That this House takes note of the state of social care in England, and the case for a comprehensive social care strategy and further support for unpaid carers.
My Lords, before this important debate gets under way, I thought it would be useful to remind the House and all Back-Bench speakers that the advisory speaking time is four minutes. This means that when the Clock has reached three minutes, noble Lords should start making their concluding remarks, and at four minutes their time is up. I have asked the Government Whips to remind noble Lords of this fact during the debate, if necessary. I thank all noble Lords in advance for their understanding, which will allow everyone to contribute to the debate fairly within the allocated time.
My Lords, it is a privilege to be opening today’s debate on such a vital issue to our national life: social care. I am very grateful to the many organisations that have sent me such excellent briefings. I particularly thank the unpaid carers who shared with me their personal experience of caring for a loved one at the drop-in event organised by Carers UK on Tuesday. It was a humbling experience. I look forward to hearing from other noble Lords who have such expertise in and commitment to this issue.
I want to start by making some general points that I feel too often get overlooked. First, social care is a hugely valuable public service in its own right, at best allowing millions of our fellow citizens to live independent and fulfilling lives, improving their well-being and that of their families. It is not simply an adjunct to the NHS. Yes, fixing social care will help the NHS address its current problems, and two of the three big shifts articulated in response to the Darzi review—moving from hospital to community and from treatment to prevention—can certainly be assisted by an effective social care system, but bailing out the NHS is not, I contend, its primary purpose.
Secondly, the social care market makes a significant contribution to local economies. Skills for Care estimates that the sector contributes more than £50 billion to the English economy.
Thirdly, social care is not all about older people, or preventing people having to sell their properties to pay for care, as the debate is too often so unhelpfully characterised. Support for working-age adults and lifelong disabled adults, particularly people with learning disabilities, has become the largest area of spend in adult social care and is growing faster than any other part.
In short, we need to frame the debate in a different way: valuing the sector as a contributor to economic activity, as fundamental to promoting the health and well-being of people in local communities and as contributing to the preventive agenda that the NHS on its own has, according to the noble Lord, Lord Darzi, and others, failed to deliver. Despite all the very real problems, there is some good and innovative practice at local level, often involving integrated neighbourhood working between social care, community health and the voluntary sector.
My Lords, I am very pleased to take part in this important debate. I congratulate the noble Baroness, Lady Tyler, on her excellent and comprehensive introduction. As the first Back-Bencher to make a speech, at least I will not be repeating anyone else’s. I very much look forward to my noble friend Lady Keeley’s maiden speech.
The fact that there are so many speakers and we are therefore limited in our time tells us how important this matter is. In my short time, I will not be doing the big-picture painting that the noble Baroness, Lady Tyler, did but will talk about some very specific practical things. I am a non-executive director of the Whittington Health trust, which is our local hospital in north London. We are an integrated care organisation and we face the same challenges that all parts of the National Health Service do. We provide hospital and community care services to half a million people in Islington and Haringey, as well as other London boroughs such as Barnet, Enfield, Camden and Hackney, and it is worth looking at the practical issues involved in how you do this.
Haringey and Islington have multiagency care teams, which work across health and the council to assess and support rising risk patients and avoid unnecessary hospital admissions, keeping people in the community. They are multidisciplinary, with pharmacists, housing officers, social care workers, consultants and district nurses working together. We have a single front door in Islington, which we have just launched, for healthcare and the council to share a single triage point to ensure that patients are seen by the right team and to avoid duplication of input, and to ensure the best way of sharing our limited resources. Again, this sees council staff and Whittington staff working together. We have social workers embedded in our hospital; they are in our teams and in our hospital offices.
These are the practical details that can inform how primary care locally can be further developed, as defined by the noble Lord, Lord Darzi, in his report, which points to the need to develop primary care, GP care, social care and community care together. I invite my noble friend and her colleagues to come and visit us at the Whittington, where they will be very welcome indeed. There is no doubt that effective and innovative practice exists. I make a plea not to reinvent the wheel as we work towards the much-needed reform of adult social care.
