I pay tribute to everyone working in health and social care and to unpaid family carers. All of them have gone above and beyond in their caring roles during the pandemic. The Government’s response to that could have been to give NHS staff a proper pay rise, to publish plans to put social care on a sustainable financial footing, or to recognise fully the tremendous contribution made by unpaid carers. Instead we have this Bill, and a top-down reorganisation of the NHS that will concentrate power in the hands of the Secretary of State, offering no guarantees of better outcomes for patients and removing rights from carers.
It is welcome that the Bill brings an end to every NHS contract having to be put out to tender and that some changes in the Bill reference unpaid carers, but further changes are needed. Change is needed to put a duty on the NHS to have regard to carers and to promote their health and wellbeing.
It is welcome that the Bill includes a duty on both NHS England and the integrated care boards to consult carers, but rather than just involve and consult them in relation to patients, the duty that is needed is for the NHS to consider carers in their own right, as proposed by the Health and Social Care Committee in its report.
It is worrying that the Bill undermines carers’ rights in relation to hospital discharge. Clause 78 removes carers’ fundamental rights by removing the need to assess a patient at the point of hospital discharge. The way that is done removes carers’ fundamental right to have an assessment to ensure services are provided to make sure the patient is safe to discharge into their care. This is an issue, as Carers UK quotes research showing that only 26% of carers were consulted about discharge and that a third were consulted only at the last minute.
The Bill proposes to extend the Care Quality Commission’s remit to cover the delivery of social care services. However, that excludes social care provided through NHS continuing healthcare. The Parliamentary and Health Service Ombudsman found last year that people continue to be seriously let down by failings in how continuing healthcare is delivered. I ask the Minister to agree with the Continuing Healthcare Alliance that there should be an additional duty on the CQC to assess integrated care systems’ delivery of their continuing healthcare duties and to hold them to account where these duties are not being met.
The Care Quality Commission will have a remit to rate local authorities’ delivery of social care, but when £9 billion has been taken out of social care budgets and long-term reform is consistently delayed, the Government should recognise that inadequate social care services are a problem of their own making.
Finally, I question the timing of the Bill. Staff are exhausted and are facing another wave of covid infections over the summer. I urge the Secretary of State to recognise that and adjust the timeframes for implementing these reforms so that they do not end up distracting from the NHS’s real job of caring for patients.