Social Care Reform

Liz Kendall Excerpts
Wednesday 23rd June 2021

(3 years, 4 months ago)

Commons Chamber
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Lindsay Hoyle Portrait Mr Speaker
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Before I call Liz Kendall to ask the urgent question, I want to wish Helen a very happy birthday. It is a delight to be able to do so.

Liz Kendall Portrait Liz Kendall (Leicester West) (Lab)
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(Urgent Question): To ask the Secretary of State to make a statement on the Government’s plans for social care reform.

Helen Whately Portrait The Minister for Care (Helen Whately)
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I thank the hon. Lady for her question, and for giving me the opportunity to talk about social care reform. I start by paying tribute to carers, paid and unpaid, for all they do in looking after people in their homes and in care homes every single day with kindness and compassion. To any who may happen to be watching or listening today, I say “Thank you for what you do.”

Over the past year in government, we have rightly focused on supporting social care through the pandemic. This has included an extra £1.8 billion of funding, sending more than 2 billion items of free personal protective equipment to care providers, distributing more than 120 million covid tests to social care and vaccinating hundreds of thousands of care home residents and most of the care workforce.

While the pandemic has posed unprecedented challenges to social care, it has also strengthened the argument for reform, and we now have the opportunity to build back better in social care. We have a once-in-a-generation opportunity to build a care system for the future, and I am hugely ambitious. I want a care system in which we can be confident, for our grans and grandads, mums and dads, brothers and sisters, children and grandchildren and, indeed, ourselves. I want people to be able to get the care that they need when they need it, and to have choices—to live life to the full in the way they want, living independently and part of a community for as long as possible, without facing an astronomical bill.

I want to join up health and care around people, so that it works as one system dedicated to meeting the needs of individuals, and giving them the personal care they want and need to live their lives to the full. I want the care workforce to be properly recognised and valued for what they do—for their skills, their compassion and their commitment. I want them to have more training, more opportunities and more prospects for career progression. I am committed to supporting unpaid carers not only in the care they provide, but with their own health and well-being, so that they can live their own lives as well as caring for others.

We are already taking steps on the road to reform. The health and care Bill will introduce Care Quality Commission oversight of local authorities’ provision of social care. It will also help to join up health and social care by putting integrated care systems on a statutory footing. We are working on our long-term plan for social care, and we will bring forward our proposals for social care reform later this year.

Liz Kendall Portrait Liz Kendall
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It has been 100 weeks since the Prime Minister promised to

“fix the crisis in social care”

with a plan he had already prepared, to give people the dignity and security they deserve. Since then, almost 42,000 care home residents have died from covid-19. Two million people have applied for support but have had their requests refused, and tens of thousands have had to sell their homes to pay for care. Families have hit breaking point, and staff have been appallingly let down. Even after all the horrors of the pandemic, nine out of 10 councils say that they face care budget cuts this year.

This week, we learned that Ministers cannot even be bothered to have a meeting to finally come up with the goods. That is not delivering dignity; it is abdicating responsibility, so can I try again with the Minister? When precisely will we see the Government’s plan? A vague commitment to some time later this year will not convince anyone, after all the delays and broken promises. Will the plan include a cap on care costs, so people’s life savings are not wiped out? That has been repeatedly promised and was legislated for seven years ago, but it has still not been delivered. Will there be proper proposals for people with disabilities, who make up a third of the users and half the budget for social care, but have been entirely absent from the debate? Where is the decent workforce plan to ensure that frontline carers get the pay and conditions they deserve, and that we end endemic staff shortages? Will unpaid family carers finally get the help they need, so that their own health does not suffer and they are not forced to choose between holding down a job and caring for the people they love?

In the century of ageing, we cannot build back a better future for Britain without a decent system for social care. This is as much a part of our infrastructure as the roads and railways are. Our country urgently needs a plan. The time for excuses is over. When will the Government deliver?

Helen Whately Portrait Helen Whately
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Of course we have focused on supporting social care through the pandemic over the past 18 months; that absolutely had to be the right thing to do when facing an unprecedented challenge. During the pandemic we not only supported social care, including, as I said, over £1.8 billion of extra funding direct to the care sector, but supported local authorities with over £6 billion of extra funding. But yes, we are determined to bring forward proposals for social care reform. We have been absolutely clear that we shall do that. The hon. Lady asked about particular meetings. Actually, the Health Secretary and the Prime Minister talk about social care reform all the time. In fact, I spoke to the Prime Minister only last week about social care reform. These are complex matters. The hon. Lady will know that nearly 25 years ago, Labour Prime Minister Tony Blair said that we needed reform of social care, but during the 13 years of Labour government, was there a plan for social care reform? No, there was not. We are the Government who are going to bring forward social care reforms. I would welcome her support for that. We are a Government who deliver. We have delivered Brexit, we are delivering vaccinations at a phenomenal pace, and we will deliver social care reform.

Winterbourne View Hospital and the Transforming Care Programme

Liz Kendall Excerpts
Thursday 10th June 2021

(3 years, 4 months ago)

Westminster Hall
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Liz Kendall Portrait Liz Kendall (Leicester West) (Lab)
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It is a pleasure to serve under your chairmanship, Ms McVey. I thank my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) for securing this extremely important debate, marking the 10th anniversary of the Winterbourne View scandal. I want to say at the start that the repeated and abject failure to move people with learning disabilities and autism out of long-stay institutions and into the community, following what we saw at Winterbourne View, is the worst political and institutional failure I have seen in my 25-year experience of working in health and social care as a Member of Parliament and before I became an MP. It is essential that we understand the underlying reasons for this failure and what we will do differently so that we can put it right in future. That is what I really want to focus on.

Many hon. Members have spoken about the horrors that the BBC’s “Panorama” programme exposed at Winterbourne View in May 2011, with patients repeatedly abused, pinned down, slapped, soaked with water, trapped under chairs, threatened and taunted by staff. The incidents included a member of staff slapping a resident across the cheek and—forgive me, Ms McVey—saying:

“Do you want a scrap? Do you want a fight? Go on and I will bite your bloody face off.”

A member of staff claimed a resident “loved pain”, and then said to the resident:

“Simone, come here and I’ll punch your face.”

Staff gave a patient cold showers as a punishment, leaving her outside in near-zero temperature, pouring mouthwash in her eyes. Patients were shown screaming and shaking, one trying to jump out of a second-floor window to escape the torment but just being mocked by members of staff.

Straight after the programme was aired, the then Minister commissioned an in-depth review into what happened, the results of which were published on 10 December 2012—a day I remember extremely clearly, as the Government statement to Parliament was the very first time I had spoken at the Dispatch Box as a Member of Parliament and a new shadow Minister. The new Minister of State promised that all patients, 3,400 in total, would have their placements reviewed by June 2013, and that everyone who was there inappropriately would be moved into the community no later than June 2014. This was followed by the Government’s transforming care programme, which aimed to close up to half of in-patient beds by June 2014.

