Care Bill [Lords]

Emma Lewell-Buck Excerpts

Monday 16th December 2013 Commons Chamber

[Mrs Emma Lewell-Buck (South Shields) (Lab)]

It is a pleasure to follow so many passionate and marvellous speeches, and I hope that my speech does them justice.

Prior to joining this House I was involved professionally and personally in the adult social care arena. Throughout that involvement I met some amazing, dedicated and brave people, many of whom were being denied the full service they deserved, and working in a system that hindered their ability to deliver fully what they knew their clients needed.

There is nothing worse than having to tell a person who is already struggling with daily life because of their condition or that of a family member that, due to funding cuts, they will get a reduced service or get no service at all anymore from their local authority. My local authority, like many others, has been restricted to offering care only to those who meet the critical and substantial criteria of fair access to care. In reality, that means that an elderly or disabled person who was struggling with laundry and housework, or who was given support with daily living or to access services or employment, may no longer receive that vital support.

The Bill is a missed opportunity to make such scenarios a thing of the past because it does nothing to address the funding crisis in adult social care. That funding crisis has led to the collapse in support for those most in need, leaving many people without access to essential services. It is not only the Labour party that has raised concerns about the absence of any funding plans in the Bill; Age UK, the Local Government Association, the Care and Support Alliance, Carers UK and the Royal National Institute of Blind People share the same concerns. According to a report published today by the Personal Social Services Research Unit,

“the scale of reductions in spending and provision…are almost certainly without precedent in the history of adult social care.”

I know from consultations I have led that people in my constituency want to remain in their homes and receive care at home for as long as they can, but those people often end up suffering from chronic loneliness and isolation, receiving, perhaps, a 15-minute visit perhaps twice a day. We need to think urgently about how we can prevent people who remain in their homes from becoming socially isolated. Although loneliness may not be seen as an illness as such, anyone who speaks to people who have suffered day after day, alone in their homes, will hear that that is what hurts them the most: the loneliness. Age UK describes loneliness as the “hidden killer”. It is therefore disappointing that the Bill removes the Care Quality Commission’s existing duty to inspect and assess the way in which councils commission adult social care services. That could have been one of the few safeguards against the proliferation of 15-minute visits.

Labour recognises that improving care standards for service users means improving things for care workers themselves, and that is why we have launched a review of exploitation in the social care sector. I welcome the review, because my husband works in the care sector. He is currently on a zero-hours contract, with irregular hours and at the mercy of his employers, and is constrained by the limited time that he can offer his clients. My husband did not seek employment in the care sector to swell the coffers of those who make money from care for the vulnerable in our society; he did it because he wanted to make people happy and comfortable in their homes. My husband and I know that the benefit of improving the standards of care at home, and enabling more people to receive care at home, is that we will see fewer people in hospital and fewer residential care admissions, which are both stressful and incredibly costly.

The local authority covering my constituency is the seventh hardest hit in the country. Its central funding has been cut by an average of £262 per person. We have higher-than-average proportions of people aged over 65, over 75 and over 85. We also have more than 1,000 people with dementia, and a higher than average number of people suffering from long-term conditions. Between 2011 and 2012, a higher than average number of people were subject to completely new social care assessments. Our rate of permanent admissions for people to residential care is 71% higher than the national average, and we currently have just under 6,000 adult social care clients receiving a service.

The year 2020 is often described as “year zero” for council budgets. Only core front-line services are expected to be delivered, and they are expected to be delivered at a reduced level. If preventive services continue to be cut and if there continues to be an impact on early pathways to care, people will be eligible for care only when they have deteriorated to the point at which their need is urgent and their care needs are significantly more costly.

Given the situation in my constituency, it is no surprise that the fear expressed repeatedly by people in South Shields is that they will not be able to afford their care in later life. For my constituents, the measure of the Bill’s success will be whether it forces them to sell their homes to pay for care in their old age. It seems that it will fall well short, because, as my right hon. Friend the Member for Leigh (Andy Burnham) pointed out at the beginning of the debate, people will still have to sell their homes.

The Dilnot commission proposed a £35,000 cap on care costs; the Government have set the cap at £72,000. The commission proposed a universal scheme for loans to help to cover care home fees; the Government have means-tested it. That means that it will take the average person nearly five years to hit the Government’s cap. It is estimated that six out of seven people will die before receiving any help from their local councils. My constituents deserve to know the truth so that they can plan for their futures, and it is a shame that the Government are not prepared to share it with them.

The fact that money is scarce does not mean that we should withdraw from our responsibility to care for the elderly and the disabled. Our response should be to rethink radically the way in which we deliver those services. We do not need to dismantle what is already in place; we simply need to think about how the services can work better together, and how we can meet the needs of people now and the needs of future generations. More crucially, however, we need to set out plans to fund this adequately. We know that the Government have legislated for fragmentation and that health funding in areas such as mine is being stripped back. We also know that if the Government wanted immediately to address the funding crisis in our social care system, they could implement Labour’s plan to use £700 million from this year’s NHS underspend. Will they do this and do right by the people who need the services the most?

I support elements of the Bill, but I am not sure how, without explaining how our future adult social care will be properly funded, any of these proposals can become a sustainable reality. I make a plea today, not just on behalf of my constituents, but in memory of all the people I have worked with—my deceased grandmother, uncle and elderly neighbour, all of whom I helped care for, and all the strong and amazing people let down by a system that can no longer support them. I hope the Minister is listening and that he will support our amendment.