Social Care

Toby Perkins Excerpts

Tuesday 25th February 2020 Commons Chamber

[Barbara Keeley]

I thank the hon. Gentleman for making that point; he does make it on every occasion that we debate this subject, so I congratulate him on doing so again. However, the person he needs to be directing his comments about cross-party talks to is sitting on the Government Front Bench. I am hopeful that the Secretary of State is going to tell us what he is going to do about cross-party talks, because those 15-minute visits are really not good enough.

[Mr Toby Perkins (Chesterfield) (Lab)]

I agree entirely about the need for cross-party consensus on this issue, but there can be no consensus until there is an acknowledgement of what has caused the care crisis—the underfunding of the health service and cuts to local government budgets, which have had an impact on A&Es, GPs and other services. Until there is an acknowledgement of what caused the situation, there can be no consensus towards a solution.

[Barbara Keeley]

My hon. Friend is right. I will come to the causes, because it is important to mention them.

The 15-minute care visit reduces the giving of care by care staff to a series of physical tasks, rather than the staff being able to see a person with their own interests, desires and opinions. It really strips them of the time to do the job they want to do. I pay tribute to all care staff, who go above and beyond in their jobs to improve the lives of the people they support. Without them, our social care system would not work, but they do not get the pay and recognition that they deserve.

Care staff, who provide essential practical and emotional support to some of the most vulnerable people in society, are among the most poorly paid workers. The average hourly pay for care staff is below the rate paid in most UK supermarkets. On average, care staff are paid less than cleaners and healthcare assistants in the NHS, and this has led to a vacancy rate of 122,000 care jobs and a turnover rate of 33%. Now the Government are planning to make the situation worse by turning away people who want to come to this country to work in social care. One in seven care workers is from outside the UK, but the average care worker earns £10,000 a year less than the Government’s immigration salary threshold, so will the Secretary of State tell us just how he thinks he is going to be able to fill the large number of vacancies in the social care workforce?

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[Mr Toby Perkins (Chesterfield) (Lab)]

It is a great pleasure to follow the right hon. Member for Ashford (Damian Green). I found myself agreeing with many of the priorities that he set out; that gives us some hope about cross-party consensus.

I wish to talk about three things: first, the proposal by Derbyshire County Council to close the Spinney care home in Brimington in my constituency and six other homes throughout Derbyshire; secondly, the wider implications of Government funding decisions over the past 10 years; and finally, the role of carers and the impact of councils’ use of private sector agencies to reduce council budgets on the quality of care provided.

First, the Spinney is a care home built in 1974 and run by Derbyshire County Council. Up until the Conservatives took over in 2017, it had been rated good by the CQC and was full; since 2017, the council has stopped taking new residents, and gradually numbers have fallen as residents have passed away. All the residents and their families to whom I have spoken speak warmly of the quality and culture of care provided by the Spinney and oppose the council’s call for closure. In the past two years, five of the rooms in the Spinney have been fitted with en suite bathrooms—the lack of en suite facilities being one of the reasons given for the closure—but none of those rooms has been used. Now, Derbyshire County Council says it will close the home and allow the residents to live more independently.

The comments from residents make it clear what they feel. One said:

“I have no relations, no family, the carers and staff are my family…I want to live the rest of my days here it has all come crashing down around me”.

Another said:

“People will not get more than 10 minutes three times a day”

if they leave and go independent. They went on to say that

“this doesn’t stop people roaming the streets and the police having to bring them back.”

A family member said:

“My mum lived independently till she was 96 years of age. We all rallied round to look after her, but she was only safe once she was here at the Spinney.”

There are many, many more stories.

I note that the county council had a £5.7 million underspend last year in its social care budget, so I roundly condemn it for its decision, and I hope that it listens to reason when the consultation finishes and that it agrees to improve the Spinney rather than to let it close.

More broadly, we all know that the money available to councils for social care has been savagely cut during the nine years of austerity. Indeed, at the very time when our ageing population were demanding an increase in care spending, the Government were cutting £5 billion from council budgets for care. The money that the Prime Minister has promised, welcome as it is, is simply one step back up the mountain.

The failure to provide care for some of our most vulnerable citizens is not just morally repugnant and does not just shame us as a society, it is also economically illiterate. Failure to care for people in residential or domestic settings and leaving them to fend for themselves means that they end up in A&E. It means that they end up being treated more expensively in our hospital system. The 148 people who were left in hospital beds in Derbyshire because there was no care package available for them were costing us more than they should have done as a result of cost savings. Cuts in care are not only barbaric, but economically crazy too.

There is no way that a Government who have reduced council spending by 50% in real terms over 10 years can be anything but complicit in the care crisis that faces us, but providing ring-fenced money for care alone will not be the step required to make this right. There must be a whole-system approach that addresses the many causes of the crisis in care. Those causes include the inadequate number of GP appointments available, particularly in more deprived areas; the crisis in the recruitment of GPs, nurses and carers; and the casual and unprofessional way that carers are recruited, trained and employed, which means that workers at McDonald’s are given greater job security and better rates of pay than someone who plays a crucial role in the health of the most vulnerable citizens in our society. There is also the crisis in A&E, which sweeps up the greater share of the NHS budget. That crisis is then exacerbated by people taking up hospital beds when they could be at home receiving care, and so the vicious cycle continues.

