Health and Social Care — House of Lords, 2021-09-09
Topic: Mixed Topics
Richard Newby (Liberal Democrats, Centre to centre-left): My Lords, according to the Prime Minister, the package of proposals in this Statement represents "a project of our era equivalent to the creation of the NHS and the welfare state." How, then, do the proposals measure up to this challenging claim Taking the spending side first, the Statement covers three separate but related areas. First, there is the implementation, at last, of something like the Dilnot proposals for placing a cap on the contribution that individuals need to make towards their social care. This principle was legislated for by the coalition in 2014 and its implementation is long overdue. Secondly, the Government are making a major investment of about £10 billion per annum for the next three years in the NHS to deal with the backlog of elective procedures. Undoubtedly this is necessary, but not necessarily sufficient. Yesterday, the Prime Minister failed to give any assurances about the rate at which the backlog of procedures would be reduced. Can the Minister today give any further indication of timescale on this Thirdly, the Government claim to be making more resources available to state-funded social care beyond Dilnot. This is arguably the most pressing problem of all, with 112,000 vacancies, massive staff turnover rates and providers teetering on the edge of financial viability. Sadly, the Statement was almost silent on the substance. Instead, all details about the future of social care are yet again pushed back into the long-promised White Paper, for which no publication date has been set, as the noble Baroness pointed out. Can the Minister confirm that there will be no immediate increase at all in funds available for social care, not a penny? If so, how does she expect care homes and domiciliary care providers to survive over the coming months? Over the whole three-year period covered by the Statement, exactly how much additional central government funding will flow into adult social care provision unrelated to the Dilnot reforms, bearing in mind that the current annual cash shortfall is somewhere in the range of £6 billion to £14 billion After the first three years, the proceeds of the levy are supposed to go increasingly towards social care. However, given that, on the basis of previous experience, overall NHS spending in future is likely to be greater than that currently budgeted for, there will undoubtedly be pressure for this additional level of NHS funding to continue, even after the pandemic catch-up is more or less complete. What assurance can the Government give that over the medium term, the bulk of the revenue raised by the levy will go to social care, as promised? When later this year does the Minister expect the White Paper to be produced? We have heard so many assurances that it is almost here, nearly here or will soon be here. We are a bit sceptical The Government document states that they want to "make care work a more rewarding vocation" How will these announcements allow care providers and local authorities to increase the wages of the many thousands of care workers stuck on zero-hours contracts and the minimum wage? Do the Government really believe that offering a few training courses will solve the recruitment and retention problem in this sector? The Government say that they will "ensure that the 5.4 million unpaid carers have the support and respite that they need" How much additional funding over the next three years will now be available to fulfil this promise The Government say that they will move towards equalising the amount paid by self-funders and those funded by local authorities. Do they plan to do this by reducing the amount paid by self-funders or by increasing the amount paid by local authorities? If it is the latter, where will the money come from I turn to the new hypothecated health and social care levy. Many people are indignant that a major manifesto promise has been broken, but why are they surprised? For this Prime Minister, a promise is not a binding commitment; it is simply a holding position, until it becomes easier to do something else. More surprising than a broken promise is that the Treasury has agreed to introduce a hypothecated tax—something that it normally never countenances, because of all the inflexibilities that it brings. Why has a new, unprecedented, hypothecated tax been introduced here? The obvious reason is that the Government know that they will have ever-growing demands for future spending in health and social care, for which tax rises will be required, and they see this tax as a vehicle for doing that in future. Can the noble Baroness confirm that, for this Parliament at least, there will be no more increases in the levy All in all, does this Statement amount—as the Prime Minister claims—to the equivalent for our age as the creation of the NHS and the welfare state? For those trying to run a care home, act as an unpaid carer or subsist on a minimum income, such a boast will ring hollow. Beveridge, Attlee and Bevan must be turning in their graves.