Health and Social Care

Lord Bishop of Lincoln Excerpts

Thursday 24th November 2016 Lords Chamber

[The Lord Bishop of Ely]

My Lords, I am grateful to the noble Baroness, Lady Finlay, for bringing this important matter before the House today. The right reverend Prelate the Bishop of Carlisle, our lead bishop on health and social care, cannot be in his place today, but I am glad to contribute from these Benches on his behalf.

The debate brings to mind two principles central to Christian faith and practice: justice for the stranger in our midst and care for the vulnerable. Mosaic law enjoins us not to withhold justice from the outsider. Only yesterday, in conversation, the Secretary of State for Communities and Local Government sought to check that I had heard the words of Jesus, “Love thy neighbour as thyself”. I am grateful to him. This reminds us that the words of Jesus tell us that every care and service given to others is a service given to God.

In the context of the present debate, I want to explore how those principles might be applied to care workers. I trust that the first of these will be upheld in line with the Government’s statement, recorded in the Guardian on 21 September, that the Prime Minister has been clear that she wants to protect the status of EU nationals already living here. In excess of 84,000 EU citizens do the demanding and essential job of caring for vulnerable people in our society, day in, day out. They deserve both our gratitude and support. For their sake, as well as the sake of those they care for, I trust they will continue to be welcome.

As we all know, social care in this country faces a challenging future. Only last week, Age UK and the Alzheimer’s Society reported that some 300,000-plus elderly people are in need of social care but are not receiving any assistance; indeed, my own mother is one of these. With an ageing population, this problem is likely to get worse unless the recruitment of care workers increases notably. It is difficult to see how this can be achieved if immigration policy is changed post-Brexit. According to modelling by the charities Independent Age and the International Longevity Centre UK, if all immigration from the EU were halted there would be a shortage of care workers in excess of 1 million by 2037. A low-migration scenario would still mean a 750,000 shortfall. Even under current migration conditions, the care sector will face a workforce shortage of 350,000 because of the likely dramatic increase in the population needing care.

I cannot stress or praise highly enough the role played by care workers, whether in care homes or through domiciliary care. Care workers play an indispensable role in promoting the health and well-being of millions, mostly elderly or disabled people. Without their intervention, the needs of many vulnerable people would go unmet. Some might go for days on end without any meaningful contact with their families or other human beings. The economic cost to the nation would be immense.

In the past I have been a trustee of a Christian care home and domiciliary care service, and I have seen at first hand the extraordinary work undertaken by care workers over and above what they are paid to do. In spite of that, care workers are seldom given the recognition they deserve, with few attempts being made to make care work a recognised and valued profession. It is therefore no surprise that there is a growing shortfall in the number of care workers from within the resident UK population. Unless underlying issues are addressed, the disparity between care provision and need will continue to grow even if Brexit’s efforts prove to be less damaging than many fear.

The UK care sector is indebted to EU workers, in part because it is difficult to recruit and retain care workers from the existing population, given the poor wages, inadequate training and low esteem in which many care workers perceive themselves to be held. The jobs of current care workers from the EU ought not to be at risk if the Prime Minister’s undertaking is adhered to, but it is really important that the UK does not continue to rely on EU workers solely because care work is attributed such a low status. The pathway to sustaining and developing the care workforce lies in improving the profession, rather than relying on others to do the jobs that many UK citizens are not prepared to do.

The Social Care Institute for Excellence, in its Dignity for Care Workers initiative, set out a series of recommendations for commissioners and providers of social care that would enable workers to enjoy the esteem in which they deserve to be held. These go beyond addressing the persistent problems of low pay and zero-hours contracts, calling on commissioners and providers to offer support and training, proper career pathways and the involvement of care workers in day-to-day decision-making and service improvement.

It is essential that Her Majesty’s Government take effective action to address the concerns of care workers, rather than continuing to rely on low-paid, unqualified positions that offer little job security or chance of advancement. Providing care for an ageing population requires a professional care force that enjoys decent pay, job satisfaction and prospects for personal and career advancement. The current question of admission of care workers from the EU ought not to mask these crucial concerns.