(1 day, 18 hours ago)
Commons ChamberRead Hansard Text Read Debate Ministerial Extracts
The Minister for Social Care and Mental Health (Alison McGovern)
With your permission, Madam Deputy Speaker, before I make a statement on the creation of the national care service, I want to pay my own tribute to Sir David Amess and his family. We are all thinking of them today, and I am reflecting in particular on how much Sir David gave to this House.
It is in the news this week that Audrey Joughlin is celebrating almost 80 years of service in the NHS. This remarkable lady has been working in the NHS since the day it was founded in 1948, and today she is volunteering at the Royal Liverpool hospital. I want to also wish a happy birthday to my constituent Vibeke Nicklin, who is turning 80, having spent 60 years as a nurse caring for patients.
When I read about these women, I feel nothing but pride; to know that they are from my home town in Merseyside just about makes my heart burst. These incredible women show what a wonderful thing it is that people are living longer—more grandparents are living to see their grandchildren as adults—but it also sets a test for our generation of politicians. When Audrey began her career, there were fewer than 6 million people aged over 65 in the UK; today, that figure is over 13 million. According to the Office for National Statistics, by 2050, 18 million people will be aged 65 and over; the number aged 75 and over will rise to more than 10 million; and the number aged 85 and over will have doubled. As the Prime Minister said yesterday, we cannot turn away from the question of social care. People who depend on care deserve better, and the dedicated staff deserve better, too.
This issue of social care has often been overlooked for two reasons. The first reason is who does most of the care. I can explain this simply in three words: working-class women. Working-class women never get a fair hearing in this country, but those in social care need to be heard right now. The second reason is what happens to people when they experience a failing care system. It is not that people do not like talking about getting old; too many people who go through our care system are traumatised by the experience, and it is too hard for them to talk about it. As the Prime Minister said at the Labour party conference, social care workers often feel invisible. Who can blame them, when 80% of care workers working for independent providers receive within 10% of the minimum wage?
We are all looking forward to the findings of Baroness Casey’s important review, but the truth is that we cannot afford to wait for her to finish that work before getting on with the job. Ask any family who have gone through the nightmare of trying to sort out care for their loved ones—the status quo cannot be accepted. Beyond the immediate impact on families, the NHS is paying the price of our failure to get a grip; hospitals are dealing with 999 calls from a failing care system, and we have the appalling spectacle of corridor care in hospitals across the country. If we carry on like this, our broken social care system will break the NHS, too. We cannot let that happen.
We on the Government Benches remember that we were elected on a manifesto that said that we would build a national care service, improve the lives of the people who draw on care, and build a system that puts people before profit, and we are already working hard to deliver Baroness Casey’s early recommendations, whether on motor neurone disease, dementia or safeguarding. That is why the Prime Minister has taken the decision to build a national care service, with free personal care, adjusting the triple lock to make it possible. Baroness Casey will report next summer; meanwhile, we will prepare the ground now for the new service.
I am sick of people looking down their nose at social care staff, who do a highly skilled job that could provide the young people of this country with a great career. Yesterday, I spoke to our partners at Skills for Care about our workforce action plan. At the heart of this is a commitment not just to older generations who need care, but to younger generations who just need their chance in life. Being unemployed for any period can damage someone’s confidence, but doing a skilled job like social care can give people a sense of pride, and a pay packet they earn themselves. That is why we will offer thousands more academy places to help young jobseekers into good jobs in care, and are bringing in the first national collective pension scheme dedicated to care workers; and it is why we have already passed the Employment Rights Act 2025, which gave more than a million people—many of them care workers—access to sick pay, and raised the minimum wage. We will introduce the first fair pay agreement in adult social care, backed by half a billion pounds. It will put care workers under the protective umbrella of collective bargaining and give them the power that they deserve—not just as a one-off, but forever.
For unpaid carers, we have announced the biggest expansion to the carer’s allowance since the 1970s. We will soon appoint the first unpaid carers’ champion to be a voice for people who provide unpaid care.
For too long, social care has been a Cinderella service, with care staff held back by not having the tools they need to look after people. Recently, however, we have been making good progress. Digital social care records are helping to reduce paperwork and improving the quality of information available to staff, which is vital for good care and saving precious time. Today, I can give the House the update that digital records are now used by 84% of care providers, compared with just 72% when this Government took office, and 92% of people who draw on care are now benefiting from that modernisation.
We are supporting the adoption of preventive technology that was the stuff of science fiction just 10 years ago—home monitoring kits to identify infections early, reminders to avoid missed medication, and specialised sensors to detect and prevent falls. If we can put the best technology in the hands of skilled and emotionally intelligent people, the result will be working-age adults with self-determination, choice and independence in life, and older people at home for longer, in better health, and with a much, much better chance of dying at home, in comfort and in dignity, when the time comes. As my right hon. Friend the Secretary of State for Work and Pensions said on Tuesday,
“A good retirement…is about more than income.”—[Official Report, 13 October 2026; Vol. 791, c. 198.]
There are those who say that we cannot afford the national care service; I say that they are asking the country to pay for the cost of failure. This issue is not going away. If our response to the test of an ageing population is simply to find an even larger bucket of sand to stick our heads in, the impact on the NHS—already plain for all to see—will only grow worse.
