Health and Social Care

Lord Ashton of Hyde Excerpts

Thursday 9th September 2021 Lords Chamber

[The Lord Privy Seal (Baroness Evans of Bowes Park) (Con)]

I thank the noble Lord and the noble Baroness for their comments, but I am slightly surprised that they have not welcomed our announcement of a new £36 billion package to help tackle NHS backlogs, reform adult social care and bring the health and social care system together on a long-term, sustainable footing. That is a hugely significant amount of money to help our precious NHS and to solve a problem that all across this House have acknowledged for many years.

We have indeed held many discussions throughout the year with leading members of the sector, specifically on reform, and will of course continue to do so. We have committed to spending an additional £5.6 billion on social care in England, across the next three years. As the noble Baroness rightly says, the deferred payments agreement remains in existence to enable people to use the value of their home, if they need to, without selling it. Both the noble Baroness and the noble Lord asked why this involves national insurance. To raise the sums needed for this significant investment in the NHS and to reform social care, only a broad-based tax, such as VAT, income tax or NICs, is able to do so. NICs already ring-fences funds for the NHS and successive Governments have increased it, so there is precedent for our belief that this is the best and fairest way.

The noble Lord is absolutely right: the levy will be ring-fenced for health and social care. HMRC will send funds to the health bodies in all four nations of the UK and, by 2023, to social care funding bodies, such as MHCLG, which will deliver it through local authorities. As I say, part of the reason for using NICs is that the more you earn, the more you pay. I am sure noble Lords are aware that a typical base-rate taxpayer, earning £24,100, will contribute roughly £180 a year, whereas a typical higher-rate taxpayer, earning £67,100, will contribute £715 a year. The highest-earning 14% of people will pay around half the revenues. The 6.2 million lowest earners will be kept out of the levy. The use of NICs also means that the cost of the levy will be shared between individuals and businesses; however, 40% of all businesses will pay nothing extra.

The noble Lord asked about tackling the backlog in the NHS. We will spend £2 billion this year, which is double our previous commitment to tackle the backlog. In addition, we plan to spend more than £8 billion in the following three years, from 2022-23 to 2024-25. On the waiting list, we do not know how many people who did not come forward for help from the NHS during the pandemic will now seek treatment, so plucking numbers out of the air about the size of the waiting list is not helpful. But I can certainly assure both the noble Lord and the noble Baroness that the funding announced will deliver 9 million more checks, scans and procedures until 2024-25. This is a significant investment and, over the next three years, will be the biggest catch-up programme in NHS history.

The noble Baroness asked about local government. She is aware that, in 2021-22, we have provided councils with access to over £1 billion of additional funding for social care, on top of the significant funding provided to help the sector. In the spending review, we are also committed to ensuring that local authorities have access to sustainable funding for core budgets. This announcement includes funding to enable local authorities to move towards paying providers a fair rate for care, which should drive up the quality of adult social care services, improve workforce conditions and increase investment. The funding package covers the costs to local government of implementing the charging reforms, including the cap, the increased capital limit moving towards paying a fair rate for care, which I just mentioned, and associated implementation costs.

The noble Lord asked about self-funders. As he knows, under the current system, individuals who fund their care often pay more than individuals who are funded through their local authority for equivalent care. Under this new system, self-funders will have a choice to ask their local authority to commission their care on their behalf, which means that individuals fully funding their own care could choose to benefit from the market power of local authorities. We will be publishing a consultation document on the details of these proposals next month.

On other issues, we are investing more in supported housing and exploring other innovative housing solutions to support more people to live independently, as the noble Baroness said. As part of the additional £5.4 billion of investment announced, we will fund an extension to the established disabled facilities grant to enable more people to live independently in their own homes.

On the integration work, the House will be looking at the Health and Care Bill shortly, before Christmas, when it begins its passage through this House. That is laying the groundwork for reform, and we will see an improved oversight of how social care is commissioned and delivered. It will facilitate a greater integration between health and care services, on which these reforms build. As we have said, we will work further with the sector and more broadly to coproduce a comprehensive national plan for supporting and enabling integration between health and social care, but I am afraid that I cannot go any further than saying that the White Paper will be published later this year.

Finally, the social care workforce has worked incredibly during this pandemic. Our investment of £500 million across three years will deliver new qualifications, progression pathways and well-being and mental health support, which is critical. We will continue to support the fantastic 5.4 million carers to have the support, advice and respite they need.

[Lord Ashton of Hyde (Con)]

I remind noble Lords that there will no doubt be lots of questions for the Leader, but the Companion is clear that they should be brief. This should not be the occasion for a separate debate, which I am sure will come later.