Social Care

Baroness Browning Excerpts

Thursday 1st December 2016 Lords Chamber

[Baroness Browning (Con)]

My Lords, I congratulate the noble Baroness on bringing this subject to the Floor of the House. I expect I am one of the old faces she mentioned who will be termed one of the usual suspects on this subject. I refer to my interests relating to this debate as set out in the register. Like the noble Baroness, I feel there is a touch of déjà vu about this. We know about demographic trends, the demands of an increasingly elderly population and the whole range of things which cover the gamut of the need for social care, and we have talked about them in this House for decades. Yet somehow, every time we have a debate about this, it is almost as though this is something new that has suddenly come from behind and we are rather astonished to find it is such a problem.

It is now a real problem. There are concerns about care services moving out of the sector. The Local Government Association has raised its concern about people closing down businesses and withdrawing their services altogether at the very time that demand is increasing and we know that it is going to go on increasing. I have a lot of sympathy with what the noble Baroness, Lady Pitkeathley, said about the way in which we look at the funding of this. Funding is at the core of a lot of the challenges we face. Local authorities purchase in bulk. They have the advantage of that negotiation. Self-funders are usually individual people, families who, when mum has a stroke, suddenly find almost overnight that they have to provide nursing or residential care. These are the challenges individual families face almost on a daily basis across the country.

I say to the Minister that I still find it bizarre that we have this subsidy in residential care in the care sector whereby self-funders subsidise those for whom the local authority purchases care. There is never any discussion around this. We do not talk about how fair it is. There is no discussion about the fact that individuals who find they have to self-fund are not paying just their weekly fees, but are also subsidising the person in the next room, or possibly even more than one person. I really think it is time that we exposed how the funding system for care works. It is like having a secret tax that nobody knows about. I find that quite abhorrent.

I agree with the noble Baroness about the need to examine what is expected when people have assets. As a Member of Parliament, I will never forget a couple who were quite elderly themselves—in their sixties—sitting in my surgery virtually in tears at the fact that they were going to have to sell mum’s home because she now needed nursing care unexpectedly, when they had understood that that was likely to come to them. In the context of understanding the responsibility of providing for care, I say to my noble friend that there needs to be joined-up thinking across government. I was quite shocked that when the pension rules were changed so that people with private pension pots could draw down huge amounts of capital from what they had saved over the years, although provisos and bars were set in place to make sure that they had enough to live on, there did not seem to be much discussion about how much of their capital assets they would dispose of, and the whole subject of the amount of capital they would need in order to pay for their long-term care did not really seem to be part of any discussion.

I have one other thing I would just ask my noble friend. Joined-up government is so important, and the weakness has always been between health and social services in terms of agreeing who pays for what. Can my noble friend give the House an update on the sustainability and transformation plans, which should be well under way? It seems to me, if I have understood them correctly, that there is potential here, not just in terms of planning but in terms of finding the resources to implement the plans. We hear a lot about these plans, but I am not sure that everybody really understands what contribution they will make to joining up health and social services, and I hope my noble friend will refer to them when he replies.