Social Care Funding: Intergenerational Impact

Baroness Bennett of Manor Castle Excerpts

Thursday 16th September 2021 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, I thank the noble Baroness, Lady Greengross, for securing this debate.

First, a minute of history. In 1987 the NHS had more than 127,000 acute hospital beds and more than 52,000 geriatric beds. Some 20 years later, geriatric bed numbers had been cut by over 60% and acute beds by 20%. In 2010 the category of “geriatric beds” disappeared altogether. That followed a 1981 White Paper, Growing Older, and a DHSS consultation paper in the same year, Care in the Community, which both planned for transferring patients from hospital settings into the community. That meant handing over the frail elderly to be units of profit for the financial sector. For all the wonderful compassion of horribly underpaid, highly skilled care workers, that is their real status. Many care homes are loaded with unsustainable debt, owned by private equity and reliant on risky financial structures. A 12% return is expected, yet this should be, without the debt, an extremely low-risk financial sector, where a 5% rate of return is considered reasonable.

I look forward to the speech of the noble Lord, Lord Sikka, who I believe will be setting out further detail on this, but I want to look at the question posed by the noble Baroness, Lady Greengross. Where is the intergenerational problem here? We have a system problem: the exploitation of each generation in turn by the financial sector, and the exploitation of the workers whose caring humanity leads them to labour for utterly inadequate wages in poor conditions. The elderly today are being treated as cash cows, and the young are being expected, through national insurance, to pay in, before in their turn being forced into the same dysfunctional, exploitative system.

I saw some debate that insurance might fill this gap, but why do we not insure all generations, and all of our futures, as we do with a still inadequate and inequitable but basic state pension, by providing free social care to all who need it, funded—in another term, insured—by all of us through general, fair, progressive taxation; far more progressive taxation than we have now? That is society taking responsibility for all its members, sharing the responsibility for all who need care.

The Green Party calls for national insurance to be replaced with a single, unified income tax to reduce loopholes and raise £24 billion to fund social care. All income, including rental and investment income, would be taxed at the same rate, and this, of course, would remove the unjust loophole whereby earnings above £50,000 are charged only at the 2% national insurance rate. As with medicine, so with care: there should be no place for the profit motive in its provision.