Care Workers

Debate between Paul Burstow and Liz Kendall

Wednesday 5th November 2014 Westminster Hall

[Liz Kendall]

My hon. Friend is absolutely right. I was going to come to that point. If someone is on a zero-hours contract, they will be too terrified to tell their employer that they are not paying the minimum wage. I am not yet convinced that the Minister is working closely enough with Ministers in the Department for Business, Innovation and Skills. According to an answer to a written question from my hon. Friend the Member for Stockton North (Alex Cunningham), the Minister has had just one meeting all year with BIS to discuss underpayment of the national minimum wage in the care sector. That is not good enough. We need more action.

Several of my right hon. and hon. Friends rightly said that £3.5 billion has been cut from local council adult social care budgets. Within that context, the pressures are building.

[Paul Burstow]

The hon. Lady and her Front-Bench colleagues want to convey the impression that in seven months’ time they will be in government and therefore making decisions about the allocation of resources for adult social care. Will she share her thinking?

[Liz Kendall]

I will, and I will come on to the extra money that we have committed to putting into health and social care. We are committed to a £2.5 billion transformation fund that will cover both the NHS and social care, and that includes money to pay for 5,000 home care workers. So we have said what we will do in addition to the ring-fenced money to try to kick-start the services in the community that patients and taxpayers need.

We have put care issues and exploitation in the care sector at the heart of our agenda. Baroness Denise Kingsmill conducted an excellent review for us on exploitation in the care sector. I encourage all Members to read it if they have not had a chance to do so already. She has set out tough, credible and realistic proposals, including on how to properly enforce the minimum wage, ban exploitative zero-hours contracts and end inappropriate 15-minute visits. She has called for better training for care workers and also for managers of care providers—that is essential—as well as support for ethical care charters such as that which Unison has promoted.

I want to say a little about what I saw yesterday, which was an inspiring example of a Labour council in Islington putting ethical care into practice. Yesterday I helped to launch and celebrate its new home care service contracts. Those will ensure that all home care staff are paid the London living wage—£8.80 an hour now, rising to £9.15 in January—including for travel time. Exploitative zero-hours contracts have been banned, and people are guaranteed a minimum of 16 hours a week.

The council is also giving far more say to the users of services so that they can decide how and when their hours of care will be provided, and, unless they specifically request a 15-minute visit, such visits will be ended, too. The changes to the contracts will benefit more than 500 home care workers, 9 out of 10 of whom are women. I met one yesterday, called Mary. When I talked to her about the difference the changes will make, she said, “It might not sound a lot for some people, but it means I can pay for my kids’ school lunches and make sure they have a decent hot meal in the evenings.” The changes will also benefit the 900 people whom the home care workers care for.

A Labour Government will back the actions of councils such as the Labour council in Islington. We will increase the fines for non-payment of the minimum wage to £50,000. We will champion the payment of the living wage through “make work pay” contracts, which give a tax break of up to £1,000 per worker to every company that signs up to the living wage. We will end the exploitative use of zero-hours contracts, too. As part of our £2.5 billion transformation fund, we will provide extra funding to support changes in the community and the services provided there, including 5,000 more home care workers.

I will end on a point that Islington council made. The changes cost the council more, but we have to think about the cost of not doing it: the cost to the NHS of avoidable emergency admissions and delayed discharges, and the cost to the taxpayer of people having to have their pay topped up when they want to be earning a decent living wage. There is a different way. Islington has shown the way. We will back its efforts and make sure we have a decent care system for those who work in it, those who use it, and all the families that rely on it.

Care Bill [Lords]

Debate between Paul Burstow and Liz Kendall

Monday 10th March 2014 Commons Chamber

[Paul Burstow]

I am grateful to the hon. Gentleman for that intervention. He makes an important point. If one looks at the trends, one sees that there is no doubt that there are questions to be asked about why some people are not receiving the service that one would expect. Some of that—although I do not pretend that this covers anywhere near all of it—can be explained by the changes to the way in which services are organised. Some of it can be explained by the need to do more to re-able people and to enable them to maintain their independence. I do not say that to evade the question. That is why I have put new clauses 7 and 9 before the House. I genuinely think that whoever is in government in future will have to have a much more systematic approach to making decisions about how we meet demand.

