Baroness Thornton
To ask Her Majesty’s Government what steps they will take to address the reported shortage of working age disabled people’s personal assistants, needed to enable them to work and live independently.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
Personal assistants are invaluable in supporting people to live independently. The Government have in place a range of measures to support recruitment and retention, including delivering a national recruitment campaign, providing a £462.5 million boost for recruitment last winter and ongoing work with the Department for Work and Pensions to promote carers in adult social care. We are also investing £500 million to support and develop the social care workforce, including personal assistants, to address long-term barriers to recruitment and retention.
Baroness Thornton (Lab)
I thank the Minister for that Answer. The lack of PAs is a serious emergency and is creating huge anxiety for the working-age disabled, who need and have a legal right to be economically and social active. What seems to have happened is that the market for and availability of people who want and value this kind of job have vanished. Welcome as they were, none of the measures that the Minister mentioned address that emergency. For example, one no-cost action that would help—it would not solve the problem, but it would help—would be for PAs to be recognised as skilled workers and be made eligible for work in the UK, since more than 32% of them vanished as a result of Brexit. Are the Minister and his colleagues meeting the disabled groups that are very concerned about this matter?
Lord Kamall (Con)
I thank the noble Baroness for raising those issues. As she will recognise, some of them fall between DWP and the Department of Health, so I can take the second question back to DWP on her behalf. We recognise this issue as part of the wider social care sector but one issue with bringing people in from overseas—as many noble Lords will know, I am in favour of recruiting from overseas—is that personal assistants are often employed by individuals and, sadly, under the Home Office rules, they are not considered sponsors. When this was raised with me yesterday, I asked for it to be looked into in more detail and was assured that more conversations will be going on. It is a reasonable suggestion; we just need to have those conversations with the relevant department.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, we have a remote contribution from the noble Baroness, Lady Campbell of Surbiton.
Baroness Campbell of Surbiton (CB) [V]
My Lords, I have contributed to your Lordships’ House for 15 years because I am supported by PAs. Without them, thousands of disabled people could not work. Can the Minister explain how the Government are honouring their commitment to support disabled people’s UN convention rights to live independently, given the current PA employment crisis? Does he agree that fixing social care must include many different ways of attracting motivated PAs? Will he meet me and disabled experts to discuss solutions to this crisis?
Lord Kamall (Con)
The noble Baroness makes a welcome point and clearly demonstrates the usefulness of and real need for personal assistants; indeed, I have met and had conversations with her and her personal assistant. This is part of the wider issues around employing and getting more people into social care, as well as professionalisation. At the moment, some of the initiatives to professionalise a service do not extend to personal assistants, partly because of the way they are employed. When I asked why we cannot harmonise between personal assistants and other people in the care sector, I was told that conversations are going on. I will have to take this back to the department and DWP to get an answer for the noble Baroness.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, we now have a virtual contribution from the noble Baroness, Lady Thomas of Winchester.
Baroness Thomas of Winchester (LD) [V]
My Lords, the Minister has partly replied, but can he say a bit more about Home Office bureaucracy which is holding up the recruitment of care workers from overseas?
Lord Kamall (Con)
One issue that I think noble Lords across the House agree on is a suggestion made by the noble Baroness, Lady Thornton. If we want to make sure that we have the right number of workers, we should improve training over here, but there will clearly be a skills gap in this country and therefore we need to look overseas. Sadly, as I said earlier, under the Home Office rules at the moment, individual employers do not count as sponsors. Officials in the department are having conversations with DWP to look at whether that can be rectified, or whether there is a way to find a trusted sponsor.
Baroness Donaghy (Lab)
My Lords, working-age people with disabilities are virtually prisoners in their own homes. We are not talking about improving skills or having conversations. When disability is supposed to be a subject where people are treated as normal citizens who want and can go out to work with sufficient support, we are looking for some answers from the Government about how they can do so. Why are the Government only having conversations, after 12 years?
Lord Kamall (Con)
The Government have been committed to ensuring that there is equality for disabled people, including plenty of initiatives in other sectors—transport, building new homes and offices, and retrofitting—but the issue of personal assistance is a particularly difficult one in the context of social care having been treated as a Cinderella service for years. Some of the initiatives that we are putting in place, such as the proper qualifications and recruitment from overseas, sadly do not yet apply to personal assistants because of the rules. We are looking at those barriers and hopefully will be able to tackle them.
Lord Polak (Con)
My Lords, I am a member of the Adult Social Care Committee in your Lordships’ House, chaired by the noble Baroness, Lady Andrews. We are looking at the invisibility of the unpaid carer, but it was timely that yesterday we went to Real, a charity in Tower Hamlets. It was a humbling and educational experience in which the difficulties and issues within the social care system for disabled people were brought to us. The difficulty of accessing PAs was very clear. My noble friend the Minister highlighted the problem in one of his answers. He said that maybe we need go to DWP or maybe we need it to be here. It needs to be coherent. To help those people, it needs to be one person, one Minister, one department dealing with this matter.
Lord Kamall (Con)
My noble friend makes a very important point. I have found this to be the case with a number of initiatives that I have been working on in my department. Quite often, I will have a joint meeting on an issue—with someone from BEIS, for example—and I then realise that they have to go and talk to someone else outside of the room. When I have been involved in such initiatives, I have always insisted that whoever else across government has a role or interest in them is in the room with us. This is clearly another example of what should be happening. It should be jointly DHSC and DWP. Rather than thinking about whose responsibility it is, we should work together to find a common solution.
Lord Addington (LD)
My Lords, does the Minister agree that if we are dealing with this, it will need every department involved, as has already happened? Will he also ensure that the Treasury leads, because if you are denying that person the chance to work, you are also denying yourself their taxation? Can he go to the heart of government and say, “Get your act together and bring your friends along as well”?
Lord Kamall (Con)
The noble Lord makes an important point about who should be in that room when we are talking about all these issues. Generally, across government, there are a number of joint initiatives in terms of ensuring that we hit our target of equality for disabled people, but as other noble Lords have pointed out, this issue falls between DWP and DHSC. I was surprised when I was briefed on this about where it fell. It clearly must be people in the same room.
Baroness Watkins of Tavistock (CB)
My Lords, it was a pleasure earlier to hear the new Health Secretary say that this is the kind of example that she would want to resolve—she did not use a particular one. Could the new integrated care boards not be the trusted sponsor for such personal assistance in each area? It would be straightforward and simple to introduce.
Lord Kamall (Con)
On the face of it, that sounds a very sensible suggestion, so let me take it back to the department, and if I am still here, I will respond.
Baroness Uddin (Non-Afl)
My Lords, I very much welcome this Question, at a time when my family has just started experiencing the hard stuff of social care. It is completely absent from many people’s lives because they are stuck in hospitals and not able to leave. People who are already in employment will be suffering exactly the same problems and issues with personal assistance. The Minister has been in his post for a long time, and we have all been requesting that he listen to what many of us with long-standing experience have said. What will he do now?
Lord Kamall (Con)
I first pay tribute to the long-standing experience of the noble Baroness and to the many conversations we have had on this. That this Question has been asked will raise and highlight the issue. It also allows me to go back to the department, kick a few desks, as it were—without being accused of harassment or violence—and make sure that government can look at this in a joined-up way.