Covid-19 Update

Liz Kendall Excerpts

Thursday 16th July 2020 Commons Chamber

[Matt Hancock]

The shadow Secretary of State said this, and the hon. Lady is now trying again. On 16 March, I said to this House—and it was welcomed by the shadow Secretary of State—

[Liz Kendall (Leicester West) (Lab)]

Orwellian!

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. Do not shout at the Secretary of State. He is answering the question.

Oral Answers to Questions

Liz Kendall Excerpts

Tuesday 23rd June 2020 Commons Chamber

[Helen Whately]

My hon. Friend makes an important point. I know that the current restriction on visiting is hard for residents in care homes and their families, and has a real impact on health and wellbeing. We are updating our visitor guidance and intend to publish it soon.

[Liz Kendall (Leicester West) (Lab)]

I, too, wish the Minister a very happy birthday.

I am sure the Minister will agree that lessons must be learned from what has happened so far, because the virus is not over for social care. With 13,375 deaths from covid-19 in care homes, what does she think she should have done differently?

[Helen Whately]

The hon. Lady is absolutely right that there will be a time when we will look back and learn lessons, and I wish that not so many people had died in social care, but right now we are looking ahead. We are making sure that we have in place the plans to support the social care sector through the months ahead, and we are also pressing ahead with work on social care reform.

Coronavirus and Care Homes

Liz Kendall Excerpts

Tuesday 19th May 2020 Commons Chamber

[Liz Kendall (Leicester West) (Lab)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on coronavirus and care homes.

[Mr Speaker]

I call Matt Hancock to answer the urgent question. The Secretary of State should not speak for more than three minutes.

[Mr Speaker]

In welcoming the hon. Member for Leicester West (Liz Kendall) to the Front Bench, I asked her to speak for no more than two minutes.

[Liz Kendall]

Over 23,000 more people have died in care homes in the first four months of this year compared with last year. This virus is the biggest health challenge of our lives, but Ministers have been too slow to tackle the problem in care homes, social care has not had the same priority as the NHS, and these services have not been treated as inextricably linked.

Will the Secretary of State explain why guidance saying that care homes were “very unlikely” to be infected was not withdrawn until 12 March, given that the chief medical officer warned about community transmission and the risks to the elderly on 4 March? NHS England rightly asked hospitals to free up at least 30,000 beds to cope with the virus, but will the Secretary of State explain why there was no requirement to test those being discharged to care homes—the very group most at risk—until 15 April? Care providers had serious problems getting personal protective equipment, as their normal supply was requisitioned by the NHS, when both are equally important. Why did that happen?

It took until mid-April for the Government to produce a social care plan, until the end of April for them to say that all residents and staff should be tested, and until 11 May for them to set a deadline for achieving this—and that deadline still is not until 6 June. Will the Secretary of State explain how he squares all that with his claim that Government have thrown a “protective cloak” around care homes right from the start? Despite all the warnings, care homes in my constituency told me over the weekend that they cannot access the Government’s new online testing portal, that tests are not being picked up and that it is often weeks until they get results back. When will this be sorted out?

Finally, the Government have said that the NHS will get whatever resources it takes to deal with this virus. Will the Minister now make the same commitment to social care and guarantee that no provider will collapse because of this virus? No one denies how difficult this is, but instead of denying problems and delays, Ministers should learn from their mistakes so that they can put the right measures in place in future and keep all elderly and disabled people safe.

[Matt Hancock]

I welcome the hon. Lady to her post and to her first question in this new role. I know that she enjoys a good working relationship with the Minister for Care, my hon. Friend the Member for Faversham and Mid Kent (Helen Whately), and that cross-party working during this crisis has gone on throughout. I thank her for that and for the approach that she is taking. She is right and perfectly reasonable to ask questions about how we can further improve the support that we are giving to the care sector, and, as I have said from this Dispatch Box before, and before her appointment, we have made social care a priority from the start. The first guidance went out to social care in February. She referred to the 13 March guidance. That was only a matter of days immediately after the risk to the public was raised on medical advice. The guidance that was in place until then, as she probably knows, explicitly stated that that guidance was in place while community transmission was low and that it would be updated as soon as community transmission went broader. That is exactly what we did.

