Social Care Funding

Kevin Hollinrake Excerpts

Wednesday 17th October 2018 Commons Chamber

[Barbara Keeley]

We have indeed been doing more work on this, but we laid out in our manifesto—the hon. Gentleman’s party did not—what our future plans for social care funding were. We said what the three options for funding social care were and that it would either be one of those three options, or perhaps a combination of all three—I think that the party that is being left behind here is his.

The impact of social care cuts means that less care is now available for older and younger adults alike. Four hundred thousand fewer older people got publicly funded care in 2015 than in 2010, and 1.4 million older people now have unmet social care needs. Put simply, that is over 1 million people who are not getting help with washing, dressing, going to the toilet, making meals or taking medication.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

The hon. Lady mentions the plans in the Labour party’s manifesto, but since then the Health Committee and the Communities and Local Government Committee have produced a joint report on the future funding of adult social care that unanimously recommends adoption of the German-style social insurance system. Will Labour consider those recommendations? Is she minded to support that cross-party recommendation?

[Barbara Keeley]

The hon. Gentleman asked me the same question six months ago, on our last Opposition day debate on this subject, and I will give him the answer I gave him then: he should really be trying to influence his own party. I thank those Committees for the work they did, as the Prime Minister did today. Labour has got as far as producing a White Paper—not a Green Paper. We have a 2010 White Paper, and I have a copy with me. I recommend that Conservative Members who keep asking about this look at the extensive proposals in that White Paper, which followed a Green Paper and an extensive consultation. The party being left behind is the Conservative party.

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[Barbara Keeley]

I very much do and thank my hon. Friend for making that point. There is a great place for co-operatives and mutuals and other such organisations. Organisations like Shared Lives are producing outstanding care in some parts of the country, and we must look at all those models.

I want to talk about hard-pressed family carers, because the situation of less care and lower quality care means that family carers are under pressure as never before to step in and provide care. The strain of caring has seen almost three quarters of carers suffer mental ill health and nearly two thirds suffer physical health problems, according to Carers UK. But too few carers can access respite from caring; they are at breaking point.

Problems with poor care quality and a lack of support were highlighted earlier this year in a report by Age UK entitled, “Why call it care when nobody cares?” At the launch of that report, both I and the Care Minister heard from carers like Joyce. At 73, Joyce cares full-time for her husband David who has had a stroke and a massive brain haemorrhage. Joyce has to do everything for David to make sure he is

“clean and comfortable at all times”.

That involves regularly lifting him in and out of his bed or chair to wash him, or take him to the toilet, throughout the day and night. She said:

“It is extremely hard to get good respite care where we live in Cheshire. Our local care home is no longer an option due to being cut as a provider by the local council. I had to fight tooth and nail for the care David currently gets in a day centre—but it just isn’t enough.

I don’t know how I’ll continue to cope without more support and regular respite breaks. Our care was cut in March, the third time that we have had respite care pulled. I am so angry and frustrated, I am so worried at what is facing us at the moment I hardly dare think about it.”

What carers like Joyce need is comprehensive support and carers breaks to allow them to look after themselves as well as the person they care for. What they have received from the Government is the damp squib of a “carers action plan” in place of a proper national strategy.

Labour has already pledged to deliver a national carers strategy as we did with our second national strategy in 2009. That national carers strategy pledged £150 million of funding for respite care breaks for carers. That funding has now disappeared into a black hole in the better care fund, leaving carers like Joyce to fight “tooth and nail” to get any respite at all.

[Kevin Hollinrake]

rose—

[Barbara Keeley]

I must make progress.

For care staff, the combination of cuts to social care funding and increasing demand for care has created the perfect storm of pressures, affecting the quality of care. Care staff themselves are reporting seeing a major decline in standards of care over the past couple of years.

Kim, one member of care staff, told her trade union, Unison, that she

“found it increasingly difficult to provide a good standard of care because of staff shortages and the greater need of clients. Often visits to clients have to be rushed, making medication mistakes by staff more commonplace and no social time for clients.”

Another care home staff member from Lancashire said that

“a lot of the time it feels like we are operating a ‘people warehouse’ and just offering the basics of feeding and personal care.”

I find those comments deeply troubling. They show the direct human impact that the underfunding of social care is having. Staff are rushing from one appointment to another, with no time to talk. They are being seen as

“heartless robots as opposed to a lifeline service”.

That is how one care home staff member described her job. Care staff are some of the most dedicated and highly skilled workers in this country, but these pressures, added to their pitifully low pay and their poor terms and conditions, are driving people from a sector where they have never been needed as much as they are now.

