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Adult Social Care
01 December 2021
Lead MP
Gillian Keegan
Debate Type
Ministerial Statement
Tags
NHSSocial CareTaxationEmploymentMental HealthChildren & FamiliesLocal Government
Other Contributors: 28
At a Glance
Gillian Keegan raised concerns about adult social care in the House of Commons. A government minister responded. Other MPs also contributed.
How the Debate Unfolded
MPs spoke in turn to share their views and ask questions. Here's what each person said:
Government Statement
NHSSocial CareTaxationEmploymentMental HealthChildren & FamiliesLocal Government
Government Statement
The Minister, Gillian Keegan, announced the publication of a White Paper titled 'People at the Heart of Care', which outlines a 10-year vision for adult social care in the UK. She highlighted several challenges within the current system, including workforce turnover, uneven access to care based on financial circumstances, and low adoption of technology. The Government's approach is underpinned by three core principles: choice, control and support to live independent lives; outstanding personalised care and support; and fair and accessible care for everyone who needs it.
Specific measures include investing £300 million in housing initiatives, setting up a practical support service for minor repairs, increasing the disabled facilities grant limit, allocating £150 million to drive digital adoption in social care, establishing a new national website to explain changes, introducing a cap on care costs at £86,000 over a lifetime, and implementing reforms to make the means test more generous. The minister also mentioned funding for mental health and well-being support for carers and providing local authorities with funds to innovate around care models.
The statement concludes by emphasising the Government's determination to address social care issues and build a fairer, healthier country.
Liz Kendall
Lab
Leicester West
Question
Ms Kendall raised concerns about the failure of the Government’s plan to address immediate pressures on social care, such as waiting lists and staff shortages. She also criticised the lack of a long-term strategy for workforce transformation and support for unpaid carers.
Minister reply
The Minister acknowledged the challenges but emphasised ongoing initiatives aimed at supporting social care workers through better training, mental health support and career pathways.
Jeremy Hunt
Con
Godalming and Ash
Question
I thank the Minister for her work putting the White Paper together in a very short period. I know that she has put a lot of effort into it, but it is hard to see it as more than three steps forward and two steps back. The step forward, which we should acknowledge, is the introduction of a cap. Whatever the arguments about what counts towards the cap, having a cap will make a big difference to many people, and that is welcome. However, these measures do not really give confidence in two crucial areas. The first is the funding to local authorities for their core responsibilities. The White Paper barely gives them enough to deal with demographic change and national living wage increases, and it is a long way off the £7 billion-a-year increase the Health and Social Care Committee called for by the end of the Parliament. It is also hard to see the NHS and social care systems being fully integrated, as they should be, and an end to the workforce crisis, which sees 40% turnover in many companies. This is a start. The Minister is a very capable new Minister and I personally have great confidence in her, but will she bring forward further measures to deal with those huge problems? Otherwise, we will see hospital wards continuing to be full of people who should be discharged, and older people not getting the care they need because the carers do not exist.
Minister reply
My right hon. Friend is right that this is a start. It is a 10-year vision, and obviously we had a three-year spending review and the spending that we set out was a three-year spending settlement, so of course it is just a start. On the steps to ensure that local authorities move to a fair rate and a fair cost of care, we are exploring a number of options, and we will set out further detail at the local government finance settlement later this year. Local authorities moving towards a fair rate of care is key to building a solid foundation for the future adult social care system, so we will be working closely with them to shape the best possible approach to implementation across different local markets.
