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Personal Care at Home Bill

My Lords, I welcome the Bill. For too long we have neglected the care particularly of elderly people but also of the disabled of all ages. This is a great step towards the introduction of a national care service. It guarantees free personal care at home for the most seriously disadvantaged. We are promised a White Paper on the broader issues in the next few weeks. I am sure that the Bill is also welcomed by carers. I have been a carer myself. I know that personal care at home is what most of the long-term ill want. Few want to go into a care home. In my own family, I had to promise my mother when she was ill in hospital that she would not be sent to a care home; she wanted to go back to her own home as soon as she possibly could. The same was true of my husband, who was in need of personal care in his last years. In his case, I approached the local authority because I felt that I needed assistance. Someone came to see me. I pointed out to her that we had at that time a scheme entitled Care in the Community and there was an obligation to assist people in my situation. "Yes," she said, "but it is within available resources. Our resources here are limited, so we’d be obliged if you would do the best you can for yourself". I was willing to pay but they did not have people to do the work, so I did help myself. A neighbour recommended a local woman who had caring experience. I saw her and arranged to pay her. She came every day, and together we looked after my husband until he became too ill and had to go into hospital, where sadly he died a few days later. I tell this story because I think local authorities must have the requisite resources to provide the services envisaged in the Bill—not just money, but also people. There is also a need for better interaction between the services available and information for families. This is important for people who, perhaps later in life, find that they are faced with having to care for a partner or a relative. I recall being phoned by an old friend whose wife’s condition had worsened. He was really quite desperate: "I don’t know what to do", he said. I was able to give him some advice, which he took, and I am glad that in those circumstances the local authority has been very helpful, and assistance is being provided to an ageing woman who has a spinal disease and is immobile, and is also blind. With this Bill, which I have said before is a first step, the Government are ultimately offering us a national service which will be able to ensure that people requiring care can receive it in their homes, plus help for them to be as independent as possible. Savings will be made because fewer people will require residential care. Care homes are desperately expensive. They are not always of as high a standard as many would like; there have been reports to that effect in recent years. Insurance schemes are currently being advertised so that people of modest incomes can afford such care should they ever need it. Many are worried that this may mean selling their homes. Local authorities only pay for residential care in cases of absolute poverty, and then at the lowest level they can find. The Government believe that arranging for people to receive care in their own homes will be very much cheaper, as well as being much better for the vulnerable people concerned. Of course, there has been some opposition to the Bill—we have heard some of it this afternoon—mainly on grounds of possible cost. However, we should be prepared to accept the obligation involved in the care of disadvantaged and vulnerable people. This is a first step towards a new national scheme, and it is directed at the care of those most in need. Issues about eligibility have been raised, notably by the Local Government Association. No doubt this is a matter that could be further explored; the LGA believes that the number of reassessments is likely to increase, as people who have been provided with care by unpaid family carers will come back into the care system for free. The eligibility system, it says, will increase the work of social care staff, as decisions will have to be taken as to who is and is not eligible for free personal care. No doubt the Minister will respond to that in her reply. These comments from the LGA highlight how much we rely on family carers providing all the work involved for nothing. I cannot help feeling that this is a bit of an imposition. We know what a drain this can be on family resources. It is not surprising that carers’ organisations fully support the Bill, but there is far too much reliance throughout the system on what families are able to do. I recall that when I was in hospital following an operation some years ago, the floor manager came to see me to tell me that I was going out the next day. When I protested that I was a widow living on my own, and would be unable to cope if I left hospital so soon, her immediate reaction was, "Haven’t you any relatives?" I responded that none lived near. She asked me who lived nearest, and I said the nearest lived in Wiltshire—I live in London. She told me she could let me have another day and I could phone my relatives in Wiltshire and get them to collect me. I was able to do that, but many older people live entirely on their own with no relatives able to assist. We should not base our care services on the assumption that relatives can always be available to provide help. This is increasingly less likely. Family members no longer live close together. The Government’s Bill recognises that, and attempts to deal with it. It is a first step towards providing social care, and I fully support what the Government are endeavouring to do in this much neglected area. I oppose the amendment: it will simply delay the Bill. We know what many organisations think, because they have already told us. Many of the objections, as we know, seem to be about cost. I believe that we should simply get on with the proposals outlined in the Bill; and I welcome the Bill.