June 2014 arrived; the Government had failed to deliver. There were still 2,615 people in in-patient units, including 148 children. Sir Stephen Bubb was commissioned to do another review, which was published in November 2014. As a result, NHS England announced a three-year closure programme called building the right support. This had a slightly reduced target of reducing the number of in-patient beds by between 35% and 50% by March 2019. March 2019 arrived; the target was once again missed. The Government had missed even the more modest target of a 35% reduction. Instead of trying to really get to grips with the cause of the failure, the target was downgraded again, from between 35% and 50% to just 35%. Surprise, surprise: a year later and even the downgraded target was missed.

The grim reality is that there are still 2,040 people with learning disabilities and autism in in-patient units, including 215 children. The average length of stay is over five and a half years, and 355 people have been in these units for at least 10 years. Unbelievably, after everything that has happened, there has been little if any change in the number of people being admitted into in-patient units each month, when, as many hon. Members have said, one of the key priorities must be preventing people from going into hospital in the first place.

Far from closing large-scale units, the Government are opening new ones. Last year, a new 123-bed medium-secure unit, including 45 beds for people with learning disabilities and autism, was opened by Mersey Care NHS Foundation Trust. Mersey Care also got planning permission to build an additional 40-bed unit, going against the Government’s own recommendations. Report after report has shown continuing unacceptable treatment in these long-stay institutions. In one month this year—just one month—3,390 restrictive interventions were used, by which we mean physically restricting people or restricting them with chemicals—drugging or isolating them. In reality, that is a massive underestimate because, scandalously, we have data for only 31 of 56 NHS providers, and for one of 16 private providers. I have one question that I hope the Minister will answer: why is providing that data every month not a requirement for every provider in this country and will she consider making it available a requirement of Care Quality Commission registration?

The latest target set out in the NHS long-term plan is to deliver a 50% reduction in in-patient beds by March 2024, but unless we are clear about why the Government have failed to achieve anywhere near that over the past decade and what we are going to do differently, we cannot have confidence that things will change.

It is my view that the first reason for that failure is simply that this has not been a political priority. I am singling out not the current Minister but Ministers over a decade who have failed to grip the issue, failed to make it one of the repeated, unmissable priorities for the Department of Health and the NHS, and failed to secure the funding that the NHS and local authorities need to shift the focus of services fundamentally towards prevention and co-ordinate support not just between the NHS and local authorities but with housing and other community services. Will the Government consider the recommendation of the Joint Committee on Human Rights to set up

“a Number 10 unit, with cabinet level leadership… to ensure reform is driven forward”?

If we do not change that, we will not have that leadership in place.

Secondly, there are institutional failings. It is just too easy for services to keep doing the same thing—commissioning large-hospital services—rather than the difficult work of individual, personalised support in the community or at home. We do not have the financial incentives in place, or the accountability mechanisms, to do things differently. Mencap says that in my own region, the east midlands provider collaborative, which commissions these services, includes some of the very private providers that have been shown to have poor records of care. How is that allowed and who is responsible?

Thirdly, and I really believe this is the key to change, we have failed to put families at the heart of the process and not just to listen to their views but put them in the driving seat of change. There are many ways to do that, but I know, and I have seen, that one of the most powerful ways to get that change is personal care budgets given to families and developed in partnership with the services. The average cost of a weekly stay in an in-patient unit run by the NHS is £3,000. If we gave families greater control over that money, I bet they could find a better way to spend it on care for the people they love.

Last but by no means least, one reason why people with learning disabilities and autism and their families believe change never happens is that they feel they just do not matter, are not important enough, and are out of sight and out of mind. As Members here know, what has happened in those in-patient units is part of a much wider pattern of unacceptable inequalities in access to services and in health outcomes for people with learning disabilities and autism. For example, women die 18 years earlier than the average and there are much worse health outcomes in a range of areas.

I am afraid that with covid-19, and despite initial claims they were at no greater risk, people with learning disabilities and autism have death rates six times higher than those for the rest of the general population. Changing that requires concerted action across the board. We need to change how we train health and care professionals, and ensure absolute clarity at every level about who is responsible for change and how they will be held to account. The trouble is that this is everybody’s and nobody’s problem. That is why we cannot get change.

I say all that to be constructive. The Minister knows that I want to solve problems, not just criticise. I would be happy to meet with her and the families and providers, as well as her officials, to see whether we can put in place a more effective plan of action. I ask her one thing: can she tell me what the Government and NHS England now propose that is different from the proposals of 10 years ago, five years ago or one year ago? From what I have read, there is no difference. The trouble with that is that we will get the same result. That is not good enough for people with learning disabilities and autism and their families.

Oral Answers to Questions

Liz Kendall Excerpts
Tuesday 8th June 2021

(3 years, 4 months ago)

Commons Chamber
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Helen Whately Portrait Helen Whately
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I have huge respect for the right hon. Lady and her work in many areas, but I am disappointed by her language. She will appreciate that, together, the Department, local authorities and the care sector are working hard on how to bring forward the right package of reforms for the system. We have already taken some of the first steps on that road. For instance, the health and social care Bill includes plans to strengthen oversight of the social care system. That is an important step, but it is the beginning, not the end, of the social care reform road.

Liz Kendall Portrait Liz Kendall (Leicester West) (Lab)
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Six hundred and eighty-five days ago, the Prime Minister promised to fix the crisis in social care to give every older person the dignity and security they deserve. Since then, more than 32,000 elderly people have died from covid-19 in care homes, millions of care workers and families have felt abandoned and pushed to breaking point, and 300 elderly people have been forced to sell their homes to pay for their care every single week. Does the Minister think that has given people security, let alone dignity, and will she tell the country, after more than a decade in power, specifically when her Government will deliver?

Dementia Action Week

Liz Kendall Excerpts
Thursday 27th May 2021

(3 years, 5 months ago)

Commons Chamber
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Liz Kendall Portrait Liz Kendall (Leicester West) (Lab)
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Dementia affects the lives of hundreds of thousands of people in this country: not only the 850,000 people who currently have the condition, but thousands more of their family and friends, as I am sure many of us in this House know. It is the leading cause of death in England, and the only condition in the top 10 causes of death for which there is currently no known treatment or cure. Our ageing population means that the number of people with dementia is set to increase to 2 million by 2050, with the cost of caring for dementia more than doubling to almost £60 billion a year.

Over the past 15 months, people with dementia and their families have suffered perhaps more than anyone else because of covid-19. A quarter of all deaths from this awful virus have been among those with dementia, predominantly because of the tragedy in our care homes. Tens of thousands more have seen their condition deteriorate, and families have been pushed to breaking point and banned for more than a year from seeing their loved ones in care homes. Those who look after a relative in their own home have been providing even more care than usual.

