Care Bill [HL]

Baroness Bakewell Excerpts

Monday 29th July 2013 Lords Chamber

[Baroness Wilkins]

My Lords, I, too, speak in support of the amendment in the name of my noble friend Lord Warner. I have said before that I warmly support the principles behind the Bill and the modern framework that it provides for social care. However, there is a world of difference between principle and delivery, and many things determine that difference.

Money is not everything, but the lack of it can mean the difference between certain misery and a chance of happiness, between one’s health deteriorating at an unnecessary rate and being maintained at its possible best, and between mere existence and feeling wholly human. Little will change for the better unless social care is adequately funded—and not just by funds transferred from an increasingly strained health service. As has been reiterated many times throughout the debates on this Bill, social care is in crisis. In the past few years, as the Care and Support Alliance has shown, many tens of thousands of people have lost vital services as a result of tighter eligibility criteria. Their needs have not changed; they have simply been redefined out of care, leaving them in many cases more isolated and, in some cases, at greater risk. The strain on family members has also increased as a result.

At Second Reading I raised the fears of the more than 20,000 disabled people with high support needs who have been funded by the Independent Living Fund to live independent lives. They fear a return to institutional care now that the fund has closed and the funding responsibility transferred to local authorities. I asked the Minister then for a reassurance that their fears were not justified and that the transition funding would not finish after one year. Sadly, he was unable to give any such reassurance, so the situation for more than 20,000 severely disabled people threatens to become much worse. As we know and have already heard, local authorities have been required to implement swingeing budget cuts for some time, most recently a cut of 10%. Can the Minister give that reassurance now? His department must have calculated the funding that local authorities require.

On 18 July, the Government launched the Caring for our Future consultation on reforming what and how people should pay for their care and support. This important document is over 100 pages long and covers a complex set of questions that are difficult for most of us to get our heads around unless we are specialists in the field. What plans do the Government have for making sure that people using care and support services and their carers are fully involved in the consultation and given the necessary information and support to make a constructive contribution?

There is no doubt in my mind that we must take a clear-eyed look at what funds would be sufficient for the aspirations of the Bill to be delivered. If we are to meet this once-in-a-generation opportunity to craft a care system that meets the real current and future challenges, we should remember that by 2030 the number of people aged over 85 is set to double; that is, a 6% increase every year on the 2013 figure. Are we prepared to aim for a decent level of well-being rather than accepting that thousands of our fellow citizens will live—and die—in misery?

[Baroness Bakewell]

My Lords, I endorse and support the amendment in the name of my noble friend Lord Warner. We have been watching a very impressive Bill go through this stage. If it is not funded properly, the political and social fallout in terms of the disappointment of an entire generation will be catastrophic. That generation will simply lose the trust that it puts in our capacity to legislate for the needs of society. That is what is at risk and why we need this review of the funding. I have not been a part of the debate so far and I will simply speak to one particular aspect of it, the postcode lottery.

Last week, the Office for National Statistics issued figures for life expectancy which show clearly the disparity between the north and the south. The lowest life expectancy for men is in Blackpool; for women, it is in Manchester. The highest life expectancy is in Dorset. That is not at all surprising. Dorset has the highest number of care homes in the country and has pioneered an outstanding care policy throughout the county based on early intervention and the reabling of people who fall ill. The county has found that this saves money and lives, and citizens are living longer because of it. It is exemplary.

It is not the same in the north of England. I was at a conference recently of the Local Government Association and I was constantly made aware of the pressures that councils in the north are under to trim their funding. Various statistics exist, but it is clear that the budgets of local authorities have fallen considerably. As was debated at the conference, the result is that the eligibility criteria are being squeezed across the north. It made me realise that councils in the north find it laughable that the cap of £72,000 for care should have any meaning for the citizens who live there. The outlook in the north is totally different from that in the more prosperous south. It is not as clear-cut as that, but I am generalising because it is important to grasp how fundamental the difference is. What I want to ask the noble Earl is this: does the funding under the Bill adequately address the increased disparity of care across the country?

[Baroness Greengross]

My Lords, I support the amendment of the noble Lord, Lord Warner. I partly echo what the noble Baroness, Lady Pitkeathley, said, because I think that the Bill is one of the best that we have seen in a long time. It really could meet our hopes and aspirations, but I am so worried about funding. We know that the funding seems quite generous, but the noble Lord, Lord Warner, did not mention that when he or Sir Andrew Dilnot talk about bringing these proposals into reality, if we set them against the costs of the NHS more widely, a minute part of the costs need to be covered to make the social care provisions real and thus take away the purely crisis intervention that we can see is on its way, as well as a complete lack of preventative care. That is what we hope for. I hope that the noble Earl will think again about the amendment so that we can keep the costing and funding of this under consideration on a regular basis.