Social Care: Workforce Strategy

Wednesday 22nd March 2023 Lords Chamber

Question

15:37

Asked by

[Baroness Pitkeathley]

To ask His Majesty’s Government what plans they have, if any, to reduce their £500 million investment in the social care workforce; and when they will publish their strategy for increasing the size of that workforce.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

The Department of Health and Social Care will shortly publish a two-year plan for how it will reform the adult social care system. That publication will confirm the Government’s commitment to the 10-year vision set out in the People at the Heart of Care White Paper. It will provide specific detail on how we will implement workforce proposals, including funding activity and milestones.

[Baroness Pitkeathley (Lab)]

I thank the Minister for that Answer, but note that he has not assured me about the proposed or rumoured cuts to the current investment in the social care workforce. As he knows, these rumours have caused great distress to those trying to provide decent care to some of the most vulnerable in our society, against the background of a 13% vacancy rate—so one in eight posts is vacant—with subsequent difficulties in recruitment and retention. The money that has been promised seems very slow in reaching the front line, according to local authorities and carer organisations.

I am very glad to know that we are going to see the plan for the social care workforce; we have waited for it a long time. When we finally see it, which I hope will be before the House rises for the Easter Recess, will it ensure that those who work in social care are properly recognised, rewarded and trained so that, at last, their status is comparable with those who work in the NHS?

[Lord Markham (Con)]

I apologise because, in some ways, the timing is slightly unfortunate with the report coming out before the Recess, as is my understanding. I am not allowed to steal much of Minister Whateley’s thunder on that, but I will answer as best as I can. I hope that noble Lords will be pleased that questions around training, recognition of the importance of the service and career structure are all addressed in the report.

[Lord Weir of Ballyholme (DUP)]

My Lords, in my experience, many families in need of social care for members of their families find themselves in a form of postcode lottery, where the quality and quantity of social care that they receive is very much dependent on the local availability of social care workers. What further steps are the Government taking to try to ensure consistency of social care provision for people throughout the country?

[Lord Markham (Con)]

The noble Lord is correct, in that this is pivotal to the whole health service and to health and well-being. It is very much the duty of the integrated care boards, and our Ministers are personally holding them to account on this. I have frequent meetings on seven integrated care boards, and this is very much on the agenda. The other six Ministers have 42 in total, seven each, so that we can make sure we hold them to account.

[Lord Allan of Hallam (LD)]

My Lords, the Minister has repeatedly agreed on the need for increased social care funding when replying to questions in debates. His party set out an ambitious plan for making such an investment in the Government’s Build Back Better strategy of September 2021. How have social care needs changed since then, such that the Government now seem comfortable to cut hundreds of millions from the commitments that they made less than 18 months ago? Does he think that we no longer need more supported housing or better digital services, two of the areas that the reports tell us are facing cuts?

[Lord Markham (Con)]

I do not recognise “cuts” in this context. Noble Lords are aware that we have committed to a £7.5 billion increase over the next two years, which amounts to about a 20% increase. We will see record investment and provision in this area.

[The Archbishop of York]

My Lords, the report by the Archbishops’ Commission on Reimagining Care was published in January. I am sure that the Minister is aware of this: in fact, I know that he is having a meeting later today with the right reverend Prelate the Bishop of Carlisle, who co-chaired that commission. We argue for a very bold approach to social care, which puts at its heart the concept of a care covenant, with clear expectations on each of us of what we should give and expect in return, recognising that each of us is a carer and that most of us will need care one day.

I speak as someone representing a region. In the cities of Hull and Middlesbrough, which I serve, I see many people in need of care and not receiving it; I discover that recruitment and retention are appalling; and I find care workers having to use food banks so that they can feed their families. It gives me no pleasure to say that we are in a very distressing situation.

I realise that the Minister is not in a position where he can say much but, surely, at the heart of this, as the noble Baroness said, it is about valuing the care worker in the same way that we value others. Can he give us an assurance that this will be at the heart of what is proposed?

[Lord Markham (Con)]

Absolutely. I speak as an ex-carer myself. Caring is part of everyone’s role, as has been quite rightly written about. Part of this is about the people we are employing. I am glad to say that we are managing to increase recruitment, which is not easy in the age of full employment. It is about the parts that you and I—all of us—can play in care in the community, and organising domiciliary care so that we can have a full wraparound service.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, on seeking to increase the size of the workforce, could the Minister give an indication of whether there will be more overseas workers? They have made such an important contribution in the past but have run down in numbers latterly, yet people want to see more coming from overseas.

[Lord Markham (Con)]

Yes, and I am delighted to say that it is working. We will have granted 57,000 visas towards that in the last year, which is a big increase on previous years. It is fundamental, and a fine tradition of our health and social care services, that we can use overseas workers.

[Lord Hodgson of Astley Abbotts (Con)]

My Lords, when you have very rapid turnover of staff and a high level of resignations, it is not always the staff who need training but the managers. As we make people more valued among the staff, will we ensure that managers learn how to do that and that training goes to all levels of the care-working profession?

[Lord Markham (Con)]

My noble friend makes a very good point. I am aware that some homes have half the turnover rate of staff than others, clearly demonstrating much better levels of management and skills. I agree, and that will be part of the training.

[Lord Kamall (Con)]

Following the question from the noble Lord opposite about recruitment from overseas, I thank the Government for acknowledging that we will need immigration to fill some of the skills gaps. An issue that has been raised a number of times in this House is visas for social care personal assistants. Can my noble friend the Minister update us on whether visas are being issued for this category of workers?

[Lord Markham (Con)]

We recognise the contribution that overseas workers can make here, as demonstrated by the 57,000 visas. I will need to come back to my noble friend in writing with details on his precise point on personal assistants.

[Baroness O’Grady of Upper Holloway (Lab)]

My Lords, on recruitment and retention, the Minister will be aware that the majority of care workers earn less than £10 an hour. Can he tell us when the majority of care workers will earn a real living wage?

[Lord Markham (Con)]

My understanding—I am doing this partially from memory so I will correct it if need be—is that the national living wage will come in shortly, in April. Care workers are paid that. I believe it is over £10, but I will confirm that.

[Lord Walney (CB)]

Further to a number of questions, I point out that the Minister talks about the recognition of the need for overseas workers to plug the gap at the moment, but where is the government strategy to focus on the growing number of British people who are trapped outside the labour market and need further support? This care profession, with appropriate levels of remuneration and support, could be a way to get more people off inactive benefits and into the workforce.

[Lord Markham (Con)]

I was very pleased, as I hope other noble Lords were, that the centrepiece of the Budget just last week was the need to get more people into the workforce. The health department clearly plays a key part in that with mid-life health MoTs to help and support people getting back into work, including things such as physiotherapy, which we mentioned just now, to give them the strength and confidence to go back to work.