Norman Warner: Promising care that can't be delivered is a cruel deception

This is a seriously flawed Bill, that has been inadequately discussed and scrutinised, and it takes us down an unaffordable path.

It has been put together in a great rush in the search for clear blue water to place between Labour and the Conservatives.

In my view, the Bill is not a step towards the wider reform of adult social care that we need and that the Department of Health has been seeking over the past two years or so; it is a political gimmick that the Government is trying to ram through Parliament before an election, without proper scrutiny of what it will result in.

Let me be clear at the outset about my position on free personal care at home. I have a track record in this area, having spent six years as a director of social services in Kent, helping elderly people to stay in their own homes as long as possible. I am proud of that record.

Like many, I would favour free personal care at home for more people if it were affordable. However, at present, it is not.

Even when the public finances were in a better state than now, the Government turned its back on tax-funded free personal care: in 1999, with the report of the Royal Commission on Long-Term Care of the Elderly; again in 2006, when Sir Derek Wanless produced his report; and, most recently, in July 2009, when the Government published its own Green Paper which "ruled out" free care paid by the taxpayer.

Cometh the electoral hour, cometh the man. When the public finances face what the Institute of Fiscal Studies has described as "two Parliaments of pain", the Prime Minister decides to tell the world that we can afford more free personal care at home, a few months after he signed a foreword to a Green Paper with seven other Cabinet Ministers acknowledging that we cannot afford to pay for free personal care. He ruled out that option.

I remain in the position I have been in for some time: that this policy is unaffordable at present.

I am really pleased to see that the Liberal Democrats have acknowledged that it is not affordable at this time.

The Conservatives remain a little inscrutable on the subject – they seem to have a preference for insurance – but they have not made rash promises that may be very difficult to deliver.

I think that promising elderly and vulnerable people and their families something which is not affordable or deliverable any time soon is a rather cruel deception, and I certainly do not want any part of it.

The Government say that this policy will cost 670m a year, with 250m being funded by local authorities. However, in a survey of 132 local authorities by the Association of Directors of Adult Social Services, the Government figures are shown to be significantly understated.

ADASS states that the annual bill will be at least 1bn – some 50 per cent more than the Government's estimate. The final cost could be even higher.

The difference is because the Government have seriously underestimated how much care per week many of the people with critical care needs will require.

It will not be over just six hours a week at an average cost of about 100 a week, it will be many more hours, with costs ranging from 200 to more than 400 a week. It may require a lot more than six hours of care a week to keep a person in their own home.

The Government's cost figures take no account of increased demand year on year, and little account of rising service provider costs.

Although this is not directly comparable to the Scottish situation, the Government's stance also flies absolutely in the face of the evidence from that social experiment.

In Scotland, when home care became free, the costs doubled in four

years between 2003-04 and 2007-08.

The number of people claiming went up by 36 per cent in the same

period.

In the last of those four years, cost increases by providers were about 15 per cent in a single year.

It is also worth noting that in Scotland, a debate has begun on the affordability of free care.

As such, we owe it to a younger, taxpaying, working population not to impose an unaffordable financial burden on them as our population ages.

There is an inter-generational social justice issue around this area of activity, and I urge the Government to get back to their Green Paper, work with the stakeholders and the other parties, and try to secure much more consensus on the funding and service reforms needed for adult social care, rather than wasting more time on this Bill.

Lord Warner was a health minister with responsibility for NHS delivery from 2003-06. This is an edited extract of a speech that he delivered in the House of Lords this week.