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Social Care: Adults

Volume 697: debated on Wednesday 12 December 2007

asked Her Majesty’s Government:

How the new social care reform concordat will affect the provision of adult social care, especially in areas where provision is currently inadequate.

My Lords, Putting People First is a cross-sector concordat—perhaps I should say agreement—setting out common aims and values to guide central and local government and other stakeholders in modernising social care. It commits to enabling people to live independently within their communities, maintaining as much choice and control as possible. It will empower citizens to shape their own lives and the services they receive. It does not seek to establish a uniform system across the country. By supporting responsive systems focused on outcomes for individuals it allows for shifts in local resources and priorities.

My Lords, I thank my noble friend for that very positive answer. This concordat probably marks an important shift in recognising that social care is as important as healthcare in the life of our nation. However, does she have any anxieties about the take-up of personal budgets under this new scheme given the rather disappointing response to some previous direct payment initiatives and the fact that many people, especially older people, are reluctant to use them?

My Lords, my noble friend is probably right that this marks a new beginning for social care in this country. I hope that, henceforth, it will be seen as an equal partner to the health service. The take-up of direct payments has been difficult to date although, this year, there has been an ongoing campaign and we are seeing improvement. But I have much more confidence in this system for the future because the move to greater personalisation will include everyone who is eligible for statutory support and they will all be given a personal budget. They will need advocates on their behalf, and there will be some anxiety, but I am confident that this is the best way forward to ensure that people have the independence and the dignity that they deserve.

My Lords, is the noble Baroness aware that disabled and elderly people frequently have difficulty enough in managing their own lives and that they will require a great deal of help to deal with the bureaucracy of employing carers directly? What can be done to make it easier for them to take on the responsibility of employing someone with the money which they are presumably to get?

My Lords, there are two things. As I said, we have to ensure that those receiving direct payments have access to advocacy and support—the sort of support which the noble Lord is suggesting will be necessary. If individuals so wish, their pot of money can be retained for the local council and they can ask it to act on their behalf. Therefore they will not be totally alone. They will indeed have the necessary support.

My Lords, does the noble Baroness accept that many of these services will be delivered by the voluntary sector and that this agreement surely will look at contracts, whereas the difficulty in the voluntary sector is short-termism in contracts and the need to deliver quality services when voluntary organisations have to be an employer and must be able to see ahead in terms of their budgets? Does she accept that that needs to be central to the concordat?

Yes, my Lords; that is one of the very important issues that should result from the concordat. We must ensure that the voluntary sector is an equal partner as we work to provide social care for people in the community. That must mean that we commission better and pay much more attention to contracts and the length of contracts to ensure that those working in the voluntary sector have more stability to enable them to deliver better services.

My Lords, many vulnerable people do not have so-called critical needs for social care, but will the Minster ensure on behalf of the Government that their lighter needs are urgently met? I hope she will agree that such care is a very sound investment which often prevents the need for intensive and much more costly care at a later stage in their lives.

Yes, my Lords; part of this policy is a recognition that if we invest more in social services, we will ultimately have to pay less for healthcare. It is an important move forward. The policy also recognises for the first time that even those who are not entitled to benefits or money from social services will have access to information on the services available so that they can make better decisions about what is available—safe care.

My Lords, do the Government accept that those with severe intellectual impairment are not capable of taking decisions about living independently within their communities? Will the new concordat respect the Government’s laudable commitment to put family carers, especially of those with severe intellectual impairment, at the heart of decision-making about their relatives’ accommodation, healthcare and social care? They simply will not be able to do that on their own and they will not be able to choose the people to take their decisions for them.

My Lords, carers and family carers are at the heart of this policy. All the individuals we are speaking about have, and will need, carers. The policy is therefore as much about carers as about the individuals concerned.

My Lords, the £520 million is available over the next three years. It is to be given to local councils to assist them in reforming the system. It is not there for individuals who are in receipt of social services, but to help transform the system so that ultimately it can transform the lives of these many people, so that we can meet the huge challenges that we know need to be met.