Families: Cost of Living

Lord Bishop of Derby Excerpts

Thursday 31st October 2013 Lords Chamber

[The Lord Bishop of Derby]

My Lords, I, too, congratulate the noble Baroness, Lady Prosser, on securing this debate and on setting such a good framework in her introduction. I want to look particularly at the human cost of this issue and at the family budgets of those who are at the sharp end of the struggle in trying to deal with rising living costs. I shall begin with the big picture. Earlier this year I organised a hunger summit in Derby. We looked at food poverty in what we call the developing countries, but we also looked at food poverty in our own city. We took the opportunity to launch a remodelled food bank system to provide a more comprehensive service to meet the growing food poverty that we are finding in our own back yard. That is the context in which we should begin to look at the pressure on family budgets. We were supported by the Fair Share Trust. Indeed, the noble Lord, Lord Newby, was in the House earlier this week when there was a Question about food waste, and I hope that one of the things we can do with excess food is redirect some of it towards organisations such as the Fair Share Trust so that it can be used to supplement those families whose budgets are so stretched that they cannot afford to eat properly.

Over the past 12 months in the city of Derby, we have seen a 100% increase in the use of food banks. The point I want to make in this debate is that the shift has been away from the normal suspects, who are, tragically, homeless people, towards families who are housed, but whose incomes are so low that they cannot feed themselves seven days a week. The increased demand has been seen among occasional users who pitch up several times a week in order to secure a proper meal for the family that day.

It is the same situation with treats. Today, many people are living on such stringent budgets that they cannot afford any treats. St Peter’s Church in the middle of Derby runs something called “Christmas Lunch on Jesus”. The project has some 400 volunteers who send a meal out on Christmas Day. Last year the meals were sent to 1,500 families, and this year the project is budgeting for 2,000 families. People do not have the wherewithal even to celebrate Christmas in the way most of us would take for granted. There is a real issue here.

I want to comment briefly on three areas of complexity. The first is work and income, the second concerns lifestyle, and the third concerns the role of the state and other support. I turn first to work and income. Recently, a family with one child turned up at one of our churches. They had got out of work and into debt. It took 15 weeks of debt counselling, providing food and childcare support—all the normal things—to turn the family around and get them back into work. The person concerned is now contributing food to the local food bank. My point is that work for many people is very insecure. It does not plough on and on and it is not just about getting a living wage. The experience of trying to be in work is insecure for many people. It is not untypical to tip out of work, get into debt because of having been living at a certain pace, and to run out of food. Churches and other groups try to pick these people up again. The problem, however, is that churches and the volunteer sector are struggling with the increased number of people in this situation and finding it harder to make that kind of generous response. When we talk about work and a living wage, we have to remember how insecure that is for so many people. Whatever the system is that underlies it, an enormous amount of energy and good will is required of volunteers to help people to cope. As other noble Lords have said, we need a more systematic approach to the provision and security of work.

My second point is about the sheer complexity of lifestyles and the difficulty around interpreting the phrase “family budgets”. Perhaps I may share another story. Two weeks ago, a family turned up at one of our city centre churches comprising a mother who was eight and a half months pregnant and five other children. They were running away from domestic violence. By the way, the woman has successfully had her sixth child. They pitched up at the church, a strange place to them, with no support systems. The children had been out of school for six months. The church has worked hard to place the children in local schools, getting them bus passes and school uniforms in order to help this woman through the trauma of the birth of her sixth child. Her benefits have been stopped because she has not replied to a letter from the DWP, but that is because she is no longer at home, having run away from domestic violence.

There is no easy answer for that story but it is not untypical of the very complex lifestyles that many people have. These are not normal families that you can just put in a box or bureaucracy, or find a welfare system for. There is a certain chaos and unpredictability about many people’s lifestyles. We therefore need to invest more in agencies with the sensitivity to pick up people who do not fit into the boxes, help them negotiate with the system, and discover what benefits and housing might be available. As family budgets are under such pressure, we really need to invest in those who can help people negotiate with the system.

My third point is about the role of the state. The big word is cuts: cuts in family budgets, in local authority budgets and in government expenditure. I encourage noble Lords to think that there is a potentially more positive side to this negative mantra of cuts in terms of the reshaping of welfare provision in our times, which is a challenge to all of us. Clearly, Government and local government are taking various decisions about the role of the state and public authorities, and we are having a political debate at the moment as to whether they are the right decisions. However, there is a very interesting role for not just the voluntary sector, which I have been talking about, but business. In the city of Derby, we are working quite closely with local businesses to see how they can support the management and leadership of schools, support the development of work opportunities for young people and raise aspirations for children in certain educational environments.

