Asked by
To ask His Majesty’s Government what steps they are taking to
meet the needs of the 10 million people in England affected by
the adult social care system.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care () (Con)
My Lords, 10 million people in England are affected by the adult
social care system, including those drawing on care and support,
unpaid carers and the workforce. We have made up to £7.5 billion
available over two years to put the sector on a stronger
financial footing, improve access to social care and address
workforce pressures. We will publish further details this spring,
setting out how we intend to make improvements to the system.
(CB)
My Lords, I am grateful to the Minister. He will know that, at
any time, any one of us could suddenly become responsible for the
care of another person who has experienced a life-changing
condition—indeed, any one of us might need to be cared for in
those circumstances. The evidence to the Adult Social Care
Committee was extremely compelling, indicating that unpaid carers
feel that they carry a huge burden but are largely unappreciated
and ignored. One wrote only last week, saying that, “after years
and years of nursing experience, I now feel completely worn out
and very lonely”. Could the Minister assure the House that the
Government will take note of the recommendations of the
report?
(Con)
I thank the noble Lord for his Question and for the work he has
done around this report. As an unpaid carer for a number of years
myself, I am familiar with the circumstances and the fact that
unpaid carers are the backbone of the social care sector. I like
to think that we are making moves in the right direction. The
weekly allowance, the ability to have a one-week break and the
ability to go to your local authority for extra support where
needed are all steps in the right direction. But there is
definitely more we will be announcing that we are doing in this
space.
(Lab)
My Lords, if the Government are moving in the right direction,
why have they yet again delayed the implementation of the Dilnot
report? Why have they taken no notice of the report from the
Select Committee chaired by the noble Lord, Lord Forsyth, in
2019, which clearly gave the Government the route forward to deal
with this perennial problem?
(Con)
Answer.
(Con)
It is lovely to have noble friends.
Given the conversations I am sure we will come to shortly about
improving hospital flow and the 13% of beds that are blocked, we
felt that the focus needed to be very much on providing beds for
short-term care. That is where we wanted to put the £7.5 billion
of extra funding. We thought that was the immediate priority
because we knew the flow issues were impacting A&E, ambulance
wait times and everything else. That is not to say that we do not
intend to implement all the Dilnot reforms, but the priorities
were very much around improving flow and discharge.
(LD)
My Lords, when was Minister for Health and
Social Care, he stated publicly what some of us had long
suspected: namely, that we have a health and social care system
that is predicated on the assumption that people will be looked
after primarily by their families. One million people are ageing
without children; they do not have close family to look after
them. When will his department acknowledge the existence of this
group of people, and when will it be a requirement for planners
of health and social care to take them into consideration?
(Con)
Again, I would like to say that the big increases in funding—the
20% increase that we are talking about in two years’ time—are
very much an acknowledgement that there is a demographic issue
here, where more and more people are going to be coming into this
situation. That is why we are putting those plans in place and
working on the workforce; we are already seeing thousands of
people being recruited every month to assist with capacity in the
system. So we are putting in place the plans to address that.
(Con)
My Lords, one of the issues identified in the report of the Adult
Social Care Committee, on which I had the privilege to serve with
the noble Lord, , was the invisibility of unpaid
carers. What are the Government doing to support services to
identify unpaid carers, and what more targeted support can we
give this vital population—more than just one week of carer’s
leave?
(Con)
Again, as I said before, they are the backbone of the system;
some of my personal experience attests to that. So I hope that
what we were talking about will be seen as the start, rather than
the end, of what we are trying to do. But we recognise that it is
a decent start, because this issue has been out there for many
years and we are starting to address it. Obviously, forums such
as these make sure that it is something that more people are
aware of. I accept at the same time that a week a year is a start
in terms of a break; it is not the end of the situation.
(CB)
My Lords, I recognise that the Government are understandably very
concerned about public expenditure, but I wonder whether they
have recently undertaken a cost-benefit analysis of spending on
social care. For £1 million of additional spending on social
care, what would be the savings to the health budget? I have a
feeling that it could be at least £1 million, and possibly rather
more.
(Con)
Absolutely, and that is the whole intention behind the ICSs: the
ability in their areas to know local needs and invest in the
right places—that is, in social care rather than having people in
beds in hospitals, because it is a much more effective use of
resources, and also in primary care. We all know that a lot of
people go to A&E because they have not got primary care
services, so the whole point of the ICSs is that they start to
invest where demand is in the area, rather than using hospitals
as the place of last resort to go to.
(Lab)
My Lords—
(Con)
My Lords—
Noble Lords
This side!
(Con)
My Lords, there is plenty of time for both.
(Lab)
My Lords, I too was a member of the Select Committee. One of the
other key recommendations of our report was the establishment of
a commissioner for care and support, to act as a champion for
older adults, disabled people and, crucially, for unpaid carers,
and that we should prioritise to ensure a review, update and
implementation of the Care Act. Do the Government support these
proposals?
(Con)
Again, we welcome the report and many aspects of it. What I and
my ministerial colleagues care most about is having the results
and the impact. I think—and hope that noble Lords will agree when
they see the work that she is doing in this space—that Minister
Whately is gripping it and providing results. Let us see how that
progresses first, because I think that that will have the impact
that we need.
(Con)
My Lords, given that the Government promised that they would fix
social care, and given that in the Answer to this Question the
Minister said that there were 10 million people affected, is it
wise to go into a general election without having done so?
(Con)
As ever, I thank my noble friend for his friendly questions. No;
we know that this is an area that needs to be addressed, and I
think that it is an area that we are addressing. I have been up
here for about five months now, and in the time that I have been
here, we have announced a £7.5 billion increase in spending over
two years, a £700 million discharge fund over this year, and the
recruitment of thousands of people every month from overseas.
Yes, there is a lot more to be done, but there have been some
very solid results in the meantime.
(Lab)
My Lords, on that theme, the Minister makes much of the
Government’s historic £7.5 billion social care funding
settlement, but he knows that it has been and remains seriously
underfunded—the Health Foundation’s estimate is a £12 billion a
year shortfall. As the excellent Lords committee underlines, it
is no good attempting to resolve the social care crisis by
providing short-term funding for more care packages while still
depending on local authority council tax flexibility to raise the
extra funds. Is the Minister concerned that three-quarters of the
largest councils in England with responsibility for social care
have been left with no choice but to raise their council tax by
the full 4.99% increase, just to keep current inadequate levels
of service going?
(Con)
I am aware of some of the challenges raised by funding through
the local authority system—and I say that as a former deputy
leader of a local authority, so I am very familiar with the
situations at play there. At the same time, we have put a lot of
the central funding in place to make sure the security is there.
As I said, we will see more measures as Minister Whately
announces them in the spring, not far from here; there will be
further progress in this area.
(CB)
My Lords, one group of carers is made up of children. What are
the Government doing to help local authorities to identify and to
give extra help to children?
(Con)
I am aware of the many circumstances where it suddenly falls to
children, who obviously have their own demanding situation with
education and are suddenly expected to provide a lot of care. We
have tried putting steps in place with the local authorities so
they can provide further support to children. We know that
childhood is a critical part of their own development, so
expecting them to look after a parent is not the right way
around, if I can put it that way. So we have done work there, but
there is more to be done.
