Social Care Strategy
Baroness Merron Excerpts(3 weeks, 3 days ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, I thank the noble Baroness, Lady Tyler, for securing this important debate—and very timely it is too, at the beginning of a Government’s time. I also thank noble Lords from across the House for their contributions. There was reference to the usual suspects being an extended group, and I certainly welcome that. I have noticed how balanced the numbers of contributions from all sides have been, which is not always the case when it comes to debates, particularly of this nature, and that chimes very well with the approach of this new Government.
It is a particular pleasure to congratulate my noble friend Lady Keeley on her maiden speech. Of course she chose this debate to make it. I would have expected nowhere else, because she brings tremendous experience, insight and sensitivity to this subject, and many others, and I am sure that we will hear much from her.
I welcome the opportunity to reiterate the Government’s commitment to social care, but also to acknowledge the role of unpaid carers. Like other noble Lords, I am pleased that the noble Baroness, Lady Tyler, was very specific in her title, and I will attempt to do justice to the title as I continue.
I share, as have other noble Lords who have said similar, my tribute to all those who provide care and support for family and friends, both those who are unpaid carers and those who work as care professionals. I use the word “professionals” deliberately, because they make a vital contribution to communities and the well-being of individuals up and down the country. They show tremendous dedication and skill in doing so.
It is important to note that today also marks World Mental Health Day. As I hope noble Lords are aware, improvement of mental health outcomes is an absolute priority for this Government. My noble friend Lady Pitkeathley was quite right to speak about the impact on the mental health of carers.
I turn to what our approach will be and the state of social care. I, like other noble Lords, acknowledge the current state that we have inherited coming into government. People are suffering without the care that they need. They are fighting complicated and complex systems, as noble Lords have described, often just to receive a quality of care that is not what it should be. There are inconsistent standards and chronic staff shortages, and people are not always treated with the care, dignity and respect that they deserve. In his independent investigation into the National Health Service, the noble Lord, Lord Darzi, outlined that, in recent years:
“Social care has not been valued or resourced sufficiently, which has both a profound human cost and economic consequences”.
We are all living longer, and that is increasing the demand for adult social care services. For the first time ever, in 2022-23, over 2 million requests for adult social care support were received by local authorities. The London School of Economics projects that demand for publicly funded social care will rise by 43% between 2018 and 2038, as a direct consequence of the demographic pressures to which noble Lords have referred.
Despite growing demand, access to local authority-funded adult social care has declined, as the number of people receiving long-term care has decreased since 2015-16. This is our starting point, along with the economic situation in which we find ourselves, including the £22 billion black hole. It is against that context that we will tackle this issue.
While there is no doubt about the appalling state of adult social care at present, there were a number of questions about a royal commission. We will be setting out the next steps—I look forward to updating your Lordships’ House on this—to build consensus on a long-term plan and comprehensive strategy. That will be through a process of consensus called for by noble Lords, including the noble Baroness, Lady Neuberger, which engages stakeholders and those with lived experience, and is cross-party. That is why I take particular pleasure in hearing contributions from around the House today.
It is important to remember—the noble Baroness, Lady Fraser, and my noble friend Lady Warwick made this point—that social care includes around 300,000 working-age disabled people who, without social care, would not be able to lead their lives, contribute to society and, in some cases, participate in employment. My noble friend Lady Warwick referred to a wish to see the ability to lead a gloriously ordinary life, and the noble Baroness, Lady Fraser, talked about the need for flexibility. Both are absolutely right, because that is what social care should do. Our ambition is for care to be tailored to people’s needs and circumstances, and to be delivered by a professional, qualified and valued workforce.
It is important that social care prevents people developing more acute needs, rather than intervening just at the point of crisis. Let us also consider the contribution to the economy and the potential for growth. With more than 1.5 million staff, the adult social workforce is larger than those of the NHS and the construction and transport industries.
As I mentioned earlier, I agree with the noble Baroness, Lady Tyler, who also spoke of the need for working collaboratively. My honourable friend the Minister for Care, Stephen Kinnock MP, has already held two significant round-table meetings, one with people with lived experience and unpaid family carers, and another with key stakeholders in the sector. I mention it because this will be the way that this Government continue to address the challenge that we have before us.
