I beg to move,
That this House notes that despite the Prime Minister announcing that austerity is over, local authorities’ spending power per household is on course to fall by an average of 23 per cent by 2020, and that nine of the 10 most deprived council areas in this country have seen reductions that are almost three times the average of any other council under this Government; recognises that this has resulted in social care budgets in England losing £7 billion; further notes that at the last General Election Labour committed to a fully costed plan to invest an additional £8 billion in social care over this Parliament; and calls on the Government to ensure that local authorities and social care are properly and sustainably funded.
If I may, I seek the indulgence of the House to briefly place on record, as shadow Communities Secretary, my utter shock and revulsion at the recent terrorist atrocities, both in Northern Ireland and in Sri Lanka, over the Easter break. We send our condolences to the families affected and to their communities. Coming so soon after the terrible events in Christchurch, New Zealand, just before Easter, they serve as a bleak reminder of how fragile our human rights and freedoms are, and how we must redouble our efforts in this place and outside to hold our communities together.
The whole House will be grateful for the way the hon. Gentleman has introduced the debate and for those sentiments. Does he agree that people do such things for publicity and public reaction, and that we should take care to ensure that our publicity and our public reaction confronts and confounds their aims, so that what they do will be in vain, even though it has taken a terrible toll on those directly affected?
The hon. Gentleman is absolutely right. We should stand firm against terrorist atrocities wherever they are perpetrated. We should stand strong as a community, both in the United Kingdom and in the global community, against such acts of terror. We should call them out wherever they take place.
I welcome the opportunity to raise the important matter of local government funding in an Opposition day debate, especially considering how scarce the opportunities are for the Opposition to raise matters in such debates. I pay tribute to the shadow Leader of the House, my hon. Friend the Member for Walsall South (Valerie Vaz), whose dogged pursuit of that issue has allowed us to debate this important matter today.
In this place our discussion has been dominated by Brexit, but across the country our local councils, and the local services people rely on, are straining at the seams. I pay tribute to councillors of all political persuasions and none for the work they do in serving their communities. I pay tribute to the council officers and dedicated public servants who deliver neighbourhood and care services on the frontline. Years of uncertainty and unfair funding have created a quiet crisis that is now impossible to ignore. Under this Government, the facts speak for themselves: local authorities have faced a reduction to core funding of nearly £16 billion since 2010. That means that councils will have lost 60p out of every £1 that the previous Labour Government provided to spend on local services.
When the Prime Minister entered Downing Street, she promised to build a country that works for everyone, and she then promised an end to austerity. As her time in office probably comes to an end, we are able to reflect on both of those promises. Like in many areas of her leadership, I am sure we will all find that in both those areas she has been sorely lacking.
As usual, my hon. Friend is making a very clear statement about the situation local government finds itself in today. My council is one of the 10 councils to have suffered the heaviest cuts, yet I represent a constituency and a city that is one of the most disadvantaged in the country. It is clear that the decisions that were made about where the cuts should fall have meant that they have been put on the shoulders of the poorest and the most vulnerable, not the richest in society.
My hon. Friend is absolutely right. She champions the cause of the communities of Kingston upon Hull. It is one of the most deprived local authorities in England, yet it is one of the areas that have received the heaviest cuts to their spending power since 2010. That was a political choice, and one that has decimated many communities, including the one she represents, across England.
I am sure my hon. Friend will come on to this argument, but does he agree that cuts to essential local government services in many areas inevitably lead to additional expenditure elsewhere? I think particularly of the decimation of youth services and early years prevention, which has undoubtedly contributed to the extra stress and extreme youth violence on our streets.
My hon. Friend is absolutely right. We used to have something called Total Place, which was all the public sector bodies working together towards a single strategy for a local area. What we have seen as a consequence of the austerity since 2010 is a complete breakdown of that collaborative working. It is worse than that, however, because rather than public bodies working together collaboratively, pooling resources and getting the best possible levels of services for communities, we have seen cost-shunting. For the sake of saving money on youth services, we are seeing a rise in crime that is pushing up costs for the police. Because of the cuts to police budgets, those costs are shunted on to other public bodies. That is not a common-sense approach to dealing with people’s needs and services, to building stronger communities or to spending public money wisely.
