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Personal Care at Home Bill

As I was saying to the shadow Health Secretary, there is discretion for local authorities under the Bill, but we have costed the Bill and we are absolutely clear about the people we expect to benefit from it. We are confident that the costings we have given will pay for the benefits that I have described this afternoon. The Bill is about putting more money into the social care system now. I do not think that anyone in the House seriously disagrees—unless I am about to discover otherwise—with the fact that the measure is much needed, prudent and fair. It is targeted on those in England with the highest needs who face the highest costs. As I said earlier, many people have had to use their own funds to pay towards the cost of their care. Reform of care and support is fiscally responsible in the long term. Failure to reform will lead to huge unmet need and pressure on public finances and public services in both the NHS and local government for years to come. The demographic pressure is rising. Year by year, more people will come into a care system that cannot fully cater for them. When the NHS was created there were eight working adults for every retired person. Today there are four. By 2050, that will figure fall to just two. We can expect that by 2026 there will be 1.7 million more adults in England who need care and support. One in five of us will need care that costs less than £1,000 during our retirement. One in five will need care that costs more than £50,000, and in the worst cases the cost can exceed £200,000. We cannot predict our risk, so it is hard to protect ourselves against it. That is why we need a reform that shares the costs and risks of care and does not leave those in the most difficult circumstances facing catastrophic costs for care. The need for bold, far-reaching reform is undeniable. That is why we propose to create a National Care Service, and why we will bring forward a White Paper in the new year. This is a major reform and, although it is essential, it will take time to deliver.[Interruption.] I hear the hon. Member for Hemel Hempstead (Mike Penning) say from the Front Bench that it has taken time. We have not done nothing for the past 11 years. We have introduced major reforms to social care in England. We have introduced the dementia strategy, the drive towards personalisation and direct budgets, the Putting People First reform. We have had the prevention for older people pilots, which have laid the ground for the present reform. It is not as if we have been doing nothing. We have been taking steps to improve the system. I did not hear whether the hon. Gentleman agrees that a fundamental reform in the next Parliament is necessary, but I shall be interested to hear whether he has the courage to commit to that. People have waited long enough. We are not saying that we have got everything perfectly right, but we have the courage and the confidence to introduce a Bill. In the interim we are introducing the Personal Care at Home Bill, recognising that those with the greatest needs cannot wait and should not be asked to wait to receive greater fairness. The Bill is not the whole answer, but it is a bold first step, and I commend it to the House.