Care Bill [Lords]

Julie Hilling Excerpts

Monday 16th December 2013 Commons Chamber

[Mr Hunt]

With the greatest of respect to the right hon. Lady, who, I know, played a good role in the G8 dementia summit last week, the Bill is extraordinarily ambitious. Nearly £4 billion is going into a merger of the health and social care systems. The previous Government had 13 years to do something about this and they did nothing. We are delivering. I hope, if she believes in this, that she might at least support the Bill in the Lobby tonight and not decline to support it, as her party’s amendment suggests.

The fund will ensure joint commissioning and the seamless provision of services, preventing the nightmare of people being pushed from pillar to post with no one taking responsibility. It has led to the unprecedented step of the NHS and local authorities working together in all 152 local authority areas to plan joined-up services.

[Julie Hilling (Bolton West) (Lab)]

rose—

[Barbara Keeley]

rose—

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[Andy Burnham]

The issues are huge. They affect every family in this country and the worries they have about how they will look after their mum and dad in later life. They did not hear any answers from the Government this afternoon. I hope my hon. Friend will hear a few from me. I know that she has campaigned on the use of zero-hours contracts in our care system. Is it not a sad reflection on both sides of the House that today in England around 300,000 care staff are working on zero-hours contracts? They do not have the security of knowing what they will earn from one week to the next, so how can we expect them to pass on a sense of security to those they care for? Is not the message that we are sending to people who work in our care service, particularly young people coming into the service, that looking after someone else’s mum or dad is the lowest calling they can answer, when really it should be the very highest?

[Julie Hilling]

Would my right hon. Friend have been as shocked as I was yesterday when I met the carer of a woman who will be 99 next week and discovered that she has a five-minute call at tea time and a 10-minute call at bed time?

[Andy Burnham]

I would like to say that I would have been shocked, but I know that the system just gets worse and worse each year as the pressure builds and corners have to be cut, and it is older people and their families who are paying the price. How can any “care” be given in five minutes? Of course it cannot. It does not make financial sense in the long run, because we have a care system that does not provide people with support in their own homes, buts leaves them to drift towards hospital, leaving our acute hospitals increasingly and unsustainably full of frail older people.

--- Later in debate ---

[Julie Hilling (Bolton West) (Lab)]

Like my constituents, I was relieved when the Government said they would act on the Dilnot report and cap the cost of care, and I was pleased when the Secretary of State told me in this Chamber that money spent on home care would be treated as part of that cap. But the legislation that this Government introduce never lives up to expectations, and it is deeply disappointing that the Bill will still leave people having to sell their homes and does not solve the care problem facing people every day of the week. Many thousands of people will be deciding today whether or not to put their loved ones into residential homes or whether or not to sell the family home. This is a very real, very live issue.

The lack of joined-up care is also presenting big problems for our accident and emergency departments. There has been a 66% increase in the number of people over 90 being “blue lighted” into A and E, and the number of over-65s admitted to hospital with avoidable conditions has been increasing—last year, it reached half a million. Of course, we also have a problem at the other end, as we cannot discharge people because of a lack of care in place. There has been a 42% increase in delayed discharge, and in October alone 78,400 delayed days were lost, so people who are admitted, often because of the lack of appropriate care in the first place, are not being discharged because of the lack of appropriate care to deal with them when they come out.

The Government cannot wash their hands of the problem and say that it is down to local authorities, because their drastic cuts to local authority budgets have had a drastic effect on local services. Bolton has had to find £100 million of cuts, which has meant that it can no longer give support to the nearly 2,000 people who have “moderate” care needs. They may be moderate to the decision makers, but they are still care needs; we are talking about care that enables people to stay safe and well in their own homes in the community and to lead independent lives. Bolton has reluctantly had to make cuts to day care and respite care, which is a real problem for real people.

Other Members have mentioned the financial cap and other elements of the Bill, so I will use the rest of my time to talk about the realities of home care, which do not appear to be solved by this Bill. As many Members know, I have a vested interest in the issue of care. Like millions of others, I entrust the care of my mothers to carers every day of the week. Most of the carers are lovely, but they are paid only just above the minimum wage and only for the time they spend with the person they are looking after; they are not paid at all for their travelling time. I find that absolutely disgraceful, but it is normal in this sector. I have been told that it is common for carers to be on zero-hours contracts, and I have been told today of the pressure put on workers in Manchester to work beyond 70 hours a week or else lose their jobs.

Caring for disabled and elderly people is a precious job, and the Bill does nothing to address the fundamental flaws in the way that care workers are treated, which of course impacts on the care that people receive. Yesterday, I met a woman and her 98-year-old mother—I will call them Valerie and Lilian. Valerie told me about a few of the problems she was encountering and why she had to change the care provider for Lilian for the second time. She told me about the endless stream of different care workers who do not know Lilian or her needs. One carer had written in the logbook that Lilian had already washed and dressed herself one morning. How did they know that she had washed, and why did they think that the bed jacket she was wearing was appropriate clothing?

Another carer wrote that Lilian was eating toast for her tea when she arrived. How did they think she had made the toast? Of course she was eating the remnants of her breakfast, and her tea, which was made by the morning carer, was still sitting untouched in the refrigerator. Another carer left Lilian with her food tray in her lap, which meant that she was unable to move until the next carer arrived a few hours later. It is no wonder that Lilian’s carers make mistakes. Her tea-time visit is a mere five minutes, and her bedtime visit is only 10 minutes. Lilian only got the tea-time visit because she now attends a day centre for two extra days, which freed up some money to spend on the visit.

Lilian lives in sheltered accommodation where, years ago, there would have been a warden who made regular visits. Now there is just a housing manager whose role does not include checking on the residents. Valerie told me about the strain being put on her because of the expectation that she would be available at all hours. As she said, she is nearly 70 herself. She has already suffered a stroke and cares for her 76-year-old husband. Once she has taken her own medication, she cannot go out in the middle of the night, but there is no other support.

Valerie and Lilian’s story is just one, and a depressingly familiar one. The reality is that carers themselves are ageing and the elderly and disabled are not getting the care that they need. I was told just this morning of a carer who left an elderly person in bed in the morning when she should not have done. When the lunchtime carer turned up, the person could barely breathe. The lunchtime carer called the doctor who, after some prevarication, came out. He left a prescription on the elderly person’s table. I do not know how he thought it would miraculously be filled in or how this ill person would miraculously be able to take the necessary medication.

I have seen first hand the distress that is caused when a carer turns up more than an hour late. There is chaos when different carers turn up and do not know what to do. I understand too the realities of inadequate care. I have also experienced the unresponsiveness of the system when care needs change temporarily. Indeed, Marie Curie Cancer Care has raised the issue of the time it can take for a terminally ill person to get care. They can often wait weeks while local authorities test their means and their level of need. Sadly, some people die before they ever get any help at all.

Care should not be determined by the cheapest provider. This most fundamental service of the most personal nature needs to be provided by workers who are appropriately trained and remunerated. I hope the Minister will confirm that every home care worker will have to be trained and qualified. We entrust the care of our most precious loved ones to strangers every day of the week. The Government should use the Bill to ensure not only that our loved ones are treated properly but that the care givers are treated properly too.