In 1997 Tony Blair told the Labour Party conference “I don’t want [our children] brought up in a country where the only way pensioners can get long-term care is by selling their home.” And yet speaking to the Health Select Committee in 2010, in Labour’s final months in office, Andy Burnham said, “every member of the Cabinet believed social care to be an area that had not been properly reformed and was one of great unfairness”. In thirteen years of talk, and promises, Labour did nothing to fix our dysfunctional, and profoundly unfair, system of funding social care.
In 2010, the Coalition Agreement included an important commitment to establish a Commission on Funding for Care and Support, which was chaired by Andrew Dilnot and reported in July 2011. We recognized that putting an end to the situation where people had to sell their homes at a time of distress to fund their care was essential to building a fairer society. When I was appointed Care Minister last year, I was determined to ensure that we took action to implement the proposals, and with Nick Clegg’s support we secured agreement that the key proposals of the Dilnot Report would be implemented as part of the Care Bill, the first draft of which had already been prepared by my predecessor Paul Burstow, and which has its second reading in the House of Commons this week.
At the heart of the proposals is a cap on the contribution someone has to make towards their eligible care costs. Up until now, some people (especially those with conditions like dementia) could face crippling care costs over many years, creating further distress and anxiety for them and their family at what is already an impossibly difficult time. Our proposals will cap care costs at the equivalent of £61,000 in 2010-11 prices as compared with the upper limit of £50,000 proposed by Andrew Dilnot. (this amounts to £72,000.00 in 2016.) However, Dilnot has said himself that, “I recognise the public finances are in a pretty tricky state. It doesn’t seem to me that it is so different from what we wanted as to radically transform the basis of the system.”
At the same time, we are increasing the means testing threshold from £23,250.00 to £118,000.00 which will mean that far more people will get some help with their care costs. Additionally, no one will be forced to sell their home to pay their care costs, with a new right to defer payment during their lifetime. Taken collectively, the proposals are expected to directly help 100,000 by the mid 2020s who would receive nothing under the current system. The proposals have been described as a “once in a generation opportunity” to reform social care funding, and as Liberal Democrats we can be incredibly proud of this achievement.
But the Care Bill doesn’t just bring about the biggest change to social care funding for a generation. It is also central to delivering the Liberal Democrats’ “better care promise”. Over the past year, many of us have been shocked by the institutional failings in our health and care system that were shown up by the independent reviews into Winterbourne View and Stafford Hospital, and the Liverpool Care Pathway. We have a duty to ensure that every patient is treated with the dignity and respect that they deserve, and that when serious mistakes are made they will be admitted, investigated, and addressed.
Following on from the recommendations of the Francis Report, Part 2 of the Care Bill establishes new fundamental standards of care, and compulsory minimum training standards for health and care workers. It also appoints three Chief Inspectors of Social Care, Hospitals, and General Practice at the CQC, to ensure that these standards are met, highlighting both good practice and unacceptable practice.
As a constituency MP and Minister, I regularly encounter situations where people, after they or a relative has been let down by our health and care system, experience complete frustration as organisations refuse to admit that mistakes have been made. In our 2010 Manifesto, we made a commitment to force organisations to own up to mistakes, and the Care Bill introduces a new duty of candour on providers of health and care, with criminal sanctions when providers supply false or misleading information. These sanctions will also apply to directors and managers where unacceptable care has been provided.
The Care Bill has come a long way from the first draft published over a year ago, and I look forward to working with colleagues in Parliament, across the political divide, in the coming weeks. I am immensely grateful to Paul Burstow for his work as Care Minister in producing the original draft Bill, and for his support since. Lib Dem colleagues in the Lords have also made important improvements to the Bill. When it comes into law next year, the Care Bill will be the most valuable legacy in health and care reform for a generation, delivering a fairer society for some of our most vulnerable. And it is happening because of Liberal Democrats in government.
* Norman Lamb is MP for North Norfolk and was Liberal Democrat Minister of State at the Department of Health until May 2015