My Lords, I have an amendment in this group, but I support the thrust of the debate so far. I should declare that I am a fellow of the Royal College of General Practitioners, having previously worked as a GP.
The noble Lord, Lord Farmer, stressed the importance of trying to prevent ill health later on and to bring a population up to be less unwell than the current population is. We have to have a very strong primary care workforce to manage people in the community. There has been a great move to try to move people out of hospital and back into the community, but primary care is currently creaking under the load and social care services are not there to provide much of the support these people need. So primary care has to be factored in as a major contributor, the more we expect people to be looked after at home, nearer home and in the community. That can be particularly difficult in rural areas, where GPs are expected to take on much broader responsibilities. They might even be managing some of the accident services in the area, working with the ambulance services.
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The amendment I have tabled is about rehabilitation. Part of the reason for it being in this group—I think it is appropriate that it is—is that recovery from any episode will require a period of rehabilitation. That must be factored in. People will need physiotherapy expertise, occupational therapy, and speech and language therapists. They might need podiatry. They might need to have technology supplied to them to manage their condition at home, and to learn about managing it. The patient and the family themselves might need education in how to manage their rehabilitation and recovery.
When a person is clearly through the critical phase of whether they are going to survive a major accident, they then have a very long haul of rehabilitation, which might take years and might require ongoing support if they are ever to realise their true potential within the limitations. There have been some astounding examples of catastrophic injury where people have gone on to contribute enormously to their own families and in life, but they have needed intensive rehabilitation services over a long time.
So my amendment is there to ensure that this does not get forgotten in the way that services are commissioned and planned for, and so that rehabilitation is viewed as an integral part of the follow-on after the acute phase, as people get home, transition from hospital into the community and look towards resuming their life. It might well be very different from the life they had before, but this would enable them to fulfil their potential.