Social Care

Lord Archbishop of Canterbury Excerpts

Thursday 30th March 2023 Lords Chamber

[The Archbishop of Canterbury]

My Lords, I am very grateful to the noble Baroness, Lady Andrews, for securing this important debate, for her Select Committee’s outstanding report on adult social care and for including the recent report of the Archbishops’ Commission on Reimagining Care in the debate title. I am also very grateful to my noble friend the right reverend Prelate the Bishop of Carlisle, who co-chaired the commission. He will be addressing some of its specific recommendations later. I would like to speak about the motivation for its commissioning by the most reverend Prelate the Archbishop of York and myself.

First, in common with those of almost every political, religious or social belief, we think the current care system is broken. It cannot be tweaked; it needs reimagining. We have had the same reason for the Church reports on housing and, I regret to say, the same indifference to them from the Government, despite the enthusiasm of the industry in both cases.

Secondly, each of the reports we commissioned is based in Christian values which have guided this country at its best for centuries but overlap almost exactly with those of other faith groups and those of humanists. We were discussing this, over an Iftar meal on Monday evening, with Muslim leaders from across the country. Anything like housing, care, households, families, ethnicity or race has to have a value base which is realistic, mitigates possible harms and exalts the value of human dignity. The values must also maintain a healthy realism on the tendency of individuals and institutions, including government and the Church, to look for short-term fixes in their own interests, not long-term solutions for the common good. The list of reports and White Papers, so eloquently put by the noble Baroness, Lady Shephard, which really should have ended with “and a partridge in a pear tree”, illustrates this point finely.

Thirdly, each report makes demands of government but also of every other aspect of society. In terms of care, it may be companies and businesses, charities, families and households, and we always point to the needs for the Church of England to improve and up its game. Every part of society is needed to be involved in care.

This commission was started in April 2021 and produced its final report in January of this year. We need an understanding that care and support is not an end in itself but the means by which every person can begin to fulfil their potential as a human being as it varies through life. The commission’s central recommendation is for the development of a national care covenant. This would clarify the mutual responsibilities of us all—individuals, families and communities, alongside local and national government—in relation to care and support.

Funding matters. If it is our starting point, we will fail. Once we know what kind of care system we are aiming for, we can begin to see how it could progressively be paid for. Much as I admire His Majesty’s Treasury, if we start with it, we will be pragmatic but are unlikely to be imaginative.

The revolutionary value that should be at the heart of our social care system is interdependence. In the report, it replaces the myth of autonomy for each person. No one is autonomous; we all rely on others at every point of life and death. We must recognise that reality, with its beauty and dignity. Interdependence builds community; autonomy creates atomisation. Atomisation is painfully described in a book with that name as the title in the English translation but which in French is called Les Particules Élémentaires, by Michel Houellebecq. Autonomy takes us to Huxley’s Brave New World; interdependence overcomes differentials of class and power and offers the prospect of robust compassion. Autonomy ends up with dependence on the state, because we all need support. It is a myth, and the truth is found in the prayerbook phrase

“whose service is perfect freedom”.

Interdependence takes us away from a narrow argument about who should provide care and instead says that responsibility lies with all of us to different degrees: with families and communities; with government, with regard to funding and implementation; and with NGOs, the voluntary sector and community actors such as churches, with regard to participation.

So I ask the Government and the Minister: will they begin, as we move forward, to reimagine the care system and to look at setting out clearly through a national care covenant the mutual responsibilities we all have?

Child and Adolescent Mental Health Services

Lord Archbishop of Canterbury Excerpts

Monday 30th October 2017 Lords Chamber

[Lord O'Shaughnessy]

I know that the noble Baroness cares passionately about this group of people. My understanding is that those policy issues are being considered in the round with the social care consultation. I shall write to her to clarify that point. She might like to know that, in the upcoming Green Paper on children and young people’s mental health, there will be an expansion of some of the work that has already gone on around providing mental health first aid and various other things in schools, which will capture some of the young people that she is talking about.

[The Archbishop of Canterbury]

I declare an interest as having members of the family who have used child and adolescent mental health services. Does the Minister not agree that the fundamental principle of the NHS is free treatment at the point of need? Does he also agree that one of the major failures in CAMHS—it has been well evidenced by academic studies over the last two years—has been that, because of the shortage of resources, only those with the most critical needs are treated at all, and the early intervention which would help prevent needs becoming critical has been deeply neglected owing to an absence or lack of specialised therapies, particularly talking therapies? Will he confirm that the work on the most critical side is going to be extended so that children and adolescents can get care earlier and more effectively, saving the state money and fulfilling the purposes of the NHS?

[Lord O'Shaughnessy]

Yes, I wholeheartedly agree with the most reverend Primate. We are making up for lost time, unfortunately, with children and young people’s mental health care and there is a lot to do. He will be pleased that the additional funding being provided is helping with the rollout of the children and young people’s IAPTs—the talking therapies. As I said, the intention of the extra funding is to be able to treat 70,000 more young people, on top of those who have already been treated, by 2021—so more young people are being seen. That will increase the 25% of the potential caseload currently dealt with to 35%. Obviously that is better but it is not the whole way.

NHS: Food Banks

Lord Archbishop of Canterbury Excerpts

Thursday 26th November 2015 Lords Chamber

[Lord Prior of Brampton]

The factors behind obesity and malnutrition are extremely complex. The all-party inquiry referred to complex and frequently overlapping factors. The work done by the University of Warwick found that there was no systematic evidence on drivers of food aid in the UK—and the evidence was drawn not just from the UK but from the US, Canada and Germany.

[The Archbishop of Canterbury]

Does the Minister recognise that the comments at the time of the previous Government about there being no link between benefit changes and food banks was significantly challenged at the time and that our experience in Church of England, which is involved in the vast majority of food banks across the country, is that between 35% and 45% of people coming to get support from food banks report that the reason for running out of food is to do with changes to the benefit system and sanctions?

[Lord Prior of Brampton]

All I can do is repeat what I said before which is that, as Ed Davey said, there is no statistical link, in his view, between the Government’s benefits reforms and the provision of food banks. I think that the issue is much more complex than the most reverend Primate is suggesting.