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Health and Social Care Services

Volume 635: debated on Tuesday 6 February 2018

The fact that the Department has been renamed the Department of Health and Social Care reflects both their interdependence and our commitment to achieve co-ordinated care tailored to individual needs. The better care fund is a national integration programme that helps the NHS and local government to deliver better, more joined-up services.

I thank the Minister for that answer and welcome her to her place. The proposal to build a community health centre in Thornbury and Frenchay is an essential part of joining up health and social care in South Gloucestershire. Will the Minister join me in highlighting the importance of Thornbury health centre and in pressing South Gloucestershire clinical commissioning group to make progress with the project as quickly as possible, after years of unnecessary delays?

I thank my hon. Friend for raising that important issue. He is right to do so, and proposals such as those for Thornbury health centre are crucial for ensuring that health and social care are truly integrated and centred around each individual in the community. I am advised that South Gloucestershire CCG remains committed to progressing those plans as soon as possible and that the local NHS expects to be able to provide an update on plans next month.

The Minister will be aware of the situation surrounding pain infusion treatment for patients in Hull and East Riding. Many of the 86 patients who lose that treatment will require increasing levels of social care. Consultants have even written letters to the CCG to say that if that treatment is removed, there is an increased risk of mortality for those patients. Will the Minister meet me urgently to discuss that and write to the CCG to ask it to urgently review its decision in the light of the evidence from consultants?

Of course blanket bans on treatments are unacceptable, and decisions on treatments should always be made locally by doctors, based on clinical assessment. I understand that those patients will be offered an alternative, more rounded service and that the CCGs have arranged for each patient to meet their consultant to discuss their treatment. Where there is evidence of rationing, we expect NHS England to ensure that CCGs are not breaching their duties.

Does my hon. Friend agree that the integration of health and social care is so important to the future success of the NHS that everything needs to be done to speed up the programme to integrate them better? Will she join me in encouraging a speedier approach to that method in Surrey, Sussex and Kent?

My right hon. Friend is absolutely right. The better care fund is already having a fantastic impact in the area. We are developing metrics for assessing progress on integration by local area, particularly at the interface of health and social care. We need to proceed with this as rapidly as possible, and I am sure that with his backing, that will happen in his local area.

It is of course very important that we see integration of the two services, but the fact remains that there is just not enough money. Over a year ago, one of the Minister’s predecessors praised my authority in Halton for the work it was doing in this area, but Halton is now on the brink in terms of the money it has and its ability to deliver its statutory duties. There is simply not enough money, and the Government keep trying to avoid that.

We have provided £2 billion of extra funding over the next three years to help councils commission high-quality services, in addition to giving councils access to up to £9.25 billion of dedicated social care funding by 2019-20.

Will the Minister look at the benefits of independent living schemes such as Priory View, pioneered by Central Bedfordshire Council, which bring reduced hospital admissions and reduced demands on social care through greater socialisation and more use of exercise classes?

Independent living schemes can keep people living healthier, more independent lives for much longer and provide the comradeship and camaraderie that keep people active and healthier. My hon. Friend is right to raise their importance, and the Government very much support them.

With reference to the integration of health and social care, the Minister may be aware that I have two outstanding respite and rehab homes in Eastbourne called Milton Grange and Firwood House. They are both under threat of closure by the county council, which says that central Government are not giving it enough money. Those homes serve a crucial purpose in supporting the local hospital. Will the Minister agree to meet me and representatives from the county council to work out a way to find the funds to keep both those vital homes open?

The hon. Gentleman is absolutely right to stand up for the good-quality respite in his local area. The Care Act 2014 requires local authorities to shape local markets and ensure that they give a sustainable, high-quality local offer. I would be more than happy to meet him to discuss that further.

I welcome the Minister to her place. One model of integration that has aroused considerable concern is the so-called accountable care organisation model. Many are concerned that that means greater private sector involvement, and given legitimate worries about Carillion going bust, Capita not being able to support GPs and Virgin suing the NHS, those concerns are well founded. Can the Minister rule out any private sector involvement in ACOs? Will she also delay laying the relevant regulations to establish an ACO until after the two judicial reviews and the NHS England consultation?

The hon. Gentleman is right to raise this. NHS England is consulting on that at the moment, and I can confirm that no regulations will be laid until that consultation has been completed.

I am extremely grateful to the Minister for offering us that clarification. May I therefore ask her about funding? The integration of health and social care needs more funding, yet the NHS is going through the biggest financial squeeze in its history and social care has been cut by billions since 2010. A few moments ago, the Minister said that the funding is adequate, but if the funding is adequate across health and social care, why are delayed discharges of care up 50%, and why did NHS England say on Friday that for the rest of this year the A&E target has in effect been abandoned?

We recognise that there are pressures on our social care as the population ages. In the short term, we have of course made the extra £2 billion of funding available to local authorities; in the medium term, we need to make sure that best practice is observed across all local authorities and NHS trusts; and in the long term, we will be coming forward with a Green Paper on social care later this year.