Social Care: Family Carers

Debate between Lord Bethell and Lord Laming

Monday 13th September 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the maths that my noble friend has done is a little bit premature. The White Paper will come out later this year; it will spell out the precise financial arrangements, and I am looking forward to that.

[Lord Laming (CB)]

My Lords, the Minister has already indicated an understanding that many carers sacrifice a huge part of their lives in trying to care for a loved one. Many of the community support services that used to be available are no longer available. When these arrangements break down and a crisis occurs, it is understandable that the only option left is to call an ambulance, which places increased pressure on the health service. Will the Minister champion a new approach, which is this: “Protect the NHS by supporting carers”?

[Lord Bethell (Con)]

Yes, I would endorse that sentiment. That has been one of the learnings of the pandemic. It is instinctively true in any case, and the evidence base during the pandemic was quite right. They are interlinked; that is one of the reasons we are bringing forward a Health and Social Care Bill that brings both services much closer together and brings a responsibility on the ICSs to combine health and social care at the same time. Our population-wide measures will try to bring those care responsibilities much closer together, as the noble Lord suggested.

Residential Social Care: Staff

Debate between Lord Bethell and Lord Laming

Monday 6th September 2021 Lords Chamber

[Lord Laming]

To ask Her Majesty’s Government what steps they are taking to improve the (1) training, and (2) remuneration, of staff in social care residential services.

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

My Lords, we are incredibly proud of our health and care staff. As a nation, we are indebted to their selfless dedication, particularly over the last 18 months. The Government fund a range of training opportunities to support the development of care staff, including through a core workforce grant of £23.47 million. However, the vast majority of care workers are employed by private sector providers, who set their pay independently of central government.

[Lord Laming (CB)]

My Lords, I am grateful, but the Minister will understand that, very often, the impression is given that the only qualification needed by these splendid staff is that of a kind heart. This is despite the fact that they are caring, day by day and hour by hour, for the people in our society with the most profound needs. Does the Minister accept that, in these circumstances, it is remarkable that the median pay for these staff is £8.12 per hour? Is it any wonder that there are 112,000 vacancies in this field? Could the Minister say whether the Government have any plans to support these staff with professional training and give them a fair salary?

[Lord Bethell (Con)]

My Lords, I endorse the noble Lord’s key point, which is that value is seen not through salary but through the skill, love and determination of our social care staff to do a fantastic job. We are extremely proud of the service that they provide. The provision of care in this country is being looked at in the spending review settlement, and the need to support the sector will be addressed in that.

Covid-19: Care Homes

Debate between Lord Bethell and Lord Laming

Thursday 17th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, PHE has published a report on that. It calculates that around 1.6% of the deaths in care homes were directly attributable to discharge. That number is very sad, but it is a relatively low proportion. This will, of course, be a subject covered in the government inquiry that the Prime Minister has already announced.

[Lord Laming (CB) [V]]

My Lords, I feel sure that the Minister will agree that it was extraordinary that, when relatives were prevented from visiting their loved ones in residential care, and many of the residents could not understand why they had been abandoned, at that very time patients were being admitted from hospital without having been tested for this virus.

[Lord Bethell (Con)]

My Lords, I completely sympathise with the point on those in care homes receiving a very tough challenge when they have been prevented from seeing loved ones. We have had to take extremely severe infection control measures, many of which are still in place for the reasons that have been discussed in this Chamber before. But I challenge the noble Lord’s point on testing. We brought in testing when asymptomatic infection was recognised and when the capacity was available.

Care Homes: Insurance Indemnity

Debate between Lord Bethell and Lord Laming

Wednesday 19th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, in the year from March 2020, the number of patients has in fact increased from 457,000 to 458,000. The CQC is monitoring the situation extremely closely and its data from the insurance industry suggests that, although there has been some pressure on some companies, there have also been new entrants and the amount of support available to the social care sector is resilient.

[Lord Laming (CB) [V]]

The Minister has a very good understanding that many of the residents in residential care homes are unable, because of their condition, to comprehend the significance of the coronavirus. At this stage in their lives, when they are at their most vulnerable, many have felt that they have been abandoned and are now unloved. Can the Minister tell the House, if the insurance indemnity is not acceptable, what other possibilities are being considered by the Government so as to ensure that the awful experiences of some residents in the past year will never be repeated?

