Social Care Funding (EAC Report)

Baroness Jolly Excerpts

Thursday 28th January 2021 Grand Committee

[Baroness Jolly (LD) [V]]

My Lords, social care funding for older people or those with a disability has been put in the “too difficult” or “too expensive” box for as long as I have been involved in health and care policy—about 20 years. At every general election since 2010, there has been a promise to fix it, and, sure enough, after the 2019 general election, as we have heard, Prime Minister Johnson joined his predecessors and promised to address the issue “once and for all”.

State provision of social care is not easy, it can be expensive and there is no right way to do it. The German and Japanese models are often quoted; they involve members of the public contributing to an insurance system that will pay for their care once they need it.

England has no state provision of social care. We have a system whereby the person’s needs are addressed and, after a means test, they will find if they are eligible for financial support from their local authority. This will go some way towards the provision of their social care, either in their own home or in a residential setting, but not accommodation costs.

Local authorities pay out at different rates. I sat on the joint scrutiny committee for the Care Bill 2014. We heard of families moving to a neighbouring county to ensure that they were eligible for a more generous provision. Sometimes there is a need to top up from savings or by selling or remortgaging the family home. Some with long-term care needs might, for many years, face care costs that seem reasonable at the outset but will quickly erode savings. So the proposed cap is welcome.

The proposal to introduce free personal care over the next five years should be adopted. This would require an immediate investment of £8 billion—the estimate from the King’s Fund and the Health Foundation.

The other part of the care system is for those adults with disabilities; the majority—1.5 million—have a learning disability. Until last year I was chair of a charity which cared for over 2,000 adults with a learning disability. With help, such people can lead a fulfilling life. Many are in residential care or supported living. The funding from this comes from local authorities, which hold the responsibility for their care. Each year the conversations with commissioners become more difficult, as local authorities’ budgets are stretched and the costs of caring rise.

As the noble Baroness, Lady Kingsmill, said, care workers are paid poorly, and should be receiving the real living wage of £9.50 per hour but many do not. Those who work in the care of either older people or those with a learning or physical disability are not unionised, as nurses are. They are not regulated; nor are they required to have formal qualifications, but many would take the care certificate. Someone who has been fired for negligence or worse can walk out and get a job straightaway. This should change.

Whichever way you look at it, the current system is no longer fit for purpose. There is a sustainable solution. The report of the Select Committee of the noble Lord, Lord Forsyth, offers a route map for the department. Mencap estimates that £3.2 billion would stabilise the system. So, when they have a moment, the Prime Minister, the Chancellor of the Exchequer and the Secretary of State for Health and Social Care should read this report, and do what successive Governments have promised to do: fix the funding of the care system. This would be welcomed by so many older people and their children.