Adult Social Care

Baroness Laing of Elderslie Excerpts

Wednesday 1st December 2021 Commons Chamber

[Gillian Keegan]

My right hon. Friend is right that this is a start. It is a 10-year vision, and obviously we had a three-year spending review and the spending that we set out was a three-year spending settlement, so of course it is just a start.

On the steps to ensure that local authorities move to a fair rate and a fair cost of care, we are exploring a number of options, and we will set out further detail at the local government finance settlement later this year. Local authorities moving towards a fair rate of care is key to building a solid foundation for the future adult social care system, so we will be working closely with them to shape the best possible approach to implementation across different local markets. We will shortly be engaging with local authorities and providers, and we will publish further guidance in due course.

My right hon. Friend is absolutely right about the workforce. I have never worked in a business where the workforce was not key to anything that needed to be delivered, but in the care sector in particular, it is impossible to deliver anything without the workforce. It is also difficult to look at the workforce structure. As I say, it is the largest workforce in the country, with 1.54 million people working in it, but with 40% churn and very high amounts of zero-hours contracts and of retraining. I have never seen something that has that—[Interruption.] This has been the case for decades, and nobody has done anything to address it. [Interruption.] Nobody has done anything to address it. We do need to address it, and that is what we are here to do today, but—[Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. Please do not shout at the Minister.

[Gillian Keegan]

Thank you, Madam Deputy Speaker. As was clear from their 13 years in Government, Labour Members are not interested in finding the answer, and they are certainly not interested in listening to my version of giving the answer.

Having 40% churn and such a high degree of insecurity in the workforce is not sustainable, so we need to fix that. We need to put the knowledge and skills frameworks in place. We need to invest in training and learning. We need to ensure it is captured and transferable. We need to have career routes that mean people can progress in the workforce. In my short time in the job, that has been immediately identifiable. The hon. Member for Sheffield, Heeley (Louise Haigh) and I worked on professionalising the social care workforce about four-and-a-half years ago, when we set up the all-party parliamentary group on social care. The issue has been recognised. It is not easy to fix. It is a large private sector. There is very large and increasing demand, but we are going to take the steps to fix it and the White Paper starts that process.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for her statement, and for the progress that she is clearly trying to achieve.

Workforce availability for care homes is vital. Today a representative of a care home bordering my constituency rang to say that a quarter of its staff are off work owing to close covid contacts, although they are now treble-jabbed, and it has no more staff and a lack of agency staff to employ. What can be done through this strategy, Minister, to ensure that the recruitment and retention of care workers are improved?

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. I cannot believe that the hon. Gentleman said “Minister” again. I thought that he was beginning to get it, and that he would not make me unhappy any more!

[Jim Shannon]

I should have said “the hon. Lady”.

[Madam Deputy Speaker]

I thank the hon. Gentleman very much for that. I can say “Minister”; it is the hon. Gentleman who cannot. Minister!

[Gillian Keegan]

Thank you, Madam Deputy Speaker.

The hon. Gentleman has asked a good question. Dealing with covid is very challenging for many workforces, which is one of the reasons for our taking the difficult step of making vaccination a condition of deployment in this sector, and also offering the third dose—the booster—which many of those people have now had. It reduces the likelihood of transmitting or contracting covid, although it does not eliminate it altogether. The hon. Gentleman is right about the pressures on the workforce, which are increased by the need to manage covid in the case of residents and also people who are in their own homes. We have invested £162.5 million to help with those pressures in the short term.

--- Later in debate ---

[Gillian Keegan]

Yes of course. There are regional differences in care. There are lots of regional differences. There are differences in how much the care cap of £86,000 is worth, which is what I think my hon. Friend is concerned about. There are regional differences in how much people pay for care: it is much cheaper in various areas compared with the more expensive areas. I am asked why we will have a fixed sum of £86,000, and that is a good question. If we are looking at it as a percentage of assets, £86,000 will be different for different people, of course. The question was: why should we not base this on a percentage of assets? When I looked at the system we would have to build, I saw that it would be absolutely unworkable. It will be difficult to implement the cap anyway, because we will need a metering system that every council will have to operate for everyone who is paying for social care at different rates and different times. The system that we will have to build is very complex. Having a cap that will also enable us to talk to other players such as insurers, to see what other insurance products come forth, was considered the only implementable way.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I gently suggest to the Minister that the rule about facing the Chair when addressing the House is not just about courtesy and politeness—I know that she is the most courteous and polite person on the planet. It is also because if she is looking at someone who has asked a question, the microphone does not pick up her voice. I say this to everyone. That is why it is important to face this way; if she does so, she can be properly heard.

[Margaret Greenwood (Wirral West) (Lab)]

The Minister said that there was a lottery in how people paid for their care. There certainly is, and this is raised with me on a regular basis by my constituents. A quarter of Wirral adults with ongoing health needs were denied continuing healthcare over the summer, according to figures from NHS England. I think the Minister would agree that the CHC—continuing healthcare—system is unfair. Just at the very time when families need support, they often find themselves facing huge bills for care and having to consider selling the home of the person who needs care. Can she tell us what action she will take to ensure that no person has to sell their home to pay for their care, or was that just another hollow promise from the Prime Minister?