Mental Capacity (Amendment) Bill [Lords]

Debate between Maria Caulfield and Barbara Keeley

2nd reading: House of Commons & Money resolution: House of Commons & Programme motion: House of Commons & Ways and Means resolution: House of Commons
Tuesday 18th December 2018 Commons Chamber

[Barbara Keeley]

Absolutely, we do, and that is a real concern. The Opposition’s concern is that we do not want to end up with a flawed piece of legislation replacing another flawed piece of legislation, and then to have to change it again.

It is worth noting that until yesterday the Government had not even published an equality impact assessment, more than five months after the draft Bill was first presented. Before that, the Government’s only published impact assessment was concerned solely with the cost savings that the new system would bring. That initial impact assessment is now woefully out of date, given the number of amendments made to the Bill in the House of Lords—I understand that more than 300 amendment were tabled. I pay tribute to the work of many peers in the House of Lords, including my colleagues on the Labour Front Bench, who worked to try to improve the Bill, despite the hurdles placed in front of them by the Government. Nevertheless, fundamental problems with the Bill remain that simply cannot be rectified by amendments.

We cannot support the Bill in its current form because, quite simply, it proposes to replace one deeply flawed system with another. I will come onto the flaws in the Bill in due course, but, first, I wish to address the need for substantial reform of the Mental Capacity Act, which we accept. We recognise that the deprivation of liberty safeguards system is deeply complex and bureaucratic, as the Law Commission identified in its report last year. Concerns about the deprivation of liberty safeguards predated even the Law Commission’s report, and we know that a House of Lords Committee declared the DoLS not fit for purpose in 2014.

The scope of DoLS is too narrow, applying only in care homes and hospitals. Authorisations outside care homes and hospitals have to be done through the Court of Protection, which is costly and cumbersome. It is clear, as we have already heard in this debate, that the explosion in the number of DoLS applications after the Cheshire West judgment left the system struggling to cope. The latest figures, as the Secretary of State has said, show a backlog of 125,000 applications. That, of course, leaves the person subject to the application potentially unlawfully deprived of their liberty. If the Government want to resolve that backlog, as they profess to, then the way to do it is to provide local authorities with the resources they need to process all the applications they receive. The Government should not be trying to hide their failure to fund local government behind a streamlined process that does not protect vulnerable people.

Although the deprivation of liberty safeguards need reform, and I agree that they do, the Bill deals with none of the challenges that have been outlined and creates some new problems that cannot be solved simply with further amendments. I am afraid we feel that the Government cannot be relied on to make the necessary changes during the remaining legislative stages given the resistance that they showed to making important changes in the House of Lords. On the contrary, the transformative spirit of the Law Commission’s draft Bill has been squashed, and the measures that would place the best interests of the cared-for person at the heart of the new system have been reduced.

The Government should have enacted the Law Commission’s proposals in full through the 15-clause Bill that was drafted, but instead we have this five-clause Bill. Why did they not simply bring forward the Law Commission’s proposals? The inescapable conclusion that we have come to from reading the Bill is that the Government are more interested in cost saving than in the best interests of cared-for people. This is a crucial point, because there can be disastrous consequences when the best interests of cared-for people are not taken into consideration.

[Maria Caulfield (Lewes) (Con)]

I say this in a spirit of co-operation on such an important issue. The Labour party amendment is to decline to give the Bill a Second Reading. Instead of trying to change the Bill and bring in some of the Law Commission’s recommendations, why, with nearly 200,000 people waiting to have a DoLS assessment, have the Opposition proposed an amendment to reject the Bill out of hand?

[Barbara Keeley]

That is a question that the hon. Lady needs to put to her own party. What has happened up to this point is that the Government have been asked repeatedly to pause, to carry out more consultation, and to consider redrafting the Bill. There is a list of 40 organisations that have asked for a pause and a redrafting of the Bill. This is a familiar situation from health and social care legislation—it has happened before in this House. The Government could have considered a pause, and the Minister for Care, the hon. Member for Gosport (Caroline Dinenage), knows that I have discussed that with her. The whole question really falls back on the Government.

Social Care

Debate between Maria Caulfield and Barbara Keeley

Wednesday 25th April 2018 Commons Chamber

[Barbara Keeley]

I will indeed, because given the cuts that many councils have been facing—I am sure Bristol is the same—these efforts to protect care services are really excellent.

I was talking about those London boroughs that have committed to pay care staff the London living wage, which, at £10.20 an hour, is way above the Government’s so-called living wage of £7.83—a commitment that is no small undertaking. That is a further example of the good that Labour-run councils are doing for the most vulnerable people in their communities. We on this side of the House—this ties in very much with the point that my hon. Friend has just made—see the need for social care to be valued as a career. At last year’s general election, Labour pledged to implement the real living wage for all care staff and to ensure that care staff were paid for travel time, that 15-minute care visits were scrapped and that zero-hours contracts were ended for care staff. Those are important steps, but we know that we have to go much further if we are to improve care quality.

It is clear from the reports of the Care Quality Commission that staffing levels are still a major issue in those care services rated as inadequate or requiring improvement. Much of the care workforce are underpaid, undervalued and overworked, which leads to high turnover and vacancy rates in the sector among care staff and, more importantly, the registered managers who are responsible for overseeing care quality. Improving pay for care staff will help with that, but we also need to commit to improving care staffing levels to reduce the workload pressure and offer better training and career paths.

The National Audit Office has criticised the Government for failing to have an up-to-date workforce strategy for the care sector and for their lack of oversight of workforce planning in local areas. Indeed, the Government have no major workforce strategy for social care. It was the Labour Government who produced the last strategy, in 2009. The head of the National Audit Office has said:

“Social care cannot continue as a Cinderella service—without a valued and rewarded workforce, adult social care cannot fulfil its crucial role of supporting elderly and vulnerable people in society.”

Skills for Care has a budget of only £21 million for care staff training, whereas Health Education England has a budget of £4.7 billion. That disparity in budgets between health and social care says it all about the Government’s lack of priority for improving the quality of social care.

At the 2017 election, Labour pledged an extra £8 billion for social care across this Parliament, with an extra £1 billion to ease the crisis in social care this year. That aimed to relieve the pressure on the social care system. It would have been enough to begin paying care staff the real living wage and would have sought to offer more publicly funded care packages for people with different levels of need. Today’s debate is not primarily about the long-term funding of social care, but Labour has made it clear that maintaining the current funding system is not an option in the long term. Recently, polling by the Alzheimer’s Society has shown that paying for social care is a growing public concern and that there is overwhelming public support for a cap on care costs. The next Labour Government will implement a lower cap on care costs than the cap set under the Care Act 2014. We will also raise the asset threshold to a higher level than under the current system.

[Maria Caulfield (Lewes) (Con)]

I am listening with interest to the hon. Lady’s opening remarks. I am obviously interested in the cap, in paying care workers more and in raising the threshold, but how would a Labour Government pay for that?