Oral Answers to Questions

Gillian Keegan Excerpts

Tuesday 23rd November 2021 Commons Chamber

[The Minister for Care and Mental Health (Gillian Keegan)]

We recognise that carers perform a difficult role and often find it challenging to access support. The Care Act 2014 secured important rights for carers, including a responsibility for local authorities to assess and support their specific needs where eligible. We will work with unpaid carers and stakeholders to co-develop further detail in a White Paper for reform later this year.

[Paul Blomfield]

The Minister will know that among those unpaid carers are 800,000 young carers, who play an extraordinary role—some from as young as seven or eight years old—in looking after parents with long-term conditions. Too many are unidentified, and as a consequence struggle without the support that they deserve. Does the Minister agree that integrated care boards could require GPs, who are uniquely placed to do this, to identify young carers and signpost them to support services? Will she also work with ministerial colleagues to require schools to create a young carers lead, as with special educational needs co-ordinators, to co-ordinate the identification of and support for young carers?

[Gillian Keegan]

We will certainly be looking at all those points within guidance. Local authorities have a duty to assess the needs of young carers under the Children and Families Act 2014, and that duty has remained in place throughout the pandemic. Authorities must ensure that young carers are identified and referred to appropriate support if needed, and that the young carer is not taking on excessive or inappropriate care and support responsibilities. We have also announced an additional £1 billion of new recovery premium funding, which schools can use to support young carers’ mental health and wellbeing, alongside their academic recovery.

[Caroline Dinenage (Gosport) (Con)]

The carers action plan published in 2018 was a two-year cross-Government attempt to try to change the way we identify and support the millions of unpaid carers across our country. They save our health and care system a fortune, but for their loved ones they are literally the world. What plans are there to publish a progress report and set out the next steps for how the Government intend to keep focused on this really important issue?

[Gillian Keegan]

I pay tribute to my hon. Friend for her work in this role and also to all unpaid carers. There are 5.4 million unpaid carers in England and they do a fantastic job. In the forthcoming Bill that we are co-producing with unpaid carers, we will make sure that we continue to make progress in this area. I look forward to sharing that with her before the end of this year.

[John Mc Nally (Falkirk) (SNP)]

Carers UK recently called for an additional payment across the UK for unpaid carers after its survey found that more than one in five unpaid carers are worried that they may not cope financially over the next 12 months. In Scotland we already have a carer’s allowance supplement, and the Scottish Government will once again make a double payment this December, recognising the impact that the pandemic has had on our carers. Will the Minister now urge her colleagues in the Department for Work and Pensions to make a commitment to match the Scottish Government’s offer?

[Gillian Keegan]

There is a carer’s allowance in the UK as well, but in most cases financial incentives are not the main driver for those providing unpaid care. However, we may see a shift towards less intensive caring activities or a reduction in the hours spent caring as people become more eligible for state support and we push through some of the reforms. Charging reforms bring an end to the unpredictability of care costs for care users and will do the same for those who provide unpaid care for them, allowing them to make informed choices. We need to do more to support them in providing respite and day services.

[Theresa Villiers (Chipping Barnet) (Con)]

What action have the Government taken to support the charities and community groups that provide help to unpaid carers, because many of these charities found it very hard to operate and raise funding during the covid shutdown?

[Gillian Keegan]

My right hon. Friend is absolutely right: charities are also a vital part of the network of support for our unpaid carers, and some of them did have to close during the pandemic, so we have been encouraging them to open up now that we can all open up. Additional financial support was provided for the charitable sector to make sure that it could continue its vital services during the pandemic when fundraising activities were very difficult.

[Liz Kendall (Leicester West) (Lab)]

Many families are pushed to breaking point because they cannot get the help they need to look after the person they love. Will the Minister now confirm that somebody who is trying to hold down a job and care for their elderly mum whose house is worth £100,000 will face a tax rise that will not improve their mum’s care or give them a break from caring, and will not even stop them from having to sell their mum’s home, because under the plans Tory MPs voted through last night, she will never hit the cap on care costs? Will the Minister further confirm that this tax rise on working people will be used to protect 90% of a home worth £1 million? If she disputes these figures, why does she not publish the impact assessment before MPs are asked to vote on the Health and Social Care Bill tonight?

[Gillian Keegan]

From October 2023, the Government will introduce, for the first time in our history, a new £86,000 cap on the amount any adult in England will need to spend on their social care. That will protect them from unpredictable and unlimited costs. But as well as that there is a more—[Interruption.] The hon. Lady may like to listen to the answer. As well as that, there is a more generous—[Interruption.] Please listen. On top of that, a more generous means test for adult social care will come into effect, allowing more people to benefit from the means-tested support. Under the current system, about half of all older adults in care receive some state support. This rises to roughly two thirds under the recently announced charging reforms, which will help many adults, including unpaid carers. Everybody will benefit from this system.

