NHS Pay

Baroness Keeley Excerpts

Wednesday 24th March 2021 Westminster Hall

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

It is a pleasure to speak in this important debate with you in the Chair, Mr Hosie, and I congratulate my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) on securing it.

We are all, rightly, incredibly grateful for the work that NHS staff have done over the last year. They have consistently gone above and beyond to cope with surges of demand in hospitals, to care for people with covid and to support family members who could not visit those patients. Now, the NHS is running the largest vaccination drive we have ever seen. As a reward for this, the Government have proposed a miserly 1% pay rise. With inflation set to rise over the next year, that will mean that NHS staff who have done so much will actually receive a real-terms pay cut. That is shameful and insulting. Ministers should have recommended a real-terms pay rise for NHS staff.

The pay proposal for NHS staff manages to be both wrong and unpopular. More than two thirds of those surveyed, including nearly 60% of Conservative voters, think that a 1% pay rise is less than our NHS staff deserve—but some NHS staff are even more underpaid. Last week, I met healthcare assistants from the north-west to listen to them talk about their roles and their pay. Band 2 healthcare assistants are among the lowest paid NHS staff. In theory, they carry out personal care tasks for patients, such as feeding, bathing and dressing. However, many healthcare assistants are in fact carrying out more wide-ranging and demanding tasks, such as casting broken bones, washing and sealing wounds, and carrying out observations or cannulations—tasks that should be carried out by a band 3 healthcare assistant, who would be paid nearly £2,000 a year more.

In one NHS trust in Greater Manchester, 98% of the healthcare assistants are employed on band 2, compared with a regional average of only 55%. That is straightforwardly keeping costs down by employing staff on one band and asking them to do the work of a higher-paid band. They are being systematically underpaid for the work they do. It is not acceptable. All NHS staff deserve to be fairly paid. When the Minister sums up, can she confirm that Ministers will ensure that all trusts have the funding they need to pay healthcare assistants fairly for the work that they are doing?

Finally, I want to come back to the 1%. For a healthcare assistant I talked to last week, who earns £9.80 an hour, the 1% increase will mean 9p an hour extra. A better pay rise is needed if we want NHS staff to stay in their vital roles in the vaccine roll-out, on covid wards and in handling the big backlog of elective surgery, screening and routine services. A better pay rise is deserved by NHS staff, who went above and beyond in the pandemic, who risked their lives and those of their families, and whom we applauded week in, week out. Clapping does not pay the bills. NHS staff are worth more than the miserly 1% on offer, and the public overwhelmingly agree.

Social Care Reform

Baroness Keeley Excerpts

Thursday 18th March 2021 Westminster Hall

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

I beg to move,

That this House has considered social reform and the social care workforce.

It is good to have you in the Chair for this important debate, Dr Huq. I am pleased to open the debate. I pay tribute to the House staff who have enabled Westminster Hall debates to return with virtual participation.

The covid-19 pandemic has exposed the failings of our social care system. With more than 30,000 deaths of care home residents, the care sector has been hit hard over the past year. However, the fundamental problems in social care long predate the pandemic. A decade of underfunding meant that we were in a situation, even before the pandemic, where 1.5 million people were not getting the social care they needed. While social care is, rightly, the last thing to be cut by local councils, the reality is that areas that have seen half of their central funding cut since 2010 are left with little choice. Underfunding has led to fewer care packages, cuts to care packages and providers being asked to take contracts that do not even cover their costs.

One clear illustration of how this is going wrong can be found in long-stay in-patient wards, where 2,000 autistic people and people with learning disabilities are detained, at enormous cost to the NHS. One reason for that is the lack of resources in the community to support them. When local authorities cannot afford care and support in the community for autistic people and people with learning disabilities, it becomes easier to put them into inappropriate NHS in-patient units, even though community support would be cheaper and more appropriate. We also have older people forced to sell their homes because they are unable to access publicly funded care support until they have exhausted almost all their assets.

There has been much focus on care in care homes during the pandemic, due of course to the tragic death toll among people living in those homes, but we must also focus on the fact that social care is needed by working-age disabled people too, and that proposals for reform must cover their needs. In fact, one in three users of publicly funded care is under the age of 65, whereas only one in four is an older person in a care home, so the crisis in our care system affects more than vulnerable older people. It is a crisis not only of catastrophic costs, but of hundreds of thousands of people being denied the opportunity to live their lives as they would choose.

