Social Care Funding (EAC Report)

Lord Bishop of Carlisle Excerpts

Thursday 28th January 2021 Grand Committee

[The Lord Bishop of Carlisle [V]]

My Lords, I add my own expression of gratitude to the Economic Affairs Committee for such a clear and coherent report, based as it is on such careful research and presenting us with such direct and forthright conclusions. Its basic principles for reform are eminently sensible. Like others, I applaud the emphasis, pace Dilnot, on a partnership approach to the funding of social care, and the principles of free personal care, with a cap on accommodation costs, and increased funding enabled by general taxation. I will focus my brief contribution on principle (j), which reads:

“Invest in the social care workforce and ensure a more joined up approach to workforce planning with the National Health Service.”


If that is ignored, any increase in funding will run the risk of being wasted.

We are all well aware of the current situation in this country. The number of older people and working-age adults requiring care is increasing rapidly. Some 1.4 million people over 65 have unmet care needs. Covid has reminded us of just how crucial care homes and carers are in our society, alongside NHS workers and social services. Yet, as the noble Baronesses, Lady Kingsmill and Lady Finlay, have pointed out, carers are usually undervalued; they refer to themselves as second-class citizens; they are underpaid, underqualified and under- resourced, with a chronic staffing shortage that is getting steadily worse.

There are too many adjectives there beginning “under”. It is no wonder that there is a turnover rate of nearly a third in such an underregarded profession, with poor levels of both retention and recruitment. As we have already been reminded, what is so obviously needed for carers is a combination of proper status, good and appropriate training, and reasonable pay. The report before us has significant implications for all of those, as pages 24 to 29 make clear.

With regard to status, if the social care workforce of 1.6 million is to be developed and stabilised, there needs to be more parity of esteem with their 1.4 million NHS colleagues. That necessitates a programme of vocational as well as academic training, which will provide social care staff with the qualifications and career structure that are currently lacking.

In its turn, that should prompt levels of pay, especially in publicly funded institutions, that begin to reflect the value to society of the service being offered. None of this can happen without a substantial increase in funding, which is why the report is so important. That is before even considering the possibility of support for the 5 million or so unpaid carers who do such a great job and save us vast sums of money every year.

However, it involves more than just financial commitment, crucial though that is. This report, like so many before it, is about a change of culture, which is why the greater integration of health and social care to which it refers is so vital. We have a renamed department, but the transformation that that implies must go beyond its title. When asked recently about his biggest hope for change, Sir Simon Stevens replied:

“Seeing health and social care as two sides of the same coin.”


The Select Committee on the Long-term Sustainability of the NHS has exactly the same aspiration.

It has already been observed that, despite many positive and encouraging statements over the years, there has so far been a huge political reluctance to grasp this particular nettle, despite the cross-party consensus mentioned by the noble Lord, Lord Forsyth. I appreciate that much time and attention is currently focused elsewhere, but we would be grateful to know from the Minister whether Her Majesty’s Government have any timetable in mind for the sort of reform of our social care system that, as this report makes clear, is so urgently needed.