My Lords, I too am grateful to the noble Baroness, Lady Tyler, for initiating this debate, the importance of which was underlined by the sheer volume of the high-quality briefing that we have all had for it. There is a fairly common analysis in those representations: declining funding for the sector over many years, leading to delays in assessment and then unmet need, in turn putting pressure on carers, aggravated by workforce pressures, which is made worse by poor pay and conditions for the workforce. The whole problem is compounded by decades of indifference by successive Governments.
In the time available I want to focus on young carers. In another place, I met a group of impressive young people, Andover Young Carers. They were different from older carers. Older carers know that they are carers; they see themselves as carers. These young carers did not see themselves as carers at all but as brothers and sisters, sons and daughters, and grandchildren. They looked after their relative because that is what they had always done; for them, that was life. Unlike older carers, they had never been non-carers. A further difference was that these young people were coping with the demands of full-time school and college, and at the same time coping with the challenges of the transition from child to adult. Their needs are very different, and I hope that we will not forget them in the short debate today.
The 2021 census showed over 50,000 young carers caring for over 50 hours a week—that is more than the standard working week. Worryingly, within that figure of 15,000, 3,000 were aged between five and nine. The Carers Trust has shown that those young carers at school are at risk of a poorer attendance record and lower academic achievement, and also more liable to social isolation and, sadly, bullying.
What do we do about it? The APPG of which I was the vice-chairman did an inquiry, and we met lots of young carers last year. They told us that, on average, it took three years before their needs were identified and up to 10 years before some of them even got support. That is inexcusable. They also told us that that support came only when they reached absolute crisis point, so we need to identify their needs much earlier, downstream. There needs to be consultation between the various settings of adult services, children’s services and education. There is a memorandum of understanding called No Wrong Doors for Young Carers, which is designed to improve joint working between adult services, children’s services, integrated care boards and other statutory organisations. Despite a requirement for local authorities to have such joint working arrangements in place, recent research by the Carers Trust found that only 7% of local authorities appear to have done so. I will ask the Minister just one question. Does she agree that all local authorities should sign up to that memorandum so that young carers get the support they need?
My Lords, the helpful House of Lords Library briefing paper by Eve Collyer Merritt started with great clarity. The opening statement was:
“Social care services help people living with illness or disability”.
That is so often forgotten. I think the people in this Chamber today know that—we would not be here if we did not. Indeed, I see assembled before us a number of what I would call the usual suspects for debates of this kind. However, vast sections of the population do not comprehend at all what social care services are. When we have a candidate for leading the Conservative Party who refers to carers recruited overseas as “bottom wipers”, I find myself in an angry rage at her astonishing ignorance, and feel that many politicians require some educating.
That problem explains, in part, the catastrophic neglect by successive Governments, who come to the elections and find that nobody is the slightest bit interested in it as a vote winner. It seems that this Labour Government, whom I expected better of, are also kicking the can down the road. That is one theme that I think will remain constant through this debate today.
The noble Baroness, Lady Tyler, set out clearly and admirably the challenges, and I can do no more than repeat her words and support her call for a long-term strategy for what should be a growing workforce and the desperate need for training of staff too—especially in dementia, I would say. In view of the fact that over half of home recipients of care and over 70% of care home residents have a degree of dementia, it is surely unacceptable that fewer than half of residential carers have any training whatever in how to manage that condition. I suppose that at this point I ought to draw the House’s attention to my lifelong professional interest in this area and current role as an ambassador with the Alzheimer’s Society.
My Lords, I too welcome this debate. I particularly appreciated the initial appeal by the noble Baroness, Lady Tyler, for a reframing of a broader conversation. Like others across this House, I pay tribute to the many unpaid carers and those who work in social care, who invest their lives in the well-being of others. As has been said, in this debate we acknowledge together that our social care system is in urgent need of reform and that this is a key moment. I share the hope that the Government will take the first steps in that reform in the very near future. Social care impacts us all, in terms of our responsibilities and needs. It brings the most vulnerable in our society from the margins to the centre of our attention and our love.
Last year, the Archbishops’ Commission on Reimagining Care published its excellent report, Care and Support Reimagined. The commission was chaired by Dr Anna Dixon MBE and the right reverend James Newcombe, then Lord Bishop of Carlisle. The report commends the development of a national care covenant. The biblical notion of covenant is based not around commercial contract but around a wider societal promise and mutual expectation, and is focused on relationships, mutuality and partnership. It demands a shared vision across society and common values.
