Social Care Funding

Baroness Keeley Excerpts

Tuesday 1st October 2019 Westminster Hall

[Barbara Keeley (Worsley and Eccles South) (Lab)]

It is a pleasure to speak in a debate with you in the Chair, Sir Charles. I think that this is the first time I have done so. I join others in congratulating the right hon. Member for Twickenham (Sir Vince Cable) on securing this important debate.

The number of Members contributing in this debate makes clear the appetite to speak on the matter, and it is a pity that more Government time—or even an Opposition day debate—has not been allocated. It is appropriate that on this International Day of Older Persons we have talked largely, though not entirely, about older people. That should remind us all that growing old with dignity is a fundamental right that we should all enjoy.

By my count we have heard 12 Back-Bench speeches and six interventions, and by the time we get to the Minister we will have heard three Front-Bench speakers. Many have rightly focused on the cuts to social care budgets and the harm caused to people who rely on and need social care. We have heard powerful examples of the impact of those cuts. That harm, however, is not inevitable. If social care is properly funded and delivered well, it can be life changing. My hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) gave an example of how life can be changed in the wrong way if social care is not available.

Social care can keep someone connected to their community rather than isolated and lonely. It can support people to live the lives they want to live, rather than just survive from day to day—sometimes not even that—when the care disappears. But that is not what our social care system looks like today. Over the past nine years nearly £8 billion has been taken out of local councils’ social care budgets as a result of cuts. Hon. Members have mentioned the swingeing cuts experienced by many local authorities. As a result, hundreds of thousands fewer people are receiving the care they need. That is the straightforward result of the cuts.

Age UK tells us that 1.4 million older people in this country are struggling with everyday activities. Whether that means getting washed or eating a meal, they are not getting the help they should be getting. Older people are being left trapped in bed all day and perhaps going unwashed all week because their children can visit them only on weekends. They are having only microwave meals, because that is all their neighbours or family friends have the time to buy in for them. That is not what this country’s older and disabled people deserve.

I am glad that many hon. Members have mentioned the immense pressure that the state of our care system puts on unpaid carers. Wherever the Government pull back from funding social care properly, the UK’s millions of unpaid carers have to step in. As we have heard, that includes young carers in the constituency of my hon. Friend the Member for Plymouth, Sutton and Devonport (Luke Pollard). It is very important to identify and support those young carers. I have tried three times to bring in legislation, including to identify young carers. The Minister’s predecessor did not support it, but we could still do it. I might give the Bill to my hon. Friend so that he can resurrect it.

It is a dire picture, including for young carers. Half of unpaid carers now spend 50 hours a week providing care, while 38% spend 100 hours of every week caring. One quarter of carers have not received any support, either for themselves or for the person they care for. Two thirds of carers say that they do not get as much social contact as they would like with other people. More than eight in 10 say that they cannot spend time doing things that they enjoy or value, and 40% of carers say that they have not had a day off for more than a year. In fact, a recent Carers UK report noted carers saying that if they had a respite care break, they would use it to visit their own GP for a medical appointment, which is very sad.

Even for the smaller number of people who manage to get a social care package, cuts mean that the care provided will not be of the quality expected. One in five social care services has been rated by the Care Quality Commission as either “inadequate” or “requires improvement”. The number of complaints to the local government ombudsman about social care provision has trebled since 2010, rising to more than 3,000, and two thirds of those complaints are upheld. There is very much wrong with our system. I find it deeply concerning that one in five care homes, housing as many as 9,000 older and disabled people, are now rated as unsafe.

These are not services that any of us would like a family member to have to rely on. The situation can mean care homes that are so unclean that residents are at risk of infection, or residents being at risk of malnutrition because nobody is monitoring what they are eating. Care in one’s own home can mean visits by staff who have not been subject to basic checks or who have not completed any training. It can mean staff being so rushed that they do not have time to take off their coat while they are getting people up and dressed. The reality is that some care providers cannot provide high-quality services with the funding available; sadly, other providers choose to protect profit margins rather than the people who use their services.

That issue is clearest in the social care workforce. There are 1.4 million people—or there would be, if the vacancies were filled—working in social care. These people provide vital support day in, day out, but they simply do not get the respect they deserve for the work they do. More than a quarter of those care staff work for a minimum wage, and the same proportion of the workforce are on zero-hours contracts. It is no surprise therefore that there are 110,000 vacancies in the care sector. Those important issues have been touched on by many Members in this debate.

Rather than providing the empathetic care that they want to offer, care staff are often reduced to visits lasting 15 minutes or less. They must rush through their tasks with barely any time to talk to the person they are visiting. This deterioration in the quality of care is the result of nearly a decade of cuts, care staff stretched to breaking point and services that barely deserve to be called “care”. Hundreds of thousands of people have to go without basic support.

[Melanie Onn (Great Grimsby) (Lab)]

My hon. Friend is making an excellent speech and paints a picture of social care in this country. On 15-minute visits, does she agree that the issue is not just the time limit but the ever-changing individual presence? With vulnerable people, consistency of care and the ability to build up a relationship are equally important.

--- Later in debate ---

[Barbara Keeley]

My hon. Friend is absolutely right. For people with dementia and learning disabilities, seeing a familiar face every day can be crucial.

We cannot allow this crisis to continue. We must see action to ensure that everyone is able to access the care that they need to live with dignity. That is why Labour has announced that we would introduce free personal care for all older people who need it and expand such provision to working-age adults as soon as possible. That would end the scandal of people having to sell their home to pay for basic care. We will fund social care in the only fair, sustainable and understandable way—through general taxation. That is how we fund our NHS and our schools, and it is how Labour will fund our national care service.

Before we can build this new system, we must also repair the damage caused by years of budget cuts. We will invest £8 billion in more care packages, in improved training and in better community support. The apprenticeship levy is not enough for training; skills for care should be better funded.

[Kevin Hollinrake]

Will the hon. Lady give way?

[Barbara Keeley]

I do not have time.

A few months ago, we pledged £350 million a year for community resources, aimed specifically at helping to bring autistic people and those with learning disabilities out of in-patient units—over 2,000 of them—in which they are trapped. It is a scandal that we do not have the social care and community resources that are needed to prevent people being trapped in abusive care. Time and again, the reason given for people being in those units is that there is no resource in the community. My hon. Friend the Member for Plymouth, Sutton and Devonport has spoken about the burden that falls on social care authorities if they end up with a very expensive case. We have to get round that.

We can fix the crisis in social care only by properly funding the system, as the Labour plans will do. Two years after the Conservatives’ disastrous 2017 manifesto plans, which were later dropped, we are still waiting to hear what they will do. The Government’s promised Green Paper has been delayed and delayed, and now it looks to many—including many in this Chamber—as if it has been dropped altogether. The hon. Member for St Ives (Derek Thomas) mentioned how embarrassing that was. It is not just embarrassing; people lose hope waiting for the care they need.

A cap on care costs, which would stop people facing catastrophic costs, and for which we legislated, was ditched by the Government in December 2017. I am sorry to say that instead the Government have provided only small, one-off cash injections—sticking plasters—rather than the long-term funding settlement that social care needs. Will the Minister tell us where the Government’s proposals on social care are? If the Government want to resolve the crisis that their funding cuts have created, as I hope they do, why have they constantly kicked social care funding reform into the long grass? It is time for a solution to the crisis that this Government have created. Labour Members have pledged a way to solve the crisis, which in itself gives hope to many people who need social care.