PARLIAMENTARY DEBATE
Health and Social Care Workers: Recognition and Reward - 25 June 2020 (Commons/Commons Chamber)
Debate Detail
That this House has considered e-petitions relating to the recognition and reward of health and social care workers.
The Petitions Committee is delighted to have been allocated this business time today. On behalf of more than 4.6 million people from across the country who have signed petitions relating to this pandemic and other issues, let me say that we hope this is now the first of many debates we will be able to have, as 29 petitions are waiting to be debated and more are heading toward the 100,000 signature threshold—the petitioners’ concerns must be heard.
I am honoured to be leading this debate today on recognising and rewarding our health and social care workers. Indeed, the first ever e-petition debate in Parliament was on contracts and conditions for NHS staff, back in September 2015. I also believe we could hold this debate 10 times over, to recognise the contribution of so many during what has been an incredibly challenging time for our country. I am thinking of those who have kept our public services going—those in the police, the fire service, local government and other Government Departments, who have been working tirelessly to ensure that the support that is needed gets to households and businesses—and those who have been working in our shops, ensuring that we can all get essential supplies. There are so many people to recognise and thank for their service.
It is absolutely right that every week for 10 weeks, we came together especially, as a country, on a Thursday evening at 8 o’clock to recognise and clap for our carers. It was incredibly moving every time. Taking a moment to stop and reflect on the lives lost to covid-19, but also on those many lives saved through the tremendous skill, care and sacrifice of health and social care workers right across our country, we must never forget a frontline on which more than 331 NHS and care workers across the UK died as a result of covid-19. Indeed, it is concerning that we do not know exactly how many health and care workers have sadly lost their lives, because the Government are not producing consistent figures. That is one of the things that I ask the Minister to update the House on in her response.
Yet, as so many people have contacted me to say, those same people have been saving lives and caring for us day after day, long before this horrendous virus presented itself. It is absolutely right that we should clap and thank them for their extraordinary service during this period, but we must also recognise that a clap and a thank you is not enough. It was not enough before this pandemic, and it certainly is not enough now.
There are clearly still huge challenges ahead for our country. We remain in the grip of one of the greatest challenges to our way of life in a lifetime. In recent weeks, more than 290,000 people have signed parliamentary petitions calling on the Government to reward those caring for us and our loved ones at this time of national need. I am sure that colleagues have received many messages and emails about this, as I have.
Last week, one of my constituents wrote to me:
“I am confined to the Freeman”—
—a hospital in Newcastle—
“after a nasty fall. It has given me an opportunity to see the NHS up close and personal. I must say the nurses and others are amazing workers. Doing more than they need without complaint. Their only beef is doing everything masked all the time. However, they keep the rules throughout long shifts. They should be properly rewarded for such skilled and professional work.”
Another said:
“What I hope for now is less posturing and instead some competent administration. Recognise the contribution of those who continue to work on the frontline. At the very least they must have proper working conditions, remuneration and PPE—and no-one working in the NHS or in a caring role should be asked to pay a surcharge.”
There is clearly widespread agreement across this House that health and care workers deserve recognition, but the question is, how do we best do that? Some have suggested medals or honours. In a statement last month, the Prime Minister said:
“The honours system recognises exceptional contributions made across every part of the UK and will play a key role in demonstrating the nation’s gratitude to all those involved in the response.”—[Official Report, 20 May 2020; Vol. 676, c. 32WS.]
He has also said that the Government will consider the creation of a new medal for healthcare workers. That call has been echoed by The Mirror newspaper, with its “Give NHS Heroes a Medal” campaign, which has picked up lots of support, from politicians and trade unions to doctors’ leaders and footballers.
“I’ve heard whisperings of NHS staff getting medals after the pandemic. Please don’t let this happen! It’s utterly ridiculous; when we are working in understaffed and under resourced settings for money to be spent on medals is outrageous! No one wants that. We’d rather the money go towards improving staff car parking or access to hot food if anything!”
Another constituent wrote to me to say:
“pay rise for the NHS and care workers. They do not need medals.”
While medals and honours have a place in recognising exceptional achievements, there is clearly also a need for true recognition of their bravery and resilience during this crisis, and also for the amazing job they do every single day.
One of the petitions we are considering today, with over 162,000 signatures, calls for an increase in pay for NHS healthcare workers. They are doing tough work in very challenging circumstances, putting their lives on the line and for ever-squeezed pay. There have been calls for staff to get paid properly for all the hours they work, especially overtime, which really is not too much to ask.
The Royal College of Nursing has taken issue with recent claims by the Secretary of State for Health and Social Care that nursing staff have received a “significant pay rise”. The college’s research shows average earnings for NHS staff have not kept pace with the cost of living since 2010. Ahead of the next pay round for 2021-22 it is calling for an
“honest dialogue…in valuing the nursing workforce”.
We know we have a shortage, and paying health workers properly is key to having the workforce we need. It would be a grave error by the Government if, following the crisis and the recession that we are already heading into, they look to balance the books on the backs of public sector staff in the way we saw after the banking crisis in 2010—the very same public sector workers we have been clapping for in gratitude for saving so many lives. Neither must we see a repeat of the junior doctors dispute, where staff were treated appallingly and morale was devastated as changes to pay and conditions were forced through.
While he and I would certainly disagree on the detail, I echo the comments made by the former Chancellor the right hon. Member for Bromsgrove (Sajid Javid), calling on the current Chancellor to focus on growth, not austerity. We cannot cut our way out of this recession, and certainly not with cuts aimed at the very people who are getting us through this crisis.
Many medical students have also stepped up to support their future colleagues in fighting the virus. There are parliamentary petitions calling for reimbursing fees and reducing student loans. The Petitions Committee is conducting an inquiry into the wider impact of this crisis on students, as there has been unparalleled disruption to higher education.
Before this crisis, student finance reforms also impacted on the healthcare workforce. The decision to scrap NHS bursaries in England and replace them with loans led to applications falling by a quarter, and there are almost 40,000 unfilled nursing posts. While that error has been partially corrected by the restoration of maintenance grants, this will not benefit current students.
One petitioner says that nurses
“will surely work tirelessly to do their best to keep the rest of us safe while at the same time they continue to be charged interest on these loans for a cost which they should not have been required to bear in the first place.”
Another, calling for the current intake to receive grants, says:
“Most student midwives and nurses in those intakes will leave university with at least £60,000 debt, despite having committed to a career in a valuable public service at a time when the NHS is in desperate need of more of them.”
Addressing student finance for healthcare students would be a way to both recognise the efforts of the current intake and help attract more to the profession, but unfortunately the insensitive comments of the Minister for Care recently are a bad start to this, so I urge the Government to do everything they can to rebuild trust.
But the most devasting impact of all has been in social care. Our care homes and their elderly and vulnerable residents have painfully borne the brunt of this crisis. More than 16,000 people have died from covid-19 in care homes, almost a third of all fatalities. Far from the Government wrapping a protective ring around care homes, in the early days of this crisis they were left exposed, without adequate PPE or testing for staff despite their desperate pleas. The human cost of this failure is harrowing.
The crisis has well and truly exposed how neglected our care system has become. Too many staff are low paid and on insecure contracts; too many have had to make choices between risking people’s lives, including their own, or going without pay. Many carers do not receive even the national minimum wage because they are not paid for travel or sleep time.
Campaigners, including the trade union Unison, have been calling for care workers to earn the real living wage of at least £10 an hour outside London. Working conditions and employment rights vary immensely between care providers and we need to see care workers properly recognised and rewarded for the vital work they do.
“I wish social care workers were considered as equally important as NHS staff.”
I think that that says it all.
Finally, across social care and the NHS, migrant workers are a key part of the workforce and make a huge contribution. The Prime Minister made the right decision to scrap the immigration health surcharge, but this must be fast tracked to include refunds for those who have already paid. Many are also worried about their visa renewal, which is stressful enough. The 12-month visa extension announced by the Home Office is welcome, but it leaves out thousands of dedicated workers who are also working on the frontline. The extension should apply to all.
