Local Government and Social Care Funding

Laura Smith Excerpts

Wednesday 24th April 2019 Commons Chamber

[James Brokenshire]

I am glad that the hon. Lady has mentioned the troubled families programme, because I will be talking about that in greater detail later in my speech. I have been hugely impressed by the outcomes of the programme, which, as she rightly points out, is making a difference in people’s lives. I strongly believe that the troubled families programme has now shown an evidence base for how it is profoundly doing that. It is doing what has rightly been described across the House as pulling together services to create a person-centric approach, and breaking down some of the silos and barriers. I am a huge champion of the troubled families programme.

[Laura Smith (Crewe and Nantwich) (Lab)]

So far, the Secretary of State has blamed striking workers and councils up and down the country. The one group that is not being blamed is his rotten Government: the responsibility for this crisis lies firmly at his door. When will he stop blaming everybody else and take some responsibility for the crisis in this country?

[James Brokenshire]

The hon. Lady must equally reflect on the fact that the Labour Opposition voted against a real-terms increase in the core spending available to local authorities this year. That included the additional funding for health and for adult and children’s social care. We recognised the pressures and made the right judgments in respect of the pressures that councils explained to us. The Opposition may wax lyrical about funding pressures, but their own councils are not even helping themselves.

The Opposition have some front to claim to be the champions of local government and localism. I took the time to read the shadow Secretary of State’s recent speech to Labour’s local government conference this year, and it contained some big and bold claims. It is just a shame that they were not backed up by reality. He said that Labour was the party of devolution. I must congratulate him on his selective memory. If I remember correctly, it was his party that, after 13 years, left the UK one of the most centralised countries in Europe. It took the Conservatives in government to roll back the era of centrally imposed targets and the tick-box culture imposed by the Labour party, and it is this Government who have put the public finances back on track and cleared up the mess we inherited from Labour.

--- Later in debate ---

[Laura Smith (Crewe and Nantwich) (Lab)]

It is a pleasure to follow the hon. Member for Totnes (Dr Wollaston).

Having listened to the contributions today, it seems that there is a consensus that our social care system is broken, but some Members seem to be living with their heads in the clouds. To describe our social care system as broken is an understatement: it is a national scandal of which we should be ashamed. I am certain that Members present get the same casework as I get. It is the stuff of nightmares. Social care is one of those issues that genuinely keeps me awake at night.

Behind all the statistics that we hear today, there is a heartbreaking human reality. As many others will have done, I have sat and fought back the tears as I have listened to those at my local surgeries who are exhausted from the battle to get the most basic level of support for their loved ones. We have only to read some of the reports from recent Care Quality Commission inspections to get a feel for the state of our social care system today. It is beyond broken.

One report, following an inspection in Crewe and Nantwich last year, found one person with injuries that were unaccounted for. It described another person as

“extremely anxious and afraid that they would be injured”,

and said that they

“lay in their bed in the foetal position”

and that

“their feet were dirty and their hair matted.”

I will never forget visiting an older lady in a nursing home who was still haunted by her experience in a previous facility, where she had suffered the most undignified neglect—a lady left shocked and confused after decades of working and paying taxes and paying national insurance contributions.

Today, I wish to focus our attention on those who work in social care. It takes a certain kind of person to work in the care sector, and I pay tribute to them all. They experience this rotten system almost every single day of their lives, yet they carry on with compassion and professionalism, despite the poverty pay and despite feeling ignored and undervalued by the Government. These are the people we rely on to protect the dignity and independence of our relatives, friends and neighbours.

What does it say about us as a nation that our social care workforce is one of the most exploited and underpaid? I cannot even imagine how it must feel to be that type of person and to be forced to leave somebody who is under their care before they have had the time to wash them, or to help them to eat. But who cares for the carers? A care worker described how staff morale was at rock bottom, with many care workers suffering from poor mental health and worried about their job security, relying on food banks and payday loans, too scared to take time off sick. He said he felt that care workers have no voice and no respect.

As if things were not bad enough, one group of care workers, many of whom already work for the minimum wage, face losing hundreds of pounds a month because their employer, Alternative Futures Group, has taken the decision to slash payments for sleep-in shifts. Sleep-in shifts are an integral part of our care service that the Government have a statutory obligation to provide. I have spoken many times previously about the importance of this work.

Calling them sleep-in shifts can often lead to people getting the wrong impression. One of the affected workers explained to me in an email this week:

“Sometimes you have to deal with emergency situations and take a client to hospital. You never properly sleep – you are half-awake all night – listening in case that person needs you. Often, we are up 5 or 6 times a night, taking them to the toilet or calming them down when they are agitated”.

