Social Care Funding — House of Commons, 2018-10-17
Topic: Health
Philippa Whitford (Scottish National Party, Centre-left): No, I am sorry, I will not give way. Members want to make speeches, but if they intervene on me, there will not be any In Scotland, we have been working for the past five years on integrating health and social care. I can say that it is an awful lot harder than the job that we did of integrating primary and secondary care, simply because one side is tax-funded and the other involves multiple private companies and is means-tested. We are already working on that. Our integrated joint boards manage one half of our health budget along with local authority funding. It is about shifting money from hospital into primary care, mental health, community care and social care There are three particular groups who need social care. The frail elderly mentioned by the Secretary of State, the number of whom will escalate massively in the coming 20 years, need support and comfort, and most of them would like to be at home. The home care hours in Scotland have doubled over the past seven years, which allows people with more complex needs to be cared for at home, so as not to end up in a care home or to land acutely in hospital As was mentioned by the hon. Member for Bridgend (Mrs Moon), who is no longer in her place, end of life is a critical issue; it is a point at which time is of the essence. Since 2015, all Scottish local authorities have provided free personal care to people defined as having a terminal condition—facing the end of life—even when they are under 65. The Government should look into such a measure, as it provides dignity Working age disability accounts for a huge chunk of social care funding. These people want to be mobile and to be allowed to participate in society, and it is important that that is what they do—that they are not just stuck away somewhere, as might have been the case many years ago. From April, under Frank’s law, which was named after the footballer Frank Kopel, under-65s with degenerative conditions, not just disability, will be able to receive free personal care. That includes people with early dementia and multiple sclerosis. We ask that the DWP does not then rob these families of that money by cutting other disability allowances I mentioned the workforce, which is an enormous challenge in the health service and one with which every local authority, integrated joint board, company and care home is struggling. Despite the workforce in Scotland increasing by 11% over the last three years, it is becoming harder to recruit. Brexit only makes that harder because a significant proportion of social care staff are from Europe We need to make social care a career—to be decent to carers by paying them the real living wage, not the pretendy one, and by paying them for all the hours they work, even at night. It is important to treat people with dignity if we want them to treat our loved ones with dignity. Carers should have job satisfaction from having time to care. Having 15 minutes to flit in and out does not provide job satisfaction, and it does not provide satisfaction or continuity for the patient or the carer. There needs to be a career structure. Caring should be looked upon like nursing, with training, investment and a way of staying in that career. It should not just be some job that people do until they get a job on the checkout at Tesco because that pays better We have talked about being able to discuss the Green Paper, but unfortunately there is no sign of it. It is meant to offer an opportunity to rethink care. The Nuffield Trust suggests looking at the Japanese system or the German system, which has already been mentioned. It is noticeable that levers have been built into the Japanese system so that demand can be controlled, and that means that eligibility may well change. On the plus side, the system is Japan is a holistic one and it looks at the global wellbeing of the older population—so if we do look at these other systems, we should look at them in their entirety The German system is based on social insurance. Well, does that not ring a bell? We used to have national health insurance, but then the "health" was dropped. Maybe we should think about whether national insurance should really stop when people retire. Perhaps we might set a level above anyone who is living only on the state pension, because there are pensioners who are very well off and who suddenly stop paying national insurance exactly at the point when their health, care and social needs start to increase. We need to look at all these options, but it is crucial that there are no sudden changes—that we do not have a WASPI situation, whereby the goalposts suddenly move with only a couple of years’ notice, and that we do not have a measure like the one in the Conservative manifesto last year that was then labelled the dementia tax We need to discuss this issue as adults, to look around the world and to look at the demands ahead. Older people and people with disability across the UK need to be able to live a life of decent quality, with dignity.