Dealing with this pandemic was always going to be extremely difficult, but the truth is that there has been a higher proportion of deaths in care homes in England than in almost any other country in the developed world. Between 17 March and 15 April last year, 25,000 people were discharged from hospital to care homes without a covid-19 test, despite clear evidence of the virus sweeping through care homes in Italy, America and France.

Care providers and trade unions warned the Government about the lack of testing and PPE. The Prime Minister was personally warned about those issues by my hon. Friend the Member for Hove (Peter Kyle) in Prime Minister’s questions on 25 March. I myself wrote to the Health Secretary about these issues on 8 April.

Despite all that, the official guidance on testing before discharge to care homes did not change until 16 April last year, almost a month after we all went into national lockdown. We do not need Mr Cummings to tell us that the rhetoric about putting a protective shield around care homes was complete nonsense; the evidence is there for all to see. The reason this matters—the reason the truth and the facts matter—is that we owe it to people who have lost their loved ones with dementia, to those who are still being prevented from having normal visits to care homes and to all the staff in care homes who have been to hell and back. We have to learn the lessons from what has happened to make sure these terrible mistakes never happen again.

If we want to build a better country as we emerge from covid-19 and meet the challenges of this century of ageing, then the needs of people with dementia must move to the top of the agenda. That starts with dementia research, because ultimately our goal must be to prevent, treat and ultimately cure this often heartbreaking condition. The rapid development of treatments and vaccines for covid-19 has shown us the amazing things our scientists can achieve when they are backed by political will and underpinned with the right resources and partnerships. Ministers now need to apply the same approach to dementia research.

In their 2019 manifesto, the Government promised to double funding for dementia research and speed up progress in clinical trials. When will they deliver on that commitment? Over the past decade, huge progress has been made in imaging, artificial intelligence, genetics and drug development, and that has brought us to a tipping point in dementia research, which the UK is extremely well placed to capitalise on because of our diverse academic research base, funded by the public, private and charitable sectors, and because of the strong foundations in clinical research provided by the NHS. Ministers need to seize this opportunity to give dementia research a greater priority and turn the UK into a world leader in clinical trials, so that patients here can be among the first to benefit from improved treatments.

The second issue Ministers need to grasp is transforming support for families. That should happen across the entire health and care system, but perhaps nowhere more so than in dementia care. Dementia gradually erodes your ability to think, communicate and even move. It destroys your memory, gradually taking away what makes you, you. That is what makes it so very painful for the people who live with dementia and the people who love them.

When someone has dementia or Alzheimer’s, their family is their memory. No matter how amazing NHS or care workers are, they cannot know the foods the person likes, the films they used to watch or the songs they like to sing. That is one of the reasons why so many people in care homes have gone downhill so fast without regular family visits. The bottom line is that we cannot provide good-quality dementia care without putting families centre stage.

Our health and care services need to do far more to identify people who help care for someone with dementia, get them better information and advice and make sure that services are far more joined up, so that people do not have to tell their story to lots of different people in lots of different parts of the system. The Government need to properly fund breaks for family carers, so that they can put their own needs first, at least for a while, and fund other initiatives, such as the amazing support group for carers run by the Alzheimer’s Society in Sefton, who I met recently. They are just absolutely phenomenal and a lovely bunch of people. I believe that Ministers need to change the law to enshrine the rights of care home residents to have family visits, so that the terrible situation facing hundreds of thousands of families over the past 15 months never happens again.

The final point I want to make is on the urgent need for the Government to make good on their promises to reform social care, because while dementia is not yet curable, our broken care system definitely is. For all that the Minister has said, the truth is that when the virus struck, our care system was far weaker than it ever should have been after a decade of cuts, taking £8 billion out of the care system at a time of growing demand. Two years ago, the Prime Minister stood on the steps of Downing Street and promised to fix the crisis in social care

“with a plan we have prepared”,

yet still these reforms are nowhere to be seen. If there is one thing, just one thing, that comes out of this awful pandemic, it must be a long-term plan that gives social care the priority it needs and deserves, and secures a sustainable funding base for the future.

Labour is calling for a 10-year plan of investment and reform to transform support for older and disabled people, including those with dementia, as part of a much wider ambition to make Britain the best country in which to grow old. In the century of ageing, we understand that social care is as much a part of our infrastructure as the roads and railways. If we neglect our country’s physical infrastructure, we get roads full of potholes and buckling bridges, which prevent our economy from functioning properly. The same is true if we fail to invest in our social infrastructure. Without a properly paid and trained care workforce, vacancy and turnover rates soar, fewer people get the support they need and families end up taking the strain.

President Biden gets that, which is why he has made home care a central plank of his post-pandemic infrastructure plan. Britain deserves that level of ambition too. In the century of ageing, everyone should look forward to getting older with confidence, not fear. Labour Members stand ready to play our part in making that happen, but it is time for the Government to act.

--- Later in debate ---
Liz Kendall Portrait Liz Kendall
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It has been an honour to take part in this debate. It is all too rare for Members to talk so much about what has happened to them personally and to the people they love. We are here to help and support people when they are going through difficult times, so the House can be at its best when we show that we are human.

I will not forget these stories of the people we have loved and the people we have lost. The hon. Member for West Aberdeenshire and Kincardine (Andrew Bowie) talked about being a little boy and lying on his bed praying that his grandmother would go back to being the person he once knew. When the hon. Member for Gloucester (Richard Graham) spoke about his parents, I was thinking—I know this from my own family and friends—“How on earth could you have gone through and done all that?” and he said, “You never know what you can do until you have to do it.”

I really feel a sense among people here that we want to help families more, and help them deal with not only the emotional strain, as my hon. Friend the Member for Stockport (Navendu Mishra) mentioned, but the financial strain. I firmly believe that we should help people to help both themselves and one another. I spoke quite a lot about the absolute need not just to involve families, but to see them as genuine partners in the care process because, with dementia, we cannot give good quality care unless we support families.

Staff also play an absolutely vital role, as mentioned by my hon. Friend the Member for Liverpool, Wavertree (Paula Barker). They have gone above and beyond the call of duty, especially during this pandemic. As part of the social care reforms, we urgently need a national strategy to transform the pay, training, and terms and conditions of the care workforce. We saw high vacancy and turnover rates before the pandemic, and half of all domiciliary care workers are on zero-hours contracts.

We need to value staff and treat them like the professionals they are, because they are so important to the quality of care. I hope that the Minister will say something about that when she closes this debate. I am proud that the Labour Government in Wales did not just take part in claps for carers, but gave them a special payment. We need a much more long-term, sustainable solution there.

My hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) secured the debate, and, as she said, the bottom line is that we need social care reform. The truth is that our politics has been far too slow in devising a solution to this long-standing issue. As my mother would say to me, “It can’t be a surprise that we’re all living longer, Liz. You knew when we were born.” Her words will always echo in my ears.

