Social Care Reform

Rachael Maskell Excerpts

Thursday 18th March 2021 Westminster Hall

[Rachael Maskell (York Central) (Lab/Co-op) [V]]

It is a pleasure to see you in the Chair, Dr Huq. The arguments are well rehearsed, the need well understood, the unfairness deeply felt and the failure exposed in countless reports, but nothing changes. Like an annual custom, the Government announce a social care White Paper to be published later in the year, but nothing ever emerges. Meanwhile, the most vulnerable families have to pay out tens of thousands of pounds, and one in 10 over £100,000, for care by underpaid, undervalued and overworked care staff, either at home or in some institution. This year, they have even been denied seeing familiar faces—imprisoned for the crime of growing old or disabled as their lives have faded into a so-called care industry that largely seeks profit out of frailty.

We must establish the core principle that the state recognises its responsibility to care with parity of esteem with the NHS. My report into care homes in York exposed the failure of governance of funded care, with a business model that protects commissioners and providers, but not residents. We cannot continue to sell the lives of our most vulnerable in the marketplace of social care. Instead, we must make a pact with people who just want to be safe and not exploited. Principle one is that the state has the duty to care. Principle two is simple: social care must be a universal benefit. None of us knows the twists and turns of life that will lead us to need help. A caring society will reach out and meet that need.

Principle three is funding—public not private insurance. As we see in healthcare and care systems around the world, the private insurance industry’s lucrative revenue has driven the sick and the frail out of health and care. Every penny must be reinvested in enhancing care. If we are ever to bring funding together, we need to have one system. We have to be honest—high-quality care costs. And a Government will pay for what they value.

Principle four is quality. First, the care must be safe. My report into care homes showed that the larger care home companies provided some of the worst care. Secondly, the care must be person-focused and meet aspiration; it should not just meet basic need or be based on ability to pay. These are our mums and dads. We need a high-quality care standard, driving up quality.

Principle five is robust accountability. Although the Care Quality Commission has its role, I have to say that it seriously needs to beef up its whistleblowing processes; commissioners of care hide under layers of contract confidentiality. We need transparency. The sequencing of the Department’s White Papers has meant that the governance White Paper has been published before we know what the social care White Paper will say. So, can the Minister give assurances that the social care White Paper will be published before the Health and Care Bill comes to the House?

Principle six is about staffing. Care professionals must be paid a professional wage, but 1.6 million of them earn less than the real living wage and a quarter of them are on zero-hours contracts. They need associated registration to keep them and the public safe. As for insecure jobs—every person needs to know that they will be loved, cared for and kept safe when they need care.