Social Care

Julian Knight Excerpts

Wednesday 25th April 2018 Commons Chamber

[Andrew Selous]

I think Germany absolutely has something to teach us, and it has a private insurance scheme on top of that as well.

We need to see weekend discharges in hospitals, on Fridays, Saturdays and Sundays, with local authorities and social care being available over the weekend, so that we do not get a bulge on Monday morning, causing our hospitals huge problems. We need proper pay for care home staff. They have a choice, but there is no choice for us as a country about whether we look after our frail elderly people and those who need social care. We have to do it, but people do not have to choose social care as a profession. Therefore, we need some proper labour market analysis and parity between similar jobs in the NHS and social care. The lowest-paid workers in the NHS have just had a 29% pay rise. If we are to have true parity, we need to treat the social care workforce as well as we treat the NHS workforce. Independent living schemes, which my own local authority of Central Bedfordshire is pioneering, are showing the way, and the Housing, Communities and Local Government Committee was impressed when it went to see Priory View in Dunstable. I gather that in East Sussex there is data to show that this type of extra care scheme—

[Julian Knight (Solihull) (Con)]

Does my hon. Friend think that there is also a role for the greater use of co-operatives such as the CareShare organisation, which matches those in need of care with care givers so that they can swap time with each other?

[Andrew Selous]

That is an excellent scheme. Returning to East Sussex, I understand that data suggests that its extra care scheme is now saving about £1,000 per resident. We have seen examples from overseas—Germany and Japan in particular—and we have a Government who are committed to finding a solution. I eagerly look forward to seeing those solutions in the Green Paper and to our implementing them quickly.

--- Later in debate ---

[Julian Knight (Solihull) (Con)]

It is a great pleasure to follow the hon. Member for Leicester West (Liz Kendall), who made a typically passionate speech, and I echo what she said about the need for a cross-party approach. When she mentioned that anyone talking about social care almost has to do it out of election time because otherwise they can end up being torpedoed by their opponents, I was reminded of one particularly vile leaflet issued in the Cheltenham constituency during the 2017 election, which stated, “First dementia will take your mind. Then the Prime Minister will take your house.” That sort of politics is pretty low and does a disservice. So I firmly believe that we need cross-party working on these very long-term issues.

Building a social care system for the mid-21st century–it is incredible to be talking about the upcoming mid- 21st century; this feels very old in that respect—is one of the most important tasks facing this Government and any subsequent Government. Many Members have mentioned the fact that our population is ageing, and indeed it is. The number of people aged 75 and over is expected to increase by 70% between 2015 and 2035, and the figure for older people as a share of the population is expected to rise from 28% in 1971 to more than 36% in 2037, when I reach retirement age. Not only are people living longer, but there will be fewer working-age citizens to support them through the taxation system. That is particularly acute in my constituency. In the Silhill ward, from which the constituency takes its name, 40% of people are over 65, and I regularly come into contact with people who are dealing silently with huge care issues. Solihull rests and survives on a sea of volunteers and those who are willing to give of their time in order to help people in this vulnerable situation.

I welcome the Government’s decision to invest an extra £2 billion in our social care sector over the next few years. That is a first step, but this is not a problem that can be fixed just by spending money. We need not only to explore why some councils are perfectly able to provide quality care on their current budget whereas others are not, but to futureproof our social care system against demographic trends that will place huge strains on it.

I wish to focus on the two structural reforms that Ministers should consider as they draw up their Green Paper, the first of which is providing more support for the co-operative movement in this sector. There has not been a great deal of debate on that, although I mentioned it to my hon. Friend the Member for South West Bedfordshire (Andrew Selous). I am thinking of examples such as CareShare, which helps to match those in need of care with care givers and which fosters that peer-group support—it is a social care platform owned by its members. There are working international examples of that in areas that do not have an NHS, such as Spain, Italy and Latin America, which also have strong family networks and strong family connections. The social care co-operatives have proved very popular and could augment rather than replace state and other systems. It is about a network, effectively, moving us forward, because the state alone cannot solve or resolve this.

On the subject of creating variety in the sector, I would also like to see support for the growth of mass market social care insurance. That could be provided by both the state and, to a degree, private suppliers. The state approach should follow a National Employment Savings Trust model for funding and for distributing that funding to the carers. That is a solid example that we can follow, and we need to look closely at the examples we have seen in Germany and Japan. That can help people to prepare for their old age while they are still able to set appropriate funds aside and make meaningful decisions about their future care.

Ministers are rightly trying to ensure that individual service users are at the heart of the reforms as we go forward. Making patients equal partners in the care process and instituting principles such as “No decision about me without me” are all about empowering people and delivering higher quality, greater transparency and more accountability as a result. Supporting a wider variety of providers and care methods is the next step in that process. That is the lesson of the free schools movement, where the Government recognised that supporting a wide range of schools was essential in giving parents and pupils meaningful choices about their education. Ministers must ensure not only that the new social care system properly supports the work of excellent third sector providers such as Mencap, but that it uses tax breaks and other incentives to help to foster alternatives such as the patient-led co-operatives I talked about earlier.

We also need to restore the market for long-term care insurance products to fund social care. That used to exist to some degree, but it was never able to achieve substantial economies of scale. Since the disintegration of independent financial advice, it has basically also disintegrated. That must change, for two reasons. First, people need a realistic idea of how much they will need to set aside to fund the level and style of social care that they want, and a properly functioning market with a wide variety of products is by far the most successful way of achieving that. Without it, that essential planning will be the preserve of the well-informed few.

At present, too many people put off thinking about social care until they have no other choice. I had this happen in my own family. At a moment of crisis, they are suddenly in need of extra support, but leaving all the decisions to this late stage hugely reduces a patient’s scope to make decisions about their care and choose a model that works for them. I believe, having echoed the point made by the hon. Member for Leicester West about the need to work across parties and not torpedoing ideas, that we need an honest conversation in this country about when we need care, and to plan it, rather than reaching those crisis points.