On cost-shunting, just this morning we heard from representatives of families with children with special educational needs and disabilities. They were talking about their needs not being met through the education budget, the high needs block from local government or the health needs budget, because each is trying to get the other to pay the bill. Children with special needs and disabilities are falling through the gap and remaining unsupported.
My hon. Friend is absolutely right. There are too many instances across the public sector where cost-shunting is resulting in precisely what my hon. Friend says: vulnerable people falling through gaps that should not exist. I think that in their heart of hearts, Conservative Members, who clearly deal with casework that is similar to ours, will know that that is happening in their areas too.
Very kind of the hon. Gentleman. He was referring to what has happened since 2010. Let us just remind ourselves that the 2010 Labour manifesto said that certain areas would be prioritised and protected. Will he remind us whether that included local government?
My hon. Friend is making an incredibly pertinent speech. Does he not agree that it is completely perverse that public health budgets in York under the Tory-Liberal Democrat council have been slashed, when the NHS 10-year plan says we have to invest in public health?
It shows precisely the short-sighted way that the Government have approached funding local government. The fact that they passed on public health budgets to local government was, I think, a good move. It was one of the few things in the Lansley Act—the Health and Social Care Act 2012—that I thought was good, because it took back to local councils precisely what they were invented to tackle, which is to improve the health and wellbeing of the citizen. Of course, many councils started off their lives 150 or so years ago as local boards of health. Having that focus on public health and on health and wellbeing is absolutely right, but we cannot do that while cutting those budgets. That is the scandal: the areas that have seen the biggest cuts to their spending power, the areas that have seen the biggest cuts to the revenue support grant, and the areas that have seen the biggest cuts to the public health grant are the ones that need that resource the most.
Let me make a point that neatly sums up what my hon. Friend is talking about. In Chesterfield, we have had a reduction of 43.2%. I took the time to look at the reduction in the Minister’s constituency and it is only 12%. That is not a difference of just a couple of per cent. It is three and a half times more in my constituency.
As my hon. Friend will hear as I develop my argument, that is not just a one-off. It is happening across England and it is unfair. The Tories do not get that blatant unfairness, because they have not seen the same levels of cuts in many of their areas that we have seen, yet the impact that has had on the communities we represent cannot be expressed loudly enough.
Let me take my hon. Friend to Nottinghamshire, where spending on adult social care is now £33 million lower than it was under Labour. That is £71 lower per head, as need is increasing. Is it not always the case under this Government that vulnerable people are paying the price?
I will give way to the right hon. Gentleman in a second, if I can answer my hon. Friend the Member for Ashfield (Gloria De Piero) first. It is worse than that, because those are the headline figures. We know that that local authority will have shifted money that was allocated to neighbourhood services to prop up the people-based services of adult and children’s social care, so although social care has been cut in real terms, it would be far, far worse were it not for neighbourhood services bailing out the gaps.
The hon. Gentleman is being generous in giving way. He talks about unfairness. Does he not recognise that it was under the previous Labour Government, in which he served, that the unfairness was introduced through the funding formula allocations, which shifted resources from local government in shire counties into metropolitan areas such as the one he represents?
The right hon. Gentleman has made the case for me. Let me dumb it down for him—I do not wish to appear condescending, but it really is as simple as this: there has always been a recognition by Governments of all colours that not every area has the same baseline. Some areas have greater need and often those areas have less of an ability to raise income locally. Because of that, there has been a mechanism, or a formula—for example, whether that was the rate support grant that became the revenue support grant—to ensure that resources from the centre followed need. What we have seen under his Government is a 60% cut to the revenue support grant. Sixty pence in every £1 for the two councils in my constituency, Stockport and Tameside, is a lot of money. A 60% cut to a very small revenue support grant is different—a number of Conservative Members’ councils have only small revenue support grants, or no revenue support grants in some cases. Sixty per cent. of nothing is nothing and that is the unfairness. A 60% cut to my area cannot be filled in by council tax rises, so it means rises in council tax for poorer services. Cuts are cuts—it is as simple as that.
