PARLIAMENTARY DEBATE
Social Care Reform - 23 June 2021 (Commons/Commons Chamber)

Before I call Liz Kendall to ask the urgent question, I want to wish Helen a very happy birthday. It is a delight to be able to do so.

(Urgent Question): To ask the Secretary of State to make a statement on the Government’s plans for social care reform.

I thank the hon. Lady for her question, and for giving me the opportunity to talk about social care reform. I start by paying tribute to carers, paid and unpaid, for all they do in looking after people in their homes and in care homes every single day with kindness and compassion. To any who may happen to be watching or listening today, I say “Thank you for what you do.”

Over the past year in government, we have rightly focused on supporting social care through the pandemic. This has included an extra £1.8 billion of funding, sending more than 2 billion items of free personal protective equipment to care providers, distributing more than 120 million covid tests to social care and vaccinating hundreds of thousands of care home residents and most of the care workforce.

While the pandemic has posed unprecedented challenges to social care, it has also strengthened the argument for reform, and we now have the opportunity to build back better in social care. We have a once-in-a-generation opportunity to build a care system for the future, and I am hugely ambitious. I want a care system in which we can be confident, for our grans and grandads, mums and dads, brothers and sisters, children and grandchildren and, indeed, ourselves. I want people to be able to get the care that they need when they need it, and to have choices—to live life to the full in the way they want, living independently and part of a community for as long as possible, without facing an astronomical bill.

I want to join up health and care around people, so that it works as one system dedicated to meeting the needs of individuals, and giving them the personal care they want and need to live their lives to the full. I want the care workforce to be properly recognised and valued for what they do—for their skills, their compassion and their commitment. I want them to have more training, more opportunities and more prospects for career progression. I am committed to supporting unpaid carers not only in the care they provide, but with their own health and well-being, so that they can live their own lives as well as caring for others.

We are already taking steps on the road to reform. The health and care Bill will introduce Care Quality Commission oversight of local authorities’ provision of social care. It will also help to join up health and social care by putting integrated care systems on a statutory footing. We are working on our long-term plan for social care, and we will bring forward our proposals for social care reform later this year.

It has been 100 weeks since the Prime Minister promised to

“fix the crisis in social care”

with a plan he had already prepared, to give people the dignity and security they deserve. Since then, almost 42,000 care home residents have died from covid-19. Two million people have applied for support but have had their requests refused, and tens of thousands have had to sell their homes to pay for care. Families have hit breaking point, and staff have been appallingly let down. Even after all the horrors of the pandemic, nine out of 10 councils say that they face care budget cuts this year.

This week, we learned that Ministers cannot even be bothered to have a meeting to finally come up with the goods. That is not delivering dignity; it is abdicating responsibility, so can I try again with the Minister? When precisely will we see the Government’s plan? A vague commitment to some time later this year will not convince anyone, after all the delays and broken promises. Will the plan include a cap on care costs, so people’s life savings are not wiped out? That has been repeatedly promised and was legislated for seven years ago, but it has still not been delivered. Will there be proper proposals for people with disabilities, who make up a third of the users and half the budget for social care, but have been entirely absent from the debate? Where is the decent workforce plan to ensure that frontline carers get the pay and conditions they deserve, and that we end endemic staff shortages? Will unpaid family carers finally get the help they need, so that their own health does not suffer and they are not forced to choose between holding down a job and caring for the people they love?

In the century of ageing, we cannot build back a better future for Britain without a decent system for social care. This is as much a part of our infrastructure as the roads and railways are. Our country urgently needs a plan. The time for excuses is over. When will the Government deliver?