If the decade after 2010 taught me anything, it is that we do not save money by tearing chunks out of the fabric of our society and then making the NHS pick up the pieces. Most importantly, if we improve population health, people will have a much better quality of life. I do not pretend that it is easy, but our pensioners deserve security and peace of mind. Our national care service will be better for them, families and the NHS. It will ease the pressures we see today; failings in our social care system mean that many pensioners are kept in hospital for longer than they need or want to be, because social care beds are unavailable. The cost of inaction will only be more pressure on the NHS through more ambulance call-outs, more A&E admissions, more corridor care and more people stuck in hospital when they do not have to be there.
We are at a crossroads. Our choice is: either pay the financial and human cost of the failed system that we have now, or build the national care service, stabilise our public finances and enable people to live happier and healthier lives. I urge colleagues to think of not just the consequences of inaction, but what it means for our constituents if we get this right. In place of fear, the rising population of elderly people we represent can grow old in a good society. Instead of corridor care, we would have a thriving NHS, in which unnecessary admission was prevented and people who become unwell recovered quickly and enjoyed their life. Care workers would be recognised for their work, and all of us would gain peace of mind about what happens later in life.
When Audrey began her lifetime of service to our country, she was part of a generation that left the greatest legacy that anyone could hope to build. It meant that when a person falls ill, they never have to worry about the bill. Today we have the chance to carry her generation’s torch into the 21st century, and to leave to our children and grandchildren something as significant as the creation of the NHS. We are ripping off the plaster. I commend this statement to the House.
Madam Deputy Speaker (Caroline Nokes)
I call the shadow Secretary of State.
Damian Hinds (East Hampshire) (Con)
I thank the Minister for advance sight of her statement. I join in what she said about Sir David Amess. Today, again, we remember his service and remarkable contribution to Parliament and public life, including through today’s Children’s Parliament.
In my lifetime, life expectancy has risen by almost a decade. That is wonderful, but as the Minister said, it means that many more people now need care for extended periods—sometimes very extended periods—and that number is only likely to grow. It is imperative for society to address this issue, and it is imperative for us as politicians to find a system that is compassionate, sustainable, affordable and fair. So much the better if we can find common ground across the House on this subject, because a sustainable approach can survive multiple changes of Government. We will approach this subject constructively and positively.
I was surprised to hear the Prime Minister announce fundamental and apparently fixed parts of this policy at the Labour party conference. What are the implications for the Casey review? We do not yet know what the big conversation on care will yield. Is the noble Baroness free to make recommendations that may not fit the model that the Prime Minister has announced?
Apparently, the Prime Minister managed simultaneously to set constraints and to omit a huge amount of practical information that people need. I think one could say charitably that today’s statement adds limit detail to what he set out. Given the use of the phrase, “national care service”, people may understandably be thinking of something more comprehensive than is being proposed, for this is not about all the costs of long-term care. It is not about what, for many people, is the biggest part: residential care. It is only about personal care. Terms like “personal care” and “social care” often get conflated, but the two things can be different, so what is the Government’s definition of what this service is to cover? The statement on the Government website says that the service will be based on need, rather than ability to pay. Does that mean that they do not envisage a fixed contribution for those in a care home, as in Scotland? Is this instead about meeting the cost of individually assessed needs? Will there be any changes to continuing healthcare or funded nursing care?
Half of those receiving local authority long-term social care support in the community are working-age adults, and we assume that what the Government have said about staff also applies to this important part of the care sector, but what else applies? Speaking of staff reforms, the Prime Minister spoke about integrating the care and NHS workforces, but how is that to work in care, which is overwhelmingly in the private and voluntary sectors?
The Government’s statement also says that this system will be
“introduced in phases, so its scope can grow as the savings increase from adjusting the Triple Lock, and as workforce and provider capacity are built up.”
Is spending on the national care service dependent on savings being made from the triple lock? Those are not currently budgeted costs, so the definition of “savings” is itself an interesting one. Does the Minister clearly commit to no new taxes or borrowing under this plan? The part about allowing capacity to be built up suggests not only a transfer of costs from individuals to the state but also a net increase, so how much of a net increase in provision are the Government projecting?
There is one change that it appears may affect the cost of being in a residential care home. The Prime Minister said that no care charges would be paid out of people’s basic state pension. That seems to imply an end to payments from income for care home residents below the lower capital limit down to the weekly personal expenses allowance. Is that interpretation correct?
When she answers, please will the Minister not just say, “These are all details for the Casey review,” because the Government cannot have it both ways. Personal care costs are closely linked to these other aspects of the system, and if the Government had wanted to allow space for the commission to look at the system in the round, they could have done. If they had really wanted to allow time to develop a cross-party consensus on the structure, they could have done. The Government themselves call what the Prime Minister set out at the party conference
“a clear plan to fix the system”,
so please can we have these answers?
Alison McGovern
I thank the shadow Health Secretary for his response. I will try to respond to his questions, but if I miss anything I will follow up in writing afterwards. Let me say to him that he is absolutely right that while politics is what it is, as much as possible we want to work across the House on this issue. For that reason, I would be very happy to meet with him regularly to discuss this.