More importantly, the hon. Lady raised the question of discharges, and I understand the questions that have been asked about discharges into care. It is important to remember that hospital can be a dangerous place for people. As well as saving lives, it can also carry risks, and does so, so it is an appropriate clinical decision in many cases for people to be discharged from hospital, and safer for them to go to a care home. What is important is that infection control procedures are in place in that care home, and those infection control procedures were put in place at the start of this crisis and have been strengthened, exactly as she says, as we have learned more and more about the virus all the way along. As the clinical understanding of coronavirus has strengthened, so too have we updated and strengthened our guidance.

The hon. Lady asked about PPE. As she and every Member of the House knows, there has been an enormous global challenge with the global shortage of PPE and the need to get PPE distribution out to tens of thousands of settings. The guidance that we have put out again, which is guided by clinical expertise, states the level of PPE that is required, and we are now delivering against those standards. We have processes in place so that all care homes that have shortages—the numbers are coming down, I am glad to say—can get in contact with their local resilience forum and make sure that they can get that PPE. Those processes are in place. It has been a huge challenge. It was called the biggest logistical exercise of the last 40 years by the head of the Army, and I think he was right.

The hon. Lady also asked about resources. Of course, if more resources are needed, we are open to those discussions. The fact that we put through £600 million more that will go directly to social care—it will not be able to be held by councils; rather, it will go directly into social care—is right, but we have also learned some really big things about social care, confirming some of the things many of us thought before. For instance, it is true that we need to have a more co-ordinated policy between health and social care. These social care reforms, which are long overdue and have not been put in place by Governments of all colours, absolutely must happen.

Oral Answers to Questions

Liz Kendall Excerpts

Tuesday 5th May 2020 Commons Chamber

[Mr Speaker]

Order. I think we are going to have to speed up the answers.

[Liz Kendall (Leicester West) (Lab) [V]]

Thank you, Mr Speaker.

I have listened carefully to the Minister’s answers, but on the ground there are still serious problems. Maria, who is a careworker in the north-east, told me on Friday that she has only just received face masks and has to wear the same ones throughout the day. Kenzie in Leeds told me exactly the same thing: one mask, all day, even though one of the elderly ladies she cares for has coronavirus and cannot help coughing and spitting on her mask. With almost 8,000 deaths in care homes so far, what changes will the Minister make and what will she do differently to get a grip of this problem, which is still increasing, to help bring this terrible death rate down?

[Jo Churchill]

As I said, there are the three strands of guidance on making sure that the appropriate equipment is used in the appropriate place. We have also used the local resilience forums in order to ensure that individual care organisations can have a back-up of personal protective equipment so that people can use it in line with clinical guidance. I will contact the hon. Lady after this session, because I would like to ensure that the young lady she spoke about has seen that guidance, and the videos that accompany it, in order to make sure that she feels properly protected, which is the aim that we are all working for.

Covid-19

Liz Kendall Excerpts

Monday 16th March 2020 Commons Chamber

[Matt Hancock]

We are looking at all those questions. The proposal to relax student-staff ratios is in the Bill. We will publish the content of the Bill tomorrow and the Bill itself on Thursday. The point about key workers is incredibly important. I am working hard with the Education Secretary to address precisely the concerns that my hon. Friend raises. Of course schools play an important part not just in educating our children but in allowing so many people to go to work, but we have to make sure that they are safe as well. One of the blessings of this virus is that it almost entirely spares children, which means that it is safe for children to go to school.

[Liz Kendall (Leicester West) (Lab)]

Can the Health Secretary give the public some reassurance about his plans for social care, which many vulnerable elderly and disabled people rely on? In particular, what plans does he have to ensure that the care workforce can continue to be effective? We already have more than 120,000 vacancies in the sector, and half of all home care workers are on zero-hours contracts. Is he confident that the care workforce can do what elderly and disabled people and the NHS need?

[Matt Hancock]

Obviously, that is an incredibly important area. Earlier today, there was a call with local authority leaders, my right hon. Friend the Communities Secretary and the Care Minister. Enormous amounts of work are being done and we will do everything we can to support social care.

