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Disabled People: Social Care

Volume 789: debated on Tuesday 20 February 2018


Asked by

To ask Her Majesty’s Government whether they have plans to improve social care for disabled people below retirement age in the light of the change in title of the Department of Health.

My Lords, the Government are committed to making sure that everyone who is assessed as having a care need can access high-quality support to maintain their independence. While the social care Green Paper will focus primarily on care for older people, it will also address questions relevant to adults of all ages with care needs. In addition, the Government are taking forward a parallel programme of work so that issues specific to working-age adults are considered in their own right.

I thank the Minister for his reply—but, as he will know, the Government have transferred responsibility for the social care Green Paper for older people from the Cabinet Office to the Department of Health. Will he confirm that the Government will use this opportunity to review the scope of the Green Paper to include younger disabled people, because the proposed parallel process, which is not a Green Paper, is simply not acceptable when half of social care spending now goes on working-age disabled people? Please will the Minister confirm that both older and younger disabled people will receive parity of status and attention from the Government?

I thank the noble Baroness for her question. She is quite right to highlight the importance of reform for this group of people. We are talking about 250,000 people now, but that is projected to rise to 400,000 working-age adults in the next 15 years. I want to reassure her that, while the Green Paper itself is focused on care reform for older people, a parallel programme of work is going on. There is an important round table coming up which is being chaired by both the new Minister of State for Care, Caroline Dinenage, and the Parliamentary Under-Secretary for Communities and Local Government, with Mencap, Scope and others. We are giving the issue equal seriousness, as it deserves.

My Lords, the charity Together for Short Lives last year put in a Freedom of Information Act request and found that one in five local authorities and one in six CCGs have absolutely no provision for respite care short breaks for the most seriously ill and disabled children. Since then we have received reports from across the country of more and more centres under threat or actually closing, such as Nascot Lawn, which I have raised in your Lordships’ House before, which is in court again tomorrow to try to save it. What is happening about this social care and nursing care provision for children? Normally, for adults, there is a negotiation between the NHS and the local authority about what is nursing and what is social care. But for these children there seems to be no such relationship; both local authorities and the NHS just point fingers at each other, and the result is children and their families not getting breaks.

I am very aware of this issue. Indeed, we have had the opportunity to speak about it in specific cases. Local authorities of course are obliged to provide respite care. The noble Baroness highlights an important point about care, which seems in a way to slip between the boundaries of the two. I shall write to her about the general policy work that is going on, but I know that we need to solve this because we have children who are now living longer who before might not have lived so long and who require care, as do their families. It is essential that they get the care that they deserve.

My Lords, I know that the Minister will tell me and the House again about the extra billions that the Government are putting into social care. However, when everyone else says that there is clearly a social care crisis, we have some dissonance here. The evidence of this crisis is the regression of opportunity and care for young disabled people, which is there to see in personal cases where people are not receiving the sort of support that they need. I am not convinced about the Green Paper looking at social care for older people. The noble Baroness, Lady Campbell, is right—that makes me more concerned, and I join her in that concern. Will the Minister explain how the Government will achieve their target of 1 million more disabled people being in work by 2027 if they cannot get out of bed and travel to work without help because of this combination of cuts and the stalling of a coherent support policy to make that possible?

I do not want to disappoint the noble Baroness, but she is aware that more money is going in. To address the specific issue that she talks about—and I obviously can talk about it only from the point of view of the Department of Health—we want and are seeing more disabled people going into work. I would point to one big investment that the Department of Health is making, which is the disabled facilities grant. That is about making sure that disabled people can live at home and have their independence, which of course is critical to maintaining their physical health and confidence to make them, in a way, ready to go into work. I know that there are other programmes being put through job centres and the Department for Work and Pensions to make sure that they are supported, too.

My Lords, I take this opportunity to thank the Minister for laying before Parliament today the government response, 11 months after the report was produced, to the House of Lords Select Committee report on the long-term sustainability of the NHS. We will now get an opportunity to debate the report and the Government’s response in due course. One recommendation that was accepted was the renaming of the Department of Health as the Department of Health and Social Care. Attached to that was the recommendation that the budgets should be amalgamated so that we can provide social care to all those who need it—both care for the disabled and adult social care. Would he like to comment on that?

I am glad to be able to publish the response at last, and apologise again for how long it has taken. I am pleased to report that we have not just changed the name of the department but given the strategic direction for social care policy back to it. That also includes strategic direction of funding—but the actual funding settlement happens through the local government funding settlement. I have to disappoint the noble Lord on that because there are no current plans to change it.

My Lords, in his Answer to the noble Baroness, Lady Campbell of Surbiton, my noble friend referred to a forthcoming round table that will address some of the issues that provoked the Question. Can my noble friend assure me that the noble Baroness will be invited to participate in that round table?

My noble friend makes an excellent suggestion. It is not my round table, so the invitation is not mine to extend, but I shall certainly be seeing my colleague the Minister of State this evening and shall do everything that I can to encourage that invitation to come.