My Lords, I first declare my interest as chairman of UCLH. The Select Committee has produced an outstanding report and I pay tribute to the noble Lord, Lord Patel—I was going to say my noble friend. He is a mentor to not only the noble Lord, Lord Kakkar; I regard...

My Lords, I first declare my interest as chairman of UCLH. The Select Committee has produced an outstanding report and I pay tribute to the noble Lord, Lord Patel—I was going to say my noble friend. He is a mentor to not only the noble Lord, Lord Kakkar; I regard...

To ask Her Majesty’s Government, in the light of the recommendations of the Dilnot Commission, when stakeholders, including local authorities, will be consulted on the implementation of the care cap; and what engagement mechanisms will be used.

To ask Her Majesty’s Government, in the light of the recommendations of the Dilnot Commission, when stakeholders, including local authorities, will be consulted on the implementation of the care cap; and what engagement mechanisms will be used.

To ask Her Majesty’s Government whether they intend to bring into effect the provisions in the Care Act 2014 for capping individual liability for meeting the costs of adult social care; and if so, when.

To ask Her Majesty’s Government whether they intend to bring into effect the provisions in the Care Act 2014 for capping individual liability for meeting the costs of adult social care; and if so, when.

To ask Her Majesty’s Government what steps they are taking to ensure that local authorities will have funds available to meet the recommendations of the Dilnot Commission; and how funding will be linked to local levels of need.

To ask Her Majesty’s Government what steps they are taking to ensure that local authorities will have funds available to meet the recommendations of the Dilnot Commission; and how funding will be linked to local levels of need.

To ask Her Majesty’s Government what is the annual cost to the NHS of bed-blocking delays in discharging elderly patients from hospitals because of the lack of adequate social care provision; and what strategy they have to ensure that adequate social care is provided, particularly for the elderly.

To ask Her Majesty’s Government what is the annual cost to the NHS of bed-blocking delays in discharging elderly patients from hospitals because of the lack of adequate social care provision; and what strategy they have to ensure that adequate social care is provided, particularly for the elderly.

To ask Her Majesty’s Government what forms of data they hold on the level of care available to older people needing care in (1) their own homes, (2) care homes, (3) nursing homes, and (4) nursing homes with dementia support; and whether they have plans to improve the data.

To ask Her Majesty’s Government what forms of data they hold on the level of care available to older people needing care in (1) their own homes, (2) care homes, (3) nursing homes, and (4) nursing homes with dementia support; and whether they have plans to improve the data.

Lords motion to take note of the challenges in the current system of social care and of proposals for reviewing it and for longer-term reform of the system. Agreed to on question.

Lords motion to take note of the challenges in the current system of social care and of proposals for reviewing it and for longer-term reform of the system. Agreed to on question.

My Lords, I join everyone else in thanking the noble Baroness, Lady Pitkeathley, for introducing the debate, which is very important. It is not easy to respond to, to be honest. I acknowledge that there are great pressures on care providers. We saw queues in A&E on the news last...

My Lords, I join everyone else in thanking the noble Baroness, Lady Pitkeathley, for introducing the debate, which is very important. It is not easy to respond to, to be honest. I acknowledge that there are great pressures on care providers. We saw queues in A&E on the news last...

Lords motion to take note of the implications for the health and social care workforce of the result of the referendum on the United Kingdom's membership of the European Union. Agreed to on question.

Lords motion to take note of the implications for the health and social care workforce of the result of the referendum on the United Kingdom's membership of the European Union. Agreed to on question.

My Lords, when the noble Lord, Lord Turnberg, said that this has been a depressing debate, he was not exaggerating. The noble Lord, Lord Warner, referred to “A Streetcar Named Desire”. Frankly, I feel more like Hamlet:

“To be, or not to be”.

It has been a very thought-provoking debate and I...

My Lords, when the noble Lord, Lord Turnberg, said that this has been a depressing debate, he was not exaggerating. The noble Lord, Lord Warner, referred to “A Streetcar Named Desire”. Frankly, I feel more like Hamlet:

“To be, or not to be”.

It has been a very thought-provoking debate and I...

We have voted to leave the European Union. We now have to make the most of it. We can make the most of it and we can make a success of it. We can use Brexit as a catalyst for change. Even though most people, like me, wanted to stay...

We have voted to leave the European Union. We now have to make the most of it. We can make the most of it and we can make a success of it. We can use Brexit as a catalyst for change. Even though most people, like me, wanted to stay...

I repeat what I said earlier: the contribution made by people coming into this country from the EU and elsewhere has been enormous. It was clear in the Statement yesterday that one of the great fundamental problems we face in this country is low levels of productivity. If we are...

I repeat what I said earlier: the contribution made by people coming into this country from the EU and elsewhere has been enormous. It was clear in the Statement yesterday that one of the great fundamental problems we face in this country is low levels of productivity. If we are...

My Lords, we have not even triggered Article 50 at this point. It would be pretty strange for us to start taking unilateral action until at least the article had been triggered and negotiations had begun.

