Social Care Funding (EAC Report)

Baroness Young of Old Scone Excerpts

Thursday 28th January 2021 Grand Committee

[Baroness Young of Old Scone (Lab) [V]]

My Lords, 12 years ago, I was the chairman of the Care Quality Commission, the regulator for the quality of health and social care. I was chilled when I saw the impact of the funding arrangements for social care on people’s access to care and the quality of care they received. Nothing much has changed in the funding system over these 12 years. In the meantime, adult social care needs are rising exponentially and funding has decreased in real terms, even with the recent additions to budgets. Local authorities are responding by raising the eligibility bar for social care, so that you have to be on your knees or virtually destitute to get funded care.

People who cannot access care are hidden at home and are a burden on unpaid carers. For those who can access it, what is the quality of that care? Much care provision at the higher end of the spectrum is fine, but it became clear to me at the CQC that care providers, funded at the very basic levels that local authorities can afford, simply cannot provide a quality service at that cost; nor can they pay the staff who deliver it more than the minimum wage. Providers either live on the edge of going bust or flee to the self-pay end of the business.

The result is that many of the less well-off in our society, who have been unable to amass savings or capital, because they have been in poorly paid jobs or unable to work due to illness or disability, are in a poor position. They are faced with a lack of access to services, poor-quality services and being looked after by staff who are often transient and paid a minimum wage, and have no qualifications and little training. I ask noble Lords: would you relish that prospect for your mum or disabled member of your family or—now that we are getting older—for you or me?

Successive Governments have failed to grasp the nettle. In 2019, the Conservative manifesto committed to building cross-party consensus and bringing forward a lasting solution, but it has not. It spoiled that assertion by continuing the old Conservative shibboleth that no one should have to sell their home. I believe that equity release schemes should not be off the table.

Three things need to happen. First, cross-party consensus talks should be set up now, be independently chaired and have a strict deadline to bring forward both proposals and implementation plans. Secondly, a progressive and pooled contributory system for pre-funding care costs should be set up, as a matter of urgency. It should be kept simple and communicated effectively to the public, in personal terms that talk about care for their family members, so that we get away from these appalling headlines of “death taxes” and “dementia taxes”. Thirdly, radical changes in social care staffing should be fast-tracked, covering qualifications, training, regulation and pay.

The Economic Affairs Committee is right: it is time to end a national scandal. The Government are politically nervous about tackling the issue, as a result of the sorts of headlines I talked about. Right now, Covid has meant that the public understand the challenges and importance of social care more than ever before. Can the Minister tell us that the Government will act now and that we will not get another Green Paper, and that we stop letting down the most vulnerable in society and the staff who are trying hard, against all the odds, to care for them?