Baroness Pitkeathley (Labour), vice president of Carers UK, requested the debate and referred to a 2011 debate on social care. She said: 'Last year's debate focused on the report of the Dilnot commission, and it is a matter of great regret to me - and to many others, I am sure - that, in spite of general agreement around the House at that time that doing nothing was not an option, still no decision has been taken about these important proposals.'
She explained: 'We must acknowledge that we are not in exactly the same place that we were last year. The Health and Social Care Bill that we were debating then is now an Act, and many promises were made about how it would make integration between health and social care easier.'
She argued: 'We need to start thinking long-term about the real costs of failures in social care and think more broadly about what those failures will mean to the economy as a whole.'
Baroness Gardner of Parkes (Conservative) followed by saying: 'We have all raised expectations to a point where we expect everything to be perfect all the time, but no one has the money for that. This is an extremely complicated issue that we have to be very aware of, and today's debate must help to increase awareness and show all the various aspects of it. There is no simple solution. I wish there was. It is going to take a lot of time and effort and we will still be relying to a very large extent on volunteers, which the noble Baroness, Lady Pitkeathley, knows so much about.'
Baroness Barker (Liberal Democrat) argued: 'The key issues in social care arise because of the successes of the NHS. The NHS was designed for and spectacularly successful at organising acute care for treatable conditions. As a result, the majority of people now live with long-term care conditions, but we still have a health service based on that old model. We need to work out ways in which the NHS and local authorities together can buy packages of health and social care that enable people to go along a health and care pathway.'
Earl Howe (Conservative), Parliamentary Under-Secretary of State for the Department of Health, responded on behalf of the government by saying: 'We have supported social care in this spending review and have made additional funding available. We have provided funding in forms that support integrated and preventive care, extra resources from the NHS and extra resources for housing.'
He added: 'There is variation in how well councils are coping with tighter funding. However, many councils are rising to the challenge; they are prioritising care, increasing efficiency and maintaining outcomes for their users. It is clear that this is where councils should be focusing and where we expect services to be by 2015.'
Other speakers included:
- Baroness Greengross (Crossbench), vice president of the Local Government Association
- Lord Shipley (Liberal Democrat), former vice president of the Local Government Association
- Lord Warner (Labour), former minister of state for NHS reform