What will the government action be? The 10-year plan will set out what joined-up looks like. My noble friend Lady Thornton raised some first-rate examples, particularly focusing on the way that the Whittington assists with support for social care, and I am grateful to her for that.
Here is what we will do. We will move from treatment to prevention. We will support local systems to prioritise early intervention, to begin to address unmet care needs and reduce the pressure on the health service and other services. There will also be a shift from hospital to home, which noble Lords have called for, and more care in the community. We will see more neighbourhood health centres, which bring together a range of services to ensure that, under one roof, healthcare is closer to home. There will also be a shift, called for in today’s debate, from analogue to digital: I can assure noble Lords that we are exploring how to build on existing progress towards digitising social care records.
On housing, the noble Lord, Lord Jamieson, rightly made the point that it is about having the right housing for the right time in our lives. This Government are committed to delivering 1.5 million quality homes over this Parliament to ensure that people have access to quality housing, and that will support people to live independently in a place that they can call home.
In the course of the debate, there has been much reference to the Government’s plans for a national care service: I have heard enthusiasm, caution and concern, which covers the whole range. This Government are fully committed to building a national care service. This will be one where care is delivered locally and will be what people need, but it will be based on national standards to improve the consistency of care. I believe that that will help to build trust and give reassurance on the quality of care being received by those who need it and will build confidence and trust among their families and carers.
I turn to the workforce. My noble friend Lord Turnberg was right to say that staff are undervalued. As I said in my opening speech, we want to see care and support workers regarded as professionals and for those who work in care to be respected accordingly. We will establish the first ever fair pay agreement for those working in adult social care. I am glad that the noble Baroness, Lady Thomas, described care workers as truly being on the front line—I recall that she said that they are worth their weight in gold, and I understand why she says that. We will engage with those working in the social care profession, and with the trade unions, stakeholders and providers, in order to make sure that we can have that agreement.
The noble Baroness, Lady Scott, asked how funding will happen. We will consult widely on how we design the fair pay agreement, because we have to engage with all those who will be affected by it. I can give an assurance that all voices will be heard, so we can ensure that the financial impacts on the adult social care market, local government and self-funders will all be considered. I am pleased that the Government are fulfilling a manifesto commitment to bring forward legislation in the first 100 days of entering office by introducing the Employment Rights Bill. That signals the first phase of delivering an adult social care fair pay agreement.
In addition, since entering government we have launched the learning and development support scheme, helping care workers and their managers to complete courses and qualifications, gain recognition for existing expertise and develop new skills and specialisms. We will continue to develop the care workforce pathway, which is a new national career structure for adult social care. Again, noble Lords are absolutely right to call for this.
I turn now to another crucial part of the debate, unpaid carers. There are 4.7 million unpaid carers in England providing unpaid care for those they want to ensure live the best life they can. Some 1.4 million are providing more than 50 hours per week. The noble Lord, Lord Young, talked about 3,000 of those being five to nine year-olds. I absolutely agree that their needs are entirely different, so NHS England will support the ongoing identification of young carers by producing young carer GP guidance and using data to inform greater join-up between health, education and social care, in order to support those families where it is needed.
Unpaid family carers have to look after their own health and well-being, not just that of those they care for, and they must have the support to do so. The noble Lord, Lord Darzi, was clear that a “fresh approach” is needed to improve support for unpaid carers and the outcomes for those they care for. We will be carefully considering those findings as part of our 10-year plan and as we develop the plans to reform adult social care.
I want to assure noble Lords today that we have heard the calls, including from my noble friends Lady Pitkeathley and Lady Keeley, for a cross-government carers strategy. This has to be addressed in the wider context of an urgent need for a renewed vision of adult social care. As we do that, we will consider how we can best support unpaid carers, because we are committed to ensuring that families have the support they need. We will be collaborating with our counterparts across government, unpaid carers and sector partners to make sure that unpaid carers are visible and not “rubbed out”—as the experience of one unpaid carer was described; and I am sure that they are not alone—and that they are supported.
