Asked by
To ask His Majesty’s Government what steps they plan to take in
response to the report by Skills for Care The state of the adult
social care sector and workforce in England 2022, published on 11
October, which shows that there are 165,000 vacancies in the
social care workforce and that this workforce has shrunk for the
first time in 10 years.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care () (Con)
My Lords, we are investing in adult social care. We have made
£500 million available to support discharge from hospital into
the community and bolster the workforce this winter; that is on
top of record funding to support our 10-year plan as set out in
the People at the Heart of Care White Paper. We are backing
recruitment at home and abroad with a £15 million international
recruitment fund and a new domestic campaign, which we will
launch shortly.
(Lab)
I thank the Minister. I expected him to mention the £500 million
workforce fund, of course, but he will know that it has been
described as a drop in the ocean and that councils are calling
for far more to be pumped into better pay and recruitment in the
social care workforce. I do not want to be disrespectful to the
new Minister, who I know has a lot on his plate, but I wonder
whether he and the Government really understand the scale of the
crisis in social care. Some 50,000 people left an already
inadequate workforce last year; that is not surprising when they
can get better pay and conditions in Tesco, and when one in five
care workers is in poverty despite being in full-time work.
The previous Prime Minister told us that he would fix social
care. The current Prime Minister has withdrawn the levy that
would eventually have provided extra funds, with no indication of
how those funds will be replaced. Is the Minister aware that,
meanwhile, thousands of older and disabled people, both in their
own homes and in care homes, are being neglected and deprived of
services in a way that no decent society should tolerate? Will he
acknowledge both the depth of the crisis and the fact that we
need a step change in the way we value social care and the
dedicated people who provide it?
(Con)
First, let me say that we value social care. As the noble
Baroness will be aware, the £500 million was in addition to a
£5.4 billion increase over three years. Again, that underlines
the importance that we see behind adult social care and how it is
a crucial part of our whole plan, as outlined in ABCD, not only
to give the right conditions and dignity for the elderly people
whom the noble Baroness mentions but as a vital way of releasing
space in our hospitals—this drives right through the system—to
create space both in A&E and through the rest of the care
system. It is an area of vital interest and something that I can
assure noble Lords has a lot of focus from the department.
(Con)
My Lords, I strongly welcome the Government’s action to put care
workers on the shortage occupation list this year, which is
important for unlocking immediate supply. However, might I ask
the Minister to note two key points from Skills for Care’s
report, which are important for further action for sustainable
care workers? The first is that, although the retention rate has
remained more or less stable since last year, the starter rate
has fallen from 37.3% to 30.8%. Can I suggest that the Minister
looks at more incentives for starters? The second point is that,
on average, employers with favourable work metrics such as high
levels of learning and development have better CQC ratings. Given
the UQ coming up later, that is another critical area to look at
for improvement.
(Con)
My Lords, my noble friend is correct that this is also a labour
supply issue. Part of the benefit of living in an economy with
full employment is, of course, that there is little unemployment.
Part of the downside of that is the competition for jobs. My
noble friend rightly points out the need to recruit more in this
sector; that is why I am pleased that she mentioned the work we
are doing to add this sector to the essential workers list so
that we can recruit people from overseas and get essential
workers in.
(CB)
My Lords, I welcome the Minister to his post. I look forward to
working with him. In that spirit, I ask him this: where might I
find the data relating to the long-term planning for the NHS and
social care workforce? If such data does not exist, will he agree
that such planning data should be made available as a matter of
urgency?
(Con)
My Lords, my understanding is that there is a 10-year plan as
part of a workforce plan, which rightly looks at the issues
raised by the noble Lord. As I mentioned in my answer to the
previous question, the workforce is key to this sector. We employ
1.5 million people; I think that they account for about 5% of our
whole workforce. So making sure that this is an area that people
want to come and work in, that people enjoy and that people see
as a vocation is vital and will be part of the plan. I will look
up the data requested and reply in writing.
(Lab)
My Lords, I, too, welcome the Minister to his place. I
congratulate him on the tone of his responses so far. I agree
with him that the workforce is key. Another feature of the report
is that a quarter of the adult social care workforce are on
zero-hours contracts and get paid £1 an hour less than healthcare
assistants on average. Given the projection in the report that,
if we are to keep up with our ageing population, we will need the
best part of 500,000 more of these workers by 2035, we must
address their low pay, must we not?
(Con)
The noble Baroness is correct that a number of people are on
zero-hours contracts. As I am sure she is aware, their employment
is through a number of agencies and local authorities, but it is
an issue in a number of places and goes to the wider conversation
about how we make this sector an attractive place to work.
Earlier, my colleague mentioned the Skills for Care working
group, which found that a significant proportion of all
employers—around 20%—have a turnover rate of only around 10%
versus the 29% average. So, clearly there are areas where certain
employers do a fantastic job of not only recruiting but
retaining, and making the sector an attractive place to work. I
believe that the whole emphasis of the conversation we are having
now is exactly about how to make this sector an attractive place
to work because, as we all know, it is a vital part of our care
and health system.
(LD)
My Lords, the Minister referred to the £500 million investment in
social care but this is only his fourth day in the job. Many
people in your Lordships’ House know that that money is for
winter pressures and was omitted from the budget for the NHS and
social care at the beginning of the year. Without it, social care
would be in even deeper trouble than it is now. The noble
Baroness, Lady Chakrabarti, made an extremely important point
about zero-hours contracts. The problem of staff working in
domiciliary care is that there is not enough money even to allow
them to be paid for travelling between clients. There is a real
shortage of money. This is a group of dedicated workers who are
being treated very badly. Will the Minister undertake to look at
this particular problem?
(Con)
Any industry with the sort of turnover rate that was mentioned
earlier demonstrates that there is a need to look further into
it, so I absolutely accept the premise of the question and, as I
mentioned before, the importance of this area. As I have said
before, this is also about looking at areas of best practice
because we can always look to spend more money but we know that
there are limitations on the public purse. I would not be doing
my job if I did not try to see where we can learn from good
employers, employ those practices and see whether we can spread
them wider so that everyone has the same level.
The other point that I made previously was about opening this up.
We know that our healthcare system is founded on good workers
from all around the world. They can be a bedrock. I am delighted
that we are looking into that area now. We are starting to see
good numbers of people coming in from abroad. It is an excellent
level of entry into our country. There are a number of things we
can do to improve the situation but I completely agree with the
noble Baroness on the importance of tackling it.
(Lab)
My Lords, the Health Foundation has described the Skills for Care
report as yet another signal of a social care system on its
knees, with care providers struggling to compete with other
employers and, in many cases, unable even to pay the national
minimum wage to essential care staff. As we have heard, the
figures are that one in five residential care workers in the UK
was living in poverty, and that was before the cost of living
crisis, compared with one in eight of all workers, which is a
shocking figure in itself. When will the Government commit
specifically to addressing the appalling low pay and poor working
conditions throughout the social care sector?
(Con)
My understanding is that the pay of carers is always at least the
national living wage. I will look into that, but that is my
understanding. That is not to say that where they deserve, and
should be paid, more that this should not be the case, but the
national living wage is set, as the noble Baroness will be aware,
exactly as it says: a national living wage. In terms of the cost
of living pressures, the energy price cap is of course about
focusing on those people who need it most, so there are a number
of measures that we are putting in place to ensure that this
happens. Most of all, it is about ensuring that this is a good,
safe and enjoyable vocation for people.
