and care system is facing an enormous deficit.

“A lack of funding will inevitably result in an emphasis on sustainability over transformation.  If we are to capitalise on the potential of STPs to deliver better and more joined-up patient care, the Government must build a cross-party consensus on a long-term funding settlement for the NHS and social care.”

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