Of course we have focused on supporting social care through the pandemic over the past 18 months; that absolutely had to be the right thing to do when facing an unprecedented challenge. During the pandemic we not only supported social care, including, as I said, over £1.8 billion of extra funding direct to the care sector, but supported local authorities with over £6 billion of extra funding. But yes, we are determined to bring forward proposals for social care reform. We have been absolutely clear that we shall do that. The hon. Lady asked about particular meetings. Actually, the Health Secretary and the Prime Minister talk about social care reform all the time. In fact, I spoke to the Prime Minister only last week about social care reform. These are complex matters. The hon. Lady will know that nearly 25 years ago, Labour Prime Minister Tony Blair said that we needed reform of social care, but during the 13 years of Labour government, was there a plan for social care reform? No, there was not. We are the Government who are going to bring forward social care reforms. I would welcome her support for that. We are a Government who deliver. We have delivered Brexit, we are delivering vaccinations at a phenomenal pace, and we will deliver social care reform.

I know that the Minister is working hard behind the scenes to get a resolution to these issues, and I thank her for her efforts to do that. Does she agree that the NHS will fail in its objective to deal with the covid backlog if the social care system continues to export its most vulnerable patients to our hospitals, filling up hospital beds that cannot then be used to deal with the enormous backlog of cancer and other operations that we have? Does she also agree that the founding principle of the NHS—that no matter who you are, rich, poor, young or old, you should be able to access the care you need—is fundamentally undermined by the way we treat people with dementia, whereby people who are wealthy are able to pay expensive care home fees but people of limited means find that they are cleaned out of absolutely everything when a loved one gets dementia?

I thank my right hon. Friend for his support for our determination to reform social care. He makes an important point that we have to look at the NHS and social care together as the two parts of the system affect each other. That is one important reason why the health and care Bill needs to improve the join-up between health and social care. On his point about dementia, it is true that some people who suffer from dementia need care for very many years and this is extremely costly. That is one of the things we want to address as part of our social care reforms.

It is noticeable that while the UK Tory Government failed to mention social care reform in last month’s Queen’s Speech and have yet to deliver the long-awaited social care Bill, by contrast, under limited devolution, the SNP Government are establishing a national care service backed by a 25% increase in social care investment. What lessons has the Minister learned from this Scottish example? What recent consideration have the UK Government given to exempting the Scottish Government’s £500 thank-you payment for health and social care staff from tax and benefit deductions? As the settled status deadline fast approaches, the SNP is calling on the UK Government to automatically grant post-Brexit residence status to prevent a cliff edge for EU nationals and a black hole in Scotland’s care sector. Will the Minister urgently discuss this with Cabinet colleagues?

The Queen’s Speech reiterated our commitment to reform of social care, and that commitment has been reiterated many times by the Prime Minister and the Health Secretary. On the hon. Gentleman’s question about looking at other systems, of course we look and learn. We look at what works across and within England and around the UK, and in fact around the world. This is a complex thing to achieve and we are determined that we will bring forward our ambitious plans for social care reform later this year.

My interests are in the register.

I was delighted to hear the Minister confirm that the reform announcements will come later this year, and obviously a centrepiece of that will be the key question of how we get significantly more money into the social care system. But can she guarantee that the proposals will cover issues such as workforce planning, the need for changes in the housing stock to enable people to live in their own homes for much longer than they can at the moment, and the use of technology to ease their daily burden, all of which are essential for a sustainable and civilised social care system?

My right hon. Friend makes an important point about the breadth of the reform that is needed. I can confirm that we are looking at how we can support the workforce further, including by raising skills and improving training opportunities and career progression, and how technology can be used to support better care and more independence as well as providing more time for the workforce to do personal care rather than administration. On housing, most people want to live behind their own front door for as long as possible, surrounded by their own things and in their own communities, so that is also absolutely part of our reform.

New analysis for the Care and Support Alliance found that since the Prime Minister stood on the steps of Downing Street some two years ago and promised to

“fix…social care once and for all”,

2 million requests for formal care and support from adults over 18 have been turned down by their local council; that is the equivalent of 3,000 requests being turned down every day, putting immense pressure on unpaid carers as well as the NHS. This shows the human cost of dither and delay, so will Ministers stop their internal spats and off-the-record briefings and commence cross-party talks immediately with the sector so that we can fix this issue?

We have of course had to focus on the pandemic over the last 18 months, but we are already working on reform. We are already consulting widely with the sector; I and the Department have together met and spoken to more than 70 different organisations and representatives of the care sector, from care providers to local authorities, and including care users and carers themselves. We will be working with this broad range of people, including parliamentarians; we need to build a consensus not only across Parliament but in society as a whole for our social care reforms.

