Social Care

Kelvin Hopkins Excerpts

Wednesday 25th October 2017 Commons Chamber

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I beg to move,

That this House notes the Conservative Party’s manifesto commitment to a funding proposal for social care which would have no cap on care costs and would include the value of homes in the means test for care at home; further notes that this proposal would leave people with a maximum of only £100,000 of assets; calls on the Government to confirm its intention not to proceed with this commitment; and further calls on the Government to remove the threat to withdraw social care funding from, and stop fines on, local authorities for Delayed Transfers of Care and to commit to the extra funding needed to close the social care funding gap for 2017 and the remaining years of the 2017 Parliament.

After the debacle of the dementia tax, there has been continuing concern that the current and future issues about the funding of social care are not being addressed. The worries stirred up by the Conservative party during the general election will not be resolved without a better idea about what the future now holds for social care.

One place where people were expecting to hear some discussion on this was at the party conferences in September, but if we thought that we would hear about it in the conference speeches of the Secretaries of State responsible for social care, we were sadly let down.

At the Labour party conference, I talked about the crisis in social care and how it was failing those who need care and their families, failing unpaid family carers and failing hundreds of thousands of care workers. People needing care and their carers face the greatest impact. Since the Conservatives came to power in 2010, there are 400,000 fewer people receiving publicly funded care and, sadly, more than 1.2 million people now living with unmet care needs, many of whom are isolated and lonely.

[Kelvin Hopkins (Luton North) (Lab)]

My hon. Friend is raising a very important issue, which is leading to a lot of suffering among elderly people in particular. Will she make reference to the Royal Commission on Long Term Care for the Elderly, which, almost two decades ago, recommended free long-term care for all? That is where we should be.

[Barbara Keeley]

I will talk about how the Labour party will take forward proposals on the future of social care. We wait to hear what the Government choose to do. My hon. Friend is right that there is a driving need now.

The number of people—1.2 million—living with unmet care needs will inevitably rise without an injection of new funding. A lack of publicly funded care means that the task of meeting care needs falls more heavily on unpaid family carers. Many carers have to give up work because of the demands of caring, which has a real impact on their finances and future career prospects. The case for listening to carers and giving them more support is overwhelming. We were expecting a new carers’ strategy this spring, or, at the latest, in the summer. Some 6,500 carers had taken the time over and above their caring responsibilities to respond to the Government’s consultation. However, the Care Minister told me that the responses will merely be taken forward into a new consultation on social care.

Katy Styles, a carer and a campaigner for the Motor Neurone Disease Association, contributed to that consultation and hoped that her voice would be heard, alongside 6,500 other carers. She told me:

“Not publishing the National Carers Strategy has made me extremely angry. It sends a message that carers’ lives are unimportant. It sends a message that Government thinks we can carry on as we are. It sends a message that my own time is of little worth.”

That is a shabby way to treat carers—the people who provide more than 50% of the care in this country.

--- Later in debate ---

[Barbara Keeley]

We will come on to that. If the right hon. Gentleman wants to get into the mess that his party made, the truth is that we legislated a number of years ago to lift the asset floor to £118,000. What his party did during the election was drop that to £100,000. At the weekend, we learned that there was an intention to make it only £50,000. He should be clear about what his Front-Bench colleagues were trying to do. Since then, all we have heard is a deafening silence.

We need to focus on the crisis in social care now. We on the Labour Benches have raised many times just how fragile the care sector is after years of swingeing budget cuts by the Government. A survey by the Association of Directors of Adult Social Services reported that more than two thirds of councils had reported closures of care providers in the first five months of the financial year. Nearly half those councils had had homecare providers handing back contracts.

[Kelvin Hopkins]

My hon. Friend refers again to local authority care homes. In my constituency, three superb local authority care homes were forcibly closed effectively by Government policy. They were loved by the residents. They had full-time, permanently employed trade union staff and were supported and applauded by the local healthcare professionals. They were all closed. Now we have only the private sector, which is in crisis.

[Barbara Keeley]

It is very important that we bear in mind that the 1.45 million workforce in care will have been local government employees and will have enjoyed local government terms and conditions. We have talked many times about the fact that they are not now paid the minimum wage or travel time. They are very badly paid, with no pensions in prospect.

--- Later in debate ---

[Barbara Keeley]

I absolutely agree, and it was helpful of my hon. Friend to make that point. The sleep-ins issue has been a real cause of worry for many organisations over many months. It just goes to the heart of our assertion that people who work in care should be paid the minimum wage, including when they are working at night, which is what they are doing on sleep-ins. I have a constituent who looks after two households of people in adjoining properties, and she does not get normal sleep during the night as alarms can go off in any part of the properties. It is not right at all that those people were paid just fixed amounts, not the minimum wage. The Government must find the funding for that decision.

