Asked by
To ask Her Majesty’s Government what assessment they have made of
the Association of Directors of Adult Social Services Budget
Survey 2019 on the state of adult social care.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care ()
(Con)
My Lords, we recognise many of the issues highlighted by ADASS.
People of all ages are now living longer, sometimes with complex
care needs. Social care funding for future years will be settled
in the spending review, where the overall approach to funding
local government will be considered in the round. Meanwhile, we
have given local authorities access to up to £3.9 billion for
more dedicated funding for adult social care this year, and a
further £410 million is available for adult and children’s
services.
(Lab)
My Lords, the ADASS survey results provide yet more evidence of
the ongoing crisis in social care caused by persistent
underfunding and a fragile and failing care market. As the report
says, there are planned cuts of £700 million to adult social care
budgets in the current financial year and there have been
cumulative cuts of £8 billion since 2010. On the last day of our
current Session, can the Minister update the House on the timing
of the social care Green Paper, which has been delayed six times
and is now two years overdue? Given this inexcusable delay and
the widespread consensus across social care about what needs to
be done, why can the Government not commit to publishing a White
Paper with actual proposals? Has the Lords Economic Affairs
Committee report calling for £15 billion of extra funding, to
include free personal care for people needing basic washing and
dressing support, not done the Government’s job for them?
I share the noble Baroness’s impatience on this issue and I agree
with the overall conclusions of the ADASS report that older and
disabled people need dignified, high-quality care and support.
When properly resourced it does work, and as a nation we must
make this an immediate priority. That is why I very much welcomed
the incoming Prime Minister’s statement that,
“we will fix the crisis in social care once and for all with a
clear plan ... To give every older person the dignity and
security they deserve”.
He will make it a priority of the incoming Government and there
will be an imminent announcement from the incoming Health
Secretary. As I do not know whether I will be part of the
department, I am afraid that I cannot commit to this, but I am
sure that whoever is in this place when that comes forward will
be very happy to do so.
(Con)
My Lords, I welcome the statement by the incoming Prime Minister.
However, does my noble friend share the concern about the
unfairness of the current system? People suffering from dementia
or motor neurone disease are not given access to free care,
whereas people suffering from cancer are. People who choose to be
looked after at home do not get free care until their assets have
been run down to £23,500, but their home is not taken into
account. However, if they go into residential care, their home is
taken into account. As my noble friend indicated, what we need
now is not another White Paper; we need the Government to write a
cheque. We need to move away from a system where local
authorities are asked to fund this out of business rates, which
results in a postcode lottery and differences in care throughout
the United Kingdom.
I thank the noble Lord for the work he has done on this issue. It
is very much welcomed. He will know that, as one of his first
statements, the Prime Minister said that his job was to,
“protect you or your parents or grandparents from the fear of
having to sell your home to pay for the costs of care”.
This was one of the first points he made. The noble Lord will
also know that one of the Government’s long-term principles is
that there must be a level of personal responsibility for social
care in England, as well as the safety net that supports
significant numbers of people today. However, we accept that
there will need to be a significant amount of funding as part of
the spending review commitment. That is being considered at the
moment and will be coming forward imminently.
(LD)
My Lords, the sustainability of adult social care is at severe
and immediate risk. We too welcome the Prime Minister’s words
yesterday. Could the Minister confirm that he will commit to
continuing with the precept, and the social care grant or the
improved better care fund after 2019-20? Otherwise, how can
councils plan their finances for 2020-21? What assurances do
councils have that any future funding will be protected for the
adult social services budget and not be part of the overall
spending at the councils’ discretion?
The noble Baroness is quite right that the better care fund has
been considered a great success. It is an important part of the
integration proposals between health and social care, which the
Government and the NHS are committed to. It is under review to
see how it can work better. That will conclude later this year so
that certainty can be given to local councils, which I hope she
welcomes. On market instability, I reassure her that the overall
number of social care beds has remained more or less constant
over the past nine years. There are also over 3,700 more home
care agencies now—so, while there will inevitably be some exits
from the market, we are more reassured than we would otherwise
have been.
(Lab)
May I take the noble Baroness back to her reference to personal
responsibility? There is a great deal of agreement across the
House and elsewhere that personal responsibility is important as
far as social care is concerned, but does personal responsibility
extend to subsidies for those on local authority placements in
nursing homes? Those paying for themselves privately are actively
subsidising those places because local authorities cannot afford
adequate rates.
The noble Baroness has got to the nub of the challenge, which is
how we get the balance right. This is why we have brought forward
the work we have been doing to make sure that, while we have the
safety net in place and an element of personal responsibility, it
becomes fairer. That is why the Prime Minister and the Secretary
of State have made it clear that they are determined to drive
this work forward faster and with more urgency than has been done
until now. That has been put forward as a key priority of the
incoming Cabinet.
The Lord
My Lords, we have heard, properly, about the needs of the
elderly. Will the Minister assure us that the needs of people
with learning disabilities will be better addressed in any action
the Government are likely to take, particularly since some 41% of
the helpline calls to Mencap in April were from people very
concerned about the loss of community care?
The right reverend Prelate has pointed out something very
important: a significant portion of those accessing adult social
services are actually those of working age and those with
learning disabilities. It is very important that does not get
lost in the debate. Anything that comes forward as part of the
social care solution must address the concerns of that part of
the community in a much more effective and joined-up way.
Integration of social care and NHS budgets, and effective
delivery, will be core to that delivery.
(CB)
My Lords, last week, with the Salvation Army the charity the
International Longevity Centre UK, which I head, published a
report on the funding gap in social care, in particular for older
people living in rural areas. The report summarised it very well
by saying that there is not just one crisis but lots of crises
and that local leadership alone cannot overturn the inequalities.
As co-chair of the All-Party Group on Adult Social Care, I hope
that the Minister can assure me that Her Majesty’s refreshed
Government will now prioritise this issue in the way I have
suggested.
The noble Baroness phrased that very elegantly—I shall use the
term “refreshed Government” myself. I will make the gentle point
that the funding available for adult social care has increased by
8% in real terms from 2015-16 to 2019-20, which is a step in the
right direction. However, there is a recognition that, to put it
on a sustainable footing for the future, there needs to be a
settlement in the upcoming spending review. That is recognised.
On the point she made about rural areas, which is important, a
lot of this hinges on workforce recruitment and retention, which
can be more challenging in rural areas. That is why the
Government have invested £3 million in the Every Day is Different
national adult social care recruitment campaign, to encourage
more people to apply to work in the social care sector and to
raise its profile. This has had some success already, which is an
encouraging picture. We need to work harder on that.