I particularly draw the House’ attention to the seven values and principles from the commission’s work, which I believe offer an excellent underpinning for the Government’s future work. Social care should be universal, fair and characterised by loving kindness, which, as we all know, is transformative. Social care should foster trust, be inclusive and promote mutuality. It is an expression of empathy, focused on what each individual wants or needs, rather than being paternalistic and presumptive.
A number of Lords have highlighted, or will do so, the need for workforce planning. Clearly, that is needed as part of a holistic, integrated, systemic approach. We are entering a period in wider society when new technologies are likely to lead to a rapid decline in the number of roles in many industries, such as warehousing and call centres, as many roles become automated. The renewal of social care gives us the opportunity to rethink and expand the workforce in an area of our lives which needs to remain distinctly personal and deeply humane. In social care, we must think not only of how to be efficient but of how to create communities of kindness. As the Motion implies, there is an urgent need to offer a matrix of support for voluntary carers, not least the funding of respite to enable rest and sabbath in their demanding roles.
My Lords, I welcome this debate and declare that I receive NHS home care.
The whole social care landscape is unbelievably complex, as we have heard. Select Committee reports in both Houses in recent years have all stressed the need for urgency to establish a new and sustainable framework for care, yet nothing is done. My noble friend Lady Tyler is right in making the case for a comprehensive strategy. The LGA, in its White Paper in June about social care, said that stabilising and supporting the care workforce must be an immediate priority, as must measures to improve pay. According to the charity Skills for Care, more than 80% of general workers are paid more than care workers, which demonstrates how low their pay is.
Our population is getting older and those with long-term disabilities are living longer, so there is no time to lose. Sir Ed Davey has called for a social care commission, so I ask the Minister whether this is being considered as a first step and, if the answer is positive, whether it could be started as soon as possible.
I want to turn now to the status of care workers. In my experience, they are worth their weight in gold. They have to be skilled to cope with all manner of machines and appliances, from feeding pumps to bed hoists, ventilators, catheters, humidifiers and suction machines, to name but a few. They have to keep cheerful and calm, however irritated or grumpy they feel. They are all truly on the front line. Nearly all of them could get much more money stacking supermarket shelves. Home carers do not get paid for travelling between clients in London and, in some districts, they have to pay parking charges. Carers notice that healthcare professionals, such as podiatrists, get free parking and can usually choose their hours for home visits. This tells carers that society in general does not rate them as equal partners in looking after someone. We should treat them as professionals giving a vital service and pay them accordingly.
My Lords, it is a great pleasure to speak in your Lordships’ House for the first time in this debate, to follow the noble Baroness, Lady Thomas of Winchester, and to listen to the comprehensive opening by the noble Baroness, Lady Tyler.
First, I thank noble Lords on all sides of this House for the warm welcome I have received. It is a pleasure to be reacquainted with former colleagues from all sides who also served in the House of Commons. I give special thanks to my noble friends Lady Hayter of Kentish Town and Lady Blake of Leeds, who were my supporters at my introduction. Thank you also to Black Rod and her team, the Clerk of the Parliaments, the doorkeepers, police officers and all the House staff who have been so helpful, supportive and welcoming.
For the past 19 years, I have represented the great city of Salford, being the first woman MP elected to represent the constituency of Worsley in 2005. I have served as a Government Whip and as deputy leader of the House of Commons, working with my noble friend Lady Harman, who was leader of the House of Commons. In opposition, my shadow ministerial roles included social care and the arts.
Before I was elected, I worked as a consultant with the Princess Royal Trust for Carers—now the Carers Trust—on a project to evaluate the then Labour Government’s national strategy for carers. We consulted over 4,000 unpaid family carers. One issue that became very clear was that carers did not receive support unless they were identified as carers, which was a particular problem for young carers, as we heard from the noble Lord, Lord Young of Cookham.
In 2010, I introduced a Private Member’s Bill on the identification of carers. Unfortunately, this did not progress and there is still a need to identify unpaid carers so that they can be supported.
