Social Care Reform

Paula Barker Excerpts

Wednesday 23rd June 2021 Commons Chamber

[Helen Whately]

Yes, absolutely. One of the strengths of our social care system is its huge diversity, with the different forms of social care and the different ways it works in different communities. In fact, that has been one of the challenges for the Government during the pandemic, because we are reaching out to over 25,000 different organisations, but actually that diversity is a positive thing, so I will continue to support it in the years ahead.

[Paula Barker (Liverpool, Wavertree) (Lab)]

Today marks 700 days to the day since, on the steps of Downing Street, the Prime Minister told the nation that

“we will fix the crisis in social care once and for all with a clear plan we have prepared”.

For clarity, this was before the global pandemic hit. I know, and the Minister knows, that the market has failed, and that that failure has been exacerbated by the pandemic, not created by it. Is it not time for the Minister to face the inconvenient truth that the only way to fund social care is through progressive taxation, with a diverse range of in-house services guaranteeing workforce standards and service user choice, under the umbrella of local government?

[Helen Whately]

The hon. Lady is right to say that when we went into the pandemic, the social care system already needed reform. That was well recognised, and that was why the Prime Minister committed back in 2019 that we would bring forward social care reforms—[Interruption.] I am not going to talk about tax policy here, but I can reassure her that we are working on our social care reforms and will bring forward the plan later this year.

Dementia Action Week

Paula Barker Excerpts

Thursday 27th May 2021 Commons Chamber

[Paula Barker (Liverpool, Wavertree) (Lab) [V]]

It is a pleasure to speak in this debate, and I want to thank the Alzheimer’s Society for its positive engagement with Members during Dementia Action Week. I also wish to note that 6 to 12 June is Lewy Body Dementia Awareness Week, which seeks to raise awareness about a common but seldom talked about form of dementia.

In Liverpool, just over 5,500 people are living with dementia, with that number set to increase by more than a quarter in less than a decade. Our ageing population means that the demand for social care services is set to increase dramatically. I refer to social care as the Cinderella service, one forgotten and avoided by successive Governments for too long. There has never been a more urgent time for reform of the sector. Its widely reported absence in the Queen’s Speech was much cause for concern. The pandemic threatens real financial instability across the sector, exacerbating the long-established crisis in social care. Under-occupancy rates in care homes are up and care home providers are failing to keep pace with demand.

There must now be a real acceptance by Conservative Members of some unavoidable truths. The first is that the market is not capable of providing the answers on putting social care on a sustainable footing. No longer can we continue to rely on regressive forms of taxation such as council tax to properly fund care. Local government should lead the reforms, but it must have the resources to do so and be able to provide a modern service, in house, where diversity of choice is respected alongside the care workforce who provide the care. That means decent terms and conditions, including good wages, as well the professionalisation of the sector, so that the workforce can grow and develop. A failure to do this will mean that the vacancy problem that exists across the sector will only worsen. If the levelling-up agenda is to be credible, social care reform should be front and centre of a strategy to reduce health inequalities in later life across all our regions.

My office and I are due to become dementia friends in the coming weeks. The information that Dementia Friends emphasises is that there is more to a person than their dementia. That sentiment should be at the heart of tailored dementia care that respects the needs and wishes of individuals and, again, of the workers looking after our most vulnerable. In bringing forward their social care reform proposals, the Government have an opportunity to bring about real change. Based on their record to date, I will not be holding my breath.

NHS Pay

Paula Barker Excerpts

Wednesday 24th March 2021 Westminster Hall

[Paula Barker (Liverpool, Wavertree) (Lab)]

I beg to move,

That this House has considered NHS pay.

It is a pleasure to serve under your chairmanship, Mr Hosie. I thank my hon. Friends the Members for Luton South (Rachel Hopkins) and for Birkenhead (Mick Whitley) for co-sponsoring this debate. I am pleased to have been allocated such a generous amount of time for the debate. That is entirely justified given the importance of the subject at hand—NHS pay.

I thank all those who have taken the time to sign the following petitions: e-petition 300073, signed by more than 170,000 people and titled “Increase pay for NHS healthcare workers and recognise their work”; e-petition 316307, titled “Award all Nursing Staff in the NHS a pay rise of 10% backdated to 1 April 2020” and signed by more than 140,000 people; and e-petition 560253, which is titled “Recognise all members of NHS nursing profession by giving them a 12.5% pay rise”, has been signed by more than 19,000 people and does not close until 7 June.

