Local Government Responsibilities: Public Services

Baroness Keeley Excerpts

Wednesday 18th March 2020 Commons Chamber

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

I beg to move,

That this House has considered the statutory and broader local government responsibilities for public services, including social care.

In the coming weeks and months, it is right that the Government focus on the fight against coronavirus. Local government will be on the frontline of that fight. Local services, from social care and public health to bin collections and now, most importantly, support for volunteering, will help us to overcome the challenge.

It is a time of uncertainty for many people across the country, and the Government need to provide as much certainty as they can. One thing we know is that older people, and those with underlying health conditions, are at greater risk from coronavirus than the rest of the population, as is clear from the social distancing guidelines issued for those groups this week. That means that, in the coming months, social care will be more important than ever because it not only helps to keep hospital beds clear for those who need them, but touches the lives of some of the most vulnerable. Care staff, therefore, will often be on the frontline of our efforts to stop the spread of the disease.

We are particularly concerned about home careworkers, who might provide care for up to a dozen older and disabled people in their homes every day. We want all necessary measures to be taken to protect care staff and the people they work with. As with the NHS, an important part of the solution is personal protective equipment and measures for infection control.

Care providers will face extra costs due to the need for more personal protective equipment and for enhanced cleaning of care homes and people’s own homes, and other measures to minimise the spread of infection—for example, zoning some staff in care homes. Last week, I raised with Ministers the fact that providers have faced great difficulty in obtaining personal protective equipment, and that also applies to infection control products, hand wash and disposable hand towels.

The care sector is extremely worried about being able to get essential supplies such as personal protective equipment. Commissioners can mitigate that by funding the extra costs and by helping providers to access personal protective equipment, perhaps by using some of their own contracts. The Government need to give guidance to local authorities and care providers, however, on the provision and use of personal protective equipment for careworkers and on whether help with accessing supplies can be given to reduce the spread of coronavirus.

We have just had a debate on statutory sick pay, which is particularly important for care staff, who are on the frontline of the outbreak. If they are ill, it is vital that they follow the public health advice and self-isolate, but the reality, as we heard, is that many care staff, like other staff, cannot afford to do so. Even if they are eligible for statutory sick pay, which we do not think they all will be, it is only £94 a week. The Minister needs to set out now what the Government will do to ensure that no careworker has to choose between doing the right thing and facing overwhelming financial problems.

Care providers are also facing increased cost pressures due to staff self-isolating or being off sick. It is right that statutory sick pay will start at day one, rather than day four, but that will increase employers’ liability for statutory sick pay. Requirements for workers to self-isolate will further increase financial pressures on employers. Given that, in virtually all cases, care providers will have to backfill sickness absence to ensure the continued delivery of support, that represents a real cost pressure on providers. With local authority budgets stretched, how can they support care providers to provide for extra statutory sick pay, the cost of backfilling care staff and the personal protective equipment and other materials that will be needed to get through the crisis?

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

My hon. Friend is making a compelling case for why the Government should announce specific support for the social care sector. I noticed yesterday that the Chancellor did not make specific reference to the social care sector which, as my hon. Friend points out, is in a fragile state and under enormous pressures. Is it not time for specific support for the social care sector to be announced?

[Barbara Keeley]

I agree with my hon. Friend. It is great to hear that the NHS will get what it needs, but what about the social care sector?

We know, as my hon. Friend just said, that many care providers were already on the brink of collapse. Many will not have reserves to fall back on. I ask the Minister, as my hon. Friend just has: what will the Government do to sustain care provision and ensure that care providers are able to carry on delivering care at this time?

[Gareth Thomas (Harrow West) (Lab/Co-op)]

My hon. Friend is making a good point about social care in the broader sense. I want to raise the needs of local charities, some of which provide social care, and others provide a range of other services. Does she know whether some of the funding that the Government have allocated to local authorities will be earmarked to support continued funding of those local charities and community groups, or whether that has not yet been considered?

[Barbara Keeley]

That is a very good question, and we should ask it in addition to the questions that I will ask, because the independent and voluntary sector is vital in our communities and in care provision.

I want to touch on the issues facing care homes across the country. We know that the Government are asking older people to avoid social contact for the next three months, but we need to be clear—clearer than we have been—about what that will mean for people in care homes. Will the Government recommend that all visits from friends and family be stopped until June? Can the Minister tell us what guidance on visits they are giving to organisations running care homes? Providers and their networks do not seem to have had any clarity yet.

The Care Quality Commission has announced a pause in its inspections, freeing up staff time to focus on care, but today it has published its independent review of Whorlton Hall. That was a shocking scandal. People with learning disabilities and autistic people and their families will want reassurances that, once this crisis passes, the CQC will focus its full efforts on ensuring that something like Whorlton Hall never happens again.