Many migrant workers in health and social care are stuck in limbo without indefinite leave to remain. The Royal College of Nursing and the Royal College of Physicians have called for indefinite leave to remain to be granted to all international health and care workers who have worked in the UK during the pandemic. Many migrant workers on the covid frontline are also subject to “no recourse to public funds”, which adds immense financial pressure, especially if they fall ill and have to self-isolate. Unison has called for the policy to be suspended. One petitioner said:
“I strongly believe the Government can do better than that one-year free automatic visa renewal for these NHS heroes. A grant of indefinite leave to remain or citizenship is not too much to ask to appreciate the covid-19 pandemic frontline fighters.”
We cannot expect migrant workers to put their lives at risk and help our nation fight this virus, and then expect them to pay through various means for the privilege of doing so.
In conclusion, the key issue at the heart of today’s debate is how we value our health and care staff and the tremendous work that they do. The pandemic has thrown their dedication, bravery and compassion into the national spotlight as they put their lives on the line, but this dedication is not new. They have been serving our country, day in, day out, long before this pandemic. I hope that this debate will be just the start of a proper conversation about how, as a country, we not only show our gratitude and appreciation for the work that they do but, take real action to make their job easier. For now, to all our doctors, nurses, carers, support staff, and every person working on the frontline during this pandemic, I say a heartfelt thank you to you all.
Over the past few months, our nation has come together to save the NHS from being overwhelmed, but it has also united every Thursday with its clap for carers. Darlington’s own newspaper, The Northern Echo, recently published a supplement featuring the incredible work of our health and care workers, providing a permanent record of an army of previously unsung heroes, and I thank it for that recognition.
Throughout the period of the lockdown, I was in weekly contact with Sue Jacques, the chief executive of our local NHS trust based at Darlington Memorial Hospital. Sue shared with me and other Members of this House from the region news of how the NHS locally was responding to the crisis. We were given updates on PPE supplies, which never ran out; numbers of covid patients they were treating; and many, many stories of service above self from the team. I want to place on the record my thanks to Sue for her leadership throughout the pandemic and for her open and transparent engagement with me. The entire team at County Durham and Darlington NHS Foundation Trust have been truly incredible and I thank them all.
I have been in regular contact with many throughout the care sector in my constituency over the past few months, and like the efforts that we have seen in the NHS, there has been incredible service, sacrifice and support for our elderly and vulnerable. I pay my thanks to them all for everything that they have done and are continuing to do.
In addition to the health and care community of Darlington, many hundreds of people have stepped up to the plate and gone above and beyond. There are literally hundreds of examples, but I particularly want to highlight the work of the Mowden pub and Maggie’s Place, the entertainment provided by Peter Miller, the exceptional service of Joanne Hammond and the efforts of Louise Graham and the team at Food for Thought. They truly are the best of us, and they have underpinned the efforts of all our key workers, not just those in the health and care sector. Again, I want to place on record my thanks to them on behalf of everyone in Darlington.
The NHS long-term plan sets out to make the NHS a world-class employer, and I understand that the NHS people plan will lay down how all NHS staff will be supported and recognised. I look forward to its publication. I fully endorse the steps that the Government have taken to support the families of the key health and care workers who have tragically lost their lives, with the commitment to the death in service award—
By definition, health is devolved in Scotland, so my remarks will be pertinent to Scotland, but they may have a wider application to England. Of course, my colleague the hon. Member for Twickenham (Munira Wilson) will be enlarging on our party’s position in the rest of the UK. As my colleagues on the Back Benches have said, the notion of an award—a gong, a medal or a ribbon with something on the end of it—without a whole-scale review of pay and conditions is just not on.
I want to make several comments about conditions, and to quote two people. On occasion during the pandemic, from under my staircase in my home, I have telephoned Dr Alison Brooks of the Princes Street practice in Thurso, in the very far north of Scotland, and she gave me sage advice at all times. Today she said this to me about the nurses with whom she works. She knows of a nurse—a friend of hers in Glasgow—who has worked 10 night shifts on the trot just to cover the job, because colleagues were sick. Dr Brooks said to me, “Remember, NHS staff don’t just walk away; they go above and beyond. They feel a moral obligation.”
Dr Brooks encouraged me to think about the toll that it takes on NHS staff when they know that they have been in a risk situation, albeit with the best of equipment, but they go back to their families, loved ones and young ones with the niggling fear at the back of their minds that they might bring the virus back with them. When we reflect on pay and conditions, we must think about how we cover sickness absence.
My second example is from a nurse from Wick in Caithness who worked in the high-dependency covid ward in Raigmore for the duration of the pandemic. This is what she wrote to me:
“My suggestion would be that there could be skills based tiers within bandings. For example: one for those who have little clinical responsibility and/or skills; one for those who have advanced clinical skills and responsibility.”
She says that the doctors cover the advanced stuff, but very often the doctor will have to cover the entire hospital, so they have to make clinical decisions. Perhaps remuneration for such people should be fine-tuned within the banding.
I conclude with this. When I was a councillor, a long time ago, my colleagues gave me the area chairmanship of social work because they thought that nobody else would want it. Remember that social work may be seen as a Cinderella service, and we must sort that out in the review.
I want to focus my remarks on home care and domiciliary care workers. If we want parity of esteem between social care workers and NHS workers, and there is a conflict there, we need the same parity of esteem between care workers who work in care homes and those who help people in their own homes.
I have heard many personal stories, both good and bad, as a member of the Health and Social Care Committee and in my work as the constituency MP for Peterborough. I remember talking to Richard, who told me that he felt that it was almost cheating to call what he did “work”, because he spent lots of his time talking to friends—the people he cared for. Mel told me that she would always recommend social care as a career, despite some of the challenges that she has, but too often we hear bad stories about the experiences of staff who work in domiciliary care. People were being tutted at for wearing their uniform out in public—there is a lack of understanding that domiciliary care workers wear their uniforms as they travel between clients’ homes.
Understanding is key to all this, because lots of people still call this low-skilled work, not understanding that domiciliary care work involves administering medicines and doing other complex tasks. A domiciliary care worker needs to be a real people’s person, and they are often hidden heroes in our communities. My father died relatively recently. He was a strong and independent man. Domiciliary care workers cleaned him, dressed him and gave him back his dignity, and my mother and I can never say thank you enough for that.
Home care is the biggest part of the social care sector and it employs hundreds of thousands of people. I would like to ask three questions in the time remaining. We talk a lot about valuing our social care staff and parity of esteem, but how can we resolve this problem relating to the value of NHS and social care workers? What can we do that is concrete? Would it be right for local authorities to pay for social care activities? Can we do better by looking at outcomes? Finally, can we look to integrate our NHS and social care workforce as they have in Denmark?
It has never been more important than now to recognise the invaluable contribution our care workers make, especially those who are not paid properly for their sacrifices and the often difficult and long hours they work to support those in need, families and local communities. I pay tribute to the Welsh Labour Government for leading the way, as ever, in recognising care workers. In April, the Welsh Government agreed a £500 payment and subsequently agreed that it will apply not only to carers in Wales, but to cooks, cleaners and a range of other key frontline staff working on the frontline in care who make an immeasurable contribution to the health and wellbeing of those most in need.
I urge the UK Government to do the right thing, make an exception in this case and allow care workers to keep the entire £500 one-off payment in recognition of their efforts not only during the pandemic, but all year round. To do anything less is an insult to the sacrifices they have made and the pressure that they put themselves under to care for those most in need during such a difficult time. I ask the Minister to confirm that she will make representations to the Treasury in this regard and will indeed allow carers in Wales to receive the full £500 in recognition of their amazing efforts during the pandemic, and remove the tax requirement in this case.
The Welsh Government have arranged for payment to thank care workers, despite operating on a budget from Westminster that has been subjected to a decade of harsh austerity. As we have heard, there are many ways in which the UK Government can give proper recognition to the many thousands of people working in social care across the country, rather than simply clapping on a Thursday night. The Government should fully recognise the work of care staff and, at the very least, increase pay, testing and the provision of PPE for NHS and care workers immediately to ease the immense pressure on the shoulders of many who provide care to those in need, allowing them to feel safe, given the many risks they face day to day, not only on the frontline during the pandemic but throughout the year. I urge the Government to act and I hope the Minister will respond accordingly.
