Local Government Responsibilities: Public Services

I beg to move,

That this House has considered the statutory and broader local government responsibilities for public services, including social care.

In the coming weeks and months, it is right that the Government focus on the fight against coronavirus. Local government will be on the frontline of that fight. Local services, from social care and public health to bin collections and now, most importantly, support for volunteering, will help us to overcome the challenge.

It is a time of uncertainty for many people across the country, and the Government need to provide as much certainty as they can. One thing we know is that older people, and those with underlying health conditions, are at greater risk from coronavirus than the rest of the population, as is clear from the social distancing guidelines issued for those groups this week. That means that, in the coming months, social care will be more important than ever because it not only helps to keep hospital beds clear for those who need them, but touches the lives of some of the most vulnerable. Care staff, therefore, will often be on the frontline of our efforts to stop the spread of the disease.

We are particularly concerned about home careworkers, who might provide care for up to a dozen older and disabled people in their homes every day. We want all necessary measures to be taken to protect care staff and the people they work with. As with the NHS, an important part of the solution is personal protective equipment and measures for infection control.

Care providers will face extra costs due to the need for more personal protective equipment and for enhanced cleaning of care homes and people’s own homes, and other measures to minimise the spread of infection—for example, zoning some staff in care homes. Last week, I raised with Ministers the fact that providers have faced great difficulty in obtaining personal protective equipment, and that also applies to infection control products, hand wash and disposable hand towels.

The care sector is extremely worried about being able to get essential supplies such as personal protective equipment. Commissioners can mitigate that by funding the extra costs and by helping providers to access personal protective equipment, perhaps by using some of their own contracts. The Government need to give guidance to local authorities and care providers, however, on the provision and use of personal protective equipment for careworkers and on whether help with accessing supplies can be given to reduce the spread of coronavirus.

We have just had a debate on statutory sick pay, which is particularly important for care staff, who are on the frontline of the outbreak. If they are ill, it is vital that they follow the public health advice and self-isolate, but the reality, as we heard, is that many care staff, like other staff, cannot afford to do so. Even if they are eligible for statutory sick pay, which we do not think they all will be, it is only £94 a week. The Minister needs to set out now what the Government will do to ensure that no careworker has to choose between doing the right thing and facing overwhelming financial problems.

Care providers are also facing increased cost pressures due to staff self-isolating or being off sick. It is right that statutory sick pay will start at day one, rather than day four, but that will increase employers’ liability for statutory sick pay. Requirements for workers to self-isolate will further increase financial pressures on employers. Given that, in virtually all cases, care providers will have to backfill sickness absence to ensure the continued delivery of support, that represents a real cost pressure on providers. With local authority budgets stretched, how can they support care providers to provide for extra statutory sick pay, the cost of backfilling care staff and the personal protective equipment and other materials that will be needed to get through the crisis?

My hon. Friend is making a compelling case for why the Government should announce specific support for the social care sector. I noticed yesterday that the Chancellor did not make specific reference to the social care sector which, as my hon. Friend points out, is in a fragile state and under enormous pressures. Is it not time for specific support for the social care sector to be announced?

I agree with my hon. Friend. It is great to hear that the NHS will get what it needs, but what about the social care sector?

We know, as my hon. Friend just said, that many care providers were already on the brink of collapse. Many will not have reserves to fall back on. I ask the Minister, as my hon. Friend just has: what will the Government do to sustain care provision and ensure that care providers are able to carry on delivering care at this time?

My hon. Friend is making a good point about social care in the broader sense. I want to raise the needs of local charities, some of which provide social care, and others provide a range of other services. Does she know whether some of the funding that the Government have allocated to local authorities will be earmarked to support continued funding of those local charities and community groups, or whether that has not yet been considered?

That is a very good question, and we should ask it in addition to the questions that I will ask, because the independent and voluntary sector is vital in our communities and in care provision.

I want to touch on the issues facing care homes across the country. We know that the Government are asking older people to avoid social contact for the next three months, but we need to be clear—clearer than we have been—about what that will mean for people in care homes. Will the Government recommend that all visits from friends and family be stopped until June? Can the Minister tell us what guidance on visits they are giving to organisations running care homes? Providers and their networks do not seem to have had any clarity yet.