Question
The challenges in social care of increasing need and demand are the same across the four nations, but until now the approach has been very different. The Scottish Government have always believed in seeing social care as an investment in allowing everyone to participate in society and live as independent and satisfying lives as possible. I therefore welcome the change in narrative and tone in the statement. The Feeley review, which was carried out last autumn in Scotland, plans a human rights approach to social care, and sets out a path to developing a national care service to ensure high quality standards right across Scotland for its users, and also fair terms, conditions and career development for staff. As has been said, workforce is absolutely central to all services and social care is delivered by people for people. The Scottish Government pay the real living wage—not some pretendy living wage, but the real living wage. Will the Minister commit to raising pay for social care staff in England to £10 an hour, as the Scottish Government have planned from this month? Brexit and the loss of freedom of movement have, unfortunately, exacerbated workforce shortages in both the NHS and care systems, with a shortage of well over 100,000 in care. Will the Minister urge the Home Secretary to widen the eligibility of the health and care worker visa to actually include care workers? It is quite bizarre that it does not include care workers. Scotland is the only nation that provides free personal care, which is now being valued by the UK Government at £86,000 a head. Will the Minister consider, in this redevelopment, providing free personal care to people in England? While the Scottish Government are planning a 25% uplift in social care funding over this Parliament, the national insurance uplift will go largely on tackling the NHS backlog over the next three years. Does she not recognise that the care crisis is right now? The problems in A&E are not caused by people coming to A&E, but by the difficulty of getting patients into beds due to delayed discharges, which are due to the lack of social care provision. Will she state, as has been called for, what funding will go to social care right now to tackle the crisis as we go into this winter?
Minister reply
Many countries across the world are grappling with this issue. We have an ageing demographic and we now live in different ways. We live much longer with more complex needs, and often we are not close to our families as we have increasingly globalised. Many countries are looking to address those challenges, including Scotland. It is important that we build the talent pipeline here. It is important that we not only invest in and train our own people, but that we build sustainability. We cannot always rely on taking workers from many other countries. We have a visa route for senior social care workers and we have reduced salary levels—I think £20,480 is the salary level—so in Scotland that probably fits the minimum hourly rate.
Damian Green
Con
Ashford
Question
I congratulate my hon. Friend on reaching this point, which we all agree is just the first step, but it is long awaited. I welcome the principles she set out, but I hope she can expand in particular on the changes that will allow more people to live in their own homes for longer through technology and home adaptations. That would not just reduce the need for residential care and therefore save money, but cut pressure on the NHS and, above all, improve the quality of life of many, many frail older people. What can we expect to see on that front?
Minister reply
I thank my right hon. Friend for recognising that reaching this point is actually a milestone. It is the first time that any Government have reached this point. Housing is key. We will increase the capacity of local areas to deliver supported housing, and we will adapt more supported housing units to make them suitable for use. In the coming months, we will be working in partnership with local authorities, housing providers and others to design and establish our new investment in housing.
Clive Betts
Lab
Sheffield South East
Question
I welcome the measures to enable people to stay in their own homes. That is exactly what the Housing, Communities and Local Government Committee recommended some years ago in our report into older persons’ housing. Will the Minister confirm that in the statement there was no money to improve the pay and conditions of the workforce, without which we will carry on getting churn; no money to help companies that are now exiting the social care sector; and no money to deal with the crisis in funding that local authorities are facing?
Minister reply
There is money to invest in the sustainability and professionalisation of the workforce. Local authorities have a local government settlement for this three-year period. We are exploring a number of options and will set out further detail at the local government finance settlement later this year.
Gosport
Question
I congratulate my hon. Friend on bringing forward this milestone piece of work. It really is very long awaited. The devil, of course, is in the detail, and I look forward to reading that detail with great interest. I know she recognises that the care cap alone will not solve the adult social care crisis. We need imaginative and bold system reform.
Minister reply
I thank my hon. Friend for all her work in this area. Obviously, I have just come in at the end of the journey and many, many people have been working on this issue for many years. She has my firm commitment that the Government are absolutely committed to fixing social care.
Daisy Cooper
Lib Dem
St Albans
Question
This statement is incredibly thin. It feels as though the Government are trying to fiddle with the light bulbs on the Titanic as it is starting to go down. We have an enormous crisis, where people who need care cannot get it and end up going into ambulances. The statement and the White Paper do not address the fundamental problem of fragmentation and integration.
Minister reply
The hon. Lady mentions a fundamental pillar: the integration of health and social care. That will be subject to another White Paper, which will come early next year and will have more details about integration.
Steve Brine
Con
Winchester
Question
Obviously I will study the White Paper that has been published today, and I welcome the cap that we are introducing. Opposition Front Benchers may have turned up in force today, although they have scuttled off now, but they did not do anything about the issue in 13 years in government.
Minister reply
We will commit a further £573 million per year to the disabled facilities grant between 2022-23 and 2024-25. We are also taking steps to ensure that the disabled facilities grant can benefit more people in need.
