Covid-19 has exposed weaknesses in public services and deepened inequalities
Poor pay and conditions in social care result in around one third of workers quitting within a year of starting, writes Baroness Armstrong. | PA Images
The House of Lords Public Services Committee has found failure in recent years to fund social care adequately and to integrate health and care services has had grave consequences during the pandemic.
“If it wasn’t for the support of my daughter, I wouldn’t have been able to cope.” That’s what Debra from Wigan told the House of Lords Public Services Committee during our inquiry into what the Covid-19 pandemic can teach us about reforming public services.
The inquiry has revealed serious weaknesses in our public services and our forthcoming report will set out how they can emerge stronger from this crisis.
Debra has cerebral palsy and even before lockdown was struggling to get the support she needed. Poor pay and conditions in social care result in around one third of workers quitting within a year of starting. Debra’s carers would often leave with little or no notice.
Failure in recent years to fund social care adequately and to integrate health and care services has had grave consequences during the pandemic.
The Association of Directors of Adult Social Care reported that discharging hospital patients into care settings without testing, and inadequate PPE for care staff, resulted in the deaths of thousands of older and disabled people. People like Debra felt particularly vulnerable. “I found a care agency that was prepared to come in but because they were visiting other residents who could have Covid-19, I was very worried for my own health, even for my life.”
Professor Sir Michael Marmot, the author of a major review of health inequality in England, told us how cuts to preventative services in the last decade meant that even before the pandemic our public services were fragile and struggling to cope with rising inequalities. It is unsurprising that the death rate from Covid-19 is high in our poorest areas.
Lord Woolley, founder of Operation Black Vote, told us how deprivation caused by structural racism and deep-seated inequalities in health had made black, Asian and minority ethnic people particularly vulnerable. In the first wave of the virus diabetes appeared on 21 per cent of death certificates where coronavirus was also mentioned. This proportion increased to 43 per cent among Asian people, and 45 per cent among black people.
Without additional support, these children are at risk of becoming a lost generation
Children’s Commissioner Anne Longfield told us that before Covid-19, more than 800,000 vulnerable children in England were “invisible” to social services. This situation has worsened during the pandemic, with struggling families pushed to the brink under the additional pressures of lockdown. Without additional support, these children are at risk of becoming a lost generation.
The committee heard that the government too often ignores local expertise. The Local Government Association said that the NHS didn’t give councils data they needed to identify the vulnerable. This lack of cooperation is particularly worrying now that we are seeing see more local lockdowns.
We heard positive stories too, from people like Shay who is recovering from alcohol addiction and volunteers now with the Revolving Doors charity supporting homeless people in Birmingham. “The help that they are getting has given them a start in life and a chance to get access to addiction services and support workers,” said Shay. But he warned that without continued support “the guys are coming back onto the streets.”
The Covid-19 crisis has shown what great work our public services can do under enormous pressure, innovation at local level and on the front line in response to the unprecedented demands of the pandemic. Local authorities have forged new partnerships with the voluntary sector to deliver services to vulnerable people.
Like Shay, I’m worried that if we don’t learn lessons now we won’t capitalise on this great work. It’s a challenge for all of us, including government, to ensure that advances are not undone.
It’s time to build something better.
Baroness Armstrong is a Labour member of the House of Lords and chair of the Public Services Committee.