Covid-19: Vulnerable Populations

Baroness Verma Excerpts

Tuesday 12th May 2020 Lords Chamber

[Lord Bethell]

The advice given to local authorities is spelled out in guidelines. Those who are vulnerable are advised to avoid social contact. Where necessary, those whom they live with, including any children they have with learning disabilities, should also avoid the same social contact.

[Baroness Verma (Con)]

My Lords, I refer the House to my interests in the register. Will my noble friend tell me what work has been done to ensure that public health messaging and advice on access to support for mental health and anxiety issues among the BAME community is easily available to those communities, particularly where they live in densely populated home environments?

[Lord Bethell]

My Lords, mental health advice is very clearly available, most of all from GOV.UK/coronavirus, where there is a huge amount of practical and pastoral advice, and access to resources.

Covid-19: Social Care Services

Baroness Verma Excerpts

Thursday 23rd April 2020 Lords Chamber

[Baroness Verma (Con)]

My Lords, I refer to my interest as set out in the register as a provider of social care. I thank the noble Baroness, Lady Wheeler, for instigating this critical debate. She spoke about the facts on the ground and going forward.

The sector was already in crisis before Covid-19. I assure all noble Lords that high pressure and anxiety is being felt not just by managers but by all those who are delivering care within the home care and care home sector. I cannot quantify the praise I have for all those who are delivering care at the moment. It is heartbreaking to sometimes see my care staff frightened to go home; they hope that they are not taking something back home to their families.

I shall focus my comments and questions on invisible disabilities, such as mental health, dementia, Alzheimer’s and anxiety—all the disabilities that most people cannot see. Our systems are there to provide support for those people. Over the past few weeks, it has been heartbreaking that a lot of our clients and service users cannot visit day centres or go out. The only people they have contact with are their care workers. Will the Minister consider, as other noble Lords have said, the thousands of volunteers who have signed up to help? If only they could be part of the social activity of isolated people in their homes. Anxiety, mental health and dementia are not suddenly going to get better once the crisis is over. They are long-term issues that need to be dealt with.

As a provider, we are facing huge bills for PPE. We want the Government to treat us like the NHS. Let us get VAT removed for us as providers. Although the extra £1.6 billion is welcome, like other noble Lords, I reiterate that it is nowhere near enough in terms of the costs that providers face at this moment. I seriously worry that we will end up seeing a crisis emerge from another crisis in a sector that was already struggling to get people to work in a highly skilled but poorly paid part of the workforce. I urge my noble friend to respond positively to my ask and get more funding in, as well as having it ring-fenced so that it goes to the social care sector.

Coronavirus Bill

Baroness Verma Excerpts

2nd reading & 2nd reading (Hansard - continued) & 2nd reading (Hansard - continued): House of Lords
Tuesday 24th March 2020 Lords Chamber

[Baroness Verma (Con)]

My Lords, I refer the House to my interests in the register. I start by thanking the Government for the actions they have taken over the last few days to help support employers and employees, especially taking into account the impact on small and medium-sized businesses.

I want to focus first on social care and the wonderful care staff who, along with their brilliant colleagues in the health service, are at the forefront of delivering care, both in hospital settings and in the homes of those who need their support. As a social care provider, I put on record how our staff have not wavered in ensuring that all our clients have been reassured, informed and been part of our contingency planning as it has developed. This is probably the same across the thousands of small and medium-sized providers across the country. Our care staff need assurances that they will be among the first to be tested for the virus, that we will ensure that protective equipment is readily available, and that the costs are not raised because there is a shortage. Will my noble friend the Minister assure the House that extra funding for social care is ring-fenced for social care provision? This is absolutely critical.

Being on the front line puts all care workers at greater risk of getting the virus. Will the Minister consider how, with the sector already under huge recruitment pressures, we can look at having all criminal checks for health and social care delivered in 24 hours, and the mandatory three to five-day basic training for care reduced to a day’s training? This would be as long as newly inducted staff work with experienced care workers in double-up calls for the most vulnerable, care-needing users.