This is not a new problem. The reality is that social care has been struggling for more than a decade now. That is why the last Labour Government published a White Paper in 2010 proposing major reforms to the way social care is delivered and funded. However, once in government after the 2010 general election, the Conservative-Liberal Democrat coalition decided to drop those proposals in favour of starting another commission on reform. That led to the provisions of the Care Act 2014, including legislating for a lifetime cap on care costs, based on the recommendations of the Dilnot commission. That would have addressed some of the issues with the social care system, although I do not think any of us believed that it was anything like the full solution. Since that change was first delayed by the new Conservative Government in 2015, we have had any number of promises of future reform.

Ahead of the 2017 election, the then Prime Minister promised far-reaching reforms but promptly abandoned them. After that election, a Green Paper was promised by the end of 2017. At the end of 2017, the cap on care costs was completely abandoned and a new deadline of mid-2018 was set for the Green Paper. That was pushed back to autumn 2018, and then to the end of 2018. In early 2019, we were told to expect a Green Paper by April 2019.

When the current Prime Minister took office, he claimed to have a social care plan ready to go, and he repeated that claim during the 2019 general election. The Conservatives’ manifesto at the last election said that they would seek a “cross-party consensus”, but they have not tried to seek that consensus. In fact, a fairly broad consensus on the future of social care has developed. Politicians from across the spectrum, including the Health and Social Care Committee and the House of Lords Economic Affairs Committee, have endorsed the model of free personal care as introduced by Labour in Scotland. That system is not perfect, but it should be a strong position to start from. However, rather than acting on that consensus, we are still waiting for proposals nearly 18 months after the 2019 election.

When the Minister speaks, she may tell us that the Government are working hard on their proposals and will publish them shortly. She would be the third Minister of State to tell me that since the Government dropped their commitment to the cap on care costs, and we have already missed at least 10 deadlines for reform. That simply is not good enough. We need action now, not the promise of jam tomorrow.

If there is a team of civil servants working on this issue, there a few points that they should consider in order for reform of social care to work. First, reform must deliver a fair deal for care staff. If the crisis of the pandemic showed us anything, it was that without the hard work put in by care staff our care system simply would not work, but too often care staff are underpaid, undervalued and given few opportunities to progress. To fill the more than 100,000 vacancies we have for care staff, social care needs to become a career of choice, with better pay and conditions and better training. When the average starting salary is only £15,000, it is little wonder that people are not turning to a career in social care.

As a starting point, reform should mean that all care staff are paid the real living wage, as my own local authority of Salford is now doing. We need to see investment so that the social care sector offers training opportunities and real career progression for staff, recognising their skills and experience. If we are to fill the vacancies in social care, we need a wide strategy working across Departments to recruit and train the workforce that we need.

The Prime Minister has said that he wants to end the scandal of people needing to sell their homes in order to pay for care. It is right that we should address the issue of catastrophic costs, but that cannot be the only ambition of social care reform. If all we do is end catastrophic costs, we will still have nearly 2 million people not getting the support they need. With providers struggling to make ends meet, local authorities are left with no choice but to cut budgets even further.

We need reform that expands access to social care services. Over the past five years, we have seen fewer older people receiving care every year as eligibility thresholds have crept up in response to budget pressures. Preventive care is increasingly uncommon, with intervention mainly coming after a crisis. Rather than providing low-level support to enable people to continue living independently at home, we are increasingly providing care only once there is no prospect of someone living independently.

When the Health and Social Care Committee looked at access to care, one witness, Anna Severwright, told us:

“I feel that I am not able to live a normal life. I do not have enough hours”—

of care—

“to be able to go out at the weekends and in the evenings, and do a lot of the normal things that make life worth living.”

That is not good enough. People should not see their horizons limited solely because they need social care, but with budgets under ever-increasing pressure, money for anything other than the basics of care is rarely available. There is a better way to deliver social care than 15-minute care visits, and people should not have curfews on their lives because care is not available in the evening.

As well as funding care properly, we could embrace the spirit of the Care Act 2014 and ensure that care packages meet people’s social and emotional needs as well as their physical ones. That kind of person-centred support would enable more working-age disabled people to be productive members of society while also supporting older adults to enjoy later life. At root, social care should be about supporting people to live happy and fulfilled lives without facing financial ruin.

There is a very poor level of support for unpaid carers. There are 13.6 million people providing care to a friend or family member. Without them, our social care system would not cope. Funding for respite care is increasingly hard to get. Many carers say that they would use a respite break to attend a medical appointment.

Responding to an Adjournment debate that I led last Friday, the Minister for Patient Safety, Suicide Prevention and Mental Health said that

“45,000 carers have received respite or other carer support delivered to the person they care for.”—[Official Report, 12 March 2021; Vol. 690, c. 1212.]