Many older and disabled people do not receive formal social care. Instead, they rely on unpaid friends and family. I know that many unpaid carers are worried that they will contract coronavirus or have to self-isolate and be unable to give the care they normally do. What steps should any unpaid carer who has symptoms of coronavirus take? If they are being asked to self-isolate, what alternative care can be provided at short notice? If someone cares for a person they do not live with, what steps can be taken if the carer has to self-isolate or if the Government have to further restrict travel, as many unpaid carers live some distance away from the people they care for?

Young carers—children and young people—may need more support than others in managing the changing situation in their lives, especially if their local supermarket or pharmacist does not have supplies. It is important that, if schools or years within schools close, it is understood which children within those schools are identified as young carers. It is often the case that a school or a teacher within a school is the only person who knows that one of their pupils is looking after someone at home. Schools could nominate a lead person to make regular contact with young carers during this difficult time when they are not in school.

Another major issue facing carers is the supply of medicines, hygiene products and food. Carers have to source supplies such as antibacterial wipes or disinfectant themselves. Unfortunately, we have seen panic buying of those goods, making them far harder to acquire. What can the Government and local authorities do to ensure that unpaid carers and the people they care for do not have to go without crucial supplies, including food?

The Government’s reasonable worst-case scenario implies that we can expect to see one in five workers off sick at the same time. There are an estimated 122,000 vacancies across social care currently—a workforce problem that we know forces existing care staff to cut visits short or work beyond their paid hours. It is understandable that people receiving care and unpaid family carers are very concerned about how care can be provided if we get to a situation where large numbers of care staff are off sick or self-isolating.

In the coronavirus Bill, the Government want to make changes to the Care Act 2014 to enable local authorities to prioritise the services they offer, in order to ensure that the most urgent and serious care needs are met, even if that means not meeting everyone’s assessed needs in full or delaying some assessments. I am sure that we will discuss those measures when we consider the Bill next week, but the guidance on the Bill says:

“Local authorities will still be expected to do as much as they can to comply with their duties to meet needs during this period and these amendments would not remove the duty of care they have towards an individual’s risk of serious neglect or harm.

These powers would only be used if demand pressures and workforce illness during the pandemic meant that local authorities were at imminent risk of failing to fulfil their duties and only last the duration of the emergency.”

I know that people who are worried about this will want to hear any further guidance on the circumstances under which the powers would be used. Finally, I want to touch on some of the issues facing specific groups who are receiving social care.

[Gareth Thomas]

I am grateful to my hon. Friend for giving way to me a second time. Is there not also a broader point about certainty of future funding for local authorities and certainty about which of the additional costs they face from coronavirus will be met by central Government going forward? My local authority, which is not by any definition well off, is concerned about when it will receive clarity from the Government on which costs it can reasonably expect Ministers to cover.

[Barbara Keeley]

My hon. Friend is absolutely right. We will need certainty about those things when we look at the coronavirus emergency Bill, which we will do shortly, but this lands on local authorities at a time when they do not have any certainty. There is much about their financial position that needs to be made clearer to local authorities. I also agree with my hon. Friend: my local authority has had budgets cut by more than 50% since 2010, and we were in what we were calling a crisis in social care even before this happened.

I want to talk more fully about people with dementia and people with learning disabilities. There are a million people with dementia in this country and many people with learning disabilities. Not all of them will be able to comprehend the importance of self-isolation and then act appropriately. What measures and guidance will the Government introduce to help people with learning disabilities or dementia to self-isolate? Many working-age people with disabilities may be more vulnerable. Conditions such as Down syndrome or multiple sclerosis could increase the risk of respiratory infection, and the guidance suggests that people with these conditions would self-isolate. Can the Minister tell us what financial support will be available for them and their families if they have to stop work to do that?

We understand that this is a difficult and challenging time for all, but the Government have talked of using volunteers in health and social care services. People with disabilities and older people who need care have some of the most complex care needs. How will the Government ensure that people with complex needs continue to receive the support and care they need to stay in their own homes?

[Theresa Villiers (Chipping Barnet) (Con)]

In this crisis we need to make the most of volunteers and that spirit in the community of helping out, but at the same ensure that things such as Disclosure and Barring Service checks are done appropriately and that vulnerable people are kept safe from other risks, including those of unscrupulous interveners.

[Barbara Keeley]

I thank the right hon. Member for that intervention. I think most of us are concerned in our constituencies to ensure that we have enough people to help out, but do not have the wrong sort of people getting involved. We do not want to start seeing scams and people defrauded, because that would be a terrible way to proceed.

