The former care minister Sir Norman Lamb is uncharacteristically irritated by the government’s neglect of social care and mental health during the Covid pandemic and the years leading up to it.
“This current crisis simply strengthens the case for confronting it [the social care funding gap]. But the combination of failing to confront it and the state of public finances makes me very worried … then so many more people across our country will be failed by the system,” he warns.
Arguably one of the most approachable, good-natured figures in politics during his 18 years as a Lib Dem MP, Lamb has recently joined a new cross-party group of former health ministers demanding more funding for care workers.
While Lamb welcomes the £500m expected for NHS mental health support in this week’s spending review, he says it must be accompanied by extra funds for social care. “I’m relieved that there is a recognition that money is vitally needed to respond to the psychological fallout from Covid,” he says. “It should be targeted at those communities most affected and the economic damage caused by the pandemic. The extra funding for the NHS is certainly positive but it is critical that this is matched by additional support for social care. I’m worried that nothing has been said about this.”
According to a parliamentary select committee report, social care needs an injection of at least £7bn a year in England alone to address rising levels of need among older and disabled people and to improve pay and skills for care workers.
A health minister in the coalition government, Lamb had some notable achievements, in particular 2014’s landmark Care Act that gave more control to carers and to people using support services. But like all governments before and since, the coalition kicked social care reform into the long grass.
So why didn’t he do more to boost care funding when he was in power? “The big decisions on where the cuts came and what was protected were way above my pay grade and were done even before I went into the Department of Health,” he replies. “But could I have done more to argue for more? We probably all could have done more with the benefit of hindsight … governments of all complexions have all failed to get to grips with this subject.
“We all profess our love for the NHS, that’s what political parties and governments focus on, but it has negative consequences in that social care gets ignored. They don’t feel the same public pressure to invest in social care.” But Lamb says it is shortsighted to ignore “the prevention end” that helps people avoid emergency healthcare.
Since standing down as North Norfolk’s MP last year, Lamb, who helped raised the profile of mental health when he was a minister, has launched a mental health fund in Norfolk and chairs the mental health trust, the South London and Maudsley NHS foundation trust, and the Children’s and Young People’s Mental Health Coalition.
In 2020, the pandemic has taken its toll on the nation’s mental health. The Centre for Mental Health has predicted that up to 10 million people (almost a fifth of the population in England) will need mental health support: 1.5 million of those are expected to be children and young people. In addition, research shows survivors of Covid appear to be at increased risk of developing a psychiatric condition as a result of the disease.
Lamb wants more acknowledgment of Covid’s lasting impact on people’s mental health and is campaigning with consultant clinical psychologist Warren Larkin for the UK government to introduce a resilience taskforce. They have written an open letter to the health and social care minister, Matt Hancock, backed by a group of more than 80 experts, outlining why such a taskforce is vital to protect people’s mental health and social wellbeing.
This is not simply about more funding, but “a public mental health response”, says Lamb.
“So often these situations can be eased through organisations that already exist,” he explains, flagging up the youth information, advice and counselling services (YIACS) model promoted by Youth Access, a network of local groups supporting 11- to 25-year-olds, as the kind of community solution that could have greater impact with government help.
As health minister, Lamb also pushed for more community-based care for learning disabled and autistic people following the Winterbourne View abuse scandal in 2011. It was part of his “transforming care” programme, which aimed by June 2014 to transfer about 3,000 people from long-stay hospitals – into more appropriate community settings nearer to their families. But it was unsuccessful, and today more than 2,000 people remain in such institutions where seclusion and over-medication is rife.
Lamb remembers one father whose complaints about his son’s abuse and over-medication at Winterbourne View were ignored by health and care professionals. “I thought, my God, what have we come to where public services are unable or unwilling to respond to a parent pleading for help when things are going badly wrong? His son’s gone in there to get the right support and they’re abusing him and pumping him with anti-psychotic drugs?”
Lamb admits he underestimated the challenge: “Looking back, there was a naivety that if everyone was committing to signing up to the [transforming care] concordat it would work.”
The young man at Winterbourne View later moved to a flat, and is “happy and enjoying life”, says Lamb. “I get told ‘there are quite a lot of people who are living independent lives who wouldn’t be, had there not been that drive, so don’t beat yourself up about it’ – that provides some reassurance, but the bottom line is that not nearly enough progress has been made.”
A big stumbling block has been cash-strapped councils’ reluctance to pick up the bill for people when they transfer from NHS-funded inpatient care to community-based care. One way to overcome this, Lamb believes, is to reallocate money from the NHS to local government.
“You have to find a way of shifting the money and pooling the budget, which we set out as a proposal,” he explains. But, he admits, “it never really happened”.
Lamb’s interest in care and support began before he took up the brief as Lib Dem health spokesman in 2006. It stems from personal experience. His son Archie struggled with obsessive compulsive disorder as a teenager. Later, in 2015 his older sister Catherine took her own life.
“It absolutely informed my thinking, made me driven and gave me a degree of empathy with families,” he says. He recalls a six-month wait for a talking therapies referral in Norfolk for Archie, so he paid for private care: “Families who have money can get help and others can’t … the brutal truth is we were able to pay for support and that’s where the unfairness of the system kicks in.”
Archie is now a successful music producer and Lamb insists this “ultimately optimistic story” proves the benefit of early support.
On the issue of unfairness, Lamb is concerned that Covid is widening existing inequality: “There’s a sense of a growing divide. People who are financially secure are fine, and particularly young people from disadvantaged backgrounds are the most vulnerable as a result of this [pandemic], and that’s what worries me most.”
He adds: “You can do so much to improve people’s lives and give people the chance of a happy life – and that is ultimately what government should be about.”
Family: Married with two adult sons.
Education: Wymondham College, Norfolk; Leicester University, bachelor of laws; City of London Polytechnic, law finals [to qualify as solicitor].
Career: 2001-2019: Lib Dem MP for North Norfolk; 2017-2019: chair of the science and technology select committee; 2015-2017: Lib Dem health spokesperson; 2012-2015: minister of state for care and support; 2012: parliamentary under-secretary of state for employment relations and postal affairs; 2010-2012: parliamentary private secretary to deputy prime minister Nick Clegg, also assistant government whip; 2001-2010: various Lib Dem party roles including shadow junior Treasury minister, shadow health secretary, chief of staff for party leader Sir Menzies Campbell, parliamentary private secretary to Charles Kennedy; 1986-2001: solicitor, then partner and head of specialist employment unit, Steele and Co law firm; 1989-91: leader of the Lib Dem group, Norwich city council; 1987-91: Lib Dem member of Norwich city council; 1984-86: senior assistant solicitor, Norwich city council; 1980-81: parliamentary assistant for Greville Janner, Labour MP.
Public life: Chair, South London and Maudsley NHS foundation trust; chair, Children’s and Young People’s Mental Health Coalition; founder, Sir Norman Lamb Mental Health and Wellbeing fund; advisory board chair, Kooth (digital mental health provider); fellow, Royal College of Psychiatrists.
Interests: Football, travel, art.