Skip to main content

Health: National Care Service

Volume 718: debated on Tuesday 30 March 2010


My right honourable friend the Secretary of State for Health (Andy Burnham) has made the following Written Ministerial Statement.

Today the Government are laying before Parliament the White Paper, Building the National Care Service (Cm 7854).

We have listened to the views of the public and stakeholders through the 2008 engagement process and the 2009 Big Care Debate. The Big Care Debate received over 28,000 direct responses, with more than 40,000 people contributing to the debate through further research or events organised by stakeholders. The consultation showed that there was strong support for our vision of a National Care Service and whilst there was no clear consensus on funding, the comprehensive option was the most preferred. Today we have published an independent summary of the consultation alongside the White Paper and placed a copy in the Library.

We also held a care and support conference last month with the Care and Support Alliance and other key stakeholders. They urged us to push forward with reform and favoured the comprehensive option.

We believe the time has come to build a comprehensive National Care Service. This will be for all adults in England with an eligible care need, providing free care when they need it—whoever they are, wherever they live in England, and whatever condition leads them to need care. It will give everyone the peace of mind that they and their families will be cared for should the need arise, and it will mean that no one need live in fear of losing their home or their savings to pay for care.

The Government’s vision is for a National Care Service that gives people choice and control, and is focused on keeping people well and independent. It will ensure that different parts of the system work better together, with a new duty for NHS bodies and local authorities to deliver integrated care.

Millions of people care for a family member or friend. This is the hallmark of a civilised society. But we must do more to give support to those who provide such care. Building on the carers’ strategy, the National Care Service will support those caring for others by improving the quality of formal care, and working with employers and Job Centre Plus, to help carers to live the life they want to live.

We recognise that building the new National Care Service will be one of the biggest changes to the welfare state since the creation of the NHS. We are also creating it during a period of fiscal consolidation. Reform to social care must be consistent with our plans for fiscal consolidation and reflect the tough decisions that will need to be made in the next spending review. This means we need to build the new service in stages.

The first stage is to create a step change in the provision of services in the home and in our communities. These services are essential if we are to ensure that more people are supported in their homes. Central to this is the Personal Care at Home Bill, to be implemented in 2011, enabling us to provide free personal care for people in their own home for those with the highest needs. The first stage of reform will also see reablement services available in every community, ensuring that there is a service by which people are supported to regain their independence and confidence when they need home care for the first time. As part of the first stage we will push forward with existing reforms that are already delivering real benefits for people such as the dementia strategy, the carers’ strategy and Putting People First.

The second stage of reform, during the next Parliament, will be to put in place the building blocks of a national system of care and support, in particular the establishment of clear, national standards and entitlements. We will introduce a National Care Service Bill early in the next Parliament as a major step forward. From 2014, care entitlements will be extended meaning that anyone staying in residential care for more than two years will receive free care after the second year. The first and second stages together will mean that the most vulnerable in our society, those with the highest needs, will be protected from very high care costs and that many more people will be supported in their own homes.

During the next Parliament, we will take further steps towards the full reform of the system—moving towards the third stage in which the comprehensive National Care Service becomes a reality, with care free when people need it.

To do this will require everyone to contribute through a fair care contribution. So at the start of the next Parliament, we will establish a commission to help to reach consensus on the right way of funding the system. The commission will determine the fairest and most sustainable way for people to contribute. It will make recommendations to Ministers which, if accepted, will be implemented in the Parliament after next. The commission will determine the options that should be open to people so that they have choice and flexibility about how to pay their care contribution. Our expectation is that the commission will consider all the various options for payment put forward by stakeholders and the public as part of the Big Care Debate and at the Care and Support Conference.

Building the National Care Service (Cm 7854) is in the Library and copies are available to honourable Members from the Vote Office.