My experience is that many local businesses have a genuine desire to be part of a new ecology of trying to reach out and help people understand what work is about, to access it and be part of growing up to make a positive contribution. As the Minister looks at the big macroeconomic and social issues that have, rightly, been raised, I hope that there might be some response on how we can properly encourage a role for the voluntary and faith sectors in this interface between those who are crushed in terms of family budgets and those systems designed to support them, and on how we can try to grow a different ecology of welfare and mutuality where society uses local resources and local businesses, and the state, in a different kind of partnership. There is lots of talk about it but, for those of us on the ground, not a lot of action and few encouraging signs.

We are, of course, approaching the liturgical seasons of All Souls and All Saints. They are wonderfully inclusive notions—you could not be more inclusive than All Souls. I hope, whatever our political divisions, that we would be united in a genuine passion and concern for all souls, particularly those whose family budgets are most pressed, most chaotic and most under pressure. I hope that there could be a positive line across all parties of the House about creating a new ecology for welfare and care that could be very appropriate for the future.

Health and Social Care in England

Lord Bishop of Derby Excerpts

Thursday 11th July 2013 Lords Chamber

[The Lord Bishop of Derby]

My Lords, I, too, congratulate the noble Lord, Lord Patel, on securing the debate. As we have heard from all speakers so far, there is a strong narrative about how precious the NHS is, how high public expectation remains and the problem of rising costs—it’s own health check has just been referred to.

I want to talk a little about care systems and the models that we might need to develop. Experience on the ground tells us that care systems are very fragmented. As systems such as family stability collapse, many people are isolated and struggle to access care and health services. The current system is very skewed towards the delivery of episodic interventions around particular crises. We need to look below that. We need to step back and see how we can create a culture of engagement, support and well-being for people that puts those episodic interventions in a different context and perhaps provides a context in which they would be less necessary and less frequent. I shall raise some questions about models and capacity, not least in relation to the elderly.

I work in the county of Derbyshire. Last year, in the city of Derby, I organised a commission, the Redfern commission, which looked at models of care in our community and how we could contribute alongside the statutory provision. We had a public hearing looking at models of care for the elderly. One of the experts who came as a witness to that public hearing raised three issues. She started by talking about people’s feet and the fact that proper foot care is very important to allow people to continue to have mobility—to be able to shop, do their cleaning and have social intercourse. Very simple things that require microengagement make a huge difference to people’s well-being and health. She also talked about the reluctance of doctors to diagnose depression in elderly patients who suffer a lot of loss. She said that something like 2 million elderly people are diagnosed with clinical depression, but there are probably far more, and it is hard for them to get treatment or even support on the ground. She also raised the lack of provision of advice for elderly people about sexual health.

Many of these things can be dealt with not through episodic major interventions but through a culture on the ground of support, care and contact. It is voluntary groups—churches especially—that in most communities provide lunch clubs, outreach and all the things that allow people who are otherwise isolated and struggling with medical and social care conditions to be supported. However, 87% of local authorities are setting their eligibility criteria at substantial or higher. I think we need models that look below the surface where people need care and can be sustained more realistically. In a parish in a rural group of parishes, the parish, the diocese and the Simeon Trust have brought together resources to appoint a chaplain. In that rural area, that lady visits 140 people regularly to monitor them, to put them in touch with each other, to help to assess them face to face and to know when support from the medical and care system might kick in, so that people do not get to an acute moment. There is a community system of monitoring, care and contact.

That kind of model needs to be developed. The Dilnot report said that there has to be a new relationship between individuals and the care system. Beneath the radar of the formal care system, there are enormous resources in the voluntary community that can allow that to happen. Will the Minister consider how the Government, local government and the framework of formal systems can enable a small amount of investment to encourage voluntary and church groups doing this face-to-face work on the ground that provides the context for care and well-being to flourish and grow so that the demand for the major interventions that are so costly might be more controlled and probably reduced because of a better sense of well-being at grass roots level? I would be interested if the Minister could comment on that model and how it might be encouraged and developed to create greater capacity in our systems of social care and health provision.