Local Government Responsibilities: Public Services

Debate between Gareth Thomas and Baroness Keeley

Wednesday 18th March 2020 Commons Chamber

[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.

--- Later in debate ---

[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?