[Jim Shannon (Strangford) (DUP)]

I sought before the debate the hon. Lady’s permission and your permission, Mr Hosie, to intervene. The petitions before us are an indication of the numbers of people across the whole United Kingdom who feel strongly about this issue. The people emailing me are not just NHS workers. They are families; they are people who have been recipients of the goodness of NHS workers. I believe that there is a moral obligation on us—I have said this to Government as well—to deliver a satisfactory pay increase for nurses. We need to give them a rose of appreciation in the springtime, not a dandelion.

[Paula Barker]

I completely concur with what the hon. Gentleman has said.

The figures that I have given lay bare the strength of feeling that people in our communities have for our incredible NHS staff as a whole. People who know me and have listened to any of my previous contributions on the public sector will know that I like to set the historical context, that context being the last decade and the political decisions taken by the Conservative party in office during that time, especially on matters of public spending and public sector pay—matters that are very close to my heart. During debates such as this, the Government may like to pretend that the pre-pandemic world does not exist. According to them, decisions that they take during the current economic crisis should be taken in the context of spiralling debt and deficits, as well as the looming prospect of inflation. But we have been here before, have we not, especially given that the last economic crisis was not too long ago? The Government are starting to sound like a broken record stuck on repeat, using the same smokescreens that they used in the early part of the last decade, which laid the pretext for an outright assault on public sector pay.

Public sector workers, and not least the brave women and men who staff our national health service, have long memories. What is it that I am referring to that existed at the front and centre of the NHS worker psyche going into this pandemic? It is the fact that nurses’ pay is down £840 in real terms since 2010. Further to that, the likes of the Health Foundation have stated that at the start of the pandemic, NHS wages were £600 lower per employee in real terms than in 2011-12. It is the fact that staff morale is at rock bottom, with many leaving certain NHS professions and the Government failing most spectacularly to fill the gap in staff shortages—nearly 50,000 combined vacancies exist across doctor and nursing professions. It is the fact that workers have had to endure rising demands on their work with less reward.

That is what NHS workers, who make up 4% of our entire labour market staff, have had to suck up since 2010 in order to pay for an economic crisis—a crisis in the casino economy that they had no part in creating. According to research delivered by London Economics for NHS trade unions, pay levels at every single Agenda for Change spine point have lagged behind inflation since 2010-11, resulting in a significant decline in total pay in real terms. Most spine points have exhibited a decline in excess of 10%, and total pay on the Agenda for Change spine point with the highest incidence of staff, at the top of band five, has declined by 15%. That is three times the decline in median earnings experienced by full-time private sector employees across the UK over the same timeframe.

Let all of us here today contextualise the debate by reflecting on the picture faced by our brilliant NHS staff before and going into the pandemic. They have had their pay cut, their spending power slashed, their living standards squeezed, and their morale smashed. That is the so-called old world that the new kids on the block—the Prime Minister and the Chancellor—would rather us all forget, one built by their predecessors. However, no amount of rebranding will disguise the fact that the current Government intend to continue the same legacy of making public sector workers pick up the tab for a crisis they had no part in creating. Indeed, this time it is even worse than that. They are paying for a crisis that they have ensured we have, and will, overcome. Some thanks, I say, and shame on this Government.

In this new decade, the message being received by NHS workers from the Government is this: brace yourself for more of the same. Staff in our NHS have had to endure all of that, and then 12 months ago were asked to once again go above and beyond, to gravely enter the unknown, risking their mental and physical health. They have sacrificed their family and personal lives. Some have paid the ultimate sacrifice of their own lives in the line of service, duty and compassion.

Let us cast our minds back to how terrifying the news headlines, the newspaper stories and social media chatter were when the virus first emerged on these shores. The virus was the absolutely terrifying unknown for all our people, except for our NHS workers who were not afforded the luxury of watching this public health crisis unfold from the sidelines as passive observers; they were the frontline against the great unknown.

