National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2020

Baroness Thornton Excerpts

Monday 8th June 2020 Lords Chamber

[Baroness Thornton (Lab) [V]]

My Lords, I thank all noble Lords who have participated in this debate, and my noble friend Lord Hunt for allowing this small but important statutory instrument to receive full scrutiny. There has been intense scrutiny and there are many questions to be addressed by the Minister. I join other noble Lords in paying tribute to those who work in the care sector for their dedication and courage over recent times. I ask for the indulgence of the House to mark national Carers Week and to pay tribute to and recognise the essential role of family carers, who have received precious little attention so far during this pandemic. Support has been desperately hard to access, and many families feel overwhelmed and pushed to breaking point.

Several noble Lords have said that this sector was in crisis before the pandemic and has been cruelly and badly served by the Government from the outset. As the noble Baroness, Lady Barker, mentioned, some of us were waving warning flags about the need to protect this sector from Covid-19 early in the outbreak. We were told that care homes would not be affected. It took a major campaign and pressure—by the media, by my honourable friend Liz Kendall MP, the shadow Minister for Care and Older People, many organisations such as Age UK, local government, MPs from all parties and your Lordships’ House—for the Government to start recognising the terrible toll and neglect in our care homes.

The notion, repeated by the Secretary of State, that a protective ring was put around our care homes is rather insulting, given the number of deaths and the time and chaos involved in providing PPE and testing. The Minister might advise his right honourable friend the Secretary of State to stop using expressions that are patently wrong and that only serve to deepen the anger and sadness of those families who have lost, and continue to lose, relatives in our care homes.

At some point, there will be an examination of the reasons for the mortality among those in care homes, those with dementia, those with learning disabilities and those in our mental health institutions. What we have to work for is seeing that the transparency and honesty of that examination, and of the price paid, will lead to real reform in our care sector.

The statutory instrument that we are discussing concerns the National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012 and makes provision for, among other things, NHS-funded nursing care. Several noble Lords have explained what all this means. These regulations amend Regulation 20 of the 2012 regulations and increase the rates for NHS-funded nursing care payment by the NHS Commissioning Board or a clinical commissioning group. Like my noble friend Lord Hunt, I welcome the proposed increase in the FNC rate that the NHS pays to care homes to cover the costs of services that must be carried out by a registered nurse. I repeat his question and echo many of the contributions today in asking: what contribution will this upgrade make to the long-term sustainability of the sector? I commend my noble friend Lady Wilcox on her strong support for reform in the sector.

According to a House of Lords Economic Affairs Committee report, as my noble friend Lady Healy said, 1.4 million older people in England had unmet care needs in 2018. The number of older people and working-age adults requiring care is increasing rapidly, while public funding declined in real terms by 13% between 2009 and 2016. When will the Government respond to that report? When will we see a new proposal for a new model of social care, as mentioned by so many noble Lords tonight? Specifically, given that this SI reached us before the pandemic, what plans do the Government have to put this somewhat battered sector on to a more secure footing in the short and long term? What assessment have they made of the impact that increased care costs resulting from the Covid-19 pandemic has had on the care home fees paid by those who are self-funding or partially self-funding?

Last month, the Health Secretary promised that by 6 June, all residents and care home staff would be tested; today, he said that care homes would only have their tests delivered. This is not good enough. The Government have been too slow to act. Care home residents and staff need to be regularly tested if we are to come to grips with this virus. We need to move swiftly to regular testing of family members, too, so that they can safely visit their loved ones. Ministers should now implement a comprehensive strategy for regularly testing more in care homes, including among the under-65s, and give social care services the priority and resources that they deserve. When will they do so?