Social Care

Baroness Fraser of Craigmaddie Excerpts

Thursday 30th March 2023 Lords Chamber

[Baroness Fraser of Craigmaddie (Con)]

My Lords, I, too, start by thanking the noble Baroness, Lady Andrews, for securing this debate today, for her very sensitive chairing of the Adult Social Care Committee, on which I was privileged to serve, and for her tireless commitment to improving the landscape of care, which is a real conundrum of our time. We must “reimagine” it, as the most reverend Primate urges, and, while many have claimed that they will fix it, it remains unfixed.

No one chooses to be cared for, or to become an unpaid carer. If the noble Lord, Lord Laming, was here, he would tell us that either could happen to any one of us at any time. But, as our report points out, both are invisible. This invisibility leads to confusion around what social care is and who delivers it. While the NHS is there “from cradle to grave”, individuals who do not currently need care cannot imagine they ever will and therefore fail to plan for such a time.

I draw your Lordships’ attention to my interests as laid out in the register, in particular my work as chief executive of Cerebral Palsy Scotland and also with people with neurological conditions. My lived experience says that we must not view social care through the prism of the NHS. Many of the people I work with are neither ill nor old; they just need help to be able to live what our committee’s report called

“a gloriously ordinary life”.

I know people who choose to study with the Open University and miss out on all those extracurricular experiences that I am sure many of us look back on with fond nostalgia, because they cannot be confident that they will be properly supported to get around campus and get to lectures like their contemporaries. I know parents who have to give up their own professional lives when their adult child leaves formal education because the system assumes that they will; and I know people who remain living with elderly parents because there is no suitable accommodation for people under the age of 65. Our committee heard from many witnesses who were not ill or old but could not get the right support. Worse than that, they were worried that, if they contacted their local authority for a review, the support they did have would be reduced.

For many of working age, what they want and need are good PAs, personal assistants. These are professional enablers who help you do what you want, whether it is getting to work, feeding you, taking you to the pub or, in a case highlighted to us during the course of our inquiry, enabling someone to pay their respects to Her Majesty Queen Elizabeth II at the gates of Balmoral—something that could never be assessed as an outcome by a local authority care package.

Yet there are not enough PAs. You are really stuck if your PA is ill or does not turn up, and the challenges of becoming an employer and dealing with recruitment, PAYE and pensions too often just puts people off. We heard evidence in our committee from Enable Scotland, a charity which works with local authorities across Scotland delivering their PA model of care, where the charity deals with all of those employer issues and provides a personalised service to people who want it. I encourage the Minister to look at this model.

For too many, as we have heard, contact with social care services is forged in crisis and fraught with difficulty. The providers of last resort are family and friends, who are thrust into roles they neither sought nor are supported to fulfil as unpaid carers. I believe the Minister himself has been a carer and appreciates the challenges. He has called unpaid carers

“the backbone of the system”—[Official Report, 20/2/23; col. 1434.],

but I am afraid that, despite warm words, unpaid carers continue to be taken for granted.

As the noble Baroness, Lady Andrews, pointed out, carer’s allowance is the least generous benefit and considerably less than the minimum wage. There is little respite, little support and severe financial implications, but too many families feel they have no other options.

If we do nothing else in the Government’s forthcoming social care plan and future work, I urge the Minister to improve identification of unpaid carers, including children who care. Self-identification is not working and neither are the formal systems set out in the Care Act. There are still so many gaps. We heard about the No Wrong Door initiative successfully employed in Liverpool. How can the Minister ensure initiatives such as this are more widely adopted?

As others, particularly my noble friend Lady Shepherd, have said, over the years, Ministers have been given a veritable shopping list of solutions. I hope these two reports and our debate today can add to the impetus the Minister needs within government, because the last thing people who rely on care want is yet another plan that fails to be backed up with action.