Social Care in England

Lord Astor of Hever Excerpts

Thursday 14th October 2021 Lords Chamber

[Lord Astor of Hever (Con)]

My Lords, I also welcome my noble friend the Minister to the Dispatch Box and wish him all the best with his new responsibilities. I congratulate the noble Baroness, Lady Pitkeathley, on securing this debate. The issue of carers is very important.

The Prime Minister set out his plans for health and social care reform in his excellent policy document last month. On the one hand, he said, it would add up to the biggest catch-up programme in the history of the National Health Service, and at the same time would address the

“long-term problems … that have been so cruelly exposed by Covid.”—[Official Report, Commons, 7/9/21; col. 153.]

These long-term problems, let us not deceive ourselves, affect each and every one of us.

One of the most challenging problems has been revealed to be the chronic shortage of care staff, a situation that endangers the well-being of the most vulnerable among the population. Also the proper management, training and deployment of care providers needs addressing. Sadly, Brexit, wholly justifiable vaccination requirements, post-Covid fatigue and the prospects of higher pay in other sectors have not helped the situation.

Covid began a nationwide debate, a tumultuous vox pop, that made people sit up, listen and respond with their own accounts of suffering. It drew people together and showed our dependence on each other in the community. Through the media, individuals and family groups up and down the country were able to share personal experiences, often shocking and heartbreaking, which revealed a range of avoidable shortcomings in the health and social care system. I can only hope that, as the past has shown us time and again, out of crises great advancements can be made. This is especially true in health and social care, and I am confident that the Government are capable of setting in motion a bold programme of reform, although it will require a great deal of organisation and commitment, in addition to funding.

Greater integration of social care provided by the National Health Service through local clinical commissioning groups and that provided by local councils is one area that is under considerable pressure; and I should like the Government to focus on that. I understand that radical plans for such integration are being actively considered by the Health Secretary. I am sure that the Minister will address that in his wind-up speech.

The experiences of a family that I know living in the West Country with two severely disabled adult sons suggest that healthcare support across the nation is patchy and variable according to postcode. They have experienced profound ignorance at junior levels as to the delivery of an effective social care service, and believe that the protective territorialism and empire-building that they have witnessed need urgent addressing, with integration managed from the top and implemented locally.

Adopting a holistic modus operandi, with an emphasis on common sense and compassion, must be the best way in which to tackle the complex and multilevel needs of the population. All of us, with our lives being extended through access to modern medicines and diagnostics, will need greater recourse to treatment and support from the National Health Service.

Health and social care reform requires the support of a complete mindset reform to enable these improvements to happen: a recalibration of the imbalance between rights and responsibilities, and the recapturing of the spirit of working together for the greater good that was present at the very inception of the National Health Service.

Social Care and the Role of Carers

Lord Astor of Hever Excerpts

Thursday 24th June 2021 Lords Chamber

[Lord Astor of Hever (Con) [V]]

My Lords, it is a real honour to follow the noble Baroness, who does so much for carers. I declare an interest as the father of a profoundly autistic daughter. My experience with our daughter, whose residential care was disrupted during the pandemic, was a real eye-opener. It is an exhausting business looking after a disabled adult, tending to their well-being 24/7. I have nothing but admiration for the carers who dedicate themselves to this task and I join the noble Baroness, Lady Jolly, in thanking them all.

Greater than the physical demand is a concern that our loved ones will be properly looked after when we are no longer around. A social care system for the 21st century needs to make us feel more secure on that score. Others are far worse off than my wife and me. I know a family with two profoundly disabled sons, aged 28 and 32, the elder in a wheelchair—sadly not electric because the parents are not disabled, so do not qualify. They have relied on carers provided by their local council to help with this full-on exhausting care, day after day. There is a chronic shortage of carers, who are on very low wages, in the care industry, so I join other noble Lords in asking the Minister how the Government plan to address this. Will the Government consider increasing the carer’s allowance to the minimum wage?

The closure of day centres, which provide much-needed respite from the constant, round-the-clock supervision, as well as swimming pools and places of worship, was a blow to this couple. Could special exemptions be considered in future lockdowns for disabled people and their families in well-supervised, safe environments? The imposition of strict procedures to limit the spread of the pandemic has weakened an already fragile and fragmented system, causing untold suffering. Covid exposed a plethora of gaps and shortfalls, in addition to contradictory and counterproductive measures, which unwittingly endangered people’s physical and mental well-being. In short, instead of social care, we had social carelessness.

The NHS will continue to suffer, as long as the social care structure is neglected, whether we are facing killer viruses or not. How do the Government propose, in practical terms, to better integrate adult social care services with services provided by the National Health Service?

Covid-19: People with Learning Difficulties and Autism

Lord Astor of Hever Excerpts

Monday 5th October 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the role of any carer is one that we should applaud and pay tribute to, for they are often the overlooked supporters of those with learning difficulties and autism. The plight of those families during Covid has been very hard, and we recognise the tough challenges faced by older parents in particular, who have big responsibilities for children with learning difficulties. The main support will be through local government, and we have put through a huge amount of finance to local authorities and charities to support those families. The adult winter plan has £500 million for the infection control fund, and the NHS has £588 million to support those who are moving from one part of care to another. We will continue this financial support in this area.

[Lord Astor of Hever (Con) [V]]

My Lords, I declare an interest as the father of an autistic daughter. Can the Minister say when clear guidance will be provided to day centres for the disabled, and when we can expect they will reopen?

Covid-19: Social Care Services

Lord Astor of Hever Excerpts

Thursday 23rd April 2020 Lords Chamber

[Lord Astor of Hever (Con)]

My Lords, the Coronavirus Act 2020 has relaxed the duties and responsibilities of local authorities to provide care and support to a revised minimum level which would solely meet a person’s needs measured according to their human rights—a very low bar indeed in this context. In the immediate short term, local authorities have other priorities. Even in better times, it is a struggle to fund social care and it is vital that we do not lose the hard-won legal support structure ensuring that correct social care is assessed and delivered to the neediest in society. Will the Government undertake to repeal the social care provisions of the Act and reinstate the pre-existing law and regulations at the earliest opportunity?

The Government have announced £1.6 billion of additional aid to local authorities to support social care. The delivery of this money to hard-pressed providers has not been smooth, and I urge the Government to press local authorities to use this money as required by the Government. Without this financial support, many providers will fail, leading to an intense crisis in domiciliary support and in homes. Will the Government apply the greatest possible pressure on local authorities to pass the additional funding on to providers of social care? Will they consider ring-fencing some of this money?

Turning to specific cases, many hard-pressed families have family members who require significant support. The strain on the mental health of family members acting as carers frequently results in provision for respite from their duties for a few nights at specified intervals. The requirements of social isolation and quarantine mean that they no longer receive the respite needed to survive. They are now locked into a cycle of support without any break and with no additional provision forthcoming to help them in any way. In the current emergency, will the Government encourage both local government and social care provision under the NHS to look carefully at the needs of the often forgotten and unsung family carers who are already saving the Government millions in care costs?