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Care at Home

Volume 542: debated on Tuesday 27 March 2012

10. What steps he is taking to ensure that people receiving care at home funded by the NHS are involved in making the arrangements for that care. (101881)

Our ambition is to enable shared decision making for all NHS patients. We expect people who are eligible for NHS continuing care funding to be fully involved in discussions about their care. Subject to the results of the current personal health budget pilots, everyone eligible for NHS continuing health care, including many people receiving care at home, will have the right to ask for a personal health budget, including a direct payment, from April 2014.

I have received a letter from one of my constituents who has had direct payments for 15 years under social services. Following a stay in hospital, she was moved on to health funding, and her life has changed dramatically for the worse. She says that she no longer has any choice in who cares for her and finds it hard to find the right people with whom she feels comfortable. She concludes:

“I’m tired of being bullied. I’m just miserable.”

Will the Minister do something to bring forward the measures more quickly, so that people who have been directing their own care under social services can have the same quality of life and the same choices that they have become used to?

I absolutely agree with the hon. Lady’s constituent, and with the hon. Lady. We need to ensure that, as soon as possible, the benefits and the control that direct payments give to individuals in social care are available to people in regard to their long-term health care and particularly to continuing health care. It is realistic to say that we can roll this out nationwide by 2014, but I know that the hon. Lady is having discussions with the authorities in Sheffield, and I encourage her to carry on those conversations about the way in which people can use the current arrangements to access those facilities.

Does the constituency case raised by the hon. Member for Sheffield, Heeley (Meg Munn) not highlight the increasingly urgent need to achieve much more integration between health and social services, and indeed between different parts of the national health service, in order to provide joined-up care that focuses on patients’ needs and delivers better value for money to the taxpayer?

My right hon. Friend is absolutely right. I urge the hon. Lady to write to me about the matter so that I can respond in more detail, but let me say to my right hon. Friend that it is not just a question of delivering more integration within health care—which is often still too fragmented—or between health and social care; it is also a question of recognising that issues such as housing and leisure are critical to the delivery of greater well-being, and to an improvement in the health of the nation. The Health and Social Care Bill, which has now completed all its stages, gives people in every part of the system a clear duty to collaborate, integrate, and deliver better care for individuals.

There are currently severe constraints on the availability of incontinence pads and on the bed linen laundry service, which is causing immense distress to the many poor families in my constituency. Will the Minister look into the problem? Will he recognise that it is simply impossible for people who are already in difficulties, and who are poor, to find the money for those extra things?

If the right hon. Lady sends me the details, I will look into the individual case. I agree with her that it is unacceptable for such products to be rationed. I think it essential to base their provision on an assessment of individuals’ needs, and for those individuals to receive what they need for a good quality of life.

My constituent Joyce Benbow was discharged from Redcar hospital last November, but is still there owing to a failure to agree on her care package. When will the managers of health and social care budgets be more joined up so that people receive the right provision at the right time?

My hon. Friend has raised an important point about the importance of joining up hospital care, community care and social care, which has often been overlooked. We have invested more than £300 million this year in developing more re-ablement services, and in January we invested an extra £150 million in support for them. We are also extending our plans for more tariff reform to ensure that local hospitals have the means to drive the development of such services in their communities.