May I, too, give a virtual hug to my noble friend Lady Donaghy? She is probably a bit overwhelmed, but in my experience you can never have too many hugs.
I recognise that many unpaid carers can face challenges in balancing employment with caring. The Government’s plan to make work pay sets out an agenda to ensure that workplace rights will be fit for modern times and empower working people, including those who provide unpaid care. This Government are committed to delivering this plan in full, reviewing the implementation of carer’s leave and examining all the benefits of introducing paid carer’s leave.
The right reverend Prelate the Bishop of Oxford and my noble friend Lord Dubs were right to emphasise the need for respite and carer breaks. The better care fund includes funding that can be used for carer support, including short breaks and respite services. I know it is not making the major difference noble Lords are seeking, and that will be part of our considerations.
The noble Baroness, Lady Meacher, referred to financial support for unpaid family carers. Understandably, unpaid carers often turn to the benefits system for financial support. We will be keeping the carer’s allowance under review because we want to see whether it is meeting its objective to give unpaid carers the help and support they need and deserve.
My noble friend Lady Donaghy, the noble Baroness, Lady Tyler, the noble Lord, Lord Jamieson, and other noble Lords asked what the Government are doing about funding pressures. We recognise that local authorities are facing significant challenges in funding adult social care. We will be working closely with them because we acknowledge that the distribution formula has not been updated for a decade, and we will be working with Ministers at the Ministry of Housing, Communities and Local Government to address that. I am grateful to my noble friend Lady Donaghy for acknowledging that the timing of the upcoming Budget constrains my ability to comment on funding, and I hope noble Lords will be kind and be sympathetic to that point.
My noble friend Lady Keeley raised the issue of those with autism. The number of people with learning disabilities or autism in mental health hospitals is unacceptable, and too many people are still being inappropriately detained. I look forward to our proposed reforms to the Mental Health Act to ensure that people get the support they need in the community.
My noble friends Lord Murphy, Lord Dubs and Lady Thornton gave great examples of good practice. I assure them and other noble Lords that we are looking at best practice and the reforms we will make for social care, the social care workforce and unpaid carers in order to change the landscape. It will not be easy. We start with a very challenging inheritance, to put it mildly, but we are determined to get there, and I am grateful to noble Lords today.
Holocaust Memorial Day
Baroness Merron Excerpts(9 months ago)
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Baroness Merron (Lab)
My Lords, it is, as always, an honour to follow the noble Baroness, Lady Altmann, and her words of hope. I feel I should say that I feel reassured to be in the company of noble Lords present today, including my noble friend Lord Dubs, who epitomises so much of what and who we are speaking of in this Chamber. I thank the Minister for her sensitive and clear introduction to such an important debate today. I draw attention to my interests in the register in respect of the Jewish community.
It is a privilege to be taking part in this debate today, albeit humbling. Why do I say that? Some events are so devastating in their inhumanity and so instrumental in shaping the world in which we live that, even if we were not actually there, we have a duty not just to remember but to be a voice and a witness. I, too, want to speak today about the power of bearing witness, which is exactly what we are doing in this debate. I have felt this very strongly in meetings I have been at in Parliament in respect of the atrocities committed on 7 October in Israel by Hamas terrorists, who still hold hostages whose fate is unknown. I, like other noble Lords, have seen footage collected from body cameras and CCTV of the horrific massacre that killed more than 1,200 innocent Israeli citizens and foreign workers, the largest number of Jews killed since the Holocaust. The noble Lord, Lord Stevens, was right to talk about the glee with which the terrorists conducted themselves. It was that that shocked me the most, along with the images I saw, which I do not feel I want to speak about again.
