Social Care

Mike Hill Excerpts

Wednesday 25th April 2018 Commons Chamber

[Dr Whitford]

I thank the hon. Lady for her intervention. In my years of working particularly as a breast cancer surgeon, where I was involved in the palliative care of my own patients, we often met that as a barrier. We started to have the fast response teams who could get hold of hospital beds and commodes and get the changes done, particularly for somebody who actually might not have very long to live.

Since 2015, those who are defined by their medical care team as being in the terminal phase of an illness, whether it is cancer, motor neurone disease or another condition, have not been charged for personal care or nursing care at home. This means that they are not delayed by means-testing, which is another thing that can end up keeping a terminal patient stuck in hospital for weeks and weeks that frankly they just cannot spare.

Younger people with disability have been mentioned. In England, approximately half of local authority spend, and in Scotland approximately 40%, is for the working-age disabled. However, Scope, a charity involved with those with disability, says that two thirds of those who applied to local authorities for care were offered no help and were simply signposted to other charities. The 83% who were given some care felt that they did not get enough hours for it to support them sufficiently.

When we discussed social care in October, I mentioned that in Scotland we were hoping to pass Frank’s law, which is in honour of Frank Kopel—a footballer who played for Man Utd and Dundee Utd and who, possibly related to heading the ball, developed dementia at a very young age. I am glad to report that this law has now been passed. Starting from April next year, those under 65 with degenerative, chronic and eventually terminal illnesses will also be able to have personal care, and this will simply be needs-based, as it is for those over 65. I pay tribute to his widow, Amanda, who fought for a very long time to raise the issue of people who are being excluded from care based on precisely when their date of birth is. However, the Scottish Government are trying to clarify with the Department for Work and Pensions whether providing this additional free personal care to someone under 65 will not result in cuts to their disability benefits, because to give with one hand and have it taken away with the other would be tragic.

The UK Government’s Green Paper provides a chance to step back and rethink care. Obviously, the aim is to achieve sustainable care—as I say, perhaps to look at more radical considerations such as combining it with health and not having it as an utterly separate system.

On those who are younger with disability, the Minister talked about a parallel workstream for the under-65s. What are the terms of reference for that? What can people with disability expect?

After the complete shambles of the 2017 manifesto, it is crucial that there are no sudden changes or things that catch people out, with no notice to prepare for what they might have to pay for care. This is something that will affect people in the future. We have all debated the WASPI women in this place. Let us not create a new tragedy of people who are trapped by some sudden change in how social care works.

As the Minister said, the workforce are absolutely key to the care service. This is a service that is utterly delivered by people. It is not high-technology or machines, and by and large, it is not hospitals. In Scotland, the homecare workforce has risen by 11% over the last three years, but all care providers are reporting that they are struggling to recruit, and all of them see that Brexit will make that much worse, because colleagues who have come from Europe, and particularly eastern Europe, make up a significant proportion of our social care workforce.

We need to value carers. They have often been treated far too much as a cheap workforce, and that says to people, “This is not a profession or a job to stay in long term. This is until you get something better.”

[Mike Hill (Hartlepool) (Lab)]

There are of course also carers who are not employed. I came across kinship carers in Hartlepool. Does the hon. Lady agree that kinship carers, and in particular those who receive no benefits, should also feature in this debate?

[Dr Whitford]

I thank the hon. Gentleman for his intervention. There are all sorts of aspects to the provision of care, for whichever age group or needs, and the Green Paper will fail if it does not result in us stepping back and taking a wider view.

It is important to pay the real living wage, which the Scottish Government already support and fund, and not the national living wage. All hours should be paid—that commitment is being consulted on in Scotland at the moment—and that should include travel as well as overnight care.

For local authorities that have social care within their service, this is the biggest driver of the gender pay gap. Men who empty the bins are paid considerably more than the women who are caring for our grandparents. We should think of job satisfaction and give them the time to care, not 15 minutes. We should think of continuity for both the patient and the carer, but particularly we need to think of the career structure and the training. Caring needs to be a profession, and a profession that is respected.

--- Later in debate ---

[Anna Turley]

My hon. Friend is absolutely right. This is a regressive form of taxation. Every time the precept or local council tax is raised, people pay twice: they see less of a service, but they are still paying through their income tax and through council tax.

I want to talk about the people who are the backbone of our care system: those who work in the care sector. In my local authority area, just over 170 social care staff are employed to support about 5,750 people. That is an average of 33 to 34 cases per member of staff, with all the challenges and safeguarding issues that come with that. The more experienced staff often deal with many more cases than that. As people live longer, with multiple and increasingly complex health conditions, the time and effort required from staff becomes greater. Currently, about 22% of residents in Redcar and Cleveland are over the age of 65. That is expected to increase to 27% by 2030. There are also many working-age disabled or vulnerable adults who have long-term care needs.

The needs of the individuals who need care vary hugely, from those who are frail and need physical support to those with learning disabilities or mental health problems. Mental health poses a particularly difficult challenge, with one in 14 people over the age of 65 developing symptoms of dementia in their lifetime. The care demands required of staff to support these people are ever more complex.

[Mike Hill]

I praise Redcar and Cleveland Borough Council for being the first council in the north-east to adopt Unison’s ethical care charter, which promotes staff training and pay and quality care. It has also been adopted in Hartlepool. Will my hon. Friend join me in supporting the further ambition to establish local care academies to guarantee that such training and care packages are written into employment contracts?

[Anna Turley]

My hon. Friend raises an important point. Much has been said today about the prestige of the sector and that suggestion would go a long way to addressing that.