Part of the debate – in the House of Commons at 3:47 pm on 12th January 2021.

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Photo of Liz Kendall Liz Kendall Shadow Minister (Health and Social Care) 3:47 pm, 12th January 2021

I know that the Minister and hon. Members on both sides of the House understand the seriousness of the situation that we now face. Yesterday, the chief medical officer warned that the next few weeks will be the worst of the pandemic, and the chief executive of NHS England said that the virus is spreading out of control in many parts of the country. As the Minister said, there are more than 32,000 covid patients now in hospital, up from 18,000 at the peak of the first wave. In my own hospitals in Leicester a quarter of patients have covid-19. Elsewhere this is 40% or even 50%, and we are preparing for those levels to hit us too.

On top of that, 46,000 hospital staff are currently off work sick with the virus, and the consequences of that are stark. Staff-to-patient ratios in acute and intensive care are stretched to the limit of acceptable levels, if not beyond. All but the most urgent operations are being cancelled in many parts of the country, including for cancer care. Ambulances are queuing for hours outside hospitals to get seriously ill patients into beds and some hospitals are even running dangerously low on oxygen supply.

Dealing with this awful virus, especially the new, more virulent strain, was always going to be extremely difficult, but I do not believe that the severity of the situation we are now in was inevitable. Over the past nine months, the Government have continually changed their message to the public, and have repeatedly been too slow to act, even though we know that the virus ruthlessly exploits ambiguity and delay. At the heart of the problem is the failure of the Prime Minister and some members of the Conservative party to understand that protecting people’s health and the economy is not a zero-sum game, because we cannot get the economy going again if we do not stay on top of the virus.

The individual freedoms that we all hold dear—our ability to learn, work, do business, travel the world and see those we love most—depend on the actions of others. No man or woman is an island. That has always been the case, but covid-19 has thrown our interdependency into sharper relief than ever before. Until the Prime Minister grasps that fact he will continue to make the same mistakes, and many in our country will pay a bitter price.

While most attention focuses understandably on the extreme pressures facing the NHS, the case I want to make is that we cannot protect the NHS if we fail to protect social care. Alongside the need for swift and decisive action, that is one of the most important lessons that should have been learned from the first wave, but once again there are warning signs of pressures building in social care which, I fear, have been downplayed or even ignored. The number of covid outbreaks in care homes has tripled in the past month. Care homes are reporting staff shortages of up to 40%. The latest weekly death rates in care homes are out today: 824 deaths for the week ending 8 January. Those numbers have doubled since November, and are the highest since May.

Ministers must heed those warnings and they must act, not just because after 20,000 deaths from covid-19 so far in care homes we must do everything possible to protect residents, or because care workers and unpaid family carers are physically and emotionally shattered after 11 months at the frontline and deserve more help and support, but because if we cannot keep people safe in their own homes or in care homes, or move them back home from hospital when medically they are able to leave, the whole system will buckle under the strain.

After all the problems earlier this year, with covid-19 patients being discharged to care homes that could not cope, the Government should finally have gripped the issue and delivered a proper plan. Yesterday, we learned that only 118 care homes have been designated as safe to accept covid patients from hospital, although the Government promised in November that there would be at least 500. Understandably, many care homes do not want to take covid patients from hospital, especially as insurers will not cover the associated risks. While the Government have provided indemnity against such claims to the NHS, they have still not done so for social care, despite repeatedly being asked to do so.

This is just one example of the way in which social care social care is still not being prioritised, treated or funded equally with the NHS. Frontline care workers are still chronically undervalued and underpaid. Almost three quarters do not even earn the real living wage, despite doing some of the most important work in society, looking after the people we love most. Millions more unpaid family carers are being stretched to breaking point, trying to look after the people they love. Even before the pandemic almost half of unpaid carers had not had a single break for five whole years, and since the virus millions more families have taken on an even bigger role, but with precious little help and support in return. So I urge the Government to consider what immediate extra support can be provided for social care—for care workers and family carers—over the coming months, when the pressures will be the greatest we have ever seen.

I know that across the country, as the Minister said, the vaccine provides real hope for care workers, care users and families that the nightmare they face can and will end, but we are in a race against time. The Government must leave no stone unturned in their plans to deliver the vaccine to all elderly care home residents and staff by the end of this month, and we will support them in their efforts to do so. However, we really do need to see daily vaccination rates for this group published so we know whether the Government are on course to complete this commitment in just under three weeks’ time.

People need to know when they can start visiting their relatives in care homes once the vaccine has been delivered, because this is currently totally unclear and causing real upset and concern for families across the country—people who have not seen their relatives for months and months on end. Ministers should also set out a more detailed timetable for vaccinating hundreds of thousands of other care workers by mid-February. This needs to include those working with disabled adults as well as older people, those working in home care as well as care homes, workers in supported living and personal assistants employed by direct payments. I think we are going to have to go way beyond the Government’s current plans if we are going to vaccinate family carers aged under 65 as part of priority group 6, as the JCVI now recommends.

The vaccine is the light at the end of a very dark tunnel, and as we begin to emerge, we must resolve to build a better Britain, not go back to business as usual. Nowhere is this more true than for social care. In July 2019, the Prime Minister promised on the steps of Downing Street that he had a plan to fix the crisis in social care. A year later, he again claimed his Government “won’t wait” to fix the problem, yet six months on his plan is still nowhere to be seen, and instead delayed until sometime later this year. In October, the Health Minister in the House of Lords said:

“There simply is not the…political capacity to take on a major generational reform…in the midst of this massive epidemic.”—[Official Report, House of Lords, 28 October 2020;
Vol. 807, c. 226.]

That is not good enough, and I would argue that this is precisely the time we need a long-term plan of far-reaching reform to give people hope that a better future is possible after the horrors of covid-19.

We need a social care system that works for older people and working-age adults with physical and learning disabilities, who make up a third of the users and a half of the budget of social care but are still too often ignored. We need a system that fundamentally shifts the focus of support towards prevention and early intervention to help people stay living independently and well in their own homes for as long as possible; a system where social care is fully joined up with but not run by the NHS, so people do not have to battle their way round all the different services, telling their story time and again; and a system that is properly funded after a decade of cuts, so care workers get the pay and training they deserve, families get decent support and there is help from the wider community too.

Yesterday, 88-year-old Moira Edwards, the first person to be vaccinated in one of the new NHS mass vaccine centres, spoke for many of us when she said that she could not wait to give her family a hug. I know that that is exactly how I feel. This pandemic has proved once again just how important our families are, but it has also exposed the fundamental flaws in the system of social care on which millions of families depend. The reality of modern family life is that more of us will need care, and need to care, as we all live for longer. So if we want to provide dignity and security for older and disabled people, and if we want to help families balance their work and caring responsibilities, and offer more than 1.5 million low-paid care workers hope for a better future, transforming social care must be a national mission. Labour Members stand ready to play our part in one of the biggest challenges facing our country, but it depends on Government action, which they must take—and now.