My Lords, with the leave of the House, I shall now repeat a Statement made earlier in another place by my right honourable friend the Secretary of State for Health on the care and support White Paper, the draft Bill and the progress report on funding reform for social care. The Statement is as follows:
“With permission, Mr Speaker, I would like to make a Statement on the future of care and support for adults in England. The coalition programme said that reform is needed urgently. We inherited a system that too often lets people down and is unfair, a system which was complex and confusing and which responded to a crisis but too rarely prevented it.
For many years, people have called for a system fitted around the needs of care users, not the preferences of the service—one that puts people at the heart of the service and delivers high-quality care with dignity and respect. We knew two years ago that we had to offer urgent support to social care. In the spending review 2010, we provided an additional £7.2 billion for social care over the course of this Parliament, including nearly £3 billion from the NHS to deliver more integrated care. This gives the current system resource backing, but not reform. We need also to build a better service for the long term.
The White Paper I am publishing today represents the greatest transformation of the system since 1948. The practical effect will be to give service users, their carers and their families more peace of mind. Services will be organised around each individual’s care and support needs, their goals and aspirations. Intervention will be earlier, promoting independence and well-being.
The White Paper will support people to remain active in their own communities, connected to their families, friends and support networks. We shall invest an additional £200 million over five years in the development of specialised housing for older and disabled people, so that people can stay independent in their own homes for as long as possible.
The role of carers is critical, so we will transform how the system views and treats carers. We will extend rights for carers to have an assessment and for the first time provide a clear entitlement to the support they need to maintain their own health and well-being.
The measures in the White Paper will make it easier for people to understand how care and support services work, and what their entitlements and responsibilities are. To give people greater consistency of access, we will introduce a national minimum eligibility threshold, as the Dilnot commission suggested. We will require councils to start supporting people as soon as they move into a new area, so that it is easier for people to choose to move home to be nearer to their relatives. Local authorities will be under a duty to ensure continuity of care and that care users are able to take their assessments with them if they move area.
We will establish a single website to provide clear and reliable information about all care and support services for self-funders and local authority-supported users and carers. As well as these improvements to national information, we will invest £32.5 million to ensure that there is better information about the range of local care and support services available in each area.
We want people to be confident that the care and support they receive is delivered by a compassionate and caring workforce. We will place dignity and respect for care users at the heart of a new code of conduct and minimum training standards for care workers.
Alongside the new minimum standards, we will train more care workers, with 50,000 more apprenticeships by 2017.
A key requirement is for people to be confident that they will be treated with dignity and respect and that providers deliver high-quality care at all times. We will rule out the crude practice known as “contracting by the minute”, which can so undermine people’s dignity and choice. We should contract for quality and service, not by the clock. We will call on local Healthwatch organisations to make active use of their power of entry, allowing them to visit care services in their local area and make recommendations to the providers and local authority commissioners.
People should also be entitled to expect that services will be maintained if a provider fails. Working with local government and the care sector, we successfully handled the consequences of the Southern Cross crisis, but we also learnt lessons. So we will consult on how we can anticipate and act to ensure continuity of care if a provider goes out of business. Care itself, not the provider of care, is the most important factor.
A key theme of the White Paper is that those receiving care and support know what is best for them. It is right that they must be in control of their care and support. We will make sure that everyone is entitled to a personal budget, so they can be in control of their own care. We will offer all who want it a personal budget and, by 2015, a legal right to request this as a direct payment.
To make it easier for people to get the care they want, we will ensure that they have better access to independent advice. We will make it easier for people to see whether a care provider is good or not, so that they can make real choices through an online quality profile for each provider. We will work with a range of organisations to develop comparison websites so that people can give feedback and compare the quality of care for themselves.
Integrated care is important for everyone, regardless of age or the reason they need care and support. However, getting integration right is particularly important for people when they may be moving from one service to another. That is why we are transferring an additional £100 million in 2013-14 and £200 million in 2014-15, beyond previous plans, from the NHS to social care, to support social care services that benefit people’s health and well-being, and promote better integrated care.
The White Paper will help people get better joined-up care at key points in their lives. We will legislate to give adult social care services a power to assess young people under the age of 18 and we will ensure protection so that no young person goes without care while waiting for adult support to start.
We want people to receive the best possible care at the end of their lives, including a choice over where they die. The palliative care funding review recommended that all health and social care should be funded by the state once someone reaches the end of life and are entered onto the end-of-life care locality register. We think that there is much merit in this and will be using
the eight palliative care funding pilot sites to collect the data and experience that we need to assess the proposal.
Alongside the White Paper, I am today publishing the draft care and support Bill. Many of the White Paper reforms need new legislation to make them work and the draft Bill is a major reform in its own right. The law for adult social care is complex and outdated. All those involved know how it has made the system harder to work in. The draft Bill sets out a single, modern statute for adult care and support. It brings together and simplifies provisions from at least a dozen Acts of Parliament, reflecting the recommendations of the Law Commission. It builds the law around the well-being, needs and outcomes of real people—clear principles, clearly set out in law.
I am also today publishing a progress report on funding reform. In July 2010, I asked Andrew Dilnot to review the funding of the system of care and support in England. I can confirm today the Government’s support for the principles of the Dilnot commission’s report as the right basis for any new funding model; that is, financial protection through capped costs and an extended means test.
It would, as Andrew Dilnot himself said, enable people to plan and prepare, so that they are not so vulnerable to the arbitrary impact of catastrophic care costs. The progress report sets out a detailed analysis of this funding model, giving us a better basis for making decisions about how these changes can be funded. Of course, any proposal which includes extra public spending needs to be considered alongside other spending priorities, which include the demographic pressures on the social care service itself. The right, the necessary, place to do this is at the next spending review. Our talks with the Labour Party were constructive, but no plan for funding Dilnot was agreed, or, indeed, proposed by either side.
A decision at the next spending review will allow time for continuing discussions with stakeholders and between the parties, and we can undertake open engagement on detailed implementation issues and options. These discussions will include the level of the cap, whether a voluntary or opt-in approach is a viable option in addition to the universal options and whether legislative provision is required.
However, as the report makes clear, we are also taking definitive steps now by accepting a number of the Dilnot commission’s recommendations. Most notably, we will introduce a universal deferred payments scheme. This will mean that no one will be forced to sell their home in their lifetime to pay for care. Provisions for this are included in the draft Bill.
The White Paper, the draft care and support Bill and the progress report on funding together set out our commitment to a modern system of care and support—one designed around the needs of individual people; one with dignity and respect at its heart; and one that brings care and support into the 21st century.
These reforms are the product of immensely helpful reviews by the Law Commission and the Dilnot commission and come from a positive and wide-ranging engagement with the care sector and the public, helping us to design the kind of care services and support that
all of us would like to see for ourselves and our families. We are determined to secure these reforms—to achieve in this Parliament that which our predecessors failed to achieve in over 13 years. I intend to continue and develop this open co-operative approach to developing these reforms. I commend this Statement to the House”.
My Lords, that concludes the Statement.
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