We have 13.6 million unpaid carers, including 4.5 million who started caring during the pandemic. For a Health Minister to report that only 45,000 carers received respite care is an appalling record. We must do much more to support unpaid carers, and we could improve their lives by funding formal care services better.

It is now seven years since we put the Care Act into law, but the Government still have not delivered for people who use social care. After years of broken promises and delayed announcements, there is anger at the way social care has been underfunded and reform neglected. This has led to people who rely on social care going without the support they need to live fulfilling lives.

Underfunding has led to care staff being paid the minimum wage and not being given the time they need to provide high-quality care. It has also led to many thousands of people facing catastrophic costs of care, often having to sell their homes to pay for it, and over the past year it has meant 30,000 care home residents dying with covid-19. They were caught in a perfect storm of an NHS discharge policy that seeded infections into care homes before providers could implement infection control measures.

People who use social care deserve better than all of this. They deserve reform that delivers a fully funded, person-centred care system that meets their needs, and they need it now, not at some point in the distant future.

[Dr Rupa Huq (in the Chair)]

Given the popularity of the debate, and the fact that we have three Front-Bench spokespeople and a concluding statement from Barbara Keeley at the end, I am going to start with a time limit of three and a half minutes. There will be a clock visible at the side of Members’ screens, and the chaps here can pull the plug if they go over the limit. With all that in mind, I will start with Andrew Lewer.

--- Later in debate ---

[Barbara Keeley [V]]

I am glad that we have, through this debate, paid tribute to the care staff who have been on the frontline of the pandemic and who have stepped up and done a fantastic job. My hon. Friends the Members for Luton North (Sarah Owen) and for Dulwich and West Norwood (Helen Hayes) did that and many other contributions highlighted it too.

From the debate, I would say that there is a real cross-party commitment to improve the pay and conditions, the training and the career progression of care staff, but we have a long way to go to do that. I am glad that a number of hon. Members talked about the important role of unpaid carers. I have recently highlighted the fact that our millions of unpaid carers were not mentioned once in the White Paper on health and social care. That must be addressed because they are partners in care.

I join others in thanking all right hon. and hon. Members for their contributions to this important debate. I believe there is cross-party support for reforming social care so that it delivers better for the people who need social care, for the care staff who deliver it and for unpaid carers who would rely on it if it were better than it is.

I thank the Future Social Care Coalition and other campaigners for their support and briefings ahead of the debate, and the House of Commons Library for its briefing. I cautiously welcome the Minister’s promise that the Government are working on reforms and will bring them forward this year. I hope that is not another promise that ends up being broken.

As I said at the start of the debate, we have seen too many broken promises and everyone involved in social care deserves better than what we have. As the right hon. Member for South West Surrey (Jeremy Hunt) and my hon. Friend the Member for Leicester West (Liz Kendall) both said, if we cannot fix this system now, after the terrible year for the care sector during the pandemic, then we never will. Let us grasp that opportunity.

Question put and agreed to.

Resolved,

That this House has considered social reform and the social care workforce.

National Carers Strategy

Baroness Keeley Excerpts

Friday 12th March 2021 Commons Chamber

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

There are some 13.6 million unpaid carers across the country, including 4.5 million people who first started caring during the pandemic and 800,000 young carers. Each of these carers provides vital support to a family member or friend, often at considerable personal cost.

Over the past year, the role of unpaid carers has become more important than ever. With many people shielding or unwilling to go out, unpaid carers have stepped up to provide additional support and keep people safe throughout the pandemic, but the reality is that these carers do not feel that their role is being recognised. One unpaid carer, Rachel Mewes, says:

“I wish I could say that the pandemic has shone a light on the situation that so many of us live in, as unpaid carers. Instead, it has driven us further into the dark. It has truly demonstrated how we are not even recognised as an entity in the British population. Personally, I feel that at no point during the past year, have the government recognised that people like me exist.”

I know the Minister will want to join me in thanking all unpaid carers, but the reality is that they deserve more than our thanks—they deserve our support.

Under the last Labour Government, this support was brought together into the national carers strategy. This was an ambitious, long-term plan built around the voices and experiences of carers, and it was first published in January 1999. In 2008, the strategy brought together seven Secretaries of State and the then Prime Minister to support an ambition that by 2018:

“Carers will be universally recognised and valued as being fundamental to strong families and stable communities. Support will be tailored to meet individuals’ needs, enabling carers to maintain a balance between their caring responsibilities and a life outside caring, while enabling the person they support to be a full and equal citizen.”