I am sure there will be plenty of people wanting to play their part in supporting the health and care sectors. To ease the pressure on our health service, our trained care staff can reduce nurse call-outs and hospital admissions for such tasks as reapplying dressings and sterilising fluids on wounds and pressure sores. Also, with the shortage of blister packs, we could ensure that care staff are able to administer properly recorded medication prescriptions. Many other basic healthcare tasks can be carried out by trained care staff, which would ease the pressure on the health service.

Will the Minister talk to his colleagues in local government to see how these and other measures could be considered? Will he assure the House that those in the most vulnerable group, including the elderly, are not left without human contact, especially where they need assistance? Over the last weekend or so, I have had so many people calling to tell me how frightened and worried they are about their elderly, vulnerable relatives.

The care sector has been underfunded for far too long; too many Governments have not put care at the heart of their policies. There is a misconception that this sector is unskilled. It is not. It is a sector with hard-working, properly trained staff, who are well regulated, and subject to regular inspections by both local authorities and the regulator. I hope that, once this crisis is over, the social care sector will be given a much-deserved priority in government plans.

The other group I want to talk briefly about today is the self-employed and contractors. Many noble Lords have mentioned them in today’s discussions. Over the past few days, I have been inundated with people calling me to ask where they can go for government support. This important group of people help to grow the economy. We have a duty to ensure that they have proper care and financial support, and I urge the Minister to ensure that they get it. It was heartening to hear the Chancellor announce that a support package will be coming through very shortly. Will my noble friend impress upon colleagues across government that a proper communication strategy must be put in place and broadcast across all media channels to ensure that people know where to go for easy information?

People have contacted me to ask about the mortgage holidays and rent holidays for renters in the private and public sectors which were announced by the Chancellor. They all have the right to an initial three-month deferral to ease their financial pressures as they are told to stay home by the Government. Have commercial landlords been asked by the Government to give the same support to their tenants, particularly the larger landlords? I shall not name any landlords today, but if they do not support the Government in giving three-month holidays to their business tenants, I will not hesitate to call them out. This is a time when we should all come together and be supportive; nobody should think it is a time when they can make money on the back of somebody else’s pain, when they are simply following government instructions to close their business and stay at home. I want the Government to understand that small businesses just do not have the means and resources to navigate around complex forms. I ask the Government to ensure that all information is easy to understand and that if there are application forms to fill in, they are easily found and navigated around.

We all want to ensure that we keep everyone safe, but financial pressures have a huge impact on mental health, as has been said today, and our role is to ensure that in these most challenging times, those who can provide well-being and health support while people stay in their homes are encouraged and supported by the Government.

Queen’s Speech

Baroness Verma Excerpts

Tuesday 22nd October 2019 Lords Chamber

[Baroness Verma (Con)]

My Lords, I refer to my interests, as listed in the register.

It is welcome that the Government have referred to social care in the gracious Speech. However, adult social care is in crisis and has been for a number of years. The issues of cost and funding will only get more difficult if Governments are not willing to see the social care sector through the same lens as they see the NHS. As a provider of homecare over the last 20 years, I am aware that, with a reduction in funding and in the time available for care workers to deliver care calls, the increasing requirements imposed on providers by local authorities cannot be met.

We all recognise that we have a growing ageing population. Living longer should be not a burden but a celebration. It should be recognised as a sign of improved living standards. However, it appears that, although politicians are willing to go out and actively and publicly claim their admiration and affection for the NHS—they are absolutely right to do so—it is not about loving the NHS so much as loving the people who work in it and the people who are looked after by it. Why cannot politicians do the same in relation to the incredible and challenging work carried out by those delivering adult social care within our communities? Millions of people depend on the services of trained, poorly paid care staff, who provide a lifeline to families struggling to care for their loved ones.

I will focus on adult social care, predominantly around the older age group. Care staff deliver care across all age groups and to people with varying degrees of disabilities, whether they are physical or unseen disabilities. For far too long, the social care sector has required a fundamental shift in how that care is delivered. Instead of tinkering around the edges with intermittent small injections of funding to fend off crisis after crisis, a total rethink is needed of how care within the community setting is delivered. There is already a challenge in making the care sector an attractive place to work. Pay is low and the working conditions are deeply challenging, and an expectation of increasing responsibilities is making care work an ever-demanding job that offers few benefits but increases stress for both care workers and families.

