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Social Care Sector: Staff Shortages

Volume 825: debated on Monday 21 November 2022


Asked by

To ask His Majesty’s Government what assessment they have made of the impact of staff shortages in the social care sector.

As acknowledged by the Chancellor, pressures in the social care sector are a serious issue. We are taking steps to boost the social care workforce, investing up to £2.8 billion of additional funding in 2023-24 and £4.7 billion in 2024-25 for adult social care, raising the national living wage to £10.42 and launching our national recruitment campaign. We will also be publishing a staffing plan for regulated professionals, including nurses and allied health professionals in health and social care.

My Lords, I thank the Minister for that Answer. Last Thursday, the Chancellor said that there were 13,500 beds occupied by people who should be at home. When are the Government going to ensure that there are enough staff to look after them in the adult social care sector, given that you can earn more money in a supermarket than in a care home? How much money are the Government intending to save by postponing the Dilnot reforms? Does the Minister agree with Sir Andrew that this delay is “inhumane”? Will it not mean that many more people are going to have to sell their homes in order to pay for the large care costs? In short, does the Minister agree that the longer this Government remain in office, the more people are having to wait for decent, affordable, proper social care?

The noble Viscount mentioned funding. Clearly, it was a difficult choice, but our priority was to make sure that the funding went into the supply of places over the next two years, because of the impact that has across the system. Noble Lords will have heard me mention many times how that affects the whole flow, which backs up into ambulance wait times and everything else. That is why I am delighted to say that we have secured £2.8 billion of extra funding in 2023-24 and £4.7 billion in 2024-25. That will obviously flow through the whole system, including into staff wages and recruitment.

My Lords, I welcome the announcement of the health and social care visa, but the Government have no separate figures for the number of workers who have come here under the new health and care special visa rules, separately for health staff and social care staff. So can my noble friend tell the House what are the median and top quartile pay rates for social care staff? I am happy for him to write to me if he does not have those figures. Do the new visa’s minimum salary requirements mean there is little hope of immigration filling the 165,000 or more vacancies, leaving 2.6 million older people without the care they need, as estimated by Age UK?

I will need to write on the detail of the median and upper quartiles, as mentioned. What I can say right now, though, is that the national living wage increase will put them over the current visa levels required, which I think will be a big boost, allowing us to increase our recruitment from overseas. We have already seen month-on-month increases and the national living wage increase will help grow that further.

My Lords, is it not the case that if the national minimum wage has gone up, therefore affecting the social care sector, it will also have gone up affecting those who stack shelves in supermarkets?

I was referring in that answer to the visa scheme. That will allow us to recruit more people from overseas who will be eligible for a visa, in the fine traditions of the NHS. We have always recruited from around the world and I am pleased to say that we are recruiting in this space. This is a consequence of a full-employment economy, which I think we would all accept is a very good thing. But, clearly, that sometimes means we need help, in areas such as the NHS, to recruit from overseas.

My Lords, Enabled Living in Newham has become the first London-based social care provider to pay its workers the real living wage—the first such employer to do so. We have heard that social care workers are among the lowest paid, with one in five residential care workers living in poverty before the cost of living crisis, according to the Health Foundation. What assessment have the Government made of the real living wage and the impact that it could have on retaining valuable social care workers?

I thank the right reverend Prelate for the passion that she clearly displays in this field. As I mentioned in my Answer to the Question, we have a national recruitment campaign, and looking at the staffing plan for allied health professionals and what needs to be paid to recruit people in the right areas will be part of that. The national living wage is a start, but clearly we need to make sure that this is an attractive career that people want to join and stay in.

My Lords, I draw attention to my interests in the register. Recently, the coroner in Cornwall ruled that some deaths in the county are probably attributable to delays in ambulance services, which are in turn associated with delays in transfers of care from acute services to care homes. There has been a reduction of more than 600 care bed places in Cornwall in the past four years. This is an example of the challenge that we face. Does the Minister accept that the Government’s objectives for the NHS will never be effectively achieved without resolving the social care challenges, and that the difficulty of recruiting from overseas, particularly in rural areas, should be acknowledged?

I agree and have often made the point that solving this part is key to the flow and to getting people through discharge quickly, which has a knock-on impact on A&E and ambulance wait times. That is why I was delighted to hear the Chancellor recognise this specifically and mention £2.8 billion of funding in 2023-24, which will account for 200,000 new care packages in this space, as well as £4.7 billion in 2024-25 to resolve the exact problems that the noble Baroness brings up.

My Lords, the Minister has now referred three times to the money that the Chancellor has said he will invest in social care from April next year. But the crisis is now and the Government’s own plan for patients says this must be resolved and there must be more social care workers immediately to help with the pressure on hospitals. What will the Government do over the next six months to ensure that there are more workers and help to relieve the problems with both discharges and A&E?

I thank the noble Baroness. In the past few days, local authorities have been notified of the £500 million discharge fund. That funding will go out in December and January, so it is very much going out there. It is very much designed to address the issues of discharge, creating new places and helping to recruit.

My Lords, is there not a case for formally involving the Commonwealth in this aspect? There is already a trial going on with Sri Lanka for nursing. I suggest to my noble friend the Minister that there are other Commonwealth countries that would be more than willing to have a two-way flow and help reduce the huge shortage that we have.

I agree with my noble friend. Overseas and Commonwealth recruitment is a key area here, which is why I am delighted that we have addressed the visa restrictions and entered social care on an essential workers list. We have already seen 15,000 people come in this space, and that figure is increasing month on month. My noble friend is correct that this is a critical area for recruitment for us.

My Lords, does the Minister agree that the more problems there are with paid workers in social care, the more difficulties fall on the nearly 10 million unpaid carers. Of those who are receiving the carer’s allowance, 40% say that they are already in debt and not sure how they will manage through the winter. Does he also agree that, in view of the myriad problems in social care, it is time to listen to what the noble Lord, Lord Forsyth, asked the House last Thursday, and think about a proper review of the whole of social care?

My Lords, I thank the noble Baroness. The new funds mentioned recognise that this is critical to the health of our National Health Service and the flow. As part of that, as I mentioned in my Answer, we are looking at staffing plans across allied health professions in the health and social care space, and it is vital that we get the recruitment to this area to solve the overall issue of flow and NHS wait times.