Care Workers

(Limited Text - Ministerial Extracts only)

Wednesday 5th November 2014 Westminster Hall

[Mrs Emma Lewell-Buck (South Shields) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I congratulate my right hon. Friend the Member for Oxford East (Mr Smith) on bringing the debate to the House today. A number of colleagues have already spoken about the minimum wage, so I will try not to dwell on those issues too long, and will address some of the other significant and worrying challenges that care staff face.

Too many care workers are underpaid for the work that they do. Unison estimates that, altogether, 220,000 are not paid the minimum wage. HMRC found that half of care providers fail to pay the minimum wage and, despite the consequences of that for care workers, their families, the overall quality of the care work force and the standard of care that people receive, the Government have continued to fail to act.

The failure to pay for travel time is a common tactic and should not be difficult to fix. Earlier this year, during the passage of the Bill that became the Care Act 2014, I and Opposition colleagues raised the minimum wage issue time and again. We tabled amendments on Report asking Ministers to look specifically at travel time and travel costs. We were told that that would be addressed in the guidance that was published at the end of last month. I think that it is fair to say that the guidance is nowhere near strong enough. It says:

“Remuneration should be at least sufficient to comply with the national minimum wage legislation”.

To me, that says that it should be, but it does not have to be. It says that it would be nice if providers paid their staff a decent wage, but that there is no requirement for them to do so.

[The Minister of State, Department of Health (Norman Lamb)]

I just point out to the hon. Lady that this is a criminal offence; it is not an option. I totally agree with the points made by the hon. Member for Sheffield Central (Paul Blomfield). It is a criminal offence, and this is not an optional matter. There is no doubt in the law. Employers have to pay for travel time between appointments at people’s homes.

[Mrs Lewell-Buck]

I thank the Minister for that intervention. If that is the case, why is the guidance not stronger? What I read out is not the language of the minimum wage. The minimum wage is not a target, but a right.

--- Later in debate ---

[The Minister of State, Department of Health (Norman Lamb)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I congratulate the right hon. Member for Oxford East (Mr Smith) on securing this debate on an incredibly important subject. I agree with him and the hon. Member for Strangford (Jim Shannon) that there are many great providers of care out there and vast numbers of extraordinarily dedicated care workers. Like the shadow Minister, I went out with a domiciliary care worker in London a while ago. He was from Sardinia, which makes the point that very large numbers of people from other countries, primarily from across the European continent, work in our care system. Without them and the dedicated work of care workers, the system would not survive. We should remember that in our debates about the movement of workers around Europe. Our health and care system depends on those dedicated workers, and the man I saw from Sardinia was a very impressive and dedicated man. He was earning a low income and not being paid for travel time between the stops in his working day, which I totally agree is completely unacceptable and a disgrace. I will come back to that issue a little later.

It is also important that we celebrate great care. I went to the first ever awards ceremony in my county of Norfolk that celebrates examples of fantastic care, and to see care workers who hitherto have never been recognised for the amazing work that they do was inspiring. Every part of the country should have similar exercises to acknowledge and celebrate great care.

Secondly, I wanted to comment on the point made by the right hon. Member for Oxford East that sometimes—indeed, quite often—the only companionship that people receive is from the paid care worker who visits their home once or twice a day. Does that not say that there is something profoundly wrong about our society, and if so, do we not all have to recognise that that must change? I have said this before, but we have inadvertently become a rather neglectful society. As our extended families have been dispersed far and wide, often older people are left rather stranded, living on their own, sometimes many miles—often, indeed, hundreds of miles—away from their loved ones. It is not a good society in which the only people seen by those older people are those who are paid to deliver care to them. The wider community and neighbours need to play a part in addressing this massive challenge that we face, whoever is in Government. There is absolutely a role for the total professionalism of paid staff, but the wider community must play its role, too.

There are amazing schemes such as the Cornwall pioneer project, in which volunteers work alongside GPs to combat people’s loneliness. There is also a brilliant community organisation called Friends and Neighbours in Sandwell, in the west midlands. That is a network in the poorest community in the west midlands, and yet volunteers give of themselves, and give companionship to people to give them their lives back. Those volunteers play a part in meeting this massive challenge we face.

Thirdly, part of the answer is for care workers to be far more embedded in joined-up and integrated teams of health and care workers. The work in Islington that the shadow Minister referred to is another of the brilliant and inspiring integrated care pioneer projects that join up health and care services and enable care workers to work alongside nurses, so that they recognise that they can possibly go on to become a nurse or a health care worker. Such projects give care workers a status and professionalism that they deserve, which can play an incredibly important part in this process.

