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Social Services

Volume 502: debated on Wednesday 16 December 2009

To ask the Secretary of State for Health with reference to Annex B, footnote 4 of the Impact Assessment for the Personal Care at Home Bill; for what reasons data from West Berkshire was used; and whether his Department holds equivalent data for other local authorities. (304806)

The model referred to in paragraphs 5.12, 5.13 and Annex B of the impact assessment is still under development. For this reason, its output has not been incorporated into any of the figures reported in the impact assessment. The model will continue to be updated and refined as more information becomes available.

The experience of West Berkshire was used because its clients have been assessed as having high needs under “Fair Access to Care Services”. The Department does not hold equivalent data for other councils.

To ask the Secretary of State for Health with reference to paragraph 3.1 of the Impact Assessment for the Personal Care at Home Bill, in what ways he expects the policy to encourage better working between the health and social care systems. (304811)

The Personal Care at Home Bill is a step towards setting up a new national care service. Our Green Paper, “Shaping the Future of Care Together”, which has already been placed in the Library, set out our vision for a national care service that promotes better joined-up working between health, housing and social care services.

The consultation on the Green Paper closed on November 13, 2009 and we will publish a White Paper early in 2010. Also feeding into the White Paper will be the work of the ministerial group on integration of health and social care services, which has met four times with a purpose of identifying what has worked well in different parts of the country, as well as what the evidence tells us, to help push forward joined-up working.

To ask the Secretary of State for Health with reference to paragraph 7.3 of the Impact Assessment for the Personal Care at Home Bill, whether local authorities with significant rural populations would receive a proportionate uplift in funding if the Personal Care at Home Bill were enacted; if he will place in the Library a copy of the outcomes of the screening equality impact assessment; and if he will publish the full equality impact assessment before the end of December 2009. (304857)

Questions on both funding formulae for councils and equality are included in the current consultation and comments are invited. The consultation will close on 23 February 2010 and a response to the document will be published subsequently. The equality impact assessment screening template has been published alongside the consultation document. Both documents are available on the Department's website at:

www.dh.gov.uk/en/Consultations/Liveconsultations/DH_109139

A copy has already been placed in the Library.

To ask the Secretary of State for Health with reference to Tables 1 and 2 of the impact assessment for the Personal Care at Home Bill, from which paragraphs of the report by the Personal Social Services Research Unit the figures were taken; and which figures in the impact assessment were taken from modelling which has not yet been published. (306479)

Table 1 of the Impact Assessment is derived from the English Longitudinal Study of Aging. For further detail of how the figures in table 1 were produced, I refer the hon. Member to the replies I gave to him on 8 December 2009, Official Report, column 290W, 9 December 2009, Official Report, column 495W, and 14 December 2009, Official Report, column 762W.

The figures for older people in table 2 of the Impact Assessment are derived from the figures in table 1 and the output of Personal Social Services Research Unit’s (PSSRU) micro-simulation model for older people. The specific output from the model used to produce the figures in table 2 is not included in the PSSRU technical report and has not otherwise been published.

I refer the hon. Member to the reply I gave to him on 14 December 2009, Official Report, column 763W for detail on the derivation of the numbers of residential care and informal care switchers. The simple model used to determine the flows into and out of residential care has not been published. The logistic regression model used to estimate the number of informal care switchers is explained in the reply I gave to the hon. Member on 8 December 2009, Official Report, column 290W.

The estimate of 110,000 younger adults eligible for free personal care at home is based principally on the Referrals, Assessments and Packages of care (RAP) data from councils for 2007-081.

Fair Access To Care Services (FACS) guidance on eligibility for local authorities establishes four levels of eligibility for services. These are critical, substantial, moderate and low, with critical representing the highest level of social care need.

The RAP data shows 82,000 younger users of local authority home care and 35,000 younger users of direct payments on 31 March 2008—out of 395,000 younger recipients of community-based services. It is not known what proportion of the 117,000 who receive personal care and are in the critical need group, but it is expected that they would be the majority.

Therefore, for the purposes of the impact assessment, it is assumed that there could be some 100,000 younger adult local authority funded users receiving personal care in the critical category. It is likely that most of them receive their care free, as their incomes are generally low. It has therefore been assumed that 90 per cent., already receive free personal care at home and that 10 per cent., make a means-tested contribution towards the cost.

Little is known about the number of younger adults who currently fund their own care at home. It has been assumed that approximately a further 10,000 younger adults may be brought under state funding following the introduction of the Personal Care at Home Bill.

No specific estimate of a margin of error has been made. However, the figures have been rounded to the nearest 10,000 to reflect the uncertainty. The figure of 110,000 should therefore be treated as an estimate.

For information on the derivation of the estimated additional administration costs, I refer the hon. Member to the reply I gave him on 14 December 2009, Official Report, column 765W.

1 The RAP data for 2007-08 can be found at:

www.ic.nhs.uk/statistics-and-data-collections/social-care/adult-social-care-information/community-care-statistics-2007-2008:-referrals-assessments-and-packages-of-care-for-adults-england-provisional-council-data

To ask the Secretary of State for Health whether the regulatory impact assessment for the Personal Care Bill assumes that 14,815 people per month are to be given access to reablement. (307687)

A flow of 14,815 per month is derived from the modelling assumptions listed in Annex B of the impact assessment. However, since we do not know for certain what proportion of people already benefit from re-ablement, for the purposes of the impact assessment we have assumed that 130,000 people will receive re-ablement over the course of a year. In addition, since we have not formally incorporated the anticipated benefits of re-ablement services in the impact assessment's headline figures, we believe we have been conservative about the number of people that may actually receive re-ablement.

The model referred to in paragraphs 5.12, 5.13 and Annex B of the impact assessment is still under development. For this reason, its output has not been incorporated into any of the figures reported in the impact assessment. The model will continue to be updated and refined as more information becomes available.

We cannot reasonably make these extrapolations because of the levels of uncertainty. Such uncertainties include the unknown detail of any future national care service and the unknown future economic climate.

To ask the Secretary of State for Health pursuant to the answer of 7 December 2009, Official Report, column 166W, on social services, (1) if he will extrapolate the cost in each year to 2030 to the Exchequer of free personal care on the basis that there are no uncertainties and the assumptions of the regulatory impact assessment remains applicable in each year; (307688)

(2) what areas of uncertainty the Department has identified; and whether each one is likely to result in (a) increased or (b) decreased costs;

(3) pursuant to the answer of 9 December 2009, Official Report, column 497W, on social services, what the figure for personal care funded from the public purse in (a) 2015, (b) 2020, (c) 2025 and (d) 2030 for each year is if the assumptions of the impact assessment of the Personal Care at Home Bill are applied regardless of uncertainty.

We cannot reasonably make these extrapolations because of the levels of uncertainty. Such uncertainties include the unknown detail of any future National Care Service and the unknown future economic climate.

It is not possible to reasonably extrapolate what effects such uncertainties may have on costs at the present time.