[Kelvin Hopkins]

I do apologise for intervening so often. Does my hon. Friend agree, as my hon. Friend the Member for Birmingham, Erdington (Jack Dromey) has hinted, that the whole care sector ought to be in the public sector in the longer term at least, provided on the same basis—free at the point of need—as the national health service?

[Barbara Keeley]

As I said earlier, I will come to our proposals; I do not want to jump around in my speech too much more.

Going back to staff working in social care, it is important to remember and think about social workers, not just care staff. A recent study found that less than half the social workers surveyed felt that decisions about a person’s care and support were being left to their professional judgment; it is now all about budgets. More than a third said that they had felt unable to get people the care they need. Less than half felt supported to have necessary difficult conversations about changes to care with people needing care and their families.

The social care crisis is a direct result of the cuts that this Government have chosen to make. The King’s Fund, the Health Foundation and the Nuffield Trust estimated that there would be a funding gap in social care budgets of £1.9 billion for this year, but the extra funding in the Budget was only £1 billion, so there is still a funding gap of £900 million this year. Labour pledged an extra £1 billion for social care this year to start to deal with that funding crisis. However, the Government have chosen instead to put the pressure on local authorities and hard-pressed local council taxpayers to deal with that social crisis, which was made in Downing Street.

Delayed transfers of care due to social care cuts increased by more than a quarter in the 12 months to August this year, putting extra pressure on local councils. Now, sadly, Ministers are threatening councils with fines and further funding cuts to social care if targets for cutting delayed transfers of care cannot be met. Indeed, ADASS reported that half the social services directors it surveyed believe that their targets for delayed transfers were unrealistic. It is barely believable that the Government’s response to the social care crisis is to threaten to make the situation worse by cutting funding for social care even further. Some councils experiencing problems meeting targets were even summoned by NHS leaders last week to a meeting to review their performance challenges.

Many people have said that the approach of blaming and penalising local councils is not sustainable. The Conservative chair of the Local Government Association, Lord Porter, said of the warning letters sent from Ministers to councils:

“No council wants to see anyone stay in hospital for a day longer than necessary. These letters are hugely unhelpful at a time when local government and the NHS need to work together to tackle the health and social care crisis.”

The president of the ADASS, Margaret Willcox, has described the Government’s actions in threatening councils with further sanctions as, “frankly bizarre”. David Oliver, who is clinical vice-president of the Royal College of Physicians and a geriatric consultant, said about delayed transfers of care:

“Some of these delays are due to systematic cuts to social care budgets and provision. Others are due to a serious lack of capacity in community healthcare services…attempts to solve the problem through initiatives like the Better Care Fund or pressure from NHS England have failed”.

Interestingly, Andrea Sutcliffe, the chief inspector of social care at the Care Quality Commission, said:

“I worry that if people focus just on moving people through the system quickly then does that mean that they will force the discharge of somebody that is old and frail into a service which we have rated ‘inadequate’”.

We now have a Government who are driving the NHS to be obsessed with dealing with delayed transfers of care, seemingly above all else. This obsession causes further problems if patients are discharged without planning what they need outside hospital.

Age UK give an example that was brought to it:

“Terry’s father Richard, 85, is in hospital following a stroke. He is ready for discharge and has been assessed as needing rehabilitative care through two home visits a day. However he was then told that there are no reablement services available in his area. Terry has been told to ‘get his father out of hospital’ and to look for and fund the care himself.”

My own local hospital, Salford Royal, sadly seems to have similar issues. Last week, I spoke to a constituent who described her own discharge by saying, “I was thrown out of hospital.” Having had surgery for an infected bite that caused sepsis and a hand that she could not use, my constituent was given no discharge summary, no advice on how to manage her wound and no advice about her recovery. When she struggled to get dressed, she was told that she had to get out quickly, otherwise, “This will count as a failed discharge.” This a theme we may remember from last winter.

I remind the Minister that the British Red Cross talked then of a humanitarian crisis whereby people were sent home without clothes or into chaotic situations. Those chaotic situations involved them falling and not being found for hours, or not being washed because there were no care staff to help them. Ordering patients out of hospital when there is no reablement service for them, without advice about wounds or recovery, or to a care facility rated as inadequate just to meet unrealistic targets on delayed discharge is a recipe for an even worse crisis this winter.