Queen’s Speech

Baroness Wheeler Excerpts

Tuesday 15th May 2012 Lords Chamber

[Baroness Wheeler]

My Lords, I thank the Clerks and the Whips Office for arranging for me to speak now in the debate and for my noble friend Lady Thornton to speak later.

I want to address the vital issue of social care because, as we all recognise, the situation has long been at crisis point, and it needs real action in this parliamentary Session and by this Government. From these Benches we echo the consternation and deep frustration expressed by virtually all stakeholders—the voluntary sector and older people’s organisations, staff professional associations, trade unions and care providers —at the fact that, instead of the comprehensive Bill that we had been hoping for in this Session, what will be before us some time in the as yet unspecified timetable will be a draft Bill addressing only one, albeit important, aspect of the action that is required and, most worryingly, failing to address the key area of social care funding for the future. This is indeed a missed opportunity, a huge let-down. It is especially frustrating for those of us in the House who pointed out on many occasions during the passage of the Health and Social Care Bill that it was not much of a social care Bill, with its predominant focus on NHS structures, competition and institutions, and that there were no measures or solutions to address the growing social care crisis.

The mantra in response from the Government that it would be dealt with in the spring social care White Paper has certainly not been translated into the promised draft Bill. It is also worth reminding the House that my noble friend Lord Warner, in his usual constructive and helpful way, even put forward an amendment that would have enabled the Government to show good faith and take powers in the Bill to facilitate the implementation of the Dilnot report in whatever direction the hoped-for cross-party consensus would take it. Of course, the amendment was defeated, as were others that would have helped redress the complete NHS/social care imbalance in the Bill. They included having a tighter and binding definition of how NHS and local authorities were to promote the integration of health and social care services and providing health and well- being boards with real teeth and powers and the authority for final sign-off of the vital CCG commissioning plans. These measures would have reinforced in legislation the requirement for real collaboration and funding of local services to make the best use of resources across the NHS and in social care.

David Cameron committed to introducing legalisation,

“to establish a sustainable legal and financial framework for adult social care”,

which is another broken promise. The Health Minister, in his response to the debate in this House on the Dilnot report, stressed that,

“this is not an issue that we will shy away from”.—[Official Report, 24/11/11; col. 1194.]

That is precisely what the Government have done by not committing themselves to a comprehensive Bill and a timetable for the implementation of reform.

Of course, the implementation of the key recommendations of the excellent Law Commission report of 2011 in the draft Bill will be supported by these Benches, even though it will mean dealing with only part of the picture. The commission report was a landmark report and its translation into legislation will help simplify what it called an “often incoherent patchwork” of 60 years of social care law,

“incomprehensible to all but a small legal fraternity”,

as the Guardian put it last week.

We on these Benches support the modernisation of the legal framework for care and support. Setting out what support people can expect from government and what action it will take to help them will allow them to plan, prepare and make informed choices about their care, but it will not lead to the major improvements in availability, consistency and quality of care that we know is so desperately needed. Throwing into the Bill the laudable extension of personal budgets without dealing with how social care is to be funded to address the current £1 billion shortfall and the demand in the future will, I fear, raise expectations that cannot possibly be met.

Reform of social care must deal with the interrelated issues of long-term funding which allows for people to plan for the costs of retirement, improved quality of care through integrated health and social care commissioning, and the desperate current funding shortfall which has intensified the underlying mismatch between funding and demand still further. The failure to address these issues as a whole results in the twin evils of a growing number of people on low incomes who are no longer eligible for state support and too many people using too large a proportion of, or all of, their own assets to meet the costs of personal domiciliary care in the home or residential care.

We must not forget that there is no long-term solution to the social care time bomb that does not address the workforce issues: the low pay of care workers; training; quality of care; staff numbers; and commissioning which provides for home visits long enough to enable staff to provide the personal care and support that frail older people or people with long-term health conditions need to maintain their independence. We know that recent reports on personal home care, such as those from the Equality and Human Rights Commission and Age UK have exposed horrendous problems that deprive older people of dignity and respect. The vast majority of care staff and social workers do a good job and want to do a good job. The reality is that, all too often, it is just impossible.

I have stressed before that as a carer of a disabled adult stroke recoverer, the local agency care we receive is of high quality and the care workers show real empathy, respect and understanding of their client’s needs and of my role as the carer. Our local experience of care is the standard and best practice for which we must aim across the country, but it will not be achieved without tackling current and future funding issues.

As we know, Labour initiated cross-party talks on the Dilnot recommendations on social care funding and these are in progress. Labour is genuine and serious in its commitment to meaningful discussions and negotiations that unlock the Government’s malaise and lead to real change. We know that tough decisions are needed and that doing nothing is not an option for older and disabled people and their carers, the economy and the future of the NHS. The current system is at breaking point. It is unfair and inefficient. It results in fewer and fewer people getting the help that they need and ever mounting additional costs to the NHS and the taxpayer when people end up in hospital or residential care when they do not need to.

I hope that the Government will think again about their decision not to address the Dilnot issues in the White Paper and forthcoming Bill. David Cameron must fulfil his promise and engage personally to give the cross-party talks the backing and momentum that are needed to enable legislation in this parliamentary Session. Burying their heads in the sand and hoping that the problem will go away if Ministers deny that it exists often enough, or blaming cash-starved local authorities for the huge cuts that they have had to make as a result of current funding reductions and increasing demand will not do. Nobody is fooled. It is the Government’s responsibility and they must act now.