As the brilliant group Social Care Future has argued,

“we all want to live in the place we call home with the people… we love, in communities where we look out for one another, doing the things that matter to us”.

The basic aspiration that older and disabled people should have the freedom and support to live a life like everyone else should not be regarded as extraordinary, yet in the 21st century, in one of the richest countries in the world, this is where we have ended up after years of political failure.

A long-term solution to the challenges facing social care, including for those with dementia, is not just desirable; it is essential. We cannot level up our country or build a better future or ensure we all look forward to living longer—not fear it—unless we invest in and reform social care. We heard lots of examples of what people are trying to do within the existing system, often against all the odds. We need a reformed system. We need to understand that social care is as important as the NHS. We have to understand that the two are inextricably linked.

We all—not just today in the debate and not just in relation to health and social care, but across society—need to understand that getting older and all these issues are not going to happen to someone else; they are going to happen to us all. Very few people want to think about what it really means to be very, very old, but one baby in four born today is set to live to 100. We need the House and the country to take long-term decisions, which our constituents and future constituents need. It really is time to act.

Covid-19: Social Care

Liz Kendall Excerpts
Thursday 22nd April 2021

(3 years, 6 months ago)

Westminster Hall
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Liz Kendall Portrait Liz Kendall (Leicester West) (Lab)
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It is a pleasure to serve under your chairmanship, Mr Twigg, and very nice to see so many people present in person. One of the things that we have all missed during this pandemic is human interaction, possibly even in Parliament.

I congratulate my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) on securing this debate and on her brilliant speech, every word of which I agree with. I thank her and the right hon. Member for Ashford (Damian Green) for their work on the APPG. Every week, I have read the readout of their discussion, even if I have not been able to attend, and that real-time information has been hugely important. I also pay tribute to my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), who was the shadow Minister for Social Care before me and from whom I have learnt a great deal over many years.

I will say something about the impact of the pandemic on the users of services, staff, families and the wider community, who have not been touched on so far. I will also talk about the underlying reasons why we have failed to prioritise and secure longer-term reforms to social care. We cannot deal with a problem unless we understand why it is there; that is how we get progress.

As other hon. Members have said, the emerging tragedy in social care over the course of this pandemic will be etched on all our brains for the rest of our lives. To see 41,500 care home residents dying from covid-19, including those residents who ended up dying in hospital, has been brutal for every single one of those people, their families and all the staff who have gone through unimaginable horror caring for people at this difficult time.

The sad reality is that the proportion of care home residents who have died in England is higher than in almost any other country that we have data for, especially in Europe, where it is surpassed only by the proportion who died in care homes in Slovenia, Belgium and, unfortunately, Scotland—despite what the hon. Member for Linlithgow and East Falkirk (Martyn Day) said. Scotland has had one of the highest rates of care home resident deaths. That is a serious problem. I will come on to why, whatever Ministers said, I think that a protective ring of steel was not put around care homes. That is related to the deep-seated problems and our fundamental challenges. We must ensure that it never happens again.

People living with dementia have been particularly badly hit by the pandemic. A third of all covid-19 deaths have been of people living with dementia. Also, the deaths of people with dementia even where covid-19 has not been present have been significantly higher. I will say something about this later, but I think the fact that so many people in care homes have been prevented from seeing their loved ones means that those with dementia have gone downhill fast. When people lose their memory, which is what dementia is, their family is their memory. No matter how hard care home staff try, family are the ones who know what films people liked or what music they liked to play, and without their absolute involvement and interaction, we have seen many care home residents with dementia go downhill fast.

I also want to touch on a point made continually by my hon. Friend the Member for Worsley and Eccles South: the impact of covid-19 on people with learning disabilities. They are six times more likely to die than the general population and, horrifically, for those aged 18 to 34, they are 30 times more likely to die. To be honest, however, that should come as no surprise to us, because we know that people with learning disabilities have far worse health outcomes and are more likely to die early because of their lack of proper access to care.

Everybody has rightly paid tribute to the amazing work of care staff, who have given more than almost anybody during this pandemic. Tragically, they were twice as likely as the general population to die from covid-19 during the first wave. That presents two really big issues.

There was an appalling lack of access to PPE, especially in the first wave. I met frontline care workers who told terrible stories of having only one mask to last the whole day, from client to client, when seeing clients with dementia, who cannot help but spit on to the mask when they are talking, so the care worker thinks, “I haven’t got another mask to see my next client.” A survey by GMB found that 85% of frontline care workers said that they were worried about the risks to their own health and that of their families, and that one in five thought about quitting cause of the lack of PPE.

That has been compounded by the low pay and poor terms and conditions of frontline care workers. We have heard time and again that many workers who needed to self-isolate or shield were forced to take unpaid leave or rely on statutory sick pay, leaving them desperately out of pocket, unable to pay their bills and facing an awful choice between going to work or being unable to put food on the table. A Unison survey found that those are absolutely essential issues that must be addressed. One care worker said:

“I was Covid-positive after contracting it at work and was off for three weeks. I have a mortgage to pay and bills, and I don’t know how I’m expected to survive. I put my life on the line, survived and was repaid with SSP.”

Three quarters of frontline care workers do not make the real living wage. Many do not even make the minimum wage at the end of the week because they are not paid for travel time between clients. We cannot deliver a better system of social care without transforming the pay, terms, training and conditions of the care workforce.

On families, there are two issues. One is unpaid family carers, who have done so much more to care for their elderly or disabled loved ones during this pandemic. There were 9 million of them in the UK, but since the pandemic struck, there have been an extra 4.5 million—it is astonishing that we have not heard more about that during the debate. They are providing even more care than usual, without breaks, and their own physical and mental health has suffered as a result. Families are as important as the paid workforce in delivering care in this country. We need a new deal—a partnership between families and the Government—to support those carers in doing their best to look after their loved ones.

We then have the families who have been banned from seeing their loved ones in care homes, and who are now also unable even to take their loved ones out for a walk or a cup of tea, because they would have to self-isolate for 14 days. We have to completely rethink that. Since June, we have been arguing that families should be treated as key workers and have access to all the testing, PPE, vaccinations and so on, so that they can safely visit their loved ones. That is not just a term or a gimmick, however; they actually are key workers. We cannot have good-quality care for older or disabled people without families’ involvement.

I urge the Minister, as I have done many times when discussing this topic, to have a rethink about this. The guidance still is not working—it is wrong on the 14-day self-isolation—and we may have to look at legislation to enshrine the rights of care home residents. They are not prisoners. Quite frankly, if we all think that, when we end up in a care home, we will be banned from seeing our family and will not be allowed out, what kind of future is that? It will be a future that we fear, rather than a future for which we look forward to getting older, and that must change.

