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Adult Social Care in Shropshire: Government Funding

Volume 670: debated on Wednesday 22 January 2020

I beg to move,

That this House has considered Government funding for adult social care in Shropshire.

It is a pleasure to serve under your chairmanship, Mr Stringer. Before I start to outline the concerns we have about Government support for paying for adult social care costs in Shropshire, I will put forward two historical contexts to try to explain to the Minister a little as to why and how we got into this situation.

In 2004, the Labour-controlled Shropshire Council increased council tax in one year by 16.4%. That was the year before my hon. Friend the Member for The Wrekin (Mark Pritchard), my right hon. Friend the Member for Ludlow (Philip Dunne) and I were elected for the first time. I am sure they will recall, as I do, the palpable anger, fear and frustration of many people on low fixed incomes in the face of that massive tax increase. When our party came into office, we incentivised councils to freeze council tax because there had been so much frustration and such a backlash against the massive increases, not only in Shropshire, but in Labour-controlled councils up and down the country where there had been double-digit increases in council tax.

Our local council, which became Conservative in 2005, decided to dutifully follow the advice and froze council tax, not just for one year, but for seven years in a row—clearly to the delight of local ratepayers. The council is now telling me that the Government have not adequately filled the shortfall in revenue that it inevitably had to face as a result of the freezing of council tax. The Minister may correct me if I am wrong, but my understanding from Shropshire Council officials is that the additional support that was envisaged to come from Government tapered off quickly, leaving the council without additional support of, it now estimates, in the region of £20 million per annum.

Labour shadow Ministers always criticise repeated references to their management and stewardship of the economy, but let us not forget that in the good times the Labour party, when it was in office, borrowed £50 billion a year, sold off our gold reserves at rock-bottom prices and put all these new hospitals on private finance initiative contracts, with the result that we will pay exorbitant interest rates for decades.

When the financial crash came in 2008, the kitty was bare. I am not ashamed of repeatedly referring to that. People forget about it, but the Minister will remember the sheer gravity of the situation when we came to office. As a nation, in 2009-10, we were borrowing £152 billion a year.

I commend my hon. Friend for securing this important debate. Does he agree that it is not only about the financial pressures on Shropshire Council but the domino effect of the under-provision of social care in Shropshire on the acute trust, and how that affects A&E waiting times? Finally, does he agree that there needs to be cross-party consensus and working together nationally? We do not need another review; we have had lots of those. We know what the problem is. We now need solutions, and that has to be done on a cross-party basis, but quickly.

I thank my hon. Friend and neighbour for that intervention. I could not agree more.

When we came into office, we of course had to rein in expenditure, and all Government Departments had to have cuts. The cuts to local government have, of course, adversely affected our council. I am pleased that the country’s annual deficit is now below £28 billion a year, down from the £152 billion a year that we inherited. However, now that we are getting the finances under control in a more sustainable way, I urge the Minister to take the message back to the Treasury that we need to increase public funding of our councils, so that they can start to meet the huge rise in demand for adult social care in our county. I will explain why Shropshire is uniquely affected.

Although it is absolutely the case that adult social care is very important in Shropshire, and in other parts of the United Kingdom of Great Britain and Northern Ireland, does not the hon. Member agree that we need to attract more workers into adult social care, because there seems to be a dearth of them, and help them to understand how rewarding it can be to make a real difference to the life of a vulnerable person? Also, does the hon. Member believe that we can do anything in this place to encourage more adult workers to be involved?

Yes, very much so, and I am sure that some of my colleagues from Shropshire will take up that point in interventions. However, I will make a few quick points before I take another intervention.

During the 2017 general election, we gave the impression to the electorate that somehow they would have to sell their homes in order to pay for their long-term care. I have to tell the Minister that I had never come across such levels of bewilderment, frustration and anger on the streets of Shrewsbury as I did following that announcement, and have not done so subsequently. Whoever came up with that policy for the then Conservative Government was really out of tune with the thinking of many of our natural voters.

