Social Care Funding — [Sir Charles Walker in the Chair]

Part of the debate – in Westminster Hall at 2:55 pm on 1 October 2019.

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Photo of Daniel Poulter Daniel Poulter Conservative, Central Suffolk and North Ipswich 2:55, 1 October 2019

It is a pleasure to serve under your chairmanship, Sir Charles.

It is also a pleasure to participate in this debate, albeit briefly, and I pay tribute to Emma Hardy for her very well-founded comments and to Sir Vince Cable for securing this debate. It is indeed good to be talking about something other than Brexit.

This issue is the biggest piece of unfinished business not just of this Government or the coalition Government, but of the Governments of Gordon Brown and Tony Blair, because the concept of social care reform has been discussed in this place and more broadly in the country for many years. The right hon. Gentleman was right to recognise that many care providers face serious structural and numerical challenges in providing adequate numbers of people who want to work in the care sector. He was right to highlight the funding challenges that the care sector faces, which began about 15 years ago but have increased over the last few years. He was also right to highlight the fact that there is often a vocalised mantra of political consensus in this area but that when it comes to legislation or any sensible proposal being made there is a failure in practice to deliver that political consensus, so as to deliver reform to the people on the ground who actually need care.

The care sector faces short-term funding pressures. I know that the Government will want to address some of those challenges by putting extra money into the system and supporting local authorities in providing better care, because we know that we have put local authorities into a position whereby they, and indeed the care sector, have faced very straitened financial circumstances for many years.

At the same time as talking about extra funding, however, we should talk about what sort of care system we want to see, because far too often the debate boils down to the funding discussion, when the reality is that we should also talk about how we want to deliver care. We should understand and put right the commissioning of care services. It seems extraordinary to me, given that we often talk about the benefits for people with long-term medical conditions of better integrated health and social care, that we have two different commissioning systems: local authorities commission local care; and the NHS commissions the health service. In their interventions today, many contributors have made the point that we are dealing with the same people with the same problems, but they are being dealt with in a fractured manner by two systems.

We must fundamentally deal with that issue of how we commission services, and the only way we will deliver improved care—care that is centred on the whole person—and dispense with fractured care is by having one point of commissioning. Unless we have that, we will end up putting more money into a system that, yes, needs to continue doing what it is doing at the moment, but it will still be a system that fundamentally is not the right one to deliver the right care for the people whom we care about.

At the moment, social care often duplicates the functions of the NHS, even when we are dealing with the same person. It is very difficult for families to understand why, on the one side, someone has undergone a life-changing medical event such as a stroke or severe dementia, yet some of their care is delivered not by the NHS but by social care. So, yes, let us put more money into the system, but let us also consider how we can have a better commissioning system and unified commissioning for the benefit of patients.