My Lords, I declare an interest as the chair of a company, listed in the register, that supplies services to the care and other sectors.

The real cost of care is of the order of £700 to £900 per person per week, yet some local authorities pay as little as £500 a week and the average appears to be around £600, well below the cost of providing the service. This is a truly shameful way for the public sector to treat business suppliers. Half of our 12,000 care homes have fewer than 40 beds, and many are SMEs. Around 3,000 are significantly undercapitalised and lack en suite or wet room provision. All face significant problems over pay and recruitment. Prices for care will need to rise, not fall. I hope I have this figure right, but I say from memory to the noble Lord, Lord Sikka, that only 13% of care homes are owned by the major corporations he focused his remarks on. Many are much smaller businesses and struggle.

Will the Minister assure us that paying suppliers less than the cost of provision will end once new funding comes on stream? There has been much debate about funding and far too little about our failure to meet the significant organisational challenges of ensuring a humane and seamless experience for individuals in the last years of their lives. I expect that many of us in this Chamber have seen through our families just how chaotic, unsatisfactory and distressing this experience can be. I echo the noble Lords, Lord Astor and Lord Bichard: surely “holistic” is the critical word.

I hope the Government will create a framework of governance and regulation to ensure that the principal players—and there are many: hospitals, GPs, local authorities, social workers, district nurses and hospices—work together collaboratively with appropriate processes, common systems and performance measurement to capture and share best practice and to identify under-performance. I suspect this can happen only if the Government set an ambitious expectation and, further, if they create some new independent leadership at local level to foster collaboration and sufficient funding to ensure effective administrative oversight. Will the Government set out a plan for transforming the effectiveness of how care is delivered as well as how it will be funded?