My area is one that got a really bad deal under past Governments and is still getting a bad deal. Let me build a bit of cross-party support. It is obvious that the Government have to find more money for social care for future year budgets, and it needs to go to my area and some areas represented by Opposition Members. It needs to be done fairly, but what is Labour’s current thinking on how much individuals and families should contribute, because in social care, one of the big issues is how much of the family asset and income is at risk? Does it have any new thinking on that?
Let me answer the right hon. Member for Wokingham (John Redwood) first. We have to have a sensible discussion about how we are going to fund social care. Yes, it is about money, and we have pledged to ensure that there is £8 billion for social care—that was in Labour’s manifesto in the 2017 general election—and we need to make sure that that commitment remains in our future manifesto and is updated, because it needs that immediate cash injection to start with. However, we also need to look very seriously at how we provide adult social care. I really do wish that we could try to break down some of the politicking that has gone on for far too long—[Interruption.] Members can heckle, but it is a fact that before the 2010 general election, Andy Burnham, the then Health Secretary, sat down with the Liberal Democrat health spokesperson and the Conservative health spokesperson to try to work out a way forward. We went into that 2010 general election with poster boards about Labour’s “death tax”. That serves nobody. We need to make sure that we will have something that is sustainable for the long term, and I hope that we can genuinely get to a place where we can do that and talk about how we fund adult social care and children’s services going forward.
I am grateful that my hon. Friend has mentioned children’s services. Clearly, the overspend on children’s services has hit a new high of £800 million—and of £12 million in Newham alone last year—and it is calculated that this funding gap will get to £2 billion by 2020. Is it not a complete and utter nonsense, and unsustainable for councils, to be told that they should be using what little reserves they still have to keep safe our very vulnerable children?
My hon. Friend is absolutely right. Politics is a question of priorities. I often remember the 2017 Budget, when the Government put forward measures to cut the bank levy by £5 billion. We tabled an amendment to the Budget proposing that £2 billion of that same money should go to fully funding children’s services, because we see precisely the cost-shunting that I talked about earlier with children’s services. It is frankly scandalous that vulnerable children and families are not able to access the support that they need.
The hon. Gentleman is being generous in giving way. I say this, again, in the spirit of co-operation across the Chamber. He makes the point about adult social care. At whatever level it is funded, he and others have pointed out the unfairnesses between different parts of the country because it is funded through local provision. Has he considered, or would he consider, going back to a system where the money is provided and distributed nationally rather than locally, so that this particular problem will be taken off the backs of local government?
Of course, I would be very happy to look at any suggestion. My hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) leads on social care issues for the Labour Front-Bench team, but the fundamental issue is that the money has to come from somewhere and some of that has to be centrally provided. We have set out how some extra resources can be put forward for social care.
I will give way later on, but I want to make some progress.
The Prime Minister has said that austerity has ended—she said it in her conference speech last October—but instead of an end to austerity, in January we saw a local government finance settlement that once again cut even deeper into council budgets.
The Minister says it went up, but actually it confirmed what many of us feared, because under this Government there will never be an end to the pain of austerity. Nothing has changed. Let’s bust this myth. This year’s funding package, while it offered an increase in spending power next year for local government, came with a £1.3 billion extra cut from central Government funding to the revenue support grant. An uplift in spending power has been paid for by local people through increased council tax. That is not fiscal devolution; it is another attempt by this Government to shift the burden on to local taxpayers and to devolve the blame for these decisions to councillors of all political persuasions, including Conservative councillors.
Areas such as the one I represent cannot bring in anything like the resources they need to meet the growing demand for social care and our neighbourhood services through local council tax increases alone. This has left areas with the greatest need unable to mitigate the cuts imposed by the Government and residents paying more in council tax for services to be stripped back even further.