5.06 pm

My Lords, we have not even triggered Article 50 at this point. It would be pretty strange for us to start taking unilateral action until at least the article had been triggered and negotiations had begun.

5.06 pm

To ask Her Majesty’s Government what steps they are taking to integrate health and social care with local authorities.

To ask Her Majesty’s Government what steps they are taking to integrate health and social care with local authorities.

My Lords, we welcome the State of Care report. We know there are serious pressures on the care system. That is why we are giving local authorities access to up to £3.5 billion in new support for social care by 2019-20 so they can increase social care spending in real terms by the end of this Parliament.

My Lords, we welcome the State of Care report. We know there are serious pressures on the care system. That is why we are giving local authorities access to up to £3.5 billion in new support for social care by 2019-20 so they can increase social care spending in real terms by the end of this Parliament.

My Lords, I think most people in the health and care system, whether it is Simon Stevens, the chief executive of the NHS, or the Secretary of State, realise how serious pressures are in social care. There is no question about that. The State of Care report from the CQC supports that view. That is why we are putting in more money towards the end of this Parliament. It is back-end loaded—I accept that—but on the other hand the £3.8 billion that went into the NHS this year is front-end loaded. I think everyone agrees that the only way out of the difficulties we are in is for health and social care to work much more closely together.

My Lords, I think most people in the health and care system, whether it is Simon Stevens, the chief executive of the NHS, or the Secretary of State, realise how serious pressures are in social care. There is no question about that. The State of Care report from the CQC supports that view. That is why we are putting in more money towards the end of this Parliament. It is back-end loaded—I accept that—but on the other hand the £3.8 billion that went into the NHS this year is front-end loaded. I think everyone agrees that the only way out of the difficulties we are in is for health and social care to work much more closely together.

My Lords, the squeeze in social care started in 2010. Between 2010 and 2015, spending on social care declined in real terms by 12.8%. That was a significant reduction in spending when the noble Baroness’s party was in power in the coalition Government. Since then, it remains very tight in social care. As I said, we are putting more money into the NHS at the front end of this Parliament. We have introduced the 2% precept for local authorities to raise money for social care and we have put £1.5 billion into the better care fund, starting from 2017-18, which will provide more money for social care at the end of this Parliament.

My Lords, the squeeze in social care started in 2010. Between 2010 and 2015, spending on social care declined in real terms by 12.8%. That was a significant reduction in spending when the noble Baroness’s party was in power in the coalition Government. Since then, it remains very tight in social care. As I said, we are putting more money into the NHS at the front end of this Parliament. We have introduced the 2% precept for local authorities to raise money for social care and we have put £1.5 billion into the better care fund, starting from 2017-18, which will provide more money for social care at the end of this Parliament.

My Lords, I know that the noble Lord is very keen on an independent commission, and he knows my views on that. I do not think we need an independent commission to tell us that social care and health care must be more joined up and integrated; we all know that. We can do that through a major reorganisation from the centre—but we know what big reorganisations do to the health service: they stymie it for years—or we can work locally in the STP and local authority areas to try to drive this at local level, which I think is the right way forward.

My Lords, I know that the noble Lord is very keen on an independent commission, and he knows my views on that. I do not think we need an independent commission to tell us that social care and health care must be more joined up and integrated; we all know that. We can do that through a major reorganisation from the centre—but we know what big reorganisations do to the health service: they stymie it for years—or we can work locally in the STP and local authority areas to try to drive this at local level, which I think is the right way forward.

There is no question but that we all recognise the enormous pressures on social care. I cannot comment on what may or may not be in the autumn Statement, but I entirely recognise the pressures to which the noble Baroness draws our attention. As I said, the Government did not have resources available to put money into the NHS and social care at the same time at the beginning of this Parliament because we have to live in the real world, which is very

financially constrained. As I said, an extra £1.5 billion is going into the better care fund and an extra £2 billion will be raised by the local authority precept by the end of this Parliament.

There is no question but that we all recognise the enormous pressures on social care. I cannot comment on what may or may not be in the autumn Statement, but I entirely recognise the pressures to which the noble Baroness draws our attention. As I said, the Government did not have resources available to put money into the NHS and social care at the same time at the beginning of this Parliament because we have to live in the real world, which is very

financially constrained. As I said, an extra £1.5 billion is going into the better care fund and an extra £2 billion will be raised by the local authority precept by the end of this Parliament.

I cannot answer specifically the question raised by the right reverend Prelate, but I would say that voluntary and support groups of the kind that he mentions have a hugely important role to play in delivering social care. I visited Crossroads in Gloucester with the noble Baroness, Lady Royall, last Thursday and was struck by the extraordinary work that voluntary groups do—and what carers do, of course. If we relied purely on statutory services, the whole health and social care system would collapse tomorrow.

I cannot answer specifically the question raised by the right reverend Prelate, but I would say that voluntary and support groups of the kind that he mentions have a hugely important role to play in delivering social care. I visited Crossroads in Gloucester with the noble Baroness, Lady Royall, last Thursday and was struck by the extraordinary work that voluntary groups do—and what carers do, of course. If we relied purely on statutory services, the whole health and social care system would collapse tomorrow.