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Care System
Madam Deputy Speaker (Sylvia Heal): Will Members please leave the Chamber as quickly and quietly as possible? We now come to the debate on the state of the care system. Mr. Speaker has selected the amendment in the name of the Prime Minister.
7.15 pm
Mr. Paul Burstow (Sutton and Cheam): I beg to move,
- That this House believes that the underfunding of social care by successive Governments has led to bottlenecks and delays in the NHS, reducing health care capacity and increasing waiting times; further believes that it is the most vulnerable elderly who suffer the consequences of inadequate care; regrets that the piecemeal approach of the Government to hospital delayed discharge simply shifts the pressures from one part of the care system to another; condemns the Government for its mishandling and misunderstanding of the care home sector and the consequent loss of homes and beds; regrets that the failure to adequately fund social care has produced serious staff shortages and reduced choice and quality for those in need of care; and calls on the Government to undertake a whole system review of funding for social care to tackle staff shortages, increase capacity, promote choice and ensure that people get the right care at the right time.
The results of that are there for all too see: long waits in our accident and emergency departments, more people waiting for treatment, more people waiting to get out of hospital after being treated. The NHS is short-staffed and struggling to deliver, but it is only part of the picture. Step back and take a look at the bigger picture—the care system outside our hospitals. The Cinderella status given to social care and the failure to invest in the care system are fuelling the pressures on accident and emergency departments and hospital wards.
There are countless victims of this Government's failure to invest in the care system—every year, 700,000 elderly people find themselves stuck in hospital and unable to leave because there is not enough care provision outside. Grotesquely, elderly people are left in hospital waiting for someone to die in a care home before the council will fund their care home place. In parts of the country, two people have to die before one new care place is funded. People are labelled bed blockers as if it is their fault that they are stuck in hospital. It is the Government's fault, but those 700,000 are just the tip of the iceberg.
Richard Younger-Ross (Teignbridge): My hon. Friend refers to "bed blockers" and suggests that the Government blame elderly people for being in those beds. Should not we use the expression "bed lockers", because it is the lack of Government funding that ties elderly people to beds?
Mr. Burstow: My hon. Friend makes a fair point. As a consequence of the Government's failure to invest in social care and the care system outside our hospitals, there is increasing gridlock in the care system. As a consequence of that, people are suffering and receiving bad care.
What is happening to people waiting for treatment? We know that in the five years since the Government came to power at least 5,000 years of bed time have been lost to the NHS as a result of delayed discharges. Who pays the price for that incompetence—5,000 years of time wasted? In the first quarter of this year alone, 22,000 more people could have been treated if the care system did not leave people stuck in bed once they are well. If we managed to treat those people in the health service and get them out quicker, we would be able to reduce or perhaps remove the need for them to fly abroad or rely on private health care for treatment.
Madam Speaker, looking at the figures for the first quarter—
Mr. Tony McNulty (Harrow, East): Madam Deputy Speaker.
Mr. Burstow: Maybe in the future. Let us guess how many operations have been cancelled in the first quarter of this year. For want of an NHS bed and appropriate treatment, 20,000 people had their operations cancelled.
Mr. Andrew Turner (Isle of Wight): I have listened carefully to the hon. Gentleman's argument. Although the Government are open to criticism for the way in which they fund social services authorities, does he not agree that some authorities hardly assist in ending bed blocking? For example, the Rev. David Barker of Nettlestone in my constituency is concerned that the Isle of Wight council, which is of course led by the Liberal Democrats, is not providing the necessary support for people who are sent home, so they are left in beds.
Mr. Burstow: It is a great pity that the hon. Gentleman is not backing his council to make sure that it has the resources to do the job. It will be noted in the Isle of Wight that he is not standing up for the Isle of Wight to ensure that it has the resources; many of his hon. Friends do defend their social services departments.
Mr. Andrew Turner: Will the hon. Gentleman give way?
Mr. Burstow: No, the hon. Gentleman has made his point. [Interruption.]
Madam Deputy Speaker: Order. I am afraid that the hon. Gentleman has made it clear that he is not giving way for a second time.
Mr. Burstow: I am afraid that the hon. Gentleman may not have liked the answer, but that is the answer he is going to get.
There is a chronic shortage of staff and a substantial loss of care home beds, and care increasingly is being rationed. These are the hallmarks of a Government who have neglected the care system. Last year the King's Fund report "Future Imperfect" warned the Government of the increasing difficulty in recruiting and retaining staff, with vacancy rates in excess of 20 per cent. and turnover rates in excess of 16 per cent. It is no wonder that some home care agencies have hit crisis point and have gone out of business.
Dr. Jenny Tonge (Richmond Park): Before my hon. Friend leaves the causes of bed blocking and the subject
of social services departments, does he agree that there has been a gross neglect of district nursing services by all health authorities in recent years? District nurses are getting older and unable to cope. People are not going into the profession, because of the pay and conditions. However, they are crucial to relieving bed blocking from hospitals.
Mr. Burstow: District nurses are an essential part of the team that is needed in the community to facilitate appropriate and prompt discharge from hospital. In too many places, as my hon. Friend has rightly said, they are not there in the numbers needed to do the job.
Added to that is the issue of the new standards for domiciliary care and the fact that a high proportion of home care workers are not far off retirement. As a result, things are set to get worse before they get better in that sector. The same difficulties beset the care home sector.
Mr. David Heath (Somerton and Frome): My hon. Friend is being extremely generous in giving way. Before he leaves the subject of the domiciliary sector, is there not now a real problem in recruiting domiciliary assistants not only in the public sector, but in the private and voluntary sectors? Is it not the case that the standard spending assessment for personal social services across the country fails to deal adequately with that problem this year, which means that the situation can only get worse?
Mr. Burstow: My hon. Friend is right, and I wish to refer to the social services SSAs in due course.
I was about to say that the same difficulties beset the care homes sector. The Association of Residential Care said recently:
- "With some supermarkets offering £8 per hour to stock shelves overnight it is hard to attract staff to a complex and often stressful job for much less money. In some parts of the country the only people applying for vacancies are those that Mcdonald's and Tesco have already rejected."
Staff shortages are no excuse for a minority of care homes that resort to the restraint and chemical management of residents instead of offering decent care. The Local Government Association has warned the Government about staff shortages: in particular, the vacancies of about 10 per cent. in management posts which have led to a cycle of heavy workloads, low morale, long hours and high staff turnover.
Care staff are voting with their feet. As many as one in five care staff, social services staff and others are actively seeking new jobs. No wonder two out of three social services departments are reporting recruitment difficulties. We are faced with the real prospect of importing staff from abroad, only to export elderly people to the continent to be cared for.
In the care homes sector, there is no escaping the fact that a combination of falling incomes and rising costs has resulted in a substantial loss of beds. In the last three years alone, 35,000 beds have been lost and the number of new registrations has dropped dramatically.
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