The right hon. Gentleman asked whether Baroness Casey is free to consider issues as she wishes. She obviously has terms of reference, but my personal experience of Baroness Casey is, just you try stopping her having opinions about anything she wants to have opinions on! We are obviously working closely with her. I have met her a number of times and was really pleased to welcome her to my constituency too.
What we mean by personal care is help using the toilet, cleaning, having a shower and so on—
Alison McGovern
Cleaning oneself. I will happily pick up the question that he raised with me in writing.
On continuing healthcare, there are a number of ways in which, as was the case under the previous Government, the interface between NHS funding and social care funding really matters—not least the better care fund and continuing healthcare. We continue to look at those, and I will happily discuss them. There are improvements we can make in the short term that will help, even as we wait for the Casey review next summer. Likewise on integration with the NHS, Members across the House will all know of good examples where, because of collaborative working on the ground, we see systems that are well integrated. The problem is that that is due to good fortune and good relationships rather than a system and structure that enables it.
The right hon. Gentleman asked about taxation. That is a matter for the Chancellor. We will have the Budget shortly, and I am sure that there will be many questions asked of the Chancellor. He asked me a couple of other questions that I did not quite catch, but I will review them and write to him.
Deirdre Costigan (Ealing Southall) (Lab)
I draw attention to my entry in the Register of Members’ Financial Interests as a proud member of Unison. For too long, care workers in Ealing Southall have lived on rock-bottom wages with no chance to progress in their jobs, so I hugely welcome the Government’s half a billion pound investment in the first ever fair pay agreement for social care. Does the Minister agree that we will never have a good quality social care service in this country unless we value our care workers properly? Will she set out how far the half a billion pounds will go in achieving that?
Alison McGovern
My hon. Friend is right that at the heart of the problems we have in the social care system are the way in which the workforce are looked down upon by others and the problems with low and uncertain pay in too many areas. We are cracking on with the fair pay agreement for all the reasons that I mentioned and that she knows only too well. It is about time that social care was seen as the great and fantastic career that it is.
Madam Deputy Speaker (Caroline Nokes)
I call the Liberal Democrat spokesperson.
Clive Jones (Wokingham) (LD)
I welcome the Minister’s statement on the national care service and thank her for early sight of it.
My Liberal Democrat colleagues and I believe that everyone deserves to be able to live independently with dignity and to receive the care they need in their own home when possible. Hundreds of thousands of people are desperately waiting for the care they need and 13,000 people every day are left stranded in hospital beds, unable to leave because their care packages have not been put in place.
One in seven people over 65 now pay more than £100,000 for their care in their lifetime. Spiralling social care costs have left many councils, such as my own in Wokingham, struggling to fulfil other basic services that residents want to see. Social care services are in crisis and have been for too long. That has been recognised for many years by Ed Davey, the leader of the Liberal Democrats and a carer himself.
Madam Deputy Speaker
Order. The hon. Gentleman will know that he must refer to his party leader by his constituency, not his name.
Clive Jones
Apologies for that, Madam Deputy Speaker.
We are pleased that the Prime Minister has recognised from his own experience that social care needs fixing. The Liberal Democrats are keen to work on a cross-party basis to fix social care. Failure to act on social care would be a catastrophe for families, for the NHS and for local services.
The Liberal Democrats have set the Government three tests for the social care reforms. First, they must put family carers front and centre, with guaranteed rights for every carer, and replace the broken carer’s allowance system. Secondly, the reforms must include a universal safety net of care, including free personal care. Thirdly, the Government must protect people from catastrophic costs so that family finances are not decimated and people do not have to lose the family home.
I am pleased that the Prime Minister committed yesterday to arranging another round of cross-party talks to fix social care. The Liberal Democrats will engage in those discussions and we urge others in the House to do the same.
Alison McGovern
The House will have heard the interchange between the leader of the Liberal Democrats and the Prime Minister yesterday. I thank the hon. Gentleman for pointing out the rather extreme impact of this situation on the NHS. We all have a choice; we cannot leave it as it is.
Ashley Dalton (West Lancashire) (Lab)
This House knows that in recent months, the issue of end-of-life care has been at the forefront of our discussions and debate. Will the Minister tell us how the national care service will dovetail with end-of-life care and support families and those at the end of their lives?
Alison McGovern
I thank my hon. Friend for all she did as a Health Minister and for raising that extremely important question. It is an often overlooked fact that in end-of-life care, the members of staff who might see a person and their family the most will be social care staff. If we cannot get the NHS working together with social care for people when they are dying, we will not be able to do it at any time. That is a priority for the work that we can do before the Casey review, and I will happily meet my hon. Friend to discuss that further, if she would like.
Sir Edward Leigh (Gainsborough) (Con)
The average cost of a home in the Gainsborough constituency is just £204,000. Typically, someone spends three years in a care home in their lifetime, which will cost them £150,000. Everything over £23,000—the upper capital limit—is taken. All over the country that really upsets people who have contributed for a lifetime, and it is a real issue outside London and the south-east, which have much higher house prices. If the Minister is to abolish the triple lock and change it to a double lock, which most commentators think is now inevitable, will she look at this issue and either raise the upper capital limit so people keep more of their money or have a cap on lifetime contributions, which was the policy of the last Government?
