Liz Kendall speech to the Association of Directors of Adult Social Services (ADASS) Spring Conference
Liz Kendall MP, Labour’s Shadow Social Care Minister, delivering a speech to the Association of Directors of Adult Social Services (ADASS) Spring Conference, said:
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I’m honoured to join you today, at such a critical moment for social care.
I first worked with ADASS almost 20 years ago on the IPPR project: “From Welfare to Wellbeing: the Future of Social Care”.
Back then, we said social care was critical to delivering a fairer society. We called for a radical shift in support towards prevention, greater devolution of power from central to local government, and for older and disabled people to be seen as co-producers of their own wellbeing and support, not just recipients or consumers of care.
David Behan was president of ADASS at the time. I learnt a huge amount from him, as I continue to learn from your members, especially Martin Samuels in Leicester, who has provided outstanding leadership during Covid-19, which has hit our city even harder than most.
I want to pay tribute to the extraordinary work and commitment of social care staff over the last year, both in the independent sector and local authorities. You’ve been at the front-line of this pandemic, going beyond the call of duty, helping hundreds of thousands of people through an extremely difficult time.
Yet despite social care being vital to so many people, over the last decade the Government has repeatedly failed to tackle the underlying problems in the system – a fact Covid-19 has brutally exposed.
Throughout the pandemic we saw that social care is still not funded or treated as equally important as the NHS; frontline care workers are chronically undervalued and underpaid; families – who provide the vast majority of care – get too little support in return; and an already fragile care market has been made even more susceptible to failure, with all the human consequences this brings.
The pandemic has also entrenched misperceptions about social care: that it is only about older people – when a third of the users and half of the budget for social care is for working age adults with disabilities – and that it is all about care homes, when there are more people getting care and support in their own homes.
Above all, this awful virus has left many people frightened about what the future holds.
We should all look forward to living longer, but too many people are scared of getting old, especially if they end up needing care and support.
The fact that more than 32,000 care home residents have died from Covid-19 so far – a higher proportion than in almost any other country – has made this even worse.
As my Mum – who turned 76 last week – said: “At best, we’re ignorable, at worst, expendable”. And I’m afraid that’s how many older and disabled people feel.
Dealing with such a virulent and dangerous virus was always going to be difficult, but when the pandemic stuck our care system was more vulnerable than it ever should have been.
The Conservatives weakened its foundations, cutting local authority budgets by £8 billion in real terms since 2010, despite growing demand. This was compounded by a failure to grasp more deep-rooted and long-standing problems.
We have a welfare state in the 2020s built on the life expectancy of the 1940s.
When the NHS was created, average life expectancy for men was 63, now it’s 80. People with disabilities now survive and live for longer, and 1 in 4 babies born today is set to live to 100 years old.
Our health and care system has struggled to keep pace with these changes, with social care in particular developing in a piecemeal, fragmented way.
One of the underlying reasons is that caring just isn’t valued like other professions. It’s seen as women’s work, ideally left to families and if they can’t cope or aren’t around, provided by some of the lowest paid workers in this country – the vast majority of whom are women with many from Black and Minority Ethnic communities.
Overarching all this is the simple fact that no one wants to think about what it’s like being really old. We don’t talk about it and barely ever see it unless there’s someone in our family or it’s part of our job.
Yet ageing, and all the implications of living, working and caring for longer isn’t just going to affect someone else. It is going to affect us all.
Many of us will spend over a third of our lives beyond the traditional retirement age. We live in the century of ageing – but the world of work, our public services and wider welfare state have barely begun to wake up to this fact.
Tackling the challenges, and seizing the opportunities that our century of ageing brings requires leadership. You are providing this in your communities, and you need a Government that backs your efforts.
Yet so far our politics has proved woefully inadequate: too short-term in its thinking, too narrow in its horizons and too limited in its ambitions.
Labour’s mission is to change this, in social care and many other areas.
Our aim isn’t just to ‘fix the crisis in social care’ – as the Prime Minister has repeatedly promised but failed to deliver. Nor is it only to stop people from having to sell their homes to pay for their care – although protecting people from catastrophic care costs is an essential part of any reform.
