Today’s debate has been about one of the most important issues facing Britain today: how we care for the increasing number of older and disabled people. The Care Bill is the result of the Law Commission’s review of adult social care legislation, which was initiated by the previous Government. The Opposition welcome the Bill’s emphasis on prevention, promoting well-being and new rights for users and carers.
I want to pay tribute to the work that has already been done to improve the Bill by members of the Joint Committee on the draft Care and Support Bill and by Members of the other place. It now promotes the integration of care and support with health and housing, which is really important, and requires local councils and the NHS to work together in relation to the needs of young carers and, in that regard, I want to thank my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), in particular, for her tireless efforts.
The right hon. Member for Banbury (Sir Tony Baldry), my hon. Friend the Member for Blaenau Gwent (Nick Smith), my right hon. Friend the Member for Coatbridge, Chryston and Bellshill (Mr Clarke), my hon. Friends the Members for Edinburgh East (Sheila Gilmore) and for Hayes and Harlington (John McDonnell), the hon. Members for Pudsey (Stuart Andrew), for Strangford (Jim Shannon) and for Totnes (Dr Wollaston), and my hon. Friends the Members for Washington and Sunderland West (Mrs Hodgson) and for Worsley and Eccles South all spoke about further changes that should be made to the Bill, for example to ensure that NHS staff identify carers, to support parent carers, to improve the safeguarding of people in social care, to improve the assessment process and advocacy, to ensure an effective transition of support from childhood to adulthood, to transform end-of-life care and to deal with portability, particularly of community care packages, in the devolved Administrations. I am sure that we will return to those issues in Committee.
The main concern, raised repeatedly by hon. Members today, is that the Bill does not address the fundamental issue facing elderly and disabled people and their families or put in place the really bold reforms we need to tackle the growing care crisis in England. It is true that council care budgets have been under pressure for many years, but this Government’s decision to impose the biggest reduction in any Department on local councils has the pushed care services that hundreds of thousands of people rely on to “the brink of collapse”—not my words, but those of Age UK.
Adult social care budgets have been cut by £2.7 billion under this Government. The result is that fewer people are getting the care they desperately need, particularly at home, which is the key issue for the future, as my hon. Friends the Members for Sheffield, Heeley (Meg Munn) and for South Shields (Mrs Lewell-Buck) pointed out. Frail, elderly people are receiving home visits that last barely 15 minutes, or in some cases only five or 10 minutes, as we have heard. Disabled people are being trapped in their homes, denied the basic opportunities to work, train, volunteer or have a social life that other people take for granted, a point powerfully made by my right hon. Friend the Member for Stirling (Mrs McGuire). Paid care staff on zero-hours contracts are not even earning the minimum wage, let alone a living wage, and unpaid family carers have been left struggling without the help they need to look after their loved ones, which means that their own health suffers, too. At the same time, more people are being charged more for vital services such as home visits and meals on wheels, which are up by £740 a year since the election.
Reducing care budgets by that scale hurts some of the most vulnerable people in society. It is also a false economy, because as more elderly people do not get the help they need to stay at home, they are ending up in hospital in increasing numbers, which costs the taxpayer far more. Delayed discharges from hospital have soared by 42% since the election, as my hon. Friend the Member for Easington (Grahame M. Morris) rightly said. Delayed discharges have costs taxpayers £225 million this year. That could have paid for almost 17 million hours of home care. It is spending money in the wrong place in a way that is not good for the people using the services and does not provide value for money.
Families are also paying the price. As my right hon. Friend the Member for Salford and Eccles (Hazel Blears) said, one in three carers now has to give up work or
reduce their hours because they cannot get the help they need to look after their loved ones, and this costs the Treasury £1 billion in lost tax revenues alone. The Bill will not solve these problems. The new rights it contains and the new focus that it places on prevention and well-being risk being meaningless as care budgets are reduced to the bone.
Nor are the Government being straight with people about their plans to reform long-term care funding in future. Any measures that protect people from catastrophic care costs are welcome, but Ministers have not spelled out the reality of their plans. They have repeatedly claimed that no one will have to pay more than £72,000 for their care, but this is not the case. People’s care costs will start to count towards the so-called cap only if they are assessed as having eligible care needs. Nine out of 10 councils provide care only for those with “substantial” or “critical” needs. If someone needs help to stay living at home but their council assesses their needs as “low” or “moderate”, what they pay for home visits will not count towards the cap.
With regard to residential care, the cap will not be based on what someone actually pays for their home care but on the standard rate paid by their local council. I see that the Secretary of State is being informed by the Minister about the reality of these plans, so I hope that he listens to more of my speech. The standard rate paid by local councils is currently, on average, about £470 a week. Government Members, as well as Labour Members, will know that many of their constituents pay far more than £470 a week for their care home, but these extra costs will not count towards the so-called cap. People will also, rightly, have to contribute towards their hotel and accommodation costs. The Government are setting this contribution at £230 a week—much higher than Andrew Dilnot recommended—and these costs will not count towards the cap either. Taking both those factors into account, it will take elderly people almost five years, on average, to hit the so-called cap, during which time they will have clocked up, on average, £150,000 for their care home bill, and much more in many cases. Because elderly people stay in a care home for about two and a half years, on average, six out of seven people will be dead before they hit the cap.
Ministers have repeatedly claimed that people will not have to sell their homes to pay for their care; again, this is not the case. The Bill puts a duty on councils to offer deferred payment schemes—care loans that will have to be paid back by selling the family home after the person has died. The loans will not be universally available, as Andrew Dilnot recommended, but means-tested. Interest will be charged on the loans, but that interest will not count towards the cap. Although the Government are raising the upper level of the means test, that will not help many pensioners on average incomes because of how the test works, whereby councils take a notional income from the remaining assets in a person’s house and add it to what they get from their pension and any savings or second pension. For many pensioners on average incomes, this combined total will take them over what their local council will pay for care, and they will therefore not qualify for any extra support.
Elderly people and their families deserve to be told the facts about the Government’s plans so that they can properly plan for the future rather than have Ministers attempt to pull the wool over their eyes. One of the
main claims made by the Prime Minister about the Government’s reforms is that they are so clear and straightforward that lots of insurance products will emerge so that people can insure themselves to pay for their care in future. I would be very interested to hear from the Minister how many of these new insurance products have emerged so far.