A decade of Conservative cuts and neglect of this policy area meant that this ambition for carers was never realised, and since the Government announced a consultation for a new carers strategy in March 2016, carers have been left waiting.

Carers were invited to contribute to that consultation to inform the new carers strategy. Over 6,500 carers, carers support organisations and charities submitted contributions. Thousands of unpaid carers gave up what little time they had and invested their energies in providing details of their day-to-day caring roles. Katy Styles, a carer and a campaigner for the Motor Neurone Disease Association, contributed to that consultation and hoped that her voice would be heard alongside others. She told me:

“Not publishing the National Carers Strategy has made me extremely angry. It sends a message that carers’ lives are unimportant. It sends a message that Government thinks we can carry on as we are. It sends a message that my own time is of little worth.”

Katy Styles went on to found the We Care Campaign to bring together unpaid carers to campaign, make their voices heard and get decision makers to value their unpaid care. A key ask of the campaign is a national carers strategy.

The Government have so far declined to publish a national carers strategy, instead bringing in a carers action plan. This flimsy document offers few substantial commitments to improve support to carers and lacks the funding needed to transform services. To give just one example of how this action plan fell short, a major issue facing many carers is that their GP or other NHS staff treating the person they care for know nothing about their caring role, and this means that they struggle to access support.

In 2012, I brought in a private Member’s Bill on the identification of carers. This would have created a new duty on the NHS to identify carers and promote their health and wellbeing. The then care Minister did not support my Bill, and when the carers action plan came along, it was not so ambitious. It merely proposed a system of quality markers so that GPs could demonstrate if they were good at identifying carers. However, carers organisations know that with proper identification of carers by the NHS we can support carers much more effectively.

The carers action plan expired at the end of 2020. While we are currently stuck in limbo on this policy, I hope the Minister will be able to confirm today that officials are working on a new strategy to give carers the support they need. There are a number of areas the Government should be considering as a priority in both the short and longer terms. The first is the issue of covid-19 vaccinations. This is a short-term priority, but many carers still have not been told when they can expect to receive their vaccinations. The Joint Committee on Vaccination and Immunisation has recommended that carers be prioritised alongside working-age adults with underlying health conditions, but we know there are still barriers to uptake.

I have heard from a full-time carer in receipt of carer’s allowance who booked a vaccination after being asked to do so by her GP, only to be turned away on the day because she could not prove her status as a carer. She was asked to provide a letter proving she was a carer, but her GP did not issue such letters to carers and she had no proof with her that she received carer’s allowance. Carers who are eligible should not be denied the vaccine on the basis of paperwork, so can the Minister set out what the Government are doing to ensure that carers are not wrongly turned away?

This could have been dealt with if the Government had set out a clear plan to ensure that all carers are identified either by their GP or by a hospital dealing with the person needing care. As they have not, we have millions of people carrying out invaluable caring work completely unacknowledged. It is also now likely that the covid vaccines will not be one-off, but an annual requirement much as flu shots are. Can the Minister tell us if the Minister for Care has had conversations with the Minister for Covid Vaccine Deployment about ensuring carers are included as a priority in all future rounds of vaccination?

Throughout this crisis, unpaid carers have taken on considerable extra costs. These range from additional spending on energy bills as people are stuck at home to having to purchase personal protective equipment and hand sanitiser. I have heard from carers who have seen their food bill double because they are having to shop online rather than going into stores. All these costs add up and are tough for carers, many of whom are retired or on fixed incomes. Despite these additional costs, carer’s allowance is one of the few benefits that has not had an uplift during the pandemic. Although people receiving universal credit have rightly been given an extra £20 a week, carers have not seen a penny more from the Government. Carer’s allowance was already pitifully low, so it is unconscionable that it should not have had an uplift during the pandemic, leaving many unpaid carers with months of financial worry. On top of that, many carers do not get even this inadequate level of support. Research from the Motor Neurone Disease Association found that even before the pandemic, one in three carers were providing more than 100 hours of support a week, and nearly half of that group receive no benefits. That is part of a broader problem which means that carers do not get the recognition they need. Three quarters of carers have not had a carer’s assessment, which means they are not getting the support they need.

Carers who worked before the pandemic have struggled more than ever, often without their employers realising they have had to take on extra caring. As formal services such as day centres closed their doors, unpaid carers were asked to take on more responsibility than ever before. Half of unpaid carers are in work, and more are of working age but unable to work, often because of their caring responsibilities. That means that one in four workers in the country are juggling jobs and caring responsibilities. Despite that, carers have little legal protection in the workplace. Working carers tell us that they are concerned that balancing their responsibilities affects how well they do their job, which is a particular concern during the economic downturn.