She went on to describe how she often finished a sleep-in shift only to start another day in work, often going days without seeing her three children. For her, the cut in pay will mean losing £300 a month—the cost of her bills. She is now having to consider getting a second job, or even leaving the job that she loves. One of her colleagues whom I met recently is already working a second job. She also goes days at a time without seeing her child. Both ladies work with adults with learning difficulties and their duties include administering medication, PEG—percutaneous endoscopic gastrostomy —feeding, as well as washing, dressing, helping with finances and facilitating day trips.

As well as physical support, these workers also provide emotional support for the people for whom they care. Their passion for their work shines through, but the cut to their income has been the final straw and, for the first time ever, these workers have been left with no option other than to take industrial action. I stand in solidarity with those workers—as should every Member here today. They are in no way to blame for the problems in our social care system.

I questioned AFG’s decision to cut the rate of pay for sleep-in shifts given that there has been no reduction in the payment that it receives from Cheshire East Council. Its response was somewhat alarming: it claims that the funding provided by the council has never been sufficient to cover the full costs of paying the national living wage rate for sleep-ins. The charity says that its position is that

“it wants to pay above the national minimum wage for all care hours”

but that this requires additional funding. I share AFG’s concerns about what it describes as

“the dire situation funding of care is having on hard-working care staff.”

However, Cheshire East Council assures me that it does not pay providers any less for sleep-in support than it does for waking-night support and that it believes that care providers should be paying at least the national minimum wage rate. When I recently asked what the Government were doing to make sure that local authorities have enough funding to allow providers to pay sleep-ins at the national living wage rate, the Chief Secretary to the Treasury replied that it was currently working on this with the Department of Health and Social Care, which implies that it is not being paid.

Will the Government accept responsibility for this dispute and admit that they are not providing adequate funding? If they do not, we really need to explore why this funding is not reaching the frontline. Whatever the case, it is the overworked and underpaid care workers who are paying the price, as well as the elderly and vulnerable members of our communities who rely on this vital service.

In her summing up, I hope that the Minister will address the following points. First, what advice do the Government currently give to social care providers and commissioning authorities in the light of the current legal situation regarding payment for sleep-in shifts? Will she join me in calling on AFG to take up Unison’s offer of a meeting to continue these negotiations in the hope of resolving this ongoing dispute? Secondly, will she commit to looking into the dispute to determine whether AFG receives sufficient funding to pay its workers at the national living wage rate? Thirdly, will she acknowledge that the Government could simply pass new legislation, positively applying the national living wage rate to sleep-in shifts? That would give the sector the certainty that it needs and make sure that care workers are remunerated as so many believe they should be.

We have been repeatedly promised a social care Green Paper, which will focus on a valued workforce as one of its principles, but I have little faith that it will ever even appear. It has been delayed for the fifth time since the Government first promised to publish it before I was even elected two years ago. If it is published, I am confident that it will not contain the radical solutions that this country owes to its elderly citizens and to the most vulnerable people in our communities.

Our problems in social care are systemic and structural. The only beneficiaries of the system are the private companies that are profiting from this misery and it is they who benefit from this Government’s inaction. In previous debates, I have raised my concerns about how, without any real debate, market values have penetrated areas where they do not belong, and social care is perhaps the worst example of this. As far back as 2016, the Centre for Health and the Public Interest outlined the failings of privatised adult social care. Research commissioned by Independent Age has produced several policy options that serve as a starting point for any political discussion, and it shows just what can be done where there is a will to do so.

We need to address these failings now, with an immediate uplift in funding, while we build a sustainable model for the future. Not to do so is a political choice and a clear expression of how this Government prioritise the elderly and most vulnerable people we represent, and those whom we employ to provide care services. Those working in social care need to be listened to. They can help us to build a national care service that is based on need and not profitability—one that is centred on independent living for all and dignity in later life.

[Several hon. Members rose—]

Local Government Funding

Laura Smith Excerpts

Tuesday 15th January 2019 Westminster Hall

[Preet Kaur Gill]

My hon. Friend makes a really important intervention. The figures are harrowing. I hope the Minister is listening carefully and will respond to Members’ interventions at the end of the debate.

Local government is not homogenous. The service needs of their populations, ability to raise revenue locally and reliance on central grants all differ substantially. Proposed and existing policies such as business rates retention and council tax limits will mean different councils can raise significant amounts, which may not match the spending pressures those councils face.

As academics from Cambridge pointed out in October 2018, the Government’s austerity politics have led to

“a shrinking capacity of the local state to address inequality...increasing inequality between local governments themselves and...intensifying issues of territorial injustice.”

