Social Care Strategy

Baroness Fraser of Craigmaddie Excerpts

Thursday 10th October 2024 Lords Chamber

[Baroness Fraser of Craigmaddie (Con)]

My Lords, last week I was attending a conference—no, not that one. It was the Cerebral Palsy Scotland conference, where there was much talk about social care. I declare my interest as the chief executive of Cerebral Palsy Scotland.

The Government have a headline commitment, as I understand it, to create a national care service, but there is no detail about timescales or resources. Coming from Scotland, the mere mention of a national care service makes me shudder. The SNP’s plan for a national care service has already wasted £28 million. Parliamentary committees and NHS bosses have warned about its flaws. Council leaders and unions have pulled their support. It will cost more billions—that is just to set it up—and, despite this, not one person’s care across Scotland has been improved. I urge the Minister: please do not make the same mistakes down here.

At our conference last week, one of the sessions laid out a job description for unpaid carers. It included the provision of personal care, housework, mobility assistance, medication management, emotional support, transportation, advocacy, respite care, health monitoring, project management, financial support and advice. They do all this, and they remain invisible and unappreciated. The most common theme that comes up in any conversation with unpaid carers, or any carers, is: “I wish I had known about it sooner”.

As the noble Baroness, Lady Keeley, said in her excellent maiden speech, identification is key. Professionals already have a responsibility for this, but it does not seem to be working. Despite the effort put into carers’ resources, research by the King’s Fund found that it does not always translate into the support that carers want. A carers’ strategy could look at what could be done to improve this.

As the noble Baroness, Lady Tyler of Enfield, said in her excellent introduction, we must stop looking at social care through the prism of the NHS. We will never get it right if we view social care only as the application for the ill or the old. The people I spoke to at the Cerebral Palsy Scotland conference last week were neither ill nor old; they are just asking for some support to live their lives in the way the rest of us, who do not rely on assistance, take for granted.

What they need and want are good PAs, personal assistants, who help you do what you want, whether that is going to work or going to the pub. Such flexible outcomes do not fit easily into local authority care packages, and there are not enough PAs. Many of the agencies previously supplying staff did not survive Covid. People are resorting to permanent ads on sites such as Facebook and Indeed. It is a bit of a lottery who applies. People often do not turn up to interviews or trial shifts, and you are really stuck if your PA does not turn up or is ill. The challenges of becoming an employer, dealing with recruitment, PAYE and pensions, too often defeat people.

I recommend that the Minister looks at the PA model delivered by the charity Enable, which works with local authorities across Scotland. It deals with employer issues and provides a personalised service to people. It may be one example of good local practice that would benefit from support to extend it further afield. At any time, any one of us could suddenly become responsible for the care of another person, or any one of us might need to be cared for. It is time the Government moved social care up their priorities list.