Ask Barbara Keeley what keeps her awake at night and Labour’s shadow cabinet member for mental health and social care will tell you it’s the stories of people in “heartrending” situations whose care is being cut.
She cites the case of a man in his 80s who has been told the NHS continuing care he has received for the past six years will stop; the two paid carers will be gone, with the expectation that his wife, also in her 80s, will look after a husband who is completely immobile, incontinent, and cannot communicate or eat or drink without help. Keeley fears that such scenarios are set to increase if the funding shortfall in adult social care continues because councils and clinical commissioning groups (CCGs) “can really only get into rationing now”.
“If you are a council, if you are a CCG, looking at paying NHS continuing care and you have to make cuts this year – quite a lot of councils have to make cuts this year – you are going to have to cut the care of people who are already receiving it, and that is tragic.” Adult social care has risen up the political agenda after years of consecutive austerity cuts coupled with rising demand for services. Myriad warnings from a slew of organisations have been issued about growing levels of unmet need, struggling social care providers and the additional strain placed on NHS services and informal carers.
Last week, the Association of Directors of Adult Social Services called for emergency government funding of £1bn for 2017-18 to stabilise a care market on the edge of collapse. The Local Government Association, meanwhile, warned that severe underfunding was putting councils at risk of not being able to provide the help older and disabled people need with basic tasks – as stipulated in the 2014 Care Act. Not surprisingly, Keeley says much of her focus since taking up the post five months ago has been on adult social care.
The government needs to bring forward £700m of social care money earmarked for 2019-20 to fund home or residential care, Keeley argues, so that older people aren’t kept in hospital unnecessarily. “They’ve allocated the funding, so they should bring it forward – because the crisis is now,” she says.
This doesn’t sound enough, however, given the scale of the funding shortfall identified by town halls and health charities. Where else could money be found? She points to surpluses identified by the trade union Unison in unallocated business rates. A rise in national insurance also springs to mind. Keeley makes no mention, though, of Labour leader Jeremy Corbyn’s suggestion that Theresa May scrap a planned corporation tax cut in April – and fund social care instead.
Try to discuss future sources of funding and Keeley will tell you that she and shadow cabinet colleagues are working on this now. But Keeley is clear that she wants Labour to work out its own long-term solutions, rather than taking a cross-party approach. Corbyn has already promised to take “failed private care homes” into public ownership – a move Keeley says refers to taking over care homes that go into insolvency to protect capacity. Ultimately, her ambition is to make social care free at the point of delivery.
“The current situation just provides a lot of problems,” says Keeley. “What we were proposing at the last general election was that certainly end of life care should be free. You shouldn’t have to get into battles in the last few months of life about NHS continuing care and what’s paid for and what’s not.“We need to be looking at a situation where if we integrate health and social care, we don’t get into all these charging issues that we do now.”
With councils short of options, Tory-led Surrey has announced a local referendum on a 15% rise in council tax, blaming cuts and the demand for services. It’s a brave move, says Keeley, MP for Worsley and Eccles South in Greater Manchester, but she believes forcing councils to plug the shortfall through a tax on local property values rather than on the basis of need is not the way to tackle the issue. “It clearly isn’t fair to create an even bigger postcode lottery where the level of service you can get depends on where you live,” she says.
Junior health minister David Mowat said last week that people with elderly parents had a responsibility to look after them, just as parents do their children. Keeley retorts that one million people over 65 don’t have children; moreover, three million family members in the UK are already juggling work and caring responsibilities, she says, with the peak age for caring being the 50-64 age bracket. “If you’re saying that caring is the responsibility of individuals in families, you have to think through how they are meant to juggle work with that.”
She is currently discussing the scope for carers to be included in Labour’s industrial strategy. Carers’ leave, for example, would give people flexibility to take time off work at times of crisis.
Keeley worked as an adviser to a carers’ charity after leaving behind a career in systems engineering, and found that family carers did not tend to raise their own needs and concerns. Her vision for social care involves looking after the needs of both unpaid family carers and paid care workers, through better support, information and recognition for the former – and better pay, terms and conditions for the latter. She cites zero hours contracts, staff not being paid for travel times and the appalling pressure some are being put under to make shorter visits. “Yesterday someone showed me a time sheet for a care worker who was given three visits at 8pm in three separate locations.”
Keeley served as shadow minister for older people, social care and carers for ten months before being among the exodus of shadow ministers who quit in a coup against Corbyn last June. In her resignation letter, she raised the need to present the “strongest opposition we can against further Tory cuts to social care … I am deeply concerned that the current state of the party means we will not be able to mount an effective front bench opposition to the Tories in parliament in the future”. By October, she was back and promoted to the shadow cabinet role. What prompted her return? “I was asked for one thing,” she says. “To do a job at shadow cabinet level where I can help carve out policy – and that is really important.”
Family: Married, no children.
Education: Mount St Mary’s college, Leeds; University of Salford, BA in politics and contemporary history.
Career: October 2016 to present: shadow cabinet member, mental health and social care; September 2015 to June 2016: shadow minister for older people, social care and carers; May to September 2015: shadow financial secretary to the Treasury; October 2010 to October 2011: shadow communities and local government minister; 2011-15: House of Commons health select committee; May 2010 to October 2010: shadow health minister and shadow deputy leader of the House of Commons; 2009 to May 2010: deputy leader of the House of Commons; September 2008 to May 2009: assistant government whip; 2007-08: PPS to Harriet Harman, minister for women and equality; 2007, appointed by Gordon Brown to lead the Labour party’s manifesto work on social care; 2006-07: PPS to Jim Murphy MP, Department of Work and Pensions; May 2005 to present: Labour MP for Worsley (Eccles South added in 2010); 1990-94 and 1995-2001: adviser, community regeneration projects across Greater Manchester; 2001-05: consultant, Princess Royal Trust for Carers; 1987-89 systems engineering manager, IBM; 1982-87: systems engineer.
Public life: co-chair (with Baroness Grey-Thompson) of the All-Party Parliamentary Group for Women’s Sport and Fitness; 2007-08: chair, Women’s Parliamentary Labour Party 2007-09 vice chair, All Parliamentary Group on Carers; 1995-2004 councillor, Trafford council and cabinet member for education and services for children and young people.
Awards: 2008 Charity Champions Social Welfare Award for helping to make sure carers’ voices are heard in parliament.