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Social Care: Free Personal Care

Volume 798: debated on Wednesday 26 June 2019


Asked by

To ask Her Majesty’s Government what assessment they have made of the Institute for Public Policy Research’s report Social care: Free at the point of need—the case for free personal care in England, published on 23 May, and whether this matter will be addressed in the forthcoming Social Care Green Paper.

My Lords, we welcome the contributions made by recent reports on how social care should be funded in future, including the report by the IPPR. The Green Paper will bring forward ideas for including an element of risk pooling to help protect people from high and unpredictable costs. This Government are committed to ensuring that everyone has access to the care and support they need, and we are clear that people should continue to expect to contribute to their care.

I thank the Minister. Age UK estimates that more than 1 million older people have died in the past two years either waiting for a care package or having been turned down and that nearly 1.3 million people have an unmet need for basic care support, such as washing, dressing and going to the toilet. Macmillan research shows that 8% of people living with cancer who have critical or substantial needs and who should qualify for council support receive no practical help at all and that 60% of their carers experience stress, anxiety and depression. I hope that when she responds the Minister will not just repeat the Government’s stock answer on so-called extra funding. The King’s Fund, the Nuffield Trust and the Health Foundation have independently identified the huge scale of government local authority social care cuts and the £2.5 billion investment needed just to keep the current system going. May I once again ask the Minister for news of the Green Paper? When is it going to be published? What is holding it up? The IPPR shows that free personal care would treble the number of older people with access to state-funded care, improve their health and well-being and save billions of pounds in hospital costs. Surely it is one of the key options for solving the current care crisis.

I thank the noble Baroness for an important question. She is absolutely right that the Green Paper must be a priority. It will set out our sustainable plans for reform. We have welcomed the contributions that have been made by a number of recent reports. The noble Baroness rightly pointed to the IPPR, the Joint Select Committees, the Health Foundation, the King’s Fund and the Resolution Foundation. They have made some important proposals which are being considered as part of the Green Paper’s work going forward. The noble Baroness is right that we cannot wait for that, because there are people who need improvements in care now, and that is part of what the better care fund has been set up to do—to improve the spreading of best practice and the new models of care work which have been put front and centre for the long-term plan improvements. That was introduced in 2015, and has brought in the funds required, taking the total of increased funding to £7.7 billion by 2018-19. We are looking at how we can make sure that that improves. It has brought changes across the system.

My Lords, research carried out by the Independent Living Strategy Group, which I chair, concluded very recently that charging for the support disabled people need to go about their daily lives is unfair and counterproductive and undermines the primary purpose of the Care Act. Will the Minister tell me whether the Government have considered implementing the recommendations of the Darzi report, which called for extending the NHS’s “need, not ability to pay” principle to social care, especially for younger disabled people who have no savings and who want to save, to get a life, to get a house, to go to university and so on?

I thank the noble Baroness for the important point she has raised. The Government have established an interministerial group for disability chaired by the Secretary of State for DWP on exactly this point to identify barriers for those with disabilities and to drive forward co-ordinated action across government to try to address this. We are identifying organisations required to provide quality and comprehensive services based on clinical need which do not discriminate between patients on the basis of disability. I will take away the points the noble Baroness has raised because they are hugely important.

My Lords, there are examples of good social care packages across the country, but these are patchy. Can the Minister say exactly how the Government are currently disseminating good practice so that the elderly and young people who need social care packages get them now rather than in the future?

I thank my noble friend for her question. We should pay tribute to those who work very hard in the social care system under very challenging circumstances. Swindon, for example, has brought in a co-designed service with users and an increase in reablement of 150%, bringing an annual saving of £1.9 million to the health and care economy, while also reducing DTOC. Services and improvements such as these should be spread across the system. That is exactly what the better care fund is designed to do, and it is what the new models of care commitment within the NHS long-term plan will spread across the system so that we can improve social care for all.

My Lords, the IPPR report also notes that, if health and social care were truly integrated, the NHS could save £1.2 billion a year, rising to £4.5 billion by 2030, by reducing the number of admissions to hospitals and delayed transfers, as well as placing a real focus on funding care in the community. Will the new Green Paper ensure that true integration is fully addressed and that it is not just a case of adding “Social Care” to the title of the department?

The noble Baroness, Lady Brinton, is absolutely right. Integrating social care funding is the key priority of the social care Green Paper. It is part of the work that we are prioritising through the better care fund, but it is also part of the ICS work.