Contribution
I thank the Minister for advance sight of her statement. I join in what she said about Sir David Amess. Today, again, we remember his service and remarkable contribution to Parliament and public life, including through today’s Children’s Parliament.
In my lifetime, life expectancy has risen by almost a decade. That is wonderful, but as the Minister said, it means that many more people now need care for extended periods—sometimes very extended periods—and that number is only likely to grow. It is imperative for society to address this issue, and it is imperative for us as politicians to find a system that is compassionate, sustainable, affordable and fair. So much the better if we can find common ground across the House on this subject, because a sustainable approach can survive multiple changes of Government. We will approach this subject constructively and positively.
I was surprised to hear the Prime Minister announce fundamental and apparently fixed parts of this policy at the Labour party conference. What are the implications for the Casey review? We do not yet know what the big conversation on care will yield. Is the noble Baroness free to make recommendations that may not fit the model that the Prime Minister has announced?
Apparently, the Prime Minister managed simultaneously to set constraints and to omit a huge amount of practical information that people need. I think one could say charitably that today’s statement adds limit detail to what he set out. Given the use of the phrase, “national care service”, people may understandably be thinking of something more comprehensive than is being proposed, for this is not about all the costs of long-term care. It is not about what, for many people, is the biggest part: residential care. It is only about personal care. Terms like “personal care” and “social care” often get conflated, but the two things can be different, so what is the Government’s definition of what this service is to cover? The statement on the Government website says that the service will be based on need, rather than ability to pay. Does that mean that they do not envisage a fixed contribution for those in a care home, as in Scotland? Is this instead about meeting the cost of individually assessed needs? Will there be any changes to continuing healthcare or funded nursing care?
Half of those receiving local authority long-term social care support in the community are working-age adults, and we assume that what the Government have said about staff also applies to this important part of the care sector, but what else applies? Speaking of staff reforms, the Prime Minister spoke about integrating the care and NHS workforces, but how is that to work in care, which is overwhelmingly in the private and voluntary sectors?
The Government’s statement also says that this system will be
“introduced in phases, so its scope can grow as the savings increase from adjusting the Triple Lock, and as workforce and provider capacity are built up.”
Is spending on the national care service dependent on savings being made from the triple lock? Those are not currently budgeted costs, so the definition of “savings” is itself an interesting one. Does the Minister clearly commit to no new taxes or borrowing under this plan? The part about allowing capacity to be built up suggests not only a transfer of costs from individuals to the state but also a net increase, so how much of a net increase in provision are the Government projecting?
There is one change that it appears may affect the cost of being in a residential care home. The Prime Minister said that no care charges would be paid out of people’s basic state pension. That seems to imply an end to payments from income for care home residents below the lower capital limit down to the weekly personal expenses allowance. Is that interpretation correct?
When she answers, please will the Minister not just say, “These are all details for the Casey review,” because the Government cannot have it both ways. Personal care costs are closely linked to these other aspects of the system, and if the Government had wanted to allow space for the commission to look at the system in the round, they could have done. If they had really wanted to allow time to develop a cross-party consensus on the structure, they could have done. The Government themselves call what the Prime Minister set out at the party conference
“a clear plan to fix the system”,
so please can we have these answers?