Health and Social Care Workers: Recognition and Reward Debate

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Department: Department of Health and Social Care

Health and Social Care Workers: Recognition and Reward

Justin Madders Excerpts
Thursday 25th June 2020

(10 months, 2 weeks ago)

Commons Chamber

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Department of Health and Social Care
Patrick Grady Portrait Patrick Grady (Glasgow North) (SNP)
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25 Jun 2020, 12:02 a.m.

I congratulate the Petitions Committee and the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) on opening the debate and securing the time for it. I also congratulate the Members who made thoughtful and, in some cases, personal speeches. One hundred and forty five of my constituents signed the main petition that is being discussed today and a proportionate number signed the others. It is important that they have the opportunity to hear that their voices have been heard. They and all of us joined in the 10 weeks of the clapping for carers, but all recognised, as others have said, that clapping is not enough and that there must be action and they demonstrated that by signing these petitions.

I would just note that there was another petition during lockdown that achieved 1.2 million signatures, but, because it did not come through the e-petition site, it is not available to be debated in the House in quite the same format, but I know that many Members would want to have the behaviour of the Prime Minister’s special adviser discussed on the Floor of the House.

When this crisis is over, the UK Government must find a way of honouring the amazing heroes in our NHS and care sector who are continuing to work tirelessly to help us all to defeat the coronavirus. The Scottish Government—the SNP Government—remain committed to passing on all Barnett consequentials for health spending to the NHS in Scotland. Throughout this time, and for many years now, all NHS staff in Scotland have been paid the real living wage, not the pretendy living wage implemented by the Tory Government. Nurses across all bands are paid better in Scotland than anywhere else in the UK, and the Scottish Government are delivering the highest pay rise for NHS agenda for change staff anywhere in the UK. Employees will receive at least a 9% pay rise for the three years from 2019.

The Scottish Government spend about £130 per head more on social care than is spent in England, and they are the only Government in the UK to fund free personal care. Also, as my hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) said earlier, they have already brought forward a 3% pay rise for social care workers in recognition of the work that they are doing at this time. Recognising the particular challenges presented by covid19, the Scottish Government, with cross-party support in Holyrood, are working to establish a sick pay fund as a matter of urgency to ensure that care workers whose employer terms and conditions fall short and who test positive for covid-19 receive sick pay above the current statutory level of £95.85 a week. As we know, that is one of the worst sick pay legal frameworks anywhere in Europe.

The Scottish Government were also the first in the United Kingdom to announce a death in service provision for covid-19 deaths among NHS staff. That benefit mirrors what is available in the NHS pension scheme: a lump sum and ongoing survivor’s benefit. However, it is unacceptable that some social care workers’ contracts of employment offer no cover for death in service, so the Scottish Government are putting in place that kind of cover for when any social care worker dies without death in service cover in their contracted pension arrangements. The Scottish Government will provide a one-off payment of £60,000 to a named survivor, and this will be retrospective. That is important because, as of 23 June, the Scottish Government have been informed by health boards or the Care Inspectorate of seven deaths of health care workers and 12 deaths of social care workers related to covid-19.

I have some experience of this. The Wyndford Locks care home in Maryhill was one of the first in Scotland to experience the death of a staff member due to covid-19. Also, one of my constituents, Christine Gallagher, lost her beloved son Michael to the disease. He was providing frontline care, employed by an agency, in central Scotland. His loss is keenly felt by his family. Too many families across the country are feeling such losses. His mother told me that she could not attend his funeral because of public health restrictions. She had to stay at home with a photograph of her son and light a candle. I want to pay tribute to Michael for the love and support that he showed to so many in his care, and express my condolences to his family and all the other families who have experienced tragic losses due to covid-19. May they all rest in peace.

This is why it is so important that the healthcare and social care workers, whether in the NHS or private sector, have the pay and benefits that they and their families deserve for the work they do to keep us all safe. That includes healthcare workers who have made their home in Scotland, even if they began their lives or careers elsewhere. So, while we welcome the principle of scrapping the NHS surcharge, it does not appear to have happened in practice yet. Perhaps the Minister can tell us when it will come into effect, because we are still hearing of healthcare workers being told by the Home Office that the surcharge is still payable and there is no guarantee of a refund.