[Laura Farris (Newbury) (Con)]

5. What steps he is taking to reduce waiting lists for (a) children and adolescent mental health services and (b) other mental health services for young people.

[The Minister for Care and Mental Health (Gillian Keegan)]

We are committed to ensuring that children and young people get the mental health support that they need. That is why we are expanding mental health services through the NHS long-term plan so that 345,000 more children and young people a year have access to services by 2023-24. This year the Government and the NHS, under NHS England, have provided an additional £109 million on top of long-term planned funding. This additional funding will allow 22,500 more children and young people to access community health services this year, earlier than planned, and that will accelerate the roll-out of mental health support teams in schools and colleges.

[Laura Farris]

In West Berkshire, a family seeking a child and adolescent mental health services diagnosis of autism spectrum disorder or attention deficit hyperactivity disorder can face a waiting time of up to two years. The Berkshire West clinical commissioning group has recently made £1.6 million available to recruit extra staff, but when I spoke to it, I was struck by the absence of any hard targets to reduce waiting lists and any consequences if it fails to deliver. These waiting times are causing misery to my affected constituents, so can my hon. Friend say what steps can be taken to ensure accountability in the provision of this service, and will she meet me to discuss waiting times in West Berkshire?

[Gillian Keegan]

I share my hon. Friend’s concern that waits for autism assessments and diagnosis are often way too long, and that is why we are investing an additional £13 million of funding this year. That funding will allow local systems to test different diagnostic pathways—including working on a multi-disciplinary basis, which will shorten the diagnosis time—and to find new solutions for addressing long waits. The precise allocation of funding for diagnostic pathways are decisions made at the local level, and those should be compliant with National Institute for Health and Care Excellence guidance. NHS England is working with local systems to evaluate what works well. Since November 2019, we have been reporting on waiting times between referral and first assessment, and that is important, because we use that to drive up local performance. I would be very happy to meet my hon. Friend to discuss this further.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

When the Government talk about waiting times, they refer to how long it takes simply to get an assessment, and not to when treatment may start. Most children face an incredibly long wait after that first step, or even have their referral closed. The real truth is revealed when we look at how long it takes for children to complete treatment. In Yorkshire and the Humber, it took one child more than 13 years to complete treatment for their anxiety. In the north-west, some children took three years to complete treatment for eating disorders. In the midlands, it is not uncommon for treatment completion to take five years. Will the Minister commit, as we have, to the provision of a counsellor in every school, a mental health access hub in every single community and regular mental health assessments for children in all key stages?

[Gillian Keegan]

We know that the prevalence of children and young people with a mental health condition has increased—in some cases, it has increased massively. That is why we remain committed to increasing investment through the long-term plan. Also, we have consulted on the potential to introduce five new waiting times standards, including for children and young people and their families and carers presenting to community-based mental health services. In addition, NHS England and NHS Improvement have announced an additional £40 million to address the impact of covid on children and young people’s mental health, including for eating disorders. Since 2014, extra funding has been going into children and young people’s community eating disorder services every year, but we know that we have more to do. This extra funding will enhance the development of more than 70 new and improved community eating disorder teams, but there is no doubt that there is much to catch up on. We are also introducing services into schools for young people.

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

When the chief inspector of hospitals placed St George’s in Tooting into special measures, he warned that the

“emergency department was not large enough for the number of patients that passed through it and privacy and dignity were compromised.”

Given the report by the British Red Cross in this morning’s edition of The Times highlighting the causal link between A&E attendance and deprivation, does the Minister understand the further huge impact that moving acute services from St Helier to wealthy, healthy Belmont will have on A&E attendances at St George’s?

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[Chris Grayling (Epsom and Ewell) (Con)]

20. What steps he is taking to tackle staff shortages in the social care sector.

[The Minister for Care and Mental Health (Gillian Keegan)]

We recognise the considerable challenges the adult social care sector faces in recruiting and retaining staff. We have put in place a range of measures to support local authorities and care providers to address workforce capacity pressures. These include a new £162.5 million workforce recruitment and retention fund, and the latest phase of our national recruitment campaign, launched on 3 November, which highlights adult social care as a rewarding and stimulating place to work.

[Chris Green]

I thank my hon. Friend for her reply. The latest figure I have for the vacancy rate for carers in August was significantly worse than those from before the pandemic, and it is likely to worsen still further due to the requirement for compulsory vaccination. When does my hon. Friend believe the vacancy rate will return to pre-pandemic levels?

[Gillian Keegan]

The first thing to say is that obviously the vaccine saves lives, and it is our responsibility to do everything we can to reduce the risk for vulnerable people. As of 14 November, 92.5% of care home staff have had their second dose. We have put in place measures, as I said earlier, to support workforce capacity, which have only just gone to local authorities. The Department continues to closely monitor workforce capacity, bringing together the available data, including the vacancy rate, with local intelligence. Longer term, we have committed at least £500 million to support and develop the workforce, and that will go some way to addressing the barriers to people taking up work in adult social care, which has been an issue for a number of years.