Carers have no right to take leave to carry out their caring role, and during the pandemic we have seen that they have no right to be placed on furlough if they need to be. This means they may have faced a choice between quitting a job and not being able to care for a family member or friend. That is not a choice anyone should be facing. The Government have talked about encouraging employers to be supportive of carers on their staff, but encouragement is no substitute for enforceable employment rights. Although the Government consulted last year on introducing a right to carer’s leave, we are still awaiting the outcome of that consultation. Will the Minister update the House on whether a right to carer’s leave will be taken forward?

Financial support is not available to the 800,000 young carers providing support to a parent or a sibling. Due to the support they offer, young carers often miss school and are more likely to get poor exam results than their peers. They face mental health problems as a result of balancing caring with the normal challenges of growing up, and that is often made worse by the fact that nobody knows they are a carer. Only one in 200 young carers receive any support through their local authority, and more than one in three say that nobody at their school knows they are a carer. That lack of support has worsened during the pandemic, with schools closed to many children and the additional caring responsibilities facing all carers. It is no surprise that young carers say they have got more stressed and more isolated over the past year. That will have a huge impact on their future, and we need to act to avoid that. Next week is Young Carers Action Day. Ahead of that, will the Minister say what targeted support is being put in place specifically to support young carers?

Looking beyond the current pandemic, we should be doing much more to support unpaid carers. Perhaps the biggest thing we could do is reduce the burden on them by ensuring that more people are able to access publicly funded social care services. One of the most damaging impacts of the current underfunding of social care is that people have to rely on friends and family members for help with basic tasks such as washing, bathing, using the toilet or having meals. Undertaking that personal care can leave carers without the time or energy to spend quality time with their family member or friend, whether by helping them get out into the community or engaging with their hobbies and leisure.

Carers are unable to take breaks, because there is no alternative care. Funding for respite care has dried up, as local authority budgets come under more pressure. We are now in a situation where 44% of carers say that they would use a respite care break to attend a medical appointment. None of us would consider going to the doctor to be a break, but for many carers, even getting time for a medical appointment for themselves is a luxury. Expanding eligibility for social care and providing comprehensive care packages will not replace unpaid carers, but it will free up time for them to do the things that only they can do—providing support and companionship to the person they care for.

Evidence from Scotland, where a Labour Government introduced free personal care in 2002, shows the impact that expanding social care services had on unpaid carers. Research has shown that having state-funded personal care meant that unpaid carers increasingly focused on emotional and social support.

In 2018, carers were told the reason they were getting only the flimsy carers action plan was that the social care Green Paper would go further and set out more ambitious plans. More than two years later, there has been no Green Paper, so I am sure the Minister will understand that carers are not happy with the continued promise of jam tomorrow. Even if the Government were to bring forward their plans for social care this year, which could be another broken promise, it may be years until those plans are enacted. Carers cannot wait that long. They need support now.

A national strategy would be based on carers’ voices and aim to start meeting their needs rather than ignoring them. As Katy Styles told me:

“The recent budget told unpaid carers and those they care for how much of a priority they are. When the Chancellor of the Exchequer gives carers 35p a week extra and carers work out that they would need two weeks of this increase to buy a can of the Chancellor’s favourite soft drink it tells you everything you need to know.”

As unpaid carer Bart Mekking said:

“My wish is that unpaid carers like me and my wife are noticed. No kind words for they are always empty. At this point, saying that the ‘heroic efforts of carers are appreciated’ sounds more like a snipe. Meaningful actions are needed.”

I wanted to lead this debate today because it is time for meaningful action for carers like Bart and his wife and because it is time we listened to the voices of carers like Katy and recognised the contribution of carers like Rachel. Meaningful action would be ensuring that every unpaid carer is able to access the covid-19 vaccine as a priority, rather than being turned away because they lack the appropriate paperwork; introducing a right for carers to be furloughed from work so that they do not have to choose between working and caring; and a right to carer’s leave. Meaningful action would be increasing financial support to carers, including increasing carer’s allowance; bringing forward the long-awaited reform of social care, so that unpaid carers get the help they need from formal care services; introducing a duty on the NHS to have regard to carers in the upcoming health and care Bill; and publishing a full national carers strategy that is ambitious and long-lasting in order to guarantee that carers remain a priority after this pandemic is over. Anything less than this is letting carers down again and allowing them to bear the cost not just of the covid-19 pandemic but of the Government’s failure to support the social care system.

