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Follow that, my Lords. I will confine my remarks to a sentence in the Queen’s Speech that really jogged my memory. The sentence was that they—the Government—
“will ensure that the social care system provides everyone with the dignity and security they deserve and that no one who needs care has to sell their home to pay for it.”
These very fine words were remarkably similar to the remit given to the three-person Dilnot commission that I served on, and which was set up in 2010 by the coalition Government. Just to remind the House, we reported in 2011 and the coalition Government, after wide public consultation, passed the Care Act 2014, which enabled the very flexible structure—I emphasise “flexible”—of our proposals to be implemented. At that time the Labour shadow Cabinet had sufficient realists in it, particularly the shadow Chancellor, Ed Balls, to be sympathetic to our proposals. So there is on the statute book a solution that had a large measure of cross-party support and which is structured to enable different Governments to be as generous or thrifty to the individual citizen as they please.
Dare I say it to the Prime Minister, but he has an oven-ready solution available to him, if he has the courage and wit to take it off the shelf. But—and there is always a but—the funding situation in adult social care has deteriorated a great deal since the Dilnot commission reported. Work done by the Health Foundation and the Institute for Fiscal Studies shows that restoring service levels for users to 2010-11 levels would require about £8 billion in extra annual investment by 2023-24. I commend that study to the House, for those who want to read it. On top of this, about another £4.5 billion is required before then to deal with increasing service demand pressures from a growing population needing services, and to enable staff pay to be kept in line with NHS pay increases. Whatever long-term solution we come up with, there is a big bill to be paid to stabilise this very creaky system.
This extra money has to start flowing no later than the start of the next financial year, and at a rate much higher than the Government promised in their manifesto. In that document, they promised £1 billion extra for social care in 2020-21, but this is to be shared with the equally hard-pressed children’s social care system. This means that, on present plans, in the next financial year adult social care service levels are likely to be worse than current levels. They certainly will not meet the aspirations of the fine words in the Queen’s Speech. Some of the worst affected areas with inadequate adult social care will be the Conservative Party’s new friends in the north, where the council tax base simply cannot meet the cost of the extra services required, whatever precept the Government choose to permit.
While the Conservative pledge to seek cross-party consensus on a long-term solution is itself praiseworthy, it is worth reminding the Government that they are now the Government for the next five years, with a very large majority in the House of Commons. If they do not come up with a plan quickly, they will deservedly be punished politically. Without such a plan, the staff and providers of publicly funded adult social care will continue their exodus from the sector at an increasingly rapid rate. Just as seriously, the extra money the Government are committing to the NHS will go not on new services but on looking after elderly patients in expensive acute hospitals in those very areas where there are large shortfalls in publicly funded adult social care.
The noble Lord, Lord Forsyth of Drumlean, has done a magnificent demolition job on the shambles of the current adult social care system. It is now time for the Prime Minister to take the oven-ready solution off the shelf.