Social Care

Baroness Wheeler Excerpts

Thursday 28th October 2021 Grand Committee

[Baroness Wheeler (Lab)]

My Lords, I thank my noble friend Lord Lipsey for securing this debate and the opportunity it presents to spotlight the issues he raises in his excellent opening speech on the possible role of the private sector in helping individuals to fund their social care costs. His expertise and knowledge across the whole range of social care funding issues—and on all things relating to social care—is much respected across the House and we are always grateful for his contribution and guidance.

Like others, I have drawn heavily for this debate on the very helpful—or not, depending which way you look at it—briefing from the Association of British Insurers, and on the work carried out examining private insurance as a means of funding social care by our own Economic Affairs Committee two years ago in its report Social Care Funding: Time to End a National Scandal. I emphasise that we would have liked to have seen the Government use that report as a first step and springboard to ensure adequate funding to local councils, so that they are able to provide the standards of care quality that are needed. They must recognise that a plan for future care has to include: funding the provision of personal care in people’s homes to meet the unmet needs of the estimated 1.5 million who need help with washing, dressing, toileting and other basic needs to help keep them living well in their homes and in the community; and working towards ending the disparity between entitlement to free NHS care and the adult social care system, ensuring that entitlement is based on the level of need rather than diagnosis, such as in the provision of free care for cancer but lack of free social care for dementia suffers. The noble Baroness, Lady Brinton, spoke very eloquently on this matter.

Indeed, we have a social care plan that is not a plan; does not “fix” social care, as the Prime Minister promised; places the burden of funding on people who can least afford it; and sets the care cap for two years’ time at a level much higher than the Dilnot recommendation and will not stop people from having to sell their homes—the pledge on which the Prime Minister is fixated and around which his proposals are built.

In the ABI briefing, the criteria set out for social care reforms that would help facilitate what it terms as a more “favourable environment” for insurance schemes have been cited by other noble Lords. They include the need for a clear offer on what the state will provide; an awareness-raising campaign about the means-testing and costs of social care, which it has been calling for since the discussions on the Care Act 2014; an easily understood care offer from the state; helping people to plan for social care costs; adding incentives to encourage people to save and plan for social care and removing disincentives which make saving towards a care plan worth while; and ensuring long-term, sustainable reform to social care that will provide stability for, in the ABI’s words, “decades and not years”.

These key criteria are sorely absent in the Government’s social care proposals. In the words of the ABI, following the Government’s announcement last month, the

“clearer the rules about what the state will provide, the easier it will be for insurers to respond to and support customers with what is not covered”.

Despite the ABI welcoming the Government’s measures as a “welcome step forward”, I am sure that, like many noble Lords, it also has the long memory of the prolonged but fruitless discussions during the passage of the Care Act and of the date for implementation of the care cap being set for 2016, then delayed twice to 2018, and then finally cancelled altogether as unaffordable. Can the Minster confirm that history will not repeat itself, and the cap will not be axed again in 2023 as the health and social care levy is swallowed up by the NHS’s herculean task of dealing with the pre and post-Covid backlog of treatments?

Noble Lords have asked specific questions about the types of financial products that could be made available in the future, such as equity release and intermediate and care cost annuities. On equity release, there have been interesting contributions from the noble Lord, Lord Balfe, and the noble Baroness, Lady Brinton. A lot of financial advisers will say that equity release is only ever worth while over the age of 80. That is generally seen as the only time when it should be considered.

I look forward to the Minister’s response to these issues. Clearly, taking out insurance to cover care costs is not an option for the vast majority of the 1.5 million who need but do not get social care support, which is why the need for state funding for personal care costs is such a key imperative in addressing the current social care funding crisis.

Can the Minister update the House on what discussions are under way on this important issue with the insurance industry? The Prime Minister promised that the Government would be working closely

“with the financial services industry to innovate and to help people insure themselves against expenditure up to that limit”—[Official Report, Commons, 7/9/21; col. 155.]

of the cap. Can the Minister reassure the House that discussions have started? Who is leading them? Will there be regular briefings on the key issues and progress? Most importantly, is he confident that any new products will be in place before the proposed implementation of the cap in 2023? Does he accept that the discussions with the industry are time-critical and need to make rapid progress?

Finally, my noble friend and other noble Lords, both today and in our debates and Statements so far, have asked key questions of the Minister about how the cap is to operate, its sheer complexity, what costs it will cover and other major concerns arising from the close analysis of the figures—such as that by my noble friend, which showed that it will be at least seven years from now before people with care needs in homes or at home will benefit from the Johnson cap. Time is fast running out for the Government to provide the answers that are vitally needed.