My Lords, I am delighted to speak in this debate celebrating the 70th anniversary of the National Health Service. I join all noble Lords in congratulating the noble Lord, Lord Darzi, on opening the debate. The NHS is proudly the envy of the world but, with the increase in population and the discovery of new illnesses and diseases over time, we need a fresh way of looking at how it will function in the next 70 years. In saying this, I would like to speak about a part of the health service that is often seen as a separate arm but really should be an integrated and well-bedded key component of the delivery of care that the NHS must provide.
I declare an interest as a provider of adult social care, through a business I started 18 years ago. Since that time, we have seen huge changes both to the National Health Service and to social care. In my opinion, we should see them as two parts of the same ecosystem. Instead, they have had to fight for budgets and space within the political debate.
There seems to be a huge deficit in the understanding of how social care is delivered and how well funded the social care system should be to support the NHS. Every day, we hear politicians saying how much they love the NHS. It does not matter from which part of the political spectrum they come, but this mantra never includes the words that they also love social care. Until we have a radical change in our thinking about social care, understanding that it is part and parcel of the delivery of support in the health systems, the burdens on the health service will continue to increase and the funding of social care will continue to decrease.
An easy example to illustrate this is that, if you suffer from cancer, you would expect the health service to provide medical care and support to you free. Why then should someone who has dementia not have the same support at the point of need, just because they are being cared for in a residential setting? It is unjust to pit one type of illness against another, and it needs to be addressed, if we are to be a community that values justice and respect for everyone. With age come new challenges of illness specific to growing older. Does that mean that because we want people to live in their own homes we ignore their needs?
Social care is not just for the elderly; it also supports those with disabilities across the whole age spectrum, so it is high time to rethink how our health service and social care work are made to work as one. Social care has always been the poor relative of our healthcare systems yet, as we become more and more dependent on treating people at home, there is a large recognition that we are fast running short of adequately trained care workers to support people in their communities. The fact that funding for social care is delivered through local authorities and is never ring-fenced means that often any extra funding from government may be used for other immediate pressures faced by local authorities. That cannot be right.
If adequate resources were put into providing people with access to well-trained and better paid care workers, it would have an immediate and huge positive financial impact on the NHS, in terms of improved exercise, dietary plans and mental well-being. How does the input of social care providers get integrated into Ministers’ wider thinking about policy? I urge the Minister not to call just on the work of clinical commissioning groups. We know that there are huge gaps in social care provision; trying to find people to work in the social care sector is getting ever harder. How does the Minister feel we are going to fill the gaps of doctors, nurses, therapists, cleaners and carers once we leave the EU? The NHS cannot change for the sake of change; the Government must understand that you cannot fix a problem unless you fully understand what all the solutions are.