Adult Social Care (Adult Social Care Committee Report)

Lord Weir of Ballyholme Excerpts

Monday 16th October 2023 Lords Chamber

[Lord Weir of Ballyholme (DUP)]

My Lords, I too commend this report and thank the noble Baroness, Lady Andrews, and the committee for producing it, not simply in my capacity as a Member of this House but as a former carer of my late mother.

The report is deeply prescient. For too long, the issue of the need for change in adult social care has been long-fingered, and it is understandable why parties of different complexions have not grasped the issue, given the toxicity particularly around how we pay for the additional needs of adult social care. But that luxury of putting things on the long finger is something that we cannot afford to ignore any longer.

Mention has been made of an estimated 10 million people in this country being impacted by adult social care, and that number is set to grow almost exponentially, particularly as we see advances in medical science which mean that people will die less of particular conditions but will have to live with them. Nowhere is that more pertinent than with dementia and Alzheimer’s, where the numbers are probably set to double in the next few years.

In the time available to me, I want to touch on three aspects of the report. The first is the need for codesign in any plan for care—codesign with carers and also those in receipt of care. If we simply look for a one-size-fits-all solution for individuals, it will not work; similarly, if we simply seek to impose it on people, it will be a recipe for disaster.

Secondly, we need a consistency of approach across the country. We are all too aware, as is highlighted by the report itself, that for many people the quality and quantity of availability of adult social care is a postcode lottery. I know that, even in Northern Ireland, where there is a greater level of co-ordination, because health and social care are within the same department, that is no guarantee of a perfectly consistent result. I was very fortunate in my own circumstances that the company providing the care for my mother was a very good one, but I know that if I was maybe 10 or 15 miles either side of where I live, that level of care might not necessarily have been available.

As indicated by the report, we need investment in the extent of training required for the workforce—and, frankly, we need to raise the salaries of the workforce to ensure that we attract and retain sufficient numbers to be able to provide that level of social care. On consistency of provision, we need to ensure that the pathways for carers are clear and that it is easy to obtain help. As someone who was an elected representative, filling in the forms and accessing the care was quite easy for me—but many others are left in a very difficult position. I also know that, perhaps because of the level of support that I and my family were able to give my mother through finances and savings, we were able to bridge the gap between what could be afforded and what was required. But for many families that is not available.

Thirdly, we need a level of co-ordination in the system. I have mentioned that in Northern Ireland health and social care are within the one system. That in itself is not a panacea for all issues—but we have seen in a whole range of health issues that within the broader health service there is a level of silo mentality that still maintains. A number of us had a meeting today about palliative care, where again the failure perhaps to realise where there can be investment to save and to ensure a co-ordinated approach damages what can be provided and the quality of that provision.

The report highlights a cocktail of measures that are required to improve adult social care. Ultimately, it requires all of us to commit to a step change in what we can provide in adult social care. I agree with the remarks of the noble Lord, Lord Polak, when he talked about the need to take the politics out of this issue. Rather than try to create a political football in which we blame one party or another, we need to work together to try to deliver a consensus. It is often said that we have a health service in this country that is in danger of being broken. If we do not tackle properly adult social care, it will not be a question of it simply being broken—it will be irretrievably and irreversibly unfixable.