Barbara Keeley was a keynote speaker at SERTUC Pensioners Network Seminar: Crisis in Care and Caring on Tuesday 15 March 2016. This account reports the discussion she had with the SERTUC seminar’s participants. Janet Shapiro – Hornsey Pensioners Action Group (HPAG) requested Barbara’s opinion on what local authorities should be doing in the current climate where they are being forced to make a legal budget stretch beyond its means. In Haringey they are considering the option of closing all the day-centres. This is because they have over spent on the care budget for care at home services. HPAG think this decision for closures will be a step backwards and the community will lose the entire infrastructure for provision. In some cases, it is said that some local authorities have abandoned their role altogether, claiming that their budgets assigned are not workable. What is the best way forward in these difficult times for local authorities?

Barbara Keeley responded by saying that local authorities have a strenuous task with lack of available resources. The unfortunate truth is the immediate future is bleak with some Councils likely to be limited to just public services they have a public duty to provide; social care at the highest level of eligibility, education, minimal transport support, and nothing else. Councils have a duty even with budget restraints to keep campaigning for residents and emphasising the message of systematic failures to George Osborne, Chancellor of the Exchequer since 2010. They must tell the Chancellor he is failing the most vulnerable in society by denying them the support they deserve and essentially require. This campaigning by Council, and residents, needs to been ongoing and repetitive to force the issue. The Local Government Association www.local.gov.uk have said for the forthcoming budget they need £700 million to be brought forward to handle the social care needs across the next two years of all proposed cuts.

Claude James, NPC and SERRTUC Pensioners Networkfelt that some businesses involved in the care service industry were just looking at bottom line budgeted supply rather than aim for top tier excellence. As a result, they are penalising families desperate for the care services. What is needed by the Labour Party is regulation to enforce a fair wage for staff and necessary care training. Labour also need to lead on demanding an effective Care Quality Commission, rather than watch resources suffer further restrictions. Closer regulation could encourage more home checks and the publicising of numerous improvement orders, and making the general public aware of potential closures and threats to the care system.

Barbara Keeley thanked Claude for his suggestion and agreed that an effective CQC was necessary but would be out of reach if the Government pursued cutting CQC resources. She agreed these special roles needed to be regulated by people who have the field knowledge, assisted by the resources to do their jobs effectively. There is an important role for local authorities in making sure that if they have a contract with care provider, that care provider looks at much more than bottom line budgeted care. It should also be recognised that there are also care providers who genuinely want to do a better job but are struggling with financial restrictions. Even though sincerely wanting to pay care staff more, they have not been given the funding to implement change.

Cate Tuitt, Vice Chair, London Co-operative Party said that delegates at the Seminar had expressed a need to work more with younger people and highlighted the importance of intergenerational fairness. Cate also said it was important to note that even with significant cuts to public spending penalising older people, this would still have little impact on younger people’s prospects, which shows how unfair these cuts are on the vulnerable. Because of the insidious intergenerational unfairness which has been deep structural drivers engraved into our society in the UK, what we really need to do is tackle the root causes and the pernicious nature of the Tories. With the budget forthcoming, our efforts need to be focussed opposing these attacks on us all. We cannot afford to have negative forces pitting young against old as we need to stand together and ensure we extend fight to tackle those tax havens where offshore companies are making large profits on the back of vulnerable people.

Barbara Keeley agreed with Cate’s sentiment and referenced the Government’s disgraceful £1.2 Billion cuts to care for disabled people, allowing the Chancellor to make a tax cut and pander to his supporters at the expense of others. All Labour MPs, and I am sure opposition MPs, feel disgusted by the cuts on disabled and the most vulnerable in society. It is important that communities and constituents hold their local MPs to account and help address the issues on social care and funding. The problem we face is the Chancellor and Treasury Ministers seem not to live in the real world and do not understand everyday people’s struggles and needs. If we mention intergenerational fairness, the Government have just altered the state pension age for women born in the 1950s, these same women who are carrying the brunt of a big change to state pension age. People looking forward to retiring at 60 suddenly find themselves forced to work on to late 60s, even if they may have health problems, made redundant, or in many cases carers themselves. We are told this is ‘equality’ but it is never understood that the older generations never had equality during their life span as equality is a recently championed concept, and a woman born in the 1950s definitely did not get equality reflected in her pay or pension. It is important to emphasise that the world does not change because you approve a piece of legislation and mention the word equality. It was agreed we have to be mindful of not pitting different generations against each other, as young people are suffering too, as seen with cuts to Education Maintenance Allowance, and college and university grants, so young people are forced to start their life in debt to pursue an unguaranteed skill or career.

