Kevin Hollinrake
Main Page: Kevin Hollinrake (Conservative - Thirsk and Malton)Department Debates - View all Kevin Hollinrake's debates with the Department of Health and Social Care
(6 years ago)
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John Grogan (Keighley) (Lab)
It is a great pleasure to follow the detailed analysis of my hon. Friend the Member for Warrington South (Faisal Rashid). As a Yorkshire MP, it is always good to follow a Member from the other side of the Pennines—it is early season yet, Mr Deputy Speaker, but particularly when Yorkshire is at the top of the county championship and Lancashire is at the bottom.
I want to take up two points directly from the seven principles that the Secretary of State outlined when he talked about the Green Paper in March. One of them is about a valued workforce, which many hon. Members have spoken about, and the other is about a sustainable funding mechanism for the future.
Every morning in the villages and towns of Airedale and Wharfedale—some of which I am lucky to represent—very early, before the commuters have got up and even thought of going into the great cities of Bradford and Leeds, another workforce have just finished their night shift and are getting the first buses and trains into those cities, where they live. They have the characteristics of the social care workforce, who number about 1.4 million in our country. They are a massive workforce. About 80% are women and 80%—the overwhelming majority—are British, with 11% coming from outside the European economic area and about 5% from within it. There is a massive turnover in the social care workforce, as Unison has illustrated, with more than one in three care workers in care homes leaving their job in the course of the year. It is higher in domiciliary care.
Members on both sides of the House have talked about valuing these workers more. They are undervalued, underpaid and in many cases undertrained. The right hon. Member for Ashford (Damian Green) and particularly my hon. Friend the Member for Leicester West (Liz Kendall) talked about building a consensus, so that in the future we value more this extremely important workforce, who look after the most vulnerable people in our society at the time they need it most.
I have a couple of suggestions for the Government. It was good to hear from my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) that a Labour Government would abolish 15-minute care—the idea that social care workers have to provide for the most intimate needs in 15 minutes, tick a few boxes and then rush off to the next appointment. It makes me proud to be a Labour MP that we are committed to ending that sort of thing and to paying people properly.
There are things the Government could do, and some are little things. I notice that there is an advisory council on the Green Paper. The great and the good are on that advisory council, but it would be good to have a figure from the workforce on it. I remember the Prime Minister speaking on the steps of Downing Street about involving the workforce more. Unison is a union you can do business with, and it would be good to have an additional person from the unions on that council. The Library’s list does not indicate that there is any such person on it at the moment.
If there ever was an industry crying out for a sectoral council, with the Government, the trade unions and the industry, to improve skills and the quality of the workforce, it surely is the care industry. Those are just a couple of ideas.
My hon. Friend the Member for Leicester West spoke passionately about the need to get consensus on a long-term funding model that all parties can agree on. I would stop talking about a “dementia tax”, and the bargain would be that the Conservatives would not talk about a “death tax”. We have used both those terms in the last 10 years, and I agree that they have not particularly enhanced our politics.
The letter from Members of all parties suggested raising and hypothecating national insurance. I would like to keep on the table the idea of an increase in inheritance tax, which the now Mayor of Manchester mentioned in the latter days of the Labour Government. Only 4% of people currently pay inheritance tax. It raises £5 billion. It is a potential way of achieving intergenerational fairness. A national insurance rise at the moment would hit many workers whose real incomes have been cut in recent years, so we should consider the option of raising inheritance tax. I think that many people in our society who are lucky enough to own their own home would accept that bargain—a guarantee that they could pass on the bulk of their estate to members of their family or to any good causes they wanted to support, in return for which I think they would be prepared to pay an additional inheritance tax.
The hon. Member for Central Ayrshire (Dr Whitford) reminded us that one in four of us will end our days in a care home, but of course we do not know which of us that will be. We have to face up to the fact that, under the current system, those of us who are lucky enough to own our own home would lose most of it, if we were in a care home for a prolonged period. I see that as a life tax, rather than a death tax.
Kevin Hollinrake
The hon. Gentleman talks about one in four of us ending up in a care home, but we do not know which of us that will be. Does that lead him to conclude that we should pool the risk through social insurance, as they have done very successfully in Germany, having moved in 1995 from a local authority-funded scheme to a social insurance scheme, which also has great community benefits?
John Grogan
I certainly agree that we have to pool risk, but it has to involve everyone in society, from the poor to the rich, so that whatever our circumstances we get the care we need in those days.
