Social Care Strategy

Baroness Thornton Excerpts

Thursday 10th October 2024 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, I am very pleased to take part in this important debate. I congratulate the noble Baroness, Lady Tyler, on her excellent and comprehensive introduction. As the first Back-Bencher to make a speech, at least I will not be repeating anyone else’s. I very much look forward to my noble friend Lady Keeley’s maiden speech.

The fact that there are so many speakers and we are therefore limited in our time tells us how important this matter is. In my short time, I will not be doing the big-picture painting that the noble Baroness, Lady Tyler, did but will talk about some very specific practical things. I am a non-executive director of the Whittington Health trust, which is our local hospital in north London. We are an integrated care organisation and we face the same challenges that all parts of the National Health Service do. We provide hospital and community care services to half a million people in Islington and Haringey, as well as other London boroughs such as Barnet, Enfield, Camden and Hackney, and it is worth looking at the practical issues involved in how you do this.

Haringey and Islington have multiagency care teams, which work across health and the council to assess and support rising risk patients and avoid unnecessary hospital admissions, keeping people in the community. They are multidisciplinary, with pharmacists, housing officers, social care workers, consultants and district nurses working together. We have a single front door in Islington, which we have just launched, for healthcare and the council to share a single triage point to ensure that patients are seen by the right team and to avoid duplication of input, and to ensure the best way of sharing our limited resources. Again, this sees council staff and Whittington staff working together. We have social workers embedded in our hospital; they are in our teams and in our hospital offices.

These are the practical details that can inform how primary care locally can be further developed, as defined by the noble Lord, Lord Darzi, in his report, which points to the need to develop primary care, GP care, social care and community care together. I invite my noble friend and her colleagues to come and visit us at the Whittington, where they will be very welcome indeed. There is no doubt that effective and innovative practice exists. I make a plea not to reinvent the wheel as we work towards the much-needed reform of adult social care.

Secondly, I want to ask my Government to look at who provides care at every level in our communities and at whether it is appropriate that we have care providers that are not going to sustain their care in our communities. For example, in 2023, Beaumont Healthcare, a homecare agency providing care to people with disabilities and complex health conditions in Cambridgeshire, went out of business and handed back the care contract to the local authorities. That would not be unusual, but it was the fifth care provider in Cambridgeshire to hand back care contracts in 2023. We know that the marketisation and privatisation of adult social care following the care Act in 1990 brought with it the dangers and instability that we see today.

I have championed co-operative social enterprise and mutuals for 25 years in your Lordships’ House. Frankly, in rebuilding our economy and in the reform of our public services we need to look at organisations that can provide public services and do so in a sustainable way. I ask my noble friend that, in the rebuilding of health and social care in the UK, we look at the failures and bureaucracy that competition and marketisation have brought and positively seek alternatives, to have a diversity in the provision of social care in our communities.