I have heard the pain of families speaking of their loved ones among the 240 Jews who were kidnapped and taken to Gaza and of those who were attacked, murdered, raped or traumatised. The devastation continues to be felt by the Jewish community here, which remains in continuing shock while 130 hostages remain in Gaza. This week, I heard of the sexual violence perpetrated on Jewish women in the disturbing testimonies of those who rescued bodies or conducted forensics and prepared the mutilated bodies for burial. In all of this, I feel helpless, as so many of us do, but there is one thing I know I can do: I can be a witness, I can remember and I can speak up. I can speak up both for those who died and for those who are living. That is exactly what we are doing today when we remember the Holocaust and the genocides that have followed in Cambodia, Rwanda, Bosnia and Darfur. With the backdrop of the ongoing situation in Gaza and Israel, this debate is particularly pertinent while we are seeing division, tension and the proliferation of anti-Semitism and anti-Muslim hatred in our own country.
The theme for this year’s Holocaust Memorial Day is the fragility of freedom, focusing our attention on the precarious nature of freedoms that need to be protected, and remembering how the descent by Germany in the 1930s from democracy to tyranny shows just how fragile that freedom can be. Let us remember that the mass murder of 6 million Jewish men, women and children did not take place only in the darkness of the ghettos and the camps. Hundreds of thousands were murdered in the bright light of forests and woodlands surrounding well-populated towns and villages. Let us also remember that the Nazis also persecuted and murdered those whom they saw as different: the Roma, the Sinti, gay men, political opponents and disabled people.
As we have heard today, the oppression of Jews did not start with the outbreak of war in 1939. In the six preceding years, Jews were persecuted by more than 400 decrees and regulations at every level of government, including by officials, who took the initiative. In every genocide that has taken place, those who are targeted for persecution have had their freedom restricted and removed before many are murdered. Genocide is after all a subtle and slow process, as the right reverend prelate the Bishop of London reminded us.
There is always a set of circumstances that occur, or are created, to build the climate in which genocide can take place. In Amsterdam, for example, even before the murders and the deportations to concentration and work camps, Jews had to give up their bicycles. They were forbidden to use trams or cars and forbidden to go to theatres, swimming pools or tennis courts, or to visit Christians at home. They were allowed to shop only between 3 pm and 5pm, and not allowed on the streets between 8 pm and 6 am.
On that point, over the summer I had the honour of being asked to review a new book called Nobody Lives Here, which paints a vivid picture of occupied Amsterdam during Anne Frank’s time of hiding through the eyes of Lex Lesgever, a young Jewish boy, the only survivor of his large family and someone whom I have never met. I accepted the invitation because I felt I had a responsibility to bear witness to that young boy’s experience so that he might be heard and remembered, and it was an honour to do so.
We all know that anti-Semitism is the world’s oldest hatred. As soon as the events of 7 October unfolded, I knew it would unleash a hatred of Jews in our own country and, as sure as night follows day, it did. Within hours of the attack, the atrocities perpetrated by Hamas were lauded on social media as an act of resistance. Since then, the global number of anti-Semitic incidents has gone through the roof. Synagogues have been firebombed, the Star of David has been smeared on the doors of Jewish homes, Jewish cemeteries have been desecrated and there have been verbal and physical attacks on Jews. Week in, week out, we see protests on our streets, with anti-Semitic slogans and signs, including calls to globalise the intifada, destroy the Jewish State of Israel and disrespect the Star of David.
In the 68 days following the Hamas terror attack on Israel, the Community Security Trust recorded at least 2,093 anti-Semitic incidents across the country. That is the highest ever total reported to the CST across a 68-day period, and the CST has been recording anti-Semitic incidents since 1984.
My Jewish friends feel the pain of explaining to their children that they must stop wearing their blazers which show that they attend a Jewish school. Colleagues are swamped with vile abuse and threats on social media for being Jewish, or for not being Jewish but speaking out against terrorism. It has left me and many others with an underlying anxiety about what might be said or done to us.
In the last year we sadly lost Sir Ben Helfgott MBE, Holocaust survivor, Olympic weightlifting champion, educator and honorary president of the Holocaust Memorial Day Trust—may his memory be for a blessing. Sir Ben touched the lives and hearts of countless people, including me, and I am grateful to him and all those who educate and inform-who take on the scourge of anti-Semitism and those who protect us, including the CST, the Holocaust Memorial Day Trust, The Holocaust Educational Trust, the Board of Deputies of British Jews and the Jewish Leadership Council. We are blessed to have them.