Helen Hayes
Lab
Dulwich and West Norwood
Question
It has been two and a half years since the Prime Minister stood on the steps of Downing Street and promised to fix the crisis in social care once and for all with a clear plan we have prepared. I think we can all be forgiven for asking what on earth the Government have been doing during that two and a half years—a time when the social care crisis has got worse.
Minister reply
The hon. Lady seems to be the only person in the whole world who has missed the global pandemic, but it occurred during the same period. We invested £162.5 million, which is on its way—it has probably just landed in most councils’ bank accounts.
Robert Jenrick
Reform
Newark
Question
Does the Minister acknowledge that one of the flaws with the increase in national insurance is that only 15% of the additional revenue will flow through to local authorities to improve the quantity and quality of care? The remainder will go to protecting relatively asset-rich families’ inheritances and to the very important task of tackling backlogs in the NHS.
Minister reply
The levy raises £12 billion a year, more or less. For the three-year period, the majority of that sum will go towards catching up with electives in our NHS. However, we know that we will need an increasing share of that fund as we go beyond the three-year period.
Barbara Keeley
Lab
Worsley and Eccles South
Question
Social care has been in crisis for a decade, requiring reforms to bridge the funding gap, improve pay and conditions for staff, and support unpaid carers. The Minister's announcement is seen as inadequate.
Minister reply
The minister acknowledged the complexity of social care reform but emphasised that it requires a 10-year vision based on demographic changes. She stated that throwing money at the problem is not sustainable; instead, creating solid foundations for a better and sustainable system is needed.
Chris Grayling
Con
Epsom and Ewell
Question
The Minister was asked to provide clear guidelines for care home visits over Christmas given the current challenges.
Minister reply
The minister agreed that visitors should have access, but safety is paramount. She mentioned a named essential carer system and updates to guidelines as the situation evolves.
John McDonnell
Lab
Hayes and Harlington
Question
Unpaid carers are struggling with limited respite services during the pandemic, living on carer’s allowance which is insufficient.
Minister reply
The minister recognised unpaid carers' vital role and urged local authorities to ensure availability of necessary services. She highlighted funding for developing new services and an increase in carer's allowance to £67+ in April 2022.
Andrew Mitchell
Con
Sutton Coldfield
Question
The Minister was thanked for her progress, especially important for areas with a high elderly population. He suggested focusing on enabling older people to stay at home.
Minister reply
The minister agreed that areas like Sutton Coldfield face unique challenges and emphasised the importance of adapting supported housing and technology to help residents remain in their homes.
Jim Shannon
DUP
Strangford
Question
Care home workforce availability is strained, with high staff absences due to close contacts despite triple-jabbing. The MP asked about improving recruitment and retention.
Minister reply
The minister acknowledged the pressures on the workforce caused by managing covid. She mentioned making vaccination a condition of deployment and investing £162.5 million for short-term assistance.
Andrew Murrison
Con
South West Wiltshire
Question
The Minister was congratulated for tackling long-standing issues, but questioned why two White Papers were needed to integrate services properly.
Minister reply
The minister agreed that vulnerable elderly people often languish in hospital beds due to a lack of community care services. She highlighted the Health and Care Bill as addressing these integration challenges.
Liz Twist
Lab
Blaydon and Consett
Question
Improving pay and terms for social care staff is crucial, given their vital role in service delivery.
Minister reply
The minister acknowledged the importance of recognition over just improving pay. She highlighted efforts to professionalise the workforce and improve perception.
Mark Harper
Con
Falmouth and Camborne
Question
Welcomed the extensive engagement in producing the White Paper, suggesting that when the local government settlement is published, it should show funding for multiple years to enable better planning of resources from NHS to social care.
Minister reply
Acknowledged Mark Harper's suggestion about transparency in local government settlements and emphasised the importance of engaging over 250 organisations to develop this White Paper.
Derek Twigg
Lab
Widnes and Halewood
Question
Asked why the Association of Directors of Adult Social Services believed that these measures will not fix the crisis in social care.
Minister reply
Responded that this is a step forward but does not claim to fix the whole crisis overnight. Mentioned the issue is global and noted the recent short-term funding has yet to be distributed.
Question
Asked if the Minister was still considering regional disparities in social care.
Minister reply
Confirmed that regional differences exist, including variations in cost of care and value of the £86,000 cap. Stated a percentage-based asset system would be unworkable.