Recruitment in the care sector has hit an all-time low. Providers are worried about the tone that has been taken in the Brexit debate on immigrants and immigration, and they fear that care provision will face serious employment problems. Filling vacancies is already extremely difficult. It is unrealistic to assume that the gap will be filled by local people because, as is evident in the NHS, those posts have always required immigrants to come in to support our critical infrastructures. The Government are talking about a points-based system and skilled workers being welcome in the UK. However, unless we are able to provide home-grown workforces to deliver for an increasingly ageing population, our hospitals will have further expensive challenges thrust upon them.

A realistic and pragmatic approach has to be taken to respond to the challenges that we face. Unless there is a fundamental shift in how care provision is viewed in this country, people who have worked throughout their lives and contributed to the growth of this great nation will increasingly be airbrushed out of society and out of government commitments. They are not seen as vote-winners or contributors. Although we have a housing crisis, it should not be acceptable for people wishing to downsize to smaller properties as they get older to have no available provision, or choice about where they spend their later years. Going into a residential home or a nursing home should not be among the few options available. It seems that, once you have less to offer, you are redundant and surplus to requirements, and can be put out of sight and out of mind. What a reflection of the country we are becoming.

The one inevitability in our lives is that we will grow old. Surely, it is not beyond our wit to develop a care system that provides care, dignity and independence. The feedback that we continually receive from our clients and their families is that care must be about more than just addressing physical needs such as washing, showering and toileting. It is about mental well-being and continuing to engage with the community at large. It is about being socially active and feeling valued. Offering a more holistic approach to care in a community setting would fundamentally reduce the pressures associated with people having to visit the NHS.

Although we talk about NHS staff with affection, care staff in the community are viewed in a completely negative way. Both systems support people in our communities, yet the care sector, which acts as a complete support system for millions of families, is, unfortunately, disregarded. I urge the Government to rethink how care provision is delivered and funded, and not to make it the Cinderella arm of looking after people. The demands associated with health and well-being will not reduce; instead, as we grow in number, they will increase. Unless we see a fundamental shift in how care provision is funded and care staff are rewarded in their pay packets, this crisis will most definitely grow and create unsustainable pressure on the NHS.

Brexit: Health and Social Care Workforce

Baroness Verma Excerpts

Thursday 13th December 2018 Lords Chamber

[Lord O'Shaughnessy]

I am grateful to the right reverend Prelate for the opportunity to say that we value every person who works in this country in those professions. We want to ensure that they are able to stay and contribute to the health and wealth of our country. I point out we are improving both recruitment and retention not only through increases in the living wage but through changes to the Agenda for Change pay deal concluded earlier this year. It will give 1 million staff at least a 3% pay increase by the end of 2018-19, and increase the starting salary of a nurse by nearly 10% to almost £25,000 by 2021.

[Baroness Verma (Con)]

My Lords, we all value the increased living wage—I speak as a provider of social care, and my interests are listed in the register. Will the Government ring fence the extra funding that they rightly put into social care, so that local authorities have to pass it on to providers? Providers have increased costs, and we cannot pass the money on to our care workers because we simply cannot afford it.

[Lord O'Shaughnessy]

I recognise the picture that my noble friend paints. It is of course incredibly important that money gets to the front line. I am sure that she is aware of this, but I would point out the operation of the Better Care Fund, which brings together local authority and NHS funding specifically to support social care provision. The amounts of money going through that have been increasing over recent years.

The NHS

Baroness Verma Excerpts

Thursday 5th July 2018 Lords Chamber

[Baroness Verma (Con)]

My Lords, I am delighted to speak in this debate celebrating the 70th anniversary of the National Health Service. I join all noble Lords in congratulating the noble Lord, Lord Darzi, on opening the debate. The NHS is proudly the envy of the world but, with the increase in population and the discovery of new illnesses and diseases over time, we need a fresh way of looking at how it will function in the next 70 years. In saying this, I would like to speak about a part of the health service that is often seen as a separate arm but really should be an integrated and well-bedded key component of the delivery of care that the NHS must provide.

