Social Care Funding (EAC Report)
Lord Young of Cookham Excerpts(3 years, 10 months ago)
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Lord Young of Cookham (Con) [V]
My Lords, at a time when your Lordships’ House is under fire, there can be no better example of its value than the document we are debating. The committee achieved in a matter of weeks what has eluded Governments for over 20 years.
In December 2000, the Queen’s Speech said:
“The legislation will also take forward my Government's response to the Royal Commission on Long Term Care for the Elderly.”—[Official Report, 6/12/00; col. 2.]
That was the Sutherland commission. Nothing happened. At the end of the Labour Government’s time, they were back where they started with the 2009 Green Paper Shaping the Future of Care Together. The coalition agreement echoed what Labour said in 1997:
“We will establish a commission on long-term care, to report within a year.”
But Dilnot suffered the same fate as Sutherland.
In 2017, the Queen’s Speech said:
“My Ministers will work to improve social care and will bring forward proposals for consultation.”—[Official Report, 21/6/17; col. 6.]
Nothing happened. The last Queen’s Speech said:
“My Ministers will seek cross-party consensus on proposals for long term reform of social care.”—[Official Report, 19/12/19; col. 7.]
Again, nothing happened, as the noble Lords, Lord Razzall and Lord Campbell, said. That is the background to the substantial achievement of my noble friend and his committee.
Some critics may say that this consensus has been achieved at an unaffordable price—not so. The chairman of the committee, my noble friend Lord Forsyth, is a notable hawk when it comes to public expenditure. I put “Lord Forsyth, control of public expenditure” into Google and got 860,000 hits. On his committee are two former Chancellors and two former Treasury Permanent Secretaries, with the imperative of public expenditure restraint in their very DNA—I do not imply that the other noble Lords on the committee are a soft touch. This is not a body of men and women who will come up with something unaffordable. The next step should be a White Paper and legislation.
I have two comments to make in the time available. I do not agree with paragraph 8:
“We share the concerns of many witnesses about the Government’s plans to make local authorities more fiscally self-reliant.”
I think local authorities should become less dependent on central government, not more, and I hope the forthcoming Green Paper will give them more powers and a broader income base. I understand the committee’s concern that some local authorities are less able to spend on social care than others, but that should be rectified through the revenue support grant, not by making all local authorities more dependent on the Government.
My other comment is about the moral hazard from free personal care, touched on in paragraph 106:
“There may be a deadweight cost to the introduction of free personal care.”
It is a dead weight as some will no longer have to pay and others may opt out of caring to benefit from the free package.
This raises the broader issue of responsibility between the family on one hand and the state on the other, touched on by the noble Lord, Lord Hunt, and my noble friend Lord Lansley. Dilnot’s view is straightforward:
“For those who can afford [social care] it should not be free”.
But that does not address the fundamental problem that the noble Lord, Lord Forsyth, identified in his powerful speech—the unfairness of the present regime for people with, for example, dementia. A possible way to minimise both the moral hazard of people opting out and the initial cost is to look again at activities that might qualify for free personal care—for example, cooking and dressing. These activities could be performed by family members without imposing huge burdens on them. Therefore, to bring the costs down initially, they might be excluded from the free package where there is an alternative. But this is a detail that we can iron out when, as I very much hope, legislation based on this high-quality report is introduced in the next Session of Parliament.
Covid-19: Vaccination Prioritisation
Lord Young of Cookham Excerpts(4 years ago)
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Lord Bethell (Con)
It will not be possible to publish any results until we have the clear data on the vaccines. Individual vaccines may behave quite differently with different groups of people. There may be some vaccines that work well with the elderly, some that work well with those with clinical conditions and some that work well with children. It is only when we know that data that the final prioritisation can be published.
Lord Young of Cookham (Con)
My Lords, on 12 November I asked my noble friend’s ministerial colleague, my noble friend Lord Greenhalgh, if he would recommend to the JCVI that rough sleepers and those who work with them should be a priority for vaccination. He said he would. Does that remain the case, and will they indeed get priority?
Lord Bethell (Con)
My noble friend has made the case for rough sleepers extremely well. It is one that we are deeply concerned about. When it comes to the prioritisation list, what has been published so far is an interim and indicative list. It will be reviewed, and a more detailed list will be published in time.
Social Care
Lord Young of Cookham Excerpts(4 years, 1 month ago)
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Lord Young of Cookham
To ask Her Majesty’s Government when they will publish their proposals for the reform of social care.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, the Government’s current priority for adult social care is for all recipients of care to receive the support they need throughout the Covid pandemic. While we published a winter plan that looked ahead through winter 2021, we are acutely aware of the long-term challenges to the social care system in England and the importance of reform. Putting social care on a sustainable footing, where everyone is treated with dignity and respect, is one of the biggest challenges our society faces.
Lord Young of Cookham (Con)
I am grateful to my noble friend for that reply, but this is not a happy story. Last year, the Prime Minister said:
“We will fix the crisis in social care once and for all with a clear plan we have prepared to give every older person the dignity and security they deserve.”
A few weeks ago, however, that reply was diluted in a Written Answer that said:
“There are complex questions to address to which we want to give our full considerations in the light of current circumstances.”
That is straight out of “Yes, Minister”. When will we see the clear plan announced 15 months ago, together with a commitment to the necessary funds to redress the imbalance between health and social care, so tragically revealed by the current pandemic?
Lord Bethell (Con)
My Lords, I reassure my noble friend that there is absolutely no dilution in the commitment to a long-term solution. No one in the Chamber would deny that the challenges in this question are extremely complex. The Government are also committed to cross-party talks and everyone in the Chamber recognises that we need a generational solution, not a political fix. In terms of finance, it is undoubtedly the case that the social care system has been under pressure during Covid. That why we have put an enormous number of funds—I could list them—into social care in the past six months. The refinancing of the social care system is one of the items that will undoubtedly be on the agenda.