My right hon. Friend the Member for Ludlow (Mr Dunne) made the point that the last Labour Government shifted money from the shire counties to the metropolitan areas. The shadow Secretary of State described them as areas of increased need, but does he recognise that in rural areas such as Lincolnshire, where my constituency is, services cost more to deliver because of the geography?
The hon. Lady makes the case that in rural areas there are greater costs to providing services. In some cases, that is correct, but it is a minority of cases. All the evidence, including in a report commissioned by the Secretary of State’s Department, shows that the opposite is actually true. I do not want to get into an argument with the hon. Lady about how we should cut the cake. The cake is shrinking. We need to grow a bigger cake so that we can share out the slices more fairly. As we continue to shrink the cake, all we do is pit her area against my area and her area’s needs against those of the area I represent.
Lewisham Council has had to propose a 2% precept to fund the widening gap in adult social care, yet Lewisham is among the 20% most deprived boroughs. Does my hon. Friend agree that rather than asking some of the poorest to pay more, we need proper funding from central Government for essential adult social care?
My hon. Friend is absolutely right. We need to grow that cake and the distribution of resources has to follow need. If we are serious about tackling health inequalities, if we genuinely want a fairer, more equal country, if we want to narrow the gap in life expectancy between the richest and poorest, which sadly is widening, we will not do it by cutting resources and services in the areas that need them the most.
My hon. Friend is making a powerful case. A man who gets on the train at Birmingham New Street and gets off in Erdington, either at Gravelly Hill station or Erdington station, is likely to live seven years less than one who continues out into the leafy shires of Four Oaks. Birmingham City Council is the sixth most deprived in the whole country, yet it suffered the biggest cut in local government history—of almost £700 million—with another £80 million to come. Does he agree that what is grotesque about the treatment of a great city such as Birmingham is not just the scale of the cuts—including 12,000 staff gone from the city council—but the unfairness compared with the treatment of some of the leafy shires? Birmingham is high need but is being treated as a low priority.
I absolutely agree with my hon. Friend. The treatment of the great city of Birmingham has been appalling. The people of Birmingham deserve the resources they need to have decent public services. He has been a feisty champion of the needs of the people of his constituency and that great city and will continue to make that case.
If ever there has been a city subject to close Government scrutiny it is Birmingham. For five years, it has been subject to the Government’s improvement panel, so the Secretary of State knows the financial situation in Birmingham inside out. How does he justify forcing up the council tax in a city where 42% of the children are in poverty?
Absolutely. I will leave it to the Secretary of State to answer that, because I think that Birmingham has been dealt a bad set of cards by this Government.
It is not just Birmingham. Researchers from Cambridge University have exposed the uneven impact of the Government’s funding of local government. They have found that since 2010 changes in local authority spending power have ranged from a drop of 46% to a fall of a mere 1.6%. When we compare these reductions to the indices of deprivation, we see that more deprived areas have been forced to undergo bigger cuts in service spending, with smaller spending cuts in the least deprived areas. Nine of the 10 most deprived councils have seen cuts three times the national average.
These findings are backed by the Institute for Fiscal Studies, which also suggests that since 2016 the most well-off councils have actually seen an increase of 2.8% to their spending power, while the poorest areas have seen very little growth, despite having faced the largest pressures on their services.
Does the shadow Secretary of State agree that the fact that eight of the 10 councils receiving the largest cuts are Labour-controlled while eight of the 10 receiving the lowest cuts are Conservative-controlled reinforces the need for this Opposition day debate?
Absolutely. We have to highlight the unfairness. We have to keep on until the Government wake up, smell the coffee and understand the damage they are doing to the fabric of so many communities in England through cutting our local neighbourhood services and depriving people-based services, such as adult social care and children’s services, of the resources they need.
Essex County Council is the second largest provider of children’s services by head of population. It has gone from being a failed children’s service in 2010 to now being ranked outstanding by Ofsted, despite there being less money going into the service, but because of a focus on early intervention and partnership working. Does the hon. Gentleman agree that what makes a difference is not just funding for our services but how the money is used?