I declare an interest as a provider of adult social care, through a business I started 18 years ago. Since that time, we have seen huge changes both to the National Health Service and to social care. In my opinion, we should see them as two parts of the same ecosystem. Instead, they have had to fight for budgets and space within the political debate.

There seems to be a huge deficit in the understanding of how social care is delivered and how well funded the social care system should be to support the NHS. Every day, we hear politicians saying how much they love the NHS. It does not matter from which part of the political spectrum they come, but this mantra never includes the words that they also love social care. Until we have a radical change in our thinking about social care, understanding that it is part and parcel of the delivery of support in the health systems, the burdens on the health service will continue to increase and the funding of social care will continue to decrease.

An easy example to illustrate this is that, if you suffer from cancer, you would expect the health service to provide medical care and support to you free. Why then should someone who has dementia not have the same support at the point of need, just because they are being cared for in a residential setting? It is unjust to pit one type of illness against another, and it needs to be addressed, if we are to be a community that values justice and respect for everyone. With age come new challenges of illness specific to growing older. Does that mean that because we want people to live in their own homes we ignore their needs?

Social care is not just for the elderly; it also supports those with disabilities across the whole age spectrum, so it is high time to rethink how our health service and social care work are made to work as one. Social care has always been the poor relative of our healthcare systems yet, as we become more and more dependent on treating people at home, there is a large recognition that we are fast running short of adequately trained care workers to support people in their communities. The fact that funding for social care is delivered through local authorities and is never ring-fenced means that often any extra funding from government may be used for other immediate pressures faced by local authorities. That cannot be right.

If adequate resources were put into providing people with access to well-trained and better paid care workers, it would have an immediate and huge positive financial impact on the NHS, in terms of improved exercise, dietary plans and mental well-being. How does the input of social care providers get integrated into Ministers’ wider thinking about policy? I urge the Minister not to call just on the work of clinical commissioning groups. We know that there are huge gaps in social care provision; trying to find people to work in the social care sector is getting ever harder. How does the Minister feel we are going to fill the gaps of doctors, nurses, therapists, cleaners and carers once we leave the EU? The NHS cannot change for the sake of change; the Government must understand that you cannot fix a problem unless you fully understand what all the solutions are.

Social Care

Baroness Verma Excerpts

Thursday 7th December 2017 Lords Chamber

[Lord O'Shaughnessy]

I can absolutely provide that reassurance on the voluntary sector. The noble Baroness is quite right to highlight the vital role it plays—it is essential and critical to this sector. On falls, she will know just how important reducing falls is. The disabled facilities grant is increasing. It is not a well-known bit of government spending and not talked about much, but it amounts to about half a billion pounds a year. It can have a really big impact by keeping people in their homes for up to four years longer, reducing falls by 40%. It is something we have had the opportunity to discuss in this House recently. It is critical. She is quite right to focus on the frontier between health and social care and making sure that it flows and works well.

On child carers, I will write with more details about what the action plan covers, but clearly we will make sure that it looks at all carers, because a carer could be of almost any age. As she pointed out, it includes very young children as well as people in their 80s and 90s. A true carers approach would encompass all of them.

[Baroness Verma (Con)]

My Lords, I thank my noble friend for the Statement. I refer to my registered interests. I will ask my noble friend about two issues. The first is respite care, which seems too often to be missed, particularly when there are reduced services. Services have been cut back for many service users. When family members have to manage the burden we need to have some discussions on extra respite support. Secondly—I am a broken record on this—we need seriously to look at the value we put on paying care workers a proper return on the work they do, given the extra responsibilities being put on them all the time.

[Lord O'Shaughnessy]

I am grateful to my noble friend for raising both those points. She is quite right about respite care. Local authorities have a duty to provide it, but I also note that there is pressure on the system. Indeed, the issue of one particular respite home, Nascot Lawn, has been raised. It is something I am interested in and I am looking at it. I will take that point away. We are trying to look at the care service in the round, so respite care must be part of that.

My noble friend is right about paying care workers properly. We have increased the national minimum wage, now moving on to the national living wage, precisely to provide a proper recompense for people who work in that sector and, critically, to start to provide a proper career structure so that people can move on, add to their skills and progress while staying in the caring profession.

