Health and Social Care Workers: Recognition and Reward

Rushanara Ali Excerpts

Thursday 25th June 2020 Commons Chamber

[Catherine McKinnell]

We will see if there is the political will when the Government respond to this debate today, and afterwards as well.

One of the petitions we are considering today, with over 162,000 signatures, calls for an increase in pay for NHS healthcare workers. They are doing tough work in very challenging circumstances, putting their lives on the line, and for ever-squeezed pay. There have been calls for staff to get paid properly for all the hours they work, especially overtime, which really is not too much to ask.

The Royal College of Nursing has taken issue with recent claims by the Secretary of State for Health and Social Care that nursing staff have received a “significant pay rise”. The college’s research shows average earnings for NHS staff have not kept pace with the cost of living since 2010. Ahead of the next pay round for 2021-22 it is calling for an

“honest dialogue…in valuing the nursing workforce”.

We know we have a shortage, and paying health workers properly is key to having the workforce we need. It would be a grave error by the Government if, following the crisis and the recession that we are already heading into, they look to balance the books on the backs of public sector staff in the way we saw after the banking crisis in 2010—the very same public sector workers we have been clapping for in gratitude for saving so many lives. Neither must we see a repeat of the junior doctors dispute, where staff were treated appallingly and morale was devastated as changes to pay and conditions were forced through.

While he and I would certainly disagree on the detail, I echo the comments made by the former Chancellor the right hon. Member for Bromsgrove (Sajid Javid), calling on the current Chancellor to focus on growth, not austerity. We cannot cut our way out of this recession, and certainly not with cuts aimed at the very people who are getting us through this crisis.

Many medical students have also stepped up to support their future colleagues in fighting the virus. There are parliamentary petitions calling for reimbursing fees and reducing student loans. The Petitions Committee is conducting an inquiry into the wider impact of this crisis on students, as there has been unparalleled disruption to higher education.

Before this crisis, student finance reforms also impacted on the healthcare workforce. The decision to scrap NHS bursaries in England and replace them with loans led to applications falling by a quarter, and there are almost 40,000 unfilled nursing posts. While that error has been partially corrected by the restoration of maintenance grants, this will not benefit current students.

One petitioner says that nurses

“will surely work tirelessly to do their best to keep the rest of us safe while at the same time they continue to be charged interest on these loans for a cost which they should not have been required to bear in the first place.”

Another, calling for the current intake to receive grants, says:

“Most student midwives and nurses in those intakes will leave university with at least £60,000 debt, despite having committed to a career in a valuable public service at a time when the NHS is in desperate need of more of them.”

Addressing student finance for healthcare students would be a way to both recognise the efforts of the current intake and help attract more to the profession, but unfortunately the insensitive comments of the Minister for Care recently are a bad start to this, so I urge the Government to do everything they can to rebuild trust.

But the most devasting impact of all has been in social care. Our care homes and their elderly and vulnerable residents have painfully borne the brunt of this crisis. More than 16,000 people have died from covid-19 in care homes, almost a third of all fatalities. Far from the Government wrapping a protective ring around care homes, in the early days of this crisis they were left exposed, without adequate PPE or testing for staff despite their desperate pleas. The human cost of this failure is harrowing.

The crisis has well and truly exposed how neglected our care system has become. Too many staff are low paid and on insecure contracts; too many have had to make choices between risking people’s lives, including their own, or going without pay. Many carers do not receive even the national minimum wage because they are not paid for travel or sleep time.

Campaigners, including the trade union Unison, have been calling for care workers to earn the real living wage of at least £10 an hour outside of London. Working conditions and employment rights vary immensely between care providers and we need to see care workers properly recognised and rewarded for the vital work they do.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

Given the sacrifices that care workers have already had to make, many with their lives given the shortage of PPE, does my hon. Friend agree that, going forward, particularly with the risk of a possible second wave of covid later in the year, the Government need to step up and make sure that care workers get not only the support and resources they need, but proper PPE in preparation for what could be a very difficult winter?

[Catherine McKinnell]

One petitioner summed it up by saying:

“I wish social care workers were considered as equally important as NHS staff.”

I think that that says it all.

Finally, across social care and the NHS, migrant workers are a key part of the workforce and make a huge contribution. The Prime Minister made the right decision to scrap the immigration health surcharge, but this must be fast tracked to include refunds for those who have already paid. Many are also worried about their visa renewal, which is stressful enough. The 12-month visa extension announced by the Home Office is welcome, but it leaves out thousands of dedicated workers who are also working on the frontline. The extension should apply to all.

Many migrant workers in health and social care are stuck in limbo without indefinite leave to remain. The Royal College of Nursing and the Royal College of Physicians have called for indefinite leave to remain to be granted to all international health and care workers who have worked in the UK during the pandemic. Many migrant workers on the covid frontline are also subject to “no recourse to public funds”, which adds immense financial pressure, especially if they fall ill and have to self-isolate. Unison has called for the policy to be suspended. One petitioner said:

“I strongly believe the Government can do better than that one-year free automatic visa renewal for these NHS heroes. A grant of indefinite leave to remain or citizenship is not too much to ask to appreciate the covid-19 pandemic frontline fighters.”

We cannot expect migrant workers to put their lives at risk and help our nation fight this virus, and then expect them to pay through various means for the privilege of doing so.

In conclusion, the key issue at the heart of today’s debate is how we value our health and care staff and the tremendous work that they do. The pandemic has thrown their dedication, bravery and compassion into the national spotlight as they put their lives on the line, but this dedication is not new. They have been serving our country, day in, day out, long before this pandemic. I hope that this debate will be just the start of a proper conversation about how, as a country, we not only show our gratitude and appreciation for the work that they do but, take real action to make their job easier. For now, to all our doctors, nurses, carers, support staff, and every person working on the frontline during this pandemic, I say a heartfelt thank you to you all.

--- Later in debate ---

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

It has been said many times, but we should never tire of saying that our NHS and care workers are true heroes and that we are incredibly grateful for their skill, dedication, selflessness and sacrifice. We came out on Thursday evenings to applaud them; now it is time to build a system that rewards them with more than applause. That is why it is important that the Government put their money where their mouth is and start to recognise them, as hundreds of thousands of people in each of these petitions have called for. After a decade of austerity, the NHS and social care system is on its knees. The Government were already missing A&E targets as far back as 2015. We know that the NHS has vacancies of 100,000 and that NHS trusts are £1.23 billion in deficit, which needs to be addressed quickly so that they can get on with the job of protecting us. Then there is the mental health crisis.

Across the NHS and care system, there is the scourge of low pay. Unison predicts that we will need another 1 million extra careworkers by 2025. It is vital that we learn the lessons now and ensure that we have a resilient, well-resourced, effective NHS, where people are properly rewarded and have their skills and expertise recognised, rather than being treated shoddily, which is what we have seen.

We also need the Government to ensure that junior doctors are properly rewarded. The Government’s behaviour in recent years has been appalling, yet the doctors, nurses and carers have been the people on the frontline, saving people’s lives and protecting us. We also know that black, Asian and minority ethnic NHS and care workers have had the highest death rate, yet the Government have been inadequate in protecting them. To be frank, the Government have treated them like cannon fodder and the fact that they do not have proper recommendations for those workers is scandalous. They need to get a grip before more lives are lost.

If the Minister for Care thinks that health and care workers should be protected, she should act instead of saying appalling things about them. I hope she will apologise for the remarks she made recently about care staff. The point is that we need to ensure that, when the crisis eases, this Government do not forget the sacrifice and commitments that people in the NHS and care system have made, and that they act to ensure those people are properly rewarded, properly recognised and protected.