The Care Quality Commission has announced a pause in its inspections, freeing up staff time to focus on care, but today it has published its independent review of Whorlton Hall. That was a shocking scandal. People with learning disabilities and autistic people and their families will want reassurances that, once this crisis passes, the CQC will focus its full efforts on ensuring that something like Whorlton Hall never happens again.

Many older and disabled people do not receive formal social care. Instead, they rely on unpaid friends and family. I know that many unpaid carers are worried that they will contract coronavirus or have to self-isolate and be unable to give the care they normally do. What steps should any unpaid carer who has symptoms of coronavirus take? If they are being asked to self-isolate, what alternative care can be provided at short notice? If someone cares for a person they do not live with, what steps can be taken if the carer has to self-isolate or if the Government have to further restrict travel, as many unpaid carers live some distance away from the people they care for?

Young carers—children and young people—may need more support than others in managing the changing situation in their lives, especially if their local supermarket or pharmacist does not have supplies. It is important that, if schools or years within schools close, it is understood which children within those schools are identified as young carers. It is often the case that a school or a teacher within a school is the only person who knows that one of their pupils is looking after someone at home. Schools could nominate a lead person to make regular contact with young carers during this difficult time when they are not in school.

I am grateful to my hon. Friend for giving way to me a second time. Is there not also a broader point about certainty of future funding for local authorities and certainty about which of the additional costs they face from coronavirus will be met by central Government going forward? My local authority, which is not by any definition well off, is concerned about when it will receive clarity from the Government on which costs it can reasonably expect Ministers to cover.

My hon. Friend is absolutely right. We will need certainty about those things when we look at the coronavirus emergency Bill, which we will do shortly, but this lands on local authorities at a time when they do not have any certainty. There is much about their financial position that needs to be made clearer to local authorities. I also agree with my hon. Friend: my local authority has had budgets cut by more than 50% since 2010, and we were in what we were calling a crisis in social care even before this happened.

I want to talk more fully about people with dementia and people with learning disabilities. There are a million people with dementia in this country and many people with learning disabilities. Not all of them will be able to comprehend the importance of self-isolation and then act appropriately. What measures and guidance will the Government introduce to help people with learning disabilities or dementia to self-isolate? Many working-age people with disabilities may be more vulnerable. Conditions such as Down syndrome or multiple sclerosis could increase the risk of respiratory infection, and the guidance suggests that people with these conditions would self-isolate. Can the Minister tell us what financial support will be available for them and their families if they have to stop work to do that?

We understand that this is a difficult and challenging time for all, but the Government have talked of using volunteers in health and social care services. People with disabilities and older people who need care have some of the most complex care needs. How will the Government ensure that people with complex needs continue to receive the support and care they need to stay in their own homes?

In this crisis we need to make the most of volunteers and that spirit in the community of helping out, but at the same time ensure that things such as Disclosure and Barring Service checks are done appropriately and that vulnerable people are kept safe from other risks, including those of unscrupulous interveners.

I thank the right hon. Member for that intervention. I think most of us are concerned in our constituencies to ensure that we have enough people to help out, but do not have the wrong sort of people getting involved. We do not want to start seeing scams and people defrauded, because that would be a terrible way to proceed.

We need to look at how far we can stretch the idea that volunteers can help in health and social care, because in certain situations—for example, an elderly person with very poor skin condition, with sores, who needed particular lifting, or somebody who was PEG-fed, using percutaneous endoscopic gastrostomy—we cannot even use DBS-checked volunteers.

There are people who genuinely want to help and do their best for their community, but I am concerned to ensure that DBS checks are in place—an issue that has been alluded to—and also about infection control, which fits nicely with what my hon. Friend the shadow Minister has just said about some of the procedures that people may be asked to help with. There are real questions about the training and the infection control that need to be in place if we use volunteers.

Very much so. I am following all the social media input from my constituents, and I am glad to see that people are very keen to help. However, we must be careful, because we are talking about very vulnerable people, often with complex care needs, and we do not want to put them into difficulties through the efforts of volunteers, so we need guidance on that point.