We need to look at how far we can stretch the idea that volunteers can help in health and social care, because in certain situations—for example, an elderly person with very poor skin condition, with sores, who needed particular lifting, or somebody who was PEG-fed, using percutaneous endoscopic gastrostomy—we cannot even use DBS-checked volunteers.

[Dame Diana Johnson]

There are people who genuinely want to help and do their best for their community, but I am concerned to ensure that DBS checks are in place—an issue that has been alluded to—and also about infection control, which fits nicely with what my hon. Friend the shadow Minister has just said about some of the procedures that people may be asked to help with. There are real questions about the training and the infection control that need to be in place if we use volunteers.

[Barbara Keeley]

Very much so. I am following all the social media input from my constituents, and I am glad to see that people are very keen to help. However, we must be careful, because we are talking about very vulnerable people, often with complex care needs, and we do not want to put them into difficulties through the efforts of volunteers, so we need guidance on that point.

Let me turn to self-isolation. I had to self-isolate for five days last week, and I know it is not easy, but it will be particularly hard for people with anxiety disorders, who rely on a routine to cope. Both now and once we are on the other side of this, what support will the Government be offering to help address the mental health consequences of the pandemic and of self-isolation or shielding for long periods? I noticed in the media that there were programmes showing what is being done in Wuhan in China, with hundreds of counsellors talking to people on a phone helpline, talking them through the difficulties they were experiencing. I think we may have to be thinking about something like that. In particular, many older people are now looking at several months potentially locked down in their own home, so what can the Government do to ensure that those people do not become lonely and isolated, with all the mental health consequences that would cause?

The challenges facing local government over the coming months are not limited to social care. The Government finally published yesterday the public health grant for the next financial year. Between 2014-15 and 2019-20, budgets were cut by £870 million, although there has been an increase to the grant this year. While the publication of the allocations finally provides some certainty to local authorities, the reality is that their public health functions are likely to be focused on coronavirus for the foreseeable future. Public health services such as smoking cessation are vital to prevent people from acquiring long-term health conditions such as chronic obstructive pulmonary disease, which can make a future case of coronavirus more serious. Will the Minister commit to allocating further money to public health if local authorities need it to keep people safe during the crisis?

The other major area of concern is homelessness. The Secretary of State for Housing, Communities and Local Government announced a fund yesterday to help local authorities provide accommodation for homeless people who might have coronavirus, which is welcome, but given the scale of the homelessness crisis in this country, can the Minister tell us whether that fund will be topped up if needed? We do not want local authorities to have to ration support now because they think they might need some of it later.

I understand we are expecting a statement at 5 o’clock on education, and the Government are not yet closing schools—we may hear more at 5 o’clock—but we do see more teaching staff off work ill or self-isolating. Schools are being closed for certain years, and other closures look increasingly likely. I have seen that in my constituency. For many children, school is a place where they can get breakfast and free school meals. If children have to stay at home, they may go hungry. What support will be put in place to protect those children if schools are closed, whether that means providing food for them or ensuring that social services are monitoring their condition?

Lastly, I want to mention bins and waste collection. The safe handling of waste that could be contaminated by coronavirus will be a major challenge for public health and for the protection of the staff who work in that vital service. Will the Minister tell us what action is being taken alongside local authorities to ensure the continuity of waste collection services, given that the staff who work in those services will themselves be subject to illness and self-isolation?

We also need to think about council tax. If the Government are giving business rate relief for coronavirus, why not council tax relief for the general population? If people are out of work for an extended period, council tax is a big cost. Councils would need reimbursement for lost income, as they would with business rates. Additionally, we need councils to show some restraint with pursuing council tax arrears through the courts. Although loss of income for councils could be a very big issue at a time like this, depending on how long everything lasts, everything points to Government support and action for that. I should say to the Minister that I am happy to supply him with a list of all the questions I have asked, because it is very difficult for him to answer everything all in one go.

Coronavirus poses a unique challenge for this country. We will all need to work together to tackle it. The work that local authorities do will be central to addressing the crisis and will help to hold communities together as we do so. It will not be easy, and I am sure there are many issues we have not foreseen. I thank everyone working in local government and in social care and all our teachers and teaching staff, because they are a vital frontline service. I hope the Minister can reassure the House that local authorities will get all the help they need in the weeks and months ahead to tackle this crisis and to carry on providing the services that people rely on every day.

--- Later in debate ---

[Luke Hall]

I reassure the hon. Lady that we are looking at speed and depth at all these issues to make sure that we get the approach right. Several hon. Members have rightly highlighted the fact that we are talking about protecting some of the most vulnerable people in our society, so of course we want to get that balance right. We are considering in detail how that is best achieved, but I will absolutely make sure that that point is taken away.