Over the past couple of years I have spoken to many families across the Bolsover constituency who are affected by social care and all the challenges that we know the sector and those who work in it face. Does my hon. Friend agree that this should not be a matter of party political point scoring and that what we need is a sustainable solution? Will she commit to delivering that solution this year so that we can have a social care sector that is fit for purpose for many years to come?

My hon. Friend is clearly having conversations in his constituency, and he makes an important point about the scale and number of people who have involvement in the care system. There are over 1.4 million people who receive care, over 1.6 million people in the care workforce, and over 5 million unpaid or family carers. The scale is huge and is growing as more people need care. My hon. Friend is absolutely right that this is not a party political issue; we need to come together and build a consensus across Parliament, but also across society as a whole—and, yes, we will bring forward proposals for reform later this year.

I thank the Minister for her statement today on social care reform. An issue close to my heart is support for carers in the form of respite; in particular we have generations of young carers who need a break after the isolation of the pandemic. Will the Minister commit to making funding available specifically to provide respite overnights for carers who carry out their activities 24/7 and need support more than ever right now?

The hon. Gentleman makes a really important point about respite for carers. Being a carer is hard and back-up support and respite services help make it more possible, but frustratingly, during the pandemic many of those services have not been able to function as normal. I am currently working with Ministry of Housing, Communities and Local Government Ministers to help local authorities across England ensure that day services and respite care are fully restarted as that is very important, and I would like to see that across the whole of the UK.

I appreciate this is very difficult for the Minister, because until we actually know what the Government’s proposals are, she is answering questions based on assumptions and guesswork, but she will know that the main concerns of families are twofold: that they get adequate care; and that they will not have to sell their family home to provide that care. What assurance can she give that the Government will take into account the fact that people want to hold on to their family home? On the assumption that the value of assets will play some part in whatever formula we come up with, what account will be taken of the vast difference in prices of property in London compared with, for example, Cleethorpes?

I hope my hon. Friend will forgive me if I am not drawn on the assumption point that he made in the second part of his question, but what I can say to him is that the Prime Minister has been clear that he wants a social care system where no one needing care should be forced to sell their home to pay for it.

On Friday I met my constituent Phil, whose mother, given the state of her dementia, has gone to into a care home. The day before I met my constituent Denise, who is trying to keep her mum, who has Alzheimer’s, in her own home. I think they are pretty typical of most of our constituents, because in addition to the cost issue, they are dealing with the complexity of a system they do not have experience of, as well as trying to get the right quality of care. Can my hon. Friend confirm that the issues of cost, complexity and quality of care will all be dealt with in the reform proposals?

Yes, I absolutely can. We know that cost is a real problem, but there is also a real variation in quality of care. In fact, we are already taking steps on that. That is one reason why the health and social care Bill introduces an assurance or oversight system of the provision of care commissioned by local authorities. Yes, the breadth of the issues that my hon. Friend refers to is being considered in our reform proposals.

The 2018 Equality and Human Rights Commission report, “Housing and disabled people: Britain’s hidden crisis”, found that disabled people in the UK were not getting the support they needed to live independently. Three years on, we still have not seen any sign of the national strategy for disabled people which was promised this spring. Does the Minister agree that that is long overdue, and can she tell the House what her Government are currently doing to support people to go into independent living?

One thing I am very aware of is that often the debate about social care reform is a lot about care for older people, but that we should also make sure we are thinking at least as much about care for those of working age with disabilities. I and the Government certainly do think about that. We are working on the national disabled strategy, which I have contributed to. It will be coming forward shortly.

The Fed at Heathlands Village in my constituency is an amazing example of what care can and ultimately should look like, so I want to start by extending an invitation to the Minister to walk around The Fed with me to see what services really should look like. What can we do to ensure that The Fed is not just a torchbearer, but the norm?

