WALES’ largest trade union has called for the next Welsh Government to set up a National Care Service within the next five years.
UNISON made its call after an opinion poll of people living in Wales showed overwhelming support for a range of measures to improve the quality and consistency of care in our nation.
The poll also showed massive public backing for an increase in carers’ pay to reflect both social carers’ contribution during the pandemic and recognising the core role they play in people’s lives.
The Savanta/Com Res poll showed 72 per cent of the Welsh public would support creating a National Care Service, similar to the NHS, to deliver social care for older, disabled and vulnerable people.
The poll, commissioned by UNISON, also found 90 per cent of the public believe Wales’ care workforce, who are largely female, should be paid at least £9.50 per hour. £9.50 per hour is the level set by the Independent Living Wage Foundation.
Typically, care workers in Wales earn only the national minimum wage, which increased on 1 April to £8.91 per hour.
SOCIAL CARE UNDERFUNDED
UNISON has prioritised establishing a National Care Service for Wales in its campaigning ahead of the Senedd elections in May. It describes the care sector as being in crisis.
The trade union says social care was in a precarious position before Covid due to chronic underfunding and workforce shortages.
The pandemic highlighted many more problems, including failure in the supply and distribution of personal protective equipment at the start of the pandemic; a lack of availability of testing; a devastating death rate in residential care and some employers’ refusal to pay sick pay when workers were isolating or had tested positive for Covid.
UNISON says only a National Care Service for Wales could bring the coordination and investment required to improve standards for care workers and clients.
Pat Jones, a care worker, responded to the poll’s findings: “It’s no surprise Welsh people overwhelmingly want to boost the wages of care workers and create a national care service.
“Covid revealed to people for the first time how many carer workers struggle with in-work poverty because of the very low wages paid.
“It struck a chord with people that if we are providing a vital service caring for loved ones, there should be much more investment in us and high-quality care.”
CARE ON THE CHEAP
UNISON Cymru Wales regional secretary, Karen Loughlin, said: “People are waking up to the fact the UK has a care service ‘on the cheap’, where thousands of mainly female care workers are deprived of the fair wages they deserve and struggle to make ends meet.
“Care workers in the private sector generally receive little or no sick pay, and the enhancements for unsocial hours working are much lower than if they were employed directly by councils.
“Care workers aren’t valued in the same way as NHS staff, and there must be a complete overhaul of the care sector. UNISON is calling for a National Care Service for Wales which puts dignity and respect for clients and staff at its heart.”
The Herald spoke to Dominic MacAskill, UNISON’s local government manager, about UNISON’s aims for Wales’ social care sector.
He told us that reform of social care provision in Wales must be a priority for any incoming Welsh Government.
Dominic MacAskill, of UNISON, underlines priority for social care reform
“Change must come within the term of the next Welsh Government.
“The new Welsh Government must set industry standards for employment, procurement, and consistency in the quantity and quality of social care across Wales.”
THE RACE TO THE BOTTOM
The change UNISON want would be sweeping, and we asked whether the union envisaged a separate organisational structure.
Mr MacAskill said that UNISON’s National Care Service would not be a separate organisation employing care workers but a Welsh Government sponsored body on a statutory footing.
He continued: “We believe most social care should rest within local government and come under the local government budget.
“Twenty-five years ago, councils provided most elements of social care with a few exceptions for specialist facilities.
“Now, there is a more fragmented picture. Local authorities were encouraged to outsource social care. That means there’s been a race to the bottom to deliver an essential service on the cheap.
“The majority of carers are paid at or barely above the National Minimum Wage.”
Part of what Mr MacAskill told us finds an echo in current private residential care providers’ concerns.
Separate councils each set their own budgets and decide how much they are prepared to pay private companies to deliver social care within their local authority areas.
That means that different councils pay different rates to private residential homes. For instance, care providers in the Vale of Glamorgan get a different rate than care providers in Pembrokeshire for delivering the same care to – supposedly – the same standard.
In North Wales, most councils pay private residential care homes considerably less than those in South Wales.
The resulting imbalance in the system means that care homes have to cut their other costs to make ends meet in areas where social care’s funding is low. And that, in turn, drives down pay and makes it hard to attract experienced and qualified staff into social care.
BRINGING CARE BACK IN HOUSE
As private providers have a significant role in delivering social care, we asked their role.
“We want to see social care’s provision by councils. Creating statutory minimum standards for care, professional development, and employment would organically return social care to where it should be: under local government’s direct control.
“The fragmentation of current social care must stop. Social care must be more closely integrate with health care.”
Mr MacAskill continued: “One of the reasons we think a separate body would not work is that health boards are involved in the professional health element of social care’s delivery. The NHS is closely involved in the packaging of care. A separate body would potentially create more confusion in the system.”
WHERE’S THE MONEY?
We asked Dominic MacAskill how would UNISON’S ambitions be funded.
He told us: “Money has to come from additional resources from the Welsh Government. It is its responsibility to set standards and ensure services are appropriately funded. Local government services need investment, and social care must be a priority for investment.
“Part of the solution must be a fairer funding formula for the Welsh Government. The current one doesn’t work as it doesn’t take account of need and the make-up of Wales’ ageing population.
“However, the Welsh Government already has some fiscal powers to raise the money needed to fund this essential change. Nobody is proposing to use those powers when considering social care, however.
“At the end of the day, it’s a question of priorities. The last year has shown how important social care is and how much we all rely upon it.
“We’ve all got a stake in seeing social care improve. That means making social care a more attractive, better-paid career. The social care workforce is ageing and needs to be refreshed with younger entrants with clear professional development opportunities.
“There are mechanisms available to increase the pot available for social care and to re-prioritise the existing pot to reach UNISON’s goal.
“As a union, we expect this to be the number one priority for the new Welsh Government after May 6.”
PLAID PLEDGES ACTION ON CARE
Launching his Party’s policy on social care, Plaid leader Adam Price said: “One of my first acts as First Minister leading a Plaid Cymru government would be to establish a Commission to explore ways in which we could source extra money to fund the creation of a seamless Health and Social Care Service, free at the point of need.
“The Commission would report within a year and consider Plaid Cymru’s preferred option of using general taxation and a levy-based Social Care Fund along the lines suggested by economist Gerald Holtham.
“A new National Health and Care Service would ensure the seamless integration of delivery on a local level, bringing together local government and health boards in new Regional Care Partnerships.
“Care assessment processes should and would focus on identifying personal care need, rather than the arbitrary definitions of ‘health’ or ‘social’ care.
“For the new Service to be a success, it must work for the carers as well as the cared for.
“This is why a Plaid government would also invest in the range and quality of care in the community by increasing the number of district nurses and nurses with a community masters’ degree and increasing nursing students’ placements in care homes alongside the development of career pathways in care for Older People and dementia care.
“We have also set out plans to bring care workers’ pay progressively into line with those of NHS staff, starting with making a £10 minimum wage mandatory for care workers.”
We invited Labour to respond to the poll and UNISON’s comments regarding its findings. However, the Party failed to either acknowledge or respond to our enquiry.
The Conservatives declined to comment ahead of their Manifesto launch, which the Party delayed following Prince Philip’s death.
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