Further, the national strategy for carers was not refreshed by Governments that came in after 2010, meaning that, for 14 years, we have had no high-level strategy across government departments to support carers.
My Lords, it is a great pleasure and honour to welcome my noble friend Lady Keeley to your Lordships’ House and to be the first to congratulate her on her marvellous maiden speech. As your Lordships have heard, we have worked together on these issues for some years and I thank her for her kind tribute.
Time does not permit me to do justice to the great experience, expertise and wisdom that she brings to your Lordships’ House. As noble Lords have heard, she was first elected to the House of Commons in 2005, as the first ever woman MP for the Worsley constituency, which later changed its name to Worsley and Eccles South. She served as chair of the Women’s Parliamentary Labour Party and held government jobs in the Treasury and as deputy leader of the Commons. In opposition, she has held an impressive variety of shadow Minister posts. Her last, as your Lordships heard, was as shadow Minister of Culture, Media and Sport, where she championed music and tourism, and worked closely with the voluntary sector as shadow Minister for Civil Society. She combined all this with close attention to her constituency and an active role in local issues, much admired by all her constituents. She begins another phase of her public service today in this House, where I know she will be a valued and valuable Member.
I thank the noble Baroness, Lady Tyler—whom I always want to call my noble friend—for her very welcome debate. I hope that she and other noble Lords will forgive me for a little trip down memory lane. I remember the many social care debates in which I have taken part in your Lordships’ House when it was very difficult to assemble a reasonable speakers list—far from the distinguished gathering that we have today. So few were those noble Lords interested in or concerned about the subject that I used to refer to them, as I have been reminded, as “the usual suspects”. Happily, the number of suspects has greatly increased today. In those days, it was also difficult to get detailed briefings; we have come a long way, with the raft of excellent material that we have from many sources today.
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All that said, social care has been described— I think rightly—as one of the biggest public policy failures of our time. The last 25 years have seen six government and independent commissions, seven Green and White Papers, 14 parliamentary committee reports and innumerable other reports on social care policy. They have identified policy options to address many of the problems and, time and again, commitments have been made but then reneged on. In particular, the funding has been subject to much analysis—not least by Select Committees of this House—and the options for reform are clear. It certainly does not need a royal commission to crawl all over it again.
There is wide consensus that things cannot carry on as they are. Our adult social care system is not fit for purpose and needs radical reform, following decades of political neglect and underfunding. Indeed, the noble Lord, Lord Darzi, in his recent report, described it as “dire”. With an ageing population and a growing number of disabled people of working age, demand is increasing but funding is not keeping pace. In reality, publicly funded social care is available only to those with the highest needs and the lowest means.
Recent analysis from Age UK found that more than 2 million older people are now living with some form of unmet need. Healthwatch recently estimated that up to 1.5 million working-age disabled people could be missing out on the social care they are eligible for. Only last week, the County Councils Network pointed out that persistent underfunding of local government in the last decade means that some councils now spend as much as 80% of their budget on care for adults and children.
Looking forwards, the Care Provider Alliance estimates that at least 1.7 million more adults will require social care over the next 15 years. In big-picture terms, the Health Foundation has estimated that meeting growing demand for care, enabling more people to access it and improving services could cost an extra £18 billion by 2032. This is serious stuff indeed.
In short, we have a system struggling with myriad problems, including: an overly stringent means test; catastrophic costs, leading to some people having to sell their homes; high levels of unmet need, so that people go without the care and support they need; a high reliance and unrealistic expectations placed on unpaid carers; patchy quality of care; poor workforce pay and conditions; a fragile and highly fragmented provider market; and a postcode lottery of access.
All these issues have solutions, as the plethora of reports on social care demonstrates. I hope that we will hear lots of potential solutions in today’s debate, but this needs to be addressed in the round, not in a piecemeal fashion with last-minute sticking-plaster solutions.
Far too often, the crucial role of unpaid carers comes last in the list, but today I will deal with it first. It is vital that we recognise the challenges that the UK’s 5.7 million unpaid carers are facing and the critical role they play in supporting people and, frankly, propping up our health and care systems. Finding appropriate support can be extremely challenging, and many carers report having to fight to get the support they need. One unpaid carer I spoke to on Tuesday said that she had found it impossible to get an assessment for her own health needs—despite the fact that this was legislated for in the Care Act 2014—and felt totally burnt out.