To this day, their unrelenting commitment to the public service still moves me, as it should all people here today in Westminster Hall. I am not one to often quote Winston Churchill, or indeed make wartime references, but never was so much owed by so many to so few. If any of this brave few were able to come up for breath for just a moment, maybe because of their shift patterns, and sit in front of a TV screen on a Thursday evening last year, they would have seen many ordinary folk applauding their efforts. They would also have witnessed the galling sight of the occupiers of No.10 and No.11 clapping for the photo op, with little intention of rewarding them for their work, their sacrifice or their trauma.

Appreciation of NHS workers is not about rhetoric, warm words and pats on the head. Let me be absolutely clear. Claps and smiles do not pay the bills. It is about deeds and actions, and when it comes to NHS pay, the only deeds and actions made by the Government have been a fresh round of insulting pay offers, or, in real terms, pay cuts.

The Prime Minister recently told the House of Commons that the Government have delivered a 12.8% increase in the starting salary of nurses. It may well be true to say that some—but not all—nurses have received a pay rise of more than 12% since 2017-18. However, that is in cash terms, not in real terms, and it does not account for the fact that inflation erodes the spending power of workers’ wages over time. It is a flattering figure in other ways: it applies only to one group of nurses rather than reflecting the experiences of all NHS workers in England, and it does not take into account the years of austerity that defined the years prior to 2017-18. The Government cannot spin an assertion that they are awarding pay rises when millions of NHS workers know the exact opposite is true.

All we ever hear from the penny-pinchers that occupy the Government Benches is that we cannot afford this or that—basically, anything of social value or any moral good. The old mantra that public sector equals bad and private sector equals good is making a return. This tired politics draws the economic orthodoxy to the conclusion that suppressing public sector pay is of economic benefit in times of crisis, rather than the opportunity to grow the economy that it represents. It is almost as if a decision has been taken according to the same logic that public wages are a drain on the public purse and therefore a resource to be tapped into in order to control public finances when it suits.

It is sound economics to deliver a just and fair pay rise for NHS staff and a decent pay rise is affordable. Currently, just over 1 million nurses, midwives, allied health professionals and NHS support staff are covered by the Agenda for Change pay framework in England. The same aforementioned research conducted by London Economics concluded that a 10% increase to the NHS England pay bill amounting to £3.4 billion would result in the net expenditure of only £0.66 billion when including factors that are offset against the original figure.

Such offsets include increased tax receipts, because public sector workers pay taxes, and increases in direct, indirect and induced tax receipts, because public sector workers spend money in their local areas that helps to grow local economies and support communities. A pro-public sector agenda is a pro-business agenda. It is a miracle that public and private sector workers exhibit similar economic behaviours—who knew?

There would also be savings in recruitment and retention, because better paid staff are happier staff. There is even an extra £130 million in savings from the lower student debt write-offs for nursing students. This is the sort of sensible, moral and longer-term economic thinking the Government are totally incapable of. Instead, we have crumbs for midwives and support staff; their dignity, livelihoods and take-home pay is unaffordable, according to this Government, but not lucrative, publicly funded contracts for the friends of Tory Ministers to deliver personal protective equipment shortages and botched public health projects to the tune of billions of pounds. Apparently, that sort of spending is every bit affordable: in fact, we are told, it should be celebrated. Not only do we have a Government guilty of cronyism, but of skewed priorities. We see that only too well today when not a single Conservative Member apart from the Minister is here for this debate.

Government policy on the NHS tells us everything that we need to know. Nurses, midwives and support staff are left neglected, their immense contributions disregarded, forgotten by a Government and party intent on reverting to type. There is no policy impact assessment, as the real burden for public sector pay restraint will once again fall on the shoulders of women who make up so much of the public sector, especially our NHS. There is no regional impact assessment on areas more reliant on public sector spending, such as my city of Liverpool—so much for the levelling-up agenda.

To round up, the public overwhelmingly support a pay rise for NHS staff because they, like me, understand and appreciate their service each and every day; in times long before covid, during it and long after. They are out on the frontline, as I speak here today, delivering vaccine shots in the arms of millions of people, as well as catching up on the huge backlog of urgent elective care procedures while the Government parade around this place telling us that the economics will not permit just recognition and reward. If any group of workers in our National Health Service collectively decide that enough is enough and they embark on a course of industrial action, they will have unwavering solidarity. I appeal to the Government to change their course, walk the walk on NHS pay and give the NHS staff the pay rise that they so deeply deserve.

