(5 years ago)
Lords ChamberThe noble and learned Baroness is quite right that people should have a choice in end-of-life care. The long-term plan recognises that we need to improve that choice and the quality of discussions around it. That is at the heart of the drive to improve personal health budgets and help staff identify personalised care planning for end-of-life care. I hope that reassures the noble and learned Baroness that this is seen as a top priority in end-of-life care planning.
My Lords, the Minister has mentioned NHS support, but she will know that by far the majority of support for carers in these circumstances comes from local authorities. How does she react to all the current research showing that not only are services diminishing for carers in local authority areas but also the number of assessments, in contradiction to obligations under the Care Act and the carers action plan?
The noble Baroness will know that this has been identified as a priority, not only from the call to action from carers themselves that services and systems that work for them should be improved, but also because it is one of the 64 actions in the carers action plan. It is something the Government are determined to take action on. We are concerned by the reports and taking action to improve it.
(5 years, 3 months ago)
Lords ChamberThe noble Baroness is quite right that the better care fund has been considered a great success. It is an important part of the integration proposals between health and social care, which the Government and the NHS are committed to. It is under review to see how it can work better. That will conclude later this year so that certainty can be given to local councils, which I hope she welcomes. On market instability, I reassure her that the overall number of social care beds has remained more or less constant over the past nine years. There are also over 3,700 more home care agencies now—so, while there will inevitably be some exits from the market, we are more reassured than we would otherwise have been.
May I take the noble Baroness back to her reference to personal responsibility? There is a great deal of agreement across the House and elsewhere that personal responsibility is important as far as social care is concerned, but does personal responsibility extend to subsidies for those on local authority placements in nursing homes? Those paying for themselves privately are actively subsidising those places because local authorities cannot afford adequate rates.
The noble Baroness has got to the nub of the challenge, which is how we get the balance right. This is why we have brought forward the work we have been doing to make sure that, while we have the safety net in place and an element of personal responsibility, it becomes fairer. That is why the Prime Minister and the Secretary of State have made it clear that they are determined to drive this work forward faster and with more urgency than has been done until now. That has been put forward as a key priority of the incoming Cabinet.
(5 years, 4 months ago)
Lords ChamberI thank my noble friend for her question. We should pay tribute to those who work very hard in the social care system under very challenging circumstances. Swindon, for example, has brought in a co-designed service with users and an increase in reablement of 150%, bringing an annual saving of £1.9 million to the health and care economy, while also reducing DTOC. Services and improvements such as these should be spread across the system. That is exactly what the better care fund is designed to do, and it is what the new models of care commitment within the NHS long-term plan will spread across the system so that we can improve social care for all.
(5 years, 4 months ago)
Lords ChamberTo ask Her Majesty’s Government what proposals they have to guarantee support for family carers following the cuts made to local authority and voluntary sector support services.
My Lords, the Government have given councils access to £3.9 billion in dedicated funding for adult social care in 2019-20. Last June, we published the carers’ action plan, a cross-government programme of targeted work to support carers, including a £5 million carers’ innovation fund to encourage new and creative ways of doing so. We are also working with local government to ensure that carers can access the support that they deserve and promote best practice in carer breaks provision.
I thank the noble Baroness for that Answer, which I listened to with great interest. I am the first to acknowledge that much progress has been made for carers in recent years, especially winning rights for them under the Carers Act. But I wonder how the noble Baroness would respond to the carer I spoke to on Friday. She is 79, recovering from cancer that has left her with severe back pain and caring for her 91 year-old partner, who has vascular dementia. Fourteen times she has asked her local authority for the assessment, to which she knows she is entitled. Fourteen times she has either been ignored or refused. Her local carers’ group, which was a support to her, has closed down because its funding has been cut. “It is no good telling me I have a right to services”, she says. “There are no services. There is only me and I am about to go under”. How does the noble Baroness respond to her?
The noble Baroness has raised an important point, which is that we need to provide carers with the support they need, because they do an amazing job. Unpaid care is a vital part of a sustainable health and social care system. This is why the long-term plan has put in place an ambition to ensure that we provide sustainable support across the public health system, and will ensure that we have a quality mark for primary care to highlight best practice. I am very sorry to hear about the experience of the carer in the case that the noble Baroness highlighted and would be pleased to follow this up with her directly, after today’s Question Time.
(5 years, 6 months ago)
Lords ChamberI shall have to write to my noble friend in order to answer her question with the best accuracy possible. However, my understanding is that the ring-fenced funding will be spent on health professionals rather than probation professionals. One of the most effective measures introduced under the five-year forward view, which has delivered very effective outcomes, has been liaison services. I shall investigate the point that she has raised and come back to deliver the response that she deserves.
My Lords, does the Minister agree that continuity is what is important here? That means continuity of care and of services across the NHS, social care and family support. In the absence of any coherent plan for social care, which is needed by mental health patients almost as much as medical care, have we any hope of achieving this continuity? And if the Minister could say anything about the Green Paper, I am sure the House would be delighted.
The noble Baroness is right to identify the need for continuity of care and the fact that community care is essential to ensuring good mental health outcomes. That is exactly why the focus in the long-term plan is on ensuring prevention and early intervention and on targeting the support of liaison services—for example, support for mental health training in the context of schools as well as for liaison services in policing and other areas. She is right that we must endeavour to deliver on the social care Green Paper. It is imminent, and I look forward to the debates in this House when it is produced.