In too many cases, the hostile environment continues despite all these warm words. Even in the middle of the pandemic, we see cases of NHS staff being told that they are no longer welcome. I have a constituent, Jessica Forsyth, an Australian national on a youth mobility visa. Her visa expires at the end of July and she has been told by UK Visas and Immigration that she cannot apply because she is deemed unskilled and earns below the £30,000 threshold, even though she is providing essential services to the NHS. She has made Scotland her home and built her life here, and I hope the Minister can help me to solicit the reply I am waiting for from the Home Office about her case.

It is clear that, while all this work has been taking place, we also have to ensure that we are planning for the next phase. We must learn the lessons and use the coming months to ensure that PPE is fully stockpiled, that supply lines are in place and that procedures are changed where necessary, so that as the second wave hits, there will be a vastly improved level of preparation. As we open up the health service to wider services, that must be done using an evidence-based, cautious and phased approach, for the sake of both staff and patients.

I think that many in the NHS and social care would echo the words of the declaration of Arbroath—it is not for glory, nor honours, nor riches that they fight. But that does not mean that they do not deserve them, and when all this is over we have to make sure that they are properly rewarded and recognised.

Justin Madders Portrait Justin Madders (Ellesmere Port and Neston) (Lab)
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I congratulate my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell), the Chair of the Petitions Committee, on introducing the debate and brilliantly articulating the many issues relating to the recognition and reward of health and social care workers. I thank all those who have signed the four petitions, which have so far amassed some 290,000 signatures between them. By doing so, they have brought this very important debate to Parliament today.

This debate comes at a particularly poignant time, when health and social care workers have been at the heart of the fight against coronavirus, working day and night to protect the NHS and save lives. They, and all the key workers who keep this country going, are the very best of us. I want to take this opportunity to once again pay tribute to the hundreds of NHS and social care staff who have lost their lives to the virus. I hope that when this is over, we can find an appropriate way to remember the frontline staff who gave their lives in the line of duty.

This was a heavily subscribed debate, and it was clear from every Member who spoke that the gratitude the whole country feels for our health and social care workers is replicated in this place. We had some superb speeches from Opposition Members, with good representation from Wales. My hon. Friend the Member for Merthyr Tydfil and Rhymney (Gerald Jones) spoke with typical eloquence and highlighted the wise decision of the Welsh Government to recognise the contribution of care workers. I hope that the Minister will be able to respond positively to my hon. Friend’s request, or at the very least confirm that she is making strong representations to the Treasury about the tax treatment of that payment. We heard a similar point from my hon. Friend the Member for Pontypridd (Alex Davies-Jones), who also reminded us of NHS Direct, which was a great innovation from the last Labour Government.

My hon. Friend the Member for Bethnal Green and Bow (Rushanara Ali) rightly said that staff need to be rewarded with more than just applause, and she drew attention through her strong speech to the sorry record we have seen over the last 10 years on the NHS. My hon. Friend the Member for Coventry South (Zarah Sultana) spoke with great passion and listed a whole series of ways in which the health workforce is hit with extra burdens in the course of their duties.

My hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare) drew attention to the scandal of nurses being forced to use food banks. That should shame us all. We also heard from my hon. Friend the Member for Hackney South and Shoreditch (Meg Hillier), who made the powerful point that medals do not put food on the table. She brilliantly highlighted how insecure work is a blight on the NHS and a systemic problem that needs addressing once and for all.

As we heard, even before the pandemic our frontline health and social care staff were working in overstretched and under-resourced settings. We must acknowledge that many of our frontline careworkers have been in extremely stressful and sometimes traumatic situations as a result of covid-19—situations that those of us who have not been on the frontline cannot even begin to imagine. Working in these uncertain times, dealing with a new and emerging disease, often without adequate protection, while coping with losing patients and worrying about getting ill themselves or taking the virus home to their loved ones are all contributing factors to staff burn-out and poor mental health. It is vital that we keep them all safe in the event of a second wave.

