Queen’s Speech

Baroness Pitkeathley Excerpts

Tuesday 15th May 2012 Lords Chamber

[Baroness Pitkeathley]

Like so many of your Lordships who, during the many long hours that we spent in your Lordships’ House on the Health and Social Care Bill, argued that we needed to make that Bill—now an Act —worthy of its title and to properly integrate social care with healthcare, I was immensely disappointed to be presented with the offer of only a draft Bill on social care in the gracious Speech. It is indeed sad that we are missing what many observers believe is a once-in-a-generation opportunity to integrate care delivery systems in a way that matches the experience of the user, whose care is not needed in neat packages labelled “health” or “social care”. Users need care which crosses lives and boundaries, both geographical and organisational, and which is funded in a variety of ways: by the state, charities, the individual and families.

My own Government missed an opportunity in this regard in the late 1990s when they established their royal commission on social care. Given the consensus around the Dilnot proposals, it is a bitter disappointment that the coalition is set to do the same. Indeed, the disappointment is even greater in the case of the coalition because of the huge consensus around the Dilnot proposals and the promises that have been made. My noble friend Lord Warner was a distinguished member of the Dilnot commission. As I and others have said endlessly in this Chamber, you will never be able to deliver an efficient National Health Service if you do not integrate it properly with social care and national assessment criteria and provide absolute clarity about what individuals and their families can expect. As the Care and Support Alliance put it in a letter to the Prime Minister, reminding him about his legacy for the future:

“Social care is in crisis. The system is chronically underfunded and in urgent need of reform. Without this too many older and disabled people will be left in desperate circumstances, struggling on alone, living in misery and fear, in danger of losing our savings, our dignity, our independence”.

The letter has already been cited by the noble Lord, Lord Adebowale.

However, we are where we are and, if we cannot have proper integration, we must at least ensure that the draft Bill that we are to see—no doubt following the long-expected White Paper—corrects some of the anomalies of the current situation. We must be thankful at least that the Government seem set to amend the confused law around this topic, following the excellent proposals in the Law Commission report.

I wish to focus particularly on what the main providers of care—those 6 million carers—urgently need from this draft Bill. I remind your Lordships that there is a very strong economic as well as moral case for supporting carers. Not only do they save the nation nearly £120 billion every year, but annually 1 million people give up work to care for others. A recent report by Carers UK, Growing the Care Market, cited by the noble Baroness, Lady Howe, suggests that a lack of stimulation of the care market means that we are missing out on about 100,000 potential jobs every year. Heaven knows, we need potential jobs, given the current situation. According to new figures from the LSE, around £1.3 billion annually is lost in revenue from carers who are unable to work and have to rely on state benefits.

Most people will become carers at some point in their lives. They provide substantial care. Those who do so for long hours are twice as likely to suffer ill health as those who do not. The majority of carers of working age say that they wish to work but the services are not there to support them. Speaking to such a carer yesterday, I was very hard-pressed to explain why we in this House had spent almost four days contemplating our navels and discussing House of Lords reform when we had not given the same attention to this urgent issue.

Social care legislation is a complex web spanning 60 years of legislation, with more than 43 different statutes and countless pieces of guidance with the force of law. Many statutes overlap, some have slightly different interpretations and some slightly contradict each other. A new law could streamline and simplify matters, making it easier for public organisations to deliver services more efficiently and helping service delivery organisations to explain and deliver against new legislation. We might then finally get to the stage where people understand what their entitlements are. So far as concerns carers, such a law needs to incorporate at least all the rights in the three major cornerstones of carers legislation, which were all Private Members’ Bills, promoted and supported by MPs and Peers from all parties in Parliament. They are the Carers (Recognition and Services) Act, the Carers and Disabled Children Act and the Carers (Equal Opportunities) Act.

Two other vital elements must be addressed: portability and national assessment criteria. In order to create truly personalised services, we must have a system that allows people to move from one area to another without interruption of their care. In order to make proper care a reality, it is vital that we have national eligibility criteria, as suggested by the Dilnot commission.

I welcome the opportunity offered by the Minister to scrutinise draft legislation before it is introduced in Parliament. We need to do that, and we also need to ensure that the user and carer organisations have an opportunity to contribute to that draft scrutiny. I hope that the Minister will be able to confirm that that is the Government’s intention. I also urge the Government to bring forward new legislation at the earliest opportunity, setting out a clear timescale for doing so. Legislation must start its journey in Parliament in this Session. Further delay will raise alarm and concern.

Talking of alarm and concern, I return to the issue of funding. Reform of the legal basis and structure of social care cannot solve the current crisis in care unless it comes hand in hand with reform of social care funding. We urgently need to bring forward measures to correct the funding crisis and to meet existing unmet need so that a sustainable, long-term settlement is created between the state, the community and the family to meet rising demand.