My Lords, I apologise to the noble Lord, Lord Davies, that in my keenness to follow the noble Lord, Lord Polak, I jumped up too early. I was very glad to hear about the experience of the noble Lord, Lord Polak, with Marie Curie. I must declare that I am a vice-president of Marie Curie; I should also declare my co-chairing of the Bevan Commission, an independent think tank on health and social care in Wales, and my experiences in palliative care.

The noble Baroness, Lady Andrews, is to be commended for a gloriously inspiring report on adult social care which spotlights how much could be achieved by co-production with those in receipt of services and those on whom they depend. The government response has pointed out that additional funding of “up to £2.8 billion” is available in 2023-24 and “up to £4.7 billion” in 2024-25. Can the Minister explain how this funding will be distributed, whether it is ring-fenced for local authorities and how it will be allocated? Palliative care patients often need both social care and specialist palliative care involving the voluntary sector. Will they be able to draw on this funding for their integrated services, which we have already heard about this evening from the noble Lord, Lord Polak?

“We all want to live in the place we call home with the people and things we love, in the communities where we look out for one another, doing what matters to us”.

This definition, as in the report from #SocialCareFuture, explains how social care is not only about services; it is about having a life. For those with progressive disease, this desire to live to the full becomes pressing and urgent. Palliative care works to restore quality of life and a sense of personal worth. This core aim should be the same across the whole of social care: to add life to years, rather than focusing only on years to life. To achieve it, the workforce must be empowered to use their initiative to meet need and with time enough to go at the pace of the person.

Today, I was fortunate enough to meet a group of mothers who have children and young adults with multiple complex conditions. They were stressing the financial problem: they are unpaid carers who are getting burned out, and there is a huge lost opportunity. They realise that their children must be somehow prepared for independence because, as they get older and die, their children are likely to outlive them. However, the current system does not encourage that. It is simply about providing a response to the most pressing needs, rather than taking a long-term preventive approach, particularly when these young people are still able to develop.

The report highlights the ageist and disability-phobic attitudes that impede the ability of those with disability and who are older to function to their maximal ability in society. Such attitudes exist widely, sadly, including in health. Will the Government work with the voluntary sector to change attitudes and ensure that people are free to state what they need? The question “What matters to you?”, followed by sensitive listening, can guide the provision of services that empower, rather than a menu of services just given to people.

As the noble Lord, Lord Davies of Brixton, pointed out, we cannot expect the social care workforce to achieve the level of personalised care needed unless there is parity of esteem for them and without attention to their own welfare. Many have a wealth of valuable experience: the NHS could co-produce education and training with the social care workforce and with those with experience of receiving care. That would break down some barriers and improve integration.

In their response, the Government refer to the grant funding to Think Local Act Personal. Can the Minister tell us how that is being evaluated to ensure that holistic approaches reach the people on the receiving end of social care? Staff with skills need to be paid at an appropriate banding, with their managers also carrying a caseload so that they understand what is going on. Perhaps colleagues in health and management will then recognise the important job being done.

One thing I want to touch on in my closing moments is timely equipment. It can be essential to maintaining independence and decreasing the calls on hands-on care. What do the Government plan to do to decrease waste by recycling equipment such as mobility aids and so on? If equipment is not being recycled, could it then be sent to countries abroad as part of our aid programme? How much is wasted simply because things are not being used again and recycled in a timely manner?