Baroness Jan Royall on tackling the emerging funding crisis in the UK care sector
I am proud to be a trustee of Crossroads Care Forest of Dean and Herefordshire which provides practical help, support and social opportunities for carers and those they care for. I also know that there are hundreds of thousands of care workers in our country who do a magnificent job, providing care and compassion for adults and children who have needs resulting from their disability, illness or age. But the strains on the sector are growing, with cuts to funding and increased demand. It is clear that the system is crumbling.
Care has always been a low pay sector, with few training opportunities and no career path, but there are some bright spots. Nine councils in England and Scotland have now adopted UNISON’s Ethical Care Charter, one requirement of which is is to pay homecare workers the Living Wage. This is terrific best practice and I pay tribute to those local authorities and care organisations that have adopted the charter. But for too many people working in the sector, this is but a dream. The National Audit Office reported last year that up to 220,000 homecare workers in England were not even paid the National Minimum Wage and thousands are still not paid for their travel time between clients. Of course this is illegal, but government action to address the problem has been woeful. Since 2014, only six social care providers have been named and shamed for failing to comply.
The main reason that care workers are so badly paid is local authority budget cuts to the sector – no wonder, perhaps, when councils are half way through a 40% funding reduction from Whitehall, with another massive cut expected in the next Spending Review. The Conservative-led LGA is deeply concerned, stating: “the government must recognise that local government is fast approaching a state where, under the current circumstances, continued efficiency savings are not enough to tackle funding cuts”.
All of this means that good organisations trying to provide quality care are increasingly restricted in their activities. The situation in rural areas is particularly acute with some care agencies limiting provision to towns and cities because they do not wish to pay for travel times. This is a nightmare for those needing care in isolated areas, with some forced into residential care or blocking beds in acute hospitals.
At the same time, from next April, the government will expect all care workers over 25 years old to be paid the new National Living Wage. Care workers deserve better pay but it is unclear how the government plans to square the circle of making less money available to councils for care whilst implementing the new rate of pay. The sums simply don’t add up.
The care sector is in crisis. Those who need care deserve better, as do their carers and care workers. Many in central and local government will understand that improved standards and quality care come as a result of properly paid and trained workers with time to listen, not forced into 15 minute visits. The evidence is overwhelming. But unless the Chancellor makes more money available to councils so that tenders awarded to charities, private and public sector organisations reflect the real costs involved, then provision of quality care is going to become more and more difficult.
Ministers can no longer absolve themselves of responsibility, by saying that decisions relating to care budgets are entirely a matter for councils. Huge efficiencies have been made and now the pips are squeaking. So I hope the government is listening to the concerns of care workers and care organisations, as well as those being cared for. I also hope they listen to the views of their own councillors. The ability to treat fellow citizens with dignity is a benchmark of a civilised society. I fear that we are on the brink of becoming uncivilised.
Baroness Jan Royall of Blaisdon is a Labour Peer in the House of Lords. She tweets @LabourRoyall
Published 14th October 2015