Local authorities vary in the needs of their population for services, their reliance on central grants and their ability to raise local revenue. With the Department planning to introduce 75% business rates retention for all local authorities, and access to public services for citizens increasingly reliant on the local tax base—whereby poorer areas are not as able to provide as many public services or the same quality of infrastructure as areas with healthier, more wealthy tax bases—without a strong redistributive element, the under-investment, or even lack of investment, in communities and the people who live there will see them unable to prosper.

Will the Minister ensure that no council has its funding reduced as a result of a new distribution system? What actions will he take to that end? The National Audit Office has highlighted the dangers of bringing in a business rates retention model that has not been fully tested. Will the Minister commit to making public a full and thorough evaluation of the pilot schemes before committing to any further roll-out?

I could raise any number of areas where Government cuts to local government are causing immeasurable immediate and long-term damage—from homelessness to fire safety, from crime prevention to children’s services and public health. Reductions in any of those areas are not impact-neutral, as they influence and prohibit the capacity to prevent and support. As I was cabinet member for public health at Sandwell Council, I will focus on public health, and I hope my colleagues will pick up on other areas.

Councils’ public health budgets are being cut by £531 million between 2015-16 and 2019-20. The Government are taking with one hand, while, at the same time, putting more money into the NHS. Preventing illness and catching problems early so they do not develop further down the line will save the NHS and social care money, so the short-sightedness of cutting public health funding must be due either to ignorance, or to a political choice to undermine councils’ abilities to improve the health of the public. Which is it?

[Laura Smith (Crewe and Nantwich) (Lab)]

My hon. Friend is making an excellent speech. The underfunding of social care is a travesty in itself, but it also has consequences for our hospitals, including avoidable hospital admissions and delayed transfers of care. Does my hon. Friend share my concern that the cuts to local government funding are far-reaching and could have a profound impact on our NHS?

[Preet Kaur Gill]

My hon. Friend raises an important point. The NHS spends only about 5% of its funding on preventive measures. That just cannot be right. As she rightly says, social care costs will soar, and that makes no sense at all.

The Government have announced that they will phase out the public health grant after 2020-21. Instead, they expect business rates retention to entirely fund public health spending. Health inequalities will increase. While they have proposed some kind of top-up system, as with many areas concerning local government, it is unclear how that would work and to what extent that top-up would support the local authorities that need it.

Oral Answers to Questions

Laura Smith Excerpts

Monday 18th June 2018 Commons Chamber

[James Brokenshire]

My right hon. Friend has made a powerful point about design. We have tried to bring people together on round tables to consider such issues, and to think about what the national planning policy framework can do to advance the agenda that he has highlighted.

[Laura Smith (Crewe and Nantwich) (Lab)]

Why is the Secretary of State pressing ahead with changes in funding for homelessness hostels and other supported housing which charities in my constituency, such as the YMCA, have said could threaten their vital services?

[The Parliamentary Under-Secretary of State for Housing, Communities and Local Government (Nigel Adams)]

As the hon. Lady will know, the Government have been consulting on that very issue. We are absolutely committed to reducing homelessness, and we will be able to provide further information in due course.

Housing and Homes

Laura Smith Excerpts

Tuesday 15th May 2018 Commons Chamber

[Laura Smith (Crewe and Nantwich) (Lab)]

I wonder how many of us here have experienced living in a home that is not fit for purpose and its damaging impact on a person’s physical and mental health. How many of us here have had to struggle to scrape together agency fees, find a deposit to put down on a rental property and find the first month’s rent, while still paying all the other basic bills, paying for essentials for the family and dealing with the added constant pressure of thinking about how ever to come out of the cycle of renting rather than owning a property? Countless times, well-meaning people have advised me, as a non-homeowner, that renting is throwing money away and that I really ought to save for a deposit on my own property. I think I can speak for most private renters when I say that, of course, that is everyone’s preferred route, but it is increasingly unlikely to happen because of the cost of living compared with income.

People who rent are faced with significant up-front costs and often very short tenures, and they have to pay more fees and find large deposits every time they move. Young people in particular have to move more often and, in England, the length of a let is so short that they face those up-front costs time and again.

Then there is the real problem of what the rented property is like. A home should not damage someone’s health, but we know that housing conditions can affect a resident’s health and wellbeing in the most appalling ways. Housing conditions such as cold and damp can affect health, as can factors such as the accessibility of the home. One estimate put the cost of poor housing to the NHS at £1.4 billion a year in England. With a growing private rented sector in England and Wales, that cost is likely to increase.

