Elderly Social Care (Insurance) Bill [HL]

Baroness Merron Excerpts

2nd reading
Friday 16th July 2021 Lords Chamber

[Baroness Merron (Lab)]

My Lords, I pay tribute to the noble Lord, Lord Lilley, for his efforts through this Private Member’s Bill to find a way forward to improve the provision of social care which is so desperately needed. There has been a theme throughout this debate which has heard many thoughtful contributions by noble Lords. It is a determination to see the right quality of social care at the point in people’s lives when they are at their most vulnerable. This debate has made clear the need to meet both duty of care and duty of dignity.

I start by paying tribute to the extraordinary work and commitment of social care staff over the past year, in both the independent sector and the local authority sector. They have been at the front line of this pandemic, going beyond the call of duty and helping hundreds of thousands of people through an extremely difficult time.

However, as my noble friend Lord Davies of Brixton and the noble Baroness, Lady Wheatcroft, reminded the House, it is some two years since the Prime Minister stood at the steps of No. 10 Downing Street promising to fix this challenge, yet nothing has changed. We can remind ourselves that there were high hopes of a Bill in the Queen’s Speech, but they were roundly dashed. Instead, today, as we read in the media, we have rumours that Downing Street is

“comfortable with some sort of tax”

to pay for social care. I wonder whether the Minister is in a position to flesh out details of this tax plan, which has clearly been some years in the making.

I should at this point acknowledge that while this Bill refers to the older members of our society, social care extends far beyond them. Half the budget for social care is for working-age adults with disabilities, who comprise a third of the users. Furthermore, there is a misconception, as has been pointed out several times today, that social care is all about care homes, when in fact there are more people getting care and support in their own homes, something we should aim and hope to expand, as advocated by the noble Lord, Lord Best.

Social care is as much a part of our infrastructure as are the transport, telecoms and energy systems we rely on. A neglect of the country’s physical infrastructure results in the lights going off and trains grinding to a halt. Well, the same is true if there is a failure to invest in social care infrastructure. As the noble Baroness, Lady Watkins of Tavistock, identified, if we do not have a properly paid and trained care workforce, we see vacancy and turnover rates soaring, fewer people getting the support they need and families—and, overwhelmingly, women—ending up taking the strain.

Covid-19 has brutally exposed existing failures, as described by my noble friend Lady Chakrabarti. Throughout the pandemic, we have seen that care is still not funded or treated as equally important as the NHS. We know that front-line care workers are chronically undervalued and underpaid, as my noble friend Lord Hendy set out. Families get too little support in return and an already fragile care market has been made even more susceptible to failure, with all the human consequences this brings.

Dealing with such a virulent and dangerous virus was always going to be difficult but, when the pandemic struck, our care system was more vulnerable than it should ever have been. We have a welfare state in the 2020s built on the life expectancy of the 1940s. One in four babies born today is set to live to 100 years old. As the noble Baroness, Lady Altmann, and other noble Lords set out, our health and care system has struggled to keep pace with these changes, with social care developing—as far as it has—in a piecemeal and fragmented way. As my noble friend Lord Foulkes of Cumnock said, we face a major and growing crisis in social care that cannot wait.

Fundamentally, as we have heard throughout this debate, social care services need to be fully joined up with, but not run by, the National Health Service. Noble Lords will be only too familiar with distressing tales of people having to battle their way around various services, repeatedly telling the same story. This is not good for them and is wasteful and inefficient. We need one care system built around the needs of users and families, with proper links to other services, including housing.

The Private Member’s Bill before us seeks to address the very real problem of older people being forced to sell their home to pay for care. However, as the noble Baroness, Lady Greengross, and other noble Lords identified, regrettably the Bill falls short of a comprehensive approach—not least because it does not address the situation of those who do not own their own homes or have the requisite level of resources.

In addition, nearly a fifth of pensioners live in poverty and may not have the assets required to finance insurance. They need care just as much. The latest figures are that 8% of pensioners would not even be able to pay an unexpected bill, as expressed by my noble friend Lady Bryan of Partick. I am sure that the noble Lord, Lord Lilley, will bear this in mind, because it certainly begs the question of whether those in poverty would consider using their assets for insurance that they might not need.

The issue of eligibility thresholds and how they would be determined is also to be resolved. According to Age UK, 2 million people have had requests for support turned down in the last two years, while local authority budget cuts have led to eligibility thresholds being tightened, as my noble friend Lord Sikka highlighted.

Although we are unable to support the Bill, I am grateful to the noble Lord, Lord Lilley, for seeking to address a challenge that hitherto remains unaddressed, while impacting on so many of us. I am grateful to him for providing more than the Government have so far managed to do. In the century of ageing, everyone should be able to look forward to getting older with confidence and without fear. I hope that the debate today will make its contribution.