Social Care Strategy

Baroness Neuberger Excerpts

Thursday 10th October 2024 Lords Chamber

[Baroness Neuberger (CB)]

My Lords, I declare an interest as chair of both UCLH NHS Foundation Trust and Whittington Health NHS Trust. I thank the noble Baroness, Lady Thornton, for what she said, because I now do not have to say it—but, yes, it is an integrated care system and it actually works. I also declare interests as the former chair of Independent Age and a present trustee of the Rayne Foundation.

I say a major thank you to the noble Baroness, Lady Tyler, for initiating this debate and for what she said. I congratulate the noble Baroness, Lady Keeley, on an amazing maiden speech, and I give a virtual hug to the noble Baroness, Lady Donaghy, because she deserves one. It was wonderful to hear the noble Baroness, Lady Thomas of Winchester, speak.

We have heard a lot about how the noble Lord, Lord Darzi, described our social care system as “dire”. It is dire for many reasons. NHS hospitals cannot discharge people who are fit to receive packages of care because there is nowhere for them to go and no money with which to do that. It makes everyone feel powerless. If we had Care England’s proposal for a national tariff of £1,500 per week for intermediate care for people coming out of hospital, people would be able to get out of hospital and we would be able to free up some beds and make the system work better. That is one small thing we could do. It may be expensive, but it is not that expensive.

It is dire because the social care workforce is so often undervalued, underpaid and insecure, as we have heard. It has a fragmented provider landscape and commissioning arrangements that limit innovation and change. That means insufficient support for untold numbers of unpaid carers who are looking after loved ones day in, day out, until they too cannot cope and are in crisis. It is dire.

However, there are ideas out there of what might help, which is why I cited my interest as trustee of the Rayne Foundation, which has a new grant programme for adult social care workforce development, Better Careers for Better Care. It is based on the theory that, if you value and invest in the workforce, people will receive better care if they need it; that way there will be fewer crises and it will cost less, so that both unpaid carers and the care workforce will feel more able to cope and be more appreciated. That should lead to a better and more secure quality of care for those who need it, and I think that the Government need to look at that very closely.

Care England has produced some policy papers, with proposals so breathtakingly obvious that I am amazed that the Government have not yet taken them up. Among them is increasing the minimum wage in the sector to £15 an hour—and we know that there is a manifesto pledge to do something. I echo the noble Lord, Lord Davies, on pensions being added to that, because that is essential. The other thing is having a proper professional register of care workers, paid for by government; that way we know that the care workers are up to the job.

These are first steps. Valuing the social care workforce is fundamental to providing high-quality care and fundamental for those providing unpaid care, for whom respite is being able to step away from their loved ones for just a few hours. Can the Minister tell us how far the social care strategy has been developed and whether the urgency that we have all expressed has been acknowledged? Might she tell us to what extent, in the shorter term, the Government will examine how the care workforce is treated and valued and move to a system where development and training are the norm? That alone would make a difference in a complex landscape where we need urgent action.