I can disagree with the hon. Lady because, for a start, funding for children’s services has increased in Essex. She should perhaps check that. If she is saying there is not a crisis in children’s services, she is going against all the evidence put forward by the Conservative-controlled Local Government Association.
I thank my neighbour in the north-west region for giving way. He is making an incredibly impassioned and very pertinent speech. Will he join me in praising Labour-run St Helens Council for protecting services through an integrated St Helens Cares model and the creation of a people’s board, but does he agree that even an innovative council that puts its residents first cannot possibly mitigate the funding cuts of 71% that St Helens Council has suffered since 2010? That is simply not sustainable.
My hon. Friend is absolutely right. I pay tribute to Labour councillors like those in his constituency who are making incredibly difficult decisions. They are the last line of defence for many of our communities, and they are doing what they can, but with both hands tied behind their backs by a Government who simply do not understand the basic economics of the areas that we represent.
I will give way shortly, but I want to deal briefly with the issue of social care before I begin my concluding remarks.
The largest of the pressures on services remains the pressure on adult and children’s social care. According to the Local Government Association, adult social care services face a £1.5 billion funding gap next year, and £2 billion is needed for children’s services.
Given that the Cabinet are too interested in internal machinations, and given the absence of any leadership from the Prime Minister, we have yet to see the much promised social care Green Paper. In fact, this year’s April Fool revealed himself to be the Health Secretary after he missed his own new deadline of 1 April for the Green Paper—but no one was laughing, because that was the fifth missed deadline, following the summer of 2017, the end of 2017, the summer of 2018, and the autumn of 2018. Despite those delays, it seems that little progress has been made.
There is so much concern in the sector that last month 15 key organisations—including the LGA, the Society of Local Authority Chief Executives and Senior Managers, and NHS organisations and charities—were forced to write to the Government expressing their concern that Brexit was becoming a distraction from any action to deal with the real crisis that is affecting the services on which people rely.
There are clearly differences between the cuts made in different authorities, but there is a collective view in local government about the crisis in social care. When Councillor Paul Carter, chair of the County Councils Network and leader of Kent County Council, gave evidence to our Committee during our last inquiry into adult social care, he simply said, “We are approaching a cliff edge.” It is possible that some councils will not immediately follow Northamptonshire over that cliff edge, but it will not be long before they do unless there is a fundamental change in the funding of social care in this country.
My hon. Friend is absolutely right. Let me say to the Secretary of State that if he will not listen to the Chair of the Committee, he should listen to the leaders of his party’s own councils, who are saying precisely the same. There is a cliff edge, and no action that the Government have taken so far has done anything to remove it. It may have pulled a few councils back and given them a few years before they topple over, but unless we fundamentally change the Government’s approach to social care services, we will not be able to solve the crisis in local government.
For the first time in England, we have seen a standard £2,000 tax bill introduced by a Conservative council. We have also seen the costs of the failures of this Tory Government. For instance, the cost of the failure of Tory-controlled Northamptonshire County Council has been pushed on to local people because the Secretary of State allowed it to raise its tax above normal limits as it grapples with bankruptcy. Local people are paying the price of Tory mismanagement: that is what happens when the Tories do not fund local government and are in charge of the town hall.
Austerity is not over, but across the country Labour councils and councillors are showing that it does not have to be this way. Under the shadow of the present Government, Labour councillors are innovating, standing up against austerity, and protecting local services. They are the torch bearers for the new politics that we will see with the next Labour Government. On 2 May, there will be a clear choice: continued austerity with the Tories, or proper investment, fairness and a real change, with Labour councils making a real difference to the communities they represent.
We need a Labour Government because we need a Government who are committed to funding children’s services, funding adult services, funding neighbourhood services, rebuilding our communities from the grass roots up, putting pride back into civic professions, and encouraging our communities to grow and prosper. We will rebuild this country, for the many and not the few. I commend the motion to the House.
Let me begin my speech in the same way as the hon. Member for Denton and Reddish (Andrew Gwynne), and underline the House’s complete condemnation of the appalling terrorist attacks in Sri Lanka and also in Northern Ireland.