Even my own beloved mother—this is the first time I have referenced her in 15 years—Halina, who is a staunch Conservative supporter, said to me, “I haven’t made sacrifices all of my life, I haven’t done the right thing, paid the right amount of tax and done all the right things, for you now to force me to sell my home to look after my long-term social care needs.” I think my mother exemplified the strength of feeling across the United Kingdom.

I am convinced that that policy lost us our majority at the 2017 general election; it was certainly a major contributory factor. I am therefore very pleased that the Prime Minister has indicated that in this Parliament a solution will be found. However, as my hon. Friend the Member for The Wrekin said, we need radical, innovative thinking that has the support of our voters.

Shropshire MPs meet the council on a regular basis. We Shropshire MPs work as a team and hunt as a pack, and one of our greatest strengths is the unity between us all. In fact, we are seeing our council this Friday, 24 January, which happens to be my 48th birthday. I am looking forward to a few bottles of beer from my colleagues during the meeting.

Shropshire Lad. The clear message from Peter Nutting, the leader of our council, from the chief executive, and from the other senior councillors is that social care is their top concern. The Minister will know—she played a part in it as well—that in the last Parliament, MPs from rural shire counties worked constructively together to get a change to the funding mechanisms for our schools. Rural shire counties were unfairly discriminated against in comparison with inner-city, metropolitan areas. In this Parliament it is my intention, and that of many other Members, to make social care the No. 1 issue, because we have to listen to what our councillors are telling us.

There is no doubt in my mind that the black hole of approximately £20 million a year that the council faces is affecting not only adult social care costs but many other services in our county. The leader of the council has to take money away from repairing potholes, and all the other things for which the council is responsible, in order to manage the black hole that is staring them in the face.

I congratulate my hon. Friend on landing the debate and on the powerful case that he is making. As he said, we have all been working very closely on the matter for some time. I think he would agree that the situation is going to get worse. Currently, 23% of Shropshire’s population are aged over 65. That will increase by 50%, to 33% of the population, by 2036, compared with the projection for England of 24%. That is an increase from 74,029 to 110,926.

I am sure that, like me, my hon. Friend is an avid reader of the Shropshire Star. On Monday there was a story titled, “Dramatic rise in dementia cases”, which reported that dementia cases have gone up by 57%. Dr Karen Harrison Dening of Dementia UK said:

“We are going to have a huge increase in population of older people, and one of the main risk factors of dementia is age. There is also going to be a reduction in the number of younger people who will be able to care for them.”

Would my hon. Friend like to comment on the inevitability of this getting worse?

I endorse what my right hon. Friend the Member for North Shropshire (Mr Paterson) has just said. In south Shropshire, the population of over-65s is currently 29%, compared with 19% of the population across the UK and 23% across the county, as he said, so the issue is particularly pressing in the south.

Today, there are twice as many people over the age of 90 as there were on the day when my hon. Friend the Member for Shrewsbury and Atcham (Daniel Kawczynski) and I were elected, nearly 15 years ago. However, it is not all gloom and doom about increasing demand, although that is a major problem. Shropshire is leading the way in this country in developing technologies to help cope with the growing pressure. I commend the Broseley project to him. It is one of the leading projects in the county, and in the country, trying to find technological solutions to keep people out of hospital or residential care. I encourage him to visit that project if he has not done so already.

I am extremely grateful for those interventions from my hon. Friends and neighbours. I could not agree with them more. Shrewsbury is listed as one of the top 10 places to retire to in the whole of the United Kingdom because of the beauty of our town—we have more listed buildings than any other town in England. We have a larger number of senior citizens as a percentage of our total population, and that percentage is growing much faster than the national average. Governments of all political colours have poured money disproportionately into inner-city, metropolitan areas while leaving us in the rural shire counties as the poorer cousins, and it is vital that we now start to take action.

Order. In half-hour debates on the Adjournment, people who speak have to have the permission of the proposer and of the Minister, and it is not good form to come in after the proposer has started speaking. I ask the proposer and the Minister whether Bill Wiggin has had permission to intervene.

I will follow your lead on that, Mr Stringer.