Fourthly, I commend to right hon. and hon. Members an example from my county. The GP practice in the village of North Elmham, in the middle of Norfolk, has set up a social enterprise that provides domiciliary care to a widely dispersed rural area. As it is a social enterprise, it is able to pay its staff better. When staff stay and demonstrate reliability, they receive more pay. The consequence is that people know who their care worker is, there is continuity of care, and there is not, as the shadow Minister suggested is too often the case, a situation in which someone different turns up each night. I had a case—indeed, it involved Care UK—of an elderly lady finding a different man turning up each night to shower her, which was an assault on her dignity. The concept of locally based social enterprises, tied in closely to GP practices, seems to be an attractive way forward.

Fifthly, there is the issue of pay. To start with, I will say that Unison is right to campaign on pay; I support it in doing so, and I am very happy to work alongside it. The right hon. Member for Oxford East and others made the point that it appears that 220,000 people in the care sector are being paid below the minimum wage. That situation is completely unacceptable, and I hope that all of us in Westminster Hall today acknowledge that we find that practice to be totally unacceptable.

However, it was this Government who decided that Her Majesty’s Revenue and Customs should carry out a dedicated push in this sector to root out employers who are breaking the law in that respect. Indeed, I can confirm to the shadow Minister that I have specifically asked for a further dedicated focus on the care sector, because it is absolutely needed.

[Liz Kendall]

I am glad that that work is continuing. However, the Minister has said several times in the newspapers that care companies that do not pay the minimum wage should be named and shamed, and yet that has not happened. Why not?

[Norman Lamb]

I am grateful to the shadow Minister for raising that issue. When I was a Minister in the Department for Business, Innovation and Skills, I specifically pushed for a change in the rules to make it easier to name and shame poor employers. That process was not completed by the time I left BIS to go into the Department of Health, but I continue to push for it. Indeed, the rules were changed, so that whenever there is a notice of underpayment of the minimum wage, the employer is named.

There is a complication in the care sector, in that arrangements are often quite complex and reaching a final decision often requires an investigation to be carried out. However, I can assure right hon. and hon. Members that I anticipate the naming of poor companies within this sector in the relevantly near future. I totally support that process; there should be no hiding places for employers who break the law in that way.

[Mr Andrew Smith]

What we all want to hear is a commitment that HMRC will proactively go out, uproot and stop these illegal practices. The thought comes to my mind that in other sectors where the Government have been shown to be negligent in regulating areas of activity—such as investment, with Equitable Life and so on—the Government end up having to pay back the victims. Why do the Government not pay back all these care workers who have lost so much money because of the incompetence of HMRC?

[Norman Lamb]

I thank the right hon. Gentleman for that intervention. However, I repeat the point that it was this Government who arranged for that themed work in the care sector. A substantial sum of money was collected from employers who had broken the law and returned to their employees who had been underpaid. I repeat that I have requested that that themed work should start again. As he will understand, I do not have responsibility for HMRC. However, I have made that request and I will continue to push for that themed work to happen. Where it seems that there is clear evidence that a problem is endemic in a sector, we ought to be prepared to focus on it.

The hon. Member for Blaydon (Mr Anderson) talked about outsourcing. That problem did not start in 2010. Most of the outsourcing—the creation of a predominantly private sector work force—happened before 2010, and we all have to acknowledge that. It is an endemic and deep-rooted problem in the sector, which needs to be challenged effectively.

I will talk briefly about the care certificate, because another issue raised by right hon. and hon. Members is the fact that training standards are often inadequate. I must say that when I came into this job I was rather shocked to discover that there were no proper mechanisms for ensuring that employers were required to provide proper training for their staff. We are changing that situation. We commissioned Camilla Cavendish to produce a report on this issue, and we have now legislated through the Care Act 2014 for a care certificate, which will come into force next April. That certificate will set a national standard for minimum training and competence levels that every employer will have to meet. They will have to ensure that their staff either have the care certificate or something equivalent, and they will have to satisfy the Care Quality Commission that that is the case. If they cannot satisfy the CQC, it can take enforcement action against them. I am proud of the fact that we are taking decisive action to improve training standards.

Hon. Members have also raised the issue of the role of the CQC. It has the power—and Ministers have the power to request it to use that power—to carry out themed inspections of local authorities where there is evidence that commissioning is falling short, resulting in poor care. Part of poor care can sometimes be the terms and conditions offered by employers. I am determined that, if evidence of poor practice emerges, we use those powers to ensure that local authorities, as well as providers, are held to account, in order to raise the standards in this sector. We all agree that that is necessary, and that the underpayment of wages to care workers is not an acceptable practice.