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Personal Care at Home Bill

The question of how we create a fairer, more affordable system of care and support is one of the defining issues of our day. From my visits to people being looked after in their own homes and my meetings with carers, I know how much it matters to individuals, families and communities. It is a subject that deserves serious, non-partisan discussion in the House. We have had many contributions worthy of it, and I welcome the forewarning that the hon. Member for South Cambridgeshire (Mr. Lansley) gave me before the Committee stage in the new year, with his detailed questions about the impact assessment. I look forward to debating them further in due course. Apart from the final contribution by the hon. Member for Eddisbury (Mr. O'Brien), we have had a welcome absence of scaremongering or political point scoring. At the start of the debate, my right hon. Friend the Secretary of State laid out the challenge ahead and explained how the changes to our society in demography, life expectancy and better medical treatment spell out the need for decisive action on social care. We know the salient facts. This is a country with more pensioners than people under the age of 16. The Office for National Statistics suggests that by 2033 the number of people aged over 85 will rise from 1.3 million to 3.3 million and the ratio of working-age adults to pensioners—the so-called dependency ratio—will drop below three. By 2050, it will fall to the point at which there will be only two working adults for every pensioner. The facts speak volumes about the need for bold and far-reaching reform. The message is stark: without radical action, our ability to meet the needs of our ageing population will decrease, and the unfairness that we already see across the care system will mount year on year. I thank my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble), who said that there had been a transformation in social care over the past few years. That was in stark contrast to the views of the hon. Member for South Cambridgeshire, who opened his remarks by criticising the lack of action. He neglected to tell the House about the 50 per cent. real-terms spending increase on adult social services since 1997, or the £500 million grant given to councils in the past three years to help personalise social care services and pursue the personalisation agenda that many Opposition Members reminded us about. He neglected to mention our efforts through the national dementia strategy, which I had the privilege of launching earlier this year, or the ministerial research group that I launched following the national summit to ensure that more resources go into researching the causes of and cures for dementia and the care of people with it. The hon. Gentleman did not mention the work under way through the carers strategy to support the friends and families who make such an important contribution to our society, the existence of 11,000 dignity champions throughout our health and social care system, or the fact that the Care Quality Commission report on care and council performance published earlier this month showed that 80 per cent. of homes and agencies and 95 per cent. of councils were rated as "good" or "excellent". Opposition Front Benchers completely ignored and overlooked all that progress. Despite the progress, we know that the structural changes in our society call for wholesale reform of our care system. That is why our proposal to create a national care service, which many Opposition Members have lauded and applauded so much this evening, is so important. I am delighted that so many hon. Members have now seen the light and are following Labour's lead in forming a national care service for the future, which will be fairer, simpler and more affordable, underpinned by national rights and clear entitlements, driven by quality and built around the individual's needs. Many hon. Members discussed the importance of improving quality. Let me remind the House of what we are doing on raising skills in the work force—another issue that has been debated this evening. For example, we have created a National Skills Academy for Social Care, driving forward training, development and career progression for the adult social care work force. Our social work taskforce sets out how we further support the social work profession. We are doing more to attract young people into the care work force, not least under our "Care First" career scheme, which was launched earlier this year, and by creating an extra 1,000 apprenticeships opportunities. We are also ensuring that a clear and wide range of interventions are available. The hon. Member for South Cambridgeshire was highly critical, but he forgot about "Putting People First" and the £60 million we made available to local authorities to encourage investment in telecare and supportive mechanisms to help people in their own homes. Our recent publication on the use of resources further promotes the use of such early interventions and preventive responses. Therefore, to suggest that there has not been a period of investment, reform and change over the past 10 years is to deny and ignore completely what has happened; and frankly, it will leave those who have done so much work on the ground feeling that the Conservatives do not know or care about their work. The Bill is part of that journey and an important bridge to a national care service. Let me set out clearly what it stands for. First and foremost, it represents action now for 280,000 people with the highest level of need—those with advance dementia and Parkinson's disease. It will remove the unfair burden of cost on those people and their families. My hon. Friend the Member for Crawley (Laura Moffatt) made a heartfelt plea, based not least on her experience of working with people with dementia, for more help now to prevent the unnecessary admission of people with advanced dementia to hospital. [Interruption.] I share her concern about that, yet for five hours, Tory Members have found reason after reason for not going ahead with the Bill. We have heard them say, "It's only a part of the jigsaw, so do nothing"—[Interruption.]