Queen’s Speech

Lord Adebowale Excerpts

Tuesday 15th May 2012 Lords Chamber

[Lord Adebowale]

My Lords, I rise to add my two-pennorth to this veritable cornucopia of subjects this afternoon. We have moved from tennis to defamation, to children in care, the criminal justice Bill and weights and measures. It is a fascinating encyclopaedia of issues, which shows the expertise available in this House. I shall refer to the draft social care Bill. I thought hard about whether I should contribute to this ritual of debates on the Queen’s Speech, mainly because it does seem such a ritual. However, a friend of mine who has had her welfare services cut asked me, “You are a Member of the House of Lords. What are you going to do about it?”. I struggled to give a response. This individual is quite wise. She actually watches House of Lords debates, which says something; but then she can because she has the time. I said, “I do not know really. It is a bit of a struggle”. So she said, “You spent all day talking about House of Lords reform, and less people are interested in that than whether they will be able to afford any health and social care. Get up there”. So here I am. I am getting up here because there is a problem. I am all for House of Lords reform, but more people care about whether they are going to get any care.

The Government made a promising start in tackling the huge amount of work needed to reform the social care system. Before I go on, I should declare an interest as the chief executive of Turning Point, which is a social enterprise in the health and social care sector. The Dilnot commission marked a good start in that it understood the,

“urgency of reforming the system of social care”,

a phrase that was in the coalition agreement published in May 2010. Setting up the Commission on Funding of Care and Support showed that the Government accepted that tackling the funding crisis was to be an imperative part of their work. Andrew Dilnot’s work was praised by many, and his report and recommendations were published almost a year ago. However, the Government are yet to publicly outline their response. They have remained quiet on funding. A White Paper on social care and a progress report on funding are therefore still eagerly awaited and anticipated by those who work in social care.

But the wait is most acute for those who are suffering in the current system. The draft care and support Bill, no doubt a fascinating read for many before a roaring fire, is a positive move towards reform, but it has been met with a lot of disappointment because it fails to mention or use the F-word—funding. Proposals on funding will be brought forward separately from the White Paper, and it is now even possible that a new funding system will not be fully in place until as late as 2025. The Treasury may be unhappy about the £1.7 billion per year that the Dilnot proposals would cost, but these changes are critical to the lives of those in need of care, as they are to their relatives, who still face uncertainty over timeframes and funding issues. The system is creaking as demand increases, so the question of funding needs to be addressed urgently for the short, medium and long term.

I was one of 78 signatories to an open letter sent to the Prime Minister earlier this month organised by the Care and Support Alliance. It warns that the system is chronically underfunded and that, without reform, too many old and disabled people will be left in desperate circumstances, struggling on alone and living in misery and fear. The need for a clear consensus on a new funding settlement is also the number one priority set out in another letter to the Prime Minister that I signed in March—I have been signing a lot of letters to the Prime Minister of late—as co-chair of the All-Party Parliamentary Group on People with Complex Needs and Dual Diagnosis. Other signatories were the chairs of the All-Party Parliamentary Group for Ageing and Older People and those groups with an interest in carers, dementia, disability, Down’s syndrome, housing and care for older people, learning disability, ME, MS, Parkinson’s and social care.

Everyone knows that reform will be expensive, but I agree with the Local Government Association and insist that it is worth paying for. There will be those who argue that we cannot afford it, but the reality is that we cannot afford not to. Local authorities are starting to feel the weight of extra responsibilities from social care to public health, while simultaneously their budgets are growing smaller. Now is not the time to stall progress. The LGA has also recently warned that the need to plug the current gap in care funding would be at the cost of other public services for vulnerable people. It is clear that this extra money is needed as the social care system is already in crisis.

While a large proportion of spending goes to support older people, it is important to remember that many others are in need of a comprehensive and well funded social care system. Indeed, at Turning Point we support many people with complex needs that range from alcohol dependency to mental health, learning disabilities and so on. Strongly linked to the need for social care funding is the need for integration and personalisation. My work in looking at the benefits realisation of integrating services shows that when they are integrated, for every £1 spent, a saving of £2.65 is made on delivery. The Department of Health-funded Partnerships for Older People Projects focused on health, well-being and independence promotion and prevention. They saw a 47% reduction in overnight hospital stays and a 29% reduction in A&E visits. There were also reductions in physiotherapy, occupational therapy and out-patient appointments, resulting in a cost reduction of £2,166 per person. The clues to the model for the funding of social care are in place. According to London Councils, better integrated services that support people with long-term conditions could also result in savings of £2.7 billion annually.

The current system is out of date and can fail on quality, varying widely across the country—not just in the case of children’s services, as has been mentioned by the noble Earl, Lord Listowel. We need an integrated and personalised system allowing older and disabled people and their families to participate and live with dignity and independence. The eligibility and assessment system needs improving as part of this process.

I know there is sympathy and desire on the part of the Government, but it has become increasingly difficult to believe that they understand the necessity of reform as a matter of urgency, two years on from the Dilnot commission. The same level of determination and the same amount of time as have been devoted to House of Lords reform need to be focused on the lives of thousands and millions of people who will need health and social care, and the same level of urgency is required in the area of health and social care finance that was put into the efforts to push through the Health and Social Care Act.