Do not get me wrong: several million people live relatively happily in rented homes, but a substantial minority do not. Some 756,000 households live in privately rented properties that are likely to cause residents to need medical attention.

Since becoming an MP, I have witnessed at first hand the poor conditions that some people are living in. In the worst properties, you can smell the problems before you see them. Damp and cold have a distinctive smell. Working taxpayers in my constituency are paying private landlords for families to live in homes where the state of disrepair is jaw dropping: cupboards lined with black mould; broken and dangerous appliances—it is simply not good enough.

I want to speak briefly about homelessness. It is important to recognise that the rise in homelessness can be traced directly to decisions that the Tories have taken since 2010, despite their keenness to ignore and deny that. There have been 13 separate cuts to housing benefit since 2010, including the bedroom tax and breaking the link between private rented sector housing benefit and private rent. In addition, the National Audit Office has revealed that vital funding for homelessness services has fallen by 69% since 2010.

I am of the opinion that a home is a right, that a home should be comfortable and in no way damage a person’s health, and that people should be able to stay in the area where they were born if they want to do that.

[Anneliese Dodds (Oxford East) (Lab/Co-op)]

When my hon. Friend says that housing is a right and particularly that it is a right not to live in damp housing, does she agree that, thanks to the efforts of a Labour Member, tenants can now take their landlord to court, but they need legal support to do that?

[Laura Smith]

Absolutely. My hon. Friend makes a very good point.

I am of the opinion that someone should be able to aspire to buy a property; that good-quality council housing should be available to those who require it; and that those who rent out properties have an obligation to look after them and the welfare of those they are making money out of. Finally, I am of the opinion that the only way that the housing and homelessness crisis in this country can be solved is by getting rid of this out-of-touch Conservative Government.

Street Homelessness

Laura Smith Excerpts

Tuesday 24th April 2018 Westminster Hall

[Adam Holloway]

Again, I do not want to be a cop-out, but I will throw that to the Minister. If someone is fit and of sound mind, there are all sorts of services, although not quite 24 hours a day, that make it possible to sleep out. I am 52 years old and I was in the Army; to be honest, sleeping rough in central London is a lot more comfortable than going on exercise when I was in the Army. For those who are mentally ill, drug addicted, old or personality disordered, it is a very different thing.

[Laura Smith (Crewe and Nantwich) (Lab)]

Will the hon. Gentleman give way?

[Adam Holloway]

Can I go on a little bit, unless the hon. Lady is desperate on this point?

[Laura Smith]

I will hold on.

[Adam Holloway]

We have to accept that some people are able to sleep rough in our cities because there are the resources to do so.

[Laura Smith]

Sorry, I cannot hold on. I have been out with homeless people in Crewe and Nantwich, and I do not relate to what the hon. Gentleman is saying at all. Does he agree that an area that needs to be looked at more closely is the high rate of benefit sanctions among homeless service users and the impact of those sanctions?

[Adam Holloway]

As I said at the beginning, this is a debate about street homelessness. I accept that is probably true in that other sector, but I did not come across it, and I am here to talk about my experience, so I do not know.

The hon. Lady said that she does not recognise what I was saying. I am not saying that even a large minority of the homeless are there because there are resources for them. I am trying to say, and I will develop this later, that we will get nowhere in solving the problem and getting to the people who are most needy if we just continue to talk about the homeless and feel sorry for everybody. We have to focus on the people in real need. Come out with me some time, and I will show you.

[Laura Smith]

I go and help the homeless in my community; we have great volunteers who also help them all the time. Thank you, but we are interpreting the issue completely differently. It worries me that you are not recognising some of the real, ingrained problems. I do not think that anybody would choose to sleep rough—I do not buy that.

[James Gray (in the Chair)]

Order. Before the hon. Gentleman replies, I must make a couple of boring points. First, interventions are getting terribly long—Members must make short, one-sentence interventions. Secondly, any Member who says “you” means me. If Members refer to another Member, they must use the third person—“him” or “her”.

--- Later in debate ---

[Adam Holloway]

Absolutely. Indeed, I experienced that. For another programme I made some years ago, I pretended to be a homeless mentally ill person in Birmingham. When I was discharged from Queen Elizabeth psychiatric hospital, I went to that very institution and the people there arranged to look after me. That was 30 years ago.

[Laura Smith]

Will the hon. Gentleman give way?

[Adam Holloway]

Yes, of course—I love the outrage.

[Laura Smith]

I find it unbelievable that the hon. Gentleman would pretend to be a homeless mentally ill person. That just shows how detached he is from the situation. I find that insulting.

[Adam Holloway]

All I can do is suggest that the hon. Lady watches that “World in Action” series from 27 years ago and draws her own conclusions about whether that was a good thing. Let us have a chat about it when she has done that.