Finally, I would like to touch on the issue of how carers are employed. Council budgets are a part of this equation, but, in truth, councils were outsourcing these services long before council budgets were shrunk. It should never be said that people who provide care on behalf of private companies—or, in many cases, those companies themselves—have any less capacity to care or any less empathy for their customers than people who do it in the public sector. However, many councils are signing tenders that can only lead to the provision of inadequate care.

Hillcare Group, a nursing care home provider in my constituency, wrote to me recently to say that the funding provided by Derbyshire County Council was £150 per resident per week less than in other local authority areas, and that ends up having an impact on the care that is provided. I have an idea: when councils set tenders, they should be setting a rate of pay at the time they use private companies. The reason for using private companies is not just about saving budget, but about that company providing care in a better way. It is not just a way of undercutting the wages of unionised council staff. If rates of pay across the sector were set by the councils, we would not find council contracts being provided by private companies in such an inadequate way.

This is a multifaceted and real problem. Residents and families of the Spinney are just the latest victims of our failure to take this matter seriously. I hope that it will be solved, because our older people desperately need it to be.

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[Helen Whately]

I have already visited two care homes since becoming Minister for Care, and I want to visit many more. I hope I will be able to take up my hon. Friend’s invitation and see that good work for myself.

I pay tribute to my predecessor as Minister for Care, my hon. Friend the Member for Gosport (Caroline Dinenage). I hear that she was visiting a hospice on reshuffle day—her actions illustrate the enormous commitment and compassion she brought to this role. I sincerely hope to follow in her footsteps.

I also thank all the hon. Members who have spoken today. Social care is important to many thousands of our constituents, and their interest and input are incredibly valuable.

[Mr Perkins]

I welcome the Minister to her post, and I welcome what she says about carers. Would it not be wonderful if, rather than just giving them her warm words, support and admiration, she were able to join a cross-party campaign to see that carers get paid more than burger flippers in McDonald’s so that we actually start recognising them with the same prestige as nurses and the same earnings as people in our health service?

[Helen Whately]

I thank the hon. Gentleman for his suggestion. It is almost as if he has seen my notes.

One thing I particularly welcome is the number of hon. Members on both sides of the House who spoke about the importance of careworkers, who provide such important care.

My hon. Friend the Member for Peterborough (Paul Bristow) mentioned that both his parents were nurses in the care sector. He drew on his knowledge of care and rightly said that the profession should be held in higher esteem and that, just as we hugely value NHS staff, we should hugely value careworkers. The hon. Members for Warrington North (Charlotte Nichols), for Blaydon (Liz Twist), for Dulwich and West Norwood (Helen Hayes), for Putney (Fleur Anderson) and for Liverpool, Wavertree (Paula Barker) and my hon. Friend the Member for Bury North (James Daly) spoke along the same lines, and I could not agree more.

Not long after I became the Member of Parliament for Faversham and Mid Kent, I joined a careworker, Kim, on her daily round. By the time I met her at 7.30 am, she had already started washing her first client. By lunch time, she had washed, dressed, fed, medicated and chatted with six or seven men and women. Some of them were grateful and some of them, quite honestly, were not grateful, but they were all utterly reliant on her care. That experience really brought home to me the skill, knowledge and compassion of our social care workers. For those who need help, there are amazing carers with hearts of gold, like Kim.

Our care system depends on an extraordinary workforce of capable and compassionate carers, but we need more people to choose care as a career. That means changing the perception of being a care worker. As a society, we must truly recognise the importance of the work. We must make sure that more people realise the range of jobs in care and the opportunities for progression. The Government are currently investing in an adult social care recruitment campaign with the strapline “When you care, every day makes a difference”. We are working with Skills for Care to support workforce development and there is funding for a workforce development fund. That is really important, but we know that we must go further in making sure that we truly value the important work that the care sector does and to make sure that the care profession attracts the workforce that we need and gives them the opportunities to lead a truly fulfilling career.

Several Members rightly talked about unpaid carers, who also provide so much vital care. We fully recognise the value of that work and know the importance of support for those people who do so much caring. That is one reason why the Government will introduce a statutory right to leave from work for one week a year for the 5 million people who juggle work alongside being an unpaid carer.

My hon. Friend the Member for Bury North talked about quality of care, and it was really important to hear that mentioned as part of the debate. He spoke about how good care is in his constituency, and he is absolutely right that we should talk about how good care is throughout England. Some 84% of adult social care providers are currently rated good or outstanding by the CQC. Let us recognise the high quality of care.

My hon. Friend also spoke about the importance of integration—of the NHS, local authorities and care providers working together—as did my right hon. Friend the Member for Ashford (Damian Green), who is knowledgeable on this subject. The interplay between the NHS and social care is critical. The better care fund and the improved better care fund are a success story in respect of enabling more co-operation between the systems. It is crucial that we continue to build on that success so that our care system meets the needs of the individual, not just of the system.

My hon. Friend the Member for Watford (Dean Russell) made some excellent points about how, paradoxically, we can use technology to help to achieve more human and more personal care for a more cohesive and effective care system.

Both my hon. Friend the Member for Thurrock (Jackie Doyle-Price) and the shadow Minister for Care, the hon. Member for Worsley and Eccles South (Barbara Keeley), mentioned those with learning disabilities and autism who are being cared for in in-patient settings. I am new to this job, but I absolutely appreciate the importance of making sure that we do better in this regard. People should be cared for in the best place for their needs. At the end of last month, the number of those in in-patient settings had been reduced by 24% compared with 2015—