That brings me on to new clause 7, which simply says that the Government should take a longer-term view. It states that every five years, the Government should look 20 years forward and take an independent assessment of the future demand for care and health services. That could be done by the Office for Budget Responsibility. It could provide modelling for the whole health and social care system that looks at the impact on demand, technology, demography and health status, and at the balance between all those factors. It could also look at the interactions between health and care, primary and secondary care, physical and mental health, and treatment and prevention. That would finally implement a recommendation that was made by Derek Wanless in his review for the Government in 2000. That is supported by the King’s Fund, which has suggested much the same thing.

In Committee, neither the Government nor the Opposition were able to make any funding commitments about part 1 of the Bill. I entirely understand why that is the case. However, we know that as the eligibility criteria are drawn more tightly, more people are excluded from help. In the long run, that does not save money, but shunts the costs. It pushes people away from living an independent life and towards a life of dependency. I hope that all parties will, in the end, sign up to something like new clause 7 as a good part of the future sound governance of our health and social care system. I hope that the Minister will support that.

I apologise to the House for speaking at such length, but I have put forward a number of issues that I hope will provide a framework for debating this important set of reforms. I look forward to the Minister’s response.

[Liz Kendall (Leicester West) (Lab)]

We are discussing a huge number of new clauses and amendments, and I will try to keep my comments brief to allow Back Benchers on both sides time to speak. I want to start with our new clauses 17 and 18, which deal with the critical issue of linking the quality of care with standards in the care work force. New clause 17 would require the Secretary of State to review the economic and financial factors affecting the employment of care sector workers, including their recruitment, training, employment and retention, and the extent to which the policies of care providers were making it more or less likely that the aims of the Bill were being achieved.

Oral Answers to Questions

Debate between Paul Burstow and Liz Kendall

Tuesday 17th July 2012 Commons Chamber

[Paul Burstow]

My hon. Friend is absolutely right. Just last week we published the world’s first ever survey of bereaved people’s experiences of the end-of-life care received by loved ones. It revealed quite stark variations from one part of the country to another, and will prove a valuable tool in driving up performance of areas that are not doing well by families in end-of-life care. As for the White Paper, we have said clearly that we are committed to doubling funding for the pilots to ensure that we have the data to take decisions about the introduction of free personal care when it comes to end of life.

[Liz Kendall (Leicester West) (Lab)]

Opposition Members are genuine in our desire to reach cross-party consensus on the funding of social care. Will the Minister demonstrate his Government’s seriousness by agreeing to include Treasury Ministers directly in the cross-party talks, as Labour has offered to do from the start?

[Paul Burstow]

Talks that start with lots of preconditions are not going to be very good talks to start with. The Government always retain the responsibility for making decisions about taxation and spending priorities. We set out our position last week on the Dilnot Commission, and we now have a clear basis for talks, as those on both sides of the House seem to agree on the principles of Dilnot as the basis for reform.

Oral Answers to Questions

Debate between Paul Burstow and Liz Kendall

Tuesday 27th March 2012 Commons Chamber

[Paul Burstow]

It is important that that is applied to all who have direct responsibility for delivering care, and hands-on care in particular. The work that Russells Hall hospital is doing on care and respect, and in its responsibility programme, is a good example of that. On issues such as dementia, we are clear that we need to ensure good advice, training and support for all nursing staff—we are working with the Royal College of Nursing on this—so that they treat people who have dementia with dignity.

[Liz Kendall (Leicester West) (Lab)]

The Government are rightly building on Labour’s national dementia strategy, and the Minister should know that the dementia crisis cannot be addressed without tackling the crisis in care. Yet his Government have cut more than £1 billion from local council budgets for older people’s care, services are being withdrawn and care charges for dementia sufferers are soaring. The Alzheimer’s Society and Age UK say that these cuts have pushed the system to breaking point. Does the Minister agree with them, yes or no?

Health and Social Care Bill

Debate between Paul Burstow and Liz Kendall

Tuesday 20th March 2012 Commons Chamber

[Paul Burstow]

Despite the noises off, the fact is that there is considerable scope for that sort of public shaping.

