HL Deb 03 July 2001 vol 626 cc770-3

3.5 p.m.

Lord Ashley of Stoke

asked Her Majesty's Government:

What action they are taking on the 15 recommendations of the King's Fund inquiry into care and support services for old and disabled people.

Lord Filkin

My Lords, we welcome the publication of the King's Fund report, Future Imperfect, which contributes to the important debate about how to improve social services. We are already working with local councils and other agencies to raise standards across social care. In addition, the Department of Health is funding a national recruitment campaign for social care staff. We have commissioned a national training strategy and are providing funding of £2 million to help to implement it this year.

Lord Ashley of Stoke

My Lords, I thank my noble friend for that comprehensive reply. Is he aware that the increase from 3 to 3.5 per cent is welcome but that it is hopelessly inadequate because we now have new evidence about the reality? The report spells out very clearly the fact that the system of care and support for old and disabled people is in what it calls a "developing crisis". That means that many thousands, or perhaps millions, of vulnerable people are suffering, and many more will suffer unless the crisis is dealt with.

The report suggests an increase not of 3 or 3.5 per cent but of 30 per cent. It argues its case very cogently and in great documentary detail. Is it not the case that the Government have a choice: they can either rubbish the report and explain why they do so, or they can accept it and act accordingly.

Lord Filkin

My Lords, we do not want to rubbish the report because we consider that it contains many sound and important points, not least the affirmation of the importance of properly restructured and funded social care services for many people in Britain. Since 1997, in real terms government have increased funding in social care services by 15 per cent, not the 3 per cent referred to. Funding will increase again in real terms for each of the next two years by 3.5 per cent. When all that investment is in place, it will amount to some £1 billion extra per annum for care services.

Money alone is necessary but not sufficient. Therefore, in addition, the Department of Health has established a major programme of service modification to try to improve the way in which that funding is best used to deliver the outcomes that the public want.

Lord Rix

My Lords, does the Minister agree that person-centred services for people with learning disabilities will be possible only if they are actively supported by staff who have been well trained under the new learning disability active framework, along the lines emphasised in the King's Fund inquiry?

Lord Filkin

My Lords, I am happy to agree with the noble Lord's point about the crucial place that training plays in the improvement of social care services. More than 1 million individuals, together, of course, with the carers, provide unpaid support to those in need. Therefore, the department understands that the development of a comprehensive improvement in training and support for staff is critical. A better induction programme is being introduced; the development of care NVQs is taking place; £2 million is being put in place this year to implement a training strategy; and, as noble Lords will be aware, some £47 million is already made available each year through social services grant to support training. Over and above that, the progressive registration of all social care staff will take place to try to ensure that not only does the training take place but that it has the effect and impact that we hope for.

Baroness Northover

My Lords, does the Minister agree that this is a devastating report and that the King's Fund does not lightly speak of impending catastrophe? Does he also accept that this sector is dangerously under-funded? It cannot be right that two-thirds of paid carers have inadequate or no qualifications relating to their work. If the new care trusts, which we discussed before the general election, are to work, is it not vital that they are adequately funded with parity between the health sector and the social services side, so that the elderly and disabled do not lose out yet again?

Lord Filkin

My Lords, I thank the noble Baroness for that question. I re-emphasise that the report is not a devastating indictment of where we are; it is a statement of where we want to be and it stresses the importance of getting there. In many respects, the report's recommendations mirror what the Government are already putting into practice. It acknowledges that nobody knows for certain the exact level of financial resources that is needed in this sector. The level of funding that the Government have already contributed has to be put to good use and an eye has to be kept on the possibility that further gaps may open in future.

I absolutely agree with the noble Baroness's second point, which was about qualifications. The workforce has often been undervalued, under-trained and under-supported, although it provides some of the most important social care functions in society. It should receive the priority and attention that it needs. The situation has been neglected for too long. The Government stand four-square with the noble Baroness on that matter.

With regard to health and social services, the Government strongly concur that it is crucial that the two arms of government continue to focus their efforts so that the public do not suffer from the difficulties that are associated with making separate agencies work. I am certain that the Government will continue to emphasise that in the coming months and years.

Lord Morris of Manchester

My Lords, I warmly endorse the well-merited welcome for the appointment of my noble friend to the Front Bench. Can he say any more today on direct payments, especially for older and severely disabled people; or about expanding the training of the workforce for providing social care for them?

Lord Filkin

My Lords, I thank my noble friend for that question. I shall be brief. The Government strongly support the extension of direct payments. In many cases people themselves know what is best for them. The principle of trying to put more power in the hands of the public in relation to the support that they need seems to be right. That is why the provisions were extended also to cover Children's Act services; that is also why, from 2002, local authorities will be obliged to offer greater freedom to people who wish to take direct payments. The evidence so far is that direct payments are a success story. They are popular with the public and research evidence seems to demonstrate that they are highly effective.