I pay tribute to the health and social care workers of Rother Valley. Once again, they have risen to the challenge and proven themselves to be the backbone of our community. Likewise GPs, such as those at the Stag medical centre and the Swallownest health centre, have been working hard to continue to treat people throughout the pandemic. I was moved by a recent letter from one of my constituents, Graham Makin, notifying me of the phenomenal work carried out by the care workers at Waterside Grange care home in Dinnington, who are looking after his wife during this crisis. Graham writes:
“the outstanding dedication and incredible expertise that all the staff give to the residents. It is very close to a ‘family’ environment. To them this is not a job—certainly not for the money they earn—it is truly a vocation and a passion.”
Graham is of course right. He goes on to urge a better deal for those in the care sector. I am delighted that the Prime Minister has made social care a priority and pledged to consider social care as being of equal importance to the NHS. I know that everyone in this House and across our nation wants us to get social care done.
However, we must not forget that behind our health and social care workers there are many others in the community who have helped the NHS. Robert Holland, an engineer from Dinnington, offered to use his engineering expertise to convert tyre inflation equipment to hospital ventilators. Cawthorne’s Travel has been laying on free buses to take NHS workers to Rotherham General Hospital. Local groups, such as the Thurcroft coronavirus action group, led valiantly by Cath MacCartan and Diane Oxley, have been doing such great work for our community. Those selfless actions are just the tip of the iceberg in Rother Valley.
I ask the House how best we can recognise and reward health and social care workers, but also those who have done so much to help the NHS. People in Rother Valley have already taken this matter in their own hands. For example, coaches, parents and players of Laughton FC’s under-11s have already been fundraising for hampers for NHS workers. Mark Kelsall from Maltby has been creating wonderful oil paintings of local NHS staff. Shaun and Halle Salmon created an amazing Lego superhero mural that is now in the reception of Rotherham Hospital. Those are just a few ways that the people of Rother Valley have given back. For my part, I am proud to have instituted the Rother Valley hero awards for this very purpose.
I contend that nationally we must do the same by rewarding campaign medals to our British heroes who have fought the virus. My constituent Andrew Gardner of Thurcroft suggested to me that we should hold a memorial event for health and social care workers, which would take place in Whitehall much like the events on Remembrance Sunday. I believe that that proposal merits serious consideration and should be taken forward. Ultimately, it is of the utmost importance that the House pursues all avenues, including looking at pay and rewards, in recognising and rewarding the heroism of our health and social care workers and the selflessness of those who have helped the NHS both in Rother Valley and across the United Kingdom. Without them, we would not have been able to pull through this crisis.
It is all too easy to reduce the NHS workforce to doctors and nurses, but given that there are around 400 different job roles in our NHS, it is important that all NHS staff are given the credit they deserve for their incredible work all year round. Among many others, the porters, cleaners, caterers, healthcare assistants, allied health professionals and the many invaluable volunteers who give up their free time truly are the unsung heroes of our NHS. The coronavirus pandemic has provided a unique opportunity to truly show our thanks and appreciation. Call me old-fashioned, but I am not sure that a handclap or a medal quite cuts it. I wonder whether the Minister would be satisfied with a handclap or a pat on the back instead of receiving her additional ministerial salary—something tells me the answer is no.
Naturally, as a proud Welsh valleys woman, it would be wrong—rude, even—for me not to take the opportunity today to highlight how different things are across the border, thanks to the fantastic Welsh Labour Government. As my hon. Friend the Member for Merthyr Tydfil and Rhymney (Gerald Jones) said, the Welsh Labour Government are leading the way in the response to the coronavirus pandemic. They say that where Wales leads, England follows, and I am more than inclined to agree.
Thanks to the Welsh Labour Government, social care and domiciliary care workers in Wales, including agency workers and support staff in care homes such as kitchen workers and cleaners will soon receive a diolch or thank-you payment of up to £500—a payment that will be available to 64,600 care home workers and domiciliary care workers throughout Wales. That comes after the Welsh Labour Government have already pledged to commit an incredible £40 million of extra funding for adult social care services, to help meet the extra costs associated with the response to the pandemic.
Clearly, that payment is a reward in recognition of the unprecedented circumstances and strain that have been placed on all our NHS staff across the Union, from Pontypridd in south Wales to Perth in Scotland. It is even clearer to me that this payment should be exempt from income tax and national insurance contributions—something that the Welsh Labour First Minister and colleagues in the House have been calling for. So far, Her Majesty’s Treasury has point-blank refused—talk about a kick in the teeth for workers who have literally put their lives on the line to keep us all safe. NHS workers in Pontypridd and throughout Wales deserve better.
Colleagues will be aware that, thanks to another fantastic Labour-led campaign, the Prime Minister was forced to U-turn again this week. He is running in circles. If the Minister needs any information on Wales and how we can best tackle the coronavirus pandemic, I am more than happy to offer my services; she knows where to find me. I hope that where Wales leads, England will follow.
During this time, I have also been listening. One of our jobs as parliamentarians is to listen. What I have been hearing is that the pandemic has shown how this Government are trying to be innovative, trying to use technology in different ways and, ultimately, trying to unbind the red tape that has held back so many people on the frontline. For so long, we have been stuck in a process of looking at points and targets, and we have forgotten what frontline workers really want. They want respect. They want trust. They want us to cut through the red tape, so that they can get on with their jobs across the health and social care sector. I am hearing loud and clear that, during this pandemic, we have enabled that to happen because we have had to, but we need to continue that.
We also need to listen to what staff really want. I had an eye-opening moment when I was delivering sandwiches to one of the wards, and the nurse said, “Don’t worry about the sandwiches—we’re getting fed over at Watford football club. We get delicious pizza over there, so we probably won’t eat those.” That really opened my eyes to the fact that, while salary is critical, this is also about what life is like on the frontline day after day.
We need to listen to what staff really want, and that is partly about career pathways and opportunities such as sabbaticals after 10 years of working in the same job. It is about corporate discounts, working with the private sector to enable not just NHS staff but social care workers to have free opportunities and discounts and go to the front of the queue. It is also about innovation and the use of data and technology. I believe that, if we look at all those things, although it may not happen overnight—it might take years, perhaps even decades—we can really make a change for the better for all our brave staff and be, not just the biggest employer, but the best employer in the world.
Across the NHS and care system, there is the scourge of low pay. Unison predicts that we will need another 1 million extra care workers by 2025. It is vital that we learn the lessons now and ensure that we have a resilient, well-resourced, effective NHS, where people are properly rewarded and have their skills and expertise recognised, rather than being treated shoddily, which is what we have seen.
We also need the Government to ensure that junior doctors are properly rewarded. The Government’s behaviour in recent years has been appalling, yet the doctors, nurses and carers have been the people on the frontline, saving people’s lives and protecting us. We also know that black, Asian and minority ethnic NHS and care workers have had the highest death rate, yet the Government have been inadequate in protecting them. To be frank, the Government have treated them like cannon fodder and the fact that they do not have proper recommendations for those workers is scandalous. They need to get a grip before more lives are lost.
If the Minister for Care thinks that health and care workers should be protected, she should act instead of saying appalling things about them. I hope she will apologise for the remarks she made recently about care staff. The point is that we need to ensure that, when the crisis eases, this Government do not forget the sacrifice and commitments that people in the NHS and care system have made and that they act to ensure those people are properly rewarded, properly recognised and protected.
It is vital that we continue to break down some of the long-standing barriers between health and social care. We have learnt the importance of both of these sectors over the past few months, and our appreciation must go equally to all carers. They play a crucial role in managing the complex care needs of thousands of people every single day. Even with the additional risks they take, they continue to work so hard to support the people we all care about in these unprecedented times.