Question
Asked about the unfairness of the Continuing Healthcare (CHC) system where people face huge bills or selling their homes for care costs.
Minister reply
Acknowledged that this is an issue and explained measures like introducing a £86,000 cap and raising the means test threshold to £100,000 to mitigate it.
Question
Asked if ensuring people can live as independently as possible for as long as possible is a driver behind this White Paper.
Minister reply
Confirmed that the focus includes supporting working-age adults with disabilities or learning difficulties to continue living independently.
Question
Critiqued the lack of substance in the announcement and questioned if it was an asset protection scheme for wealthier individuals.
Minister reply
Defended the plan, stating that previous Labour Governments produced no deliverable solutions. Emphasised support for young carers and a 10-year vision to start changes.
Kevin Hollinrake
Con
Thirsk and Malton
Question
Asked about the German social care system's focus on domiciliary care and personal budgets, inquiring if this would be included.
Minister reply
Acknowledged personal budget usage today but stated they will explore greater use of it after metering towards the cap.
Mohammad Yasin
Lab
Bedford
Question
Inquired about the impact of current and forthcoming hourly rates for care staff, suggesting these are insufficient to retain or recruit staff.
Minister reply
Noted £162.5 million funding has been put in place to help councils retain and grow their workforce.
Philip Hollobone
Con
Kettering
Question
The number of stranded and super-stranded patients at Kettering General Hospital has recently been increasing. Thankfully it is not at the level it was a few years ago, when as many as 200 of the 550 beds were occupied by stranded and super-stranded patients. They are mainly elderly and vulnerable people who, as the Minister will recognise, should not still be in hospital because they have completed their medical treatment. They need to be placed in an appropriate social care setting or at home with appropriate social care support. When can we expect firm proposals from the Government to address this issue? Unless we can get these very vulnerable people into the care they need, not only will it make life very unhappy for them but it will be extremely expensive and will clog up our NHS.
Minister reply
My hon. Friend is absolutely right, and this is something that happens pretty much every year. For the short term, we have around £500 million as part of our winter plan to focus on the discharge process and to make it work as effectively and as efficiently as possible. Of course, a big part of that is making sure social care is in place. In the longer term, the integration White Paper is key to making sure we have much better processes so that people get the care they need, with the right care in the right place.
Robert Buckland
Con
South Swindon
Question
I congratulate my hon. Friend on introducing the White Paper. I see the Secretary of State for Health and Social Care in his place, and I am grateful to him, too, for ensuring the Government published the major part of the White Paper process before the end of the year. We know the integration White Paper is to come, and that will be important. Other hon. and right hon. Members have asked about accountability on funding and ensuring that we have a share of the pot for social care. In particular, I am interested in the excellent initiative of £300 million going to local authorities for supported housing and increased choice. How will we make sure that money is used to enrich the lives of, in particular, adults with disabilities, who currently do not have the choice they deserve?
Minister reply
I thank my right hon. and learned Friend for his question and, indeed, for all his work in this area. I know this is dear to his heart. I look forward to working with him on a solution. The £300 million is specifically to help to solve supported housing and to provide much better supported living and mental health support for young adults with disabilities or learning disabilities. Based on conversations with my right hon. and learned Friend, we have also put something in the White Paper on further help to get these young people into work, as many of them want help and support getting into work, and not enough of them are getting that support today.
Shadow Comment
Liz Kendall
Shadow Comment
Labour’s Liz Kendall acknowledged some positive aspects of the White Paper but criticised its failure to address immediate pressures facing social care during one of the most difficult winters on record. She pointed out that over 400,000 older and disabled people are waiting for council-provided care, with more than 100,000 staff vacancies reported. The lack of a plan to end waiting lists was highlighted as a major concern.
Kendall emphasised the need for a long-term strategy focusing on workforce transformation, improved pay, training and conditions for care workers, and increased family carer support. She criticised the Government’s separate NHS and social care workforce strategies, arguing they should be integrated given their interdependence. Regarding the funding announced for unpaid carers, Kendall called it insufficient.
The Labour response concluded by saying that the White Paper falls short of a long-term vision required to put social care on an equal footing with the NHS. It criticised the proposal as not addressing current issues and potentially exacerbating inequalities in asset protection.
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