Phil Hooley, NPC and BECTU said when the NPC Council were last addressed by guest speaker Andy Burnham (Shadow Secretary of State for Health, Oct 2011 – September 2015) his view was for putting health and social care under the same umbrella, which many NPC Council members’ thought was a very good idea. Even though funding for this idea now is an issue, does Barbara believe that the Labour Party should move towards the idea that health and social care should be as one?

Barbara Keeley said when Andy Burnham was responsible for health he wanted the NHS as the favoured provider. When she was a member of the Health Select Committee there was a very serious level of concern, especially among Labour MPs, about what was happening to social care and end of life services in Staffordshire where there were moves to privatise all on a geographic basis, which was horrendous. No one is surprised by some of the bigger privatisation plans coming to grief such as Staffordshire, Stoke and Cambridgeshire.

Keren Lewin, London Borough of Barnet reported that her local council has no provision to maintain residents needing care, which is having a fatal impact for many older residents, who are angry and fearful at the prospect of not being able to manage for themselves. The Head of the Council has been constantly campaigned on these issues of concern. Campaigning has included correspondence to Jeremy Hunt MP, NHS England, and the struggle for equality for the old and vulnerable continues. People with long term, chronic conditions, are not entitled to private medicine and very few people realise this. This is all done under the premise of being more cost effective for the company whilst less effective for those needing the provision. As a person needing provision I do not only have a problem getting through to my local GP, but have countless other issues surrounding waiting times and working criteria directive. Proposed cuts are recognised and expected, but it seems that no one at the top imposing these regulations seem to have empathy with the impact at ground level affecting pensioners, disabled and other vulnerable people in society surviving on a government pension.

Barbara Keeley felt that a lot of Tory Ministers do not understand what it is like at grass roots level, as if they did they could not support the impractical movements inflicted on disabled people.by Iain Duncan-Smith, Secretary of State for Work and Pensions. The battles fought over women and the state pension as we see people left in the sixties with absolutely no means to live on. These are the same people who have paid into the system all their lives, often starting work at fifteen with 44 years of national insurance contributions – how is this fair? For people with Conservative members of Parliament you have to push the opposing message twice as hard and be three times as persistent. But it is also important to note that far too many people who need the most help are too tired and stressed to go and see their MP and emphasise their dire concerns. And this is why SERTUC Pensioners Network and this Seminar, alongside campaigning organisations and campaigning individuals are so important to assist the vulnerable and those needing the support. It is imperative that the message is constantly be relayed to members of Parliament who have been elected to represent the people’s needs and concerns.

Judy Harrington, London Borough of Lewisham: we have heard comments about the impact of privatisation and private contracts affecting the health service and social care. What is Labour’s position on bringing back services into the public sector and restricting private companies blatantly profiting off the vulnerable, whilst at the same time impacting on necessity services?

Barbara Keeley replied that Labour is entirely committed to bringing back services into the public sector and this is a key objective. It is important to tackle the issue of funding. We have a system whereby NHS Continuing Care funding is free in cases for people with cancer, but not for patients with dementia.. This is why there was a commitment by Labour to cap care costs which has been totally abandoned by the Government. What do we say to a family having to use all their life savings to accommodate care for a loved one suffering from dementia but not receiving levels of care required? This is what Labour is committed to changing, which was outlined in the last Parliament and completely abandoned by the Government. The Government had a commission on how to fund social care and then ignored the findings.

Tom O’ Callaghan, Brent Pensioners Forum and Pensions Trustee asked is it possible to get cross party agreement on an increase on income tax annually to cover the cost of keeping the NHS and that may also help the Carers who would probably automatically be enrolled in a pensions scheme in 2017?

Barbara Keeley replied that National Insurance is naturally linked with social care and the NHS. This is one of the things it is meant for, not just pensions and benefits and perhaps that is something the Party will need to emphasise and she is happy this has been raised today.

Lois Acton, BECTU: said the media angle is something that also needs to be considered. She said she was one of many really angry and fed up with going to endless meetings about the same issues and nothing changing. Like today’s SERTUC’s Seminar she said there were a lot of clever people with lots of great ideas which do not get embraced because the Government, and previous governments, do not want to embrace grass root solutions – and change is not just a government but a responsibility of the people at grass roots. We can have an imaginative social care future which has to be taken away from private companies’ grasp.

As well as public ownership we also can have social enterprise – a legitimate company which ploughs back its profits into what it represents, rather than just represent the specific greedy needs of shareholders. With a private company they push the wages down and the profits up, benefitting themselves alone with no care and attention for others. With a social enterprise the money goes back into the company, subsidising training needs and other provisions. https://unltd.org.uk which gives grants for people to set up social enterprises is actually doing this with banking partners. There is nothing wrong setting up a Care Centre social enterprise themselves to help others. I would like to see any government looking at social enterprising. The NHS has someone assigned to look at it. In South East London SELDOC takes on the night care work for GPs which is already an active social enterprise model.

