The Government has outlined changes to the social care system in the Care Bill, which builds on the recommendations by the Law Commission review of adult social care and Labour’s White Paper before the last election “Building the National Care Service”.
Over the last couple of months I served on the Bill Committee scrutinising the Care Bill proposals. Although I welcome some steps in the Bill and the principles that seek to make the social care system fairer, simpler, and more sustainable, the Bill doesn’t go far enough.
It also does nothing to address the funding crisis in social care or to help those who are currently facing a daily struggle to get the support they need right now. As I mentioned in the Committee, a constituent of mine who was blind, came to one of my Saturday morning surgeries and told me how her care package had been cut from 13 hours to 8. She had come to the surgery with her Personal Assistant and said that after our meeting she wouldn’t have any contact with anyone until Monday. I know she isn’t alone in her predicament.
Under this Government, £1.8 billion has been cut from local council budgets for adult social care – and the system is now close to collapse. In Oldham adult social care has had a real terms cut of £10 million since 2010/11. Charges for vital care services, like home help and meals on wheels, are increasing fast and preventative services have all but disappeared in many areas. Cuts of this scale are a false economy, because if older people end up in more expensive hospital and residential care when they don’t need to, it costs us all far more. And of course, most people want to stay in their home.
Also, Ministers aren’t being straight with people about how much older people will have to pay for their care. The Bill won’t cap care costs at £72,000, as Ministers have repeatedly claimed. The £72,000 is only for care, not accommodation costs. Older people in residential care will have to make a ‘cost of living’ contribution of £230 per week per person (£12,000 pa per person) regardless of where you live, to cover the cost of your accommodation, food and heating – and this is NOT included in the so-called ‘cap’.
The figure was also based on the average care costs paid by local authorities, not the actual amount self-funders are charged which is much higher than the Council rate. In addition, if you don’t have cash to pay for this care there a new ‘care’ loans available, but they will be means tested, so those with modest savings will lose out. Most people will still have to sell their homes to pay for their care after they die. The Government is completely disingenuous about this and again unfortunately it got voted through.
There are other important aspects of the Bill, including improving the rights of carers of all ages. But again, this is meaningless in the current social care crisis.
The use of patient data was another important area the Government tagged on to the Care Bill. Patient data is vital to enable research advances in medicine and improvements in care and safety. However it is essential that adequate safeguards are in place to ensure patient confidentiality and privacy. There are serious concerns that not only is patient confidentiality not being protected, but that these data are being sold for commercial purposes. Labour is opposed to this and built in safeguards to protect patient confidentiality which unfortunately was defeated by the Coalition.
The Government has also used the Care Bill to try and steamroller through hospital closures without proper community consultation. This follows the embarrassing defeat of the Government in the High Court last year when Jeremy Hunt tried to close down Lewisham Hospital. Just before the Report Stage of the Bill in the Commons last month, over 100 local people contacted me about these plans which Labour voted to remove from the Bill. A few backbench Liberal Democrats initially disagreed with these plans and put their names to a compromise amendment to stop the Government but withdrew it at the last moment – another U-turn from Lib Dems. As such the Coalition Government won. Labour has committed to repeal this part of the Bill.
The Bill has now gone back to the House of Lords to debate the amendments made in the Commons.
I believe that we need a bolder response to the challenges we face. Labour’s proposal for the full integration of health and social care would improve the quality and efficiency of care. It would also underpin changes that would make a real difference to families, including one point of contact to help meet all of a person’s needs.
The Oldham Report, which was published this month, sets out proposals to provide better care for millions of older people who would benefit from a single care team – doctors, nurses, therapists – working together to support them. The report focuses on how we can ensure better, more efficient care for the millions of older people and those with long-term conditions who have multiple needs.