Let us carry on with some realities. It is very depressing, after 27 years, to look at streets with the same cohorts of mentally ill and drug-addicted people on them—the people who fall through the cracks in the system. Although the police are more able to intervene when a mentally ill person is on the streets and local authorities have particular duties to those who are vulnerable due to mental illness, the reality is that someone who has had serious psychiatric problems is extremely unlikely to maintain a tenancy or stay off the streets for some time. Indeed, I had not appreciated the churn of people—even when people are engaged, the system does not seem able to keep them for the time that it needs to.

Let us be honest about the correlation between immigration and the rising number of street homeless. It is no surprise to me that, in 2016-17, 1,950 rough sleepers were migrants from Romania, Poland and Lithuania. Obviously, homelessness is a much greater risk when people are far from home and from familial support structures. It became clear to me that some migrants sleep on the streets by choice, preferring to sleep rough than to pay for accommodation. It is a no-brainer that years of high immigration and of successive Governments not building enough houses will have a knock-on effect for people at the bottom of society. Of course that will make rents unaffordable.

[Adam Holloway]

The shadow Minister, the hon. Member for Great Grimsby (Melanie Onn), will attest to the fact that I am not well enough versed on what is happening in the rest of the country, so I cannot answer that question, but if my hon. Friend says that, I imagine it must be true.

On people from eastern Europe, perhaps it is time to ask ourselves whether it is exploitative to build an economy on cheap labour provided by those who can barely afford to accommodate themselves in our country. We could of course argue that those people are not strictly homeless, because they might have a home back home, but that is their reality when they are here.

My hon. Friend the Member for Angus (Kirstene Hair) alluded to the housing crisis. We must face up to the inevitable impact of that crisis, and of the related issues of lack of supply and affordability, on homelessness. It is estimated that between 2010 and 2016, population growth, including net international migration, was around 1.58 million. The number of rough sleepers has increased by 169% since 2010. In 2016-17, the housing stock in the UK increased by around 217,000 residential dwellings—an increase of 15% from the previous year, but short of the estimated quarter of a million-odd new homes required to keep up with household formation.

It is not difficult to see that the sums just do not add up, including under this Government. Although the Homelessness Reduction Act 2017 strengthens the duties of local authorities to provide advisory services to people threatened with homelessness and encourages pre-emptive action where house building has not kept up with population increases, it is absurd to think that that will not impact the people at the bottom of society who are often the most unseen—not those on the streets but those on sofas.

We must address the fact that homelessness impacts men and women in different ways. Rough sleepers are overwhelmingly men. During my recent stint on the streets, I saw only a handful of women whom I unscientifically judged to be street homeless—the big giveaway is people carrying bags and suitcases. CHAIN data for 2016-17 shows that only 15% of rough sleepers in London were women. Part of the issue must be that those who care for young children—typically women—are rightly prioritised in the allocation of social housing. However, somewhere along the line we seem to have forgotten that men who live on the streets were once part of a family unit.

[Laura Smith]

Will the hon. Gentleman give way?

[Adam Holloway]

I would love to give way again; the hon. Lady is so informed.

[Laura Smith]

Again, I am astounded by the misogynistic comment that it should be women who look after the children. I know that is a different issue to the debate, but I cannot let it go by.

[Adam Holloway]

I will read what I said again: part of the issue must be that the allocation of housing priorities goes to those who care for young children, who are typically women, and rightly so.

[Laura Smith]

“And rightly so”!

[Adam Holloway]

Yes, absolutely. It is right for housing priority to go to people who look after children, and typically they are women. Again, I am just stating the reality. If it is different, the hon. Lady should tell us.

Let us move on. We must recognise the particular challenge of mental health issues that affect men, and the way that men who battle for many years with the perceived stigma of mental health problems can be particularly susceptible to a sudden crisis that can lead to homelessness. I also learned about the ways homelessness affects women. Some women in London ride the bus for 24 hours a day to stay off the streets, and some go from place to place in return for a bed to sleep in.

We must also address the issue of how people’s generosity can sometimes be as much part of the problem as the solution. The man I met near Victoria station spent the night drinking beer bought with £30 that kind members of the public had come up and given him that evening. St Mungo’s staff told me of a client who had abused drugs for many years and had a leg amputated as a result, but who finally managed to get clean. This man told them that if he had not been given money by the public for so long he would have sought help much sooner. Begging is part of the problem—an able-bodied person can make quite a lot of money from begging on the streets of London. Generosity by members of the public is a factor in this; generosity can be enabling and mask those in real need.