Alison McGovern
The point raised by the Father of the House is an important one, and it is one for the further discussions that we will have next summer once the Casey commission has reported. The steps that I wish to take in the immediate weeks and months are focused on improving what we can within the care system now. None the less, he raises an important point.
Jen Craft (Thurrock) (Lab)
I welcome the statement, and I hope that the national care service affords an opportunity to develop a sufficient road map to community support for the more than 3,000 people with a learning disability and autism who are currently locked away in secure mental health units that are inappropriate and, in some cases, actively harmful. That commitment was given to me at the Dispatch Box nearly a year ago by the Minister’s predecessor, my right hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock). I would be grateful if the Minister could meet with me, Mencap and those campaigning to bring these people home from hospital.
Alison McGovern
I will, of course, meet my hon. Friend. She will know that I am also the Minister for Mental Health, so across those two responsibilities, I will happily work with her to fulfil that commitment.
Vikki Slade (Mid Dorset and North Poole) (LD)
For the last year, I have been campaigning for Richard’s law after Louise and Richard were robbed by a care worker in their own home in Dorset. The law would ensure that all care workers are registered with the Disclosure and Barring Service, have minimum levels of training and, most importantly, are on a single national carers register. That is supported by Visiting Angels and the National Care Association, as it will allow carers to move employers more easily, reduce employers’ costs and professionalise the sector. Will the Minister support that?
Alison McGovern
The hon. Lady rightly raises an important issue. One of the interim recommendations of the Casey review was that we create a national safeguarding board. If the hon. Lady wants to send me the details of her proposal, I will happily raise it with the chief social worker.
Anna Dixon (Shipley) (Lab)
I declare an interest as the chair of the all-party parliamentary group on carers. The Minister sadly knows from personal experience the challenges that family members face in trying to secure care and support for our loved ones, and it is even more distressing when they are close to the end of their life. Will she outline how the Government will ensure that the national care service gives peace of mind to families and carers that care and support will be there when they need it, regardless of their finances or where they live?
Alison McGovern
My hon. Friend’s question gives me the opportunity to thank her for all the work that she does in Parliament to raise the issues that relate to family carers in the care system. She mentions that, sadly, I have recent experience of the social care system, from when my mum died in July. I can only say that the system that we will try to achieve is one that takes burdens off the shoulders of people at that time and not the current one where, unfortunately, the complexities only add to the distress.
Edward Argar (Melton and Syston) (Con)
May I associate myself with the Minister’s remarks about the amazing work done by care workers day in, day out across our country? Labour Governments, Conservative Governments and Governments with Liberal Democrats in them have all been unable to find a way to implement significant changes for the future of social care. That is not, I suspect, from a lack of desire, but due to the complexities of doing so and of securing a degree of meaningful agreement across the parties in this House. Will the Minister therefore confirm that the contours of what the cross-party discussions and the Casey commission can consider and potentially conclude are in no way predetermined by the Prime Minister’s announcement?
Alison McGovern
The right hon. Gentleman was a Minister in the Department of Health and Social Care; he understands the challenges very well, and was an excellent and courteous Minister. The Prime Minister set out his position, which is his long-standing view. He acknowledged at Prime Minister’s questions, and on other occasions, the ups and downs of the debate we have all been through. We all want to try to work across parties to get to a better place on this. I can only refer the right hon. Gentleman to the remarks that the Prime Minister made at PMQs yesterday about how determined he is to find cross-party agreement.
Chris Vince (Harlow) (Lab/Co-op)
I also declare an interest as a member of the trade union Unison. I thank the Minister for her statement and welcome her and the PM’s comments and commitment to a national care service, which has the potential to make a big difference to residents and carers in my constituency. I am really interested in the role of the unpaid carers champion. This is not me putting in a pitch for the job, but how will this role ensure that the voices of carers and young carers—she will know I have a passion for supporting them—are heard as part of this conversation?
Alison McGovern
I know that the only job my hon. Friend ever wants is to be the Member of Parliament for Harlow—it is such a great job. As we build the national care service, it is important that the voice of family carers and unpaid carers is heard loud and clear. They have a specific viewpoint on some of the changes that we are trying to achieve. Once we have made the announcement, whoever is appointed will work very closely with him, particularly on young carers.
Alison Bennett (Mid Sussex) (LD)
I appreciate being called at this point, because at 1.50 pm there is a debate in Westminster Hall on support for unpaid carers; I encourage all hon. Members to join us. Does the Minister think that the national care service can be funded through efficiencies in the NHS?
Alison McGovern
I thank the hon. Lady not just for her question, but for seeking the debate in Westminster Hall. I apologise to her for not replying to it myself, but there is a sort of time clash going on. My very good friend, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury North (Mr Frith), will respond to her.
The argument I was making in my statement was that unless we are prepared to grapple with the issue of social care properly, we will pay for the cost of failure, most especially in what we are seeing in the NHS. I feel sure that this is the right thing to do for the country financially, as well as in terms of ensuring that people can live very good lives into old age.
Nadia Whittome (Nottingham East) (Lab)
I very much welcome the Minister’s statement, and I am glad that the Prime Minister has already committed to a national care service that is free at the point of use—a vital principle that mirrors our NHS. Does the Minister agree that one of the key problems in our current system is our reliance on private providers? Will she explore how we can make the new national care service publicly run, with people who receive care, care workers and unpaid carers co-producing that system?