[Barbara Keeley]

I would just like to ask a further question on the protective equipment that we have just talked about. I am glad to hear that masks, hand sanitiser and any of the things that are needed are coming forward, because there has been a lot of concern in the care sector about it. I would like it to be a consideration that in some of the situations that care staff will be, they will need what is in very short supply in the NHS. They are going to need more, because it is not just a question of normal infection control. We need to protect the care staff themselves, because I think there is a very real fear that may cause more people to give up on the job if we are not careful about it. It is too risky for the staff to have that contact with maybe up to a dozen people in their homes every day. I hope we can expand our thinking to take into account that sometimes the more serious PPE that is used in hospitals will have to be used by care staff.

[Luke Hall]

I am glad the hon. Lady welcomes some of the immediate progress being made. She makes an important and serious point, which I will consider in depth. I am happy to discuss it with her in the days ahead.

We must also acknowledge that the crisis will not only put enormous pressure on our social care system and our most vulnerable people, but hit our local economies. We must play our part to protect those around us as well as to actively protect the local economies that underpin our communities. I will therefore set out measures the Government are taking to reflect that local priority.

Local venues, including pubs and theatres, are the pillars of local communities, and we understand the importance of giving them our wholehearted support in the weeks and months ahead. That is why we are giving all retail, hospitality and leisure businesses in England a 100% business rates holiday for the next 12 months and increasing grants to small businesses eligible for small business rate relief from £3,000 to £10,000; we are also increasing the planned rates discount for pubs to £5,000 as part of mitigating the social and economic effects of the virus.

--- Later in debate ---

[The Minister for Housing (Christopher Pincher)]

May I first congratulate and thank hon. Members across the House for their valuable and important contributions to the debate? They have been largely co-operative and collaborative at a time of extraordinary emergency for our country.

I am sorry that I was not here at the beginning of the debate to hear the opening remarks of the hon. Member for Worsley and Eccles South (Barbara Keeley) and the Under-Secretary of State for Housing, Communities and Local Government, my hon. Friend the Member for Thornbury and Yate (Luke Hall); like the hon. Member for Oldham West and Royton (Jim McMahon), I was in a Westminster Hall debate discussing the Greater Manchester spatial framework. It is a great pleasure to have the chance to close the debate.

I join my hon. Friend the Under-Secretary of State in reiterating the Government’s unwavering support for local authorities across the country in responding to the covid-19 emergency. Like other right hon. and hon. Members, I pay particular tribute to frontline staff and other council officers for their tireless efforts in reassuring residents, protecting the elderly and most vulnerable, and helping keep the public safe. Let me assure the House that the Government will continue to work hand in hand with local partners, including councils and local resilience forums, to assist in this vital work and ensure that communities receive the support and help they need during this unprecedented and challenging time.

Hon. Members across the House described powerfully the incredible work that their local communities and local public services are doing. Let me say, on behalf of the Prime Minister and my right hon. Friend the Secretary of State for Housing, Communities and Local Government, how grateful we are for all the tireless work that people are already doing. I am particularly conscious of the vital contribution of local voluntary organisations, and I pay particular tribute to them, as other Members did. I was struck by what my hon. Friend the Member for Milton Keynes North (Ben Everitt) had to say about the support the local volunteer organisation The Bus Shelter is providing.

Our responsibility in Government is to knit that work together into a national programme to ensure that all communities and all vulnerable people, wherever they may be, have access to the right support at the right time, and we will do that. We will take every step necessary to support local communities, local authorities, all public services and the myriad volunteers who are coming forward to help, as my hon. Friends the Members for Ruislip, Northwood and Pinner (David Simmonds) and for Devizes (Danny Kruger) made clear.

We know councils need assurance from the Government that they will have the funding they need to play their crucial role in the coronavirus response, especially in providing social care services to those in greatest need, as a number of Members on both sides of the House have said. As my right hon. Friend the Chancellor has made clear, we will do whatever it takes—whatever it takes—to respond effectively. That includes making sure public services, including vital council services, have the money they need to respond. The Chancellor announced last week that £5 billion has been made available for the NHS, and more money has been made available for other public services, such as the half a million pounds made available to local authorities, with more to come if necessary.

We are urgently agreeing a funding package for councils, and we will make further announcements as soon as possible.

[Barbara Keeley]

The Under-Secretary of State for Housing, Communities and Local Government said earlier that the Government will make sure that, whatever social care and the NHS need, they will get it. Will the Minister for Housing repeat that? That is an important thing to say. It is not just the NHS that needs funding; social care needs it, too.