Health and Care Bill

Lord Harries of Pentregarth Excerpts

2nd reading
Tuesday 7th December 2021 Lords Chamber

[Lord Harries of Pentregarth (CB)]

My Lords, I too thank the noble and national “treasure”—the noble Lord, Lord Stevens—and welcome him to the House. I wish to focus on three areas: care homes, care workers and carers.

Last night, “Panorama” examined the financial structure behind two big care home chains. It discovered that the ultimate owner was a private equity company based in a tax haven, and that between that owner and the home there might be more than 100 other shell companies. Furthermore, the equity companies owning the chain changed frequently, each time taking more money and loading the debt on care homes.

The result was that at least 20% of the money that should have gone to support the resident was used to pay interest on the debt and dividends to shareholders, leading in some cases to poor care. Moreover, in a number of cases, the debt became unsustainable, so the home had to go into receivership, with the residents left in great uncertainty about their future. Is the Minister content that the present Bill will be able to ensure that the financial structure behind care homes in the future will not be of this type, able to load debt on to homes in a way that harms residents?

That having been said, the vast majority of care homes provide dedicated service. This was very much shown in the first phase of the pandemic when, for example, care workers actually lived in some homes to safeguard the residents from infection. However, there are now 170,000 vacancies in care homes and almost every home in the country has been hit by staff shortages, as underpaid and exhausted care workers leave. This raises the whole question of their pay, conditions and status.

There is a totally unacceptable turnover rate of care workers, as the noble Lady, Baroness Altmann, emphasised, while their average pay compares very unfavourably with that of a shop worker. Of course, this applies not just to those working in care homes but to the vast number now working in the community, trying to care for people in such a way as to keep them in their homes. We are still in a position where far too many hospital beds are being occupied by those who should be cared for in the community. That depends on care workers actually being available.

I believe in and greatly value the business sector of our society, not least innovators and genuine entrepreneurs. The whole country depends on their success but no less should we value the care sector and recognise this in the status that it is given, which should be reflected in how its workers are paid and treated. At a time when we will soon have 1 million people suffering from dementia and with the prediction that by 2050 that figure will be 2 million, we are no less dependent on the care workforce than we are on those working in business.

I welcome the Government’s recent statement that they are spending a least £500 million so that the social care workforce has the right training and qualifications and feels recognised and valued for its skills and commitment; they are also prioritising workforce well-being and support, including better access to occupational health services. The second question I ask the Minister is this: is he satisfied that this Bill, as set out at the moment, will ensure that this very excellent aim will be properly checked and monitored?

I now turn to carers—that is, those caring for a relative or friend on a voluntary basis. The support provided by people caring for a family member or friend who is older, disabled or has a long-term condition is vast. Prior to the pandemic it was estimated to be worth £132 billion per annum and during the pandemic, in one year, at about £193 billion. With an ageing population we are likely to continue to see a rise in the number of people providing care in this way. Carers’ health is often impacted by caring. Those who care for people in their house for more than 50 hours a week are twice as likely to be in bad health than non-carers. Carers UK has suggested some interesting amendments to this Bill to ensure that this element of the care sector is properly recognised and taken into account.

Finally, the word “care” is a precious one. The categories of “care worker” and “carer” are fundamental to our society. They need to be recognised accordingly, both in our attitudes and in the law, the latter so often being powerful in shaping those attitudes. I hope that as a House we will be considering amendments which ensure that that is indeed the case.