Social Care

Lord Patel Excerpts

Thursday 1st December 2016 Lords Chamber

[Lord Patel (CB)]

My Lords, it is a pleasure and an absolute privilege to follow the noble Baroness, Lady Cavendish of Little Venice. On behalf of the whole House, I congratulate her on a brilliant, thought-provoking and only marginally controversial maiden speech. We would have been surprised if it had not been thought-provoking, from someone who had been a director of the No. 10 Policy Unit, and if it had not been challenging or a little controversial, from someone who has written so many articles; I have scanned through upwards of 450 of them.

Some noble Lords may remember the noble Baroness as a campaigning journalist with the Times, and latterly with the Sunday Times, when she campaigned about the practices of the family courts regarding children. At the time, those who opposed her branded her as confused, biased, salacious and even malicious, but she was proved right and legislation was brought in to change the situation. In policy terms, she obviously convinced the Prime Minister and Chancellor that sugar and fat are bad for us, hence the legislation that has come forward relating to the sugar tax. We hope she will deal with some other matters in future, such as alcohol.

I found her writings interesting. If she goes back to journalism, particularly to the Times, it will be interesting to see how her articles on climate change contrast with those of the noble Viscount, Lord Ridley. In my view, the noble Baroness is the country’s best social analyst and thinker. No doubt we will be privileged to listen to her in future.

Noble Lords might wonder if there are any chinks in her armour. I found one, and I think it is from a reliable source. I do not think she campaigned to ban homework but she certainly thought about doing so when she forgot to take her son’s homework when they went to a literary festival in Cheltenham—I see that she suddenly remembers. The thought about banning homework may have come from François Hollande, who tried to ban it in France.

I hope the noble Baroness will speak often in this House. I encourage her to do so; I suspect she will be challenging, thought-provoking and entertaining to listen to. For today, I have the privilege of welcoming her to the House, and I look forward to hearing more from her.

I turn to my small contribution relating to social care. I currently chair your Lordships’ Committee on the Long-Term Sustainability of the NHS. Witness after witness has told us to concentrate on social care and, as the noble Baroness, Lady Cavendish, alluded to, have a wider public debate about social care and its implications. The noble Baroness, Lady Pitkeathley, and others have referred to how a lack of social care and the problems associated with it are currently killing the NHS. Hospital beds are blocked by people who should be in social care.

With regard to the workforce, we have heard evidence suggesting that by 2037, the gap in the workforce will be around 1.1 million if we have zero immigration or, if we have full immigration, 370,000. That is a huge gap in the social care workforce. On funding, the evidence we have heard from several witnesses is that the gap will be between £2.8 billion and £3.2 billion per year. That may not seem a large sum in terms of our national debt of trillions of pounds, but none the less it is a considerable gap in the funding, particularly of the local councils that have to deal with this.

So with that in the background, we need a solution that must involve the public. We must have a debate about the role of the state, of individuals, of the family and of the community in the provision of social care, and how individuals are going to take responsibility for their social care in future.

A Guardian article in October suggested that the Government have no intention of implementing Dilnot, but the Minister may correct me on that. If that is the case, a different solution needs to be found. In my view, the solution must be some commitment from the individual. It can only be through insurance. Insurance companies have hitherto not been encouraged to provide that and have never shown any enthusiasm to do so.

National insurance, as operates in Germany or Japan, is another way. In Germany, individuals pay 2.35% of their salary, which next year will increase by another 0.25%, which provides social care—although not all of it is provided; the public understand, and are encouraged to take out top-up insurance to cover for what state insurance does not cover. The Japanese system is interesting, because, over the age of 40, it is related to your income. You pay about 2%, related to your income, but it covers the totality of social care, including building modifications, appliances that are needed, respite care and all that. That is on top of the tax-funded health insurance, which covers most of the rest. Although I have not witnessed it, I am told that it works very effectively. However, part of its effectiveness is because of the responsibility that their family and communities take.

Will the Minister tell us, first, whether there is an intention to implement Dilnot? If not, given the crisis developing in social care, which some say is a bigger crisis than the pensions crisis, is any thinking going on as to how we will deal with and fix this crisis? Perhaps I may suggest that here is an opportunity for some bold thinking for a Prior solution that could be synonymous with the Beveridge solution and that fixes the social care problem for the long-term.