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My Lords, I refer to my interests, as listed in the register.
It is welcome that the Government have referred to social care in the gracious Speech. However, adult social care is in crisis and has been for a number of years. The issues of cost and funding will only get more difficult if Governments are not willing to see the social care sector through the same lens as they see the NHS. As a provider of homecare over the last 20 years, I am aware that, with a reduction in funding and in the time available for care workers to deliver care calls, the increasing requirements imposed on providers by local authorities cannot be met.
We all recognise that we have a growing ageing population. Living longer should be not a burden but a celebration. It should be recognised as a sign of improved living standards. However, it appears that, although politicians are willing to go out and actively and publicly claim their admiration and affection for the NHS—they are absolutely right to do so—it is not about loving the NHS so much as loving the people who work in it and the people who are looked after by it. Why cannot politicians do the same in relation to the incredible and challenging work carried out by those delivering adult social care within our communities? Millions of people depend on the services of trained, poorly paid care staff, who provide a lifeline to families struggling to care for their loved ones.
I will focus on adult social care, predominantly around the older age group. Care staff deliver care across all age groups and to people with varying degrees of disabilities, whether they are physical or unseen disabilities. For far too long, the social care sector has required a fundamental shift in how that care is delivered. Instead of tinkering around the edges with intermittent small injections of funding to fend off crisis after crisis, a total rethink is needed of how care within the community setting is delivered. There is already a challenge in making the care sector an attractive place to work. Pay is low and the working conditions are deeply challenging, and an expectation of increasing responsibilities is making care work an ever-demanding job that offers few benefits but increases stress for both care workers and families.
Recruitment in the care sector has hit an all-time low. Providers are worried about the tone that has been taken in the Brexit debate on immigrants and immigration, and they fear that care provision will face serious employment problems. Filling vacancies is already extremely difficult. It is unrealistic to assume that the gap will be filled by local people because, as is evident in the NHS, those posts have always required immigrants to come in to support our critical infrastructures. The Government are talking about a points-based system and skilled workers being welcome in the UK. However, unless we are able to provide home-grown workforces to deliver for an increasingly ageing population, our hospitals will have further expensive challenges thrust upon them.
A realistic and pragmatic approach has to be taken to respond to the challenges that we face. Unless there is a fundamental shift in how care provision is viewed in this country, people who have worked throughout their lives and contributed to the growth of this great nation will increasingly be airbrushed out of society and out of government commitments. They are not seen as vote-winners or contributors. Although we have a housing crisis, it should not be acceptable for people wishing to downsize to smaller properties as they get older to have no available provision, or choice about where they spend their later years. Going into a residential home or a nursing home should not be among the few options available. It seems that, once you have less to offer, you are redundant and surplus to requirements, and can be put out of sight and out of mind. What a reflection of the country we are becoming.
The one inevitability in our lives is that we will grow old. Surely, it is not beyond our wit to develop a care system that provides care, dignity and independence. The feedback that we continually receive from our clients and their families is that care must be about more than just addressing physical needs such as washing, showering and toileting. It is about mental well-being and continuing to engage with the community at large. It is about being socially active and feeling valued. Offering a more holistic approach to care in a community setting would fundamentally reduce the pressures associated with people having to visit the NHS.
Although we talk about NHS staff with affection, care staff in the community are viewed in a completely negative way. Both systems support people in our communities, yet the care sector, which acts as a complete support system for millions of families, is, unfortunately, disregarded. I urge the Government to rethink how care provision is delivered and funded, and not to make it the Cinderella arm of looking after people. The demands associated with health and well-being will not reduce; instead, as we grow in number, they will increase. Unless we see a fundamental shift in how care provision is funded and care staff are rewarded in their pay packets, this crisis will most definitely grow and create unsustainable pressure on the NHS.