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Adult Social Care

Volume 566: debated on Tuesday 16 July 2013

2. What recent assessment he has made of the effects on NHS services of changes in local authority spending on adult social care. (165199)

Data on delayed transfer of care suggest that the interface between health and social care has improved since this Government have been in office. In 2012-13, the number of bed days lost because of delays attributable to social care was nearly 50,000 lower than in the previous year.

In May, the King’s Fund report,“Paying for social care” warned that local authority spending is continuing to fall and that fewer people are getting help. It is my understanding that last month an internal NHS document recognised that pressure on social care budgets meant “more delayed discharges”, increasing the problem in accident and emergency. Therefore, cuts to care budgets are increasing delayed discharges. What will the Minister do to tackle that problem?

The right hon. Gentleman would have done well to listen to my answer before he read out a pre-prepared question. In 2012-13, the number of bed days lost because of social care delays was 50,000 fewer than the year before. However, he is absolutely right that we need to do more to ensure better integration and better joined-up care between the NHS and social care. That is what this Government are doing, and that is why we have allocated a £3.8 billion fund to do just that in the spending review.

Does my hon. Friend agree that there is no solution to the economic challenges facing the health and care system—still less any solution to the quality challenges that are increasingly coming to light—that does not involve proper integration of health and care? Is not the decision announced by the Chancellor a couple of weeks ago the first tangible step of a Government delivering a policy that Governments have talked about for a generation?

My right hon. Friend is absolutely right, as always. He is a tremendous advocate—and has been since his time in office—of integrated health and social care, and of the transformation in the delivery of care that we need to make if we are to better look after patients with long-term conditions and the frail elderly. This Government are the first Government who are committed to doing that. Compare that with the real-terms cut in funding for social care that happened under the last Government, according to the Dilnot report.

17. Bolton hospital has told me that it needs a much greater concentration on social care. Indeed, a recent NHS Confederation survey of NHS chief executives and chairs said that two thirds said that a shortfall in local authority spending had impacted on their services over the past year. Will the Minister finally accept that the Government’s deep cuts to social care are having a serious effect on the ability of the NHS to deliver safe care? (165215)

I am not sure whether the hon. Lady is referring to the Association of Directors of Adult Social Services report that was published recently. It is important to look at that report in context and not misinterpret the figures. The report shows that spending has been roughly flat in social care, and the last survey also shows that councils are expecting a small increase in expenditure on social care next year. The 20% or £2.7 billion that is often touted by the Opposition in fact represents savings that councils have made through efficiencies, and that money is obviously being reinvested in front-line care.

Will my hon. Friend give an indication of the long-term cost savings of integrating health and social care, as against the short-term cost of making the changes?

My hon. Friend is right to highlight the fact that the figures show that last year alone 50,000 bed days that would otherwise have been wasted were saved by investing in social care and implementing the service transformation that we all require. However, this is about making all NHS and social care budgets go further, and recognising that if we are to improve the care of older people, particularly frail elderly people, we have to invest in more community prevention and community-based care, which is what this Government are doing.

As we have heard, two thirds of NHS leaders have said that the shortfall in social care spending is having an impact on their services. The Minister can try to get rid of that and talk it away, but in week after week of taking evidence in our inquiry into emergency care, the Select Committee on Health has heard the same thing. We know that elderly patients now form a much larger proportion of admissions—40% of admissions to emergency units are people aged 65 to 85. Is not the £1.8 billion cut in spending now really hitting NHS services and making the emergency care crisis worse?

I am afraid that the Opposition are very confused about their figures. As I explained earlier, the £2.7 billion—or 20%—figure represents the savings that councils have made to meet demand, and real-terms spending next year is expected to go up. The point from the ADASS and other surveys is that integration works. This Government are investing in integration. According to the Dilnot report, it was the last Government who cut in real terms the amount of spending going to social care between 2005 and 2010—and the hon. Lady was a member of that Government.