The direction of travel for adult social care is set out in “Putting People First”, the shared vision and commitment to the transformation of adult social care, published in December 2007. It is confirmed in the Green Paper, “Shaping the Future of Care Together”, which was published in July this year.
“Putting People First” commits to significant change by April 2011. It confirms that reform of social care can only be delivered through partnership across central and local government. It is holistic in its approach to delivering social care services for all individuals in the community, not just those eligible for statutory support.
“Putting People First” clearly sets out a vision of a universal offer to the entire community, including social care service users. Not only will this increase the provision of social care support, but the strategic shift towards prevention and early intervention services is designed to provide more help to people with lower level care needs, to reduce the likelihood that they will need more intensive services in the longer term and to help them retain their independence.
By the end of 2009-10, this Government will have increased local government funding by 45 per cent. in real terms since 1997. These are unprecedented rises in funding to local councils and provide the resources they need to improve the provision of care and support for their populations.
The Department is investing circa £3.5 billion over this comprehensive spending review period to support improvements in the provision of social care. In particular, the social care reform grant will provide over £500 million for the reform and transformation of adult social care. In 2009-10, Coventry will receive approximately £8 million of revenue and capital grants from the Department to help support this agenda.
For the longer term, the Green Paper, “Shaping the Future of Care Together”, together with the public consultation, “The Big Care Debate”, which will run until 13 November, is addressing the national and local challenges we face in providing care and support in the future.
The fairer access to care services (FACS) guidance has just been revised and is out for consultation until 6 October 2009.
The Commission for Social Care Inspectorate's (CSCI) state of social care report 2006-07 identified a trend for councils to raise their eligibility thresholds and the potential implications for people seeking support. In the light of recommendations made by CSCI in their report “Cutting the Cake Fairly: CSCI review of eligibility criteria for social care” (October 2008), the Government worked with stakeholders to revise the FACS guidance. The revision of the FACS guidance is aimed at bringing about improvements to the system as it currently stands, making implementation fairer and more consistent for people seeking support and reinforcing the current direction of policy established by “Putting People First”, a copy of which has already been placed in the Library.
The “Fairer Contribution Guidance” was also published on 14 July 2009 to accompany the existing “Fairer Charging guidance”. Copies have been placed in the Library. This provides councils with a model to help them decide how much (if anything) a person should contribute to their personal budget. Councils will be expected to implement the “Fairer Contributions Guidance” by March 2010.
The Fairer Access to Care Services (FACS) guidance (June 2003), a copy of which has already been placed in the Library, sets a framework to help local authorities identify those people who are eligible for social care services. The FACS guidance sets out four eligibility bands of criteria (Critical, Substantial, Moderate and Low).
The Commission for Social Care Inspectorate’s (CSCI) State of Social Care report 2006-07 identified a trend for councils to raise their eligibility thresholds and the potential implications for people seeking support. In the light of recommendations made by CSCI in their report “Cutting the Cake Fairly: CSCI review of eligibility criteria for social care” (October 2008), the Government have been working with stakeholders to revise the FACS guidance and this is out for consultation until 6 October 2009.
The revision of the FACS guidance is aimed at bringing about improvements to the system as it currently stands, making implementation fairer and more consistent for people seeking support and reinforcing the current direction of policy established by “Putting People First”, a copy of which has already been placed in the Library.
The Fairer Contribution Guidance was published on 14 July 2009 to accompany the existing Fairer Charging Guidance. Copies have been placed in the Library. This provides councils with a model to help them decide how much (if anything) a person should contribute to their personal budget. Councils will be expected to implement the Fairer Contributions Guidance by March 2010.
Local authorities must ensure that everyone who is eligible for social care has their needs met.
Central data collated in 2007-08, show that the number of adults (aged 18 and over) with a physical disability or sensory impairment and receiving care services was 221,000 adults (aged 18-64) and 1.045 million adults (aged 65 and over).
The gross current expenditure on adults aged 18-64 with a physical disability or sensory impairment was £1.48 billion in 2007-08, and the net current expenditure on adults aged 18-64 with a physical disability or sensory impairment was £1.39 billion in 2007-08.
