Social Care Funding

[Sir Charles Walker in the Chair]

Order. There are plenty of speakers, so we will have a time limit of four minutes, perhaps dropping to three as the debate develops.

I beg to move,

That this House has considered social care funding.

I should like to introduce a discussion on the funding of social care and narrow that to adult social care and the specific areas covered in the admirable Library briefing around the Green Paper in its absence.

It is a relief to debate something that is not about Brexit, although there is probably some indirect connection. Attempts have been made to blame the delays on Brexit, but the Secretary of State was candid enough to acknowledge that deep-seated disagreements going back 20 years explain why we are at an impasse on the basic principles.

There are a couple of contradictions or paradoxes that we must try to unravel. We all say that the only way forward is to have an all-party consensus, but at the same time the issue is increasingly weaponised. We all say that this is an incredibly urgent problem, but it stays for longer and longer in the long grass. Until we get to the root of those problems, we are not going to make any headway.

Will the right hon. Member give way?

Will the hon. Gentleman wait a moment? I will happily take interventions in a few minutes.

At the root of this—and trying to be generous to all parties—is a lot of public misunderstanding. This is a complex subject. To take just one point, half of the adult social care budget is not about old people; it is for younger adults. The public fundamentally misunderstand the nature of the means test—most people do not realise it exists until they encounter it. Consequently, people are frightened when they see proposals that are characterised on one side as a death tax and on the other as a dementia tax, apparently unaware that we have a death tax and a dementia tax now.

I cannot in my short contribution solve such a fundamentally difficult problem that has been going on so long, but we need to try to disentangle issues that are fundamentally different. My primary concern is social care—how we support people in the community so they can function with a proper life, preferably at home, outside of hospital.

A totally different set of problems—wealth, property and inheritance—leads to a lot of the emotional angst caused by what is sometimes called catastrophe risk: people landed with financial obligations as a result of having long-term personal care and the expense of £50,000 a year or whatever in a residential home. However, that is about wealth, distribution and assets. It has nothing to do with health and we have to try to separate the two.

I am grateful to the right hon. Gentleman for giving way. I am also grateful for the opportunity to discuss this matter on a cross-party basis. He mentioned a cross-party consensus earlier. Is he aware of last year’s joint report by the Health and Social Care Committee and the Communities and Local Government Committee on the future funding of social care? That report came to a cross-party consensus on how we can move forward, and one of the solutions was a social care premium.

Yes, there is a lot of joint thinking. We have the joint House of Commons Committees, and my hon. Friend the Member for Totnes (Dr Wollaston), as Chair, was critically involved in that. There is also a very good piece of work by the House of Lords, and the considerable brains of Lord Lawson and Lord Darling contributed to a cross-party consensus. A lot of think-tanking is going on in the vacuum created by the Government’s non-publication. There is no shortage of ideas, but we need to be clear what the problem is—and it is a very serious one.

Will the right hon. Gentleman give way?

If the hon. Gentleman lets me go through this, I will take an intervention.

The first point is the rapid growth of demand as a result of an ageing population. We all know that. As far as we can establish, because of ageing and the onset of dementia in particular, we have a growth in demand of about 3.5% a year. That is considerably in excess of the growth of the economy and the resources to fund it. That is the fundamental problem at the heart of all this. We have 800,000 people with dementia at the moment, which goes up to 1 million in 2025, rising to 2 million in 2030. At the moment, there is no clear picture of how this demand is to be met.

My second point, related to that, is that we have a large and growing hidden cost that is not quantified—unpaid caring. If we take dementia alone—just one dimension of adult social care—we have 350,000 carers at the moment, of whom 110,000 have had to give up their job, which is a cost to them, the Exchequer and their employers.

I will take an intervention, but I will return to the theme in a moment.

I congratulate the right hon. Gentleman on securing this timely debate. He refers to costs. The costs to families and individuals hit with dementia are 15% higher than they are for any other illness. They are about £3.5 billion because people have had to give up their jobs for all sorts of reasons. I hope that further assists him and I hope he agrees that we have to think about it.

Yes, that is quite right. We tend to use dementia, particularly the work of the Alzheimer’s Society and others, to illustrate the problems here but they are not unique. Many people with arthritis, diabetes and serious stroke conditions face the same set of problems.

I am grateful to my right hon. Friend for giving way. He rightly points out the importance of unpaid carers. Any new consensus, which must come, should make clear provision to support those who do the caring— 12,000 unpaid carers in my constituency alone. If they were to cease caring—if we do not care for the carers—the social care burden on the taxpayer more generally becomes even more unmanageable.

Indeed. My hon. Friend is right, and he reinforces the central point I am making.

A constituent of mine raised the case of her father who had been assessed by the health service as needing 24-hour, one-to-one support. That was withdrawn when he went into a care home, because the burden fell back on social care. There was then the problem of who was going to pay. He immediately had a series of falls and became more frail and more vulnerable, causing him and his family enormous stress. The right hon. Gentleman mentioned Labour’s proposal that we will support particularly those with dementia and their families in paying for social care costs. In the spirit of cross-party consensus, does he agree with that?