Last week, the House of Lords debated the future essential services run by local authorities. As local government is so important to Liberal Democrats, it’s no surprise that several Lib Dems took part in the debate.
Celia Thomas talked about two critical issues – social care and, first the provision of public toilets and the impact that cuts have on isolation of people with continence problems.
She warned against the idea that we need to provide support for disabled people so that they can work as this can promulgate the idea that there are deserving and undeserving disabled people. Every disabled person, she said, should be able to live a life of dignity and respect:
My Lords, I shall concentrate on the provision of social care but, before that, I want to mention something that I would call an essential service but which turns out to be discretionary. Here I shall lower the tone of the debate so I hope noble Lords will not mind; I am talking about the provision of public conveniences, lavatories, toilets or loos throughout the country. Those that are left are now often maintained by town or parish councils, but for how long? In 2010, there were over 5,000 public toilets; now, there are 4,486. Is it right that fast-food chains, supermarkets and coffee shops have now virtually taken the place of public toilets? What happens when these places are closed, when managers are reluctant to let everyone use their facilities or when there are no accessible toilets? We should not forget the silent number of people trapped in their homes because of continence problems.
I turn now to social care. As the noble Lord, Lord Kerslake, said, we are no nearer to seeing the Government’s Green Paper; as late as October, we were told it would be with us by the end of the year. The funding issue is a fiendishly difficult problem because social care encompasses so much and is so little understood. We need a different term; I agree with the noble Lord, Lord Patten, about language. The word “social”, according to the dictionary, means,
“marked by friendly companionship with others”.
But, in local government terms, it has a much sterner face to cover the state’s obligation to help care for children, including those with mild or severe learning difficulties, as well as disabled and elderly adults. It may have to cover playschemes for disabled children, personal assistants, aids and equipment, care at home and residential care.
Not only are we all living longer, but there is now a better survival rate for people with serious health conditions. I believe that the dictionary definition of the word “social” is one reason why so many people think the service is free for council taxpayers rather than means-tested, or partly means-tested. Anyone who thinks the answer for even quite severely disabled people is NHS continuing care should think again as it is very difficult to get. As for delays in hospital discharges, these are still causing a problem due to care packages having to be negotiated or re-negotiated. Can the Minister say how the Government have evaluated the impact of health and well-being boards in tackling the increasing number of these delays?