Our goal is to transform support for older and disabled people, as part of a much wider ambition to make Britain the best country in which to grow old.
In the century of ageing, Labour understands that social care is as much a part of our infrastructure as the roads and the railways. If you neglect your country’s physical infrastructure you get roads full of potholes and buckling bridges, which prevent your economy functioning properly.
The same is true if you fail to invest in your social infrastructure. Without a properly paid and trained care workforce, vacancy and turnover rates soar, fewer people get the support they need, and families end up taking up the strain.
1 in 3 unpaid family carers has to give up work or reduce their hours because they can’t get the help they need to look after their loved ones. So they lose their incomes, employers lose their skills, and Government loses their taxes.
Where on earth is the sense in that?
President Biden gets all this, which is why he has made home care a central plank of his post-pandemic Infrastructure Plan.
Britain deserves this level of ambition too.
It is essential that the Government’s long delayed social care reforms are included in next month’s Queen’s Speech, but a short-term fix that attempts to paper over the cracks, or just put more money into a broken system, won’t cut the mustard.
Labour is calling for a 10 year plan of investment and reform, based on the following priorities.
First, empowering users and families to live the life they choose, ensuring their views and experiences drive change throughout the system. You can’t deliver good quality care and support, or improve people’s wellbeing, without giving users more power and control.
Second, a guiding principle of ‘home first’. we are always going to need residential and nursing homes, but the vast majority of people want to stay in their own homes for as long as possible. Yet too many struggle to get even the basic support or home adaptations that make this possible.
Greater use of technology can also help people live independently for longer, as can expanding the housing options between care at home and a care home which other countries have done far more to develop.
Delivering on the ‘home first’ principle requires a fundamental shift in the focus of support towards prevention and early intervention. 1.5 million older people need help with the basics of getting up, washed, dressed and fed but don’t get any support at all. That’s not good for them, or taxpayers if they end up needing more expensive care as a result.
After a decade of cuts, help with things like shopping and cleaning, and community projects where volunteers spend time with older people to tackle loneliness and isolation, have almost entirely disappeared too. In a reformed system, this must change.
None of these improvements will be possible without transforming the pay and conditions of the workforce.
This pandemic has shown – more than ever – that frontline carers are essential to a properly functioning society and economy, yet two thirds don’t earn the real living wage and a quarter are on zero hours contracts.
It’s time for a new deal for care workers to back the aspirations of staff, tackle high vacancy rates, and deliver at least half a million extra staff we need over the next decade just to meet growing demand.
As a starting point, Labour has called on the Government to guarantee all care workers are paid a least a real living wage of £10 an hour in their plans for social care reform.
Alongside this, families need decent support to help care for their loved ones, and so they don’t put their own health and livelihoods at risk.
Labour backs a new partnership with unpaid carers, so they get proper information, advice and breaks and more flexibility in the workplace to help them balance their work and caring responsibilities.
Last but by no means least, Labour’s vision is for social care services to be fully joined up with – but not run by – the NHS.
One of the biggest complaints I hear is people having to battle their way around all the different services, telling their story time and time again. This isn’t good for them and its wasteful and inefficient too. We need one care system built around the needs of users and families with proper links to areas like housing and education too.
As the brilliant group ‘Social Care Future’ has argued: we all want to live in the place we call home, with the people we love, in communities that look out for one another, doing the things that matter to us.
The basic aspiration that older and disabled people should have the freedom and support to lead a life like everyone else should not be regarded as extraordinary.
Yet in the 21st century, in one of the richest countries in the world, this is where we have ended up, after years of political failure.
A long-term solution to the challenges facing social care isn’t just desirable, it is essential – because you cannot level up our country or build a better future if you fail to invest in social care.
In the century of ageing, everyone should be able to look forward to getting older with confidence, not fear.
Working with everyone in the sector and crucially side by side with the people who matter most – the people who use services Labour stands ready to play our part in making this happen.
It is time for the Government to act.