NHS Staff Pay

Baroness Keeley Excerpts

Monday 8th March 2021 Commons Chamber

[Helen Whately]

Absolutely. We submitted our evidence to the pay review body last week, which included the affordable pay envelope from the Government. The Pay Review Body will look at a wide range of evidence, and we will look at its response when it comes back to us.

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

This pay proposal for NHS staff has managed to be both wrong and unpopular. Over two thirds of those surveyed, including nearly 60% of Conservative voters, think that a 1% pay rise is less than our NHS staff deserve, and I believe that the Secretary of State should be in the Chamber answering this urgent question about it. Does the Minister agree that NHS staff are worth a real-terms pay increase? Does she consider that the billions wasted on ineffective or undelivered personal protective equipment could have been better spent on giving our NHS heroes a pay rise?

[Helen Whately]

It is absolutely right that we invested in ensuring that we could supply PPE to the NHS and the social care workforce during this extremely challenging time. There was a global shortage of PPE, so it is right that we spent money on that. As we look ahead at the pay deal for the next year, it is right that we exempt NHS staff from the wider pay freeze for the public sector and ensure that they get the recognition they deserve for what they have done and are still doing.

Covid-19

Baroness Keeley Excerpts

Monday 22nd February 2021 Commons Chamber

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

People with learning disabilities have been marginalised in health and care for decades. We know from the learning disability mortality review that people with learning disabilities have a life expectancy 20 years lower than the general public. Now we know that, during the pandemic, people with learning disabilities have been even more at risk. After adjusting for age, people with learning disabilities are six times more likely to die from covid than their peers. Despite that, the Government have not given people with learning disabilities the protection and support they need in the pandemic. It took months for people with Down’s syndrome to be added to the clinically extremely vulnerable list, and Ministers still do not fully accept that people with learning disabilities are more vulnerable to covid than their peers.

Only those people with a severe or profound learning disability indicated on their GP record are currently eligible for a vaccine in cohort 6. A Public Health England report on deaths from covid in people with learning disabilities details the fact that GP records are not sufficient to reach all people with learning disabilities who are at risk. It said:

“The great majority of people recognised as having learning disabilities in schools are not recognised as such by health services in adulthood. Those missed… are known to have poor physical health, including higher rates of obesity and diabetes, putting them at increased risk of death from COVID-19.”

This means that people may be being denied the vaccine they need because of a postcode lottery in medical record keeping. The learning disability mortality review programme report on covid deaths told us that deaths were not limited to people with severe or profound learning disabilities. Can the Minister tell us that the Government will update the vaccines delivery plan to make clear that all people with learning disabilities should get the vaccine as part of cohort 6?

It is also deeply worrying to hear that people with learning disabilities may have been denied life-saving medical treatment for no reason other than they have a learning disability. The Care Quality Commission found that inappropriate “do not resuscitate” orders may have led to potentially avoidable deaths during the first wave of the pandemic. That was rightly condemned, with both the CQC and NHS England making clear that “do not resuscitate” orders based solely on someone’s learning disability should not be used, but there are reports that this practice has resumed. It is clear that the CQC does not have the powers it needs to address this, so will the Government agree to suspend all “do not resuscitate” orders applied to people with learning disabilities during the pandemic until a full review can be carried out? Access to healthcare and treatment is a human rights issue and an equality issue. It is past time that we took action to ensure that people with learning disabilities get the same access to the healthcare and treatment they need as their peers do.

Covid-19 Update

Baroness Keeley Excerpts

Tuesday 9th February 2021 Commons Chamber

[Matt Hancock]

The rigour and the security of both home quarantine and hotel quarantine are important. It is a matter of the degree of risk, and that is why we have attempted to strike the balance that we have. However, what is not in balance is the need for rigorous quarantine both for those coming from red-list countries and those coming from all other countries who quarantine at home. It is important that this takes place, whether it is at home or in a hotel, and hence the stronger enforcement measures.

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

One of my constituents is a long-term in-patient in the spinal injuries unit at Southport Hospital. He is 70 years old and is tetraplegic. Despite there being covid cases on the ward, he has not yet received a vaccine, and staff tell his partner that they have no idea when they will be able to offer one to him. Vulnerable patients in units like this may be there for months or years. What is the Secretary of State doing to ensure that all long-term in-patients, including my constituent, get the vaccine at the same time as they would if they were an out-patient?

[Matt Hancock]

Yes, that is exactly the principle on which we are proceeding. I pay tribute to the work that the hon. Lady does in this area and in always speaking up for those who are in in-patient care. It is very important that we make sure that there is equal and fair support for all according to clinical need, and that will be addressed in the next phase of the roll-out, once we have ensured that the offer to all those in categories 1 to 4 is achieved by next Monday.

