Elderly Social Care (Insurance) Bill [HL]

Baroness Brinton Excerpts

2nd reading
Friday 16th July 2021 Lords Chamber

[Baroness Brinton (LD) [V]]

My Lords, I declare my interest as a vice-president of the Local Government Association and a vice-chair of the All-Party Parliamentary Group on Adult Social Care.

I thank the noble Lord, Lord Lilley, for securing this early slot to present his Bill, although these Benches have serious issues about the principles and details of his proposals for creating an insurance scheme for elder social care. In March, I read the noble Lord’s paper on his scheme, which was published by Civitas. It is right that policymakers on all sides of the political spectrum think through the series of complex problems our social care sector currently faces. I thank him for continuing that debate in your Lordships’ House through the Bill, even if we do not believe that it is the solution.

The noble Lord referred to a live rail running alongside the funding reforms for elder social care. As many other noble Lords have said, these proposals miss the point. We need to devise a comprehensive elder social care system for everyone, whether home owners or not, and regardless of the value of their property if they are. We agree with many speakers today who have talked about having that universal social care system for everyone regardless of assets or income. I also echo the comments made by other noble Lords about the excellent report on this issue by the committee chaired by the noble Lord, Lord Forsyth, and the noble Lord, Lord Cormack, is right to say that this House needs to debate that report as soon as possible. It is a disgrace that we have not had the chance to do so. It is very overdue.

In 2011, Andrew Dilnot’s report on the funding of elder social care was published and, for a while, all three major parties worked together to make it happen. Dilnot proposed a neat solution, using facts about average stay in a care home, percentage of people needing it and average costs. All three parties were on the point of agreeing it, when, I am sorry to say, the Conservatives walked away. Ten years on from the publication of the Dilnot report, it looks, if the leaks to the Times and the Telegraph are right, as if it is back on the agenda. I hope that is correct. It was a fair and equitable proposal that merited serious consideration.

We await the Government’s long-overdue proposals. It is two years since the Prime Minister announced it as an absolute priority and well over 18 months since he stood at the door of No. 10. However, the devil will be in the detail. The current funding system for elder social care is a disgrace, and we must remove the fault line, as the noble Baroness, Lady Chakrabarti, called it, between health and social care at the source. The problem with this Bill is that it tries to create an insurance system which the insurance sector does not want to provide for, so the noble Lord proposes that the Government go into the insurance industry themselves, an industry where they have no experience or track record of success. That way disaster lies.

What we need is a system that sets a cap on costs that individuals have to pay, in the style of Dilnot, but underlying that there must be a mechanism for funding social care properly, on a par with health and, as we said in our manifesto in 2019, to be funded beyond that Dilnot cap through taxation. That means that those who do not own their own homes or have homes of low value will have access to the same social care as those who have houses of high value. It would also stop the current inevitable but wrong practice of private social care patients funding the publicly funded ones because local authorities are not given enough funding by central government to cover that public funding duty.

Our social care sector needs a much more fundamental review, and I hope that the Government will provide that root-and-branch review beyond funding. The noble Baroness, Lady Verma, is right: until there is parity of esteem with the health sector, it will always be treated like the Cinderella service it feels it is. This Government’s callous discharging of patients with Covid into care homes last year in order to protect the NHS epitomises that, and I am glad they stopped that practice. Pay structures, career pathways and the treatment of staff are always compromised by the amount of funding coming into the social care system, which is why we are in this mess.

We also need to fund care support that is not based around care homes, which gives older adults the protection and support they need to keep them independent to avoid the need to go into care homes, which is vital with a rapidly ageing population. This Bill would not cover that critical part of the multidisciplinary services, including, for example, encouraging post-retirement, part-time working, whether paid or in the voluntary sector, to keep minds active, or including a healthcare system that considers prevention as a priority—for example, of fractures, rather than always just having to repair them, which often leaves people much less independent than they were before. It should also include investment in social activities in communities, which many local councils can no longer afford to do with their squeezed funding following government cuts.

We on these Benches do not support the Bill. I hope that proposals from the Government, whenever they finally appear, will present a root-and-branch reform of social care and not just the funding mechanism for home owners. Can the Minister say when they will be published and whether they will be the comprehensive reforms that all Members have highlighted in today’s debate?