National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2020

Lord Mann Excerpts

Monday 8th June 2020 Lords Chamber

[Lord Mann (Non-Afl)]

My Lords, the Government have a great opportunity because the public mood, as I judge it, is that the time for some coherent change is now. I think that the public would be prepared to pay that bit more to underwrite the changes that would guarantee the system.

There seems to be a growing consensus across parties that a significant amount of extra money will be needed. I am sure that there are plenty of arguments about where precisely that will come from, but I want to address where it goes. Nothing has frustrated me more over the last 20 years than seeing this disparity between the NHS and local authorities. Care for the elderly, as defined by care homes, has to be the provenance of the NHS. It is absurd that someone having to be released into a care home by a hospital, because they are not capable of living in their own property—whether owned or rented—and require additional support, is a health decision.

We are missing some obvious tricks. Where I live, housing is dealt with by the district council, social care by a county council. Our CCG is coterminous with the district council. What ought to happen is agreement on funding so that the district council builds housing for what I have in the past termed intermediate care. It must be housing that is fit for purpose so that people significantly delay going into a care home. It is supported living.

It is undeniably the case where I live is that old-style council bungalows—two bedrooms, very simple, very small, with a tiny garden, semi-detached or in blocks of four—are the most popular. Why? It is because they are the cheapest to live in and heat, and the easiest to clean, maintain and grow old in. If they were all fully adapted, people would be able to live in them for even longer. Families can and would want to give that support in the vast majority of cases. That is a form of care home, but I have seen so many people put into institutions when they would have thrived far more with a level of independence, if the system had allowed it.