A child and older person should share equal rights. Why should older people get second rate care, which is not usually the fault of the Carers with their hands tied by obstacles such as the 15-minute rule?. In England Councils fund 15-minute visits, which are not long enough to provide adequate care for vulnerable and address their needs. The government said the Care Bill would prevent “inappropriate” short visits but would not outlaw 15-minute visits. Care Workers also crave adequate training. In Hong Kong they work a model where young people reaching the age of 16 are integrated to work with older people to encourage an age friendly society attitude and structured opportunity for those who choose to take up care as a profession, rather than unprepared last resort. We also need to hear ideas on care and illness prevention with classes such as singing, dancing, keeping people to be mobile.

Barbara Keeley said an awful lot of work that would have helped with prevention has unfortunately had its funding removed which in turn generates new threats to the vulnerable. Barbara reported a forthcoming meeting for her Salford constituents with a Malnutrition Taskforce. It was realised that constituents were being omitted to hospital suffering with malnutrition. You take away day care centres and charge people for meals and wheels https://petition.parliament.uk/petitions/111854, making a meal a day unaffordable, we cannot then be surprised when vulnerable people are losing weight, or giving up on food or the will to live. Salford has the highest level of malnourished people admitted to hospital. Whilst the old day care model may be seen as unworkable that does not mean it should be abandoned completely causing people to feel and be isolated and not eating properly. She is developing ideas to do something and make contact with people in the NHS. It is understood that particular exercises can help prevent falls. Once people have broken something (e.g. hip) that can often be the road that ends up with moving to a nursing home, so there must be ideas for prevention. We know singing classes help people suffering with dementia or stroke affect – so classes are a great thing. Labour supports social enterprises but the problem is the competition rules applied by the Government mean that lots of local social enterprises lose out to bigger competitors (e.g. Virgin Care). The competition rules are too tight and the processing of tendering is too hard with many social enterprises unfairly losing out, another obstacle that needs addressing.

Joe Gluza, UCU and SERTUC Pensioners Network said he would like to see the Labour Party pledge that people suffering from dementia would in future be cared for under the NHS rather than under social care. This pledge should happen now rather than wait for a Party manifesto commitment in five years.

Barbara Keeley said this would be a pledge she would personally support Labour are not in a position yet (only 6 months following General Election) to be presenting pledges. But all the people with any influence over John McDonnell MP, Shadow Chancellor and the Treasury should definitely reemphasise this worthy pledge. This pledge idea will also be mentioned when next seeing Jeremy Corbyn, Labour Leader.

Pat Turnbull, NUT said she gets worried when people talk about taking money out of the NHS to fund social care or projects to keep people healthy. The NHS is already under funded – no money should be taken out of the NHS, but more money be made available for the NHS. Would a future Labour Government return the funding to the NHS that has been taken away and also return the funding to the local councils so that they can reopen the day care centres, lunch clubs and other provision required at grass roots? We used to have top tax rate a great deal higher than it is now and a future Labour Government should not be afraid to install top tax rate.

Barbara Keeley said it was clearly visible to all that funding for the NHS had been cut and the effects of this are being felt. She said she would only agree with funding leaving the NHS to fund social care, where the funding would prevent people ending up in hospital causing more strain on the system. If taking action like this stops people ending up in hospital then it was right to fund it. With NHS cuts we have to face the fact that more people are living longer, creating an increased ageing population, with more ailments and more care necessary. This means more funding is required and we all have to be prepared either to pay more tax or pay more national insurance. Funding for the NHS reached its peak under past and recent Labour Governments and we should be looking to get back to that, but that is not within Barbara’s brief. There are a lot of priorities delegates wish to see money spent on such as getting rid of the Bedroom Tax, or more support given for disabled people. In what order we commit to doing the best is a discussion needed and she would be supporting this conversation and today’s findings would be discussed with her colleagues John McDonnell and Jeremy Corbyn.

Biographical note:
Barbara Keeley was elected as the Member of Parliament for the Worsley Constituency in May 2005. In September 2015 she was appointed as the shadow Minister for Older People, Social Care and Carers. She was a member of the Health Select Committee between 2012 and 2015. Barbara introduced three Private Members Bills to improve support for carers. Before becoming an MP, she worked as an adviser to a national charity for carers, for whom she co-wrote three national reports on carers’ issues. In Parliament she continues to campaign for improvements in social care and support for carers.

With thanks to SERTUC administrator Darren Lewis