If there is some positivity to hopefully come out of this horrendous time, it is how it has highlighted to us all that the social care sector does so much. We are now all well aware that, without them, our communities and our loved ones would suffer. I have received many tributes to our carers. Indeed, the Porthcawl male voice choir, of which I am vice chair—not a participant, the House will be pleased to know—have produced a wonderfully emotional and heartfelt video to say thank you, and I encourage others to watch it. It bears a fitting strength of feeling, recognising how proud we are of our carers during this global crisis.
I was also delighted to see the personal message that Ant and Dec sent to all the care staff in the Princess of Wales Hospital, and I will end with their words:
“We just wanted to say thank you so much for all the hard work you're doing every day on behalf of the whole country, and we would like to send you lots and lots of love. Keep up the good work.”
In social care, many do not work in the public sector. Two million people in care jobs are largely on the minimum wage. Half are on zero-hours contracts, yet they are undertaking highly skilled work, taking care of the most vulnerable and providing intimate care. They are often not paid benefits or for travel time, which can be significant in London. It is possible to earn more money stacking shelves in Tesco. It is important to recognise that they have 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. That is because of the funding crisis in social care, which is keeping those wages down. The case for ensuring that our care workers are at the very least paid the real living wage is overwhelming and a moral imperative.
In the longer term, to tackle the workforce crisis and put social care on an equal footing with the NHS, pay scales must be reviewed and ideally aligned with the NHS, but that obviously needs to go hand in hand with tackling the long-term funding crisis in social care. Those reforms are well overdue.
We know there is a huge number of migrant workers in social care and in the NHS. The figure is one in seven in the NHS and one in six in the care workforce. We on the Liberal Democrat Benches have argued through the crisis that the cruel policy of no recourse to public funds must be suspended. That is particularly relevant for those on the frontline who may be reticent to take time off or self-isolate because they are only eligible for statutory sick pay, which, frankly, is not enough to live on. A number of other benefits are not available to them, but, most importantly, when people have put their lives on the line for us and our loved ones, we must recognise those workers by granting them indefinite leave to remain. A visa extension is not enough. It is not enough to just take their service and say, “Bye bye. Thank you very much.” We have a moral responsibility to allow them to stay.
We have always looked at adult social care as being on the bottom tier of the ladder in terms of the NHS funding allocation, and I would like to see it brought up to the top. I would like to see it given equal footing with the NHS to allow for career progression and for the statutory duty that councils now have to take on. That should be reflected in the money that is allocated to councils to carry out their care responsibilities.
We have gotten through this crisis, and I pay tribute to my local council and Bucks clinical commissioning group, but we need to look at how we can give care workers the respect and the pay that they deserve as we move forward. The money comes from the same pot, but we need to look at how it is allocated. I hope the Minister will join me in looking at how we can help give people in the care sector career progression, the pay they deserve and respect for the jobs that they hold.
The simple truth is that NHS staff and carers have been failed for far too long. Since 2010, newly qualified nurses have faced an 8% pay cut. Half of frontline carers are paid less than the minimum wage and years of devastating cuts to the NHS and neglect of care work have left us all more vulnerable to a pandemic. We saw that with the PPE shortages in hospitals when the crisis hit. We saw that when doctors and nurses repeatedly —desperately—asked for testing, only to be told that there was not capacity. We saw it again with black and ethnic minority NHS workers killed by coronavirus at a disproportionately higher rate, exposing the inequalities that lie at the heart of our society.
Let me go through some of the experiences that my constituents who work in our health and care system have told me of. There are migrants who work on the frontline, but have been hit by the hostile environment and burdened with visa fees and health surcharges. There are NHS staff who, until recently, were forced to pay obscene parking charges at University Hospital Coventry—in some cases, almost £500 a year. These charges are exploitatively set by private companies that are making profits on the back of our workers.
There are nurses robbed of NHS bursaries, leading to a 32% decrease in nursing applicants nationwide. Now we have an overstretched and overworked workforce, with more than 7,500 nursing vacancies in the midlands alone, which has been called a “full-blown crisis” by the Royal College of Nursing. Then there are the A&E workers, who face a mental health crisis, with one of my constituents describing their work as heart-breaking and soul-destroying and their work environment as a war zone.
Those are just some of the wrongs done to the NHS and care workers in my constituency. I urge the Government, who clapped for them through this crisis, to match that with action: give our carers, nurses, porters and cleaners a real pay rise; end poverty wages in the NHS and care work; ensure that they are all on good contracts with no more precarious work; give indefinite leave to remain to all migrant workers; and restore the NHS to a truly public service, free from privatisation and run for the public good, not private profit.
In our community, district nurses from the Bridgewater NHS trust, our village and town GPs, along with doctors, nurses, cleaners, porters and healthcare assistants from Warrington Hospital, have all worked alongside social carers and mental health teams at the North West Boroughs NHS trust. The leadership in Warrington has meant that the supply of PPE has continued uninterrupted, urgent A&E services have been maintained and the number of high-dependency beds has increased, so that everyone who needs care gets its. Hospitals have collaborated. I want to recognise Professor Simon Constable, chief executive officer of Warrington Hospital, who has led the fight against covid-19 from the front.
One group we should single out is the infection control teams, not just in Warrington but across the country, who have worked around the clock in hospitals to keep areas clean and to minimise the spread. I also want to pay tribute to the nursing and care staff at Spire Cheshire Hospital in Warrington. It has turned its operating theatres over to the national health service so that urgent cancer care and trauma operations can continue in a non-covid hospital environment. Our health and care workers, and social care workers, have been one team, dedicated and working together to do the best for everyone in our community, through our national health service.
I do not underestimate how challenging the recent months have been for health and social care staff in Warrington. I saw this at first hand as a member of my family was hospitalised with covid-19. I also saw the dedication and care that was given to her in the most difficult circumstances, and I am incredibly thankful for their heroic efforts. I also want to remember and give thanks for three nurses, Jo Habab, Andy Collier and Janice Glassey, who worked for our local NHS trusts and have, sadly, succumbed to this dreadful virus. I am sure the thoughts of this House and everyone in Warrington go to their families at this difficult time.
Life in our hospitals has been made just a little easier by the tremendous efforts and generous giving of our community. Last week, I met the aircrews from Manchester airport who were operating Project Wingman, where pilots and cabin crew were caring for our nurses and our doctors in their staff lounges. The Sikh community have delivered 13,000 meals free of charge to our NHS staff, turning up every week without fail.
To conclude, I put on record my thanks and incredible appreciation for our teams in Warrington.
For years, this Government have stood by as our NHS and care staff have given their all to provide a great healthcare service while their families fall further into poverty. In 2018, we saw a rise in the number of nurses using food banks, with one study finding that 38% of nurses struggle to buy food and that 50.5% had considered quitting their profession because of financial difficulties. More than half of all care workers are paid less than the real living wage and these workers are four times more likely to be on a zero-hours contract than the average worker.
This pay rise is not just about rewarding people for their hard work; it is about recognising the real and negative impact that low pay has had on our health and social care workers. Some 15% of workers in low-quality, low-paid jobs say that they have poor-quality health, which compares with a figure of 7% for those in good working environments. Covid-19 has thrived on inequality, with people in the poorest parts of England twice as likely to die from covid-19. Perhaps there is some correlation between that fact and the fact that our poorly paid social care workers are almost twice as likely to die from covid-19. Ensuring that health and social care staff work in a high-quality and well-paid environment benefits us all.
Covid-19 has highlighted how much the UK needs a well-functioning NHS and social care system, and how lucky we are to have access to healthcare. However, organisations are already warning of mass vacancies in the future. How are the Government planning to fulfil their promise, as well as to recruit more than 100,000 employees to the care sector, given that what they are offering is low-paid, high-stress, insecure work? I have been contacted throughout this crisis by many constituents urging me to support a pay rise for workers in the healthcare sector. Today, I am asking the Government to show all the hard-working NHS and social care staff in Erith and Thamesmead, and across the UK, the support they deserve and to give them this much-needed pay rise.
