My Lords, it is a pleasure to follow the noble Baroness. Many patients past, present and future have reason to be extremely grateful for her work.
I was listening with half an ear to the opening debate on the gracious Speech in the other place, when I thought I heard the Prime Minister say that the Government were giving confidence to people so that they knew they would be looked after in old age by fixing social care. I did a bit of a double take and thought, “I can’t possibly have heard that right—he can’t have said that”. So the next day, I got the Hansard of the debate and, sure enough, there it was in black and white: the Government are “fixing social care”. Well, you could have fooled me.
Most people in employment, including of course many of those actually providing social care, will have noticed the effects of the health and social care levy on their pay last month—their contribution to the £12 billion that is set to improve health and social care. Most of those of us who worked in the social care field for years were always pretty cynical that any of the £12 billion would reach the front line, as it was always going to be used first to clear NHS waiting lists. Social care is, after all, used to being the tail-end Charlie in these matters.
Given that waiting lists now stand at 6.5 million, the highest figure since records began, and seem to be growing exponentially—perhaps reaching 14 million by 2024—I do not hold out much hope of any of the money reaching social care. Yet why are people waiting so long for a knee replacement? Why are they waiting more than 12 hours for admission via A&E? Why are paramedics stuck in queues for a whole day, as we have heard, instead of answering emergency calls? The answer is so obvious that it beggars belief it does not drive the policy.
The answer is that patients are not being discharged at the other end of the process. And why not? Because there is inadequate social care to receive the discharged patients and care for them so that they are not readmitted to hospital, thus starting the whole sorry process all over again. Is it any wonder that the usual suspects who speak in your Lordships’ House on social care are weary, disillusioned and angry?
When it comes to social care, I always remind your Lordships that the main providers of this care are not public services but the millions of unpaid carers who do most of the heavy lifting. With regard to carers the Queen’s Speech was a bitter disappointment, as the noble Baroness, Lady Brinton, reminded us. In 2019, the Conservative Party manifesto committed to introducing a right to one week’s unpaid leave—I repeat: one week, unpaid—to help with caring responsibility. We expected an employment Bill to contain this provision but it was notable by its absence. That the promised employment Bill has been excluded from the Government’s commitments for the next year is a severe blow to unpaid carers and a huge missed opportunity.
The Government had been very keen to stress the introduction of a right to carer’s leave, as support for unpaid carers, as an important part of their delivery of social care reform, hospital discharge and staying in work. It is essential, given the pressures on families as the cost of living crisis deepens. Are the Government now back-tracking on their manifesto promises to carers? This is such a missed opportunity to value carers and to ensure they have the support to continue to juggle work and care.
With severe social care shortages and pressures on the NHS, families simply cannot do it all. Many are at breaking point. This is precisely the time when the Government should be investing in carers and their families, as well as employers, by bringing in the right to one week’s unpaid carers leave, and a right from day one to request flexible working. It is a modest enough request, surely. Five days unpaid leave might just stop you having to use all your holiday leave to take the person you care for to their endless hospital appointments and would be a small step towards helping employed carers stay in employment as long as possible. Why do we want them to do that? To help them stay solvent while they are caring, and to stop them building up poverty for the future by losing access to pensions from employment.
As I have been so disappointed in the gracious Speech, I must pin my hopes on a Private Member’s Bill. Three times over the last few years we have had success for carers through this route, and if any Member of the other place wishes to take up the issue—I hope at least some of them are listening—I earnestly hope that the Government will commit to support it.