Social Care Funding
Debate between Lisa Cameron and Vince Cable(5 years, 2 months ago)
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Sir Vince Cable
That is a helpful and humane suggestion, and if we approach this whole question in terms of its practicality, rather than with abstract ideology, we might make some headway. What my hon. Friend suggests seems an eminently sensible way to start that process.
The last and most difficult issue is the one in which successive Governments have got hopelessly bogged down: the so-called catastrophe risk for the small number of people who are caught with prolonged expenses as a result of residential care. When I was in government the Dilnot report attempted to address that issue, but I think we have moved beyond that now. This is a classic problem of insurance, and it is now recognised in a way that it was not before—I think the current Prime Minister said this publicly—that the private insurance market cannot, and will not, deal with this problem. If there is to be insurance it must be social insurance, and large numbers of people will have to make a contribution to prevent the burden falling on a small number of unfortunates who contract long-term conditions, with all the costs involved.
That could be done in a variety of ways. One idea is a supplement to national insurance. Another idea from 10 years ago, which I had no problem with, is that if we are to solve the problem of people losing their inheritance, everyone who pays inheritance tax should pay a small supplement. That struck me as a good social insurance principle. Whether or not that formula was right, we have now got to a point of accepting that this is a social insurance problem, and there are different mechanisms for dealing with it. If we are reasonably grown up politically, we should find a way of closing that gap.
Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)
The right hon. Gentleman is making a fantastic speech on what we will all agree—Brexit aside—is the issue of the day. I visited Parkinson’s UK in East Kilbride, and Parkinson’s sufferers are particularly affected by social care catastrophe burdens because theirs is a degenerative condition that can start in their 50s, or even earlier, and go on for the rest of their lifespan. Does the right hon. Gentleman think the Government should look at conditions that particularly affect people and start by focusing on those as a priority, as the hon. Member for Totnes (Dr Wollaston), the Chair of the Health and Social Care Committee, said?
Sir Vince Cable
The hon. Lady is quite right. We are talking about a variety of conditions. I listed some, and Parkinson’s is clearly one. With Parkinson’s, it is difficult to separate the health and the social element, which is one of the problems with a lot of these conditions and why the current distinction is so arbitrary and unsatisfactory.
Perhaps I could finish with a quotation from Her Majesty the Queen, although it does not relate to her need for social care. Two and a half years ago she made a speech in which she said:
“My Ministers will work to improve social care and will bring forward proposals for consultation.”—[Official Report, House of Lords, 21 June 2017; Vol. 783, c. 6.]
That was two and a half years ago, and the basic question is: where are they?