I thank my hon. Friend for his invitation. I do my utmost to get out and about—at the moment, mainly virtually—but I am looking forward to being able to go on more visits in the weeks and months ahead. Absolutely, what I want to see is a high standard of care available for everybody across the whole country.

It is nearly two years since the Prime Minister promised to fix social care. In the intervening period, we have had the false promise that there was a ring of protection around social care homes. The Government’s treatment of people in care homes, their families and the workers in that field of public service is appalling. This is a highly politically charged issue. We tried to fix it when we were in government and were attacked by the Opposition. The Government have had a similar experience. The only way forward on this is for the Government to have cross-party talks on how we find a solution to this problem. Will she commit to doing that?

I would just remind the hon. Gentleman of the unprecedented level of support we have given to the social care sector during the pandemic, as I mentioned a moment ago. I know it has been extremely hard, but that is why we provided over £1.8 billion-worth of funding, free personal protective equipment, access to testing, and, of course, priority in the vaccination roll-out. On his point about needing to build a consensus around social care reform, I am already talking to parliamentarians across parties. In fact, just a couple of weeks ago I had a really helpful session with the all-party parliamentary group on adult social care. I look forward to continuing to work with colleagues across the House.

Will the Minister ensure that quality of care for the person needing it is central to the review? Can we learn lessons over the safe discharge of people from hospital into care settings? Will the NHS ensure that in future GP and nursing care, where needed, is available to support those patients on discharge?

One thing I will say is that during the pandemic GPs and primary care in general have really stepped up to support those in care homes in particular, with every care home having a point of contact in primary care to ensure the support from GPs that those residents require. Yes, quality is at the centre of our proposals for social care reform.

We all know that commissioning in social care is broken. The price paid for care is too low, the wages paid to carers are too small and there is a lack of training and professional development for carers. I would like the Minister to address the issue of home care being commissioned by the minute—it is the only publicly funded service commissioned or measured by time. Will the social care plans address that? She could do worse than look at the GMB’s ethical care commissioning charter to see a way forward.

Some really interesting and important work has been done on commissioning, looking at the outcomes of care rather than being so focused on inputs, which sometimes leads to the situation described by the hon. Member. One of the opportunities of the oversight system that we propose through the health and care Bill is that it will shine a light on the different ways in which local authorities commission care and give more visibility to what works. Those ways of commissioning that do not lead to such good outcomes can therefore learn from others. We look forward to seeing an improvement in how care is commissioned and, therefore, the care that people receive.

Fixing our social care system is the biggest long-term challenge facing the country. However, for all the scale and complexity of the issue, fundamentally it comes down to money. We must find a way to fund our social care system fairly and sustainably. Will the Minister assure the House that she will work on a cross-party basis to bring forward reforms as soon as possible so that we can prevent the appalling situation in which people are forced to sell their home to pay for care?

I can absolutely assure my hon. Friend on that point. One of the things we are committed to addressing is the situation where people may have worked all their lives to purchase and own a home and pay off a mortgage but then find themselves faced with a care bill of a size that uses up the value of their home when, perfectly reasonably, they want to be able to pass something on to their family.

When I was a care worker, I was lucky enough to work alongside care workers from across the world. We know the sacrifices that all care workers have made during the pandemic and how care home residents were put at risk by the Government’s covid response. There has now been over a decade of empty promises. When will there be a plan for social care that offers more for these heroes than just a badge, some bin bags for PPE and a failure of an NHS boss in waiting who does not value the efforts of overseas healthcare workers?

I absolutely respect the experience that the hon. Member brings to this House, but I do not agree with quite a bit of what she said. We have done our utmost to support the more than 1.4 million members of the social care workforce during the pandemic, and our thinking about the care workforce puts them front and centre of the social care reforms that we are developing. That, of course, is because the quality of care is so much dependent on that fantastic workforce. I am determined that they continue to be front and centre of our work on reform. As I said, we will bring forward proposals for reform later this year.

A world-class healthcare system cannot exist without effective and sustainable social care. The health and care Bill is an important step, but will my hon. Friend ensure that the social care reforms go further in integrating health and social care so that everybody who needs care can get the tailored support that they need?

