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Social Care

Volume 804: debated on Wednesday 8 July 2020


Asked by

My Lords, we all agree that social care needs to be put on a sustainable footing where everyone is treated with dignity and respect. That is why the Prime Minister made clear commitments in the manifesto and the election, and why the Secretary of State wrote to other parties to begin the process of cross-party talks. We must now come together to find a common solution to this challenge: a long-term plan for social care that enjoys cross-party support.

My Lords, will the Minister confirm that the Prime Minister, said in his first speech in office that

“we will fix the crisis in social care once and for all with a clear plan we have prepared to give every older person the dignity and security they deserve … I will take personal responsibility for the change I want to see”?

Is that still the policy, or will the Prime Minister again claim that he has been misunderstood, as with his recent unpleasant attack on social care, for which he has refused to apologise?

My Lords, that is very much the policy, but I emphasise the following. No plan can succeed unless it gains the support of a wide number of stakeholders, including cross-party support. Attempts to foist a plan from one group on to another simply will not work. That is why a bridge-building exercise is needed and why the Secretary of State has invited others to cross-party talks. I invite all those players to go into that process with a spirit of collaboration.

It is good to hear that the Minister now accepts that piecemeal reform of social care will not do. Can he confirm that the Government will consider finally putting social care on the same level as the NHS and creating a national care service in which risks and costs are shared? Sharing costs must apply to the whole population for the whole of their lives, not just when they are in need of care—in fact, from the cradle to the grave.

My Lords, the Covid epidemic has been a vivid experience for me personally. I have seen how the Department of Health and Social Care prioritises the care for those in social care. I completely endorse the noble Baroness’s view: piecemeal reform is not on the cards. The Government have made it clear that a holistic solution is needed. That is what we are working to achieve.

My Lords, following on from the previous question, given that a long-term settlement for social care is one of this Government’s top priorities, and that there is general agreement that this should involve cross-party consensus and a significant measure of integration with the NHS, does the Minister agree that, in the continuing absence of a White Paper, the time has come to establish a Select Committee or perhaps a parliamentary commission with a specific timescale to make recommendations that might finally resolve this complex issue?

The right reverend Prelate is entirely right that we will need some kind of formal structure to go about cross-party talks and achieve a solution. That formal structure will need to be agreed in cross-party conversations. Those conversations have been ongoing during the epidemic and are now very much the focus of the Government’s attention.

My Lords, in the light of the surge in support from neighbours, family and friends for older people who have been shielding at home during the pandemic, would my noble friend agree that it is still the policy of Her Majesty’s Government to encourage people to remain receiving care in their own homes for as long as possible?

My Lords, the role of carers during the epidemic is one of the great stories of commitment and sacrifice. I pay tribute to all those who have given up their time and taken the risks necessary to perform this important community role. On encouraging people to stay home, there are clear guidelines on who is recommended to stay at home. It depends on clinical need and people’s precise circumstances, according to their GP’s recommendations. I urge all people to follow those guidelines.

My Lords, I remember that there was cross-party support 10 years ago for the Dilnot review’s proposals. I support warmly the comments of the noble Baroness, Lady Pitkeathley, about the need for a national care service. Will this review and White Paper also look at matters that are often forgotten in a care setting: housing standards for life, and sheltered and community settings, to make sure that we do not yet again end up looking at just adult social care and care homes?

The noble Baroness is quite right to shine the spotlight on those who are in social care but not necessarily aged over 65. Half of all social care costs are now dedicated to those under 65. Housing standards is an important question. The stock of housing for social care will be considered in any forthcoming review. It is imperative that we have a modern and up-to-date industry.

This policy could lead to literally unlimited costs and a bottomless pit that would make the National Health Service look like a modest outfit. When we devise this policy, we must make sure that adequate contributions are made by those affected and we do not fall into the trap of saying that inherited potential wealth is somehow to be exempted. People must pay a fair share.

My noble friend is entirely right: there is a massive potential liability. We are acutely aware of the intergenerational implications of social care reform. It is only right that we treat both those in social care and future generations fairly. Those considerations will be uppermost in our minds.

My Lords, can the Minister assure the House that any reform of the social care system will be accompanied by a comprehensive workforce strategy and fundamental improvements to employment conditions by moving away from zero-hours contracts, perhaps to an annualised hours system, to guarantee social care workers regular incomes?

My Lords, the precise remit of any review will be the choice of those doing the review when it comes, but I entirely endorse the noble Baroness’s sentiments that the social care workforce is worthy of our respect, particularly for its hard work and commitment during the epidemic. Workforce remuneration has improved since the introduction of the national living wage in 2016. Flexible contracts suit many workers, so a blanket commitment to annual wages is not necessarily suitable, but I endorse a focus on solutions that encompass all aspects of the social care industry, including the workforce.

My Lords, following on from what the noble Baroness, Lady Brinton, said, the Minister’s party has form for not honouring cross-party co-operation on this issue. To mitigate that, given that the Prime Minister has said that he is currently finalising plans, perhaps the Minister could commit the Government to setting a firm date and a timetable that could be published before the House rises for the Summer Recess? Does he accept that we need a plan to be delivered within a year?

The noble Baroness is kind to think that I am in a position to articulate a timetable from the Dispatch Box—that is beyond my abilities. However, she is entirely right to focus on the urgent need to focus on this area. The Prime Minister and the Secretary of State could not have been plainer that when the time is right and we have dealt with the epidemic, social care reform will be uppermost in our mind and will be the focus of our attention.

My Lords, since 1998 there have been 12 Green Papers, White Papers and other consultations, and five independent reviews, and like the Economic Affairs Committee, they all say that the system needs to be properly funded. Will the Government do that for immediate needs so that the White Paper can go on to do real good for the long term?

The noble Baroness is quite right to allude to the very large number of White Papers, think tank reports and amount of documentation in this area. All I can say is that I have never seen such acute political will and focus on social care reform. Nor have I seen a Prime Minister, a Secretary of State and a chief executive of the National Health Service to be so focused on the matter and to have raised it as a major priority in all their communications.