Yesterday, following the Prime Minister’s announcement of the relaxation of the 2-metre rule and sweeping changes to the lockdown in England, health leaders called for a rapid and forward-looking assessment of how prepared the UK is for a new outbreak of the virus. Those health leaders from the Royal Colleges of Surgeons, of Nursing, of Physicians and of GPs say:

“the available evidence indicates that local flare-ups are increasingly likely and a second wave a real risk.”

They also point out:

“Many elements of the infrastructure needed to contain the virus are beginning to be put in place, but substantial challenges remain”,

and they call on the Government to focus on

“areas of weakness where action is needed urgently to prevent further loss of life”.

We cannot have any failures in preparation this time.

We may no longer be gathering outside our homes on a Thursday night to clap for our carers, but our admiration remains. It has been incredible to see the effort from staff in the last three months—staff who, too often, get very little in return. We hope that they are recognised for their true worth now.

Jamie Stone Portrait Jamie Stone
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Will the hon. Member give way?

Justin Madders Portrait Justin Madders
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I am sorry, I will not have time to give way.

Many of our NHS and care staff are exhausted and fearing burn-out. They need our support now, which means safe staffing ratios, adequate PPE and decent fair pay, because for them the hard work is not over—it is only just beginning. They will continue to give their all as they begin to tackle the backlog in non-covid care. The millions of routine operations, screening tests, treatments and therapies that were suspended or cancelled during the pandemic will now have to restart. Those challenges cannot be met without the staff.

As we know, there are well over 100,000 vacancies in the social care sector, and systemic insecure work and low pay are not the answer to resolving that issue. We know that prior to the covid-19 outbreak there were also 106,000 vacancies across the NHS, including 44,000 nurse vacancies. Those vacancies matter. They mean that NHS services were already under extreme pressure due to the ongoing staff shortages, before being further stretched by more shortages due to sickness or caring responsibilities during the pandemic. That, in turn, has put all healthcare staff under intolerable and unsustainable levels of pressure.

On top of those staff shortages, healthcare staff have had to work in unfamiliar circumstances or in clinical areas outside their usual practice, and of course they have had to work in very difficult circumstances. A survey by the Royal College of Nursing found that half of nursing staff felt under pressure to work without the levels of protective equipment set out in official guidance, and a survey by the British Medical Association of 7,000 doctors found that 45% were experiencing stress, exhaustion and burn-out. We need to listen to what the staff are telling us.

Just last week, we learned that student nurses who joined the frontline six months ago as part of the coronavirus effort are seeing their paid placement schemes terminated early, leaving them with no income and no guarantee that they will not face extra costs for completing their studies. That is no way to treat student nursing staff who have put their studies on hold to join the fight against coronavirus, and who are at the start of what we hope will be a long career in the NHS. They deserve better.

The Government still have not quite resolved the issue of the immigration health surcharge, where NHS and social care staff coming from abroad and working on our frontline are required to pay a surcharge of hundreds and sometimes thousands of pounds just to use the NHS themselves. It was welcome that, after considerable pressure, the Government announced last month that the surcharge would be abolished, but, as we have heard, there are still reports of people being charged. I would like an update from the Minister about what is happening in respect of that.

In conclusion, no one hearing this debate would be in any doubt that our health and social care workers are appreciated, admired and respected, but warm words are not enough. A clap on Thursday night is not enough. It is time for action, and for the Government to finally recognise the monumental contribution that health and social care workers make. No more poverty pay. No more “work until you drop”. No more sending people into work inadequately protected from exposure to a deadly virus. That cannot happen again.

The Government were too slow to recognise the need for PPE, too slow to protect the social care sector, and now they are too slow to properly reward our brave health and social care workers, who have literally put their lives on the line for us all. It is time we put that right.

Helen Whately Portrait The Minister for Care (Helen Whately)
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25 Jun 2020, midnight

I welcome this debate, because our NHS and care system is only as strong as the people within it. Throughout the pandemic, NHS and care workers have taken centre stage; we have all seen the dedication and care with which they approach their work, and the esteem in which they are held by the public, as these petitions demonstrate. This debate has also demonstrated the esteem in which they are held by hon. Members. I am determined that we should look after our health and social care staff, just as they look after us.

