Social Care Funding

Damian Hinds Excerpts

Thursday 10th November 2011 Westminster Hall

[Kelvin Hopkins (Luton North) (Lab)]

It is a pleasure to serve under your chairmanship this afternoon, Mr Robertson, and it was also a pleasure to hear the speech by the hon. Member for Truro and Falmouth (Sarah Newton). She referred to me, unusually—because I think that I am the only hon. Member here who was born during the second world war, and I survived it, but only just: we were evacuated shortly before a V1 landed on our house and blew it up, but nobody died. Fortunately I was with my grandparents in Leicester at the time. We are concerned about elderly people who fought in that war and now are either in care or being cared for in their own homes.

A headline in The Daily Telegraph of 28 October read, “Misery for millions as elderly care funds cut”. The Telegraph is not a newspaper of the left. It is normally supportive of the Conservative party, and I would hope that that is the basis for some sort of consensus, because we can all agree on this. I do read the Telegraph and find it very useful, and quite a good newspaper at times. I have no particular dislike of it, and it is spot on in that headline.

Importantly, it has been observed on more than one occasion that we do not care enough for our elderly people. Our attitudes to the elderly in Britain are not good, especially compared with those of some minority communities that have come from abroad, which have a kind of reverence for elderly people. Perhaps I would say that, because I am not as young as I was, but I think they value elderly people in a way we do not.

In some circumstances elderly people are regarded as a bit of a nuisance. I have some rather horrifying quotes from Professor David Oliver, who is senior lecturer in elderly care medicine at the university of Reading and secretary of the British Geriatrics Society. He said:

“Not long ago, a senior doctor walked onto my ward, turned to a nurse and laughingly asked: ‘How do you stand working with all these crumblies?’”

That kind of attitude is utterly poisonous. On another occasion a senior doctor said

“he was spending too much of his time ‘market gardening’—ie, looking after cabbages (old people)”.

Those are dreadful things to say, and people who say them should not be around elderly people. We must make sure that the people who look after elderly people have compassion and empathy, and a bit of reverence for people who have spent their lives working in society and contributing. I raise those incidents in a sense to shock us all into realising that in many instances we are not doing right by our elderly people.

That said, I know that there are many people who do wonderful work. I had two local authority care homes in my constituency and I visited them on several occasions. They had devoted staff, whom the residents loved; they thought they were really cared for. The visiting professionals all said that the care homes and what went on in them were first class. They have both been closed down, essentially forced to close by central Government. It is wrong that we should forcibly encourage local authorities to close local authority care homes and send the residents to private care. Some of the people who left may well have gone to Southern Cross homes—some of those that are now being criticised by the Care Quality Commission. We are not doing right by our elderly people, and we must do more.

As to costs, some 12 years ago the royal commission on long term care recommended that all care should be free of charge—free at the point of need, like the national health service. It was not a unanimous recommendation because, I think, the Government of the time, rather mischievously, made sure that one or two members of the commission brought out a minority report opposing free long-term care. Since that time Ministers have time and again said, “Oh, it wasn’t unanimous, therefore, implicitly, we don’t have to do that.” I took a different view, and tabled early-day motions in two successive Parliaments, calling for the Government to implement the recommendation for free long-term care. That did not happen; it was all about cost in the end, but I still believe that is the way forward. The costs involved would be significant, but in the scheme of things not an enormous amount.

I am the chair of the support group in Parliament for the National Pensioners Convention and Andrew Dilnot came along to present his recommendations to us two or three weeks ago. He is quite brilliant, frankly. His analysis and what he has come up with are first class. That should be the minimum default position, which any Government should take. I would like to go further than he went, but I think he is realistic, and, thinking that pushing Government to spend will be hard, wants to find the fulcrum point at which they might accept his idea. What he did was brilliant. The National Pensioners Convention, like me, believes that care should be free at the point of need, like the national health service, but Dilnot has come up with a fine scheme.