My hon. Friend is absolutely right. The proposals in the health and care Bill are just a step on the road to reform, but they are an important step. That step includes the joining up of health and social care in integrated care systems and putting those on a statutory footing, and the oversight arrangements for social care provided and commissioned by local authorities. We will be building on those plans in our long-term plan for social care reform.

I am sure the Minister will agree that the two conditions that people most fear getting at some point in their lives are probably cancer and dementia. Yet, if someone gets cancer, the NHS will take care of them and the taxpayer will fund their treatment; if they get dementia, broadly speaking that is not the case. As has been said already, surely the only way through this is a significant injection of money. That means being honest with the British people that, collectively, we will have to pay for it. Does she agree that we would be right to say to the British people that they should pay an extra penny on income tax for social care, so that people do not have to lose their home and their dignity if they lose their health?

I would not want to upset the Chancellor by talking about tax policy at the Dispatch Box, but, as I have said to colleagues—and, in fact, as the Prime Minister has said—one of the things that we are committed to as part of our social care reforms is ensuring that nobody should have to sell their home to pay for their care.

People across our country will have breathed a huge sigh of relief when the Prime Minister stood on the steps of Downing Street and exclaimed that he had a “clear” and “prepared” plan to solve the social care crisis, but almost two years have passed and there is still no plan in sight. Indeed, the Minister has said today that the Government are still working on a plan. What is the hold-up? Who is obstructing the Prime Minister—or was he simply misleading the nation as usual?

The hon. Member asks about the hold-up. As I have said quite clearly, we have had a pandemic, which has been an unprecedented challenge for our country, our Government and our social care system. In fact, all those working on social care in the Department have been focused on our pandemic response for most of the past 18 months— perfectly rightly, I think the House would say. Thankfully, as we emerge from the pandemic—thanks to the fantastic vaccination efforts across the country, meaning that a huge number of those in care homes and care workers have been vaccinated against covid—we are now able to focus our attention on social care reform. That is why we will be able to bring forward our proposals for reform later this year.

Despite repeated promises by successive Governments, our social care system has not received the attention it deserves, and my constituents want to see that attention. Will my hon. Friend confirm that the Government will honour the promise that we made to the British people and deliver the long-term solution that the sector needs?

My hon. Friend is absolutely right; reform has been talked about by many Governments. One of the challenges is that people say, “Social care is broken and we must fix it”, but different people mean different things. Some are particularly concerned about what are called catastrophic costs, including the problem of people selling their home to pay for their care. Others are much more concerned about care—and rightly so—for working-age adults and the increasing costs for those of working age with disabilities. For other people, it is about questions of housing or technology. We are hugely ambitious about our social care reforms and want to bring this all together into a long-term plan for social care.

Instead of bringing forward plans to fix the social care crisis as the Prime Minister has promised, the Government intend to put in place a legal framework for a discharge to assess model, whereby NHS continuing healthcare and NHS-funded nursing care assessments can take place after an individual has been discharged from acute care, instead of before. The Government have told me that an independent evaluation of the implementation of the hospital discharge policy is currently under way, and that it is due to report this autumn. Will the Minister tell us why the Government are pressing ahead with this policy, despite not yet fully understanding the impact that it is having on patients and unpaid carers?

I would not see this as either/or. We have said that we will bring forward proposals for social care reform. To the hon. Lady’s point about discharge, it is well known at that, particularly for an older person, spending a long time in hospital can be harmful to their prospects of recovering and living a good quality of life. I have seen that in my own family as well as knowing that it is a long-standing challenge across our health and social care system. It is absolutely right that we should take steps to support people to be discharged from hospital to home when they are clinically ready.

I very much welcome the plans for integrating the NHS, local authorities and social care providers. Can the Minister assure us that the plans will not lead to any more centralisation or bureaucracy in the system, and that, on the contrary, we will see more local flexibility, more choice and control for patients and, crucially, more support for the families and community groups that are so important in the delivery of social care?

