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Social Care

Volume 469: debated on Tuesday 18 December 2007

Through the recent comprehensive spending review settlement, the Government have already committed an additional £2.6 billion by 2010-11 to local authorities that provide social care, with an additional £190 million for social care through Department of Health grants. Last week, we announced £520 million funding for councils to redesign and reshape their systems for social care.

I thank my hon. Friend for his reply and welcome the Secretary of State’s announcement last week of cash for authorities such as Stockport to reform the way carers deliver to older people. Often, the frustration for older people and their carers is negotiating a way through the different funding streams and agencies that provide health, social care, community transport, leisure and benefits. Does my hon. Friend agree that funding streams need to be simplified if older people are to have real choice and control in accessing the services they need?

I agree entirely, and I pay tribute to my hon. Friend’s championing of social care over many years. It is absolutely true that we need to define the amount of money available in every local community in terms of health and well-being, not just the money spent through adult social services departments. We spend large amounts through local authority mainstream services and the area-based grant—we have announced the social care reform grant. We also spend resources through the local NHS and the voluntary sector. We must be much better at co-ordinating those resources to create a single health and well-being system that is easy to access for the people who need the services and for their family members.

But will the Minister not recognise that next year’s local government settlement is enormously worrying for adult social services departments, and is he not concerned by the warnings that we are getting from directors of adult services that next year they will have to restrict services to either life-threatening or emergency conditions and cut back severely on preventive work?

The right hon. Gentleman reinforces the need to recognise that there is a large amount of resource that goes through a variety of channels in local communities to support maximum independence for older people, disabled people and people with mental health problems. We need to ensure that we are making the best use of those resources. However, some very inconsistent decisions are being made at a local level. One local authority is spending £300,000 launching a TV station and increasing charges for domiciliary care to the same level. Other local authorities are able to cut council tax—in London, I am told, by 3 and 4 per cent. Of course there are genuine demographic challenges that we have to face in terms of a new funding system for social care in the long term. That is why the Government are committed to a Green Paper. But in the meantime we could do an awful lot to improve services for older people and disabled people by changing the way in which we provide those services.

I very much welcome the Government’s proposals to give personal budgets to the elderly who need care, so that they can have a real choice about the type and nature of care that they receive. For many people that will be a really liberating experience, but some elderly people will feel a bit daunted by the prospect of having to manage the budgets. Some will have family who can help them, but will the others be offered advice and assistance that is independent of those who provide the care, so that people can make genuinely informed choices that will benefit them?

My hon. Friend makes a really important point. It is a significant advance in public service reform to put maximum power and control in the hands of people who use services and their families, but that requires different levels of support, depending on the needs and circumstances of individuals and their family members. Some people will be able to exercise that control and choice over the use of personal budgets with little additional support. Other individuals will need a high level of support in order to make those choices and exercise that control. However, we should not hesitate to sign up to the notion that, as a starting point, everybody is entitled to self-determination and maximum control and choice. That is entirely consistent with the values of this party and this Government throughout their history.

The Minister will know that a recent study by the Office for National Statistics showed that productivity in social care had been falling by 2.3 per cent. every year. The problem is that putting in more money will not get us very far if productivity is worsening. What is the Minister going to do to turn those figures around?

There is a lot of objective evidence that the quality of provision of social care is going up year on year. The announcement that we made last week—which was unprecedented in the sense that it was cross-Government and involved partnership with local government, co-producing public service reform—is about our ability to transform the social care system significantly within existing resources. We want quality information, advice and advocacy for all, including self-funders, and we want a shift to early intervention and prevention. What is crucial is world-class commissioning that incentivises and rewards high-quality provision, but is punitive in relation to care homes and providers that do not offer people quality services.

Need I even mention the utter nonsense that demographics and falling social care productivity make of the Government’s social care funding announcements? It would be a welcome surprise to end the year without another rant from the Under-Secretary of State for Health, the hon. Member for Bury, South (Mr. Lewis), but let us see. Does he recall that, 18 months ago, his predecessor started a review of social care funding? However, the Government have published nothing. Will he share the findings of the review with the House, in the interests of his much-vaunted consensus, or will he admit that the review and next year’s Green Paper are thinly disguised attempts by the Government to kick the issue into the longest grass that they can find and to cover up his failure to persuade the Prime Minister to make a decision on social care funding and to protect home ownership?

May I also wish the hon. Gentleman a merry Christmas?

Actually, for the first time we have a very clear route map towards improving the system in this country for older people, disabled people and carers. We have a commitment to a long-term process with a Green Paper. We must respond to not only demographics, but the rising expectations of people who need social care services. We have a transformation programme, which will begin over the next three years, that will involve a radical transformation of services, shifting to early intervention and prevention and putting personal budgets at the heart of a system that gives people far more control over, and choice about, the care that is provided. In spring next year, the Prime Minister will announce a new deal for carers in recognition of the fact that increasing numbers of families are caring for older relatives and children with disabilities. We face the whole question of young carers and, with regard to older people, dementia.

Those are some of the big challenges that face our society. I have not heard one policy solution from the Conservative party. I urge Conservative Members to join a political—