Social Care
Laura Smith Excerpts(6 years ago)
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Laura Smith (Crewe and Nantwich) (Lab)
It is an honour to follow my hon. Friend the Member for Stretford and Urmston (Kate Green).
Four weeks ago today, one of my constituents from the village of Hough attended Parliament to speak at Age UK’s parliamentary reception. We meet some people in life whom we will never forget. Joyce Yoxall is one of those people. Those who came to the event will remember her harrowing account of life as an unpaid carer. I was as moved then as I was when I first visited Joyce at her home to discuss the problems she is having with our social care system. Joyce’s husband David suffered a stroke in 2014. Since then, she has been forced to stop the care that David should be entitled to because of its high cost and poor quality. She talked about crippling care costs and how she felt she had been “let down”. I had to fight back the tears as she spoke about being mentally and physically exhausted, and how she dare not think of the year ahead.
Joyce has literally become the face of hundreds of thousands of people—and maybe more—who are in a similar situation by featuring on the front cover of Age UK’s aptly named report, “Why call it care when nobody cares?” The report is the result of 127 interviews regarding the quality of social care that people have experienced. I encourage anybody who has not read the report to do so.
The reason I started by talking about Joyce and David is that I want to remind everybody of the heartbreaking human reality behind the statistics I will refer to later. Let us start by reminding ourselves why those like Joyce might feel let down. As has been mentioned, a growing and ageing population is placing ever more demand on the social care sector, but that should not come as a surprise to anybody who has been living in the real world for at least some of the time in the past few decades.
Almost eight years ago, the Dilnot commission was set up by David Cameron’s coalition Government, tasked with making recommendations for changes to the funding of care. It published its recommendations in 2011, including a more generous means-testing threshold and a cap on care costs. That sounded promising, but after another general election the Government announced that the measures would be delayed until April 2020 and, at around the same time, closed the independent living fund. Then the Government promised to publish a Green Paper in the summer of 2017, but along came yet another general election, during which the current Prime Minister threatened to introduce a dementia tax.
Since then, we have had an autumn Budget in which the Chancellor failed even to mention social care, let alone provide adequate funding. We have seen the Department for Health and Social Care’s single departmental plan, which failed to mention the social care workforce. More recently, we had the spring statement, and still there is no lifeline for those with care needs or their families or carers.
We know that at some point, hopefully before the summer recess, the Government will publish their Green Paper on social care for older people, but we do not yet know when any proposals will be implemented after the consultation. To make matters worse, the Green Paper will not cover care for younger adults, which accounts for almost half of all council spending on adult social care.
Laura Smith
No.
There has been one missed opportunity after another—delay, delay, delay. Meanwhile, local councils, which are responsible for delivering social care, are seeing their budgets slashed, and one care home after another is placed in special measures or forced to close. What is the result? Research published recently by BMJ Open links cuts to adult social care and health spending to nearly 120,000 excess deaths in England since 2010.
The Care Act 2014 has been about as useful as a chocolate fireguard against a backdrop of inadequate funding and insufficient resources. The legislation has done nothing to protect the 1.2 million older people whose care needs are not being met. Our system clearly places more emphasis on councils setting balanced budgets to an ever-reducing bottom line than it does on making sure that all its residents’ care needs are met.
Laura Smith
No.
Cuts have consequences: I refer to my constituent’s words—that she
“dare not think of the year ahead.”
I do not blame my constituents for having little faith. The past eight years have been nothing but empty promises and never-ending cuts. Fully integrated health and social care would be a good start, but that does not go nearly far enough. We need a whole new approach to disability and ageing based on a commitment to the social model of disability that permeates every aspect of Government.
For example, our social care system needs to be aligned with an appropriate welfare policy and housing strategy, so that we remove as many barriers to disabled people as possible. Access to services should be on the basis of need and not affordability. I wholeheartedly agree that pumping more money into a broken system is no long-term solution.
Laura Smith
I have waited a long time to speak and I am going to carry on.
We need to stop viewing social care as a cost or a burden and instead see it as a wealth creator. Penny-pinching has proved to be a false economy when it comes to social care. It undermines the ability to take preventive action that not only is morally and ethically the right thing to do, but saves money in the long run by reducing the demand on our NHS. We also need to stop neglecting our 1.5 million workers in social care and build a more highly skilled and better-paid workforce. Finally, we need to address the failings of privatised adult social care, as outlined in the 2016 report by the Centre for Health and the Public Interest. Without any real debate, market values have penetrated areas where they do not belong and social care is perhaps the worst example of this. We cannot keep burying our heads in the sand and letting the crisis escalate.