Long Covid

Baroness Keeley Excerpts

Thursday 14th January 2021 Commons Chamber

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

I thank my hon. Friend the Member for Denton and Reddish (Andrew Gwynne) and the hon. Members for Oxford West and Abingdon (Layla Moran) and for Central Suffolk and North Ipswich (Dr Poulter) for securing the debate and the Backbench Business Committee for scheduling it in the Chamber so that all MPs can take part.

The debate is important and timely as we pass the grim milestone of 100,000 covid-19 deaths and well over 3 million confirmed cases. We should remember each of those 100,000 deaths as the human tragedy it is as well as a sign of the failure to control the virus.

Together with colleagues who are taking part in the debate, I have heard evidence of the impact of long covid from witnesses to the all-party parliamentary group on coronavirus. The impact on their lives is profound, and their numbers are growing rapidly.

It is important to recognise that covid-19 is not binary, with people either dying or recovering fully. We still have little idea about how covid-19 affects those who survive it in the longer term. Even people who start with mild covid symptoms may end up suffering noticeable effects and developing new or worse symptoms for months.

Among the many issues that witnesses with long covid raised at the APPG, an important factor is where they contracted the disease. Our witnesses this week all worked in the NHS, and we heard that the doctors’ long covid group is expanding rapidly. It is right to ask whether the conditions on the frontline might mean that long covid is more prevalent among those who acquire it at work.

Given the devastating impact of long covid, we need to establish whether it is an occupationally acquired disease. If it is, it should be reported on, monitored and protected against, as any other workplace-acquired disease would be. Will the Minister therefore set out what the Government are doing to require employers, including the NHS, to monitor long covid among their staff, and what steps will be taken to support frontline staff with long covid?

As I said, covid is not a binary disease. It is simply not the case that people either die from it or recover fully. We must remember every covid death as the tragedy that it is, but we must also fully acknowledge and deal with the long-term impacts that the disease can have. People are living with the effects of the virus for months, and perhaps even years. They need our support. They need a health system that can identify long covid and research so that we can begin to treat it effectively. They need financial support if they cannot work.

We need a covid strategy that goes beyond preventing deaths. We need to drive cases down, even when the most vulnerable are vaccinated, so that we do not create a new generation of people living with long-term health conditions. We particularly need to establish covid-19 as an occupational disease and support the frontline staff with long covid who cannot work because of their symptoms. They must not be forgotten.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I am afraid we must now move to our last Back-Bench speaker.

Mental Health Act Reform

Baroness Keeley Excerpts

Wednesday 13th January 2021 Commons Chamber

[Matt Hancock]

It is very moving to hear the personal testimony of so many people, and I am grateful to my hon. Friend for his personal testimony today of how important this is. Like him, I am thrilled that we have been able to make organ donation an opt-out system, and we did that in the middle of the pandemic. He is right that it is not just about physical recovery; it is about physical and mental recovery. The point he makes so sensitively just shows how important and how broad this subject is, and I would be very happy to work with him on this specific subject to make sure that people get the best possible services.

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

With the detention of 2,000 autistic people and people with learning disabilities who are currently trapped in inappropriate mental health units, the news that autism and learning disabilities will no longer be grounds for detention under the Mental Health Act is welcome. As well as changes to the legal framework, ending this in-patient detention means putting in place funding for community support, which has often not been available due to cuts to council budgets. Can the Secretary of State set out what additional funding the Government will be putting into those community services so that we can follow through on this much-needed reform?

[Matt Hancock]

We have put extra funding into those services. I absolutely appreciate, of course, that they are under pressure, especially with the pandemic. The hon. Lady is right that we must have the community services in place. Whether those are NHS community services or community services provided by councils, it is very important that they are provided in as seamless a way as possible. In fact, the best commissioning is often joint commissioning between local authorities and the NHS. I hope that a wider set of reforms to the provision of local services that have initially been set out by the NHS, but that we will be taking forward, will help us, combined with this legislation, to ensure that the link-up that she rightly addressed is much stronger.

Public Health

Baroness Keeley Excerpts

Wednesday 6th January 2021 Commons Chamber

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

With case rates rising and hospitals under pressure, it is clear that these regulations are necessary and I will be supporting them today. The situation in hospitals is particularly concerning. In London, we are seeing the cancellation of non-covid care, including urgent cancer treatments. This was one of the most damaging consequences of the first wave, when many people had to wait months for urgent treatment and diagnostic tests. This cannot be allowed to happen again. Will the Secretary of State set out exactly what steps they are taking to guarantee that the most urgent cancer treatment can still go ahead over the next six weeks?

