Health and Care Bill

Baroness Greengross Excerpts

2nd reading
Tuesday 7th December 2021 Lords Chamber

[Baroness Greengross (CB)]

My Lords, I add my sincere congratulations to the noble Lord, Lord Stevens. I am delighted that he is joining us in this House.

May I start by saying that the Government correctly acknowledge that their White Paper proposals to be enacted by this Bill will not solve all the problems affecting adult social care in the UK? They refer to their reforms as a “journey”, but we have been on this journey for decades now, and the people of this country cannot wait any longer for meaningful and equitable reforms to be enacted. People across the country are suffering now from inadequate social care, and as our population ages these problems will multiply unless we seize this opportunity at last to enact a system that is sustainable and fair.

We all know that demand for social care is not being met, causing hardship for families. Local authority budgets continue to be under great strain, private providers are withdrawing service provision, experts warn that the system is unsustainable, and the system is terribly inequitable. People with dementia, for example, must pay for their care, whereas people with cancer can rely on the NHS. That is grossly unfair.

However, under the Government’s proposals, we will to see one inequitable regime replaced by another. The Government’s proposed cap of £86,000 on the social care costs that individuals will have to pay is significantly less generous than that recommended by the Dilnot proposals. As a wise friend observed to me, the Government’s proposal appears to be more a means of protecting the assets of the wealthy than resolving our social care funding problems. Under these proposals, most people in this country, who do not have huge personal assets, will still lose most, if not all, of their savings, and they will now be paying the Government’s new levy as well.

As a result, many people with modest assets—perhaps only the value of their home, if they own one—may be worse off than before. In addition, most of the funds raised by the Government’s new levy will initially be used to support the NHS, not social care. One wonders how it will ever be politically feasible for this distribution of levy resources to be realigned to pay for social care alone, which remains the Cinderella service under the Government’s plans.

I recognise and welcome the Government’s proposals to support the integration of housing into local health and care strategies, with a focus on increasing the range of new supported housing options available. I welcome the Government’s stronger overall support for independent living, including more funding to enable the greater adoption of technology to support independent living. I also welcome more funding to ensure that social care workers have the right training, but I have to question whether the sums proposed are adequate to meet even current needs in these areas.

The Government have to improve on their proposals, particularly in overall funding for the social care system and social care workers. The Government should reduce the cap on social care costs paid by individuals to provide much more generous support to people who have only modest assets. They should not require young people to pay the levy, given the high housing costs and the burden of student loans that so many of them face. There are better ways to raise the funds needed to provide decent care, including replacing higher rate tax relief on pension contributions with a lower flat rate relief. The levy should also be used simply to pay for social care and not the NHS, which already absorbs the bulk of government revenue.

There is not time for me to set out the myriad inadequacies of the Government’s White Paper and this legislation, but in addition to a fairer system for funding social care, we know that the glaring need is for social care workers to be much better paid and to have a clear career path. Until these valuable workers are more fairly rewarded, I am afraid we will continue to see an exodus of staff to easier and better paid work. The best carers provide a wonderful service, but they do so despite our social care system, not because of it, and this remains a great injustice. They, and the people they care for, deserve so much better.