Alison McGovern
The system we have is not working. It is far too fragmented, and I have a lot of concerns about the situation faced by the workforce. Hon. Members will have noticed, yesterday, that the Prime Minister responded to a question regarding the role of co-ops in the future of social care. I am interested in all ideas that Members have on how we get the best possible mix of organisations involved in the national care system.
Dr Andrew Murrison (South West Wiltshire) (Con)
The trauma of care that the Minister refers to includes keeping frail elderly people in acute hospital units well beyond their date of expected discharge. That is dreadful for them. It means that they are likely to succumb to hospital-acquired infections and the various other things that are attendant on hospital stays. It means that they are not in homely settings in the community, which is where they need to be and where their families want them to be—and at a quarter of the cost of keeping them in an acute hospital unit. Will the national care service incorporate savings that can be made through our NHS by getting people the care that they need—that is to say, care in the community rather than in busy acute hospital beds?
Alison McGovern
I could not have put the argument better myself. That is exactly the trauma that I am referring to. It is a terrible thing to see an older loved one in hospital, which is not a good environment for them and is likely to make them ill through infection, lose mobility or other things. Nobody wants that. As I said to the hon. Member for Mid Sussex (Alison Bennett) a moment ago, this proposal is the right thing financially, but frankly, it has to be done for quality of life reasons.
Rachael Maskell (York Central) (Lab/Co-op)
I share the Minister’s pride; my mother turns 89 today, having dedicated her life to the NHS. I also extend that pride to the 1.6 million care workers, and believe that we could do so much more to lift their confidence in their professional skills. I welcome the Prime Minister’s extending his interest to care co-operatives, because those can empower staff and service users. Will the Minister work with the Co-op party, which has done extensive work in this area, to deliver that model?
Alison McGovern
Yes, of course, I will. May I, through my hon. Friend, wish her mum an extremely happy 89th birthday? My hon. Friend and I are both daughters of people who worked in the NHS, and nothing makes me more proud.
Adam Dance (Yeovil) (LD)
I welcome the Minister’s statement—there was a lot of good in there—but if we are not getting a national care service in this Parliament, what steps will the Government take now to ensure continuity of social care across local authority borders? One constituent’s mother moved from Dorset to a care home near her family in Somerset. They sought support from the council, because their personal funds were running out. Sadly, the constituent’s mother passed away before the complex dispute over which council should pay was ever resolved.
Alison McGovern
I thank the hon. Gentleman for bringing that point forward. We have a lot of work to do with our colleagues in local government to get the system right. Helpfully, my previous job was Minister for Local Government, so I am aware of some of the issues. If the hon. Gentleman sends me a note with that border issue, I will happily look into it. That sounds like the sort of thing that is probably happening in loads of places.
Liz Twist (Blaydon and Consett) (Lab)
I declare my interest as co-chair of the Unison group of Labour MPs and as a unison member. I thank the Minister for the work that she is doing on workforce issues, but many unpaid carers struggle to balance their caring responsibilities with paid employment, with consequences for their household finances and future pensions; indeed, many have to give up work because they cannot balance them. What steps are the Government taking to ensure that carers get the support they need to stay in work if they wish to do so?
Alison McGovern
I thank my hon. Friend for her contribution and, through her, thank all the Unison group MPs and Unison for their input on the issue. The important matter she raises is one of the reasons we are going to appoint a champion for unpaid family carers. We have talked about all the other financial impacts of this failure, but there is also the economic impact on the labour force of people giving up work to care for an older loved one. We have to take that impact into consideration as we build the new national care service.
Robert Jenrick (Newark) (Reform)
Instead of cutting foreign aid, net zero subsidies or benefits for migrants, the Government have chosen to cut the state pension to pay for their care system, but most experts agree that that does not even touch the sides of the problem: there is an £18 billion to £40 billion black hole. Will the Minister accept that, to pay for this, taxes are going to have to rise a lot? People are very worried, so will she use this opportunity to rule out the death tax, in which the Government would go after people’s homes—their nest eggs—at the end of their lives?
Alison McGovern
I do not accept what the right hon. Gentleman has just said, and I do not agree with it either.
Clive Efford (Eltham and Chislehurst) (Lab)
I very much welcome the statement and any move towards a national care service, but my hon. Friend knows as much as I do that people often experience a clash of bureaucracies, which leads to a slowdown in the delivery of care or care packages. People are stuck in hospitals for a variety of reasons, but for many it is because that clash cannot be resolved to move them from hospital in a timely fashion. We cannot wait for that to be resolved; we need to resolve it now. Can she reassure me that she is working on that, because if we can solve that, we can solve large parts of the problem in this Parliament and not have to wait for the next?
Alison McGovern
My hon. Friend makes exactly the argument as to why we have to take steps now to improve the system. In my statement, I mentioned the increase in the number of organisations using digital care records to help smooth the system, but it also takes the working together of NHS organisations, local authorities and care companies. That is happening in some places. The problem is it is not happening everywhere, and he is absolutely spot on that we have to take steps now.
