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Social Care Green Paper

We are issuing guidance on how to commission appropriate services for carers, but I recognise the issue that the hon. Gentleman is raising. The Princess Royal Trust has done some good work on that issue. There is a balance to be struck. The hon. Gentleman and his colleagues on the Liberal Democrat Benches have sat there and lectured us many times about being too top-down, on ring-fencing too much and on target-setting too much. They say we are taking away local discretion and how disgraceful that is, but then the hon. Gentleman says that if we allow too much local discretion, local bodies do not do what we want. There is a balance to be struck. The Government allocated this money because of the importance of the issue, but I stress to the hon. Gentleman that although I and the Minister responsible for care services, the Minister of State, my hon. Friend the Member for Corby (Phil Hope), have a responsibility to ensure that our objectives are met, it is the responsibility of Members of Parliament to challenge primary care trusts if they are not commissioning services in the expected way. I was speaking a moment ago about people living longer, particularly those with disabilities and long-term conditions. The life expectancy of people with Down's syndrome is just one illustration of that. Just after the war, a child with Down's rarely survived into adulthood. Today, it is possible for them to live well into their 60s and, with the right support, to enjoy a full and rewarding life. What a wonderful sign of health and human progress that is, yet the sense of a world transformed brings into sharp focus the challenge ahead for social care. It has been remarked, quite fairly, that if William Beveridge had sat down today to develop the welfare state he would have put social care at the centre rather than the periphery of his plans. More than 60 years after the birth of the NHS, it is worth reflecting that the same unfairness that originally drove Nye Bevan still exists in social care today, and it is this: people with the greatest needs are paying the most; the services that a person receives vary markedly according to geography; and what an individual spends on their care is only loosely linked to their ability to pay for that care. Hon. Members will appreciate that the spectrum of care costs is extremely wide. About one fifth of people can expect to need care costing less than £1,000; for another fifth, the cost will be in excess of £50,000; and, for a smaller but growing proportion with very high needs, particularly those who develop dementia, the cost can run into hundreds of thousands of pounds. That is a cruel lottery, and the fact that people born after the war, the first real property-owning generation, will soon enter the care system only intensifies the need for change. We could see unfairness played out on a far greater scale over the next 20 or 30 years if we do not make changes to the care system today. It is therefore no exaggeration to say that the Government's Green Paper "Shaping the Future of Care Together" is a Beveridge moment for social care. It is a chance to rebuild the social care system from first principles and to raise our ambitions for care and support in the future. One of the main messages that I should like to communicate today is this: in the time that this Parliament has left, one collective responsibility is to build an unstoppable momentum for legislation on social care in the next Parliament.