Queen’s Speech — House of Lords, 2020-01-09
Topic: Social Welfare
Alfred Dubs (Labour, Centre-left): My Lords, it is a great pleasure to follow my noble friend Lady Blower and to congratulate her on her maiden speech. She was being unduly modest, because she has an enormous amount of educational experience, not just, as she said, as general secretary of the National Union of Teachers; she has also taught in a number of comprehensive schools in the London area. To say that other noble Lords have more knowledge of education than she has is to be unduly modest. She will make an enormous contribution to educational debates, thinking and policy in this House, and we look forward to hearing from her on many future occasions I will speak about social care. The gracious Speech included a reference to social care and the Government seeking cross-party consensus. That is fine, but we have been waiting for something to happen on social care for years. There have been reports, commissions and bodies talking about social care. What has happened to the long-awaited White or Green Paper that the Government promised quite a long time ago? Could the Minister tell us whether it is still going to happen and, if so, when If one talks to people of our age or older, one will know that most in this country are concerned about what will happen to them when, or if, they get to the point that they cannot look after themselves unaided. There is a deep concern. According to the British Social Attitudes survey, only 23% of people are satisfied with social care. There is a real gap in the system and concern for the future. Of course there is a need for more money. The Government are talking about an extra £1 billion a year, but most people who have looked at it say that we are nearer to needing about £8 billion a year, rather than £1 billion, to provide a decent standard of care. That is the sum required to return to the standards of 2009-10 Eligibility for social care is very much a postcode lottery. It depends on which local authority one lives in and all sorts of random factors. No wonder there is concern. It also depends a great deal on unpaid carers. They give up their jobs to do care work and get £60 a week for that. It is pretty miserable. Care staff are not always able to work on Christmas Day or New Year’s Day. Retention is poor and many are non-UK nationals. I wonder what will happen to them post Brexit Everybody talks about better integration of health and social care. We hear the expression "bed blocking". There are enormous costs to bed blocking. If there is no seamless transition from hospital to social care, which is provided by local authorities, people tend to stay in hospital. I know of the experiences of people who were in hospital for quite a long time—probably unnecessarily, had there been better transition to care outside hospital. I heard one estimate that a night in hospital costs £350, a night in a care home £85, and a night at home with care support under £20. People often have to contribute to their care but, because by staying in hospital they do not have to so, paradoxically, they save a bit of money, but it is not an efficient and humane way of proceeding. It is also erratic, because people with dementia have to pay for everything themselves and people with other illnesses do not. I understand that a good model has been developed in Manchester, which has a better way of integrating health and social care. It would take legislation to bring it about fully, but it needs to be looked at I looked into some other things, such as records. We have very little information about social care and few hard facts. Most of what we know is based on estimates—approximations, almost guesswork. For example, local authorities have different methods of collecting data. Nothing is standardised, so one cannot even compare one local authority to another. I challenge anybody to look at the form for eligibility for social care produced by a local authority. I have seen one—it probably takes a PhD or two to complete. They are very difficult, and people who are deprived and disadvantaged cannot always do that. There is a terminology difference as well between NHS support and social care. Surely we all agree that reform must be evidence-based There is pressure in the system, because the health service dominates, in a way. The health service needs far more money, but it has power to attract more money than local authorities can for social care. Local authorities are hard-pressed enough as it is. I urge that we should have proper records; be generous in saying that social care has to work properly; and that we must integrate health and social care. We would save money and provide much better care. For heaven’s sake, let us get on with it.