Speaking to us at her office in Portcullis House in the heart of Westminster, Kendall was predictably scathing in her assessment of the government’s record on social care.
“We have had a decade of the government failing to deliver on funding with the rest of the system falling apart,” Kendall says. “One of the biggest problems we have seen is this very short-term, sticking plaster approach.”
The shadow minster for care and older people cites the example of the government’s £750 million Delayed Discharge Fund this winter as a glaring example of short termism.
“There are currently 130 fewer people in hospital because it came too late through the winter, Kendall says: “It didn’t tackle the root cause of the problem, which is staff shortages, and it failed to put the reforms in that we need to prevent people from going into hospital in the first place.
“More than half a million older and disabled people waiting to have their needs assessed in the first place – not even on a waiting list. They are going to end up in hospital because we have no long-term planning. When we were in government and I worked for the health secretary, our winter plans were done in September. They weren’t being announced in December. It’s a joke and it’s negligent.”
The shadow minister says tackling the 165,000 vacancies in social care is her “absolute priority”. “We have said we will have a new deal for care workers so that they get fair pay, training, terms and conditions, and career progression,” she notes.
The shadow minister says the sector needs to come together to negotiate a fair deal for its workers. She would not be drawn on a figure for a minimum care wage, however, commenting: “We have said on the Minimum Wage that we would change the remit of the Low Pay Commission so that it actually takes into consideration the Living Wage and we have said that social care is the priority in these new sectoral agreements. We will not make a commitment unless we can show how we will pay for it.”
The shadow care minister calls for a “much more joined up approach with the NHS” on recruitment and retention.
“The Health Foundation has shown using Skills for Care data that one in ten people who leave care go to hospitality and retail, and one in three go and work for the NHS,” she says. “So it’s absolutely crazy to be treating the NHS workforce as totally separate from the care workforce.”
If you have a situation where we are struggling to get people to work in social care and the NHS is struggling to get people out of hospital but a third of social care workers are going to work there, the days of looking at them separately are long gone.
When asked if there should be pay parity with the NHS, Kendall says the two sectors need to be looked at together. “If you have a situation where we are struggling to get people to work in social care and the NHS is struggling to get people out of hospital but a third of social care workers are going to work there, the days of looking at them separately are long gone,” Kendall comments. “It’s not going to be the same because you are not employed by the NHS and you are not on Agenda for Change NHS grading and pay system, but I do think we have got to start looking at the two systems together.”
Taking pay out of the equation, we ask Kendall if the NHS and social care should be given parity in terms and conditions. “I understand why you want me to say that but I am saying there is a negotiation to take place,” she counters.
“That isn’t a way of avoiding the question, it’s a way of answering the question because that is the only way we are going to make progress. I believe many providers want to see a different approach. The good ones feel undermined by the poor providers. They are desperate to hold onto staff that the NHS can pay more to.”
Kendall says social care needs a 10- year plan with a National Care Service among the key reforms being explored by Labour.
Shadow health minister Wes Streeting last year commissioned the Fabian Society to launch a review of how a National Care Service would work.
Plans for a National Care Service in Scotland have faced widespread opposition with the SNP being accused of a “power grab” and implementing a “nanny state”, so what would Labour’s reform look like?
“If what you mean by a National Care Service is something run by a man in Whitehall, as that’s who it usually is, or by the NHS, that’s not what we want,” Kendall explains.
“What we want is clearer national pay and conditions for staff, national eligibility criteria rights for users and families, and for it not to be run centrally because it won’t work.”
Kendall is a devout devolutionist when it comes to social care reform. She says the devolution of powers on social care had to go even further than the local council and be dictated by the individual service user and their families.
“People want control over their lives,” Kendall argued. “The council may say ‘we can put you in touch with a befriending service’ but they want to see their friends. They need a personal assistant who can help them get out the house to see their actual friends.”
Kendall said she was a “big champion of direct and personal budgets when they are run properly”.
“The people who use care and support are the ones who know best how to reform it,” Kendall argues. “My job as a politician is to say how do I give them more power and control? How do I win power in order to give it away?”
The shadow minister says she’s not in favour of means-tested budgets for individuals stressing the idea should be about giving people “power and control over the money and how to best meet their needs”.
“Direct payments and personal budgets already exist but ended up being a tick-box exercise where people say this is what’s on offer what do you want?” Kendall says. “How do you reshape what’s on offer locally? Can we expand services? Can we make them more effective?”
Kendall also wants to see more devolution to service users in regulation, commissioning and even social care staff training.
“I’d like to see users and families having a far greater say over the regulatory process to make sure that their views are actively sought out and taken into account,” the shadow minister says. “Families are the eyes and ears of the system. It’s been a real problem during Covid. I still hear terrible things. I have done a lot of work with Rights for Residents and The Residents & Relatives Association and we are still having situations where families are being prevented from seeing their loved ones. We had one case where a lady had gone into a home and found her dad’s hair had all been shaved off. Why? I want to look at how users and families views are fed much more directly into the system.”
On training, Kendall says one of the best examples of service user empowerment she’s ever seen was a university that involved people living with dementia and their families in nurse training.
“The nurses had never seen anyone with really bad dementia,” Kendall explains. “They didn’t know what the families wanted." “How do we change commissioning and training so that people who use care and support are more in the driving seat of change? That’s real reform and that’s what I hope we will deliver.”
While Streeting has said a National Care Service should be inspired by the model of the NHS, Kendall is quick to scotch any idea of free universal social care. “It’s not about saying it’s free at the point of use and it’s all nationalised and centrally run,” she emphasises.
“This is about a vision where people know what they are entitled to, the standards of care that they get, and the staff know they have fair pay terms and conditions. My adult social care director in Leicester is telling me I don’t need to buy care home beds, what I need is care in the community at home. You have got to have locally determined care by your local council which is developed by local users and families. I believe that care and support has to be determined locally. The health needs of my population are different from Surrey and Sussex.”
Labour has also said it would give a National Care Service powers to crack down on private equity providers failing to provide good standards of care.
“Providers that are providing poor standards of care have got to change,” Kendall says. “We also want to see requirements in terms of open book accounting for some of the very large private equity firms. We want there to be greater transparency there in terms of public funding that’s going into the system. We have seen difficulties with providers collapsing. We need to relook at that to make sure where public funds are going and for self-funders to make sure that patients and families get what they want, as well as ensuring the taxpayer gets good value for money.”
Kendall refuses to be drawn on where the money will come from to fund Labour’s 10-year vision.
“I’m not going to make any pledge that I can’t guarantee I can deliver,” she says. “As a politician, I have had 10 years of a promise of a cap on care costs by government that’s not been delivered. We will only make a commitment if we can show how we pay for it.”
The shadow minister says she doesn’t want to see people lose their savings to pay for their care, but isn’t more specific on a long-term sustainable funding system for the sector, while at the same time ruling out insurance payments.
“I don’t think that people should have to see their whole life’s savings wiped out because they are unlucky enough to need substantial amounts of care for dementia,” the shadow minster stresses. “That isn’t what happens if they are unlucky enough to get a terrible disease like cancer.
“We understand that people want to see where the investment is coming from,” Kendall adds. “Any commitments we make, we will show how we pay for them just as we have done on the NHS workforce where we’ve said we will pay for it by scrapping non-dom tax status. I understand that people want extra investment into social care and we will set out more plans as we get closer to the next election. I think my job at the moment is to make the argument for a different way of doing reform because quite frankly the government of the last 10 years has not delivered. I think it’s about time for something different.”
It appears we will just have to be patient for more details on what that “something different” is.