Social Care Reform

Helen Whately Excerpts

Thursday 18th March 2021 Westminster Hall

[The Minister for Care (Helen Whately)]

It is a pleasure to speak under your chairmanship, Dr Huq. I thank the hon. Member for Worsley and Eccles South (Barbara Keeley) and her co-sponsor, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), the Chair of the Health and Social Care Committee, for securing this debate on the important and interconnected subjects of social care reform and the social care workforce.

The 1.5 million people who make up the paid social care workforce, and the 5.4 million unpaid carers, do the most wonderful thing—caring for people, whose lives depend on what they do. It is a service not just to those individuals, but to the whole country, and never has that been more true than during this cruel pandemic. Yes, our social care system needs reform. It has needed it for decades, and my party committed to that in our election manifesto. The pandemic gives us a moment in time; if not now, when? The pandemic has delayed our work, but I reiterate the Government’s commitment to bringing forward plans for social care reform this year.

This has been a really good debate, with many well-informed contributions from across the parties. I will mention just a few of them. The hon. Member for Worsley and Eccles South talked about the long-term nature of the problems with social care; the fact that the system is as important for those of working age as it is for older people; and the importance of unpaid carers.

The Chair of the Health and Social Care Committee, my right hon. Friend the Member for South West Surrey, talked about the catastrophic costs faced by one in 10 people, who end up spending over £100,000—using their life savings—on their care, and about the problem of high turnover in the care workforce. I thank him for his recognition of my personal commitment and the work I am doing, largely behind the scenes, on social care reform.

My hon. Friend the Member for Northampton South (Andrew Lewer) drew on his experience in local government, going back around 20 years, if my maths is right. He spoke about the need for closely integrated health and social care. My hon. Friend the Member for Peterborough (Paul Bristow) draw on his personal knowledge, as I have heard him do with great value before. I very much look forward to reading the report on supported housing that he mentioned, and I will look it up. This debate would have been missing something if my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake) had not mentioned the German system as one for us to consider as we work on proposals for reform.

I will set out some of the support we have given to social care and the social care workforce over the last year, because it really is quite different from anything that has been done by Government for social care before. I also want to pick up on several points that hon. Members made during the debate.

At the start of the pandemic, we identified carers, both paid and unpaid, as essential workers or key workers. That was in recognition of how crucial they are, but also so that they could access support, such as places at school for their children when schools were closed, or priority slots at supermarkets. We made it clear, in guidance and communications to care providers and local authorities, that care staff should receive full wages if required to self-isolate because of covid. That has been one of the uses allowed for the infection control fund, which to date has amounted to £1.4 billion in ring-fenced funding for social care.

To the point made by the hon. Member for Luton North (Sarah Owen), who spoke about care workers being told to work despite having symptoms, that absolutely should not have happened. I have heard of a small number of cases and have investigated, and work has been done to stop that happening. It has been made very clear to care providers that nobody should come into work with symptoms. The Government’s funding was provided specifically so that care workers would not have to worry about lost earnings in the event that they were either covid-positive themselves, or required to isolate as a contact. In addition to that, in January we provided a further £120 million to boost the social care workforce and help providers that faced staff shortages, particularly as a result of staff sickness and self-isolation.

During the pandemic we have also provided free PPE, which runs through to June. We have provided millions of tests to identify covid cases in social care, protecting staff and those who receive care. I was disappointed to hear the shadow Minister, the hon. Member for Leicester West (Liz Kendall), suggesting that there was some form of requisitioning of PPE from social care by the NHS. When I heard stories about that, they were investigated, and the investigations simply did not bear that suggestion out.

On vaccinations, as we started the herculean task of rolling out vaccinations across the country, we put care home residents and staff in the highest priority group. Thanks to the dedication and hard work of so many people, by the end of January we were able to offer vaccinations to all residents in over 10,000 care homes for older people. More than 90% of residents and over 70% of staff have now been vaccinated.