Ian Sollom (St Neots and Mid Cambridgeshire) (LD)
My constituent Maxwell has spinal muscular atrophy and needs a significant amount of personal care. He has just started a graduate job, but because of the frozen £23,250 capital limit, any savings he builds up go on care charges, so he cannot save a deposit for a home or for the safety net that his disability demands. The right hon. Member for East Hampshire (Damian Hinds) said that we assume this to be the case, but will the Minister confirm that free personal care will be included for working-age disabled adults such as Maxwell? Until it arrives, would she unfreeze and raise the capital limit so that we are not placing a limit on his aspiration?
Alison McGovern
I thank the hon. Member for raising his constituent’s situation. If he would like to send me the details, I will happily look into it and formally reply to him and his constituent. Baroness Casey’s commission is working on recommendations for fixing social care for everyone who needs it, including working-age adults, but I would just acknowledge that some of the challenges are different, so we need to take that into account as we move forward to the future system.
Matt Rodda (Reading Central) (Lab)
I declare an interest, as I have a close relative working in the care sector. I welcome the Minister’s statement on this important matter. Could she say more about how she and the Department plan to build consensus across the wider community and with stakeholders, as well as with political parties?
Alison McGovern
I thank my hon. Friend for his question and thank whichever of his relatives is working hard in social care. I have been lucky to be in touch with a wide number of organisations. We had an opening meeting in the Department with lots of organisations a month or so ago, and there is a lot of expertise out there. This issue is seen differently by those involved in the different parts, and also because of the different conditions and experiences that people have. I feel positive about that work so far. Many people have engaged with the Casey commission and, I am sure, will do so going forward.
Dr Ellie Chowns (North Herefordshire) (Green)
I welcome the statement from the Minister, as I am sure will many people in North Herefordshire—people who draw on care and people who provide care, both paid and unpaid. Does the Minister agree that we need to end the lottery of care—the postcode lottery of care being provided in different ways in different places, the life lottery of people’s access to care being partly determined by their circumstances, and the lottery of whether someone ends up having catastrophic care costs at the end of their life and potentially losing their life savings? Can we agree that we need to ensure that care is locally provided but nationally funded, and will she lobby her colleague the Chancellor to include fair taxation of wealth in the mechanisms considered to fund that?
Alison McGovern
I thank the hon. Lady for her contribution. She makes a good argument, which I think we all see, about how disjointed and fragmented the system is. [Interruption.] The shadow Health Secretary is trying to help me out by explaining that her question was probably slightly out of scope of my policy responsibilities, but I will certainly mention to the Chancellor, if I bump into him, that she had a view that she would like to share with him.
Mr Clive Betts (Sheffield South East) (Lab)
I very much welcome my hon. Friend’s statement. We have talked about this issue for so many years, and it is time that we got on with it and tried to get cross-party agreement. While we are waiting for the Casey report—I know Louise from old, and she will be robust and independent in what she recommends—is it the idea that we will set out a national framework, where Government lay down standards and hopefully the funding, and then the service is organised at a local level by local authorities, working closely with primary care, public health and local housing providers, who are often missed out in the important join-up that we have to achieve?
Alison McGovern
I thank my hon. Friend for his question and his experience in this area, which he has shared with me over many years; I appreciate it. He describes the situation well. We need a system that is much less fragmented, easier to understand and that responds to the local context. It is very different providing care in urban areas and rural areas, for example. We have to think through those issues. There are certain things, which I laid out in my statement, that we need to crack on with now, such as giving young people the chance of a job in social care, and other issues we will work through alongside local government colleagues and, as he says, housing providers, too.
David Chadwick (Brecon, Radnor and Cwm Tawe) (LD)
Those demographic statistics are alarming. In Powys, there are high average occupancy rates for nursing beds across community hospitals—91% in Llandrindod Wells and 82% in Ystradgynlais—yet Powys teaching health board is consulting on potentially cutting the number of community hospital beds from 160 to 60. Does the Minister agree that community hospital beds play a vital role in the care system, and does she share my concern that if those beds were cut, it would just mean that more elderly residents from Wales are left stranded in English hospitals?
Alison McGovern
I am sure the health board that covers the hon. Member’s constituency will have heard his opinion, which was strongly given. We need to make the system work better, and I am sure that the board will want to reply to him directly.
Darren Paffey (Southampton Itchen) (Lab)
I join my hon. Friend in praising care workers up and down the country, and I pay particular tribute to those who gave such excellent care to both my parents in their final years. From day one as an MP, my constituents have come to me with increasingly distressing stories of what is happening when things go wrong, so I really welcome the long-term statement to put it right. While we wait for Baroness Casey, can my hon. Friend assure us that there is a plan to do the most urgent improvements starting now?
Alison McGovern
Yes, I can assure my hon. Friend of that. That is part of the reason for the statement today. Whether it is on workforce, improvements on technology, local authority commissioning or the initial recommendations of the Casey review on motor neurone disease, safeguarding and dementia, we are getting on with those things that are urgent and can be done now.
Ben Lake (Ceredigion Preseli) (PC)
I congratulate the Minister not only on the statement, but specifically on the creation of a national care service. It will undoubtedly have a transformational impact on so many people. Will she ensure that representatives from political parties in Wales can be included in some of the cross-party talks? Although the provision of social care in Wales is a devolved responsibility, there are important considerations, including the arrangements for cross-border packages and matters of funding, that are perhaps best understood and addressed at an early stage.