On the wider community, one of the positive things from the pandemic—I am very proud of what has happened in Leicester, the city that I represent—is how many voluntary groups and mutual aid groups have sprung up to try to do things such as helping older people with shopping, delivering it quicker than either the local authority or the private sector ever could. That support for the wider community—ringing older people to help them if they are isolated—has got to be part of our future social care system, too.

Let me move on to why we have seen the problems that we are all relating here. The immediate and glaring issue, as the Alzheimer’s Society has said, of why we have seen such problems in the care sector, is that the pandemic struck at a time when social care was already overstretched and undervalued. Local authority care budgets have been cut by £8 billion in real terms since 2010 and that has pushed many to absolute breaking point. It is not morally right, but it does not make economic sense either, because if staff are not paid properly and there is high turnover and vacancy rates and family carers are not supported and their health suffers and they end up in hospital, that costs us all far more.

It is also the failure to put in place long-term reforms, as the right hon. Member for Ashford (Damian Green) said. Why is that the case? It is a big challenge, but it is not rocket science, to ask for older and disabled people to live as normal a life and as full and fulfilling a life as possible, with help to get up, washed, dressed and fed, maybe go to the shops, with help for a disabled person to live independently and maybe have a job. It is not that complicated, yet we have ended up in this crisis. Why?

First, when the NHS and the wider welfare state was created, average life expectancy was 63. Now, it is 80. We did not live in a world where people lived for so many years, and so we have been scrabbling to catch up ever since, with a fragmented and piecemeal system. Secondly, in many ways we have left it to families—“This is a family issue; families should look after elderly or disabled relatives.” Yes, and they want to. They want to do all they can, but they need help and support, especially in a world where women work; they want to work and balance their family lives. Thirdly, it is about caring and caring is women’s work—undervalued, underpaid and yet some of the most important work in our society.

What that all adds up to is a failure to understand that a third of our lives will now be lived aged over 65. We have got to transform society—not just the care sector, but housing, transport and planning—because getting older should be something that we look forward to with hope and optimism, not fear. It is my lovely mum’s birthday today. She is so worried about the pandemic, but I am afraid, when I was discussing this debate, she said, “You know what, Liz? You know what we feel? At best, ignorable; at worst, expendable.” That is not a country that any of us want to live in.

The legacy of this pandemic must be to transform services and support so that every older and disabled person can live the life they choose. It is politically controversial and my strong advice to the Government would be to bring forward proposals early on, because the closer we get to an election, the worse it will be. The Labour party was accused of a death tax; the Conservatives have been accused of a dementia tax. In the end, it is not us who suffer. It is the people who use services and their families.

We need a long-term settlement for older and disabled people that pools our resources and shares our risks and has a fair balance of funding across the generations. That is surely within our grasp. I know Opposition Members will continue to do everything they can to secure a better future for all.

Derek Twigg Portrait Derek Twigg (in the Chair)
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I remind the Minister to leave a few minutes at the end for Helen Hayes to wind up.

Oral Answers to Questions

Liz Kendall Excerpts
Tuesday 13th April 2021

(3 years, 6 months ago)

Commons Chamber
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Helen Whately Portrait Helen Whately
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I share the hon. Gentleman’s sorrow for the lives that have been lost among the health and social care workforce during the pandemic. I am determined that we will support and continue to support our health and social care workforce through these difficult times. One of the things that I want to achieve for our social care workforce, for whom I am truly ambitious, is that rather than doing something one-off for the pandemic, we should come up with a workforce strategy that will improve the opportunities for those working in social care to develop their careers, with a real career progression in working in that sector. That will be part of our social care reform proposals.

Liz Kendall Portrait Liz Kendall (Leicester West) (Lab)
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Despite repeated promises, the truth is that someone would be better off stacking shelves at Morrisons than caring for older or disabled people, and that is simply not good enough for our country. Can the Minister confirm that the Government’s covid infection control fund had to be used to improve pay so that staff did not have to work for more than one care home and could actually afford to self-isolate? If that is the case, will she commit to permanently enshrining these improvements across the sector to keep all care users and all care workers safe?

Helen Whately Portrait Helen Whately
- Hansard - - - Excerpts

In response to the hon. Lady’s question about the use of the infection control fund, it was available to providers to use in a range of ways to keep their residents safe from covid, including, for instance, reducing the movement of staff between one care home and another, which is often part of the service model of how care is provided, and also, as I mentioned earlier, funding full sick pay for staff who needed to self-isolate because of covid. I am determined that as part of our social care reforms that we will be bringing forward, we will look at how best we can support the workforce.

World Social Work Day

Liz Kendall Excerpts
Thursday 18th March 2021

(3 years, 7 months ago)

Westminster Hall
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Liz Kendall Portrait Liz Kendall (Leicester West) (Lab)
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It is a pleasure to serve under your chairmanship, Mr Twigg. I congratulate the hon. Member for Ruislip, Northwood and Pinner (David Simmonds) on securing this important debate on World Social Work Day. He will not know it, but my parents grew up in Pinner, so I know at least part of his constituency fairly well.

I start by thanking the 100,000 social workers in the United Kingdom, including 320 in Leicester, the city that I am extraordinarily proud to represent. I thank them for their hard work, passion and commitment over all the years, but especially during the horrors of the covid-19 pandemic.

Social workers work at the heart of our communities to support millions of people, in order to improve those people’s chances in life. They work with people who have learning disabilities, autistic people and children at risk. They support families where there is domestic abuse and mental illness, and those people who do not have the mental capacity to make their own decisions. That means that social workers can be found across many different sectors and many different services, from residential care homes to hospitals and children’s homes, and in local authorities, charities and the community.

As my hon. Friends the Members for Lewisham East (Janet Daby) and for South Shields (Mrs Lewell-Buck) have already said, social workers have faced huge extra pressures during the covid-19 pandemic, which come on top of a decade’s worth of cuts to local council budgets— £8 billion pounds has been removed, putting extra pressures, stresses and strains on social workers, who were already reporting burnout and stress.

As many hon. Members have said, the latest survey from the British Association of Social Workers has clearly demonstrated concerns that more people need help and support from social work, but also that it is much harder to get help and support, especially—this is absolutely critical—the up-front early intervention and preventive care and support that is so crucial to prevent problems from getting even worse and ending up in an emergency, which is not good for families and actually ends up costing the taxpayer far more money. In particular, the survey showed that almost eight out of 10 social workers say that they are increasingly concerned about safeguarding children and vulnerable adults during lockdown. That is a real concern as we begin to emerge from the pandemic. What are we going to do? Where is the plan and strategy to tackle and deal with those issues that we know have been building up during lockdown?