The hon. Member for Central Ayrshire (Dr Whitford) talked about how the pandemic had affected social care workers, including how some social care workers have been bereaved by the sad loss of those they cared for. She is absolutely right about that being a hard part of the experience of the care workforce. I have talked to many care workers over the last year and knowing that they have been facing that during the pandemic has been a real concern to me. I have spoken to employers about this, and many care providers have put in resources—access to counselling and mental health support, for instance—to support their staff to cope with what they have been going through. In government, we have worked alongside the NHS and brilliant organisations such as the Samaritans, Hospice UK, and Shout to provide a package of emotional, psychological and practical resources for the workforce, which includes support helplines and guidance and specific support for registered managers in care homes.

I want social care to have a stronger voice in our health and care system and more visible leadership. That is why, in December last year, we appointed Deborah Sturdy as the first chief nurse for social care. Deborah is providing that leadership. She is already a galvanising force, particularly in supporting infection prevention and control, which must continue, even with the high levels of vaccination that we have.

Hon. Members spoke about vacancies in the care sector and the problem of staff turnover. I am well aware of the challenges for social care employers and how some do struggle to recruit and retain the staff they need in both care homes and the domiciliary care sector. We are and have been supporting the sector with a national recruitment campaign across broadcast, digital and social media, highlighting the vital role that the social care workforce has played during the pandemic, along with the longer-term opportunities of working in care. We are working with the Department for Work and Pensions, and I am working with ministerial colleagues in that Department to promote adult social care careers to jobseekers. I am hearing directly from care providers that they are seeing people taking up those jobs in care and discovering the rewards of care work. However, I am clear that that alone is not the solution to the challenges of having the workforce we need in social care and that, as part of our reforms, we must also focus on what is needed to develop and support the social care workforce.

I turn to social care reform. The Government are absolutely committed to the reform of the adult social care system. As I have said, we will bring forward proposals this year. Despite the challenges of the pandemic, we have been gearing up for the reform so that, as we build back better, we have a system that is fairer and fitter for the future. I assure hon. Members that the work has already begun. In fact, our White Paper, published last month, sets out plans for a health and care Bill that will both further integrate health and social care services and improve the oversight of how social care is commissioned and delivered for people. The Bill will also allow us to get better data on what is going on at a local level so that we can follow the evidence about what works.

The enhanced assurance framework set out in the White Paper will introduce an independent voice through the CQC, with clear and consistent oversight of adult social care, supporting local authorities to improve the outcomes and experience of people and their families in accessing high-quality care and support. That is only the beginning. For the long term, we want a sustainable adult social care system that meets people’s needs and aspirations and gives them the care and support that they need to live life to the full. We want to empower recipients of care and support people to live independently in their own homes and communities for as long as possible. We also want to improve the information provided to the public about the social care system, enabling people to plan for their care and make more informed choices. A stable and well-qualified workforce is central to our ambitions for social care.

[Kevin Hollinrake]

The Minister is doing a fantastic job on this issue, which is one of the biggest issues that faces us. If this is not going to be a blank cheque for the taxpayer or for the recipient of the care, does the Minister agree, as I think the shadow Minister, the hon. Member for Leicester West (Liz Kendall) did, that there has to be a pooled solution, perhaps like the German-style system of social care premiums?

[Helen Whately]

My hon. Friend makes an important point. I will not be drawn into further detail about the system at this point. The questions about funding lie with the Treasury rather than with the Department of Health and Social Care. We want to tackle the problem of the catastrophic costs of care that a minority of people face, as mentioned by my right hon. Friend the Chair of the Select Committee. I emphasise that we have made the commitment that no one who needs care should be forced to sell their home to pay for it. How we do that is indeed part of the reform work.

As we emerge from the pandemic, we will continue talking to stakeholders, pivoting the many conversations that we have been having about covid to more conversations about reform. Our reforms will be informed by a wide range of voices, not only colleagues and experts in the sector but also care providers, the workforce and those with lived experience of the care sector.

I thank all right hon. and hon. Members who have contributed to this important debate. I know that everyone who has spoken is deeply committed to their support of the social care workforce and reforming social care. The Government are on the case to make that happen. I take this final opportunity to thank all of those on the frontline providing care—people who go the extra mile to care for our loved ones, day in and day out. Carers have been truly remarkable throughout this pandemic. It is for them and the people they care for that we must move forward with the much bigger plans for the reform of social care.