Queen’s Speech

Baroness Barker Excerpts

Tuesday 15th May 2012 Lords Chamber

[Baroness Barker]

My Lords, this is the 13th Queen’s Speech that I have been present for in your Lordships’ House. In the first Queen’s Speech debate that I took part in, the key issues that were exercising the House were the royal commission on the funding of long-term care, and reform of this House. It is always difficult to find a theme in such a disparate debate, but I have detected a similarity between Lords reform and social care. Both problems have been analysed for decades, and whenever a Government put forward a proposal for reform, there is an instant queue of people seeking to pick holes in and criticise the proposals—and the people in the queue are the ones who support the reforms.

The proposals on social care in the gracious Speech are an important step forward for families as they work out how best to support their older relatives. I point out to noble Lords that increasing numbers of older people in our society will have dementia. They are also a test for Parliament as a whole. Reform of social care is an issue that previous Governments did not resolve in times when there was far less pressure on public finances.

In the debate on 24 November last year, there was a great degree of consensus in this House, reflecting the consensus among the relevant charities, that the Dilnot report and the Law Commission provided the way forward to reforming social care. However, we should pause for thought. I read in Community Care on 11 May an article by Mithran Samuel. He said:

“Public understanding of the social care funding system remains problematically low with the effect that too many people believe services are free when they are anything but”.

Mr Samuel went on to say:

“I’ve spotted a couple of pieces in the national press recently that have inaccurately described the system of means-testing care in England … Both pieces claimed that people with assets of £23,250 or less do not have to pay for care at all, and that the Dilnot commission report last year proposed increasing this threshold for, in effect, free care to £100,000. However, this is wrong—£23,250 is the threshold above which people must pay the full cost of their residential care; it doesn’t apply to community-based services, and the threshold below which people do not pay for their care is £14,250”.

Andrew Dilnot’s proposal was to extend the system of charging up to £100,000. So a great deal of work needs to be done to convey the complexity of the system as it is now, and there is a far greater need to expand understanding of exactly what the Dilnot proposals are among the media, never mind the general public. I hope that parliamentarians from all parties and none, and voluntary organisations, will take the opportunity which the draft legislation gives us to increase their understanding over the next year as we focus on these issues.

Last Session, we went through the Health and Social Care Act. In January this year, the King’s Fund, closely followed by the NHS Future Forum, published reports on integration of health and social care. Both called for developing integrated care to have the same priority over the next decade as reducing waiting times did for the previous Government and they urged that government policy should set a defined date for delivering integration. I agree with that. In their response to our debate, will the Government say what progress has been achieved? The issue of continuing health care and NHS criteria is important to people who are knowledgeable about social care and it is a critical point at which health and social care systems come to bear on the lives of individuals. I hope the Government will take the opportunity of the draft legislation to address that point.

A number of key issues are identified by the Social Care Institute for Excellence, in a report in March 2012, called Crossing the Threshold. It points up the issues which need to be decided before the Dilnot proposals—or anything like them—can be implemented. These are issues such as clarity and consistency on assessment of care needs, and eligibility, in particular how publicly-funded social care can be better integrated with universal services. A key question which has to be answered is how needs would be assessed fairly alongside the operation of a practical cap. I put those forward as somebody who knows about social care, not in an effort to delay the implementation of what I think are two very important reports. I put them forward as issues which this House has to discuss and agree over the course of the next year if we are to get to the settlement which we all wish to see.

I welcome in particular the Law Commission’s proposals on safeguarding vulnerable adults. For too long, older people have been vulnerable to abuse and local authorities have been powerless to intervene on their behalf. In particular, I welcome the removal of the existing power under Section 47 of the National Assistance Act to remove a person from their home. It is a power which has long been in existence and contravenes the European Convention on Human Rights. It was described by one of my colleagues in Age Concern as the power of a local authority to remove a vulnerable person from insanitary conditions which might harm them to sanitary conditions which would almost certainly kill them.

The proposed draft Bill will, I hope, be subject to scrutiny by both Houses. There is considerable experience both here and in another place which is relevant to that. My colleague Paul Burstow in another place has worked hard to bring us closer than we have ever been before to settling what for decades has seemed to be an intractable issue. Families need certainty about what the costs of social care will be and they also need to be certain that they will have access to high quality and suitable services. We on these Benches support the proposals which have been put forward. We do not wish to wait longer than is necessary to see the implementation of the Dilnot report. That is why we will wholeheartedly support this. For myself, I do not want, in another 13 years’ time, to be considering yet more reports saying that social care is not working and that there is a need to reform this House. The issues are before us. We should take them forward and make sure that the proposals are implemented with due care and in detail.