Care Sector

Baroness Howells of St Davids Excerpts

Tuesday 25th November 2014 Lords Chamber

[Baroness Howells of St Davids (Lab)]

My Lords, I, too, congratulate the noble Baroness, Lady Kingsmill, on raising this debate and giving a very thorough insight into her report on what is happening in the care field. I have a particular interest in carers because so many immigrants from the early 1950s and 1960s from the Caribbean, when they were invited to come to support the mother country, found work in the caring sectors and were happy to do so. It is no secret that I have been a tireless campaigner for better services for black communities, but today I speak for all citizens of the United Kingdom.

I was very struck in October by a Statement read out in this Chamber by the Parliamentary Under-Secretary of State in the Department of Health. It was entitled Five Year Forward View. This Statement brought to our attention how the proposed plan would make the service better and fit for purpose. The Government claimed to have recognised the challenges facing care and declared that continuing with a comprehensive tax-funded NHS was intrinsically doable and that there were viable options for sustaining and improving the NHS over the next five years.

The Statement also claimed that the challenges of an ageing population can be met by a combination of increased real-terms funding efficiencies and changes to the models of how care is delivered. Much was said of the value of greater integration, of releasing hospital beds by combining primary community and specialist tertiary sectors alongside national urgent and emergency networks. The Statement went on to say that this would give older people in particular the personal care we would all want for our own parents.

That is very laudable, but what has been done? What has happened? When the Statement talked about reducing variations in quality in the wake of the tragedy of Mid Staffs, they were all very grand words. Can the Minister tell the House what has gone wrong? We are told that the economy is doing well, so cash should not be a problem. Did the Government really mean to downgrade the workers who carry out some of the most important work; the sort of work that is meant to have a real impact on those receiving care?

The trade union Unison cites that there are a number of appalling examples of exploitation. Employment rights are not properly observed and bogus self-employment presents a big problem. Employers operate with relative impunity in an unregulated sector. This is not care; it is an abuse in this century not only of those needing care but of those giving the care. They need to be cared for so they can offer good care.

Those who are engaged in caring know what a difficult task it is. They do it because they care. To them, the patient is first but needs time. The report highlights that the sick, elderly and disabled people who rely on care services are increasingly facing a 15-minute visit from carers. What can you do in 15 minutes? If the person is well and healthy you might do something, but if they are not, 15 minutes can never be enough to bathe, dress and feed a patient. Some people may need 15 minutes, but others need a lot more.

I recently met carers who have had nervous breakdowns because of the strain of getting to places on time. Caring is natural, but we need to help. We need not only to train carers but to be aware of their circumstances and to give them more. I urge the Minister to put his weight behind the recommendations of the Kingsmill report. Most of those needing care are those who have paid into the health service. It is not a charity. Those who advocate 15 minutes per patient are those who live inside the radar of the healthy, the employed and the respectable. They have no idea of what it is like to be in the other camp.

Unless you have been a carer you have no idea of what is happening. I cared for my husband for seven years, and I assure noble Lords that the man I married was not the man I was caring for. Being unhealthy, unemployed and treated as not respectable so that any old thing will do is not good enough for citizens of the United Kingdom. Care workers should be treated fairly, and I trust the Minister will revisit the five-year plan because patients and carers deserve better.

This country can do better and must take heed of the report and implement the recommendations as soon as possible. As lawmakers, we are guilty of failing the most vulnerable, those most in need. I say this not because I want to make noble Lords feel bad but because I have seen carers, some of whom have retired from nursing, who have had to take breaks because of the strain of caring. Those who are caring and those who are dependent on them need our help. If not, we are very guilty as lawmakers.