There is no excuse for the Government’s inaction. The CQC warned us last year that social care was reaching a “tipping point”. This was after the Prime Minister had herself acknowledged that our system is broken. This cruel, callous Conservative Government have turned their back on older people and disabled people up and down this country. They have also repeatedly let down the social care workforce and the invisible army of unpaid carers.
Laura Smith
No.
We need a Government who put people before profits. Until then, I fear that we will be left with the same fragmented, failing system that is letting our constituents down daily.
Privatisation of NHS Services
Laura Smith Excerpts(6 years ago)
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Laura Smith (Crewe and Nantwich) (Lab)
Hundreds of my constituents in Crewe and Nantwich signed this petition because they want their Government to put people before profit. Fourteen hospital trusts have had to trigger emergency contingency plans and delay hospital building because of the collapse of Carillion earlier this year. Given that Capita’s annual losses are rocketing, does my hon. Friend agree that the Government’s response shows that they remain dangerously obsessed with privatisation in our NHS?
Mike Hill
I agree. As I said, it is estimated that, over the next three years, up to £10 billion-worth of NHS contracts will go to the private sector, including the provider that my hon. Friend mentions.
Are such fears irrational or are people right to be concerned about the privatisation of NHS services, given the fact that the influence of private healthcare providers has risen sharply in recent decades? The use of the private sector has been progressed by successive Governments over many years. The present Government blame Labour for introducing private finance initiatives, which they say have burdened the NHS with eye-watering debts, but the Government compounded the problem through PF2. They also blame Labour for opening up the NHS to marketisation by splitting primary care trusts into commissioning and provider arms, and introducing the concept of “any preferred provider” in its transforming community services programme, even though the Secretary of State at the time, Andy Burnham, expressly stated that the NHS would always be the preferred provider of services. Yet from 2010 onwards this Government extended that model, creating clinical commissioning groups and pursuing competition and commercialisation with renewed vigour. Today, therefore, many traditional public health services are run by private providers such as Virgin Care and GP consortiums in their own right—services such as out-of-hours urgent care, sexual health and mental health residential care.
The Health and Social Care Act 2012 was designed to bring in a far greater private sector element to the NHS through expansion of the internal market. Since then, the privatisation picture has been more mixed than had been feared, not only as a result of campaigns by Unison, the GMB and others, but because various Government initiatives to boost privatisation fell flat. However, there is still significant evidence of increasing privatisation, with companies such as Virgin, Serco and Spire continuing to prosper.
NHS Winter Crisis
Laura Smith Excerpts(6 years, 3 months ago)
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Laura Smith (Crewe and Nantwich) (Lab)
I start by paying tribute to the incredible staff working in our NHS. Keeping the nation fit and healthy is a noble calling. They make the NHS what it is—a national treasure—and they ought to be proud. Many participants in today’s debate know someone who might not be with us today, or whose quality of life would be significantly worse, had it not been for the NHS.
I would like to take this opportunity to pay tribute to Elle Morris, an 11-year-old cystic fibrosis sufferer and friend in my constituency, who sadly lost her fight last week. Elle’s family have expressed their thanks to the NHS workers who looked after Elle with such love and care right until the end, and supported her parents, Becky and Ian, and her sister Cara. Elle was a pioneer of raising awareness of cystic fibrosis and opt-out organ donation, and I speak on behalf of Crewe and Nantwich in saying how much she will be missed and how proud of her we all are. Breathe easy, Elle.
Everyone has quoted the facts and figures relating to the debate, and I will not repeat them. We all treasure the NHS, and it needs to be funded. My constituents do not want the Prime Minister to apologise for the NHS crisis. They want the Government to act and to resolve the crisis. By rewarding the Health Secretary, the Prime Minister will have sent a clear message about her vision of the NHS. Conservative Members have an opportunity to prove that theory wrong by supporting the motion, which calls on the Government to increase cash limits for the current year, allowing hospitals to resume a full service to the public. Actions speak louder than words, and today we will discover whether the Prime Minister’s apology was sincere.
Social Care
Laura Smith Excerpts(6 years, 6 months ago)
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Laura Smith (Crewe and Nantwich) (Lab)
Social care has been pushed into a state of emergency. A report by the CQC in July found that one in four social care services is now failing on safety grounds, with at least one care home closing every week. Only 2% of providers are regarded as outstanding.
