Social Care Funding (EAC Report)

Baroness Scott of Bybrook Excerpts

Thursday 28th January 2021 Grand Committee

[Baroness Kingsmill (Lab) [V]]

My Lords, I am delighted that we have at last got this debate, and I share the frustration of the noble Lord, Lord Forsyth, at the time it has taken. He has been an indefatigable leader and chairman of the Economic Affairs Committee in the time that I have served on it, and I am most grateful to him and my colleagues on it for all the work and energy that have gone into not only this report but others, where we have tried to be practical and helpful and to make achievable suggestions for policy change.

I am also grateful for the passion with which the noble Lord, Lord Forsyth, has dealt with this and spoken about it today. My passion is somewhat dimmed by defeat, in a way, because it feels as if this is something that I have been banging on about for ages and we are still not really getting anywhere—but I am sure that everyone in the sector feels the same.

I will focus particularly on the plight of the care workers because that is my background and area of interest. The noble Lord, Lord Forsyth, has mentioned them, but it is worth going into some of the privations that they suffer in a little more depth. They are under- valued, underpaid and definitely undertrained; they do not have the status of nurses or even of childminders. The sector is subject to very weak regulation: we just do not know who they are or what qualifications they hold, and they are not registered with any professional body. The workforce of 1.8 million people in England is almost invisible—that is, until you need them, when they become very important.

The low status and poor treatment of care workers have led to a really vicious downward spiral in one of the most difficult sectors for workers, with a huge amount of exploitation. It is not just that they are badly paid; most of them earn less than the minimum wage, if you take into account the fact that many of them do not get paid for working in between clients. They are not paid for the journeys that they make and are often subject to very exploitative zero-hours contracts, which destabilise their lives and make it extremely difficult for them to do their work properly.

The workforce tends to be older women or migrant workers, which may very well account for the fact that they are not given much priority within the health and care service generally. They are overlooked and, as I say, we do not really know who they are. Turnover among care workers is enormous—between 30% and 40%—because they are badly paid; sometimes the supermarket down the road is offering a pound an hour more, and they have to go. They are often the main wage earner in their family, and they have to go where they can earn the most money, so there is a terrible, very rapid, turnover.

In the context of the Covid crisis that we are suffering, care workers are seven times more likely than the rest of the population to become infected with it. There is a huge amount of absenteeism at the moment because of illness or isolation, and there is a vast unmet need for care workers at the moment.

The other issue that is important when we talk about care workers is the fact that they have no career opportunities. Attracting people into the profession is very difficult: there is no progression and it is seen as unskilled work, which it most certainly is not because, so often, they need to have the skills to deal with complex feeding methods, using hoists for moving patients, dressing wounds and administering medication, as well as providing vital domestic and emotional support for the care recipients. They have to do all of this in 15-minute slots, if they are a domiciliary worker—

[Baroness Scott of Bybrook (Con)]

I remind the noble Baroness of the four-minute time limit.

[Baroness Kingsmill (Lab) [V]]

On that point, I will sum up simply by saying that I commend this report and hope that action comes as a result of it.

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[Lord Taylor of Holbeach (Con) [V]]

My Lords, I refer to my interests as set out in the register. However, I have a personal interest in the subject of the report, as, way back in 1987, an announcement was made by the then South Lincolnshire Health Authority that it was to close Holbeach Hospital. I was active in the local community and the area generally and perceived this to be a considerable threat. The hospital provided general bed care; there were consulting rooms for out-patient clinics and a physiotherapy department. It worked with local GPs and hospital doctors to provide the substantial rural community with health and social care. To cut a long story short, with local support, we negotiated a takeover of the premises by forming a local charitable trust, which then raised the money needed to improve the building up to registration standard at nursing home level and entered into a contract with Lincolnshire County Council for the funding of 22 beds. An agreement was reached with the health authority to continue with six doctors’ beds, the out-patient clinics and the physiotherapy department. We reopened in 1989.

I chaired the Holbeach and East Elloe Hospital Trust for 18 years. When I came to your Lordships’ House, I became its patron. The trust has thrived and maintains support locally. As a result of income generated and bequests, we soon purchased the freehold and doubled the number of beds to 47, including 12 re-enablement beds under the doctors’ supervision.

I congratulate my noble friend Lord Forsyth of Drumlean on chairing the committee and producing such a full report. Reforming the sector will be one of the most challenging undertakings for our Government. With such a complex system, it is important to look at all the options on the table. Notwithstanding the challenges, putting social care on a sustainable footing, where everybody is treated with dignity and respect, is imperative.

It is not as though we need a reminder, for the past year has shown just how vital this sector is for people who rely on social care. I welcome the Government’s recognition of the challenge that this sector faces during the pandemic by providing £1.1 billion of ring-fenced funding, which is vital to help put measures in place to improve infection prevention. How much funding have the Government made available for the costs associated with increased testing in care homes?

I want also to focus on the quality of care received by those who rely on adult social care. Despite increasing challenges, it is important that we recognise that the sector continues to provide high-quality care and support. I was encouraged to read that 85% of adult social care providers are currently rated good or outstanding by the Care Quality Commission. I think that the Committee will welcome this figure and want to pay tribute to the care givers, who are doing such a fine job, as many noble Lords have said, during such difficult circumstances.

All social policy areas have been put under pressure as a result of the pandemic, for they are interrelated. Social care, healthcare, pensions policy, the benefits system and even education all play a part in a civilised approach to need, even in the best of times. We need a consensus—

[Baroness Scott of Bybrook (Con)]

My Lords, I remind the noble Lord that there is a four-minute speaking limit for this debate.