In the financial year 2019-20, the social care budget for Shropshire Council was £103.1 million. That represents 48.2% of the council’s net budget, up from 32.6% in 2015-16, which is extraordinary: our council’s budget for just dealing with adult social care costs has gone up from a third of its net budget to practically a half. I find those figures staggering, and my colleagues from Shropshire agree. Since 2015-16, Shropshire Council’s adult social care budget has risen by an average of £7 million per annum. In the coming financial year, it is projected to rise by approximately £10 million; £6 million of that is inflationary, meaning that only approximately £4 million is due to increasing demand.

As has been said, Shropshire’s senior citizen population is rising at a much faster rate than the national average, and Shropshire Council has become more efficient, which is the point that my right hon. Friend the Member for Ludlow was making. The Local Government Association has assessed our council as being very well managed, and as implementing new and innovative policies in this regard. Shropshire Council has become more efficient and innovative in an attempt to control rising costs in social care. Of all initial inquiries into adult social care, 85% are signposted to external support, and of the remainder, only 14.8% enter paid services. In total, 2.25% of all inquiries enter paid services; in 2014-15, the comparable figure was 32%. The financial pressures on Shropshire Council go beyond single-year budget increases. The most recent available analysis shows that if our council were funded at the English average per head of population, it would have an additional £20 million in its base budget.

I am grateful to have had the opportunity to raise this issue, and look forward to hearing the Minister’s answers. I am pleased that all the MPs from the Shropshire Council area have attended this debate, and I am very grateful for their support. They know as well as I do the huge pressures that our council is under at the moment because of its lack of funding, and will share those pressures with the Minister. Our hon. Friend the Member for The Wrekin also mentioned serious problems with our local hospital acute trust, which we are trying to raise with the Secretary of State for Health and Social Care.

We in Shropshire are experiencing a unique combination of problems at the moment, meaning that our constituents are given services that are creaking at best. That is not something I feel comfortable with. We are the fifth-largest economy in the world; I read today that last year, we reduced our debt as a percentage of GDP by 0.9%, and I am delighted and thrilled that the International Monetary Fund is now forecasting that our country will grow at a faster rate than the eurozone over the next three years. We have turned a corner, so we can start to loosen the purse strings a little bit. We as Conservatives must demonstrate that we have a long-term solution to this issue, which affects so many of our constituents.

It is a great pleasure to serve under your chairmanship, Mr Stringer. I congratulate my hon. Friend the Member for Shrewsbury and Atcham (Daniel Kawczynski) on securing this important debate on the funding of adult social care in Shropshire. He is a strong and consistent champion for both his county and his constituency on a range of issues but, particularly today on the subject of adult social care. As he mentioned, he and his colleagues hunt as a pack; they work very effectively together, and I am pleased to see him joined by his colleagues. I do not know what the collective noun is for a group of Shropshire MPs, but it is clearly something very robust and effective. I am pleased to see them all here, and grateful for all the points they have raised.

Clearly, adult social care is one of the biggest challenges we face as a country, but it is not just our country that faces it; it is a global issue. How do we face the challenges of an ageing population? We have to preface this by saying it is not a bad thing that people are living longer; we should be celebrating that. This is not doom and gloom, but we need to make sure that we are equipped to support people in later life. People are also living longer with much more complex conditions. Over half of local authority budgets are spent on working-age adults; although that cohort includes a lower number of people, it is also more expensive, and we need to make sure that we are looking after those people sufficiently as well and supporting local authorities to do so properly.

Successive Governments have wrestled with the challenges of how to deal with the issues caused by an ageing population and of adult social care. Frankly, they have all then put those challenges in the “too difficult” pile, because the solution is very difficult and potentially very expensive. Unfortunately, the sand has run through the hourglass and we no longer have the luxury of being able to put those issues aside; we now have to face the challenges of an ageing population and of adult social care head on. That is why the Prime Minister, on the steps of Downing Street on his very first day, committed to tackle them. We will therefore set out much more on this issue in due course.