The timing of the attack in Sri Lanka at Easter, when people were murdered at prayer, was utterly shocking, and has—rightly—been utterly condemned throughout the House. Our thoughts are firmly with the Sri Lankan community in the United Kingdom, and we send our prayers and condolences in the knowledge that so many people will have lost loved ones. Let me also say, as a former Northern Ireland Secretary, that the brutal murder of Lyra McKee was utterly shocking and disgusting, and that our thoughts and prayers are very firmly with her loved ones, her family and all who cared for her. What an incredible individual she was. At this time, as her funeral is under way, I know that the House will wish to send its thoughts, prayers and condolences to all who love her and all who care for her.
Let me now turn to the subject of today’s debate. Our local authorities and the people who serve them are delivering essential services and changing lives, and it is right that we help them to succeed. I pay tribute to all who work in our local councils up and down the country for the work that they do and the difference that they make to the lives of so many. As Secretary of State, I have made clear my support for local government, and my wish to enable councils to deliver benefits to the people whom they serve. I commend and support those councils, and I look forward to finding new ways in which services can be delivered most effectively, in the spirit of devolution, closer to the point at which they are received.
Let me say gently to the Secretary of State that what he has just said will be taken as weasel words in Harrow, in the context of a 97% reduction in revenue support grant. Can he offer any assurance that he has persuaded the Chancellor of the Exchequer, in the coming comprehensive spending review, to invest in local government health and social care?
Let me point out to the hon. Gentleman that this year we have given our local authorities access to £46.4 billion, a cash increase of 2.8% and a real-terms increase in funding. The settlement includes extra funds for local services, with a strong focus on support for some of our most vulnerable groups. It is part of a four-year settlement that has been accepted by 97% of local authorities, and gives so many areas access to substantially more funding than the least deprived. The average spending power per dwelling for the 10% most deprived authorities in 2019-20 is about 22% more than that for the least deprived.
Does my right hon. Friend agree that as part of the process of increasing the funding that is available, we should increase the practice of business rates retention as a way of incentivising local innovation and enterprise? In places like Cheltenham, it provides an incentive to build out things like our cyber-park, which will create a pipeline of local businesses providing income that can be spent on vital public services.
My hon. Friend makes the point very effectively about the innovation that we see in local authorities and he rightly underlines the work in his own community. Local authorities have campaigned for more flexibility and control over the money they raise, including the ability to create a more self-sufficient sector funded from their own resources. That includes the move to 75% business rate retention, with the benefits that that brings.
I wonder whether my right hon. Friend will consider changing the funding system to reward efficiency. As he knows, councils such as Bromley, which is near his Bexley authority, are historically low-cost authorities that have achieved enormous efficiencies over the years, yet they are asked again and again to make further efficiencies. Does he agree that it is time to adjust their baselines to reflect the historical efficiencies they have achieved?
I know that Bromley does incredible work for its local community. It has innovation, efficiency and real quality at the heart of its efforts. Equally, my hon. Friend raises an ongoing issue in respect of our fair funding review—the review of relative needs and resources. As we reflect on the submissions we have received to date in respect of how that balance is struck, we will certainly give careful consideration to a range of factors to ensure that the funds are applied in the appropriate way to recognise the relative needs and resources of individual authorities.
Does the Secretary of State not recognise that in the case of Birmingham, cumulative cuts of £775 million over a 12-year period are simply not sustainable for a city that has 42% of its children growing up in poverty? Whether or not he accepts that, will he at least do something about the historical underfunding? He will know that the formula for Birmingham was changed to recognise historical underfunding in 2016-17, but because that was not backdated to correct underfunding in the previous two years, Birmingham has been short-changed by £100 million. Will he at least put that right?
I say gently to the hon. Gentleman that Birmingham is one of the authorities with the highest funding per capita. Equally, I am looking carefully at the representations that he and other Birmingham MPs have made to me. The ongoing strike action in Birmingham, with the non-collection of rubbish and the impact that that is having on communities, clearly has not helped. I therefore urge him to support the council in dealing with the challenges caused by the industrial strife that is being felt very firmly in Birmingham, with all the manifestations that that is creating.
