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Debate on the Address

My Lords, the gracious Speech outlined by the noble Lord, Lord Darzi, certainly has vision, as the noble Lord, Lord Warner, said in his inimitable way, but vision has value only where it has application, and the government programme will succeed or fail on its implementation and outcomes. Remember: aspiration is not achievement. As deputy chair of CAFCASS, I know that only too well, having moved into an organisation whose conceptual framework was excellent but whose application and implementation were chaos. Fortunately, with a strong board and a superb chief executive, we now have an organisation serving more children than any other social work department, and serving them well. But it shows that you have to have a clear plan of implementation whatever the concept of the vision. The Government tell us, for example, that they want the best for children and young people, especially children in care. I know that that is a continuation of the Every Child Matters agenda, on which I congratulate the Government, but there remains much to be done. I continue to watch with care and interest—I will no doubt come back to the Minister on this at some point—the way in which Ofsted inspects some social care services. We know that children want to be heard, to be emotionally understood and to have continuity in their care, but that can be achieved only if we have the right professionals in place. In his discussions the Children's Rights Director, Roger Morgan, was told of the importance of social workers in the lives of children and young people in care—indeed, one in three of the children and young people in his survey saw them as among the most helpful and important people—and yet we still fail to value them. Consequently, there is a high turnover in many areas and it is extremely difficult to recruit, particularly in London. Surely the children's voices should be heard here. So perhaps I may quote one young person who, looking back on their time in care, said: "““with children in care, they need to always know they have someone to turn to and talk to. I never felt that. I ended up in and out of prison and felt I had no support. The longest I had a social worker was three months then from there I've had 14 different social workers””." Contrast that with the experience of a man called Michael, who came into care at birth. His childcare officer saw him through placement breakdown and approved schools into a secure foster home and through the formation of his own secure family—50 years of contact. He credited much of his emotional security to her and his foster families' consistent emotional connection to him. Of course there were care plans, but he received what another child described as wanting from their ideal social worker: "““support, advice, friend, someone I can trust, someone I know really cares about me, not just a number or a client they don't really care about””." I do not expect that every child will have a care worker such as the one I have described, but does the Minister think that we will come anywhere near this in the new Bill while we continue to undervalue and underpay the social work profession? Will he not commit himself again to improving conditions so that children have people with the right skills and attitudes to meet their needs? It is that and not more structural change that will achieve what I know the Government and the Minister seek. As I am speaking of children in care, perhaps I may raise an issue that came to mind during the debate. If we are trying to keep children in placements consistently, what will the Government do about school exclusions? Many children with difficult backgrounds are difficult in class and in some schools there is great encouragement to exclude them because of the difficulties they cause for others. There is a real conflict of interests here and I should be interested to know how the Government intend to tackle the issue. The question of value arises also in other fields. For example, does the Minister consider it appropriate that support workers for young adults with challenging behaviour that stems from learning difficulties—whose tasks require skill, a capacity for careful risk assessment, and the charge of these young people on behalf of their parents—should be paid barely above the minimum wage? I recently heard that a cleaner at Heathrow could earn almost as much as a support worker working with people with learning disabilities. One example after another—it is only shortage of time that prevents me giving further illustration—seems to demonstrate that personal care has become the poor relation in health, education and the social care spectrum. That was stated far more eloquently than I can by the noble Earl, Lord Howe. I would like the Minister to reassure me that when the legislation is introduced to create what is described as a strong health and social care regulator, social care will have as central a position as health. Social care increasingly affects more people than health, yet we spend huge sums on acute services to save people with brain injuries or premature babies, only to tip them out into an inadequate postcode lottery of community support services. If you bust your head in a car accident and survive, most likely with serious personality changes and physical disability, you may be lucky enough to be in the catchment area of a brain injury support unit such as the Grooms-Shaftesbury in Suffolk; but you are much more likely to have very little indeed apart from your frantic family, and we know that many of these families break down. We need a regulator who, apart from monitoring existing services, is able to say something about this; a regulator who has the same commitment to users as the Commission for Social Care Inspection has demonstrated under the leadership of Dame Denise Platt. Progress since the commission's inception has been strong, with an increase in 2005-06—for the fourth consecutive year—in the average percentage of minimum standards met in the services inspected by the commission. The commission also drew attention to the matter raised by the noble Baroness, Lady Barker, which I also emphasise: the gap in the legislation protecting the human rights of elderly people in private homes. I hope that we can fill that gap during this Session. As the Healthcare Commission merges into the new super-regulator, the Care Quality Commission, I would ask the House to ensure that, in its consideration of the Bill at all stages, the voice of social care is strongly maintained and carried forward. It would be wrong not to note that there are serious concerns in the social care and voluntary sectors about the proposed merger. Too many people are closely affected by these services. Any of us sitting in this Chamber, our friends and our families might need to use those services. The commission has led much of the debate on improvement. It has championed individual budgets and direct payments, examined the workings of the market for care and carried out a range of well-regarded and important studies. I would therefore ask the Minister whether it is true that, as the legislation is currently drafted, the new commission will be precluded from producing reports or studies until 2010, and then only after an annual discussion with the Secretary of State. I thought that the new Government were to be more open and transparent. If the position I described is true, it smacks of extraordinary control over the facts being collated by the new commission in its wider role. Whether it be for vulnerable children, people with a variety of disabilities or the steadily increasing numbers of frail elderly people in need of support, social care is vital to our civilised society. To meet this need it must not be lost in other services but be a true and equal partner with health and education, meeting the aspirations of our people to enjoy a full life and to experience emotional—as well as good physical—health and well-being.