National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2020

Baroness Brinton Excerpts

Monday 8th June 2020 Lords Chamber

[Baroness Brinton (LD) [V]]

I thank the noble Lord, Lord Hunt, for tabling this Motion. Along with other colleagues, I agree completely with the principles behind regretting these regulations.

I start by praising the care sector—all the homes and ancillary care staff, whether professional or family carers, who during the last two and a half months have done all that they could to care for the most vulnerable in our society, against all the odds. It is important this week, as Carers Week begins, to recognise the unpaid carers, especially the young ones, who have often provided support. I recognise that this is slightly off the topic of the statutory instrument, but it is important to understand the structural problems in our care systems at the moment.

Other noble Lords have outlined how the structural problems started 40 years ago. In 1979, two-thirds of care homes were run by local authorities or were not for profit—now, 84% are run for profit. The noble Baroness, Lady Bennett, outlined how in the mid-1980s things started to change. I can remember as a Cambridgeshire county councillor in the 1990s and early 2000s how the standards changed in care homes at very short notice. Many local authorities, which were not permitted to borrow any capital costs at all, had very regretfully to close down their care homes. That was when the surge started, in about 1995-96, and it continued through the next decade.

We moved as a country towards having a privatised system, but we did not fund it properly. Money for care homes certainly needs to be upgraded. One of the difficulties we face is that, even though we are approving a weekly rate—I know this from experience of my mother’s two and a half years in a care home—the CCG started from a position of arguing, either with the individual and their family or with the local authority, about what the amount should be. Almost standing over my mother’s bed, we had to try and fight back against the CCG representative who did not want to pay anything at all after her second stroke. We need to understand the pressure on families, particularly regarding the way this allowance is used, and recognise that it is not the true picture.

We need also to look at the extra costs that care homes are facing at the moment. Other noble Lords have mentioned that PPE costs have increased. They have not doubled—care homes are now paying five times the amount they were paying in February. We heard that PPE was diverted, and the noble Lord knows, as I have challenged him long enough about this, of concerns about whether Clipper Logistics were going to come on board. Can the Minister confirm the report in the Health Service Journal that the Clipper system is now to be used only for emergencies and is not to be the resource that the care home sector was led to believe it would be? If it is not, where on earth will individual care homes be able to access PPE at the price they used to pay before the pandemic?

Testing has also been a problem over the last few weeks. In order to keep people safe, it was important that everybody, in all care homes, was tested right from the start.

My noble friend Lady Barker and others have talked about that month between mid-March and mid-April, before the Secretary of State announced that care homes could have tests. We heard that last Friday was the date by which everyone in a care home for the elderly would have access to testing. It is good that today, the Government announced that those who have learning or other disabilities can now finally access testing, but care homes for the elderly still desperately need assurances that, as with the NHS, their staff and patients can access regular testing. Can the Minister confirm that this will now happen? Otherwise, there may be a local flare-up which, before we know it, is running rife through certain care homes again.

Many noble Lords have talked today about the importance of treating our care staff well. We know that they have gone way above and beyond the call of duty. Those who have given up life with their families and moved into care homes deserve special credit. I like the idea outlined by the noble Baroness, Lady Wilcox: the Welsh proposal to award £500 to care workers as a bonus for their considerable effort. For them, many of whom are on the absolute minimum wage, it is a significant amount, although it still will not reward them for everything they have done.

At the end of this, we must return to the long overdue Green Paper. I completely agree with all noble Lords who said that it must be cross-party. Dilnot was certainly a good starting point, but the problem with Theresa May’s proposals was that they were Dilnot upside down. I gently remind the Government that it was not the Liberal Democrats or the Labour Party that walked away from the last cross-party arrangements. My party is keen and eager to become involved, whatever we decide for the future. The Green Paper is very much overdue; it must come along quickly. We need to look at everything structural. This should not be just about who pays what for a bed. We need to review the entire system.