(1 month, 1 week ago)
Lords ChamberMy Lords, I too congratulate my noble friend Lady Keeley for her outstanding speech. May we hear many more from her.
Of late, we have heard quite a lot of brave words about the prospects for a national care service, but I am very sorry to say that I do not have a great deal of faith in the idea of grand schemes. For example, we have seen the creation of integrated care boards, but these are yet to have much of an impact outside the Whittington Hospital. As always, it is the funding that counts. As long as we have two types of funding arrangements, one for the NHS and another for social and community care, the latter will always be the poor relation. While local authorities continue to be starved of funds, we will always have major problems—and we have very little money. We have our brave new Secretary of State, Wes Streeting, laying out his ambitious plans, but it is inevitable that he will not be able to do everything, and we will have to ask: what is the highest priority? What will give us the biggest bang for our buck? That is where funding for social and community care should come top of the list. It is least expensive but will do the most to save the NHS. Think of the advantages that it would bring not just to the NHS—we all know about those—but to all those in desperate need in the community.
There are many practical solutions that we could adopt now. First and foremost, we must repair the damage we have inflicted on the caring staff. The way they are currently treated is nothing short of a national disgrace. Not only are they underpaid, they are completely undervalued. Some 20% of new recruits leave within 12 months for better paid jobs in supermarkets. Being a carer of those in need—the elderly or disabled—can be fulfilling, but not if you feel undervalued and underappreciated. There is little prospect of career progression and, as we have heard, if you last in the job for, say, five years, your pay is just 10p an hour more than you were getting when you started. Little wonder there are such high vacancy rates, and that the total numbers have held up only because of a cohort of foreign workers that sadly is now drying up.
But we can correct the problems. I follow the noble Baroness, Lady Tyler—we have to set up a national register of care workers so that they can be registered as the professionals that they are. We should assure that they are given a recognised qualification after a nationally approved training programme. Amazingly, that does not exist—they do not have a nationally recognised qualification. We should open up satisfying career progression, possibly even leading to a career in nursing. They should, of course, be paid at a rate that reflects the vital importance of their work that they do as caring professionals. It might cost a bit of cash, but think what we could save the NHS.
Secondly, as we have heard, there is the whole issue of the inadequate recompense that we pay those who care for relatives or friends at home. If you manage to jump through the tortuous series of bureaucratic hoops, you are allowed £76.70 a week, after you have had to give up paid employment to gain the full amount. Yet we know that the value of home care to the economy is at least in the order of £5 billion a year. Talk about slave labour.
Finally, there is the cap on the costs of care beyond which those in need have to pay—set so low that few can gain any support. It is now time for the Government to at least reconsider whether the Dilnot report can offer some help. These were proposals that last the Government almost adopted but finally scrapped. We will, of course, have to consider how we might provide the money, but I am running out of time. If noble Lords want to know more about what I think, perhaps they can read my book on how to save the NHS.