Yes, absolutely. One of the strengths of our social care system is its huge diversity, with the different forms of social care and the different ways it works in different communities. In fact, that has been one of the challenges for the Government during the pandemic, because we are reaching out to over 25,000 different organisations, but actually that diversity is a positive thing, so I will continue to support it in the years ahead.

Today marks 700 days to the day since, on the steps of Downing Street, the Prime Minister told the nation that

“we will fix the crisis in social care once and for all with a clear plan we have prepared”.

For clarity, this was before the global pandemic hit. I know, and the Minister knows, that the market has failed, and that that failure has been exacerbated by the pandemic, not created by it. Is it not time for the Minister to face the inconvenient truth that the only way to fund social care is through progressive taxation, with a diverse range of in-house services guaranteeing workforce standards and service user choice, under the umbrella of local government?

The hon. Lady is right to say that when we went into the pandemic, the social care system already needed reform. That was well recognised, and that was why the Prime Minister committed back in 2019 that we would bring forward social care reforms—[Interruption.] I am not going to talk about tax policy here, but I can reassure her that we are working on our social care reforms and will bring forward the plan later this year.

The report of the joint Health and Social Care and Housing, Communities and Local Government Committees, of which I was a part, left open the possibility of insurance-type solutions for adult care funding, as successfully operated in many countries comparable to our own. That would have advantages of finance, focus and structure. Given how hugely ambitious my hon. Friend has said she is on this, can she confirm that both insurance-based solutions and an enhanced role for local government remain options for her and the other key decision makers when determining the way forward for adult care?

I thank my hon. Friend for his involvement on the Health and Social Care Committee, whose reports I find really helpful; they provide great insight and contribute to the conversation. He alludes to the different models for paying for social care, and clearly there are many different approaches. We have been considering them, but I am not able to go into detail here and now. I will have to ask him to wait until we publish our proposals for social care reform.

This pandemic has starkly demonstrated the unequal footing of social care alongside the NHS in this country. The Prime Minister’s announcement back in 2019 that he had a social care plan ready to go has been clearly shown to be untrue, and according to Age UK, 1.5 million older people are going without the care they need. People living in areas with a low council tax base, such as Newcastle, have seen their local council tax precepts rise because the Government have shifted the burden of paying for social care on to those who can least afford it. I agree with the shadow Minister, my hon. Friend the Member for Leicester West (Liz Kendall), that the time for excuses is over, so what is the Minister doing to ensure that the Prime Minister and the Health Secretary stop making empty promises so that we can start building much-needed cross-party consensus on this issue without any further delay?

We are working on our proposals for social care reform, and we are working across the sector. As I have said, I am already talking to and meeting those across the sector—care providers, representatives and, in fact, users of the care and carers themselves. This is complex. There are reasons why there have been discussions about this for many years without proposals for reform being brought forward. We are hugely ambitious, and we want to get it right. That is why I make no apologies that we are taking some time, but as we have said, we will be bringing forward our proposals for reform later this year.

Across Sedgefield—from Hurworth to Thornley and Piercebridge to Bishopton—many people are concerned about the cost of social care and how they are going to cope with it. With property prices in my constituency at about 30% of London ones, any use of that property value to pay for care just becomes catastrophic. The average weekly cost of care is substantially more than average earnings, so I understand the concerns they all have. Can I press the Minister again on ensuring that we do not leave them in a situation where they have to sell their house to fund such care?

My hon. Friend is absolutely right. Care is expensive, and about one in seven people end up spending more than £100,000 on their care. Many people do not realise that care may cost them that sort of amount. It can take them by surprise, so people are not ready for that kind of cost. Yes, people who have worked hard and saved all their lives for their home can be devastated by the value of that home going on the cost of their care. That is why we are determined that this will be one thing that we address in our social care reforms.

The 42,000 care home residents who have died of coronavirus during the pandemic are, sadly, just a recent example of how our social care system is failing. The Prime Minister stood on the steps of Downing Street 700 days ago and promised to fix the social care crisis. The bereaved families and everyone whose family depends on our wonderful social care workers deserve answers. Social care staff cannot do this on their own. Those who need the crisis to be fixed need certainty, not the ambiguity of “later this year”. So Minister, no more delays—give us a date. Tell us: when will the Government finally publish their plan and fix the social care crisis?