I am grateful to those who protect us, including the CST, the Holocaust Memorial Day Trust, the Holocaust Educational Trust, the Board of Deputies of British Jews and the Jewish Leadership Council. We are blessed to have them.
Today we bear witness, and in so doing we honour those who survived and pay tribute to those who did not. It is a privilege to do so.
International Holocaust Memorial Day
Baroness Merron Excerpts(1 year, 9 months ago)
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Baroness Merron (Lab)
My Lords, there are some debates where it feels daunting to do justice to the enormity and significance of the subject. I feel that today, but I also feel among friends and colleagues. At the outset, I declare my interests in the register as a vice-president of Liberal Judaism and the European co-chair of the International Council of Jewish Parliamentarians. I have also been an adviser to the World Jewish Congress and am the former chief executive of the Board of Deputies of British Jews.
I thank the noble Lord, Lord Pickles, for leading today’s debate in his characteristically powerful way. I continue to be grateful for the diligence and dignity with which he carries out his national and international responsibilities for Holocaust remembrance. I have been moved by the contributions from noble Lords across the House, whom I also thank. The sentiments expressed in this Chamber today will echo far beyond its walls.
I start by speaking fondly of Bob and Ann Kirk, who came to this country from Germany on the Kindertransport. As my noble friend Lord Anderson said, we should be grateful to the likes of Nicholas Winton, who did not stand by, for saving so many. Ann was an only child whereas Bob, whom she would later marry in 1950, was the youngest in his family. His parents perished in a concentration camp in Riga. Ann tells the story of her parents frantically waving as she left on the Kindertransport—the last time she ever saw them.
Many thousands of parents showed unimaginable courage in letting their beloved children go unaccompanied to England on the Kindertransport, with no idea what would lie before them. These were ordinary people doing extraordinary things. Bob and Ann cautioned me on the use of language, as did the noble Baroness, Lady Altmann. As my noble friend Lord Cashman said, it all started with a whisper. They also talked about the value of Holocaust remembrance and what it meant to them, because it could prevent the same devaluing of humans being repeated and the brutal consequences that follow. My noble friend Lord Griffiths read a moving poem that repeatedly asks, “Where is God?” I say to him that Bob and Ann put it to me in a similar way, asking, “Where was humanity?”
Ordinary people just like Ann, Bob and their parents are the theme for this year’s Holocaust Memorial Day. I congratulate the Holocaust Memorial Day Trust on its organisation of remembrance through this fundamental truth. As it says:
“Genocide is facilitated by ordinary people. Ordinary people turn a blind eye, believe propaganda, join murderous regimes. And those who are persecuted, oppressed and murdered in genocide aren’t persecuted because of crimes they’ve committed—they are persecuted simply because they are ordinary people who belong to a particular group”.
The noble Baroness, Lady Greenfield, made an elegant scientific case for the ordinary and the extraordinary, while my noble friends Lady Whitaker and Lord Glasman talked about the relevance of hatred and standing by in our world today.
My noble friends Lady Thornton, Lord Liddle, Lord Watson and Lord Young all spoke of the pain of anti-Semitism that was a stain on the Labour Party. It was a stain not only on Labour but, we felt, on politics in our country. Like them, I acknowledge and appreciate the determination and action of Keir Starmer in rooting it out, which he has done and will continue to do. I thank the noble Baroness, Lady Burt, for her commendation of his actions.
This debate resonates deeply with me, reflecting on my visit to the Holocaust Galleries at the Imperial War Museum, no doubt in the same way as it does for the noble Lord, Lord Sandhurst. The light and brightness of those galleries is a deliberate feature to highlight that 6 million people were not murdered in the dark, nor did they live in it.
It was a profoundly shaping experience for me, as an MP, to first go to Auschwitz-Birkenau with the Holocaust Educational Trust on its “Lessons from Auschwitz” project. I thank the Holocaust Educational Trust for its work and influence over many years. The project allows young people to pass through the infamous “Arbeit macht frei” gates and through the rooms filled with tonnes of human hair, prosthetic limbs and glasses seized from the victims, to walk along the train lines and to stand at the site of the former crematoria. It has an unparalleled impact on understanding the past, and through reflective assemblies on their return, it often ignites in them a determination to speak out against the anti-Semitism and hatred that allowed the Holocaust to happen.