[Bill Esterson]

There are 105,000 vacancies across all social care workforce grades, but employers are unable to recruit across those grades. The Government have accepted the need to add senior care workers to the shortage occupation list—they did that in April—but the Migration Advisory Committee is not due to report until next April on the need to recruit social care workers. It is no good the Minister saying employers need to pay more money to recruit UK workers, because this Government are the ones underfunding the employers, who cannot then compete with the likes of Amazon. When will the Government admit that they need to add all grades of social care workers to the shortage occupation list if they are to have any hope of addressing this shortfall and providing the care that is needed to address the care crisis?

[Gillian Keegan]

As I mentioned earlier, we have sent out £162.5 million, which has not yet been put into effect. For example, Sefton received £1,032,474. That money has only just gone into the bank account, and has not yet been utilised to retain staff, or to recruit agency or other staff. As the hon. Gentleman says, adult social care providers can recruit key adult social carers from overseas from the shortage occupation list. That provides lower fees and a reduced salary threshold of £20,480 for someone to be eligible for the skilled worker visa.

[Helen Hayes]

The adult social care sector faces the worst staff shortages in living memory. A recent survey by the National Care Forum found that one third of managers of registered care homes are limiting or stopping admissions from hospital, due to staff shortages, with direct consequences for both the NHS and for vulnerable people who cannot access the care they need. The care sector needs action now, not warm words and job adverts. Will the Minister commit to paying a retention bonus to frontline care staff, to help stem the tide of those exiting the care sector this winter? Will she commit to a fully funded, permanent pay increase, to bring the minimum level of pay for care workers up to £10 an hour—the minimum rate at which Amazon is recruiting in many areas where the care shortage is at its most acute?

[Gillian Keegan]

We have committed to bring forth new measures in the White Paper, and to spend at least £500 million on recruiting that workforce. To address the emergency now, as I mentioned, there is £162 million. In addition, we have put around £500 million particularly to address discharge processes, and to ensure a discharge to assess process, which means it can be much quicker. We must ensure that those teams work together to shorten the discharge process. There is no doubt that our NHS and our whole system is under extreme pressure this winter, and we thank it for all the work it is doing.

[Chris Grayling]

There is a particular challenge in a county such as Surrey that has a rapidly ageing demographic, high housing costs, and where the cost of living is high generally. Could I urge the Minister and the Secretary of State to ensure that they consider all possible avenues to assist with what is becoming an acute shortage of key staff? We cannot end up in a position where the elderly do not receive the care they need, and we need maximum flexibility to ensure they get that care.

[Gillian Keegan]

There is no doubt that the sector is facing extreme pressure. It always faces pressure as the demographic need grows by 1% to 2% every year, but we have set out money to help with the short-term impact of that. Surrey will receive £2,704,702, so just over £2.7 million. We recently started the biggest national recruitment campaign we have ever done, Made with Care, to thank our care workers and to show what a fantastic and rewarding career it would be. We will continue to work with local authorities to help as much as we can.

[Tony Lloyd (Rochdale) (Lab)]

In the context of what the Minister has announced about increased money for staff terms and conditions, what does she make of the Alternative Futures Group, which operates in the north-west? It refuses to take up the real living wage, even when councils offer to fund it, and is in a process that is seeing the terms and conditions of its workforce deteriorate? Is there a need to look at that group, and to have a collective agreement for the whole sector?

[Gillian Keegan]

Yes, and I would be grateful if the hon. Gentleman would write with the details. We have a skills shortage in many areas across our economy. Because of the success of the Plan for Jobs, and our bounce back from the pandemic, anybody who does not treat their staff well will find that their skills shortages become very acute indeed.

[Chris Loder (West Dorset) (Con)]

11. What steps he is taking to ensure booster doses of the covid-19 vaccine are available to all eligible people in West Dorset.

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[Andy McDonald (Middlesbrough) (Lab)]

T4. Now that the cap on care costs has unravelled, many of my constituents feel misled and betrayed, especially those with modest capital in the value of their home. How can it be that those with the most will contribute the least and that those with the least will contribute the most? Where is the equity, where is the fairness, and where is the justice in any of that?

[The Minister for Care and Mental Health (Gillian Keegan)]

I thank the hon. Gentleman for his question. We are trying to solve something that has not been solved for decades, and the Labour party does exactly what it always does when it comes to this point: it picks one specific part without looking at the package as a whole and misleads the whole country. I want a better system not only for our grans and grandads, but for our mums and dads and all of us. If this system had been in place for my grandmother when she had dementia before dying in 2018, she would have been a lot better off. While we sit here doing nothing, the reality is that everybody loses—

[Mr Speaker]

Order. Questions and answers are meant to be short and punchy. We cannot get into a full-blown debate.