The lack of accessible and affordable social care hinders carers’ ability to juggle work and care. The extra expenses associated with caring for a loved one with a complex condition, coupled with the inability to work, can have a massive adverse effect on family finances. The development of a new national carers strategy—which I strongly support—should be a priority for the Government as part of their wider reforms of social care and, crucially, be seen as integral to the development of the national care service. We need to be ambitious here. From these Benches, we want to see it include paid carers’ leave and a statutory guarantee of regular respite breaks, as well as increasing carer’s allowance, by expanding eligibility to it, and bringing to an end the overpayments scandal.
I turn to the social care workforce. According to Skills for Care, last year there were around 130,000 vacant posts and 1.7 million filled posts. That is a vacancy rate of some 8% and a turnover rate of just under 25%. This is about three times higher than for the wider economy. Skills for Care attributes turnover and vacancies in the sector to a range of factors including low pay, zero-hours contracts and difficulty accessing full-time work. Today’s debate is timely because only this morning, Skills for Care published its annual report, which shows some modest improvements in filled posts and a slightly lower turnover. However, these improvements were mainly driven by international, rather than domestic, recruitment, and there are signs that the supply of international recruits is declining, not least due to changes in visa rules debarring migrant workers from bringing family dependants with them. So domestic recruitment and retention problems continue.
As many in this Chamber have said, the silence in the King’s Speech on social care was deafening, and many people felt badly let down. It felt, once again, as though social care had been pushed to the back of the queue. The Government must, as a matter of urgency, produce an updated vision for social care that tells us what good looks like and then start work immediately on finding a long-term, cross-party solution to putting social care on a sustainable footing. I hope that this House, with all its expertise, can make an important contribution to that debate.
I ask the Minister what plans the Government have to publish a comprehensive reform package for social care with a clear timeline attached for action in this Parliament. I note that the Nuffield Trust has called for a rapid diagnostic exercise similar to the Darzi NHS review to build urgency and the case for change. Can the Minister say whether such an exercise is being considered, and, if so, what the timescale would be?
I recognise the financial constraints the Government face, but that is not a reason for silence or inaction. A comprehensive plan for social care reform can be framed according to short-term, medium-term and long-term actions. The most pressing priority is for the Government to provide an immediate uplift in social care funding in the upcoming Budget to stabilise the sector in the short term. However, there are also a number of short-term and relatively low-cost actions, such as setting up a mandatory professional register of adult social care staff in England, which already exists in Scotland and Wales; requiring direct adult social care representation on all integrated care systems in England; establishing a new commissioner for adult social care to promote the rights of those relying on care; and developing a more simplified, consistent and efficient approach to how councils commission care. These are simply examples of things that could be put in place relatively quickly.
In the upcoming comprehensive spending review, the Government must commit to multiyear settlements to local government, so that the social care system can plan with confidence over the medium term and provide further stability. The Government also need to provide clarity on their plans for social care—including, I hope, more detail about developing a national care service and the fair pay agreement—and what they hope to achieve by when, and how that will be funded. I look forward to hearing more from the Minister on this today.
Credible longer-term reform plans must, at the very minimum, cover funding, a workforce plan and support for unpaid carers, which I have already talked about. On the workforce, social care is a job requiring skill, insight, compassion and commitment, but that is not recognised in the terms and conditions on offer. Front-line roles typically attracted only £11 an hour in March this year—58p higher than the national living wage then. I also find it staggering that care workers with five or more years’ experience were earning just 10p more per hour that those with less than a year’s experience. In short, there is no progression. More than 80% of jobs in the economy pay more than social care, so it is scarcely surprising that employers find it hard to attract and retain people already resident here. If you do a similar role in the NHS, you are paid appreciably more.
We need a social care workforce plan sitting alongside the NHS workforce plan with equivalent government commitment to implement its recommendations. Pay is hugely important, but it is not the whole story. Social care needs a formal career structure, along with training and development to help people advance and be appropriately rewarded for doing so. The Liberal Democrats are calling for a royal college of care workers to improve recognition and career progression, and a higher minimum wage for carers.