We have seen an astonishing contribution over recent months, but many NHS and social care staff make fantastic contributions every day as part of their normal work. People go into the NHS and social care with open eyes—they are not naive about what their roles entail—but that does not mean that we should not try harder to understand better how some roles and areas of work do not give staff the work-life balance that we would expect or the ability to deliver the care that we would want them to be able to deliver. As the workforce more generally moves towards greater flexibility and better work-life balance, NHS and social care staff will increasingly compare their work experiences and will perhaps not recommend that future generations go down the same route. We must tackle that.
That is why I am glad that at the most recent election the Government made some incredibly ambitious commitments for NHS staffing levels, particularly GP and nursing staff levels. The successful delivery of those goals will make an enormous difference. To get there, the Government will really have to get to grips with recruitment and retention in the NHS in a way that in recent years no party has done. We have made some good progress already: we have seen some good figures today on the increases in NHS and doctor numbers; junior doctors’ pay scales will have increased by at least 8% by 2023; and nurses will have received increases of between 6.5% and 9% by next year. The reward package also includes things such as pensions, some of which are the best available: members of the scheme can generally expect to receive £3 to £6 in pension benefits for every £1 that they contribute.
This is not just about pay, though. For example, in GP practice we see an enormous shift among new recruits to part-time work, because people want more flexibility. They want to live a different style of life, and that will have an enormous impact on the workforce across NHS. I want to use the focus on NHS and social care staff that has come about in the light of the pandemic and the extraordinary contributions that have been made to get everybody in this place to engage with the significant workforce challenges that we will face given an ageing population and an increase in demand.
Pay is never easy for any Government—there is always a need to look after the nation’s finances—but a recognition of the important role that healthcare can have in stimulating the economy and creating jobs and innovation should be given greater weight in the Treasury’s calculations. We do not yet know what the underlying finances are going to be in future years, as all the impacts of the pandemic play out, but within those constraints I want the Government to do everything they can to go as far as they can to reward and recognise the contribution of NHS and social care staff.
I speak today solely about contract staff in the NHS, although I associate myself with the comments made by the hon. Member for Twickenham (Munira Wilson) about the similar situation in the social care sector. I am not talking about those who are directly employed; I am talking for myself and on behalf of my right hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott), who is unable to speak because of shielding, about the thousands of staff working on outsourced contracts who are paid considerably less—often lower than the minimum wage—and who have fewer rights to sick leave; who have much less job security, if any; who are often on zero-hours or uncertain contracts; and who are disproportionately from black, Asian and minority ethnic backgrounds. I pay tribute to the GMB trade union for highlighting how many agency workers were going to work sick because they had to choose between working and paying their basic bills. The move to a secure sick pay is a start, but it is not enough and it is not yet firmed up for the long term.
Homerton University Hospital in my constituency is an excellent hospital that does great work, but it is now in the throes of agreeing a five-year extension to a contract for hospital cleaners and other ancillary staff employed by ISS. My right hon. Friend and I are concerned about such a long extension leaving key workers on low pay without the protection and recognition that NHS employed staff have, but the real issue is systemic: it is not about the individual trusts but about how the Government choose to fund hospitals, such that from day one they cannot fund their full staff complement. The NHS systemically is funded such that it bakes in the assumption of low-paid, insecure workers on outsourced contracts. As of 2018-19, for which we have the most recent figures to be audited, the combined deficit of trusts in England was £844 million—up £86 million from the year before. That is the heart of the problem.
My right hon. Friend and I are really clear that the Government need to foster a system that is not reliant on low pay. So low-paid are these workers, the irony is that their pay is topped up by taxpayer-funded universal credit and other benefits. We are both clear that if people are facing the same risk, they should have the same reward. This inequality cannot continue, and if we are to learn anything from the covid-19 crisis, it is that we need to level up so those who work for the lowest pay—poverty pay—are getting a fairer deal.
As the Member of Parliament for Gedling, I receive regular updates from Amanda Sullivan, from NHS Nottingham and Nottinghamshire CCGs, and Tracy Taylor, the chief executive of Nottingham University Hospitals NHS Trust. I would like to thank them for their work in updating me. I was amazed in those updates at the very hard work being done throughout the county, such as working rapidly to expand intensive care capacity and ensuring that the demand for PPE across the county was being met.
I would like to put on record my thanks to the doctors, nurses, GPs, pharmacists, care home workers and other key workers who have worked hard for their dedication. It is clear to me that that dedication and hard work is widely appreciated. As I have walked through my home town of Arnold, I have been amazed at the drawings of rainbows in front windows, showing support for key workers and offering hope for a better time to come.
That better time will, of course, require a strong economy to generate revenues for our public services. I am pleased that, because of that, we have been able to offer a 6.5% pay rise for all staff on the “Agenda for Change” pay scales, including nurses, and the implementation of a five-year GP contract framework. I am also pleased that we have been able to deal with the thorny issue of pension tax rules and the change to the taper allowance at the last Budget, which I know had been a big concern for consultants and made additional work prohibitive. As the British Medical Association has acknowledged, the vast majority of doctors have now been removed from the effects of that taper.
We have faced what is possibly a once-in-a-century event, and I think it is right that we recognise that in some way. A constituent of mine, Elizabeth Gull, has proposed the creation of a medal for NHS workers. When I raised this with the Prime Minister last month at Prime Minister’s questions, I was pleased to see that he considered it to be an excellent suggestion, and I understand the Cabinet Office is looking into the measure.
We should also recognise that NHS staff and others have been working at full capacity for several months now. I hope that there will be some reflection by employers and others about giving assistance not only in pay, but to help them rest and recuperate so that, going forwards, they will be able to work at their full mental and physical strength.
The clapping—yes, the clapping—became to many a symbol of a country coming together and of thanking the ones on the frontline. They are the ones who, in effect, were coming out of the trenches every day to save people who had caught this terrible virus. I can only imagine how it would have felt for myself or my wife going to work and knowing that one of us would be coming into contact with this deadly disease, which could be taken home. Even worse would be knowing that I would, at some point in the day, see someone die, and such deaths would be reported on the news each night. Some might say, “Well, that’s what nursing is about.” Some might say, “You must get used to it.” Some might say, “It’s just another day.” Some might, but I will not: I was not there, so how can I? What I can say is that I am glad that they were there for us. Thanks to this Government, the efforts of the frontline staff and our national effort, we are coming through this. There is light at the end of the tunnel. In fact, it is within touching distance—so much so that we can now start to reflect on what we have all been through.
This motion comes after several petitions calling for us to recognise and reward our health and social care workers. When I last counted, 200,000 people, including 245 of my own constituents, had signed one of these petitions calling for our frontline staff to receive the recognition they deserve. I keep saying “frontline staff” because I think that many thanks should go to the doctors, carers, nurses, porters, cleaners and everyone else who makes up the frontline in our NHS and social care sector—those who, when many in the country were furloughed and spending time with their families, were putting themselves at risk and missing time with their loved ones. For many in these frontline jobs, Easter was cancelled, and many have worked back-to-back shifts.
We must remember that we may not all end up in hospital during our lives, but there is a good chance that we may spend some time in a nursing home, so carers there, who are pretty much all on the frontline, need recognition, too. Some of them really went the extra mile, as they never went home at all to keep the virus away from their residents. Every night the Government have taken time to stand in front of the nation and tell us where we are with this virus, but they have never given us the figures for the people our carers have put back on the road to recovery. This is difficult with care homes—
As we watched things unfold in other countries—in Italy, for example—I read inspiring stories that lifted my heart and ones that filled me with dread for our country. I thank the Government for spending the money and making the finance available to source the additional ventilators to prepare for what was to come. I knew, at the end of the day, the burden would rest on the shoulders of every person in the NHS and in care home facilities—those on the frontline, who did not let us down. Over 20,000 staff returned to the NHS to fight this battle—20,000 people who had already paid their dues and yet were prepared to return and stand in the breach. We thank them for hearing the call and responding to it.
The army of volunteers—some 600,000 people—said, “We will do what we can.” They helped with the shopping lists and the food deliveries. They rang and spoke to the elderly people to be a social lifeline and to ensure that no one was absolutely isolated. We do not know, and possibly may never know, what the whole story of corona- virus would have been without their input.