Let me turn to self-isolation. I had to self-isolate for five days last week, and I know it is not easy, but it will be particularly hard for people with anxiety disorders, who rely on a routine to cope. Both now and once we are on the other side of this, what support will the Government be offering to help address the mental health consequences of the pandemic and of self-isolation or shielding for long periods? I noticed in the media that there were programmes showing what is being done in Wuhan in China, with hundreds of counsellors talking to people on a phone helpline, talking them through the difficulties they were experiencing. I think we may have to be thinking about something like that. In particular, many older people are now looking at several months potentially locked down in their own home, so what can the Government do to ensure that those people do not become lonely and isolated, with all the mental health consequences that would cause?

The challenges facing local government over the coming months are not limited to social care. The Government finally published yesterday the public health grant for the next financial year. Between 2014-15 and 2019-20, budgets were cut by £870 million, although there has been an increase to the grant this year. While the publication of the allocations finally provides some certainty to local authorities, the reality is that their public health functions are likely to be focused on coronavirus for the foreseeable future. Public health services such as smoking cessation are vital to prevent people from acquiring long-term health conditions such as chronic obstructive pulmonary disease, which can make a future case of coronavirus more serious. Will the Minister commit to allocating further money to public health if local authorities need it to keep people safe during the crisis?

I thank the hon. Member for Worsley and Eccles South (Barbara Keeley) for the constructive and collaborative tone she has taken in this debate. She has raised a number of very sensible and serious questions. I will do my best to answer as many as I can, and I will try to make sure the ones I cannot answer are answered in the wind-up.

I join the hon. Lady in putting on record my thanks to local authorities across the country for their wholehearted response to the coronavirus crisis and for reassuring and supporting residents. I have seen that with my local authority, and I am sure Opposition Members have seen it with their local authorities, too. I know hon. Members on both sides of the House will join me in recognising the contribution local authorities will make in the weeks and months to come as we move through this difficult time for our country.

As the Prime Minister has said, this is the worst public health crisis in a generation. We are committed to responding, and our measures are comprehensive. We are offering UK-wide support to ensure people in all four corners of the country receive the help they need. Our fiscal action will support public services, households and businesses, and whatever resources the national health service needs, it will get.

I am working closely with the Secretary of State for Housing, Communities and Local Government and with ministerial colleagues across Government to ensure councils get the funding they need to see their residents through this crisis. Our priority response is to provide security and support for those who get sick, and for those who are unable to work, through the direct funding of public services. Of course, we stand ready to do whatever is necessary to support councils in their response to the coronavirus.

The Secretary of State addressed over 300 council leaders in England on Monday and outlined the three priority areas on which we are asking them to focus in the weeks and months ahead: social care, supporting vulnerable people and supporting local economies.

I welcome this as a nudge in the right direction. Although I appreciate the “dear colleague” letter we have all received and what the Minister has just said, there is still a vulnerable group of people who risk being overlooked by the Government’s initiatives, and that is the elderly and vulnerable who live on their own, whether or not they are ill. There is a risk that they will be inadvertently overlooked in such a scenario and in such extraordinary times. As a society, we have to reach out to them.

I urge the Minister to look at this again because, at the moment, that group does not feature in any Government initiative. The Government should be sending a clear message that they will provide whatever support it takes for local councils to reach out to those people. Many may be in rural settings, but there may be a lot in the city, too. Local councils should reach out, locate them, identify them and offer help, if necessary tying in local charitable causes or charities to help them in that assistance. The message must go out to local government to reach out, because we do not want anyone to be left behind.

I thank my hon. Friend for his intervention. I give him my assurance that the work has already started. We are already starting to compile those lists and, of course, we are working with local resilience forums and councils, which will be the fundamental units in administering that support. We will, of course, talk more about this in the weeks ahead.

I do not want to test the Minister’s patience, but I want clarity on this issue. This is not just about those who may be self-isolating or who may be ill; it is about people living on their own who we simply do not know about, whether or not they are healthy. We have to reach out and find out. Is that what the Minister is saying from the Dispatch Box?