To add to those points, social workers in Leicester say how isolating working from home has been during our year-long lockdown—in fact, in Leicester we have never been out of lockdown—and how much they have missed their colleagues. Those relationships are vital, both professionally and personally. To deal with the problems caused by lockdown, social workers have also had to be benefit advisers, furniture finders, and food bank directories. They feel undervalued compared with organisations such as the NHS, the police and the other services that the hon. Member for Ruislip, Northwood and Pinner mentioned, when they are all trying to work as one system and one team across so many different organisations. In future, we really need to focus on the importance of identifying strengths in families and communities, rather than focusing only on deficits and problems. I think that is something that we in politics could all learn from, quite frankly.

In the rest of my speech, I will focus on the three really big issues that we need to tackle in order to improve the lives of our constituents and the lives of people with whom social workers work day in, day out. First, we urgently need to tackle rising rates of poverty, particularly child poverty. The vast majority of parents in poverty are doing their very best to support their children, but for those who are already struggling, poverty makes things much harder. In reality, even before the pandemic struck, more than 4 million children in this country were growing up in poverty, including 12,000 in my constituency alone. Once housing costs have been taken into account, more than 40% of children in Braunstone, Abbey and New Parks are growing up in poverty.

Since the pandemic struck, more than 2,500 children across Leicester have had to claim free school meals. The number of people claiming universal credit has doubled, and there has been a 300% increase in the number of people using food banks, as I know only too well from my role as chair of Feeding Leicester—I know that my hon. Friend the Member for South Shields is really involved in the Feeding Britain organisation. They are not just people who out of work; they are in work but on very low incomes, and they just cannot afford to put food on the table.

We are seeing some appalling examples of the levels of need in our city from the work that we have been doing on our winter grant. Increasing numbers of people need help with the absolute basics of living, such as food and paying for their gas, electricity and water, and we have had an increasing number of claims for duvets that people can put on their beds and for coats to put on their children’s backs. In the 21st century, in one of the richest countries in the world, that is a national disgrace, and it does not have to be that way.

The last Labour Government lifted more than 1 million children out of poverty, and President Biden’s covid recovery plan in the US will halve child poverty—that is absolutely essential. If we want to build back a better future for our country, and if we want to level up in every part of the country for all our constituents—especially those with whom social workers work day in, day out—tackling child poverty must absolutely be a priority. I look forward to hearing the Government’s plans on this issue when the Minister responds.

Secondly, I want to focus on a point that has rightly been made by the British Association of Social Workers: an unacceptable number of people with learning difficulties and disabilities are still in hospital settings and assessment and treatment units because there simply is not enough support in their home communities. The association says that must be a priority for the future, and I agree.

It has been 10 years since the appalling scandal of Winterbourne View, when the BBC’s “Panorama” programme exposed the shocking, and indeed criminal, treatment of people with learning disabilities in that institution. At the time, 3,400 people with learning disabilities were in long-stay institutions. The Government promised more than half of them would be moved into the community by 1 June 2014, yet by November 2014 the Government had failed to achieve that—there were still 2,600 people in these hospital units. I vividly remember that, because it was the first ever urgent question I asked as the shadow Minister for Social Care.

The review by Sir Stephen Bubb called for urgent action to tackle this problem, which the Government again promised to deliver, this time by 2016. At the time, I said that the missed deadline was a total disgrace, and that I feared Sir Stephen Bubb’s review risked gathering dust alongside all the other reviews. I am sad to say that this has proved to be the case, despite all the promises and all the reviews. I say to the Minister that despite the Government’s Transforming Care programme, in September 2020 the CQC found that there were still more than 2,000 people with learning disabilities in assessment and treatment units. Many are subjected to, “undignified and inhumane treatment, including prolonged seclusion and unnecessary restraint”.

This is one of the worst examples of a failed policy that I have seen in more than 25 years of working in the health and care sector. We need leadership, grip and focus from Ministers and NHS England. Crucially, we need the views of people with learning disabilities and autism, and the views of their families and social workers, to drive fundamental and lasting change. I hope that the Minister will set out what the Government are doing and will continue to do in order to tackle this issue.

Finally, there is an urgent need for the Government to bring forward longer term plans for reforming social care—an issue we talked about just minutes ago in the previous Westminster Hall debate. More than 19 months ago, on the steps of Downing Street, the Prime Minister promised to fix the crisis in social care with a plan he had already developed. That plan is still nowhere to be seen. There was nothing in the Budget on these vital long-term reforms. The Minister says that the Government will bring forward these plans this year, but that is what she promised last year. I hope that when she stands up she will set out why we should believe that it will be different this time around.

Social Care Reform

Liz Kendall Excerpts
Thursday 18th March 2021

(3 years, 7 months ago)

Westminster Hall
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Liz Kendall Portrait Liz Kendall (Leicester West) (Lab)
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It is a pleasure to serve under your chairmanship, Dr Huq. As many others have done, I congratulate my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) on securing this debate. She has been a tireless, long-standing champion of these issues, and I really do pay tribute to her for her hard work.

I think that reforming social care—along with tackling climate change—is the challenge of our generation. If we cannot sort this issue out after the horror of the covid-19 pandemic, then frankly, as policy and law makers, we should pack up and go home, because this pandemic has brutally exposed the fundamental flaws in our system of social care, on which many people who have spoken today and many people who are watching this debate have campaigned for years.

First, despite all the rhetoric, social care is still not treated as equally important to the NHS. We have only to think about all the effort and focus that went into setting up the Nightingale hospitals and contrast that with what happened to care homes. Frankly, there was not a ring of steel around care homes; that was not the case. We can think about the examples of frontline care workers saying that their PPE was requisitioned for NHS staff. I want our NHS staff to have proper PPE, but to have it actually taken from people when they were caring for some of the most vulnerable in society was appalling.

Secondly, social care and the NHS are still not seen as inextricably linked. We saw that with the discharges from hospitals into care homes without covid-19 tests, and we saw it with many care homes feeling abandoned and feeling as though they did not get the support that they needed and deserved from the NHS at the start of the pandemic.

Thirdly, our frontline care workers are chronically undervalued and underpaid. The Minister will know that of the infection control fund that went to care homes, the vast bulk went towards ensuring that frontline care workers were paid enough so that they could self-isolate if they had to have time off sick, and so that they did not have to have several jobs between care homes. Quite frankly, that should not be additional, extra funding; it should be embedded in the bottom line of funding for our frontline care workers.

Finally, the families who do the bulk of caring in this country get precious little help and support in return. Unpaid family carers have come to my constituency office absolutely broken by the pressure from the extra hours of caring that they have had to do. They tell me that they just have nothing more to give. We have to do more to support families in the longer term. I also think that the pandemic has entrenched the misperceptions about social care: that it is about only care homes, not care in people’s own homes, and that it is about only elderly people, not working-age adults with disabilities, who make up a third of the users and half the social care budget.