We thank every consultant, GP, doctor, nurse, nursing ancillary worker, porter, lab technician, cleaner and administrative agency worker—we thank them all. Saying thanks sometimes seems so little for those who signed up to help. I know that sometimes they must have felt that they were in something similar to a warzone. It is my sincere belief that we must do more than just say thank you to all those who went above and beyond their job descriptions and into community hero mode. We appreciate every person who could not see their children or partner because their work was too dangerous, and every exhausted parent who worked their shift and then went home to carry out household tasks, home-school their children, shop and everything else. We appreciate the sacrifices that they made more than words can ever say.
I subscribe to the view of speakers who have said that we should be looking at some sort of financial remuneration and pay rise for those who served on the frontline in the NHS. They do deserve that, but they also deserve investment in the NHS, more training in the NHS, more technology and more staff—all those things. It is not enough—it can never be enough—but it would be a lasting testament to the battle fought, a reminder of the precious lives lost, and a demonstration that this wonderful United Kingdom of Great Britain and Northern Ireland, always together, always better, can rise to any challenge when we stand together shoulder to shoulder.
A few weeks ago, I suggested in oral questions that we should have a special honours list to recognise those who have done so much and sacrificed so much during this period. I say again to the Minister that I feel that is something we should pursue. I suspect that many, many people from Bolsover would be suggested for inclusion on such a list.
One of the most humbling and difficult things that I have done during this period has been to speak to every single one of the care home managers in my constituency. One in particular stands out. She said that this had been the most difficult period of her life. In tears, she said, “But I’m also incredibly proud of what we’ve done—of the leadership we’ve shown and how well my team have coped.” That just goes to demonstrate the amazing spirit that we have seen in this period. In my conversations with my local hospitals—the Chesterfield Royal, the King’s Mill Hospital and the hospital in Bassetlaw—I have heard only good things about the efforts that the staff have put in.
Our manifesto committed us to seeking a cross-party consensus on the future of social care. Now more than ever, we should continue to seek to do so. We can talk about pay and conditions—we can talk about all sorts of aspects of social care—but ultimately we need a vision for that sector that is sustainable and that is suitable for those who live long lives. I have a background in the care sector, and I know that there is so often a stigma attached to it. There is a fear of care homes and a fear of older age that should not be there. Based on the contributions today, I think there are many things on which we agree and many things that we should look to solve together.
Yesterday in this place I thanked NHS staff and care workers in Ipswich for their incredible work to save lives during the covid-19 pandemic. I reiterate that gratitude for those professionals as we discuss these petitions to recognise their fantastic work and to consider the pay that they receive.
I mentioned yesterday that these workers have taken on considerable additional risk to their own physical health to help look after the most vulnerable. Most of us can only imagine what it is like for them to deal with many sick and deteriorating patients under such tough conditions, always having the thought in the back of their mind that they could catch the virus themselves and potentially pass it on to their loved ones when they leave work that day.
It is clear to me from the correspondence I have received quite how much my constituents want to thank NHS and care workers. There are a couple of stories that I want to elucidate slightly. One is about the local pub on Woodbridge Road, the Lattice Barn, which right now still faces an uncertain future. It closed its doors and there were lots of questions about its finances and so on, but the first thing that the landlord thought about was local NHS staff and how he could open his doors to nurses and frontline NHS workers. Immediately, he thought not about himself but about how he could support our wonderful NHS workers. I also thank Northgate High School and Ipswich School, where all the pupils worked together to make PPE for our frontline workers.
Yes, a monument or a medal would be a good idea. These things are not insignificant, and I do not think they should be belittled. They do matter, and they are a way of us saying collectively, as a society, “We acknowledge what you’ve done and we will never forget it.” However, I encourage the Government to reflect on the strength of feeling in the country and to consider any way that we can increase pay, particularly for frontline NHS workers and social care staff, at the first opportunity. In particular, we should show everybody who works in the social care sector how much we value them and the work that they do, give those workers the status they deserve and acknowledge that they have been the best of the best. From the bottom of my heart as the Member of Parliament for Ipswich, thank you.
To pick up on the comments of my hon. Friend the Member for Darlington (Peter Gibson), we have both had excellent communications with our local NHS throughout the coronavirus period. Sue and the entire staff of the County Durham and Darlington NHS Foundation Trust have been absolutely phenomenal, whether at the main hospital in my hon. Friend’s constituency, over at the University Hospital of North Durham, down at Bishop Auckland or in the small community hospitals, such as Weardale in my constituency and Shotley Bridge—which is one of my main campaign issues, just to flag that up to the Minister.
We are desperate for Shotley Bridge to see renewal. The number of beds that it has had to use has increased from eight to 16 over the past few weeks, to look after the extra patients. As Simon Stevens said in evidence to the Public Accounts Committee, one of the things that the NHS wants to look at in the long term is ensuring that we have capacity within the existing NHS estate for crises when they occur.
I also pay huge tribute to the care homes in my patch, in particular Shotley Park and Crescent Homecare in Langley Park, which have been in regular communications with me, to all the other care providers locally and to the pharmacies. Last week, I visited Consett pharmacy, which only does direct delivery to homes. It has seen a 25% increase in the number of people getting those home deliveries, often the most vulnerable in society, people who cannot go out and might not have friends and family nearby. The pharmacy has been delivering direct to homes, which over the past few months has been such a lifeline for many people, in particular those with complex conditions.
I have two final shout-outs. One is for people who were not mentioned when the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) introduced the debate: carers who are still at home, caring for people in a home setting. My dad is one of those; he has been caring for my grandmother throughout this crisis. A lot of people in my constituency have been carers at home, often having to shield themselves with the person they are caring for, and the sacrifices that people have made on incredibly low pay have been phenomenal.
Finally, I associate myself with the comments of my hon. Friend the Member for Peterborough (Paul Bristow), who hoped that this will help us to look towards how to integrate the health and social care system in the future. I hope that, across the House, that is something we will be working on going forward.
North Norfolk has been exemplary in its fight against covid-19. Our number of infections has been one of the lowest in the country, significantly behind the national average, and so have our death rates. That is in large part thanks to the incredible work of the NHS staff and to the resilience of my residents, who have followed the guidance religiously, keeping one another and the area we live in safe.
Our carers are the group most often forgotten about. They are often unsung heroes, and they must have the recognition that they need and deserve. Many people have even taken leave from their jobs to care for the vulnerable and for family members. Some carers in my constituency have worked tirelessly caring for those who have dementia. None must be left out of recognition.
I want to spare a thought here in the Chamber for our young carers, who have not been mentioned today—young people who may be caring for a parent who is ill. During the lockdown, I spoke to some young carers, and it made me wonder whether we really knew enough about these young children—sometimes they are as young as five or six—who, day in, day out, support their parents at home. Research shows that young carers are often vulnerable. They are part of a hidden group that is falling through the gaps in public policy and health and social care services. Imagine a five-year-old climbing on a stool to boil a kettle to make a drink for their parent who is incapacitated. These young people must not be forgotten. They are not getting a proper childhood.
I pay enormous tribute to the tireless work of Julie Alford and all of her team at the Holt youth project, who are looking after 38 young carers across the constituency. We must do more to raise the profile of this group of people who need support. They must not be forgotten. Their education often falls behind. I call on the Government to do everything they possibly can.
Caring Together is a charity in East Anglia, doing great work to support all carers. I warmly endorse its carer-friendly tick scheme, in which a wide variety of organisations help to identify that there is a support system out there for young carers.
“A loving kind man who gave everything for his community.”
In remembrance and in recognition of his service, hundreds of members of our community lined the streets to pay their last respects to a doctor who spread kindness and warmth over two decades within Bury.
Carol Jamabo was a care worker in my constituency. She served the public as a key worker for more than 25 years. She was popular, caring and compassionate. A relative commented that she will be remembered for her “uplifting, joyful and enthusing” personality.
There are doctors, nurses, healthcare assistants, porters, cooks, receptionists, ambulance service staff and drivers. There are just too many people to mention, but all are working in NHS and care services in Bury, Ramsbottom and Tottington. All have made immense sacrifices to help those affected by coronavirus. They are all heroes and heroines. I cannot mention them all, but we shall forever be in the debt of kind, compassionate, caring individuals such as Marie Sharp, the manager of Bankfield care home on Gigg Lane, and Dr Afzal Hussain of Walmersley Road medical practice.