The Government’s plan to broker a fair pay agreement for social care is welcome in principle—and it is timely, as it is part of the Employment Rights Bill published today—but we need to understand how it will be funded. Will there be commensurate increases in local authority funding, or will the cost be passed on to care providers and self-funders? I would welcome clarification from the Minister on this point.
We need to think about the workforce in the widest possible sense. There is an obvious role for the voluntary sector to provide a lot more of what is often called wraparound support. There is scope for the sector to do so much more and for every area to have a stronger safety net in place.
On funding reform, transformational reform cannot happen without us working out and agreeing, as a society, how we can fund it, both in the short term and into the future. So far, efforts to achieve this have been half-hearted at best and egregious at worst. The lesson from other countries that have successfully grasped the nettle of modernising social care is the need to have a pretty honest conversation with the public about the options for funding it and how the costs are shared between the individual and the state. We need a cross-party commission to look at the realistic options for sustainable long-term funding, not least to try to future-proof the outcome and lessen the risk of a successor Government undoing decisions made.
As the Government develop their approach to social care reform, they should draw on the significant body of existing policy analysis. The main options—free personal care, which of course has my vote, a cap and a comprehensive NHS-style care—are well known and costed. Respected independent commentators such as the Health Foundation have set out the options and costs, so we are not starting from scratch. The sooner work begins on thinking through the options and engaging with the wider public, the better. The nearer we are to the next election, the harder the task will be.
To conclude, despite countless commissions and reports, successive Governments have failed to enact meaningful reform. With many of the policy options already on the table, and a clear willingness for cross-party talks, the Government have the chance, finally, to implement social care reform and to improve the lives of older and disabled people and their carers. This does not need a lengthy royal commission, simply a substantial injection of political will. Social care reform is a top priority for the Liberal Democrats and, as I hope I have demonstrated, we have plenty of ideas to bring to the table. I look forward to hearing the wisdom of other noble Lords on this thorniest of public policy challenges.
Secondly, I want to ask my Government to look at who provides care at every level in our communities and at whether it is appropriate that we have care providers that are not going to sustain their care in our communities. For example, in 2023, Beaumont Healthcare, a homecare agency providing care to people with disabilities and complex health conditions in Cambridgeshire, went out of business and handed back the care contract to the local authorities. That would not be unusual, but it was the fifth care provider in Cambridgeshire to hand back care contracts in 2023. We know that the marketisation and privatisation of adult social care following the care Act in 1990 brought with it the dangers and instability that we see today.
I have championed co-operative social enterprise and mutuals for 25 years in your Lordships’ House. Frankly, in rebuilding our economy and in the reform of our public services we need to look at organisations that can provide public services and do so in a sustainable way. I ask my noble friend that, in the rebuilding of health and social care in the UK, we look at the failures and bureaucracy that competition and marketisation have brought and positively seek alternatives, to have a diversity in the provision of social care in our communities.
Since the Dilnot commission report of 2011, there has been talk of capping care costs in residential care, but I am pleased to say that the one thing the Government have said is that they do not support that line. Capping costs simply transfers the burden from those who have the resources, albeit often locked up in property and capital assets, to the Government and, by extension therefore, to the working population through taxes. It has the effect of unjustifiably allowing older people who need residential care to hang on to properties and pass them on to their children, while adding an extra tax burden on to younger people, most of whom will not own homes. There are many ways to ensure that payment can be deferred so individuals and spouses do not have to pay and, in that sense, I agree with the Government’s announcement.
I do not think we can ever get away from the profound unfairness that was established in 1948, when healthcare and social care were separated. We are in danger of recreating a national care service which makes all the same mistakes as the behemoth of the National Health Service. Please do not move away from having a locally focused and locally accountable social care service. By all means have a national strategy but not, please, a national care service.
So much that is good is offered by home carers, volunteers, partnerships with faith communities, local authorities and businesses. The Government now have a significant opportunity and responsibility to reimagine care and support, and the need to begin this task is very urgent.
