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Adult Social Care

Volume 792: debated on Wednesday 11 July 2018


Asked by

To ask Her Majesty’s Government when their Green Paper on the future funding of adult social care will be published; and whether the Green Paper will draw on the experience of other countries.

My Lords, as recently announced by the previous Secretary of State for Health and Social Care, the Government will publish a Green Paper in autumn 2018 setting out proposals for social care reform alongside the NHS plan. In developing the Green Paper, the Government are drawing on best practice of what works abroad to create a sustainable social care system.

I thank the Minister for his Answer. Is he aware, however, that according to a report in May by the Health Foundation and the King’s Fund, adult social care funding needs to increase by between £5 billion and £8 billion by 2020-21? Can he reassure those service providers who are leaving the publicly funded adult social care system in droves that the Government’s financial cavalry will arrive by Christmas?

The noble Lord is quite right that there is a need for more money in the social care system. That is why, in addition to the funding set out in the spending review, the Government have put £9.4 billion over three years into the system in the short term. The point he makes, which is right, is about the long-term sustainability of the settlement. I would point him to the seven principles underpinning the Green Paper, which my right honourable friend set out. One of those is a sustainable funding model—a model which, as we have said, cannot put pressure on the NHS. That means that we need to find the money to ensure that it can subsist.

My Lords, the noble Lord is well aware that we need more money for social care, and that integrated care is vital. He may also be aware that Salford has successfully integrated health and social care. I am sorry to keep banging on about Salford, but it is where I spent many happy years working. It has done it very successfully, and Sir David Dalton has led it wisely. What lessons are being learned centrally, not just from abroad but from the UK and similar experiments?

The noble Lord speaks with great wisdom and he is absolutely right to highlight Salford, as he always does, because it is the root of the integrated care service being put in place in Greater Manchester with unique devolution powers, and we want to see that model rolled out across the country. Of course, the point of that is to ensure a better interface between the National Health Service and social care, so that one of the problems that bedevils us at the moment—delayed transfers of care—does not get in the way of proper care.

My Lords, it is good to be back, but very depressing to find that some of the things that were happening when I left are very much the same as I return—in particular, in respect of the Green Paper. The world may be changing radically in other ways, but I find that we have yet another Green Paper to add to the pile of other reports on adult social care.

I briefly pay tribute to the health service, particularly in Norfolk, which has saved my life and put me partly back on my feet. When I came out of the health service and had to use social care, however, I found myself spending thousands of pounds of my savings on carers. Many others, like me, find themselves uncertain about what the future will bring when they come to the end of their savings because we do not have the answer in the Green Paper. I am asking the Government not only to look very carefully at the issue of people who need carers, but to tell us the timeframe so that people are not left in a state of uncertainty about what the future will bring.

I am very pleased to welcome the noble Baroness back to the House, and am glad to see that she is on the mend. She highlights a critical point about certainty, which she makes movingly from a personal insight. It does not matter what age someone is; there is a great deal of uncertainty about what the system will look like when they retire—whether that is in five or 50 years. Providing that security and certainty is one of the principles underpinning the reform. It will be in the Green Paper. I know that successive Governments have had Green Papers, but we need to seize the chance of a long-term plan for the NHS and a Green Paper coming together to try to make it work.

My Lords, I declare my interest as recorded in the register. The recent Local Government Association survey of council leaders and social care cabinet members found that 96% believe that there is a major national funding problem in social care. I think we all agree that we urgently need a long-term funding solution for social care. With that in mind, will the Minister commit to working with the Local Government Association, as it consults on its own social care proposals, and seek to start a debate on how best to fund the care we want to see for adults of all ages? Will he update the House on whether the Government’s Green Paper will commit to new funding for social care?

I absolutely agree with my noble friend. I know that she speaks from great experience. We have some good working practices now, through the better care fund, between health commissioners and local government, which is an essential part in making sure we have a sustainable system.

Will the Minister reassure the House that the Green Paper will address the parity of esteem between mental and physical health in terms of eligibility for social care support at home? Although there is serious concern that many people suffering debilitating mental illness, particularly depression, are not receiving the basic social care support they need, it is very difficult to assess the national scale of the problem because of the very poor data on how the current eligibility criteria are applied in mental health support. How is this key issue being addressed?

I reassure the noble Baroness that it will be addressed. When we have the consultation, there will be more opportunity to explore that.

In addition to looking at funding mechanisms from abroad, will the Green Paper look at some innovative solutions, such as the projects in Holland where students live in sheltered accommodation with the elderly, improving the quality of life for the elderly and financial support for students, which is much cheaper for the state?

That sounds like an excellent idea, and I would be delighted to consider it, as well as any other ideas that the noble Baroness has.

I welcome the Green Paper but it is only a Green Paper. Does the Minister have any assessment of how long it will be before legislative changes can be brought in to make new initiatives a reality?