Data are not collected centrally on the gross and net costs of adults aged 65 and over with a physical disability or individually broken down to show packages of care for rheumatoid arthritis and the associated costs.
The Health and Social Care Act 2008 requires the Care Quality Commission to report annually on the provision of national health service care during the year, the provision of adult social care services during the year, and the carrying on of regulated activities during the year. The Care Quality Commission has informed us it is planning an integrated report on the state of health care and adult social care in England. It will lay its first annual report to Parliament to cover the year 2008-09 and its second report will cover the year 2009-10.
The care and support Green Paper, ‘Shaping the Future of Care Together’, announced that the Government will publish a White Paper in 2010. The consultation on the Green Paper will run until 13 November 2009 and we will make further announcements about the timing of the White Paper in due course.
I have been asked to reply.
The Green Paper “Shaping the Future of Care Together” set out the reasons for considering the future role of disability benefits in the context of the social care review. It proposed that one option is to bring some disability benefits and the new social care system together into a single system, as a better way of providing support. However, it is important to note that this is a consultation exercise for long-term reform and no final decisions have been made on the specific merits of changing the Disability Living Allowance programme. We are seeking the views of all stakeholders in further developing these proposals.
The care and support Green Paper, ‘Shaping the Future of Care Together’, announced that the Government will publish a White Paper in 2010. The consultation on the Green Paper will run until 13 November 2009 and we will make further announcements about the timing of the White Paper in due course.
The Personal Social Services Research Unit (PSSRU) at the University of Kent and the London School of Economics have carried out analysis to model the cost of the Green Paper funding options. The statement that under partnership a third to a quarter of basic care and support costs could be paid for by the state is based on that analysis.
We expect to publish shortly a report by PSSRU outlining the modelling and costs of the Green Paper funding options. A copy will be placed in the Library.
The Department published a regulatory impact assessment alongside the Green Paper “Shaping the Future of Care Together” which sets out the estimated costs and implications of the funding models discussed. The impact assessment is available online at:
http://careandsupport.direct.gov.uk/greenpaper/the-green-paper-and-supporting-documents/
A copy has been placed in the Library.
Due to the wide range of reforms proposed within the Green Paper, full introduction of a new care and support system will be around 2014 at the earliest.
My right hon. Friend the Secretary of State wrote to Ministers in Wales, Scotland and Northern Ireland to provide them with the full text of the Green Paper prior to publication. Departmental officials have been in regular contact with their counterparts in the devolved Administrations and a further series of meetings are planned.
Care and support covers a range of reserved and devolved issues. Where matters are devolved, there will inevitably be consequences for people who live near the geographical boundaries between two areas with different policies. This is the case with the current system. We will continue to work with the devolved Administrations to ensure the implications of the Green Paper for people living near the borders are fully understood.
We do not envisage the new national care service altering any existing cross-border provision of health services. For example, the new national care service will not mean that patients in England who are registered with general practitioners in Wales cannot continue this arrangement.
The Big Care Debate closes on 13 November 2009. The Government's response to the consultation will be published after this date.
We believe that reform of the care and support system is necessary in order to make the long term care costs sustainable for the State and the individual. The Impact Assessment for the Green Paper ‘Shaping the Future of Care Together’ suggested that a National Care Service could cost the State between £18.2 billion and £20.7 billion in 2014, depending on the funding model chosen. These are illustrative comparative costs suggesting the possible cost to the state of the different models. These are indicative only and could be subject to change. Costs would be met from within the public spending envelope set for future spending reviews, which will be in line with the plans for fiscal consolidation set out at Budget 2009.
Local authorities are key to the delivery of our vision for the future. This Green Paper underlines the important, continued and strengthened role they will play under reform, in any future funding system. But we also know that one of the most common problems with care and support is an apparent lack of connection between different services, particularly health, social care, housing and benefits. So a central plank of a National Care Service will be a coherent strategy centred on patients, care-users and their carers, to support local leaders to make sure that joined-up services are delivered.