This lockdown also comes at a time when health and care staff have been working flat out for almost a year. They have gone above and beyond this year, from working with inadequate PPE last spring to stepping up over Christmas to ensure that patients continued to receive treatment. This week, a constituent who works in the NHS wrote to me and said this:

“I am tired as an NHS employee, I am tired of working beyond my contracted hours because there aren’t enough staff in work. I am tired of covering for colleagues who are shielding or pregnant and cannot have direct patient contact. I am tired of not having enough equipment to do my job because it is stuck in the supply chain. I am tired of having to tell bereaved women that their whole families cannot visit due to social distancing, I am very tired.”

At the start of this crisis, we came together as a nation to thank our health and care staff, but I feel that this sense of unity and support for them has been lost. Whether it is doctors being bombarded with abuse from covid deniers on social media or outside hospitals, or NHS staff not being prioritised for vaccines, we are no longer showing staff the respect and appreciation they deserve for the amazing job they are doing in this pandemic, and we need to change this. Staff are now being asked to work flat out caring for covid patients or on delivering vaccines. The Government must take a lead on showing appreciation for staff, starting with vaccinations for everyone on the frontline.

When we debated the tier 4 regulations a week ago, I said that restrictions work only if people can and do follow them. Throughout this crisis, one of the major barriers to self-isolation has been that people cannot afford to do the right thing. The £500 self-isolation payment is available only to those with no other financial resources, so people with savings are being denied this payment. In Salford, four out of five people who applied for the payment were turned down. We are asking people to spend their savings intended for house deposits or even treatments such as IVF to support themselves and their families while they self-isolate. This is not right. Nobody should be worse off because they are doing the right thing in a pandemic. The Government should extend statutory sick pay at the level of lost wages to everyone asked to self-isolate. Anything less risks people continuing to break self-isolation through financial necessity.

These regulations are necessary, but they may not be sufficient. I hope that the Secretary of State can ensure that everyone is supported to do the right thing and beat this virus.

Public Health

Baroness Keeley Excerpts

Wednesday 30th December 2020 Commons Chamber

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

May I join colleagues in thanking House staff, Mr Speaker and the Deputy Speakers for enabling us to be recalled today?

This is a dangerous moment for our country, with hospitalisations now higher than they were during the first peak. With a new variant of the virus circulating in many areas of the country, we need action to protect lives. The route out of this pandemic is vaccination, so it is welcome news that we have the Oxford-AstraZeneca vaccine and that the vaccine roll-out is accelerating. However, there remains significant confusion about who is currently eligible for the vaccine. We have been told that NHS and care staff will be a priority, but I have also heard that some trusts are putting a 5% cap on the number of vaccines for staff. We have already lost more than 600 healthcare workers to the virus, and leaving them unvaccinated for longer puts them at risk.

Does the Minister agree that we need a target date for vaccinating all frontline NHS and care staff, rather than just leaving it that they can get any vaccines spare at the end of the day, as the Secretary of State said earlier? The Minister thanked our staff, but can we now ensure that we protect them by vaccinating them?

We know that restrictions will work only if people comply with them, and although compliance has been generally high with people choosing to do the right thing, it appears to be slipping. That is deeply concerning in the context of the higher transmission rates that we are now seeing with the new variant. Unless compliance remains high, we will need ever-tighter restrictions to keep the virus under control. Will the Minister set out what the Government are doing to boost compliance, particularly with regulations such as those on face coverings? Will he confirm what support the Government are giving to local authorities and businesses to allow them to enforce the regulations? At the moment, many businesses feel unable to take the steps they need to take to keep their customers and staff safe. That is vital because of the pressure that our NHS is now under.

With more than 21,000 people in hospital and major incidents declared across the south-east, it is clear that our hospitals cannot cope if cases continue to rise. On top of that, many NHS staff are worn out and burned out after a year in which they have been under constant pressure. We are facing a situation in which the NHS may be overwhelmed, and there appears to be no safety net. Will the Minister confirm what the Government are doing to get more staff into or back into the NHS, and what contingency plans they have to ensure that routine services can continue if coronavirus cases continue to rise?

Finally, I want to ask the Minister what will happen if moving many areas into tier 4 restrictions, which we have been told is necessary to control the new strain of the virus, proves insufficient. What are the escalation plans and trigger points after tier 4? Setting out any plans for escalation in advance would enable people and businesses to plan for the worst while hoping for the best. I hope the Government will now set out a plan that makes clear what they will do if case numbers continue to rise. As my hon. Friend the Member for Nottingham North (Alex Norris) said, the British people can take honesty.