As for retaining staff, it was interesting to note from Skills for Care that care workers from overseas tended to stay longer than the domestic workforce. Simplifying the whole system of care will surely help the NHS manage hospital admissions and discharges, and take the pressure off local authorities, which have to spend a lot of their scarce resources on matters such as financial assessments.
It was disheartening that the gracious Speech did not mention care. We do not want to hear the words “in due course” from the Minister, rather the word “straightaway”, and for the Government to be prepared to put far more money into the social care we need. Thank you.
I have raised these and other concerns repeatedly, particularly when I served as the shadow Cabinet Minister for Mental Health and Social Care. To my mind, support for carers has been left too much to carers groups and even to carers themselves.
Katy Styles is a full-time carer for her husband, who has motor neurone disease. Alongside her caring responsibilities, Katy has founded the “We Care” campaign to empower carers to feel visible and valued. This campaign is motivated by the belief that
“all carers deserve so much better”
and I wholeheartedly agree.
I have worked on carers issues across the years, and I acknowledge the work of my noble friend Lady Pitkeathley, who has done so much for carers. I hope that our new Labour Government will redevelop a national carers strategy and work to improve life for carers.
I have also worked for a number of years to highlight the appalling treatment of autistic people and people with learning disabilities who are held for too long in inappropriate in-patient units. The families affected need champions of their cause, which they have in the noble Baroness, Lady Hollins. It is a privilege for me to be in your Lordships’ House at the same time as the noble Baroness, so that I too can raise their concerns and issues.
My most recent roles were as shadow Minister for Music and as shadow Minister for the Arts. I have worked with many noble Lords, including the noble Lord, Lord Berkeley of Knighton, on issues related to music and the decline of music education in state schools. Music and the arts can offer children and young people so much in the way of confidence, teamwork and well-being. I look forward to working with noble Lords across the House on what can be done to bring the joy of music and the arts to all young people, not just those whose families can afford it.
I conclude by saying how happy I am to be working with noble Lords and learning from the great collective wisdom that resides in this House.
Your Lordships will not be surprised to know that I am especially grateful to the noble Baroness, Lady Tyler, for including unpaid carers in her Motion. Going again down memory lane, I remind your Lordships that, when I became involved in the carers movement in the 1980s, the word “carer” was not in the Oxford English Dictionaryand spell-check always changed it to “career”. When I went to collect my gong at the palace in 1993, my citation was announced as “for services to careers”. We have come a long way since then.
Carers are central to legislation now and some individual bits of legislation are aimed at them specifically. Even spell-check has caught up. However, I met a carer at a drop-in this week who told me that she feels completely rubbed out by a system that makes her fight for the slightest assessment of her own needs, despite that being enshrined in legislation since 1995, as we have heard, and strengthened in the Care Act 2014. Another told me of her struggles with mental health as a direct result of all the caring stress.
Your Lordships all know what needs to be done. We cannot fix the NHS without fixing social care. We must shift resources from hospital to the community. We must focus on prevention and early intervention. We must find a way to share the risk so that catastrophic care costs do not fall in an unfair way. We have known all this for years but, above all, we must understand that you cannot fix social care without supporting the main providers of social care: not staff, care homes or care workers but the unpaid carers, who are there all the time, providing £162 billion a year, as the value of their care, to individuals in need—often at terrible cost to their own mental and physical health, not to mention their finances. If they withdrew their labour or worked to rule, they would get more attention, but they are not going to do that because they are motivated by love, duty or a combination of both.
As the All-Party Group on Carers, which I had the honour to chair, so forcefully said, carers’ problems can be addressed by developing a new national carers strategy, which would set a clear direction of travel and a long-term vision for how carers can be supported, look at the interaction between different policies and departments and ensure that their needs are recognised and responded to at the highest levels of government.
It is 16 years since the last national strategy was developed, led by Prime Minister Gordon Brown. Surely it is time for another. If not now, when? The problem is going to get only more acute as our population ages and lives with increasing comorbidities. As the increased interest in this once-neglected subject shows, this is not someone else’s problem. We are all—every one of us—a hair’s breadth, a fall, or an accident away from being cared for or being a carer. As we have heard, there is a strong economic case for supporting carers. The Government need the will and determination to do it, but the rewards will be ample, for not only 6 million carers but every one of us.