Coronavirus

Liz Kendall Excerpts

Wednesday 26th February 2020 Commons Chamber

[Matt Hancock]

Decisions on precise travel advice for each country is of course a matter for the Foreign Office, but I can tell my hon. Friend that all those considerations are taken into account. We have to base decisions on the best possible science and clinical advice.

[Liz Kendall (Leicester West) (Lab)]

What assessment have the Government made of the potential economic consequences of the spread of the coronavirus, globally as well as in Europe and in the UK? The Secretary of State will know that northern Italy is in lockdown and that other countries with a much greater spread of the disease have provided an economic stimulus because whole areas are shutting down. We are not there at all in the UK, but has he discussed this issue with the Treasury, because the potential impact on growth and the nervousness of financial markets is very real?

[Matt Hancock]

The hon. Lady is absolutely right to raise this issue. I have of course talked to the Treasury and the new Chancellor of the Exchequer on this question. Another important consideration is that overreaction has economic and social costs too. We have to keep the public safe, but we need to act in a way that is proportionate, so that does come into our considerations. My primary goal is to keep the public safe—of course it is—but we also have to take into account other impacts. For instance, as I set out in the statement, schools should stay open, with no blanket ban, unless there are specific reasons for them not to. Closing a school does not just have an impact on children’s education—there are wider social and economic impacts too.

Social Care

Liz Kendall Excerpts

Tuesday 25th February 2020 Commons Chamber

[Matt Hancock]

My hon. Friend is right that it is about more than just money. The money is, of course, important, but it is also about how the system is structured. There are parts of the country where the co-commissioning he calls for already exists, and we can see the improvement in efficiency that we get out of that. The hon. Member for Worsley and Eccles South (Barbara Keeley) rightly mentioned those with learning disabilities and autism, of whom there are more than 2,000 in in-patient settings. We are reducing that number and supporting more people to move into the community, including in the example that she mentioned. She talked about the challenge of that requiring more money. Actually, community settings are often better for the patient and cost the taxpayer less. As my hon. Friend says, improving the commissioning and the system is a critical part of the solution, so that yet more people can be moved out of in-patient settings.

[Liz Kendall (Leicester West) (Lab)]

The Secretary of State talks about transforming care and services so that we focus more on prevention, early intervention and help in the community and at home. That is what we should be doing, so why, as the National Audit Office has just reported, have we seen less money spent on public health, primary care and community care under this Government in the last five years? This Government are obsessed with hospitals, which is not the way that we want to go—it is about care in the community and at home.

[Matt Hancock]

The hon. Lady is dead right, and I have changed that direction of travel. This year is the first year for a generation when there has been an increase in the proportion of the NHS budget going to primary and community care. That change was at the core of the long-term plan. I insisted on that because I entirely agree with her analysis that getting more support out into the community is critical. This has been going in the wrong direction for a generation, and we are just starting to fix it.

--- Later in debate ---

[Liz Kendall (Leicester West) (Lab)]

We need three things to make our social care system fit for the future: access to good quality care for every older and disabled person who needs it; more support for families to look after the people they love; and better care jobs so that paid careworkers can afford to stay in work and support their families as they care for ours. I will take each in turn.

First, it is a disgrace that in the 21st century, in one of the richest countries in the world, 1.5 million older people are not getting the basic help they need to get up, washed, dressed and fed—that is one in seven of the entire population aged over 65—and that figure will rise to 2 million in a decade’s time unless the Government change course. It goes without saying that this is not good for the people who need support to perform the functions of basic daily living, but it is not good either for the taxpayer, as more older people end up going into hospital and getting stuck there when they do not medically need to be there, with all the knock-on consequences that has for hospital waiting times and NHS budgets. We have got to stop treating the NHS and social care budgets separately, because they are inextricably linked, and we have got to stop fixating on hospitals, because the care system of the future lies in the community and closer to home.

Secondly, we need to give more help to families. Many of the UK’s 6.5 million unpaid family carers face a desperate daily struggle to look after their older or disabled relatives. They often feel pushed to breaking point financially, emotionally and physically. One in three carers have to give up work or reduce their hours because they cannot get the help they need to look after their loved ones, so they lose their income, the economy loses their talent and the Treasury loses their taxes. How does that make any sense? We no longer think parents should be forced to give up work to look after their children, so why do we accept it for those caring for elderly or disabled relatives?

