Social Care

Liz Kendall Excerpts

Thursday 24th November 2022 Westminster Hall

[Liz Kendall (Leicester West) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Ali. I congratulate the right hon. Member for Ashford (Damian Green) on securing this debate.

It is about time that we celebrated the huge value and potential of social care, and about time that we see the fact that we are an ageing society, and all living for longer, as something that we should be excited about, proud of and look forward to, not something that is simply a problem and a drain. However, we must also be realistic about how we get from where we are to fulfilling the full potential of social care.

I shall make three broad points today about the value of social care, first, to those who draw on it, secondly, to the communities they live in, and thirdly, to the wider economy—a point the right hon. Member for Ashford rightly touched on.

At its best, social care is about ensuring that every older and disabled person can live the life they choose, in the place they call home, with the people they love, doing the things that matter to them most, as Social Care Future has so powerfully argued. Put simply, social care is—or should be—about ensuring that every older and disabled and person can live an equal life to everybody else. That is its intrinsic value.

I would go further. We all benefit when we have a decent social care system, not just because we may all end up using it or relying on it because of having to care for and support our own parents, but because we ourselves may live to require social care. This is not going to happen to somebody else: it is going to happen to us all, so we had better get it right.

I also argue that our communities massively benefit when we have a decent system of social care. We lose out when older and disabled people cannot make their full contribution in the workplace, in our voluntary and community organisations, and in being part of our lives, like everybody else. It is a tragedy that so many older and disabled people feel shut away and shut off from the rest of their communities. They lose, and we lose too.

I am optimistic about social care. I believe that in the 21st century—the century of ageing—social care is an essential part of a modernised welfare state and our economic infrastructure. But I am also realistic about the challenges we face. The truth is that social care is in a worse situation than it has ever been, after a decade of cuts, the pressures of covid and now the cost of living crisis.

I recently heard directly from members of the Care & Support Alliance about the quite frankly awful choices facing users and their families: disabled people trapped in their own homes because they cannot afford fuel to go out, and their care packages are being cut; older people skipping meals or only eating cold food because they do not want to use their gas and electricity; tens of thousands of people waiting for care assessments, seeing their health worsen day by day; thousands more trapped in hospital, where neither they nor their families want them to be; and families having to spend even more money on care, or cutting back support and giving up their own jobs because they cannot afford the help they need for their loved ones.

As the right hon. Member for Ashford said, at the heart of it all is the absolute crisis in the care workforce. Vacancy rates are up by more than 50% in the past year. There are a record 165,000 vacant posts. Employers are simply unable to recruit or retain the staff they need, especially when people can earn more in hospitality and retail. The Government have still failed to produce a proper, long-term workforce plan. I was very interested in the right hon. Gentleman’s comments—I agree with them—about how we could look at how the care workforce might link up with “Agenda for Change” so that we can get a decent workforce system and plan across health and social care.

Recently, we finally heard details of how the £500 million social care discharge fund will work. I understand that £300 million is going to the integrated care boards and £200 million to local authorities. How much of that will go directly on paying more for the workforce? We cannot do the discharges without the staff. We may need beds, but it is really about the staff. Will the Minister say more about that, because it is an absolutely essential point?

Alongside what I call the intrinsically moral case for care is the increasingly strong economic case. I believe that our care system is, like the NHS, the bedrock of our national prosperity. If the care sector is struggling, other parts of the economy will begin to break down, as those who need care see their own health suffer and the demands on families and friends mount. Having more and better paid care workers in every village, town and city will probably make the biggest contribution to levelling up the economy and getting growth into every part of the country, because we know that care workers do not save their money but spend it locally. Not every rural village can have a solar factory, but every village, town and city needs decently paid care workers. That would make a huge contribution to women’s equality too. We know that the workforce is predominantly female, often from black and minority ethnic communities, and always low paid.

First, then, having more and better paid staff could help to boost jobs and growth. Secondly, it is about helping the rest of us stay in work. Almost 5 million people are already juggling work and care. That is one in seven of all workers. Half have to give up work because they cannot get the support they need to look after their loved ones. Families lose their incomes. Businesses lose their talents. The Government lose their taxes. We would not accept half of all new parents completely exiting the workforce, so why do we accept it for family carers?

The truth is that in modern Britain social care and, I would argue, childcare are as much a part of our economic infrastructure as the roads and the railways. They should be at the heart of our economic policy and strategy for growth. That is why Labour has made improving care one of the four missions of our industrial strategy. We understand its centrality to the workforce and economic growth. We are calling for a 10-year plan of investment and reform, and a new deal for care workers to ensure they get the pay, terms and conditions, training and career progression they need. We need to improve access to care early on, because the quicker people get help, the more likely it is they will stay living independently for longer.

Thirdly, although we will always need care homes, we need a fundamental shift toward prevention and early intervention, with a new principle of “home first”—putting the home first every time. That includes greater housing options, home adaptations, technology to help people to stay living independently and, critically, work with local voluntary and community groups to do things such as tackle loneliness and isolation. People do not always need to turn to the state for the help and support they need.

Fourthly, for disabled people, who are all too often completely cut out of this debate, social care is not all about helping them to get up, washed and dressed—vital though that is. It is about them living independently, having fulfilling lives and having the same sort of access to friends and work that everybody else takes for granted. We need to ensure that working-age adults with disabilities have greater choice and control over their support and personal budgets. We need to make direct payments really work and give people the power to change services, as they know what is best.

Finally, I want to talk about unpaid carers—an issue that has been going on for years and years. Carers say they have to battle their way around the system, telling their story time and again. They need joined-up services; one point of contact, information and advice; proper breaks; and flexibility at work. I think the family friendly and flexible working agenda for the future is absolutely about people in their ’50s and beyond, and I am not just saying that from a selfish perspective.

In conclusion, in the 21st century and in one of the richest countries in the world, the goal of ensuring that all old and disabled people live the life they choose should not be regarded as extraordinary. It is the missing part of the jigsaw of the welfare state. It was never part of it when it was created, because back then life expectancy was 65 and women stayed at home. We need to change our thinking so that social care is at the heart of the modernised welfare state and an essential part of our economic infrastructure. We cannot do it all at once, but with a 10-year plan of investment and reform we can achieve it.

I have to say that it beggared belief that the Chancellor, when Chair of the Health and Social Care Committee, said that his greatest regret as Health Secretary was not putting in place a long-term plan for reform, but then put the final nail in the coffin of reform in his autumn statement. I urge the Minister to make the case again. Yes, we need to tackle the immediate challenges, but we need a long-term vision to be implemented. I look forward to her comments.