--- Later in debate ---

[Paula Barker]

I thank all the hon. Members who spoke today and all the hon. Members who applied to speak but were unable to do so because the debate was over-subscribed. I hope today’s debate will go some way towards demonstrating to our incredible NHS workers that they are valued by some people in this place.

I am astounded that the Minister has come here today to try to defend what is, frankly, indefensible. I extend an invitation to the Minister to meet the NHS staff that I speak to, because they will tell her that what they need and want is a pay rise.

I am horrified to hear that some things are non-negotiable, yet NHS staff do not seem to fall into that category. I assure every worker who has held the hand of someone in their last moments, who has comforted family members who were unable to be with their loved ones at the end or who is currently vaccinating people to ensure that the spread of this virus comes to an end, that I, and my colleagues on the Opposition Benches, will continue to fight for the pay rise they deserve, and the dignity that they should be afforded, because that is what we believe is non-negotiable.

The Minister’s Government has the power to do the right thing. They do not have to wait for the pay review body to tell them what the majority of people in this country already know. If there are billions of pounds for Serco’s failed Test and Trace and for failed PPE contracts, there is money to reward those who have personally given so much during the pandemic. Our NHS staff must be awarded a decent pay rise because nothing less will do.

Question put and agreed to.

Resolved,

That this House has considered NHS pay.

Covid-19

Paula Barker Excerpts

Wednesday 18th November 2020 Commons Chamber

[Paula Barker (Liverpool, Wavertree) (Lab)]

I am delighted to start my contribution to this debate by paying tribute to the key workers on the frontline of this pandemic. Their commitment to public service and their selflessness in the face of the most severe of circumstances set an example to us all.

I am deeply concerned by the dangerous polarisation on public health measures that have been implemented to save lives, and that is what I want to focus on. I am sure that Members across this House have been inundated with correspondence from constituents sharing very legitimate concerns about restrictions that have been imposed in order to protect the NHS, keeping us agile enough to deal with covid, while thousands of elective care patients have had procedures and treatments delayed. This suffering is real. The diversity of the issues raised is phenomenal, spanning mental ill-health, business support, attendance at funerals, redundancies, access to universal credit, and care home closures. We also receive correspondence from constituents reasonably seeking to clarify the rules in respect of their own actions.

On the other side of the coin, we have all received correspondence from angry constituents—on occasion aggressive, even abusive—about the restrictions that this Parliament has collectively implemented, under great duress and with an increasingly heavy heart. Aggression and abuse are never acceptable, but the anger is justified, and it is not taken lightly; neither is it dismissed by anyone in this place, especially coming from those many constituents who have fallen on hard times.

However, I want to shine a spotlight on some of the more sinister and fringe drivers of that anger. A cause for growing apprehension is the misinformation, the fake news and the dismissal of science in the post-truth world that a small number of hardened minds occupy. Assertions are made, social media lies are repeated, and distrust in our institutions, our scientists and our elected representatives is sown in reference to their motives. That translates into real-world consequences. This ugly underbelly has seen a small number of aggressions against those in Liverpool waiting patiently in line to be tested. There have been megaphones outside school gates screaming at parents and pupils about testing, confrontation sometimes of those wearing masks, and the outright dismissal of the growing prospect of a vaccine—a prospect that is giving so much hope to a beleaguered population who yearn to return to some normality.

It is apparent that much responsibility for such behaviour lies with social media platforms: most people receive their information through that medium. People currently have many insecurities, both health and economic, and the misinformation plays into these deeply held fears and is easily shared at the click of a button. My colleagues on the Front Bench are right: the producers of such material should be denied a stage to peddle these lies and myths that have no basis in truth. Ahead of the delivery of a vaccine, we cannot let the naysayers spread further mistrust when so much is at stake for all our people.

Oral Answers to Questions

Paula Barker Excerpts

Tuesday 17th November 2020 Commons Chamber

[Matt Hancock]

I am very happy to meet my hon. Friend and to discuss with him how we can strengthen the services that are available across Dorset, especially as the population is not as dense as in some other parts of the country. We need to ensure that we get services out into the community, rather than just in the big cities.

