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Personal Care at Home Bill

For a relatively small group of people across the country who are struggling at home with a high level of care need and who are worried about the cost of that and whether they can continue to live in their own home or will have to go into residential care, this Bill will transform their lives. We need to put things in context, as I have attempted to do all the way through these debates, by saying that that group is relatively small. That is why this Bill, despite being good and worthy of support, is only the next step in the reform of social care. It is not the first such step and it is important to emphasise that over the past 12 and a bit years many advances have been made in the provision of social care. One that the Opposition continually fail to mention is the fact that if someone goes into care and does not want to sell the family home that they have lived in, local authorities now have the money to put a charge on that home to pay the social care debts after that person's death. The reason why so many people still sell their family home against their will is that Conservative councils and, I have to say, Liberal Democrat councils all around the country forget to tell people about that benefit that is now available. That is not the only social care reform. Extensive efforts have been made to upgrade the status of the social care work force, to qualify them, to ensure that the regulation of social care is fit for purpose and to ensure that appropriate training is available to people who work in social care. Measures have been taken to improve the methods of discharging people from hospitals so that there is no longer bed blocking and to ensure that social care provision is available for people in the community when they need to be discharged from hospital. Reablement schemes are available around the country and improvements have been made to the provision of services and to the integration of services between the NHS and social care. Efforts are also being made to extend the availability of telecare and of extra care accommodation. I remain disappointed by some of the comments made by the Opposition about extra care. If, as they say, they are approaching this Bill in an open-minded spirit and if they want to approach me, I will happily take them to see some extra care accommodation and to see the benefits that such care can provide to people. All the measures that have been put in place so far have been the first steps in improving social care provision in this country, but the Bill that we are discussing today is only the next step on that path. The biggest step of all remains in front of us: we need to fold all those measures together into the comprehensive social care package that we know we have to face up to. In my view, it will necessitate some form of co-payment and some method of bringing in extra resources from the population. I said on Second Reading that my preference would be a hypothecated inheritance tax, and I shall continue to reiterate that until somebody takes the idea seriously. Whether we use that solution or some other insurance-based solution, a solution will have to be found. We must find a solution to how we can get local councils to assess people's care to ensure that packages are portable and to agree on how they will be funded so that they are funded to the same level around the country. That will have major implications for localism and the role of local authorities in the future. These are huge issues that will have to be addressed—and addressed they must be—but this Bill is nevertheless a valuable contribution to that process. It will radically transform the lives of that group of people with high levels of care needs who want to stay in their own homes. For that reason, this Bill is absolutely worthy of the House's support, but only with the caveat that we should all commit ourselves to taking the next step as soon as possible.