We heard a lot from the hon. Member for North Cornwall (Scott Mann) and other hon. Members about the potential of technology. That is a worthwhile point to make. Age UK has provided all hon. Members with the number of elderly people in our constituencies who need care. For example, in Keighley there are 3,500 long-term disabled people and 16,000 people with long-term illnesses. One way of helping them is through telemedicine from Airedale General Hospital. Even when the “beast from the east” was raging at its worst, people in Keighley, Airedale and the dales, even in remote areas, could still have tests and get treatment via broadband. That kept them out of hospital, even in the depths of winter.
This has been a great debate and I look forward to the Green Paper—may it come sooner, rather than later.
Laura Smith (Crewe and Nantwich) (Lab)
It is an honour to follow my hon. Friend the Member for Stretford and Urmston (Kate Green).
Four weeks ago today, one of my constituents from the village of Hough attended Parliament to speak at Age UK’s parliamentary reception. We meet some people in life whom we will never forget. Joyce Yoxall is one of those people. Those who came to the event will remember her harrowing account of life as an unpaid carer. I was as moved then as I was when I first visited Joyce at her home to discuss the problems she is having with our social care system. Joyce’s husband David suffered a stroke in 2014. Since then, she has been forced to stop the care that David should be entitled to because of its high cost and poor quality. She talked about crippling care costs and how she felt she had been “let down”. I had to fight back the tears as she spoke about being mentally and physically exhausted, and how she dare not think of the year ahead.
Joyce has literally become the face of hundreds of thousands of people—and maybe more—who are in a similar situation by featuring on the front cover of Age UK’s aptly named report, “Why call it care when nobody cares?” The report is the result of 127 interviews regarding the quality of social care that people have experienced. I encourage anybody who has not read the report to do so.
The reason I started by talking about Joyce and David is that I want to remind everybody of the heartbreaking human reality behind the statistics I will refer to later. Let us start by reminding ourselves why those like Joyce might feel let down. As has been mentioned, a growing and ageing population is placing ever more demand on the social care sector, but that should not come as a surprise to anybody who has been living in the real world for at least some of the time in the past few decades.
Almost eight years ago, the Dilnot commission was set up by David Cameron’s coalition Government, tasked with making recommendations for changes to the funding of care. It published its recommendations in 2011, including a more generous means-testing threshold and a cap on care costs. That sounded promising, but after another general election the Government announced that the measures would be delayed until April 2020 and, at around the same time, closed the independent living fund. Then the Government promised to publish a Green Paper in the summer of 2017, but along came yet another general election, during which the current Prime Minister threatened to introduce a dementia tax.
Since then, we have had an autumn Budget in which the Chancellor failed even to mention social care, let alone provide adequate funding. We have seen the Department for Health and Social Care’s single departmental plan, which failed to mention the social care workforce. More recently, we had the spring statement, and still there is no lifeline for those with care needs or their families or carers.
We know that at some point, hopefully before the summer recess, the Government will publish their Green Paper on social care for older people, but we do not yet know when any proposals will be implemented after the consultation. To make matters worse, the Green Paper will not cover care for younger adults, which accounts for almost half of all council spending on adult social care.
Laura Smith
No.
There has been one missed opportunity after another—delay, delay, delay. Meanwhile, local councils, which are responsible for delivering social care, are seeing their budgets slashed, and one care home after another is placed in special measures or forced to close. What is the result? Research published recently by BMJ Open links cuts to adult social care and health spending to nearly 120,000 excess deaths in England since 2010.
The Care Act 2014 has been about as useful as a chocolate fireguard against a backdrop of inadequate funding and insufficient resources. The legislation has done nothing to protect the 1.2 million older people whose care needs are not being met. Our system clearly places more emphasis on councils setting balanced budgets to an ever-reducing bottom line than it does on making sure that all its residents’ care needs are met.
Laura Smith
No.
Cuts have consequences: I refer to my constituent’s words—that she
“dare not think of the year ahead.”
I do not blame my constituents for having little faith. The past eight years have been nothing but empty promises and never-ending cuts. Fully integrated health and social care would be a good start, but that does not go nearly far enough. We need a whole new approach to disability and ageing based on a commitment to the social model of disability that permeates every aspect of Government.
For example, our social care system needs to be aligned with an appropriate welfare policy and housing strategy, so that we remove as many barriers to disabled people as possible. Access to services should be on the basis of need and not affordability. I wholeheartedly agree that pumping more money into a broken system is no long-term solution.
Laura Smith
I have waited a long time to speak and I am going to carry on.
