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Social Care: Green Paper

Volume 797: debated on Monday 13 May 2019


Asked by

To ask Her Majesty’s Government what assessment they have made of the costs and effects of the delay in publishing their green paper on social care.

My Lords, the Green Paper remains a priority for the Government, and we will publish it at the earliest opportunity. Despite the delay in publication, the Government are committed to improving adult social care. We recently launched our social care recruitment campaign, Every Day is Different, and continue to support the sector by distributing £12 million a year through the workforce development fund. The Government have also given councils access to up to £3.9 billion of funding for social care for 2019-20.

My Lords, the Green Paper was first promised in 2017, when the Government said that,

“we cannot wait any longer—we need to get on with this”,—[Official Report, 6/7/17; col. 987.]

and pledged to publish by the end of that year. I remind the House that this was a year after they abandoned the Dilnot provisions on future care funding, which had cross-party support under the Care Act and were due to start in 2016. The Alzheimer’s Society has estimated that, over the past 26 months, there have been more than half a million delayed transfers of care for people affected by dementia; nearly 3 billion hours of unpaid care have been provided; and, at any one point, more than 120,000 people with dementia in England receive no help from social care or family carers. Emergency cash injections do not address the chronic underfunding of local services, change the eligibility criteria or help people plan for future care needs. When we finally get the Green Paper, can the Minister promise the House that it will address these issues and provide the major, immediate and long-term funding that is urgently needed?

I thank the noble Baroness for an extremely important question. I know that she will agree that decisions on future reforms must be aligned. That is precisely why the long-term plan and the upcoming social care Green Paper have been considered alongside each other. Some important measures within the long-term plan are already beginning to improve social care; for example, the enhanced health in care homes model, which will ensure stronger links between primary care networks and local care homes; the comprehensive model for personalised care, which will put the individual at the centre of services; and personal health budgets. However, the noble Baroness is also right that we have to make sure that we get funding reform right—that is why we have increased funding from £3.6 billion in 2018-19 to £3.9 billion in 2019-20. She is also right that we must ensure that we build on the carers action plan and put carers at the heart of social care. Finally, we must ensure that we recruit, retain and build on workforce development at the heart of the social care Green Paper. That is what we will do, and I look forward to the debates in this House when we bring it forward.

My Lords, is my noble friend aware that the Economic Affairs Committee is conducting an inquiry at the moment into social care? One of the manifestly obvious conclusions is that we will not be able to address this important issue unless we are able to get a degree of consensus between the Opposition and the Government? Would it not be a good idea for the Opposition to take a constructive approach when the Green Paper is published?

I think that the noble Lord speaks for the whole House when he calls for consensus on social care. One reason why it is taking slightly longer to bring forward the plan is that we are doing a lot of work on consultation and collaboration to ensure that we produce a robust proposal which can command the support of the House and be delivered effectively and implemented well. The Government are committed to ensuring that everyone has access to the care and support they need, but we need to be clear that there should continue to be a principle of shared responsibility and that people should expect to contribute to their care as part of preparing for later life. The Green Paper will bring forward ideas for including an element of risk pooling in the system to help protect people from the highest costs. We look forward to support from the Opposition on those proposals.

My Lords, in 2009 there was a proposal that we should all work together, cross-party, for social care, started by the then Labour Government. All three major parties signed up to it, and then one party withdrew, making it undeliverable—it was neither the Labour Party nor the Liberal Democrats. The Minister said all the warm words that we want to hear about support for health and social care integration, but the new Health for Care coalition of 19 major health organisations is very clear that, while it is doing all it can for social care services and the NHS working together, and integration is improving, it can go only so far when services are being placed under so much strain. It points out that we would need an annual increase of 3.9% to meet the needs of an ageing population and an increasing number of younger adults. Seven hundred days since the social care paper was first promised is too long: when will it actually be delivered?

I share the noble Baroness’s impatience for progress on this. She is absolutely right that there is no point in bringing forward the proposals if they are not properly costed and funded. That is exactly why these proposals have been developed in collaboration with the long-term plan and the social care plan. We have to ensure that the right funding for social care is agreed alongside the rest of the local government settlement at the forthcoming spending review. That is partly why this process is taking the route that it is.

My Lords, I feel sure that the noble Baroness will agree that this has become an embarrassingly long-running saga. I am sure the whole House will agree that the people who depend upon these services are the most vulnerable in our society and have such high-dependency needs that they ought to have the security of knowing that their well-being and safety is being properly attended to. Will the noble Baroness use all her influence to make sure that these people get the security and peace of mind that they deserve?

I am absolutely delighted to offer the noble Lord my assurance that we will work as hard as we can to deliver the most effective and most deliverable Green Paper we can. He is absolutely right that the most vulnerable people within our society depend on the effectiveness not only of social care services but the integration of social care services with our public health services and the long-term plan. That is why it is encouraging that social care sits right at the heart of the long-term plan and why it is well integrated with the other commitments within the plan to improve outcomes for major diseases and including measures to support older people, through more personalised care and stronger community and primary care services. These will improve outcomes and reduce the demand on social care, and that is exactly the kind of holistic approach that we want to see.