My Lords, I thank the noble Lord, Lord Freud, for introducing this debate and giving the House a concise breakdown of the legislation. I also note with interest the remarks of the noble Lord, Lord Hunt of Kings Heath, and I am sure we shall return them in due course.
I will talk briefly about public health and then spend time on parts of the Care Bill, but not in any great detail, because that is for Second Reading next week. The coalition Government’s mid-term review commits to “reducing preventable early death” as a key priority. Nothing would do more to reduce the number of preventable early deaths than dissuading children from drinking or smoking.
Aside from the cost to our economy of policing drunken young people, and later the NHS looking after their liver diseases or offering a diagnosis of cancer to those who are too young to hear it, we owe it to society to do whatever it takes to stop young people killing themselves early with too much alcohol or too much tobacco.
Her Majesty said in her speech:
“Other measures will be laid before you”.
I sincerely hope that as soon as the Government have finished their consultation they heed the advice of the Minister for Public Health and that of the chief executive of Public Health England and bring before Parliament measures to standardises cigarette and tobacco packaging and introduce minimum alcohol pricing.
Those of us who have sat through debates in the past couple of years know that the legal provisions relating to adult social care in England have been scattered over many Acts during the post-war period. Those of us who have caring responsibilities know what a quagmire the current system is. It lacks cohesion and a common purpose; there is no recognition of the role of carers or provision for them; it is a postcode lottery.
There have been plenty of well argued reports during the past 20 years, but it has to be said that successive Governments have put all this in the too-hard-to-deal-with box. The issue of funding catastrophic care costs was parked and the care of the most vulnerable was ducked for decades. However, a Liberal Democrat Minister of State was intent on rectifying that. I am proud that my honourable friend Paul Burstow, as Care Minister, persuaded his colleagues in the Department of Health to consult on these issues, resulting in the White Paper Caring for our Future. Furthermore, in line with the coalition agreement, the Department of Health asked Andrew Dilnot to chair a commission, with commissioners the noble Lord, Lord Warner, and Dame Jo Williams, to examine the funding of adult social care.
The Dilnot-led commission—we have already heard of it today—developed an elegant model leading to a solution for the affordability of catastrophic care costs. Implementation of the report was made tougher by the emerging reality of the recession. It was welcomed by the sector but it was several months before it gained Cabinet approval. I commend those from all Benches in your Lordships’ House who used all avenues of communication to influence that decision.
Based on the White Paper and the Law Commission report on social care, last summer my honourable friend Paul Burstow published the draft Care Bill. Health Bills seem to come along quite often, but social care Bills are few and far between, so the outcome had to be right. The decision was taken to put it before a joint scrutiny committee. I had the privilege to sit on this along with some of Parliament’s acknowledged experts in the field. We took some considerable time taking evidence from those in the sector, supplemented by a public consultation, and a report was produced with nearly 100 recommendations.
A Bill was published last week to reform the law relating to care and support for adults and the law relating to support for carers. It puts the individual’s well-being at the heart of decision-making and gives carers new legal rights to services. It places duties on councils and the NHS to work together, defines a single, streamlined assessment and eligibility framework, and, for the first time, gives adult safeguarding boards a statutory footing. All the legislation of past decades has been updated and put into a single Bill.
When we visualise a carer, what do we see our mind’s eye? Do we see one in the mirror every morning? Do we think of someone our own age, a neighbour or relative? I expect that very few think of a child, yet a BBC survey in 2010 showed that there are 700,000 young carers in the UK, many of whom care for more than 50 hours a week, and they go to school, too. They care for parents, siblings and sometimes grandparents.
In this legislation, I fear a lacuna. In general, issues surrounding children are dealt with by the Department for Education. It is imperative that children have the same rights as an adult carer or an adult carer caring for a child, so there must be adequate cross-referencing of the Care Bill and the Children and Families Bill to make sure that that is the case. My noble friend Lady Tyler of Enfield is not in her place today, but I am sure that many others will join her in making sure that this is achieved.
It is worth remembering that this Bill is for adult social care. Many assume that it is solely to address the care of those who are old, but we have to remember that the Bill applies equally to adults of working age and those who have care needs as a result of disability, long-term mental health problems or enduring illnesses.
This Bill championed by one Lib Dem Care Minister is being delivered by another. They share a Liberal perspective of fairness, guided by principles for social care set out in a 2010 Lib Dem policy paper: partnership, personalisation, prevention, protection, performance and productivity—I apologise for the alliteration. Some may say, “Bring it on”.