Ageing: Public Services and Demographic Change Committee Report

Lord Hunt of Kings Heath Excerpts

Thursday 17th October 2013 Lords Chamber

[Lord Hunt of Kings Heath (Lab)]

My Lords, it is a great pleasure to wind up for the Opposition and to congratulate the noble Lords, Lord Livingston and Lord Borwick, on their excellent maiden speeches. I also congratulate my noble friend Lord Filkin and the members of his committee on producing such a good report. We have had a good debate and many issues have been raised, but for me one of the most important was mentioned by my noble friend Lord Hutton. He was surely right to point to the impact of defined contribution schemes on pensions and whether the well known shortcomings of those schemes really are going to be dealt with. The noble Lord, Lord Griffiths, talked about literacy in terms of the financial issues facing pensioners. We have been discussing in the Care Bill the whole issue of whether vulnerable older people are able to make the big decisions that often have to be taken on their finances without access to proper information and advice. The recent ABI report on annuities makes for sobering reading in relation to the differences between the best and the worst annuity schemes, and the seeming inability of very many people to understand that they can shop around when the time comes to make a decision.

We also heard about the cliff edge of retirement and the need for businesses to be flexible. The positive point which has come through that I would stress to the Minister is that it can be a key advantage to businesses if they are flexible with their workforce in terms of the contribution that older people can make to the working environment. My noble friend Lady Wilkins talked about housing and the need for a much more cohesive approach to meeting the housing needs of older people. I refer also, of course, to the pressures on our health and social care system.

Above all, the message has come through to the Government and indeed to the Opposition that there is the need for a vision. We are facing a tremendous challenge, and at this point none of us is confident that we know how to meet it. I hope to hear from the noble Earl, Lord Howe, that there will be a greater recognition on the part of the Government of the kind of challenge we face and the vision that is needed. Certainly the initial Government response to the report is what I would call a worthy one, where each department has put forward a number of points, but at the moment it does not read like a cohesive whole. That, I think, is what the clear message of this debate is all about. Certainly from the point of view of the Opposition, the Leader of my party is very well aware of these issues and we will be assessing how we can take the lessons of this report forward into the next election.

The noble Lord, Lord Bichard, raised a very important point when he talked about the failure of different government departments to work together. That leads to different performance and management processes at the local level and different regulatory systems. The result is that when people at the local level are planning and delivering services, there are often perverse incentives in the way of them working together. I would be grateful if the noble Earl could say a little about how the Government can encourage local organisations to work more together effectively by blowing away some of the bureaucracy that often gets in the way.

We have to talk about health and social care, as did my noble friend Lord Filkin. There are huge pressures in these areas. Now, in mid October, many hospitals are facing an A&E crisis. If we are facing a crisis in October, the winter is going to be bloody. It is very simple: primary care is inaccessible and therefore 24/7 A&E is often the only place where people can go. Discharge has become much more difficult, and so hospitals are getting fuller and fuller. At the same time, the pressures that have come, quite rightly, from the Francis report, the Berwick report and the Keogh report, have been particularly around the need for hospitals to increase their staff. But money has got much tighter and something is going to have to give. That is a serious issue which underpins what my noble friend Lord Warner said. We are marching towards a real crisis in health and social care, and at the moment, I do not think that any of us are confident that we really know the way through. Clearly, we have to integrate services and find answers to the funding issues. We must not only meet the demographic challenge but engage the huge technological advances, which can do much for older people but will cost more money, particularly in the short term.

The noble Lord, Lord Crisp, talked about the workforce in health and social care. How right he was. I would just say to him that the recent Royal College of Physicians’ report on the future hospital did not just look at new ways of running hospitals, reflecting that most people in hospital will be older, but said that we should move away from specialisation and that the way forward was for general physicians to treat the patient as a whole, with many comorbidities. It is really exciting that a royal college is leading that kind of movement. We need to work on that.

My noble friend Lord Filkin said that the committee was continuing, albeit unofficially. That is very welcome. The report has given us a huge wake-up call and the responsibility falls on all of us to respond as effectively as we can.