Let me talk my right hon. Friend through some of those changes. We are establishing local health and wellbeing boards, which are made up of clinical commissioning groups, elected local authority members, the various directors to which I just referred, and, importantly, local healthwatch organisations. They have the statutory responsibility for identifying population need for their area and for then framing the strategy to meet those needs. The local commissioner must evidence that the strategies for delivering that—the local commissioning plans—reflect the commissioning strategy that has been produced by the health and wellbeing board. That is the first opportunity to intervene and to help shape the nature of services that are being commissioned for a local population. Indeed, we made amendments that make it clear that health and wellbeing boards must involve their population in that work.

The next stage when people can be involved is when the clinical commissioning group produces its commissioning intentions and plan. CCGs have obligations to consult on their plans and to involve the public in their formulation. That is a further opportunity, but beyond it there is a role in commissioning decisions, or decisions to change or reconfigure a service, for the local authority’s health and overview scrutiny committee, which we are retaining and enhancing, so that, for the first time, NHS providers in the public sector or private providers providing NHS-contracted services can be held accountable for their decisions. That is a change from the arrangements under the previous Administration.

Those are just a few of the steps, but ultimately we have retained the provisions for a reference by the local authority to the Secretary of State to make decisions regarding major reconfigurations. There are a number of steps. I hope that that reassures my right hon. Friend and gives the lie to those who suggest that the provisions have been watered down—the contrary is the case.

We have committed to use the Secretary of State’s powers to specify the criteria that local healthwatch organisations must satisfy when it comes to strong involvement by volunteers and lay members, including in their governance and leadership. We want to ensure that local healthwatch organisations break out of existing models and find ways of reaching and involving far wider and more representative populations than hitherto.

I can confirm that there are a number of amendments, the majority of which are technical in nature, relating to the Health and Care Professions Council, NICE, and the NHS Information Centre. Part 7 of the Bill relates to the regulation of health and social care workers. The Government have made a technical alteration to the provisions amending article 12 of the Health Professions Order 2001 to enable the Health Professions Council to recognise training undertaken in Wales, Scotland and Northern Ireland as sufficient for admission to its register as a social worker. The amendments also give the council the power to assess training or professional expertise and experience in social work gained outside England but within the UK.

Part 8 of the Bill establishes the National Institute for Health and Care Excellence—I emphasise the word “care”—and extends its remit to adults’ and children’s social care. NICE will play a central role in driving quality improvement through the production of robust, evidence-based quality standards and other guidance across the NHS, social care and public health. That is yet another measure in the Bill that supports and drives greater integration of health and social care than has existed in the past. The Government have made minor and technical amendments to part 8 to avoid the potential for misinterpretation and to ensure that NICE’s functions can be exercised effectively in practice.

It is important that patients continue to have access to NICE-approved drugs and treatments in line with the NHS constitution and accompanying handbook, whether those fall within the future responsibilities of the NHS or of local authorities. We have therefore amended the regulation-making power in clause 234 of part 8 so that the provision in regulations to replicate the effect of the current funding direction for NICE technology appraisal recommendations may also be applied to local authorities in respect of the drugs and treatments that they may prescribe for public health purposes, such as smoking cessation aids.

Part 9 establishes for the first time the NHS Information Centre in primary legislation, setting out its powers in relation to the collection, analysis, publication or dissemination of information. The Government have made a number of amendments—to clauses 255 and 257—and inserted new clauses after clauses 252 and 257 that further strengthen the protection of individuals’ confidential personal information while ensuring that the wider benefits of safely and securely sharing information, which include improvements in the quality of services and treatments, can be realised.

The amendments will, for example, restrict the people who can require the centre to collect confidential, personal, identifiable information; clarify the circumstances in which the centre may require others to provide it with confidential, personal, identifiable information; and require a code of practice to be published, setting out how confidential information must be handled. That provides an essential safe haven that can provide a powerful driver to support research and quality improvement in the NHS.

To support these amendments, we have made a number of minor and technical amendments to part 9 and to schedule 19. Finally, we made a minor and technical amendment in part 11 relating to the transfer scheme, which is set out in clause 294. That provision allows for flexibility in how the Secretary of State holds his shares in any property company. That is normal for company structures and is in a form already used by the Secretary of State with his other companies.

I urge hon. Members to support these amendments, including amendment 181.