We need to stop viewing social care as a cost or a burden and instead see it as a wealth creator. Penny-pinching has proved to be a false economy when it comes to social care. It undermines the ability to take preventive action that not only is morally and ethically the right thing to do, but saves money in the long run by reducing the demand on our NHS. We also need to stop neglecting our 1.5 million workers in social care and build a more highly skilled and better-paid workforce. Finally, we need to address the failings of privatised adult social care, as outlined in the 2016 report by the Centre for Health and the Public Interest. Without any real debate, market values have penetrated areas where they do not belong and social care is perhaps the worst example of this. We cannot keep burying our heads in the sand and letting the crisis escalate.
There is no excuse for the Government’s inaction. The CQC warned us last year that social care was reaching a “tipping point”. This was after the Prime Minister had herself acknowledged that our system is broken. This cruel, callous Conservative Government have turned their back on older people and disabled people up and down this country. They have also repeatedly let down the social care workforce and the invisible army of unpaid carers.
Laura Smith
No.
We need a Government who put people before profits. Until then, I fear that we will be left with the same fragmented, failing system that is letting our constituents down daily.
Andrew Gwynne (Denton and Reddish) (Lab)
We have had a very wide-ranging debate with 16 Back-Bench contributions. I pay tribute to my hon. Friends the Members for Redcar (Anna Turley), for Luton North (Kelvin Hopkins), for Weaver Vale (Mike Amesbury), for Leicester West (Liz Kendall), for Blaydon (Liz Twist), for Warrington South (Faisal Rashid), for Keighley (John Grogan), for Stretford and Urmston (Kate Green), for Crewe and Nantwich (Laura Smith) and for Bedford (Mohammad Yasin) for their passionate, powerful and well-informed contributions. I also thank the right hon. Member for Ashford (Damian Green), and the hon. Members for North Cornwall (Scott Mann), for South West Bedfordshire (Andrew Selous), for Cheadle (Mary Robinson), for Solihull (Julian Knight) and for Redditch (Rachel Maclean) for their contributions. We might not always see eye to eye, but there is consensus that we have to fix the problem in adult social care, although how we go about that will always be up for debate.
Kevin Hollinrake
Is the hon. Gentleman aware of the very constructive cross-party, collegiate visit of the Communities and Local Government Committee to Germany, where we looked at its social insurance scheme, which could provide the perfect, sustainable and scalable solution to the adult social care conundrum?
Andrew Gwynne
The Government need to decide their position, but there are examples across the world of how adult social care can be funded. We need to make sure we get a system that works for England.
I also pay tribute to the workforce and carers. They do not just need platitudes from us in the House; they need the Government and politicians on their side.
This is the second time we have had to call an Opposition day debate on this issue, following the Government’s lack of action on social care. In our debate last October, there was broad agreement across the House, as there has been more or less today, that reform of social care was a priority, but here we are, six months later, and little has changed. Last month, we heard the Secretary of State for Health and Social Care tell the British Association of Social Workers that he accepted his share of responsibility for the lack of progress since the Conservatives entered government in 2010.
The social care Green Paper, due this summer, has faced substantial delays. We need a commitment from the Government that it will not be delayed any further. There is only so much longer that the sector can wait. Let us remember that in January there was hope that the Government would place an extra focus on social care after the Department of Health was rebranded, but then, shortly afterwards, in what sounded like a tribute act to the Prime Minister, the Secretary of State for Housing, Communities and Local Government told a packed LGA conference—I was there—that
“nothing has changed, nothing has changed”.
Confusion still reigns, and it is true: nothing has changed. This confusion means that 1.2 million people are being denied the support they need.
Let us look at what the cuts mean. According to its director of adult care, social care provision in Northamptonshire County Council—a Conservative council —is
“on the verge of being unsafe”
as a result of the cuts. That council has effectively been the first in England to declare insolvency. According to the director, the additional funds in the local government finance settlement will have “little impact” on the county’s problems, and I fear that that is right, but the Minister will be aware of the widespread fear that what has happened in Northamptonshire could happen again elsewhere. Mark McLaughlin, who was appointed from the Department for Environment, Food and Rural Affairs in December to oversee Northamptonshire’s finances, has warned that all top-tier local authorities will soon face similar issues. Then, only last week, we heard that Worcestershire County Council, the Conservative-run local authority in the constituency of the Secretary of State for Housing, Communities and Local Government, had buried a report expressing urgent concern after rising costs, including the cost of adult social care, had forced the council to use more than half its reserves in the past five years. The Chartered Institute of Public Finance and Accountancy expects the growth in demand to result in a budget deficit of £60.1 million by 2020-21.