Alison McGovern
Let me say “diolch” to the hon. Gentleman. Yes, we can definitely do what he asks; as somebody whose constituency is very close to north Wales, I understand what he means.
Neil Duncan-Jordan (Poole) (Lab)
I welcome the Government’s move towards a national care service because, as the Minister said in her statement, everybody knows that we will not fix the NHS until we fix social care. But tens of thousands of care workers currently face a change to their immigration status. We should not be changing the rules for those who are already here and making a valuable contribution to both the care sector and our wider society. Does the Minister agree?
Alison McGovern
The issue that my hon. Friend raises is rightly one for the Home Office, and I will pass on his question to the relevant Minister. I will just say that whether it is the NHS and its creation, or social care down the years, we are grateful to those people who have come to put in a shift and take care of the ones we love.
Mike Reader (Northampton South) (Lab)
Could the Minister confirm, as I think she has in previous answers, that the interface between health and social care will remain front and centre of the national care service, not only for those being discharged from hospital but for those who are in care—particularly residential care—and face challenges in accessing health services?
Alison McGovern
I am very happy to confirm that. I think we all understand how challenging and bureaucratic that border between health and care can be, and that is one of the urgent matters that I am looking at.
Jodie Gosling (Nuneaton) (Lab)
I really welcome this statement, especially the recognition of the trauma caused to families when services fail. That is why it is so important to preserve strong local services like Mary Ann Evans hospice in Nuneaton, which provides dignity in death to thousands of families at home but is currently on the breadline and in insolvency talks, with last-minute legacy donations extending the deadline from the end of this month to the end of the year. I am in talks with the integrated care board, and we are doing everything we can, but there is a fundamental problem with the funding level. What can we do to protect these fragile services now, so that we can build on them in the future?
Alison McGovern
I thank my hon. Friend and pay tribute to her for all the work she is doing with her local hospice and her community on this issue. Members across the House will understand that we have a challenge in hospice funding, which I am looking at as part of the end-of-life care work that I am doing. It sounds like she is more than on top of it with her ICB, but if I can be of any assistance to her, I would be happy to do so.
Brian Leishman (Alloa and Grangemouth) (Lab)
The creation of a national care service is in the very best socialist traditions of the Labour party. However, pensioners funding its creation through the removal of the triple lock is not, especially when we have over 2 million pensioners living in poverty. The Institute for Fiscal Studies has said that the £15 billion of savings from the removal of the triple lock is actually more like £4 billion. Making any savings is a bit of a speculative gamble, because if we see high inflation, there are potentially no savings to be made. If there is going to be a financial shortfall in providing the national care service, how will it be funded and realised?
Alison McGovern
I thank my hon. Friend for his question, and in responding to him, I would like to quote the Secretary of State for Work and Pensions, who said in his statement to the House this week:
“We know that people want security in retirement and we are committed to protecting the poorest pensioners. Under our plans, pensioner poverty is set to fall.”—[Official Report, 13 October 2026; Vol. 791, c. 198.]
I hope my hon. Friend read that statement, and I hope he understands why I will respectfully disagree with him.
Richard Baker (Glenrothes and Mid Fife) (Lab)
In Scotland, our health and social care partnerships face a £500 million funding shortfall, and the SNP has failed to deliver on its commitment to establish a national care service for Scotland. As the Government take forward these vital plans for social care, will the Minister ensure that her counterparts in the Scottish Government are regularly updated on this work, so that they can learn how improvements in social care can be made effectively and encouraged to fulfil finally their pledge to provide the improved social care services that my constituents need as well?
Alison McGovern
I thank my hon. Friend for asking that very important question. When I have heard about the situation in Scotland, I have to say that it worries me, so I will happily agree to his suggestion.
Nesil Caliskan (Barking) (Lab)
As I listened with great interest to the Minister’s statement on our country’s care sector, which has persistent vacancies, I was thinking about the one in six young people in my constituency who are out of employment and not in education. With that in mind, does she agree that building a national care service means that we can improve care for older people but also create rewarding career pathways for young people in my constituency through training and better care in the care sector?
Alison McGovern
I have visited my hon. Friend’s constituency before; I know what amazing young people there are, and they deserve a better chance. Working in care can be an absolutely fantastic career. A young person who has perhaps experienced unemployment might need a bit of confidence, and being in an emotionally intelligent profession like social care can be a really great start to their career. I will happily work with her on that if she would like.
Chris Hinchliff (North East Hertfordshire) (Lab)
I thank the Minister for her powerful statement. Some 84% of care beds in England are run by private companies, and Baroness Casey has highlighted that private equity is often holding councils to ransom, so that they can extract maximum profit from the public purse. I note the Minister’s earlier answers on ownership models, but can she confirm that Labour’s national care service will put an end to the essential care of our parents and grandparents being used as a profiteering investment vehicle by private equity?
Alison McGovern
I refer my hon. Friend to the comments I made in my statement about the importance of putting people first and also to the response that the Prime Minister gave yesterday about the development of co-op organisations in the care system. I think we can make important progress on this, and I am happy to work with my hon. Friend to do that.