The NHS long-term plan outlines the next step in the Government’s vision to support staff not just through headline pay but through improving their working lives, giving them the reward and recognition they deserve for always putting patients first and providing the high-quality care that all Members in this House have seen throughout the covid-19 crisis. They will forever be heroes to us all.
I will conclude by associating myself with some of the remarks of my hon. Friends. I have had the pleasure and honour of speaking with all care home managers and workers in my constituency. My hon. Friend the Member for Ipswich (Tom Hunt) called them the best of the best and they truly are. They deserve recognition for their highly skilled work and for the care they give to some of the most vulnerable in our community, and as a House we must do everything possible to recognise that skill and to reward their immense contribution to our country.
I would just note that there was another petition during lockdown that achieved 1.2 million signatures, but, because it did not come through the e-petition site, it is not available to be debated in the House in quite the same format, but I know that many Members would want to have the behaviour of the Prime Minister’s special adviser discussed on the Floor of the House.
When this crisis is over, the UK Government must find a way of honouring the amazing heroes in our NHS and care sector who are continuing to work tirelessly to help us all to defeat the coronavirus. The Scottish Government—the SNP Government—remain committed to passing on all Barnett consequentials for health spending to the NHS in Scotland. Throughout this time, and for many years now, all NHS staff in Scotland have been paid the real living wage, not the pretendy living wage implemented by the Tory Government. Nurses across all bands are paid better in Scotland than anywhere else in the UK, and the Scottish Government are delivering the highest pay rise for NHS “Agenda for Change” staff anywhere in the UK. Employees will receive at least a 9% pay rise for the three years from 2019.
The Scottish Government spend about £130 per head more on social care than is spent in England, and they are the only Government in the UK to fund free personal care. Also, as my hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) said earlier, they have already brought forward a 3% pay rise for social care workers in recognition of the work that they are doing at this time. Recognising the particular challenges presented by covid-19, the Scottish Government, with cross-party support in Holyrood, are working to establish a sick pay fund as a matter of urgency to ensure that care workers whose employer terms and conditions fall short and who test positive for covid-19 receive sick pay above the current statutory level of £95.85 a week. As we know, that is one of the worst sick pay legal frameworks anywhere in Europe.
The Scottish Government were also the first in the United Kingdom to announce a death in service provision for covid-19 deaths among NHS staff. That benefit mirrors what is available in the NHS pension scheme: a lump sum and ongoing survivor’s benefit. However, it is unacceptable that some social care workers’ contracts of employment offer no cover for death in service, so the Scottish Government are putting in place that kind of cover for when any social care worker dies without death in service cover in their contracted pension arrangements. The Scottish Government will provide a one-off payment of £60,000 to a named survivor, and this will be retrospective. That is important because, as of 23 June, the Scottish Government have been informed by health boards or the Care Inspectorate of seven deaths of health care workers and 12 deaths of social care workers related to covid-19.
I have some experience of this. The Wyndford Locks care home in Maryhill was one of the first in Scotland to experience the death of a staff member due to covid-19. Also, one of my constituents, Christine Gallagher, lost her beloved son Michael to the disease. He was providing frontline care, employed by an agency, in central Scotland. His loss is keenly felt by his family. Too many families across the country are feeling such losses. His mother told me that she could not attend his funeral because of public health restrictions. She had to stay at home with a photograph of her son and light a candle. I want to pay tribute to Michael for the love and support that he showed to so many in his care, and express my condolences to his family and all the other families who have experienced tragic losses due to covid-19. May they all rest in peace.
This is why it is so important that the healthcare and social care workers, whether in the NHS or private sector, have the pay and benefits that they and their families deserve for the work they do to keep us all safe. That includes healthcare workers who have made their home in Scotland, even if they began their lives or careers elsewhere. So, while we welcome the principle of scrapping the NHS surcharge, it does not appear to have happened in practice yet. Perhaps the Minister can tell us when it will come into effect, because we are still hearing of healthcare workers being told by the Home Office that the surcharge is still payable and there is no guarantee of a refund.
In too many cases, the hostile environment continues despite all these warm words. Even in the middle of the pandemic, we see cases of NHS staff being told that they are no longer welcome. I have a constituent, Jessica Forsyth, an Australian national on a youth mobility visa. Her visa expires at the end of July and she has been told by UK Visas and Immigration that she cannot apply because she is deemed unskilled and earns below the £30,000 threshold, even though she is providing essential services to the NHS. She has made Scotland her home and built her life here, and I hope the Minister can help me to solicit the reply I am waiting for from the Home Office about her case.
It is clear that, while all this work has been taking place, we also have to ensure that we are planning for the next phase. We must learn the lessons and use the coming months to ensure that PPE is fully stockpiled, that supply lines are in place and that procedures are changed where necessary, so that as the second wave hits, there will be a vastly improved level of preparation. As we open up the health service to wider services, that must be done using an evidence-based, cautious and phased approach, for the sake of both staff and patients.
I think that many in the NHS and social care would echo the words of the declaration of Arbroath—it is not for glory, nor honours, nor riches that they fight. But that does not mean that they do not deserve them, and when all this is over we have to make sure that they are properly rewarded and recognised.
This debate comes at a particularly poignant time, when health and social care workers have been at the heart of the fight against coronavirus, working day and night to protect the NHS and save lives. They, and all the key workers who keep this country going, are the very best of us. I want to take this opportunity to once again pay tribute to the hundreds of NHS and social care staff who have lost their lives to the virus. I hope that when this is over, we can find an appropriate way to remember the frontline staff who gave their lives in the line of duty.
This was a heavily subscribed debate, and it was clear from every Member who spoke that the gratitude the whole country feels for our health and social care workers is replicated in this place. We had some superb speeches from Opposition Members, with good representation from Wales. My hon. Friend the Member for Merthyr Tydfil and Rhymney (Gerald Jones) spoke with typical eloquence and highlighted the wise decision of the Welsh Government to recognise the contribution of care workers. I hope that the Minister will be able to respond positively to my hon. Friend’s request, or at the very least confirm that she is making strong representations to the Treasury about the tax treatment of that payment. We heard a similar point from my hon. Friend the Member for Pontypridd (Alex Davies-Jones), who also reminded us of NHS Direct, which was a great innovation from the last Labour Government.
My hon. Friend the Member for Bethnal Green and Bow (Rushanara Ali) rightly said that staff need to be rewarded with more than just applause, and she drew attention through her strong speech to the sorry record we have seen over the last 10 years on the NHS. My hon. Friend the Member for Coventry South (Zarah Sultana) spoke with great passion and listed a whole series of ways in which the health workforce is hit with extra burdens in the course of their duties.
My hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare) drew attention to the scandal of nurses being forced to use food banks. That should shame us all. We also heard from my hon. Friend the Member for Hackney South and Shoreditch (Meg Hillier), who made the powerful point that medals do not put food on the table. She brilliantly highlighted how insecure work is a blight on the NHS and a systemic problem that needs addressing once and for all.
As we heard, even before the pandemic our frontline health and social care staff were working in overstretched and under-resourced settings. We must acknowledge that many of our frontline care workers have been in extremely stressful and sometimes traumatic situations as a result of covid-19—situations that those of us who have not been on the frontline cannot even begin to imagine. Working in these uncertain times, dealing with a new and emerging disease, often without adequate protection, while coping with losing patients and worrying about getting ill themselves or taking the virus home to their loved ones are all contributing factors to staff burn-out and poor mental health. It is vital that we keep them all safe in the event of a second wave.
Yesterday, following the Prime Minister’s announcement of the relaxation of the 2-metre rule and sweeping changes to the lockdown in England, health leaders called for a rapid and forward-looking assessment of how prepared the UK is for a new outbreak of the virus. Those health leaders from the Royal Colleges of Surgeons, of Nursing, of Physicians and of GPs say:
“the available evidence indicates that local flare-ups are increasingly likely and a second wave a real risk.”
