We must not waste the chance to fix the social care system

The Liberal Democrat health spokesperson on why the NHS’s sister service needs to be treated as such. 

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History will judge us by how we treat the most vulnerable and poorest in our society during this pandemic. The situation in social care has undoubtedly been one of the greatest failures and tragedies of our country’s response, with too many in the care system overlooked and let down.

We are talking about individuals of all ages who may be frail, and have complex conditions and significant needs. We are also talking about the staff who are often forced to work on the national minimum wage with zero-hours contracts and only statutory sick pay. The unpaid carers of those who have been unable to get the care they need have also struggled during this crisis as a knock-on effect of the care system being left behind.

Yet, despite social care’s importance to both the people it serves and to the sustainability of the NHS, it is often described as the “Cinderella service”. When people say this, they do not mean the story where she gets to wear the glass slipper and live happily ever after. They mean the bit of the story where Cinderella is neglected and forgotten. For decades, the system has consistently been overlooked, underfunded and misunderstood. During the pandemic, these issues have only got worse.

At the start of the pandemic, care homes were effectively forgotten by the government. Despite warnings from countries such as Spain of the serious situation that would face care homes, they received inadequate advice and resources. Care homes faced delay after delay in the government’s roll-out of a system to provide PPE, while patients were discharged into homes without coronavirus tests.

We know that since the start of the pandemic, close to 20,000 people have died in care homes in England from Covid-related causes, yet it took until 6 June for the government to offer tests to care home staff and residents (and even this did not include learning disability care homes). Even now, there are yet more delays to the government’s regular programme of testing in care homes, which does not bode well as we approach a potential second wave. The case for a full independent public inquiry to learn lessons is unquestionable.

Despite their immense sacrifice and service to this country in caring for the vulnerable, care staff have also been overlooked. People in care jobs are largely on minimum wage and half of them are on zero-hours contracts. Yet they are undertaking highly skilled work, looking after the most vulnerable and providing intimate care.

There are very few career prospects and little training. The pay differential between care workers with less than a year of experience and those with more than 20 years’ experience has now reduced to just 15p an hour. The case for ensuring that our care workers are at the very least paid the real living wage is overwhelming and a moral imperative.

On becoming Prime Minister, Boris Johnson announced on the steps of Downing Street that he would “fix the crisis in social care once and for all with a clear plan we have prepared”. Yet so far, the only thing he has set out to do differently is change the UK’s immigration system in a way that actively harms the already overstretched care system.

A quarter of a million of our 1.5 million care workers – workers we clapped throughout the crisis and who put their lives on the line – are not British and have come here to take care of our loved ones. Under the government’s new system, these care workers would not qualify to move here. When we have more than 100,000 vacancies in the workforce, meaning care needs for many are not being met, this regressive action risks plunging the sector into further crisis.

The first step to doing this is to stop social care being ignored. The Chancellor said he would give the NHS “whatever it needs” to cope with coronavirus, yet no such lofty promises have been made for social care. It is high time that it was recognised as the NHS’s sister service rather than a poor relation.

In the longer term, we can also do this by respecting our care workers and funding social care properly. A professional body for care workers should be created where clear career pathways can be delivered, along with training and development opportunities and improved pay structures. Social care funding needs to be more sustainable – the sticking plasters we have seen during the pandemic just will not do.

Care workers have been sharing with me their concerns regarding the long-term impact the pandemic will have on their mental health. Many are feeling exhausted and traumatised by what they have experienced, for which they have had little training. That is why the Liberal Democrats have campaigned for a 24/7 hotline for mental health support for care workers, to ensure they have help when they need it.

Simultaneously, work must begin now to develop a cross-party health and social care agreement. Only a system with broad agreement will survive successive governments run by different parties.

And the time is right to do this. Although the pandemic has been incredibly challenging, it has also brought impetus for real change. The government must use this time now to learn lessons on how we can tackle the issues facing social care. Grave challenges are ahead, particularly with the possibility of a second wave, but there are also opportunities, and one of these is fixing social care. The government must not waste it.

This article originally appeared in a Spotlight supplement on healthcare. Click here to download the report.

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