Covid-19: Social Care Services

Lord Tyrie Excerpts

Thursday 23rd April 2020 Lords Chamber

[Lord Tyrie (Non-Afl)]

My Lords, I agree with a great deal of what has been said. Some extremely powerful points have been made. I will confine myself to just one further point about making sure that we maximise the effectiveness of public expenditure in this environment.

The underlying objective of policy must be to minimise the loss of life from the epidemic. The challenge is to find ways to use all the resources available for that job. Some core facts help us think about that. We know that 80% of deaths are likely to be among the over-70s and that most of the remainder will be among those with underlying health conditions. It must follow from that that a very robust lockdown, with whatever financial support is necessary—substantially more than currently —to the elderly and other vulnerable groups, is needed. That funding will need to be maintained indefinitely, unless a vaccine or treatment is found or it turns out that, as now seems less likely, general immunity can develop in the population at any pace. That is the backdrop to this debate. A very high proportion of the most vulnerable people are in care homes, so they need particularly rigorous protection with a much more intensive infection control regime than is currently in place, and the public expenditure simply has to be found to pay for it.

Of course, the merits of any increase in spending among the elderly or the vulnerable will have to be set against the cost of the currently indefinite lockdown, but some basic numbers help to flag up how clear it is that the money should be spent. The overall cost to the Exchequer of coronavirus is forecast to be £218 billion, or 11% of GDP. Total local authority spending on adult social care last year was £21 billion, or 1% of GDP. I think that your Lordships can draw conclusions from those figures. Spending on infection control in care homes is affordable when seen against the backdrop of those numbers, and it would pay off in spades. Of course, analysis of that type can and should form part of an overall assessment of the health effects of the lockdown, both on morbidity and particularly on mortality. I argued for such an assessment and for greater concentration of support on care homes a month ago in the Chamber, on the last day before the Recess. In my view, it is now absolutely essential. Of course what I am describing is very difficult work, but it seems scarcely less difficult and uncertain than the work already being undertaken on the epidemiology and more widely.

I urge the Government not only to undertake that full healthcare analysis—of which care of the elderly will be a crucial part, including the funding of care homes—but to publish it. I very much hope that the Minister will tell us that it is already under way.