Hull City Council has seen a reduction in its funding of 37.8% since 2010. That is having an impact on children with special educational needs and disabilities. Historically, no account has been taken of the number of children with SEND in an area and the amount of funding that it receives for the higher needs block. If the Government are serious about reviewing the way that local authorities are funded, surely that should be something they take into account.
I am working closely with the Secretary of State for Education as we look towards the next spending review. I will come on to the support that is being provided for adults’ and children’s social care, as well as how we are investing further on a number of other fronts. Therefore, we have recognised and reflected on a number of the pressures that we have seen. Clearly, in the further review of relative needs and resources, and as we look towards the next spending review, I will look at the data and the evidence very closely and carefully.
I am grateful. One thing that has been missing from the debate so far in terms of social care is that the vast majority of domestic visits are carried out by employees of private sector companies, as opposed to employees of local authorities, because most of these services have been outsourced. Huge numbers of those companies are going bust. It surely shows the Secretary of State that the system is unsustainable when 100 care homes have gone bust in the last couple of years.
The Minister for Care, who is sitting on the Bench next to me, says that the number of providers is going up. I can assure the hon. Gentleman about the steps that we are taking in conjunction with the Department of Health and Social Care; the assurances; the quality work that colleagues across Government support and strengthen; and the arrangements that we put in place to step in when there are failures in the market and a failure of supply in relation to a particular provider. When we look at a number of these examples, we can see the work that has gone in to make sure that they are dealt with effectively.
It is about the quality of service. When we look at the broader issues of social care, which many Members across the House have rightly touched on, the focus is on the delivery of care and the delivery of outcomes. Simply spending money is not the answer in terms of delivering the high-quality care and the outcomes that some of the most vulnerable in our society need.
My right hon. Friend is right to talk about the quality of care. Does he recognise that Bromley, his next-door neighbour, provides an example of a willingness to participate in close joint working between the health sector and social services? Given that one of the greatest pressures is the growing cost for top-tier authorities of caring for the elderly, will he ensure that the new funding review and the new arrangements enthuse and support authorities that, like Bromley, are prepared to do joint working?
Interestingly, the hon. Member for Denton and Reddish tried to suggest that there was not good joined-up working, but my hon. Friend the Member for Bromley and Chislehurst (Robert Neill) rightly highlights some of the good practice that is taking place in the further integration of health and social care. Indeed, the £240 million of funding that has been committed through this year’s settlement was very firmly aimed at ensuring that those pressures were taken off the NHS. I pay great tribute to the work that local authorities up and down the country have been engaged in, particularly around things like delayed transfers of care, where there has been a 45% reduction since the high point fairly recently. That demonstrates very clearly how we are making a difference.
On the delayed discharge of care, we recognise that ultimately there needs to be more integration between health and social care, and more money. The point that my right hon. Friend makes has a lot of impact, because where we have put money into social care and there has been good structural working between local authorities and the health service, we have seen a radical reduction in the delayed discharge of care. It is not all about money; it is about innovative joint working.
I totally agree with my hon. Friend. Joint working has been done on delayed discharges of care. It is about ensuring that there is good practice and sharing that more broadly. We are doing that equally in children’s social care, where the Department for Education is providing funding to ensure that that is better adopted. It is about good practice and looking at the outcomes. The simple binary approach that the Opposition take is, I think, mistaken.
Another issue on which the hon. Member for Denton and Reddish was fulsome was that of council tax. I want to remind Labour Members that it was the Labour Government who made ordinary families pay the price for their failures, with band D council tax more than doubling under Labour and families paying an extra £750. Even now, Labour wants to abolish the council tax referendum limit, which prevents excessive rises in council tax. It is all very well for the hon. Gentleman to suggest that he is on the side of ordinary hard-working families, but that is not what we saw from Labour in government and it is not what we are seeing now. The real price of Labour is that it always costs you more. This is not just about the cost of a Labour Government; it is also about what people are paying now. Households in Labour-controlled areas have to pay higher council tax to make up for incompetent collection. In the worst-hit areas, Labour councils have unpaid council tax bills of up to £100 million, which is the equivalent of £439 for every household. The 10 councils with the worst collection rates in England are all Labour-run.