[Liz Kendall]

I start by sharing with hon. Members a letter to the Prime Minister on 13 March from Malcolm Alexander, who is the chair of the National Association of LINks Members, the national body representing 150 statutory independent local involvement networks that promote the public and patient voice in health and social care. The letter is about the amendments to HealthWatch that were made in the other place and are before us now. He wrote to register his

“strong objections to the government’s major policy change on Healthwatch—specifically your decision to abandon plans to establish statutory Local Healthwatch bodies…Instead of creating independent statutory bodies led by local people who can monitor, influence, involve the public, hold the local authority and NHS to account; the government plan to create weak bodies that will not be independent, but will be funded by and accountable to the local authority they are monitoring. There will be no genuine accountability to the public.”

He then makes this rather perceptive comment:

“Plans for a statutory Healthwatch body were probably the only part of the Health and Social Care Bill that had any public support.”

He continues:

“Your government’s ambition”—

not your Government, Mr Deputy Speaker, but the Prime Minister’s—

“to establish independent, statutory Healthwatch organisations that would help achieve equity and empowerment in relation to access to NHS and social care services, has been diminished to such a degree, that Healthwatch will have little impact…The aspiration to achieve equity and excellence in public involvement in health and social care, especially for the most vulnerable people, has been replaced by a model that has lost its central purpose of building effective patient and user led bodies that can influence the planning of health and social care.”

Oral Answers to Questions

Debate between Paul Burstow and Liz Kendall

Tuesday 21st February 2012 Commons Chamber

[Paul Burstow]

My hon. Friend, who chairs the all-party group on cancer, has been pursuing that issue vigorously. We certainly need to ensure that we use both proxy and other performance indicators on cancer outcomes, and I will want to continue examining whether that indicator is the most appropriate one to tell us what we need to know about improvements in cancer outcomes performance.

[Liz Kendall (Leicester West) (Lab)]

The hon. Member for Basildon and Billericay (Mr Baron) is right that early diagnosis is crucial for treating cancer, and it is often very worrying for people to wait for their test results. Under the current Government, waiting times for diagnostic tests have soared. Will the Minister confirm that the number of patients waiting more than six weeks for their test has more than doubled since May 2010, the number waiting more than 13 weeks has more than trebled and the average wait is up, too, by 28%? It is a simple question, so will he give us a simple answer—yes or no?

[Paul Burstow]

It was a somewhat longer question than that, so I hope the hon. Lady will let me go a little further than a yes or no. I tell her that at the end of December 2011 only 1.4% of patients were waiting six weeks or longer for one of the 15 key diagnostic tests, and that just five NHS trusts are responsible for about 30% of all waits of six weeks or longer. We are working specifically with those five trusts to bear down on those waits and ensure that people do not have to wait so long. Of course she is right to make her point about waits, which is why the Government are focused on the issue and have sent in the additional support needed to ensure that trusts deal with it.

Oral Answers to Questions

Debate between Paul Burstow and Liz Kendall

Tuesday 7th December 2010 Commons Chamber

[Paul Burstow]

In fact, there is a further pot of money, which relates to the proposals for a ring-fenced budget in respect of public health. One of the problems has been the NHS’s raiding that pot to spend on other things. We believe that public health is a priority, and we will therefore ring-fence those resources in future. The £1 billion that will go into social care directly through the local government settlement will be available for local government to support social care services. The £1 billion that will go in via the NHS will also be there to support social care, but it will particularly address issues such as reablement and preventive services.

[Liz Kendall (Leicester West) (Lab)]

The Government are abolishing all PCTs and handing £80 billion to GP consortiums that do not yet exist for services including the co-ordination of care. Is not this reorganisation a huge gamble for patients and taxpayers, which is why No. 10 and the Treasury are so concerned, as we see today in The Independent? Will the Minister finally agree to publish details about the financial assurance regime for GP consortiums, and will he guarantee that under his plans £80 billion of public money will be accountable to Parliament in the same way that it is today?

[Paul Burstow]

Of course the money will be accountable to Parliament, as it is now. The hon. Lady’s comments reflect an interesting campaign that the Labour party has dreamed up, which is very much to ally itself with the interests of primary care trusts rather than those of patients and ensuring that we improve public services. This Government’s proposals will improve the way in which services are commissioned, deliver better outcomes for patients up and down the country, and deliver the integration across health and social care that the previous Government failed to deliver.