Of course, the immediate cause of those problems is the 10 years of cuts to local authority budgets. Local authorities have had £8 billion removed, which has meant fewer people getting help and not enough people getting the type and quality of help that they need. We know that there are longer-term problems, too. Social care was never included in the initial creation of our NHS and welfare state. Any politician who has tried to solve that problem has risked being obliterated by their political opponents. We saw that in 2010, with accusations of a Labour death tax, and we saw it with Theresa May’s Government and the accusations of a dementia tax. In the end, however, it is not politicians who suffer, but the users of social care and their families.

There is another issue that has not been touched on so far in the debate: one reason why this issue has not been grasped is that caring work is predominantly done by women and is not valued in the same way as medical care provided by the NHS. We desperately need a new settlement of investment, yes, but we also need one of reform, because putting more money into a system that is not working is not the right approach.

We need a system that works for older people and for disabled people. I want to pick up on a point that several hon. Members have made: ensuring that people do not have to sell their homes to pay for their care is an issue—an important one—but it is not the issue, because for working-age adults with disabilities, that is not the fundamental problem in the social care system. We need a system that works for both.

We need a real shift in the focus of services and support towards prevention and early intervention. I think we should have a “home first” principle and more options between care at home and care in a home. Other parts of the world have lots of different examples of housing and care being brought together, and that is what we need in this country.

We need a system that is fully joined up with, but not run by, the NHS. One thing that care users will say is that they have to tell their stories time and again to lots of different services. We cannot have that in future, because people do not see a health need over here and a care need over there; they have just one set of needs. We should design services around users, rather than getting them to fit into different parts of the system. We need to put the principle of choice and control at the heart of the system, enabling older and disabled people to live the lives that they choose, with a radically transformed, paid care workforce, and radically transformed support for families, too.

Kevin Hollinrake Portrait Kevin Hollinrake
- Hansard - - - Excerpts

I agree with virtually everything the hon. Lady has said. A funding solution is key, because in order to expand capacity there has to be more money. Does she have a funding solution for that? Would she consider a German-style system, which has cross-party support, or would she at least be willing to sit down with a number of people who support that system to engage with the idea?

Liz Kendall Portrait Liz Kendall
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The hon. Gentleman may know that I have been calling for cross-party work on this issue for the past five years. The principles are clear—we should not leave the costs to individuals alone. We should pool our resources and share risks. That is essential for the future. I do not think any sort of private insurance system works. One issue around the cap on care costs was that the Government thought a private insurance market would spring up. That was not the case, and it will not be the right solution for the future.

The Prime Minister stood on the steps of Downing Street 19 months ago and said he would fix the crisis in social care with a plan that he “had” developed—that he had it already. It is still nowhere to be seen. Lord Bethell recently said that now is not the time to have fundamental reforms, because we are busy dealing with the covid crisis. I argue that now is precisely the time for reforms to give people hope that, after the horrors they have been through, there is a better system for the future. That is why I was disappointed not to see anything in the Budget about social care reform.

Yesterday, there was an unprecedented statement from social care leaders, who called on the Government to end years of inaction and fix the system. They said that as well as emergency funding, we need longer-term plans to make social care a cornerstone of the modern welfare state. The crucial point is the potential for social care not only to transform the lives of millions of older people, disabled people and families who use care, but to create jobs and drive economic recovery.

In the remaining minutes, I will focus on this point. We often talk about the costs of reform, but the costs of not reforming the system are just as important. First, social care has huge potential to create good quality, valued jobs in this country. We need 520,000 more frontline care workers just to meet growing demand by 2030. The Resolution Foundation rightly argues that if we want to create jobs immediately in every community—that is what we need to do to level up all parts of the country—social care is the place we should start, and I completely agree.

Secondly, investing in social care is essential if we want all families to be able to balance their work and caring responsibilities. In today’s world, with our ageing population, social care is as important a part of our economic infrastructure as the roads and the railways. When one in three unpaid family carers have to give up work or reduce their hours because they cannot get the support they need to help their loved ones, it is bad for them, because they lose their job and income; it is bad for business, because they lose their skills; and it is bad for the economy.

Finally, investing in social care is vital to make the best use of taxpayers’ money. We should not be paying more for elderly people to be stuck in hospital when they could be cared for in the community and at home. As we seek to get our public finances back on a more sustainable footing, value for taxpayers’ money is essential. This issue is the biggest challenge of our generation. I hope the Minister will tell us when the Government will introduce their reforms, because reforming social care is not just a matter of social justice, but an economic necessity.

Rupa Huq Portrait Dr Rupa Huq (in the Chair)
- Hansard - - - Excerpts

Finally, the last of the all-female Front Benchers, Minister Helen Whately.

Oral Answers to Questions

Liz Kendall Excerpts
Tuesday 23rd February 2021

(3 years, 8 months ago)

Commons Chamber
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Matt Hancock Portrait Matt Hancock
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Yes, I do. All those who arrive in this country as passengers need to undergo quarantine, and we have both the hotel quarantine and home quarantine; all need to be tested; and all the positive test results are sent for sequencing so that we can spot any new variants. This is a critical part of our national defences. The good news is that we can see from the data that the number of new variants in the country is falling and is much lower than it was last month. We obviously keep a very close eye on that, because making sure that we do not have a new variant that cannot be beaten by the vaccine is a critical part of the road map, as set out by the Prime Minister yesterday.

Liz Kendall Portrait Liz Kendall (Leicester West) (Lab)
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The Prime Minister promised that all staff in elderly care homes would be vaccinated by the end of January. Will the Secretary of State confirm that more than 30% of those staff in England have not been vaccinated, and that the proportion rises to almost half of all staff in elderly care homes in London? Will he urgently set out precisely how the Government will increase uptake and tackle lies and misinformation about the vaccine among this vital group of workers, as we have been urging the Minister for Care to do since before Christmas?

Matt Hancock Portrait Matt Hancock
- Hansard - - - Excerpts

Yes. We are absolutely all on the same side on this issue. To be totally clear for the hon. Lady, and all those listening, the Prime Minister set out that we would offer the vaccine to all residents of care homes by the end of January and to all staff by 15 February, and we achieved that. The challenge is uptake. Rather than having a political ding-dong about it, what we all need to do is get out the positive messages about the vaccination programme. I am delighted that the Minister for Care and the Minister for Covid Vaccine Deployment have both been working incredibly hard on this issue, and we published an uptake plan last weekend. I am sure the hon. Lady will want to join the efforts to try to encourage everybody to get the jab.

Covid-19

Liz Kendall Excerpts
Tuesday 12th January 2021

(3 years, 9 months ago)

Commons Chamber
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Liz Kendall Portrait Liz Kendall (Leicester West) (Lab)
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I know that the Minister and hon. Members on both sides of the House understand the seriousness of the situation that we now face. Yesterday, the chief medical officer warned that the next few weeks will be the worst of the pandemic, and the chief executive of NHS England said that the virus is spreading out of control in many parts of the country. As the Minister said, there are more than 32,000 covid patients now in hospital, up from 18,000 at the peak of the first wave. In my own hospitals in Leicester a quarter of patients have covid-19. Elsewhere this is 40% or even 50%, and we are preparing for those levels to hit us too.