Adult Social Care in England

Baroness Verma Excerpts

Tuesday 10th October 2017 Lords Chamber

[Lord O'Shaughnessy]

I agree in part with what the noble Baroness said in the sense that demographic change represents a big challenge. She mentioned the over-100s. The population of over-85s will double between now and 2037. As the CQC report makes clear, many of those people will have difficulty with the basic behaviours and actions they need to be able to live independently. That is the big challenge that we face. The report provides a very honest exposure of strengths and weaknesses in the current system. The strengths are there, though the noble Baroness perhaps did not give them as much credit as they deserve. The report says:

“Overall, the quality of care remains relatively stable, with the majority of all care rated as good and improvements in some services”.


Indeed, only 1% of services are rated inadequate. Clearly we want that percentage to be zero but it is better than in other sectors. I do not disagree with the noble Baroness about the demographic challenges we face. As I said in my first Answer, we are trying to put more funding in, to recruit more staff and raise quality now that we have this national threshold. We hope to decrease variation and then look for a long-term solution that will solve this problem that we have all been wandering around for the last 20 years.

[Baroness Verma (Con)]

My Lords, as a care provider for the last 17 years I say humbly to my noble friend that we need to pay care staff a proper wage so that they can actually have a life that is not just about existing. I am told constantly that local councils are being given extra funding. It is not trickling down to the providers and there needs to be a really serious look at the level of funding and at what we are entitled to pay care staff, because with Brexit around the corner we are going to need ever more of our own homegrown talent to provide those places.

Social Care

Baroness Verma Excerpts

Thursday 1st December 2016 Lords Chamber

[Baroness Verma (Con)]

My Lords, I thank the noble Baroness, Lady Pitkeathley, for initiating this debate, and I congratulate my noble friend on her maiden speech.

I declare an interest as a social care provider. I started the business 16 and a half years ago and have seen many changes in the sector, none of them for the better. It is right and proper that we value care workers, but we cannot do that if we do not have the funding, the time or the ability to recognise their work, which is so important that it would put much more pressure on the NHS if it was not done.

During the years that I spent on the Front Bench, I was unable to speak. Now that I am able to do so, I say to my noble friend the Minister that the NHS is a precious commodity which we all value but, as the noble Lord, Lord Warner, said, it needs to be combined with social care. We need to place social care and the health service on an equal footing. It is not just the elderly who have need of social care; many disabled people and young people are dependent on care workers to support them to live independently.

It has been said that we are the fifth largest economy in the world. If we are to muster a service that is reflective of our society, we must recognise that we need to pay the right price for the right care. I agree completely that we need the living wage, and I would pay care workers even more, but we have to recognise that, while we put the NHS on a very high pedestal, we do not do the same with social care. We need to reduce that gap and equalise the two.

In recent years, the social care businesses delivering domiciliary care have seen added administration costs—there are extra things that care staff and office managers have to deliver—yet there has been no indication of how that is going to be paid for by local authorities. Local authorities claim, rightly, that they do not have the funding. If there is to be funding for social care, it needs to be ring-fenced so that it cannot be diverted to other areas where local authorities face pressures.

In recent years we have had to implement electronic monitoring. To the noble Lord who thinks we are not monitored properly, I say that the social care sector is very well regulated and monitored. Of course, there will be the occasional bad apple, as there will be across all sectors, but I can tell the House that, having worked with and listened to my care staff and managers, I understand the frustrations of having to deliver good-quality care to people. Those care workers, who often will be the only contact that people have throughout a whole day, have to rush through delivering a package of care because the time they can spend on each visit has been so greatly reduced. This is an unacceptable way of treating the most vulnerable people in our community.

I urge the Minister to bear in mind that the social care sector looks after a lot of people, and not just the elderly, although the elderly make up a large proportion of those who end up using the NHS because often they do not get sufficient assistance in their homes. I urge the Minister not to look at integration for the sake of integration but to understand that there is a balance to be struck. Good-quality home care and rest home care prevents people ending up in the very expensive National Health Service.