My hon. Friend is absolutely right to highlight the fact that by 2040, one in four people in the UK will be aged 65 or over. However, it is important to remember that this is not just about older people, as the number of those aged below 65 who access long-term support is growing year on year. Central to all our thinking are all those magnificent adult social care professionals, the social care workers, social workers and nurses, as well as the army of unpaid carers—loved ones, friends and family—who do so much in Shropshire and the whole country to look after their loved ones.

The Minister has just reminded me of one thing. Of course, we should pay tribute to the millions of citizens out there who are carers and who look after their elderly relatives in a voluntary capacity, as we looked after my beloved grandfather in the latter stages of his life. It is very important to acknowledge what they do. It is true, is it not, that the way in which a country treats its senior citizens is an indicator of what sort of society and culture prevails in that country?

That is absolutely right. It is because of the army of paid and unpaid carers that my hon. Friend mentioned that there are many reasons to be positive about the care people receive in Shropshire.

As of 1 January, 86.5% of care home beds in Shropshire were rated good or outstanding by the Care Quality Commission, which is much better than the national average, and 90.3% of care home agencies in Shropshire are good or outstanding. Moreover, in the 2018-19 adult social care survey of users, more than 90% of people receiving care in the county reported that they were satisfied with the care and support that they received. However, we know that there is still a long way to go.

My right hon. Friend the Member for Ludlow (Philip Dunne) spoke about how Shropshire leads the way in technology. If we are to face the challenges of adult social care and tackle what might be regarded as a crisis, we need to look at not just funding but harnessing all modern technology. We need to look at the workforce, and at modern models of care and methods of housing to make sure that we are harnessing the best in all those areas. He was a fantastic Health Minister and a brilliant co-chair of the all-party group on adult social care.

Last autumn, the most recent spending round announced further investment in social care for 2020-21. That will give councils access to an additional £1.5 billion for adult and children’s social care, which includes an additional £1 billion of funding and a proposed 2% council tax precept that will enable councils to access a further £500 million specifically for adult social care. The £1.5 billion is over and above the existing £2.5 billion of social care grants that were rolled over in the spending review and is part of the biggest increase in overall core spending power for local government since 2015—an increase of 4.4% in real terms in 2020-21. A key stakeholder, the Local Government Association, said that it was delighted that the spending round

“has delivered a funding package of more than £3.5 billion for our vital local services...This is the biggest year-on-year real terms increase in spending power for local government in a decade”.

For Shropshire, the settlement puts considerable new resources into social care. It will receive an additional £7.9 million in funding from the new social care grant and £11.5 million through the improved better care fund, which will drive the integration to stop pressure being put on acute health services. Shropshire will also have the opportunity to raise an additional £15.1 million through the dedicated adult social care precept. That additional funding is an important step towards putting adult social care on a fairer and more sustainable footing. We recognise that it is important for local authorities to have security, predictability and certainty about future funding for social care, which is why the funding beyond 2020-21 will be set out at the next spending review.

On Shropshire Council’s wider funding, my hon. Friend the Member for Shrewsbury and Atcham set out beautifully the challenges facing local councils up and down the country. All Government Departments and local authorities had to make tough decisions to deal with the parlous finances and extremely high borrowing that we inherited from the last Labour Government. He is right to say that that put huge pressure on local authorities, which were also trying not to put up council tax to deal with the problem. That is why the Government are committed to undertaking a review of the relative needs and resources.

The review will consider the drivers of local authorities’ needs, the resources available to them to fund services, and how to account for them in a way that draws a more transparent and understandable link between local circumstances and local authority funding. In my hon. Friend’s area, for example, the rurality and the relative size of the ageing population would have to be taken into account. The Government are working closely with local government representatives and others to examine all elements of the review, including adult social care. The aim is to share the emerging results with the sector shortly, followed by a full consultation in the spring. I hope that he will find good news for Shropshire Council in that.

I finish by assuring my hon. Friend that my Department and the Government are by no means complacent. Fixing the issues with adult social care is a huge priority for us. As the Prime Minister said, the Government will deliver on their promises and bring forward a plan for social care this year. There are complex questions to address, but we have been clear on two things: everybody will have dignity and security, and nobody will be forced to sell their home to pay for their care.

Question put and agreed to.