In Cheshire East, almost a third of care homes have been rated inadequate or as requiring improvement. Imagine the uproar if Ofsted published such statistics for schools. The CQC’s chief inspector, Andrea Sutcliffe, admits that adult social care is still approaching a “tipping point.”
The only reason the social care service has not completely fallen to pieces is because it is being held together by an incredible and skilled workforce who are swimming tirelessly against the tide. A recent Unison survey of homecare workers found that more than three in five are given only 15 minutes, or less, to provide personal care. Three quarters end up rushing and have to compromise the dignity or wellbeing of those they look after. Nearly a third are unable to wash, bathe or shower the people for whom they care.
I am always lost for words when I speak to care workers in my constituency. It takes a certain kind of person to be a care worker, and imagine how it must feel for that type of person to be forced to leave somebody for whom they care before they have had time to wash them or to help them eat. To make matters worse, many work on poverty pay, a consequence of the chronic underfunding of this service.
The National Audit Office has stated that 220,000 care workers in England are being paid below the minimum wage—the national minimum wage, not the Government’s living wage. Care workers in my constituency have been underpaid for years by Cheshire East Council, which is breaching minimum wage regulations despite having a policy to pay all workers at least the local living wage. Those workers have yet to receive back pay for the duration that they have been underpaid, and it is unclear whether that back pay will lift them to a living wage.
Only yesterday, a care worker contacted my office because he did not know where else to turn. He described how staff morale is at rock bottom, with many care workers suffering from poor mental health, worrying about their job security and relying on food banks and payday loans. They are too scared to take time off sick and unable to afford annual leave. He described how care workers feel that they have no voice and receive no respect. Is it any wonder that more than 900 care workers are leaving their job every single day?
Autism Diagnosis
Laura Smith Excerpts(6 years, 7 months ago)
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Bambos Charalambous
My hon. Friend makes the excellent point that the delay in diagnosing autism leads to further economic and social concerns that may have an adverse impact on society in general. That point was very well made.
NICE also has a quality standard for adults with autism, which again recommends that people should have a diagnostic assessment within three months of referral. NICE’s rationale for that states:
“It is important that the assessment is conducted as soon as possible so that appropriate health and social care interventions, advice and support can be offered.”
In my constituency of Enfield, Southgate there is currently no local diagnostic pathway. That means that an adult looking for assessment and a possible diagnosis could not have it done at North Middlesex hospital or Chase Farm hospital—or even Barnet General or the Royal Free, which are within the trust. Instead, they would have to be referred to the Maudsley hospital in south London—a distance of more than 23 miles. While I respect the excellent work that the Maudsley hospital does in mental health, I find it staggering that my constituents not only have to wait three years before getting an appointment for diagnosis, but then have to travel 23 miles to access the services. I suspect the distances may be longer for colleagues in other parts of the country.
Some parents and carers cannot bear the long wait and so feel compelled to pay privately to have their child diagnosed, putting them under extra unnecessary financial pressure in an already stressful situation. Once correctly diagnosed, a child will receive the support they need in schooling and wellbeing via a specifically designed local education, health and care plan, which could have life-changing effects.
Laura Smith (Crewe and Nantwich) (Lab)
On that point, a constituent, Zoe, explained to me how the diagnostic procedures are outdated. Some children are not being diagnosed as autistic because they can do things such as make eye contact, and then that diagnosis is proved to be wrong. She also said:
“If you become desperate and obtain a private diagnosis with an expert in the field, you are made to feel that you have bought the result and it is not seen as valid by schools and other SEN professionals. I think that the worst thing is the treatment of parents who are trying to help their child under what are extremely stressful and upsetting circumstances. Your parenting skills and your mental health are questioned regularly.”
Does my hon. Friend agree that that is a problem?
Bambos Charalambous
My hon. Friend makes an excellent point. Sometimes the private assessment is not recognised by the local CCG, so referral does not take place as planned, leading to more stress on families and children. I have enormous sympathy with her constituent who has faced that situation.
We all know that the early years of a child’s life are so vital for their long-term development. If a child does not get a good start, it is always hard to catch up. Research conducted by the charity Autistica has found that a programme of parent-led video therapy delivered during the early years of an autistic child’s life could significantly improve their communication and social interaction skills. People who are not diagnosed until adulthood can experience depression and have suicidal thoughts.