First, I will talk about pay, as that is the focus of the petitions. I want to reinforce that we have already delivered multi-year pay and contract reform deals for over 1 million NHS staff, in partnership with trade unions. In the past three years, nurses have seen their starting salaries increase by more than 12% and the vast majority of nurses have seen their pay increase by at least 6.5%, while the starting salaries for healthcare assistants have also increased by 16%. We have also increased pay for junior doctors to recognise the huge contribution that they make to our NHS. By the end of their four-year deal, junior doctor pay scales will have increased by at least 8%.

My hon. Friend the Member for Crewe and Nantwich (Dr Mullan) referred to the Government’s commitment to increase the number of doctors and nurses in the NHS, and he rightly said that recruitment and retention is not just about pay, but about experience. I am determined that we must improve the experience for the NHS workforce.

The shadow Minister spoke about vacancies in the NHS. I hope that he will welcome the good news that we heard today in the latest NHS workforce statistics that the number of nurses in England has gone up by more than 12,000 in the past year and we have over 6,000 more doctors. Compared with 2010, we now have 23,100 more doctors and 22,200 more nurses in the NHS. We want to recruit more, however, so we are providing financial support for nurses to train, and from this September, new and continuing nursing students will be able to get a maintenance grant of at least £5,000 per academic year.

Our social care staff have also played an incredible role during the pandemic. I am always blown away by the compassion that is shown by our care workers, who look after people who are at their most vulnerable. That was articulated so well this afternoon by my hon. Friends the Members for Peterborough (Paul Bristow), for Watford (Dean Russell), for Beaconsfield (Joy Morrissey) and for Rother Valley (Alexander Stafford) and many other colleagues.

Hon. Members will be aware that the Government do not set pay for social care workers in England. However, we are committed to raising the profile of our social care workforce and giving them the support they need. At a recent meeting of the Health and Social Care Committee, we heard from care workers about how some of them felt underappreciated by the public as a whole, and that is something we need to fix. After all, this is a job where staff have a chance to make a difference to people’s lives every single day that they go to work. As a start, we have adopted the CARE brand, for which I thank Care England. We have taken that on in order to build recognition of care workers.

Since the pandemic hit us, we have put in place support for care workers who have been at the frontline during this time. We are providing mental health support and bereavement support commissioned from Samaritans and Hospice UK. We have launched the care workforce app to bring together resources and guidance, and we are providing funding of £3.2 billion and then a further £600 million for local authorities to pass on to care providers so that they can provide full pay to staff who are isolating. We have made it clear to local authorities and providers that we expect that to happen.

One of the petitions that is in front of us today is entitled:

“We would like the government to consider social care as equally important to NHS”.

That is something that I passionately believe in. Social care is, absolutely, equally important. I know my colleagues in Government agree. As we heard in this debate, that sentiment is shared by many hon. Members, and we rightly now talk about health and social care workers in the same breath.

In the months ahead, as we pledged in our manifesto, we will be looking at how we can build a long-term solution for social care, so that in the long term care workers get the rewards they deserve, and—as argued for by my hon. Friend the Member for Bolsover (Mark Fletcher), in particular—so that everyone can have the dignity and security that they deserve.

Finally, I want to raise the contribution of our overseas staff. The NHS has benefited from the contribution of so many people from all over the world. I would like to take a moment to thank all our overseas NHS staff. I know that this has been a difficult time for many of you, especially as we have learned that BAME communities have been disproportionately impacted by the virus. We are so grateful to you for your hard work, and I want the system to do all it can to protect you.

On 21 May, the Prime Minister announced that NHS and social care workers would now be exempt from the immigration health surcharge. NHS and care workers who paid the surcharge from 21 May will be refunded, and we are getting on with the arrangements as fast as we possibly can. We are also continuing to provide free visa extensions and auto renewal of visas for workers who are eligible, and we will be introducing a new fast-track healthcare visa to make it quicker and easier for health and care staff to come and work in our health and social care system.

Our NHS and social care workers do a truly wonderful job delivering world-class care to so many. I would like to thank everybody who signed the petitions for making their voice heard. I would like to end by encouraging everyone who is thinking about joining our health and care system to do so. Caring for others is one of the greatest and most important vocations. We will do everything in our power to protect and support health and social care workers during this pandemic and beyond.