They also point out:
“Many elements of the infrastructure needed to contain the virus are beginning to be put in place, but substantial challenges remain”,
and they call on the Government to focus on
“areas of weakness where action is needed urgently to prevent further loss of life”.
We cannot have any failures in preparation this time.
We may no longer be gathering outside our homes on a Thursday night to clap for our carers, but our admiration remains. It has been incredible to see the effort from staff in the last three months—staff who, too often, get very little in return. We hope that they are recognised for their true worth now.
Many of our NHS and care staff are exhausted and fearing burn-out. They need our support now, which means safe staffing ratios, adequate PPE and decent fair pay, because for them the hard work is not over—it is only just beginning. They will continue to give their all as they begin to tackle the backlog in non-covid care. The millions of routine operations, screening tests, treatments and therapies that were suspended or cancelled during the pandemic will now have to restart. Those challenges cannot be met without the staff.
As we know, there are well over 100,000 vacancies in the social care sector, and systemic insecure work and low pay are not the answer to resolving that issue. We know that prior to the covid-19 outbreak there were also 106,000 vacancies across the NHS, including 44,000 nurse vacancies. Those vacancies matter. They mean that NHS services were already under extreme pressure due to the ongoing staff shortages, before being further stretched by more shortages due to sickness or caring responsibilities during the pandemic. That, in turn, has put all healthcare staff under intolerable and unsustainable levels of pressure.
On top of those staff shortages, healthcare staff have had to work in unfamiliar circumstances or in clinical areas outside their usual practice, and of course they have had to work in very difficult circumstances. A survey by the Royal College of Nursing found that half of nursing staff felt under pressure to work without the levels of protective equipment set out in official guidance, and a survey by the British Medical Association of 7,000 doctors found that 45% were experiencing stress, exhaustion and burn-out. We need to listen to what the staff are telling us.
Just last week, we learned that student nurses who joined the frontline six months ago as part of the coronavirus effort are seeing their paid placement schemes terminated early, leaving them with no income and no guarantee that they will not face extra costs for completing their studies. That is no way to treat student nursing staff who have put their studies on hold to join the fight against coronavirus and who are at the start of what we hope will be a long career in the NHS. They deserve better.
The Government still have not quite resolved the issue of the immigration health surcharge, where NHS and social care staff coming from abroad and working on our frontline are required to pay a surcharge of hundreds and sometimes thousands of pounds just to use the NHS themselves. It was welcome that, after considerable pressure, the Government announced last month that the surcharge would be abolished, but, as we have heard, there are still reports of people being charged. I would like an update from the Minister about what is happening in respect of that.
In conclusion, no one hearing this debate would be in any doubt that our health and social care workers are appreciated, admired and respected, but warm words are not enough. A clap on Thursday night is not enough. It is time for action, and for the Government to finally recognise the monumental contribution that health and social care workers make. No more poverty pay. No more “work until you drop”. No more sending people into work inadequately protected from exposure to a deadly virus. That cannot happen again.
The Government were too slow to recognise the need for PPE, too slow to protect the social care sector, and now they are too slow to properly reward our brave health and social care workers, who have literally put their lives on the line for us all. It is time we put that right.
First, I will talk about pay, as that is the focus of the petitions. I want to reinforce that we have already delivered multi-year pay and contract reform deals for over 1 million NHS staff, in partnership with trade unions. In the past three years, nurses have seen their starting salaries increase by more than 12% and the vast majority of nurses have seen their pay increase by at least 6.5%, while the starting salaries for healthcare assistants have also increased by 16%. We have also increased pay for junior doctors to recognise the huge contribution that they make to our NHS. By the end of their four-year deal, junior doctor pay scales will have increased by at least 8%.
My hon. Friend the Member for Crewe and Nantwich (Dr Mullan) referred to the Government’s commitment to increase the number of doctors and nurses in the NHS, and he rightly said that recruitment and retention are not just about pay, but about experience. I am determined that we must improve the experience for the NHS workforce.
The shadow Minister spoke about vacancies in the NHS. I hope that he will welcome the good news that we heard today in the latest NHS workforce statistics that the number of nurses in England has gone up by more than 12,000 in the past year and we have over 6,000 more doctors. Compared with 2010, we now have 23,100 more doctors and 22,200 more nurses in the NHS. We want to recruit more, however, so we are providing financial support for nurses to train, and from this September, new and continuing nursing students will be able to get a maintenance grant of at least £5,000 per academic year.
Our social care staff have also played an incredible role during the pandemic. I am always blown away by the compassion that is shown by our care workers, who look after people who are at their most vulnerable. That was articulated so well this afternoon by my hon. Friends the Members for Peterborough (Paul Bristow), for Watford (Dean Russell), for Beaconsfield (Joy Morrissey) and for Rother Valley (Alexander Stafford) and many other colleagues.
Hon. Members will be aware that the Government do not set pay for social care workers in England. However, we are committed to raising the profile of our social care workforce and giving them the support they need. At a recent meeting of the Health and Social Care Committee, we heard from care workers about how some of them felt underappreciated by the public as a whole, and that is something we need to fix. After all, this is a job where staff have a chance to make a difference to people’s lives every single day that they go to work. As a start, we have adopted the CARE brand, for which I thank Care England. We have taken that on in order to build recognition of care workers.
Since the pandemic hit us, we have put in place support for care workers who have been at the frontline during this time. We are providing mental health support and bereavement support commissioned from Samaritans and Hospice UK. We have launched the care workforce app to bring together resources and guidance, and we are providing funding of £3.2 billion and then a further £600 million for local authorities to pass on to care providers so that they can provide full pay to staff who are isolating. We have made it clear to local authorities and providers that we expect that to happen.
One of the petitions that is in front of us today is entitled:
“We would like the government to consider social care as equally important to NHS”.
That is something that I passionately believe in. Social care is, absolutely, equally important. I know my colleagues in government agree. As we heard in this debate, that sentiment is shared by many hon. Members, and we rightly now talk about health and social care workers in the same breath.
In the months ahead, as we pledged in our manifesto, we will be looking at how we can build a long-term solution for social care, so that in the long term care workers get the rewards they deserve, and—as argued for by my hon. Friend the Member for Bolsover (Mark Fletcher), in particular—so that everyone can have the dignity and security that they deserve.
Finally, I want to raise the contribution of our overseas staff. The NHS has benefited from the contribution of so many people from all over the world. I would like to take a moment to thank all our overseas NHS staff. I know that this has been a difficult time for many of you, especially as we have learned that BAME communities have been disproportionately impacted by the virus. We are so grateful to you for your hard work, and I want the system to do all it can to protect you.
On 21 May, the Prime Minister announced that NHS and social care workers would now be exempt from the immigration health surcharge. NHS and care workers who paid the surcharge from 21 May will be refunded, and we are getting on with the arrangements as fast as we possibly can. We are also continuing to provide free visa extensions and auto renewal of visas for workers who are eligible, and we will be introducing a new fast-track healthcare visa to make it quicker and easier for health and care staff to come and work in our health and social care system.
Our NHS and social care workers do a truly wonderful job delivering world-class care to so many. I would like to thank everybody who signed the petitions for making their voice heard. I would like to end by encouraging everyone who is thinking about joining our health and care system to do so. Caring for others is one of the greatest and most important vocations. We will do everything in our power to protect and support health and social care workers during this pandemic and beyond.
I am disappointed with the Minister’s response. I do not think it fully acknowledged the question put by the petitioners that we do not yet have full recognition and reward for our health and social care workers in the way that we would like to see, but, as I said in my contribution at the beginning of the debate, I hope that this is the beginning of a conversation on how we can arrive at that point. I am sure that hon. Members will support that conversation continuing and action to follow. Above all, I want to put on record once again our gratitude, from this House and from the Petitions Committee, for the service that every health and social care worker has made to this country in the weeks that have passed and will continue to make in the weeks ahead.
Question put and agreed to.
Resolved,
That this House has considered e-petitions relating to the recognition and reward of health and social care workers.
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