Many of us on the Opposition Benches believe universal childcare to be as much a part of our economic infrastructure as the roads and railways. That we are living longer means we need to see social care, too, as an essential part of our economic infrastructure. With so many people now looking after their elderly mums and dads as well as their own children, we need to be thinking about universal family care and leave to meet the realities of modern life, because families should never have to choose between holding down a job and caring for their own.

[Alex Cunningham]

I ought to have declared that I am a co-chair of the all-party group on carers. I am pleased my hon. Friend has mentioned unpaid carers. The Secretary of State took 19 minutes to acknowledge the existence of the millions of unpaid carers in our society. I wonder if my hon. Friend has any tips for the Government for how they could address their needs.

[Liz Kendall]

Unpaid family carers need family-friendly working arrangements so that they can balance their work and caring responsibilities; they need an NHS that recognises that their own physical and mental health could suffer too, and they need to know that we are there to support them. Rather than criticising families and saying that they should be doing more, we should acknowledge that many carers have not had a break for weeks, months or even years. We have to change that, because this is not going to happen to somebody else. This is going to happen to every single one of us here.

Thirdly, we need better care jobs. Paid careworkers do some of the most important work in the country, looking after the people whom we love, but many struggle on low pay and zero-hours contracts, with high levels of stress and little training. No wonder staff turnover and vacancy rates are so high, although the vast majority of careworkers say they love the work that they do. We need a comprehensive strategy to improve the pay, professional development and employment security of care staff, and we desperately need to increase the number of careworkers too. We shall need more than half a million more careworkers in a decade’s time, not to improve the care system by providing better quality or wider access, but just to meet increasing demand.

That is why the points-based immigration system announced by the Government will be a disaster. If we already need more than half a million extra careworkers just to meet levels of demand, how on earth will we cope with that new system? It will not be possible. I beg the Minister to meet me, and others, to discuss the development of a separate route into social care in the migration system of the future, because otherwise we simply will not cope.

None of those changes—improving access to care, more support for families and better care jobs—can be delivered on the cheap, but the truth is that families, the NHS and our economy as a whole cannot afford for us not take action. We need, first, an immediate and significant injection of cash into the system in next month’s Budget, and, secondly, a long-term plan for investment and reform. Any new funding system must work for disabled adults as well as older people. It must strike the right balance between individuals and the state. I, for one, strongly believe that we should pool our resources and share our risks rather than leaving people to cope alone. The system must also be fair across the generations. I do not believe that the working-age population should pay for all the additional costs of caring for our ageing population Wealthier older people will need to make a contribution too.

Alongside this funding reform must be a change in the way in which social care is provided, so that it is not just about time slots and tasks simply to keep people alive, but about offering great support how, where and when people want it, so that they can lead the lives that they and their families choose.

This radical reform of social care is just one of the changes that we must make to meet the needs of our ageing population, which is one of the biggest challenges that we face as a country. We need to change our housing so that it helps people to live independently at home for longer. We need to reform the world of work so that, as we live for longer, we can work for longer and more flexibly. We need to change our health services so that they keep people fitter and healthier for longer as we live for longer. None of those things will be easy, but if we want to meet the challenge of our ageing population and if we want to make Britain the best country in the world in which to grow old, we need to grasp this nettle, and we need to do it now.

[Several hon. Members rose—]

--- Later in debate ---

[Helen Whately]

The shadow Minister is shaking her head; I know that there is more to do.

At times this has been a heated debate, but I heard on both sides truly constructive suggestions for how we can solve our social care challenges. That gives me much hope for cross-party consensus. I heard suggestions from my hon. Friends the Members for Newton Abbot (Anne Marie Morris) and for Meon Valley (Mrs Drummond), my right hon. Friend the Member for Ashford, the hon. Member for Leicester West (Liz Kendall) and my hon. Friend the Member for Bexhill and Battle (Huw Merriman), whom I thank for his kind words welcoming me to my job. He set the bar high for me to meet.

