Adult Social Care Debate
Full Debate: Read Full DebateNigel Evans
Main Page: Nigel Evans (Conservative - Ribble Valley)Department Debates - View all Nigel Evans's debates with the Department of Health and Social Care
(12 years, 1 month ago)
Commons ChamberOrder. To accommodate as many Members as we can, a five-minute limit will be introduced, with the usual overtime for two interventions.
Adult social care is probably one of the biggest, if not the biggest, challenges that we as politicians and policy makers face. We have heard thoughtful contributions from Members on both sides of the House explaining why it is so difficult. If people are fortunate, they never need to access adult care. If they are unfortunate, they do need to do so, or members of their family do. As we heard from the hon. Member for Southport (John Pugh), it can be a cruel lottery. One of our purposes should be to minimise the extent of that lottery and maximise entitlement and support for all individuals.
One of the most humbling experiences I have had since becoming Member of Parliament for Scunthorpe was going to visit a constituent in his home last week on this very issue of care and support. He is a similar age to me. When he was younger, near the end of his training in the medical profession, he went out into the sea and suffered a terrible accident. As a result, he was paralysed from the neck down. Since then, he contributed to society in a number of different ways. He retrained in higher education until he was advised by his GP to retire because if he did not, in the GP’s words, “the wheels would come off” and he would no longer be able to contribute to society.
After going to see my constituent, he wrote to me—this is about individuals and real people’s lives—about the publication of the draft social care bill:
“I have just been reading the latest on social care funding on the BBC website—it would seem that meaningful cross-party dialogue re Andrew Dilnot’s recommendations has broken down and that the government wants to put decisions off until the spending review late next year.
My suspicions about kicking into the long grass appear justified!...I have already contributed over £60000 towards my care package and seem to be paying more and more each year—despite the fact that North Lincolnshire council reduce the value of my care package every time there is a review.
My condition has not improved. I am, in fact, starting to suffer more and more of the long term complications that inevitably hit ageing tetraplegics.”
The worry and concern are there. When visiting my constituent in his home, I observed that the people who were providing the care were brought in at his expense. Resources were not adequate, because that cost was being taken out of his small pension from working in higher education, which went up by 5% a couple of weeks ago, although the contribution to North Lincolnshire council went up by 25%. What is the incentive to do the right thing in difficult circumstances when those sort of things happen?
What I have described was additional care. The core care was provided by my constituent’s mother, who was in her mid 80s, and his sister, who travelled for two and a half hours to spend half the week helping to care for him. As politicians, we need to step up to the plate. It is about leadership—cross-party leadership—and being able to do the right thing for people, such as my constituent, who suffer misfortune. Had that misfortune occurred, as he said to me, in a car crash, he would have received insurance compensation, which would have paid for his care package. Because it took place in a situation of utmost tragedy—nobody was responsible for it, but it was a total misfortune—there is no underpinning support from the state, which should properly protect him and his family from having to pay more and more money. My plea is for us to show the leadership across the parties—
The hon. Member for Southport (John Pugh) was kind enough to say that people of a pensionable age can sometimes make useful contributions. He is very kind to me—I am the only Member of a pensionable age to speak in the debate. I am 37 in my mind, but with a son of 42, that is rather unlikely.
The Government have failed at the core of the White Paper on the question of funding. This is about money, not leadership or consensus or saying nice words in the Chamber. I am very pleased that Labour Front Benchers have accepted Dilnot. His proposals are not perfect, but he goes a long way to proposing a free national care service, which my hon. Friend the Member for Blaydon (Mr Anderson) and I want.
I know Andrew Dilnot well—he is a fine, highly intelligent and compassionate man. He went to great lengths to tailor a precise scheme that could be accepted by the Government, but at the last minute, they have buckled and not committed to it. The problem is the Treasury—the worst Government Department of all. It has failed the country over and over again with terrible mistakes. The European exchange rate mechanism destroyed the credibility of the Conservatives, but the Treasury has done lots of other bad things. It is a dreadful Department. I hope that Ministers now tell me how wonderful it is.
There has been almost no mention of the royal commission on long-term care from some 14 years ago—I think my hon. Friend the Member for Blaydon mentioned it—which recommended free long-term care, which is precisely what he and I want. However, the Government at the time—they happened to be a Government I supported—could see that the report was going to be unanimous, so they slotted in two people at the last minute to ensure that it was not unanimous, and from that point onwards they hung on to the minority report of those two members. It was a bit of a disgrace, and I made that point strongly. I tabled an early-day motion in the 1997 to 2001 Parliament calling for implementation of the royal commission’s recommendations, which was signed by more than 100 Members of the House at that time, and in the 2001 to 2005 Parliament I tabled another early-day motion saying the same thing, again with the same sort of support. I also have the support of the National Pensioners Convention—a body with which I am closely associated—which also wants free long-care on the same basis as in the NHS.
In Scandinavia they do it. Indeed, what I have always wanted my party to do—as well as the others, but particularly mine—is to move in the direction of Scandinavia, not the United States of America. If Members read the book “The Spirit Level”, they can see that the civilised societies—where people are happier and all sorts of social problems are lesser—are in the Scandinavian- style countries. The worst end of the spectrum is in America, and we have been steadily moving towards the American end, not the Scandinavian end.
In the end it is about cost and this word “affordability”. We choose what is affordable. It is not written in stone: we can choose to make things affordable, and we can choose to pay for them by progressive taxation—if we wish. It is a political choice. People say, “Oh, well it’s not affordable.” However—I have told this story many times—I remember that when my children were young, if they asked for a second ice cream, my wife would say to them, “Mummy can’t afford it,” when what she was really saying was: “You can’t have another ice cream.” Of course she could afford it. We can afford to pay for free long-term care too, but we choose not to—so far. I hope to persuade my side at least to commit to it in time.
The extra costs of Dilnot would initially be £2 billion a year. That is the equivalent of 0.5p on the standard rate of income tax. I have put this to many people in meetings and asked them, “What would you choose: the threat that your home would be taken away, with no equity to hand on to your grandchildren, or an extra 0.5p on the standard rate?” Without exception, they say 0.5p on the standard rate. Of course, we do not have to do it that way, because there is plenty of cash in the tax gap, which is estimated to be as much as £120 billion a year, or even more. If we collected a tiny fraction of that—one sixtieth—we could cover Dilnot’s proposals; and, if we have to have a bit more, let us squeeze the tax gap a bit further. However, since Margaret Thatcher’s time as Prime Minister, we have seen the standard rate cut by 5p, which is 10 times more than the cost of Dilnot, so do not let us pretend that it not affordable. We choose not pay for it, because we think—or some people think—that low taxes are better or that letting tax evaders and tax avoiders get away with it is better than looking after elderly people in great need.
We are also committed, apparently—I understand that this goes for both sides of the House—to the idea of owner occupation, but we are actually seeing the gradual erosion of owner occupation, particularly by poorer people having their houses taken away when—
Would my hon. Friend like to comment on some of the Opposition’s assertions that the efficiency savings from reductions in management levels in NHS are not being put back into front-line services to enable integration, and that they are somehow being siphoned off to the Treasury? I do not believe that—
Order. I must ask the hon. Lady to turn round so that the microphone can pick up what she is saying. I know that she is finding that difficult, but she should be heard by everyone in the Chamber.