User-led Social Care

James Murray Excerpts

Wednesday 5th February 2020 Westminster Hall

[James Murray (Ealing North) (Lab/Co-op)]

I beg to move,

That this House has considered user-led social care.

It is a pleasure to serve under your chairship, Sir Christopher. I draw inspiration today from Jerry Ndi, a student at Northolt High School who just last night won the Ealing regional final of Jack Petchey’s “Speak Out” challenge. I am sure that all Members here will join me in saying that everyone who took part and spoke last night should be very proud of themselves.

Social care is in crisis. Some 1.5 million people over the age of 65 do not get the social care they need. More than a third of people who receive local authority-funded care or support have to purchase additional support themselves. In fact, over the past two years nearly 10,000 people have had to approach their local authority for help after running out of money. That is the result of the Government’s deep cuts to public services since 2012, with a total of £7.7 billion taken out of social care budgets. As councils have been forced to narrow the eligibility criteria for social care, far too many people are denied the support that they need. This chronic underfunding, alongside a shift to private providers, has hit not only those who need social care, but those working in the sector—people who are routinely paid below the London living wage or the living wage outside of London.

There are more than 122,000 vacancies in the adult social care sector. Care workers are far too often undervalued, underpaid and overworked. The numbers providing care informally to friends and family is growing rapidly too; 1.25 million people in the UK, nearly 70% of whom are women, combine looking after young children with caring for older or disabled relatives. Nearly 90,000 of these care workers provide more than 35 hours of care each week, and half are still in paid work.

Our social care system is in urgent need of proper funding and a system that no longer incentivises a race to the bottom on quality and on workforce conditions, which is why, on 16 January, after giving my maiden speech, I voted to ensure that health and social care are properly funded, with an additional £26 billion in real terms. This extra funding is vital to support the social care system that we need.

Alongside greater funding, we also need to look at the way that social care is provided, which is why the focus of the debate is on the key role that co-operative principles can play. Under a co-operative approach to social care, care services should be not-for-profit. We will never be the caring society that we should be when services supposed to help the vulnerable are driven by profit. Services should protect workers’ rights. Those who protect this most valuable and often difficult of services deserve our support and protection, not to be forced on to lower wages and insecure contracts. Services should put care workers and providers at the heart of decision making. The commissioning and running of services should benefit from the invaluable knowledge of those who receive and provide care.

These principles and co-operative approaches to care are not just theoretical; they are beginning to be implemented and developed in places across the country. The Equal Care Co-op in the Calder Valley is just one example of a local area leading the way. I am pleased that the London borough of Ealing is also taking a lead on this. Following the local elections in 2018, Ealing Council held a public meeting for local residents who were interested in establishing a care co-operative. That led to a founding group being formed, including carers and those receiving care, who deserve our thanks for their valuable work on this matter. The group is currently developing a feasibility study, and their experience, particularly of the challenges they face, can help us to better understand the barriers that co-operative models of care face more widely, and therefore what support is needed from national Government.

It will not surprise anyone listening to learn that the feasibility study faces the challenge of growing demand for care services in the face of inadequate funding. However, it also faces challenges with the competitive commissioning regime, the current system of Care Quality Commission registration and the lack of an appropriate Government funding framework.

The experience in Ealing shows that councils could do far more if they had support from national Government, so I will put several points to the Minister. First, there should be a right of first refusal for social workers to step in and take over failing private organisations that provide social care. At the moment, when private organisations face financial difficulties, they are often sold on to another private organisation or simply closed down. Where private organisations are failing, employees should have an opportunity to take on all or part of that organisation.

Secondly, we need protection against asset stripping. Mutualised social care services should be asset-locked, to ensure that assets of all types are locked within the organisation, which is crucial to preventing asset stripping or demutualisation. Thirdly, we need regulation to support co-operative models over for-profit ones. Currently, all non-state providers are categorised as independent, which undermines the ability of care users and their families to distinguish between for-profit and not-for- profit providers. The CQC should modify its inspection methodology to ensure that the benefits of non-profit co-operative models can thrive. Fourthly, local authorities should be given a duty to promote co-operative organisations to deliver care in their area. We can learn from the Social Services and Well-being (Wales) Act 2014, which puts a duty on local authorities to promote co-operative organisations to deliver care in their area.

These steps by national Government would help support co-operative approaches to social care, putting the people who need social care, their families and their care workers at the heart of decisions about how social care is provided. We must stop allowing private companies to profiteer while those who rely on social care, and the workers who provide it, pay the price.