Social Care

Lord Turnberg Excerpts

Thursday 30th March 2023 Lords Chamber

[Lord Turnberg (Lab)]

My Lords, I also thank my noble friend Lady Andrews for introducing this debate in such an inspiring way. I was not a member of her committee and nor was I, for obvious reasons and much to my regret, a member of the Archbishops’ Commission, but I can hardly express ignorance of the reports or of the many reports that have come out before this, so I am fairly well informed.

We have become so used to debating a situation that has been a disgrace for so long that it has become a sort of constant background noise that we have managed to ignore. For example, we are all fully aware that, for many years, large numbers of patients have been stuck in acute hospital beds quite unnecessarily, when they would be much better cared for in the community, but they cannot be moved, sometimes for weeks, because there is no one out there to look after them. Nowadays, it is almost as difficult to get out of hospital as it is to get in. If that phrase sounds familiar, it is because I have used it many times before in the more than 20 years that I have been in this House. I may be a bit of a bore on the subject, but I will emphasise a few more obvious facts.

As others have mentioned, the number of patients who need care in the community is rising as the population ages, yet the number of staff available to support them is going down. No one seems surprised by that anymore. In my few remarks, I will concentrate on the workers on whom this whole shaky system is dependent; it is they with whom the buck stops.

The care workers’ lot is not a happy one. Recruitment is difficult and retention is worse. The turnover rate of care home staff is 35%; that is a third of staff leaving every year. I have heard various figures, such as 105,000 adult care worker vacancies advertised every day and 15,000 fewer filled posts last year than eight years earlier. As we have heard, pay is a significant factor in this poor recruitment and retention. An average of £9.60 an hour means many can earn more in jobs at Tesco or Amazon, and about a third of them are on zero-hours contracts, as we have heard.

But it is not just about pay. We must pay them at a rate commensurate with their responsibilities, but it is about much more than that. These workers are at the bottom of the feeding chain: they are underappreciated, underrated and underrespected. We know that nurses and doctors are widely respected in the community, but not care workers. There are no media articles extolling their virtues and no TV programmes or films with them as heroes. They are the neglected end of the health and social care system. “Entrenched invisibility” was the phrase I heard today, yet we absolutely depend on them. So many of the problems in the NHS—bed blockages, ambulance queues, long waits in A&E and departments on trolleys waiting for beds—are due directly to the paucity of care in the community. So it is here, with the care workers, that we should begin.

As we have heard today, we must give them the recognition and respect that they deserve, by not simply giving them a salary that recognises their important roles but much more than that. We must offer them a training programme that is both mandatory and nationally recognised. We must then give them a professional qualification and a place on a national register. Only in this way will they hold their heads up as qualified professionals, along with the prospect of career progression within care work or even on to a nursing career as, for example, nursing auxiliaries. Will the Minister please ensure that something along those lines is included in the long-awaited social care plan?

I know that this is not a novel set of proposals. I recently took a rather unrewarding look back at some of the speeches I have given on this topic in the Lords over the very many years that I have been here. I am more than used to not being listened to—how could I not be, having been married for more than 50 years? On this occasion, at least, I hope the Minister will give me a little more encouragement.