The care sector is teetering on the edge of a cliff. Without an urgent response from the Government, it could topple altogether. Ministers in this place talk glibly about making hard choices, but the truth is that this Government have chosen to pursue austerity on the backs of older people and vulnerable adults, who rely on social care. If austerity is now over, as the Prime Minister has claimed, the Government must put in the funding that social care needs to bring it back from the brink.

At last year’s election, Labour outlined a plan to invest an additional £8 billion in the social care system. We want to lift the quality of care and to lift access to care and support for carers before moving on to build our new national care service, as outlined in our White Paper. The Prime Minister said last year that the Government would act. They must now commit to a sustainable long-term funding plan. I urge hon. Members to vote for our motion tonight, to ensure that the Government honour the Prime Minister’s promise, because the people who need care, their family carers, and the care staff who care for them deserve better than this.

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[Matt Hancock]

Yes; I enjoyed reading that report on my summer holidays and thought the research that underpinned it was very interesting. Of course, the taxpayer does contribute to the system, but we cannot rely only on the taxpayer to support the growing cost. Some people propose the answer that the taxpayer should simply fund everything, but I do not think that that is a valid solution.

Alongside the reforms to the funding, we need to transform our care system, so we will look into how the Government can support innovation and encourage new models of care provision. That will include looking at the role of housing and how we can replicate the very best models that combine a home with quality of care. For instance, I love the examples of combing care provision for the young and the old. I pay tribute to the doctors behind the “Old People’s Home for 4 Year Olds” project, which is good viewing on Channel 4. We also need to better support people through well-designed aids and adaptations, and we must ensure better support for carers, too.

[Kevin Hollinrake]

The Secretary of State is making some good points, but may I press him on the point made by my hon. Friend the Member for Northampton South (Andrew Lewer) about the social insurance recommendation in the Select Committee report? The shadow Minister refused to confirm whether she would consider the findings in that report; will the Secretary of State agree at least to consider the proposals and recommendations that were delivered on a unanimous cross-party basis?

[Matt Hancock]

Yes, absolutely. I am considering them. In fact, I shall go further and say that I am attracted to the insurance and contribution model. There are many different potential details in how such a model can be delivered, but I am very much taking that Select Committee report into consideration as we draft the Green Paper.

Alongside ensuring that the funding is in place, we need to make sure that we support carers. In June, we published the carers action plan, a two-year package of support for carers to ensure that they are properly recognised, helped and valued in a way that supports their health and wellbeing. The Green Paper will go further and propose how society can strengthen support for carers as a vital part of a sustainable health and social care system.

The guiding principles behind the Green Paper will be sevenfold: first, improving the quality and safety of care; secondly, integrated care, with the NHS and social care systems operating as one; thirdly, giving the highest possible control to those receiving support; fourthly, better practical support for families and carers; fifthly, a sustainable funding model supported by a diverse, vibrant and stable market; sixthly, greater security for those born with care needs or who develop those needs in later life; and seventhly, a valued NHS and social care workforce. Those will be the principles behind the Green Paper, and I hope that we can build cross-party support for it.

As a society, we need to rise to the unprecedented social care challenge that our generation faces. For the sake of future generations, we must act now to build a better and more sustainable social care system, in the short term and the long term, that ensures that people are properly valued: a system both for those in need of care and for their carers, a system that supports carers—not only those who work in care homes but those who care for loved ones at home—and with the goal of building a sustainable health and social care system of which we can all be proud.

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[Kevin Hollinrake (Thirsk and Malton) (Con)]

A former US President once said that there are no easy solutions, but there are simple solutions. What we need to solve this problem is a simple, scalable and sustainable solution.

Ideally, when people look for a solution, they try not to invent a new one but to find one that somebody has already used for that problem. That is exactly what the Joint Select Committee inquiry did. It looked at the German system. We looked at it twice, in our earlier report and in the joint report between the Health and Social Care Committee and the Housing, Communities and Local Government Committee. We looked at it cross-party and unanimously came to the conclusion that this was the right solution for us. It is a social insurance, not a tax.

The hon. Member for Central Ayrshire (Dr Whitford) mentioned that national insurance would be a suitable vehicle. National insurance went the same way as every other hypothecated tax—it was spread around general taxation. That is not the right way; it must be separated from government.

This solution is simple and scalable. It is not easy, but it is simple and cross-party, and I very much hope that both the Opposition and the Government will support it.