The National Insurance Act 1948 recommended that there should be a capital limit, which I think was £8,000 at the time. The minimum amount of capital that people could have was £8,000. If that is indexed forward it comes to a figure of between £250,000 and £300,000, so when Dilnot talks about £100,000 he is way below what would have been the case if we had simply indexed the figure forward. What we have now is disgraceful.

One result of what we have is that working-class people who managed, through saving and struggle, to become owner-occupiers are now having that little bit of equity in the family taken away from them. The wealthy do not have to worry. They have plenty of equity, and to look after granny when she has dementia they can perhaps take a little cash out of their overseas account, so it will not be a problem. However, for working-class people who have bought their home and become the first owner-occupiers in their family—and perhaps all of us would support in principle the idea of owner-occupation, if at all possible—that is being taken away from them. Many people in my constituency bought their council houses. I was not in favour of selling council houses, but it is just those people who now find that their capital has been taken away to use to look after granny. Typically, the grandchildren who would have inherited that equity and gone into owner-occupation will now not be able to do so.

People have come to my surgery and reluctantly admitted that they are keeping granny at home deliberately because they are desperately fearful that if she goes into a care home her house will be sold, the equity will be lost and their children will not be able to get into owner-occupation; there are no council houses to rent and they will be forced into private rented accommodation, and will have a much poorer quality of life as a result. That is the reality—it is actually happening. Those admissions are made reluctantly, because it is not something people want to say. Granny—it is usually granny because women live so much longer than men—may be suffering, and not getting quite the care that she should have, because she is staying at home. In the best of all possible worlds we all want to stay at home for as long as we can, and it is right that we should do so, but even care at home is not up to scratch.

I have examples, as I am sure others do, of care companies that look after elderly people in their own homes. The carers sometimes are not kind and are a bit impatient. The elderly person has to get out of bed when they turn up and go to bed when they turn up, and is sometimes left sitting in a chair all day with stale sandwiches on a plate beside them, not being able to do anything—not even go to the toilet. We are not getting the care even when we have paid-for carers coming in, so a radical change is needed. We must not only pay for care but ensure that it is good care, and that the people who deliver it are caring, compassionate and professionalised.

I spent much of my life before Parliament working as a research officer for the major public services trade union, Unison. In the past, many care home staff would have been Unison members, but the private care homes are not unionised. In my constituency, when one of the care homes I mentioned was privatised—closed down—I had a difficult conversation with the senior officer at the local authority, who eventually, after an hour, said: “We are doing it to cut costs. There will be fewer staff, they will not be in unions, and they will have shorter holidays, lower pay and poorer conditions of work. We can get the costs down.”

[Damian Hinds (East Hampshire) (Con)]

Does the hon. Gentleman agree that it can be difficult to find people who want to be carers, whether in the public or the private sector, at home or in a care home setting? Perhaps we need to find new ways, beyond just unions, of elevating the status of the job as a profession or occupation, in the same way as social workers are now considering creating a college of social work.

[Kelvin Hopkins]

I agree absolutely about elevating the status, but we do that first by having the carers professionally trained, ensuring that we get the right people to begin with, having them properly paid and having staffing at the right level. If someone is looking after too many patients and cannot cope, either in a hospital or a care home, the patients do not get proper care. In most areas of life, as quality improves we want higher productivity, which means a lower level of labour intensity, but in this area we want more people working, with each care person or nurse looking after fewer patients, to ensure that everyone gets the care they need, rather than having one junior nurse looking after a large room full of elderly people and not being able to cope late at night.

In the past couple of weeks we have heard some distressing stories about elderly people in hospitals not getting the care they need. We will all be elderly one day, and some of us might finish up in care because we might not have extensive families to care for us. I do not like the idea of being in pain and suffering at night and not being able to get anyone to help. I am physically fit and doing well at the moment, but we shall all be old one day. People are suffering in that way now, and the only way to deal with it is to ensure that we put in sufficient resource. I think there are people around who want to do these kinds of jobs but they will not do them if they are going to be overworked, undertrained, underpaid, and treated badly by private companies or care managers in hospitals.