Let me say to the hon. Member: we have said we will publish proposals for social care reform, and we will; we have said we will set out a long- term plan for social care, and we will; and we have said we will reform social care, and we will.

Residents in Blackpool spend a higher percentage of their income on council tax than those anywhere else in the whole country. Although allowing councils to implement the social care precept has brought in much-needed revenue, it has in some cases placed a disproportionate burden upon ratepayers. While the case for reforming social care is clear, does the Minister agree that we require a national funding model to meet the costs, and that they cannot fall disproportionately on councils in deprived areas?

I thank my hon. Friend, and I recognise the situation right now. That is one reason why we are providing £3.8 billion in grants for adult and children’s social care this financial year, which has gone up from £3.5 billion in the previous financial year. Of course, looking ahead in our reforms, we do have to make sure that the way social care is paid for is fair across the country.

I was a carer for my daughter Maria for almost 27 years, so I know the demands that carers face every single day caring for those they love. Does the Minister really believe that £67 a week carer’s allowance is a fair amount for round-the-clock care, and will this amount be raised under the Prime Minister’s “prepared” plan for social care?

I pay tribute to the hon. Member for the hours, the love and the effort that she has put into caring herself. She knows, from her own experience, the experience of carers across the country and what it takes in time, physical effort and emotional effort.

Carer’s allowance is not intended to be somebody’s income; it is intended to support people with some of the costs of caring. It is primarily led by the Department for Work and Pensions, but I can say that I am committed to ensuring that there is support for unpaid carers and family carers, and, as I said earlier, ensuring that, as well as caring for and looking after others, those individuals should be able to have time for themselves to lead their own lives.

Does my hon. Friend agree that a Dilnot-style proposal would reward and incentivise people who had not saved or used financial planning to pass their assets and savings on to relatives or to trusts? A German-style social care premium would be a much fairer system. We would all pay a small amount to cover those who were hit by the catastrophic costs to which she has referred. When she makes proposals, will she include perhaps two or three, including a social care premium, so that we can have a proper debate on this important issue and try to achieve cross-party consensus?

I do not on this occasion agree with my hon. Friend, but I do very much appreciate his consistency and his commitment to ensuring that we have an informed conversation about the funding options for social care, as well as his well-informed drawing on international examples.

From providers to staff to those cared for, the sector really feels abandoned, and has been abandoned, by the Government during the pandemic. In Warwickshire, we have lost 347 people during the past year or so. We have heard that two years ago the country was promised by the Prime Minister an oven-ready plan. There was nothing. Globally, we are the sixth wealthiest country. Other, less prosperous nations have resolved the issue. Why cannot we, and when will the Government publish their plan?

I remind the hon. Member about the unprecedented support we have given social care during the pandemic: extra funding of £1.8 billion, over 2 billion items of free PPE to providers, a new system of distributing PPE direct to care homes and other care providers across the country, distributing over 120 million covid tests to care providers, and vaccinating hundreds of thousands of care home residents and the care workforce. We have been supporting the social care sector to our utmost during the pandemic, and we will introduce our proposals for reform of social care.

May I reiterate the point made by the hon. Member for Wirral West (Margaret Greenwood) about the importance of hospital discharge and of assessment happening while someone remains in hospital? As one who has experienced this at first hand, I know that in taking care of a loved one it is important that accountability and pathway care structures remain in place. Does my hon. Friend agree that the time for action on adult social care reform is now, that we must be bold and courageous, and that we must put an end to the second-class service many disabled adults and elderly people are receiving right now?

It is really important that discharge is carefully planned and that there is care and support at home for somebody when they are discharged from hospital, but it is also really important that we ensure that people are discharged when they are ready to leave. I saw that with my own grandmother, who ended up spending months in hospital owing to problems with her being discharged. Goodness, I wish that she had been discharged sooner—that would have been so much better for her. It is right that we support people to be discharged when they are ready to go home, and we should press ahead with doing that, although we must also ensure that support is there for people in their home.

