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A hugely fragmented provider landscape has been one of the major problems in the social care sector. Hundreds of providers are operating in some areas, and most councils have experienced provider failure or the return of contracts. The Government’s fears about providers going out of business may explain their reluctance to clamp down harder on companies that are failing to fulfil their minimum wage obligations. Britain’s four largest privately owned care home operators have built up debts of £40,000 per bed, which means that their annual interest charges alone absorb eight weeks of average fees paid by local authorities on behalf of residents. Despite that, HC One, the UK’s biggest care home operator, has still managed to pay out more than £48 million in dividends in recent years.
A report produced recently by the Centre for Health and the Public Interest demonstrates just how much money is allowed to leak out of the social care sector in the form of, for example, profits, rent and interest payments, with the level of leakage far higher among for-profit providers. Any funding boost for social care must therefore be accompanied by meaningful reform of the sector which moves away from the failing markets and, instead, embraces a vision for care that puts a public sector ethos and core ethical requirements at its heart.
As we heard earlier from my hon. Friend Liz Twist, a critical part of social care must be to produce a workforce who are fairly rewarded and properly valued. Careworkers have been absent from much of the discussion about implementing the NHS long-term plan and developing the final NHS people plan, although the future vision for the NHS is one that brings health and care closer together. As the House of Lords Economic Affairs Committee pointed out:
“The care workforce needs a career structure which better reflects the skills required to be a good care worker and the social importance of the sector.”
The Nuffield Trust recently stated that
“a realistic and comprehensive workforce strategy is needed to combat the chronic recruitment and retention crisis that that is affecting the social care sector.”
Recent work by the Institute for Public Policy Research has begun to point the way towards the development of a workforce strategy for the sector, with a focus on proper pay, professional registration, and improved training and development. Working in care needs to become an attractive career choice if social care is to shed its unwanted reputation as a low status, high turnover sector. My trade union, Unison, recently launched the Care Workers for Change campaign, which calls for a real living wage as a minimum, fair contracts, no zero-hours contracts, and enough time to care and a safer working environment for our incredible careworkers.
I sincerely hope that cross-party talks are constructive and meaningful. I therefore ask the Government to enact meaningful market reform of the social care sector that moves away from the current landscape of fragmented providers, and to develop an effective workforce strategy so that staff are fairly rewarded and properly valued.