For me, the most powerful impact of being immersed in this experience was when I saw a wall of black and white photos of ordinary people doing ordinary things: young women having a laugh with each other; families strolling on the beach; people getting married; or toddlers taking their first steps. These ordinary people were condemned to persecution, inhumane cruelty and extermination on an industrial scale just because they were Jews and were inferior and expendable in the eyes and minds of some—as were the Roma and Sinti people, gay men, disabled people, political opponents and others.
As these murderous events soon pass from living memory and leave us without the first-hand testimony of survivors, it is all the more necessary that we tell the individual stories of some of the 6 million Jewish people who were murdered. I want to pay tribute to the survivors, as many noble Lords have done—those ordinary people who have done and do the extraordinary without even seeing it as such. Their strength, testimonies and very existence present not just an inspiration but a reminder. As Lily Ebert said on her 99th birthday—which she marked with a family trip to the seaside—she was proof, in her own words, that the “Nazis did not win”.
I am immensely proud that the UK played such a pivotal role in the establishment of Holocaust Memorial Day as the International Day of Commemoration in 2000, but let us remind ourselves that the underlying issues have not gone away. The Community Security Trust recorded 786 anti-Semitic incidents across the UK in the first six months of 2022. As my noble friend Lady Anderson said, today’s CST report shows a 22% increase in anti-Jewish hatred. The world’s oldest hatred is alive and kicking, and this is shameful. This year, 2023, is a particularly poignant anniversary for genocide commemoration as we mark 20 years since the start of the genocide in Darfur, while also remembering those affected by genocides in Cambodia, Rwanda and Bosnia. With misinformation so often leading to hatred and prejudice, we all have a responsibility not just to remember but to act, and to identify the warning signs of genocide today.
The UK needs a national memorial to the Holocaust, and there is no site more appropriate than next to the mother of Parliaments—this Parliament. I hear that some noble Lords do not share this view, and I am sure we will continue to debate this. There has been a stalling in the progress of this important project, but I hope the Minister can commit today to a cross-party, all-community effort to revitalise it.
As my noble friend Lord Kestenbaum said, today we all carry the burden of history. It is a responsibility which we all share. There are many ordinary people who have done and will do extraordinary things—I hope we can be among them.
Smoke-free Pavements
Baroness Merron Excerpts(2 years, 11 months ago)
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Baroness Merron
To ask Her Majesty’s Government what plans they have to introduce rules on smoke-free pavements outside pubs and restaurants.
The Minister of State, Home Office and Department for Levelling Up, Housing & Communities (Lord Greenhalgh) (Con)
The temporary pavement licence provisions introduced in the Business and Planning Act 2020 and subsequently extended have a national smoke-free condition requiring businesses to provide seating where smoking is not permitted. In addition, local authorities can attach their own conditions, including those that prohibit smoking. The Government have committed in principle to making the pavement licensing permanent and will provide further details in due course.
Baroness Merron (Lab)
My Lords, the pandemic has of course seen a major expansion in the use of pavement space, alongside which the Government have committed to deliver a smoke-free nation by 2030 to improve our health. How is the Minister working with his Health colleagues to bring this all together for smoke-free pavement licences to play their part in the forthcoming tobacco control plan? Will the Government take the opportunity to adopt the tobacco amendments to the Health and Care Bill when they come before this House from the other place?
Lord Greenhalgh (Con)
My Lords, this Government can walk and chew gum at the same time. We are working closely with my noble friend the Minister and colleagues at the Department of Health. I should probably declare a personal interest as the son of a vascular surgeon who served on the Chief Medical Officer’s Scientific Committee on Tobacco and Health in the period when the noble Baroness was an esteemed Minister in the Administration in the first decade of this century. Of course we have not committed to how we will move forward with regard to the future of this legislation, but it is important to achieve the target of reducing smoking while reviving our economy.