If we are truly to see the full integration of health and social care, that will require us also to see the full integration of the funding of health and social care—free at the point of need, contributed by all. When the Minister brings forward her proposals, will she ensure that that is an option we can consider? Will she bring forward those proposals ahead of debating the health and care Bill, so we actually know what we are trying to debate in that piece of legislation before talking about social care?

I cannot at this point go into the details of the proposals that we are working on for social care reform. I have tried to give the House today a sense of the breadth and scale of our ambition. As to the point on timing, the way I see it is that the health and care Bill is a step on the road to reform, including the statutory role of integrated care systems and the development of the assurance system. I do not see them tied together in the timing in the way she sets out. What I can say is that we will be bringing forward our proposals for social care reform later this year.

First, I wish the Minister a happy birthday. Can she reassure the House that the focus will remain steadfast on patient outcomes and happiness as part of the health and care Bill?

I thank my hon. Friend very much for his birthday wishes. I was not particularly planning to spend my birthday in this way, but it is a pleasure to talk about social care reform because I feel strongly about it and am clearly spending a great deal of time working on it. What really matters is making sure that the outcomes and the experience of care are better for people. What really matters is that people get to live their lives to the full, whether they are of working age or older, and get to live as independently as possible, as part of a community and with their own front door for as long as they can. It is the outcomes of care that really matter.

The Minister’s responses today further confirm that social care and the millions who rely on it are simply not a priority for her or this Government. It was recently reported that the Minister leaned on Public Health England to alter its proposed advice to care homes in the pandemic, from ensuring that those discharged from hospital tested negative for covid to not requiring any testing of patients at all. That led to more than 30,000 deaths. Will she take this opportunity to apologise to those who lost loved ones?

Actually what the hon. Member has just read out is completely untrue, completely misleading and does not reflect for a moment what has happened. I am very disappointed to hear her read it out.

Rotherham Council is benefiting from the £120 million that this Government are making available to councils to boost staffing levels, which helps residents across Rother Valley to receive the best quality care. Does my hon. Friend agree that, as we begin to work to build a world-class care system, ensuring care homes have the staff they need is a vital first step?

My hon. Friend is absolutely right. At the heart of care is the workforce. They are the individuals who are providing the care and who make the difference day in, day out for those who need their important care. Absolutely, I want to make sure that we have the workforce across social care. We need to ensure we have the training there and greater career progression opportunities for those who work in social care.

It has been reported that the Prime Minister is in favour of finally implementing the cap on care costs legislated for in 2014. While that would be welcome, it would do nothing to support working age adults with a disability to live independently, nothing for the 1.9 million older people with unmet needs and nothing to improve pay and conditions for care staff. Does the Minister recognise that a cap on care costs alone does not go far enough, and can she confirm that further measures to deal with these other needs will be part of any reforms?

I hope the hon. Lady will forgive me if I am not drawn on specific models of funding or paying for care, but the Government and I recognise that we have on the one hand the challenge of catastrophic costs and the problems some people face of having to sell their home to pay for their care, which many Members have mentioned already today, but also we have the other part of the system, which is those who receive care funded by the state. Many of them are of working age, as well as there being older people. She is right: in our social care reform, we need to look across the breadth of the system.

I thank the Minister for her responses to the questions so far. As part of Warrington’s £22 million town deal, the town is launching an innovative social care academy, in partnership with Warrington & Vale Royal College, to tackle the shortage of trained carers, so that residents in my constituency receive the best quality care. Does she agree that initiatives such as that, which address an identified skills gap, will mean that both care homes and in-home care in Warrington will have tailored and targeted support? Would she like to come to see the academy when it is up and running?

My hon. Friend outlines a fantastic example: that is a really good use of town deal funding by Warrington. The academy—there are examples around the country—does an important thing in raising the profile of the social care workforce and developing their skills, which are so important. I absolutely support this initiative and, as and when the time is right, I would be delighted to visit.

I thank the Minister for responding to the urgent question, and I am suspending the House for two minutes.