Social Care

Baroness Wheatcroft Excerpts

Thursday 29th November 2012 Lords Chamber

[Baroness Wheatcroft]

My Lords, I should like to add my thanks to the noble Baroness, Lady Pitkeathley, for securing this important debate and for her eloquent speech which showed how well she knows this important sector and the issues it faces. She also made an eloquent plea, as have others, for more money. But money is not the only answer to this problem, and that is just as well because, as we know, we are living in a time of austerity and the money to do everything we would like to do simply is not there. We have to look for more creative and collaborative solutions, as the noble Baroness, Lady Campbell, has just said. We have to look for more integration and the greater use of computer technology. We have to be inventive.

There are productivity gains to be had. A recent report from the King’s Fund pointed to the fact that there is a great search for cuts as an end in itself rather than a search for the productivity gains that could deliver cuts in spending. A recent report from the Policy Exchange, of which I am delighted to be a trustee, sets out the following sentiment:

“If we could provide integrated care bringing together primary, community, acute and social care we could provide better care for the frail elderly and save a great deal of money”.

That statement was made by David Prior, the chairman of the Norfolk and Norwich University Hospital NHS Foundation Trust—and he was talking only about integration within the NHS itself. Here we are talking about the need for integration across the NHS, social services and housing, but none of that can be done until the NHS itself manages to bring down some of the extraordinary barriers it has put up between the various parts of its own organisation. The NHS could and should be a much more integrated and efficient organisation. Experiments are being carried out in parts of the country, but nowhere near enough is being done on that front. Even the Local Government Association accepts the need for reform and that money alone will not be enough to solve the problems we now face in this area.

The state cannot do it all. Although we have already heard some appalling stories of people who are really suffering, I would maintain that that is not just because of the cuts; they are suffering because of some very severe breakdowns in our society. Those who have seen the Times today will have noted the headline on the front page about the number of people in our country who will spend Christmas alone this year—some 250,000. The Times quotes a survey which has found that one in 10 of those aged over 75 confesses to being intensely lonely all of the time. Loneliness is not just a misery in itself; it is a cause of ill health. It drives people to see their doctors. It is something that we all need to address together. Family breakdown has caused severe agony in this country. We have to look for creative solutions to help those who are growing old not to feel lonely and end up seeking medical help. They need to be integrated into communities and not to live in single-person households, as so many do, unless that is what they really want. We should be able to offer more constructive, healthy and enjoyable alternatives. While they are still fit and well, we need to get people to move into communities where they will have the sort of wonderful life that we in this House enjoy. It actually encourages life expectancy far beyond the norm. People need to be in groups. If they were living in groups, the state could provide at much less expense the sort of 24-hour care that will eventually be required.

We have heard about people who have had to give up their jobs to care for elderly members of their families, but they are rarities now. What we need is to make sure that the community as a whole takes on the responsibility of looking after its elderly. There are other constructive ways in which we can do this. Some schemes arrange for younger people with nowhere to live to be paired with elderly people who live in houses with too much space. The relationship benefits both sides. The young person agrees to do a certain amount of work helping around the house and doing the shopping, although just being there is often more than enough. That sort of help can preserve an elderly person’s sanity and keep them fit for many years.

We will hear again today about the need for more money and more spending, but I think that we could spend what we have more effectively, more efficiently and more creatively.