I am fully aware of the challenges that face our care system and I have no illusions as to the scale of the challenge facing us. In the next 10 years, we expect the number of people over 75 to go up by 1.5 million, and the number of people under 65 with care needs is growing, too. We have a system that is under pressure and the demands are only going to grow.

[Liz Kendall]

In the spirit of being constructive, let me mention, as I did during my speech, the huge and rising pressures on social care. There are 120,000 vacancies here and now. We need more than half a million care workers in a decade’s time just to keep up with rising demand—that is not to improve the system, but just to keep pace with demand. The proposed points-based system of immigration will be catastrophic for social care. Will the Minister meet me and others who work in this area to explore the potential for a separate route into social care, so that we can avoid further pressure and worse care for the people for whom we love and care?

[Helen Whately]

What I would like to emphasise in response to the hon. Lady’s point is the importance of our recognising, valuing and making sure that social care is an attractive career. In that way, those who are already working in social care will continue to work in social care. It will be for us to build the workforce that we need for the future.

[Liz Kendall]

rose—

[Helen Whately]

I am conscious of time, so I must now come to my conclusion.

We all bring our experiences to our work, and, as I conclude this debate, I want to mention one of mine. When my grandmother was 100 years old, she was admitted to hospital and she stayed there for five months. She was signed off as ready to leave numerous times, but each time the failure to find a care package delayed her discharge, during which time she would acquire an infection, further delaying her discharge. She was eventually discharged, but only in time for her to die—thankfully, peacefully at home. This is a cycle with which too many people are familiar, and it means that our hospitals are looking after people who would be better off at home.

As I have said, I am under no illusions about the challenges that we face in social care. The problem that I have just described is nothing new, but let us be the generation that solves it. That is a commitment that we as a Government have made. We will fix the crisis in social care. We will deliver the funding that is needed now to stabilise the system. We will find a long-term solution to the growing need for care and seek to build a cross-party consensus on this. We are committed to the view that the prerequisite of that solution is that no one needing care will have to sell their home to pay for that care.

We will not be supporting the Opposition’s motion tonight, but where I think we can all agree is on the importance and the urgency of reform of social care. As we bring forward those plans, I look forward to working with colleagues from all parts of this House. Just as we had a consensus in the 1940s on the NHS, the time has now come for a new consensus on social care. Let us be the generation that works together and makes our care system work for all those who so badly need it.

Question put (Standing Order No. 31(2)), That the original words stand part of the question.

NHS Long-term Plan

Liz Kendall Excerpts

Monday 7th January 2019 Commons Chamber

[Matt Hancock]

Yes, I would be very happy to meet my hon. Friend to discuss the legislative changes. These changes have been proposed by the NHS. The NHS wants the changes set out at a high level in the plan. Of course there is a lot of consequential work to do to turn them into a full legislative proposal. The NHS is working on that. If it does that alongside and working with the Select Committee, I would be very happy to meet with her to discuss how that might happen. This is very much the NHS’s proposed legislation and I look forward to discussing it with her.

[Liz Kendall (Leicester West) (Lab)]

I am glad that the Secretary of State says that he will listen to clinicians if they want to change primary legislation. I just think that many of those clinicians and many Labour Members wish that he and his colleagues had listened to us when we warned about the problems with the Lansley legislation six years ago. But let us put that to one side. The biggest challenge facing the NHS is indeed the increase in the number of older people with two, three or more long-term chronic conditions. They need more joined-up services in the community and at home. The local NHS has been asked to put forward its plans for these new services by April. It cannot do so without proper long-term funding for social care. So will we hear about that in the Green Paper before April—yes or no?

[Matt Hancock]

When I answered a previous question on the timing of the social care Green Paper, I said it would be provided “soon.” I certainly intend that to happen before April. My previous commitment was to do it before Christmas, so it is well advanced. But the hon. Lady is right on the legislative proposals. There is a broad consensus on the need for more integration, as my hon. Friend the Chair of the Select Committee said. The proposals that are made by the NHS in the paper are what it thinks is needed in order to deliver this integration, which I very strongly support.

Social Care Funding

Liz Kendall Excerpts

Wednesday 17th October 2018 Commons Chamber

[Liz Kendall (Leicester West) (Lab)]

This year is the 70th anniversary of the NHS. It is also the 70th anniversary of our social care system, but that has received far too little attention to date. It is not getting any of the national celebrations—the birthday cakes and cards—and certainly none of the £20 billion birthday present that the NHS received from the Prime Minister.