[Lord Bethell (Con)]

My Lords, the noble Lord speaks movingly of the plight of many people in care and I agree with his sentiment—it has been a very difficult year indeed—but we cannot blame the insurance industry for the pressures that have been put on residents. On the specific point about residents receiving visitors, which has, I think, been attributed to problems with insurance, I remind the noble Lord that 82.5% of care homes in England are now able to accommodate residents, compared with 40% at the beginning of March—a very large increase.

Social Care: Person-centred Dementia Care

Debate between Lord Bethell and Lord Laming

Monday 17th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am afraid it is beyond my reach to define the terms of the inquiry, but I entirely endorse the noble Baroness’s depiction of the very cruel dilemma we have faced over the last year: between safety—the preservation of life—and the care, love and consideration we owe to older people, particularly those with dementia. It has been a horrible and extremely uncomfortable dilemma. I pay tribute to those in social care who have sought to navigate it as thoughtfully as they could, but there is no doubt that it has been a horrible moment.

[Lord Laming (CB) [V]]

My Lords, as we have heard, dementia is a cruel illness because it strips away both individual personality and memory. Does the Minister agree that, learning the lessons of this past year, we must in future do everything possible to reinforce the message to each sufferer that they are loved for who they are, a unique person, rather than for what they are, just another patient with dementia?

[Lord Bethell (Con)]

My Lords, I entirely agree with the extremely touching way the noble Lord put that. To take a glass-half-full approach for a moment, I have been struck in the pandemic by the huge amount of public support for the protection of those who are older and vulnerable, including those with dementia. It has been a very touching feature of the national response to the pandemic that the country has come together to protect the most vulnerable, and I think there has been a national rethink about how we relate to those in that condition.

Covid-19: Over-75s

Debate between Lord Bethell and Lord Laming

Tuesday 9th February 2021 Lords Chamber

[Lord Bethell (Con)]

I completely recognise the concern of my noble friend and of many in the Chamber on this point, so I shall provide concrete reassurance. Everyone will receive their second dose within 12 weeks of the first one. All those booked in at vaccination centres will have an appointment, made at the same time, to receive their second dose, and those who do not have a date today will receive one from their GP.

[Lord Laming (CB) [V]]

My Lords, the Minister will know that six out of 10 people with dementia live in their own home, so they depend on a range of care workers coming into their home—sad to say, often without PPE and some even without face masks. In contrast, those living in residential care have now gone almost a year without being allowed a visit from a loved one—they are not able even to hold their hand. Does the Minister agree that now is the time to set up a formal review in order for us to learn the lessons of the impact of Covid-19 on the over-75s suffering from dementia?

[Lord Bethell (Con)]

The noble Lord explains the situation of those who have been in care homes and separated from their loved ones extremely well. We all feel extremely heartbroken by the stories of people who have been separated from their loved ones, but we need to put the saving of life as the first priority. Visits have been allowed outdoors, behind screens and in safe environments. I appreciate that that is not the same as an intimate face-to-face meeting but, where we can, we have put in place guidelines to ensure that people are protected. A review of the guidelines will happen on 22 February, and that seems the right moment to review these procedures.

Covid-19 Update

Debate between Lord Bethell and Lord Laming

Monday 14th September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I sympathise with my noble friend’s point, but I remind him that the regulations come into force later today. It is up to the Metropolitan Police to implement crowd dispersal but the sentiments he expresses are ones that I share.

[Lord Laming (CB) [V]]

My Lords, will the Minister please accept that while there may be good reason for the Government to ratchet up further the restrictions on social distancing, it is surely unreasonable to at the same time pressure people to return to their offices? These two objectives are incompatible, as was shown by government officers last week. Surely the Government should accept that they can press either greater social distancing or a return to offices, but not both?

[Lord Bethell (Con)]

My Lords, I do not think that this Government are pressuring anyone into doing anything. We are keen to give those who have a reason to, whether personal or professional, the confidence to return to their workplace. I pay tribute to the very large number of employers who have invested a huge amount in making those workplaces socially distanced and safe for employees.

Independent Residential Care

Debate between Lord Bethell and Lord Laming

Tuesday 7th July 2020 Lords Chamber

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

My Lords, this disease has targeted the vulnerable, and those working and living in social care have faced daunting threats. The Government have intervened with £3.7 billion for local authorities, including specific funds such as the £600 million infection control fund and the £500 million announced on 2 July. Delivery is being supported by our social care Covid-19 task force.

