Care Bill [Lords]

Debate between Norman Lamb and Sharon Hodgson

Monday 16th December 2013 Commons Chamber

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I am grateful for the opportunity to speak in this debate, not least because this Bill, particularly part 1, is being followed very closely in my constituency. I am pleased to follow my hon. Friend the Member for Easington (Grahame M. Morris), who spoke very well about the issues at hand. Given the high level of interest in my constituency, I recently held a listening event that was kindly supported by Age UK Sunderland and Sunderland Carers. I wanted to find out what the people who would be affected by the Government’s planned reforms thought of them. In the time available, I will give a potted account of that discussion.

Before I do so, I want to say a few words about young carers. After concerted lobbying by Members on both sides of the House, particularly my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), we now have clauses in the Children and Families Bill providing for young carers’ needs assessments and there are clauses in this Bill covering a young carer’s transition to adulthood—a very welcome step forward. I pay tribute to the Minister and to his predecessor, the right hon. Member for Sutton and Cheam (Paul Burstow), who are both in the Chamber today, and to the children’s Minister, the Under-Secretary of State for Education, the hon. Member for Crewe and Nantwich (Mr Timpson), for listening to Members and campaigners on this very important matter. However, I would like the Bill also to include a duty on medical professionals to identify and refer young carers so that they can benefit from those needs assessments. Family doctors are by far the best placed professionals to be able to identify where a child or young person is probably providing support to their parents, and it is not unreasonable to expect them to make sure that that child or young person has their needs assessed by the local authority. I very much hope that we will see more progress on this issue as the Bill continues its passage through the House.

Turning to the main provisions of the Bill on social care, if the Minister thinks that my constituents are happy with the package we have before us at present, he is very much mistaken. People’s first question is understandably, “Will this benefit me or my family members?”, and many of them, when they look beyond the press releases at what the Bill actually says, are finding out that it does not. They know that only people who are eligible for care will be covered by the headline-grabbing £72,000 cap on care costs. Therefore, if the Government say—as looks likely—that only those with the most severe needs are deserving of help, very few will be covered by the cap at all. Even if they are covered, £72,000 will not be the maximum amount they will have to pay; they will also have to pay hotel and accommodation costs of £230 a week, as well as any difference between the rate the local authority is able to pay and the actual care costs. All in all, they could be looking at an extra £300 a week that does not count towards the cap. That means that, over five years, a pensioner would have to find an additional £78,000.

The situation may be different for the Secretary of State’s constituents, but I cannot think of many pensioners in my constituency who would be able to afford that kind of bill without selling their home. Of course, there will be a deferred payment option, but that is just a more expensive version of what 95% of councils do already and it will not be available until a pensioner has run down all their other assets. Assuming they do qualify and they defer five years of care home charges, they could end up clocking up an extra debt of £13,800 in interest, on top of the £78,000 charge and the £72,000 cap.

[Norman Lamb]

I am grateful to the hon. Lady for acknowledging the change we made in the Children and Families Bill with regard to young carers. Does she welcome the fact that we are massively extending the means-tested support by increasing the threshold from £23,250 to £118,000, which means that people with assets right up to that level will get some contribution to their care costs for the first time ever?

[Mrs Hodgson]

But that is only if they and their needs are eligible. In all the cases I have looked at, no one has been able to convince me otherwise.

The average price of a home in my constituency is £150,000, so someone needing care for five years could see the entire value of their home gobbled up. Whether the home is sold before or after they die is academic, because it will still need to be sold and all but £23,000 will be called on to pay for care bills and the interest on them. The only real difference I can see between that and the current system is that people will pay interest for the privilege of deferring their home sale, and that is why the Opposition say that this is nothing more than a care con. Ministers have been keen to gloss over those facts, but they cannot con my constituents, who are wordly wise and have seen straight through all the spin.

The next thing my constituents asked me at the listening event was whether the Bill will improve the quality of care that they or their loved ones can expect to receive. The issue of quality of care quite rightly hits the headlines every now and again when particularly shameful examples of the treatment of the elderly or vulnerable are exposed. Those peaks in interest only reinforce the worries people already have about either moving into residential care or becoming dependent on strangers who come into their homes on a daily basis.

There are tens, or even hundreds, of thousands of very capable and dedicated care workers out there who do what they can in an extremely challenging job and often on terrible terms and conditions, examples of which we have heard today. The Bill does very little to tackle the problems of long hours—or even zero hours—and those of low pay, no training and low staffing ratios that can lead to demotivation and desensitisation with regard to the dignity of the people being cared for. Ultimately, that is what brings down the standard of care that everyone who needs it should have a right to expect.

On the quality of care that people receive and the impact is has on their quality of life, I received an e-mail today from my constituent, Steve Hudson, regarding clause 48, which has been inserted in the Bill thanks to my noble colleague, Lord Low of Dalston. Clause 48 extends the protection of the human rights framework to everyone receiving regulated social care, whether they are in residential care or their own home and whether they are self-funding or in receipt of local authority support. Frankly, I was surprised that that was not the case already. As the Equality and Human Rights Commission said in its briefing, closing that loophole would be extremely beneficial in ensuring that the dignity and basic human needs of every person receiving care are at the forefront of every manager and business owner’s mind. I therefore hope that if the Bill progresses tonight, the Government will not seek to remove that provision in Committee.

The final big concern that my constituents shared with me at my listening event relates to funding constraints. It is clear to everybody that cuts to local authority budgets have a knock-on effect in the NHS, with beds, clinical staff and other resources unnecessarily tied up while care packages are put in place or even just reasonable adjustments to accommodation are made. It is no coincidence that delayed discharging is at an all-time high and costing the NHS some £20 million a month at a time when many local authorities are at financial breaking point and struggling to see how they can provide even the services they are legally obliged to provide over the coming years, let alone the kind of preventive services that they provided until recently.

Of course money is tight, but because it is tight, we should use the money we have in a smarter, more innovative way, as my right hon. Friend the Member for Salford and Eccles (Hazel Blears) said so eloquently. That means pursuing the ideas put forward by my right hon. Friend the Member for Leigh (Andy Burnham) and my hon. Friend the Member for Leicester West (Liz Kendall) for a whole-person care approach and the full integration of health and social care.

My constituents do not hate this Bill—they are pleased that there is a Care Bill—but they are frustrated by its lack of ambition and disappointed that the Government have watered down and cherry-picked the Dilnot recommendations so much that very few people will actually be any better off in the long run than they would be under the current system.

The Bill is inadequate and the House should decline to give it a Second Reading today, so that the Government can go away, have one of their famous pauses and come back with a version that meets the challenges that our health and social care systems will face over the coming years. Most importantly, the Government need to come back with a Bill that lives up to the hype that Ministers have tried to generate, and which does what all our constituents want and need it to do.