Social Care Strategy

Baroness Scott of Bybrook Excerpts

Thursday 10th October 2024 Lords Chamber

[Baroness Scott of Bybrook (Con)]

My Lords, I thank the noble Baroness, Lady Tyler of Enfield, for bringing this important debate to the House today. I warmly welcome the noble Baroness, Lady Keeley, to the House and congratulate her on her maiden speech.

It is estimated that 10 million of us are affected by adult care services in England at any one time. It is fair to say that there are few of us whom this issue does not touch. We saw that very clearly today when seeing and hearing the noble Baroness, Lady Thomas of Winchester. Personally, it was lovely to see her in the Chamber once again, even though she was on a screen. Also, the noble Baroness, Lady Donaghy, made it very clear how important adult social care services are. Yet this is a sector facing profound challenges, and the Government are failing at the moment to provide detailed and costed plans on how they will support the social care system as it performs this most vital role.

The Opposition have concerns about the Government’s approach to adult social care for four key reasons. Many of the Government’s pledges lack detail, including on how exactly they will be delivered and funded; the Government’s policies fail to focus on the immediate challenges faced by the sector, with very little information on how the immediate industry stressors will be resolved; the Government have failed to set out a plan to end our reliance on foreign workers to fill vacancies in the social care sector; and they have failed to set out plans to recognise and support—as we have heard clearly today—unpaid carers. I urge the Government to listen the concerns of noble Lords in today’s debate and to take a pragmatic, detail-orientated and financially sound approach to reforming the social care system in England.

We have heard several pledges from the Government. The Labour manifesto pledged a “fair pay agreement”, with terms for pay and conditions, and training standards for adult social care workers. The Labour manifesto also included an aim to create a national care service and a “new legal right” for people in residential care to see their families. While these may be admirable statements, at the moment they lack crucial detail.

The “fair pay agreement” is set to be enmeshed in the Employment Rights Bill. However, this Bill is only being introduced to Parliament today. Although we welcome the Government’s intention to ensure fairness in the pay, conditions and training of carers, it is a shame that they have taken so long to publish the Bill, thereby failing to give the House ample time to examine the contents of the Bill before today’s debate.

It is also crucial that the Government focus on those who receive care, not just the workers in the sector. Can the Minister confirm to the House what practical steps the Government are taking to ensure that social care bills are affordable and that the services that people receive in the social care system are of the highest quality?

Given this lack of detail, it is unclear whether the Government have considered the most basic of governmental truths, “What is spent must be funded”. Unless pay increases for carers are matched by an adequate increase in local government funding, as we have heard, and direct financial support for older people, care providers and local council budgets will be further squeezed.

Regarding the national care service, there is little available detail on how this will evolve, how it will be set up or how much it will cost. Can the Minister confirm when we will see further plans for this service?

The Prime Minister has said that the Government are building a 10-year plan for healthcare reform which they expect to publish in spring 2025, after consultation. Although I am sure that this House will appreciate the need for a considered and long-term approach to social care, so any new system will be equipped to handle the care needs of an ever-ageing population, there are many pressing issues facing social care now.

With the Employment Rights Bill only just introduced, scant detail on the proposed national care service and the 10-year plan not due to be published for several months, it seems that the Government have no immediate plans to improve the state of social care in England.

In the year 2023-24, there were record levels of international recruitment for social care workers, while the sector struggled to recruit and retain domestic employees. More specifically, 105,000 international recruits started direct care roles in the independent social care sector in 2023-24, whereas the number of people in the workforce with British nationality shrunk by 30,000. Over the last two years, 185,000 international recruits joined this sector and the number of British workers fell by 70,000.

Clearly, the social care sector could not function today without the wonderful contribution of workers from overseas. We must be grateful to those who come from overseas to provide these vital services. Without them, many people would simply not receive the care they need.

However, in their manifesto, the Government pledged to

“end the long-term reliance on overseas workers in some parts of the economy by bringing in workforce and training plans for sectors such as health and social care, and construction”,

and to “reduce net migration”. The Opposition must ask the Government how they intend to honour their manifesto commitment to deliver lower immigration and wean the social care sector off overseas workers?

The 2021 census found that approximately 4.7 million people were providing unpaid care in England. This represented around 9% of the entire population and, as we have heard today—I thank my noble friend Lord Young of Cookham for making this very clear—that includes children. The report from the noble Lord, Lord Darzi, noted the “huge contribution” of unpaid carers. It called for a “fresh approach” so that the NHS can provide unpaid carers with support and treat them as an “equal partner” when working up care plans. However, the fantastic work of these truly selfless and very kind people is notably absent from the Government’s social care reforms. What steps are the Government taking to better recognise the invaluable contribution that unpaid carers make in our society?

Can the Minister tell us whether the Government will provide greater detail on what the “fair pay agreement” and the National Care Service involve, and when can this House expect to see a detailed cost analysis of the proposed social care reforms? Do the Government have any policies currently in play that will ease immediate pressures on the social care sector in England? I reiterate my earlier question: how do the Government intend to honour their manifesto commitment to deliver lower immigration and wean the social care sector off overseas workers? Finally, how are the Government going to support unpaid carers and ensure that their voices are heard during the creation of care plans?

Having a functional, efficient and, above all, compassionate social care system in England is of critical importance to all of us. Without this, there will be no way to relieve the strain on the NHS, which is currently treating those who would be much better served by local community care services. The Opposition urge the Government to listen to our concerns and urgently provide this House with detailed, costed and pragmatic plans for the social care sector in England.