Yet social care is more important than ever before. A quarter of older people now need help with daily living—getting up, washed, dressed and fed. More adults with physical and learning disabilities need substantial packages of support. There are 1 million paid care workers and 6.5 million unpaid carers. Yet despite the fact that this touches so many people’s lives and that there is an increasing demand, we have no sense from the Government of the reality of the situation. There has been a 10% cut in real terms in social care spending, with 400,000 fewer people getting any kind of help and support. A third of carers have to give up their job or reduce their hours to look after their loved ones, and a quarter of the paid care workforce leaves every single year. There is nothing from Government Front Benchers—no sense of the urgency of the challenge we are facing.

We cannot solve this problem without substantial extra funding. The Health Foundation says that we need £6 billion just to maintain the current inadequate system. It is not good enough.

Over the last 20 years, we have had 12 Green and White Papers and five independent commissions, but we have not solved this problem, and we need to understand why. Most people think that they are not going to end up needing this support. When they end up needing it, they do not realise that many of them will have to pay. They think the current system is unfair, but when radical proposals have been put forward for how to fund the system, they believe that those are unfair too.

This issue has been a political football. Labour was accused of imposing a death tax, and the Tories were accused of imposing a dementia tax—but it is not the politicians who suffer; it is the people who use the services and their carers. We cannot go on like this any longer.

I believe that one of the reasons this issue has not been solved is that much of it is about low-paid women who work in people’s homes and care homes invisibly. Caring is not valued, and we have to change that.

[Karin Smyth (Bristol South) (Lab)]

My hon. Friend is making an excellent speech and she is an expert in this area. She is right; the language we have heard today is all about the challenges and the costs. This is an infrastructure issue, and it needs to be treated as such. Because women lead this workforce, it is not considered an infrastructure issue, and if we did that and changed the language around this, we would have a completely different debate. Does she agree?

--- Later in debate ---

[Liz Kendall]

I absolutely agree. If a third of parents had to give up work or reduce their hours because they could not get childcare, it would be a national scandal. We need to make social care as much a part of our economic infrastructure as childcare, and we have to wake up to that.

The reality is that we face a choice: either we leave individuals to pay for care, through no fault of their own, with only the wealthy able to afford to put aside extra money—the idea that a “care ISA” will solve the huge challenge of social care is, quite frankly, ridiculous—or we pool the costs and share the risks for a fairer and more equitable and efficient system. My view is that we have to look at the contribution of wealthier older people, not just the working-age population who are already struggling with so much of the cost of daily living.

Alongside extra money, we need real reform. We have to change and improve the way we offer care and support, to give people more choice, say and control and to ensure that care is personalised and flexible around the needs of individuals and families, not just one size fits all. We have to shift the focus towards prevention, early intervention and promoting genuine wellbeing. We have to put people who use care and have lived experience at the heart of the system, in terms of both policy and delivery. That is what has to be in the Green Paper. I cannot believe we are still without it. The Government need to get a move on and take action.

Dangerous Waste and Body Parts Disposal: NHS

Liz Kendall Excerpts

Tuesday 9th October 2018 Commons Chamber

[Stephen Barclay]

My hon. Friend makes a valid point about the lessons to be learned from this. Part of what I would expect to look at as we move forward are questions about when the NHS was first made aware of this and what powers are available to enforce at an earlier stage. As I have mentioned, enforcement notices cover a spectrum of risk. Some of those risks are more technical in nature than others, so while there have been 13 notices, their enforcement encompasses a range of severity.

[Liz Kendall (Leicester West) (Lab)]

According to its most recent accounts, HES made a gross profit of over £15 million last year. What financial penalty will it suffer because of its gross incompetence?

[Stephen Barclay]

The first financial penalty it has suffered is the prompt action we took over the weekend, with 15 NHS trusts cancelling those contracts and moving across. There is a clear financial penalty in that loss of business. As for fines, that is a matter of legal process, through the Environment Agency, in the normal way. That is not an NHS matter. The focus for the NHS is on maintaining continuity of service.