[Paula Barker (Liverpool, Wavertree) (Lab)]

Our home care workers have gone above and beyond during the pandemic. Tragically, they are some of the lowest paid workers in the entire labour market. Does the Secretary of State agree that there is a role for local government, as the commissioners of home care services, in strengthening enforcement of national minimum wage legislation to ensure that no home care worker, anywhere, is not properly paid for travel time between visits?

Covid-19

Paula Barker Excerpts

Monday 16th March 2020 Commons Chamber

[Matt Hancock]

It is the headteacher, and there are discussions with regional schools commissioners in such cases in England. We are looking to address that issue in the Bill.

[Paula Barker (Liverpool, Wavertree) (Lab)]

I join other Members in placing on record my condolences to the families of those who have lost loved ones. I pay tribute to the workers in the NHS who are working around the clock and to those working in social care.

After a decade of austerity, our NHS and public health were already at breaking point, even before the coronavirus hit our communities. Public sector workers have borne the brunt of austerity over the past 10 years, and they are the very workers who are expected to continue to provide services to the most vulnerable people in our society.

Today, I have been contacted by Paul, a critical care nurse in my constituency who has had to self-isolate after developing a cough. He has been told that he will not be tested. His skills, along with those of his colleagues, are vital to care for patients. Frontline staff need to be—

[Mr Speaker]

Order. We are going to have stop the question there because we have to get everybody in.

[Paula Barker]

Can I just say this, Mr Speaker? When will local government be provided with the additional ring-fenced funding for public health? When will public health officials be provided with their allocations for the new financial year?

[Matt Hancock]

I have addressed the question on testing repeatedly. I am delighted that we go into this situation with a record number of people in our NHS, and I pay tribute to each and every one of them.

Social Care

Paula Barker Excerpts

Tuesday 25th February 2020 Commons Chamber

[Paula Barker (Liverpool, Wavertree) (Lab)]

A hugely fragmented provider landscape has been one of the major problems in the social care sector. Hundreds of providers are operating in some areas, and most councils have experienced provider failure or the return of contracts. The Government’s fears about providers going out of business may explain their reluctance to clamp down harder on companies that are failing to fulfil their minimum wage obligations. Britain’s four largest privately owned care home operators have built up debts of £40,000 per bed, which means that their annual interest charges alone absorb eight weeks of average fees paid by local authorities on behalf of residents. Despite that, HC One, the UK’s biggest care home operator, has still managed to pay out more than £48 million in dividends in recent years.

A report produced recently by the Centre for Health and the Public Interest demonstrates just how much money is allowed to leak out of the social care sector in the form of, for example, profits, rent and interest payments, with the level of leakage far higher among for-profit providers. Any funding boost for social care must therefore be accompanied by meaningful reform of the sector which moves away from the failing markets and, instead, embraces a vision for care that puts a public sector ethos and core ethical requirements at its heart.

As we heard earlier from my hon. Friend the Member for Blaydon (Liz Twist), a critical part of social care must be to produce a workforce who are fairly rewarded and properly valued. Careworkers have been absent from much of the discussion about implementing the NHS long-term plan and developing the final NHS people plan, although the future vision for the NHS is one that brings health and care closer together. As the House of Lords Economic Affairs Committee pointed out:

“The care workforce needs a career structure which better reflects the skills required to be a good care worker and the social importance of the sector.”

The Nuffield Trust recently stated that

“a realistic and comprehensive workforce strategy is needed to combat the chronic recruitment and retention crisis that that is affecting the social care sector.”

Recent work by the Institute for Public Policy Research has begun to point the way towards the development of a workforce strategy for the sector, with a focus on proper pay, professional registration, and improved training and development. Working in care needs to become an attractive career choice if social care is to shed its unwanted reputation as a low status, high turnover sector. My trade union, Unison, recently launched the Care Workers for Change campaign, which calls for a real living wage as a minimum, fair contracts, no zero-hours contracts, and enough time to care and a safer working environment for our incredible careworkers.

I sincerely hope that cross-party talks are constructive and meaningful. I therefore ask the Government to enact meaningful market reform of the social care sector that moves away from the current landscape of fragmented providers, and to develop an effective workforce strategy so that staff are fairly rewarded and properly valued.