[Lord Laming (CB) [V]]

My Lords, I am grateful to the Minister for that reply, but he will know that, nowadays, residential care homes are provided not by local authorities but by thousands of independent organisations. It is now thought that some of these organisations may be in financial difficulties. Can the Minister tell the House what plans are in place to protect the residents of a home which ceases to operate, especially as these residents are not only very vulnerable but, frankly, have nowhere else to go?

[Lord Bethell [V]]

My Lords, the noble Lord is entirely right. The protection of residents is our number one priority and our responsibilities under the Care Act 2014 remain in place. The care home economy is mixed. We are looking very carefully at the financial resilience of all the providers involved. We are providing the funds necessary to see them through this epidemic and we will do whatever it takes to protect residents.

Care Homes: Covid-19 Testing

Debate between Lord Bethell and Lord Laming

Thursday 14th May 2020 Lords Chamber

[Lord Bethell]

I think the noble Baroness casts the situation unfairly. There are undoubtedly cases where test results have taken longer. Last weekend, a laboratory let us down and we had some delays, but I pay tribute to the team who turned around a very difficult situation. By far the vast majority of tests are turned around within our target time, and we are currently trying to reduce that time by using mobile and satellite units to take the tests to residents. That work is showing great and encouraging signs of improvement.

[Lord Laming (CB)]

My Lords, will the Minister assure us that the department accepts that residential care homes exist for those who suffer from multiple and serious health problems? That being so, can he help us understand better why, when we have known for months that Covid-19 was a severe threat to residents and staff, it is still not possible to guarantee either testing or essential equipment?

[Lord Bethell]

I completely acknowledge that one of the most horrible aspects of this disease is that it targets those who are most vulnerable and live closely to each other. Care homes are therefore a priority. I also acknowledge that we started with a very low base of diagnostic testing and have had to work extremely hard to build that up. But now that that capacity is there, we are focusing it on care homes and using innovative methods to get those tests directly to people. We could not be working harder to get the right people tested in the care home sector.

Covid-19: Care Home Deaths

Debate between Lord Bethell and Lord Laming

Wednesday 22nd April 2020 Lords Chamber

[Lord Laming (CB)]

I know that the well-respected Minister recognises that his department is the department not only of health but of social care. Does he agree that there has been an almost total preoccupation in the department with the NHS and a near disregard of social care, resulting in a high price being paid by both individuals and communities? Does he agree that there would be great benefit in a fundamental review of the role of social care, the training and skills of the staff, and a proper regard accorded to those who daily are meeting the needs of the most vulnerable people in our society?

[Lord Bethell]

The noble Lord, Lord Laming, makes a point that I am afraid I cannot agree with. While the press may be more focused on hospitals, we in the department have put an enormous amount of focus on social care. I pay tribute to my colleague Helen Whately, the social care Minister, who does not allow us to spend one minute not thinking about social care. However, the noble Lord is right that social care was deserving of a review in any case, and this epidemic will make that review even more poignant, relevant and important. I very much support his view that a review should take place after the epidemic and that it should be a root and branch look at the social care provision in this country.

Dementia: Accident and Emergency

Debate between Lord Bethell and Lord Laming

Wednesday 11th March 2020 Lords Chamber

[Lord Bethell]

The noble Baroness is entirely right to say that this is an important issue. Short-term funding has been put in place for the best possible short-term arrangement, but this is a long-term problem that cannot be solved by any Government on their own. It requires cross-generational and cross-party agreement. That is why an important and well-organised set of engagements has been initiated. It is timetabled, and the Government have committed to action in this area.

[Lord Laming (CB)]

My Lords, does the Minister agree that it is most unfortunate, to say the least, that many of the staff who are caring for patients with Alzheimer’s disease and other forms of dementia have been classified as unskilled? Most people who have experienced those services and met the staff involved recognise their skill and the contribution that they make to their fellow citizens. They should be valued.

[Lord Bethell]

The noble Lord makes an important point. I completely sympathise with it. Low paid does not mean unskilled or unvalued. We are looking at the classification, but I should like to communicate the value that we put on the people who care for those we love and the importance they play in our society.