Social Care

Baroness Pitkeathley Excerpts

Thursday 30th March 2023 Lords Chamber

[Baroness Pitkeathley (Lab)]

My Lords, it is a pleasure to speak in this debate today, and I congratulate my noble friend Lady Andrews. I have lost count of the number of debates on social care in which I have participated in my 25 years in your Lordships’ House, and it has often been a rather depressing experience. I would often have to cajole, persuade or even beg people to take part. I took to calling the few stalwarts who could always be relied upon to speak—the “usual suspects”. We were a small but devoted band. For me, the best thing about today’s debate is the number of your Lordships speaking and the attention that is being drawn to social care, at last. To be able to call my noble friend Lady Andrews and the most reverend Primate the Archbishop of Canterbury “usual suspects” is a measure of the progress being made. Their influential reports mark, in my view, a step change in views about social care, which for so long has been the poor relation or the Cinderella vis-à-vis the NHS.

That is not to say that the social care scene is any better than the dire situation to which I have drawn attention over the years. On the contrary, it is worse, as the statistics and examples cited in the debate today illustrate. There is not enough money, not enough integration, too many broken promises, and too many vulnerable people and their families neglected. I, like others, had hoped that we would have the long-promised plan from the Government today, but in its absence we must once again rely on promises and assurances that the Government hear our pleas and will answer our questions.

Your Lordships will understand that, for me, the most important recommendations in both the reports we are discussing today were about unpaid carers. I thank the noble Lord, Lord Polak, for sharing his moving personal experience on the issue of being an unpaid carer. Our social care system relies heavily on the care and support from these carers. In fact, they outnumber the paid health and care workforce by at least two to one. Many live in poverty or on its margins, often building up poverty for the future because of a lack of access to pensions and paid employment. Their health suffers physically and mentally, as we have heard.

The House of Lords report makes a series of sensible and modest recommendations, recognising that carers have to deal with a baffling range of organisations and agencies, which is stressful and time-consuming. For example, the report recommends that carers should be properly identified and have mechanisms for getting information. It states that carer’s allowance is inadequate and should be reviewed—hurrah—and recognises how important respite care breaks are and that there should be ring-fenced funding to provide them.

The recommendations from the Archbishops’ Commission are summed up as a new deal for carers which ensures that they have the practical, financial and emotional support to be able to provide care, maintain a loving relationship and live a full life themselves. These are modest enough demands which surely every carer deserves so that they have opportunities for a rest, better advice, better financial support, and coproduction so that they are involved in planning. None of these recommendations is rocket science, and neither are any of them unreasonable. They are simply actions and commitments which would help unpaid carers do what they want to do, willingly and with love: provide care for their loved ones, as well as caring for themselves.

It is a great disappointment that the Minister is unable to respond to all these recommendations today in the absence of the Government’s plan. I acknowledge that their White Paper, People at the Heart of Care, published in 2021, set out a 10-year vision for adult social care in which unpaid carers were recognised as equal partners in care. I cannot fault the Minister for the words he has shared many times in your Lordships’ House when acknowledging the vital role played by carers. I was delighted by the support his noble friend, the noble Lord, Lord Johnson, gave to the Private Member’s Bill that would give carers access to unpaid leave, which we hope will receive Royal Assent very soon. However, carers are at breaking point. I ask the Minister to assure the House today that he knows that more funding and better integration is vital for their support. Warm words are not enough.

Beyond carers, can the Minister assure the House that when we finally see this long- awaited plan, it will have some vision in the spirit of that 10-year plan, and that it will make some attempt to address the causes of the difficulties in health and social care and not leave the Government open to charges of yet another sticking-plaster solution? Health inequalities must be addressed. They are the result of poverty and inadequate services, which are in turn the result of many years of spending cuts. The most efficient way to ensure our health and social care services are not overwhelmed is to make sure that people do not need them. If we could rebalance the agenda towards the prevention of ill health, that is the sort of vision and focus that could give some hope for the future of social care and reassure the carers who are its main providers.