Lizzi Collinge (Morecambe and Lunesdale) (Lab)
I draw the House’s attention to my membership of Unison. I would also like to pay tribute to former Conservative county councillor David Westley, who I found out has recently passed away. He was the chair of Lancashire’s health and adult services scrutiny committee. I served as his deputy, and we worked together in Lancashire to try to address the problems that the Minister is trying to sort out now.
My constituency has large rural areas. Can the Minister assure me that the problems in rural care will be addressed as part of her plans?
Alison McGovern
Could I, through my hon. Friend, pay my respects to Councillor David’s family and all those who love him and miss him?
As I have said, it is important to think about this matter from the point of view of the different communities we have across England. There are challenges in rural areas, and we need to be cognisant of them as we think about what the care service looks like on the ground.
Mohammad Yasin (Bedford) (Lab)
I welcome the Government’s commitment to putting unpaid carers at the heart of a national care service, but as I heard when I visited Blue Sky Carers Support hub in Bedford recently, this must mean more than words. What concrete, properly funded commitments will the Government make to ensure that unpaid carers receive meaningful breaks, financial security and support to balance caring with work or education—particularly for young carers—so that we do not just recognise carers but really care for the caregivers?
Alison McGovern
My hon. Friend rightly raises a really important issue. We cannot think about the welfare of people who are receiving care if we are not thinking about the welfare of people caring for them. That is why we are going to appoint a champion for unpaid carers, who can be their voice as we build the new national care service, to ensure that all the issues he rightly raises are considered in this process.
Alistair Strathern (Hitchin) (Lab)
I think most of us or our friends and family will be familiar with the really personal, emotional, financial and, frankly, human cost of our broken system. It is a cost resulting from successive generations of politicians’ failure to face into the difficult choices and act, and I hold my own party as accountable as any other in that. I thank the Minister and the Prime Minister for not just stepping up on this but facing into some of the difficult choices, including the triple lock adjustment, that will be needed to fund it. My constituents tell me they will be perfectly happy to pay more and to make sacrifices if they can be confident they will be getting the care they need when they grow older. Will the Minister assure my constituents that, over the next Parliament, every penny we are saving through that triple lock adjustment will be invested in ensuring that we have the care service my constituents deserve?
Alison McGovern
I thank my hon. Friend for an insightful and important question and for the work he does to ensure that his constituents’ views are put forward here. What matters in order to fulfil the test that he sets for the national care service is to be really clear on outcomes. A number of Members have mentioned the travesty of people staying in hospital longer than they need to, and how traumatic it is when we experience a loved one not being cared for in the way that we would wish towards the end of their life. We all have to be clear about the outcomes that we want to see from this new service, and then we will be able to meet the test his constituents set.
Samantha Niblett (South Derbyshire) (Lab)
The reason I joined the Labour party—in my 30s, quite late—was the national health service and the welfare state, two incredibly important institutions in this country that look after people at their most vulnerable. After today, the national care service would be the third reason why I would join the Labour party. I mention that because in my South Derbyshire constituency, we saw the closure of the most beloved care home, Castle Court care home in Gresley, by the Reform-led county council. It was galling this week to see a couple of Reform county councillors celebrating the fact that the care home has been bought by a private company—hurrah for it coming in to save the day, by the way—when Reform was responsible for closing it, putting staff out of a job and residents out of a home. Does the Minister agree that it is only ever Labour Governments who create the institutions that look after people when they need help the most?
Alison McGovern
I thank my hon. Friend for that question, and through her, I thank all the people who campaigned for good care in her constituency. She tempts me; I am trying to be non-partisan today, and she is sparking my inner party-political fire. All of us, and all parties, can make a contribution to getting this right. We are rightly proud of the role of the Labour party in founding the NHS, and I want us to be just as proud of what we do to create the national care service from this point on.
Andrew Pakes (Peterborough) (Lab/Co-op)
I refer Members to my entry in the Register of Members’ Financial Interests; I am a member of the GMB. I welcome today’s statement, and thank the Minister for grasping the issue of a national care service. For too many of my constituents, it has been a national profit service, with many of the big care providers owned or backed by private venture capital. All of us MPs will recognise from casework and from speaking to constituents that people feel that they have no voice when it comes to the care system, be they people in care, their families, or our amazing and brilliant care workers, who do not get listened to enough in the system. The Prime Minister yesterday spoke about his father, and gave a powerful commitment that co-operation and co-operative values will be integral to how we build a service that we can be proud of. Will my hon. Friend give a commitment that the likes of the Co-operative party, but also Co-operatives UK and brilliant care co-operatives, will be fully involved in the Department’s work as we think about the diversity of provision that we need?
Alison McGovern
I thank my hon. Friend for that contribution. He is absolutely right: people feel as if the current system is a fog, at best. It is totally fractured, and it is too hard to navigate for people already dealing with some of life’s biggest challenges. Those Co-op values are an important factor in our thinking as we move forward with the national care service. He mentioned the Prime Minister’s comments yesterday; I am glad to confirm that those are exactly the values that we want to bring to this discussion. We are trying to ensure that people are empowered and have their voices heard, and that they work together for the good of those who need care.
Madam Deputy Speaker (Caroline Nokes)
I thank the Minister for her statement.