Contact in Care Settings

Debate between Nigel Evans and Liz Kendall

Thursday 27th October 2022 Commons Chamber

[Liz Kendall (Leicester West) (Lab)]

I thank my hon. Friend the Member for Liverpool, Walton (Dan Carden) and the hon. Members for Chatham and Aylesford (Tracey Crouch) and for St Albans (Daisy Cooper) for securing this hugely important debate. I hope my hon. Friend the Member for Liverpool, Walton will forgive me for saying that I thought he spoke incredibly bravely and powerfully about his father, who I am sure would be very proud of him today.

The terrible consequences of banning families from seeing their loved ones in care homes is an issue very close to my heart. It is something that Labour has been campaigning on since the very first covid lockdown in June 2020. Indeed, we first called on the Government to bring forward a legal right for care home residents to see a family member or friend in February 2021. We continue to do so today because, as we have heard in the debate, this issue has not gone away, and because with winter almost here and, God forbid, in the event of any future pandemics, we need to ensure that the rights of residents and relatives are clearly guaranteed by law. We make this case because it is good for residents, good for family members and good for care staff.

I will say more about that later, but I want to start by thanking the organisations that have campaigned so hard on this issue, including Healthwatch, Mind, Mencap, the Alzheimer’s Society, Parkinson’s UK, Dementia UK and Disability Rights UK. I especially want to thank the Relatives and Residents Association, John’s Campaign and Rights for Residents, which have been at the forefront of the campaign. In particular, I pay tribute to Jenny Morrison and Diane Mayhew from Rights for Residents—two phenomenal women who have blazed a trail on this issue. After their terrible personal experiences, they set up Rights for Residents, to give a voice to all the other care home residents and families who had been banned from seeing their loved ones. The reaction to their campaign has been astonishing, which I saw for myself on joining them in Downing Street—or, rather, locked outside it—in September 2021, when they presented a petition calling for a change in the law, signed by more than 250,000 people.

Almost all the campaigners I met had never been involved in protests or petitions before. They were not there because of any political agenda, but because of their personal experience and the fact that they wanted to see a change. The reason why so many people joined Jenny and Diane is that this issue really matters. It matters to the thousands of families who have faced unbelievable anguish, guilt and distress because they were banned from seeing the people they love most—their mothers, fathers, husbands, wives, brothers, sisters, sons and daughters—at a terribly frightening time. It matters because of the physical and mental impact that isolation has on older people and, as the hon. Member for Chatham and Aylesford said, crucially, on people with physical and learning disabilities. We have heard much evidence about increased depression and anxiety, and people losing weight because they are not eating. The truth is that, as the hon. Member for St Albans said, families are not just visitors; they are an essential part of the care given to residents, and should be treated as such.

Banning families from seeing their loved ones also matters to care home staff. There is lots of international evidence that staff in many countries have faced increased workloads because some of the emotional and other support that was normally provided by families, such as helping people with eating and taking them on walks, completely disappeared when they were banned.

There is much I could say about all the powerful things that hon. Members said about their constituents; I was contacted by many deeply distressed constituents too. Because time is short, however, I will emphasise something that has not really been mentioned today, which is that families have always understood the need to protect their loved ones from covid and never wanted to expose them to unnecessary risks. All they wanted was to be treated the same as care home staff. They could not understand, once the PPE, testing and vaccines were finally available, why they were banned and treated differently from everybody else.

Throughout the pandemic, the Government have resisted calls for residents to have a legal right to see their family member. They have consistently said that the guidance they issued was enough, but the guidance, which changed more than 30 times during the pandemic, is not enough, as we have seen time and again. I will make two points. First, anything that is issued 30 times will be totally unclear. People will lose track and it will not be properly followed. Secondly, the clue to the problem with guidance is in the name—it is guidance, which can be ignored.

Neither is oversight from the CQC enough. The Joint Committee on Human Rights said in May 2021 that there was an

“astonishing lack of awareness by the CQC as to whether care homes are…allowing visits”.

The Chair of the Committee, my right hon. and learned Friend the Member for Camberwell and Peckham (Ms Harman), said at the time that the CQC’s assurance

“that visits are being allowed…is wholly unconvincing”.

We have heard evidence today that that remains the case and we know that the guidance and regulations are not working or being enforced.

The Relatives & Residents Association and Rights for Residents recently surveyed more than 650 families. They found that visiting restrictions during the majority of covid outbreaks between April and September this year were more restrictive than advised by current Government guidance. One in five outbreaks saw residents confined to their rooms. One in nine outbreaks saw residents not allowed any visitors at all. Shockingly, 45% of families who responded said that there were visiting restrictions in place despite there being no covid outbreaks. That is why those organisations have repeated their call for a new legal right to guarantee people’s access to in-person support from at least one care supporter—a person important to them, such as a relative or friend.

Opposition Members agree, as does the cross-party Joint Committee on Human Rights, which says that the default position must be that those in care homes can receive visits from a “significant person” and that blanket bans are in breach of the legal right to family life. We can learn quite a bit from other countries on this issue. I understand that the Dutch Parliament recently accepted a corona Act that guarantees that each resident has the right to welcome at least one visitor in the case of covid-19 outbreaks.

I ask the Minister to look at this subject again. She should heed what families want, what organisations representing residents and families demand, and what is done in other countries, and put this legal right in place.

[Mr Deputy Speaker (Mr Nigel Evans)]

I remind the Minister to leave a couple of minutes at the end for the hon. Member for Liverpool, Walton (Dan Carden) to wind up.

Covid-19

Debate between Nigel Evans and Liz Kendall

Tuesday 12th January 2021 Commons Chamber

[Liz Kendall (Leicester West) (Lab)]

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.

[Mr Deputy Speaker (Mr Nigel Evans)]

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.