On top of that, 46,000 hospital staff are currently off work sick with the virus, and the consequences of that are stark. Staff-to-patient ratios in acute and intensive care are stretched to the limit of acceptable levels, if not beyond. All but the most urgent operations are being cancelled in many parts of the country, including for cancer care. Ambulances are queuing for hours outside hospitals to get seriously ill patients into beds and some hospitals are even running dangerously low on oxygen supply.

Dealing with this awful virus, especially the new, more virulent strain, was always going to be extremely difficult, but I do not believe that the severity of the situation we are now in was inevitable. Over the past nine months, the Government have continually changed their message to the public, and have repeatedly been too slow to act, even though we know that the virus ruthlessly exploits ambiguity and delay. At the heart of the problem is the failure of the Prime Minister and some members of the Conservative party to understand that protecting people’s health and the economy is not a zero-sum game, because we cannot get the economy going again if we do not stay on top of the virus.

The individual freedoms that we all hold dear—our ability to learn, work, do business, travel the world and see those we love most—depend on the actions of others. No man or woman is an island. That has always been the case, but covid-19 has thrown our interdependency into sharper relief than ever before. Until the Prime Minister grasps that fact he will continue to make the same mistakes, and many in our country will pay a bitter price.

While most attention focuses understandably on the extreme pressures facing the NHS, the case I want to make is that we cannot protect the NHS if we fail to protect social care. Alongside the need for swift and decisive action, that is one of the most important lessons that should have been learned from the first wave, but once again there are warning signs of pressures building in social care which, I fear, have been downplayed or even ignored. The number of covid outbreaks in care homes has tripled in the past month. Care homes are reporting staff shortages of up to 40%. The latest weekly death rates in care homes are out today: 824 deaths for the week ending 8 January. Those numbers have doubled since November, and are the highest since May.

Ministers must heed those warnings and they must act, not just because after 20,000 deaths from covid-19 so far in care homes we must do everything possible to protect residents, or because care workers and unpaid family carers are physically and emotionally shattered after 11 months at the frontline and deserve more help and support, but because if we cannot keep people safe in their own homes or in care homes, or move them back home from hospital when medically they are able to leave, the whole system will buckle under the strain.

After all the problems earlier this year, with covid-19 patients being discharged to care homes that could not cope, the Government should finally have gripped the issue and delivered a proper plan. Yesterday, we learned that only 118 care homes have been designated as safe to accept covid patients from hospital, although the Government promised in November that there would be at least 500. Understandably, many care homes do not want to take covid patients from hospital, especially as insurers will not cover the associated risks. While the Government have provided indemnity against such claims to the NHS, they have still not done so for social care, despite repeatedly being asked to do so.

This is just one example of the way in which social care social care is still not being prioritised, treated or funded equally with the NHS. Frontline care workers are still chronically undervalued and underpaid. Almost three quarters do not even earn the real living wage, despite doing some of the most important work in society, looking after the people we love most. Millions more unpaid family carers are being stretched to breaking point, trying to look after the people they love. Even before the pandemic almost half of unpaid carers had not had a single break for five whole years, and since the virus millions more families have taken on an even bigger role, but with precious little help and support in return. So I urge the Government to consider what immediate extra support can be provided for social care—for care workers and family carers—over the coming months, when the pressures will be the greatest we have ever seen.

I know that across the country, as the Minister said, the vaccine provides real hope for care workers, care users and families that the nightmare they face can and will end, but we are in a race against time. The Government must leave no stone unturned in their plans to deliver the vaccine to all elderly care home residents and staff by the end of this month, and we will support them in their efforts to do so. However, we really do need to see daily vaccination rates for this group published so we know whether the Government are on course to complete this commitment in just under three weeks’ time.

People need to know when they can start visiting their relatives in care homes once the vaccine has been delivered, because this is currently totally unclear and causing real upset and concern for families across the country—people who have not seen their relatives for months and months on end. Ministers should also set out a more detailed timetable for vaccinating hundreds of thousands of other care workers by mid-February. This needs to include those working with disabled adults as well as older people, those working in home care as well as care homes, workers in supported living and personal assistants employed by direct payments. I think we are going to have to go way beyond the Government’s current plans if we are going to vaccinate family carers aged under 65 as part of priority group 6, as the JCVI now recommends.

The vaccine is the light at the end of a very dark tunnel, and as we begin to emerge, we must resolve to build a better Britain, not go back to business as usual. Nowhere is this more true than for social care. In July 2019, the Prime Minister promised on the steps of Downing Street that he had a plan to fix the crisis in social care. A year later, he again claimed his Government “won’t wait” to fix the problem, yet six months on his plan is still nowhere to be seen, and instead delayed until sometime later this year. In October, the Health Minister in the House of Lords said:

“There simply is not the…political capacity to take on a major generational reform…in the midst of this massive epidemic.”—[Official Report, House of Lords, 28 October 2020; Vol. 807, c. 226.]

That is not good enough, and I would argue that this is precisely the time we need a long-term plan of far-reaching reform to give people hope that a better future is possible after the horrors of covid-19.

We need a social care system that works for older people and working-age adults with physical and learning disabilities, who make up a third of the users and a half of the budget of social care but are still too often ignored. We need a system that fundamentally shifts the focus of support towards prevention and early intervention to help people stay living independently and well in their own homes for as long as possible; a system where social care is fully joined up with but not run by the NHS, so people do not have to battle their way round all the different services, telling their story time and again; and a system that is properly funded after a decade of cuts, so care workers get the pay and training they deserve, families get decent support and there is help from the wider community too.

Yesterday, 88-year-old Moira Edwards, the first person to be vaccinated in one of the new NHS mass vaccine centres, spoke for many of us when she said that she could not wait to give her family a hug. I know that that is exactly how I feel. This pandemic has proved once again just how important our families are, but it has also exposed the fundamental flaws in the system of social care on which millions of families depend. The reality of modern family life is that more of us will need care, and need to care, as we all live for longer. So if we want to provide dignity and security for older and disabled people, and if we want to help families balance their work and caring responsibilities, and offer more than 1.5 million low-paid care workers hope for a better future, transforming social care must be a national mission. Labour Members stand ready to play our part in one of the biggest challenges facing our country, but it depends on Government action, which they must take—and now.

Nigel Evans Portrait Mr Deputy Speaker (Mr Nigel Evans)
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Order. Just to remind everybody in the Chamber that we now have a new one-way system, so Members enter via the door in front of me, and exit via the side doors or behind me—do not enter behind the Speaker’s Chair. I call Sir Peter Bottomley. There is a three-minute limit.