Social Care

Lord Balfe Excerpts

Thursday 28th October 2021 Grand Committee

[Lord Balfe (Con)]

My Lords, I thank the noble Lord, Lord Lipsey, for initiating this debate. We have gone round and round on this subject for many years; as the noble Lord said, he was on a royal commission long before I ever got anywhere near this House—indeed, before I ever thought I would.

One of the difficulties is that there is a wide range of social care. Some people who are in need of residential care, which they pay for, are not that far away from people who are in need of care through the NHS or some other public body where it is not even thought that they will pay. There is a penumbra in between. The wide range of social care is also reflected in the demographics of the country. My generation is living longer than any previous one. No member of the previous generation of my family ever lived as long as I have now, so there is a general tendency to live longer.

However, there is also a general tendency to wish not to face facts. It exists in our household, where we cheerfully say to each other, “Well, of course, all our family died of strokes. They haven’t lasted very long. They’re unlikely to need anything other than an ambulance to take them off to the hospital, and they probably won’t come back.” This is a factor when people look at whether they should make any advance provisions for social care. I stress “advance” because, if you are going to ask people to take out insurance policies, the policy will be meaningless for many of them; they will never draw on the policy because they will die in a way that means them not needing its benefit.

I have a limited example of equity release. I must say, there must be a lot of money in it. Two years ago, in an idle fit on a Sunday night, on my computer, I filled in one of those forms that says, “How much could you get for your house if you sign up to our equity release?” I thought, “That’s interesting. I wonder how much I would get.” I filled in the online form; it is the only form I have ever filled in but, since then, I have had a regular stream of offers of equity release on my house—and not only from the people whose form I filled in. It is fairly obvious that the information has been sold off around the industry. Every couple of months, I get an invitation to take up equity release. Clearly there is a lot of money there. I also think that there is a lot of capacity for mis-selling in the equity release market; we probably need to look at that.

Next, the Conservative Party’s proposals are interesting. I am pleased to say that the Conservative Party is a party that looks after the wealth of people like me. In other words, what we are talking about is wealth preservation. When we talk about the cost of care for the elderly, we are actually asking whether we can preserve our wealth, particularly in our house, to pass it on to the next generation. Putting it crudely, that is what this is all about. Of course, for many ordinary people who live in council flats or rented accommodation, there is no pool of wealth; that is the big challenge that we face.

I am afraid that my solution to help individuals to pay for social care is that they should probably pay a sum of money towards it, and that most of the fancy systems devised will prove to have flaws in one way or another; they all have weaknesses. It is the fairest way of all. It may be hard luck on the children but, frankly, if you have built up a sum of capital it is not unreasonable that you should spend it on looking after yourself. After all, you would not say, “I need to save money for my children, so I won’t eat or pay the rates.” If you are unfortunate enough to need some form of care, that should be paid for by the person utilising that care.

I noted the noble Lord’s point about the housing association remedy. That is fine if you are a single person, but it is no good if you have a partner living at home—let alone dependants of that partner—because they will need to carry on living there. You cannot give the house to a housing association and draw money. My not very happy conclusion is that we probably have to carry on not far away from where we are at the moment. It may produce its anomalies, but the anomaly of getting people who have money to use it for their care is not unacceptable. It is not as bad as some of the anomalies that would occur if you tried to tilt the system so that the owners of capital were somehow exempt from using it for their care. It is a rather gloomy prognostication, but it is my conclusion.

I hope that the Minister and the department will be very cautious before they come forward with plans. I warn them that there has been a problem in some continental countries, in northern Europe. Where you go down this slope of free care, you will face enormous bills. Take a day trip to Denmark, and ask about the cost of care for the elderly. They are not only tremendous but unceasing. At the last election in Denmark, part of the debate was about how many baths per week should be provided by the local services that cared for people in their own homes. That is because Denmark has the universal system, but that system will run out of money every time more money is put into it. It will make the National Health Service look a relatively tame organisation. You will find that there will be huge debt if you go down that path. I caution the Minister: he should be very careful.