A Plan for the NHS and Social Care

Debate between Nigel Evans and Damian Green

Wednesday 19th May 2021 Commons Chamber

[Damian Green (Ashford) (Con)]

It is always a pleasure to follow the hon. Member for Rhondda (Chris Bryant).

Like other Members across the House, I welcome the performance and incredible dedication of NHS and social care staff throughout the pandemic. In the specific context of the Queen’s Speech, I also welcome the Government’s commitment to greater integration. The NHS is a great institution full of massively dedicated people, but my observation over the years has been that it is also a series of individual institutions, all of which are tenacious in the defence of their own interests. GPs are wary of hospital trusts, community services have a separate set of interests, and so do ambulance trusts and others such as pharmacies, which play a vital role but too often do not feel engaged enough.

The integration that the promised health and care Bill seeks to bring about is exactly the right solution, in a number of fields. Technology is clearly key—not just technology at the cutting edge of diagnostics or life sciences, but straightforward stuff so that systems talk to one another and patients do not have to repeat the same set of symptoms to doctor after doctor in different settings because their records have not been passed on. That kind of frustration has no place in the 21st century and should disappear.

The biggest prize of all is proper integration between the health and social care systems. My right hon. Friend the Secretary of State is absolutely right to focus on that in one of his White Papers, and I welcome that as well, but with two caveats. This must not be a takeover by the NHS of social care. The White Paper suggests integrated care systems, which are fine, but I slightly raise my eyebrows at the proposed dual system where the NHS effectively gets its integrated decision in first and then shares it with the social care system. It is vital that social care has a voice at the table where the decisions are taken.

My second caveat is that the social care voice must be properly representative. Too often when people say, “We have consulted social care”, what they mean is, “We have consulted the local authorities.” Clearly, local authorities have a key role to play in this, but they are not the whole social care sector. There are third sector providers and private sector providers, and their voices need to be heard as well. There are 1.6 million workers in the sector—it is larger than the NHS—and their voices need to be heard.

Of course, all this will mean something only if we have a stable and sustainable solution to the social care conundrum that has defined Governments since the 1990s. On that, I want to make four quick points. The first is on funding, which lies at the root of many of the frustrations. It must come out of national, not local, taxation, and it must certainly involve extra state spending, possibly through a hypothecated national insurance increase for some people. It should also involve extra personal savings from those who can afford it, perhaps based on a small percentage of total assets rather than a flat figure for the whole country.

We need to solve the question of funding to solve this, but as well as that, we need a proper workforce plan, not just with better pay, though that is needed, but with a career structure, so that a social care career can be seen as the equivalent of a career in the NHS. The great value of social care workers should be reflected not just inside the system but in wider Government policy, including, for example, in the immigration system.

We also need changes to our attitude to housing and planning. We need to build homes so that people can live in their own homes for longer than they too often can now. Everyone prefers to live in their own home. And, fourthly, to assist that, we must do much better with technology. We need to use the technologies that are now available—it is not cutting-edge technology—to allow people to spend much more of their life in their own home, living a life in comfort before they may have to go into residential care. That is not only better for people, it is much cheaper for the taxpayer and for the families.

All these reforms are necessary if we are going to have a long-term, stable system. Along with my right hon. Friend the Member for South West Surrey (Jeremy Hunt), I have called for a 10-year plan for social care to go along with the long-term NHS plan. That is absolutely essential. It is also essential that this is the year in which we start down this path. We have talked for too long about social care: we need to act.

[Mr Deputy Speaker (Mr Nigel Evans)]

We are in for a treat now: one of two maiden speeches today. I remind everybody that, by convention, there will be no interventions. We are not putting the clock on the maiden speeches, but both Members have been told about the time constraints, so good luck! To make her maiden speech, I call Anum Qaisar-Javed.