It is true that Labour is promising £500 billion of extra spending, but what it is not telling ordinary hard-working families is that that will mean an increase in income tax and a doubling of national insurance, council tax and VAT. Those are not my words, but those of a former Labour shadow Chancellor.
The interesting thing about some of our earlier exchanges was the acknowledgement that the last Labour Government, going into the 2010 election, did not guarantee to protect local government. We have had to make difficult choices and confront difficult issues to put the public finances back on an even keel, and that has not been easy. I pay tribute to the innovation that councils have been engaged in up and down the country to help us to put this right. It is telling that there was no acknowledgement of that in the hon. Gentleman’s opening remarks.
The Minister is saying that the Tory Government want to spend on things that work. I can tell him that what works is the troubled families programme, which is due to end next year. Will he take this opportunity to commit to the House to doing everything he can to keep that programme running after 2020?
I am glad that the hon. Lady has mentioned the troubled families programme, because I will be talking about that in greater detail later in my speech. I have been hugely impressed by the outcomes of the programme, which, as she rightly points out, is making a difference in people’s lives. I strongly believe that the troubled families programme has now shown an evidence base for how it is profoundly doing that. It is doing what has rightly been described across the House as pulling together services to create a person-centric approach, and breaking down some of the silos and barriers. I am a huge champion of the troubled families programme.
So far, the Secretary of State has blamed striking workers and councils up and down the country. The one group that is not being blamed is his rotten Government: the responsibility for this crisis lies firmly at his door. When will he stop blaming everybody else and take some responsibility for the crisis in this country?
The hon. Lady must equally reflect on the fact that the Labour Opposition voted against a real-terms increase in the core spending available to local authorities this year. That included the additional funding for health and for adult and children’s social care. We recognised the pressures and made the right judgments in respect of the pressures that councils explained to us. The Opposition may wax lyrical about funding pressures, but their own councils are not even helping themselves.
The Opposition have some front to claim to be the champions of local government and localism. I took the time to read the shadow Secretary of State’s recent speech to Labour’s local government conference this year, and it contained some big and bold claims. It is just a shame that they were not backed up by reality. He said that Labour was the party of devolution. I must congratulate him on his selective memory. If I remember correctly, it was his party that, after 13 years, left the UK one of the most centralised countries in Europe. It took the Conservatives in government to roll back the era of centrally imposed targets and the tick-box culture imposed by the Labour party, and it is this Government who have put the public finances back on track and cleared up the mess we inherited from Labour.
I am sure the Secretary of State would not want people watching this debate to be misled by what he has just said about police funding. He knows as well as all of us that the reason Labour voted against the spending plans for the police was that we were proposing far greater spending on the police. That is why Labour Members voted against what we saw as his derisory offer to our desperately under-resourced police services.
We have given significant investment to the police. Indeed, the Chancellor has made further commitments on some of the most acute pressures that we know are being experienced. I was actually talking about the local government settlement, rather than the police settlement, which was dealt with separately. However, we made a commitment to providing additional resources, and we are backing the police to deal with the issues of crime.
I am glad that my right hon. Friend is reminding Labour Members of Labour’s record. Someone had to come in and pick up the pieces in 2010. Might he also like to remind them that it was Labour that introduced compulsory capping on council tax levels, reducing the discretion of local authorities? That was then abolished by the Conservative-led coalition. It was Labour that introduced central planning through the directly imposed regional spatial strategies, overriding the wishes of local communities, and it was Labour that enforced compulsory unitary councils in areas that did not want them. One of those decisions was reversed by the Conservative Government in favour of the bottom-up approach brought in by this Government. Labour posing as the party of devolution has more front than Harrods, as my old grandma used to say.
My hon. Friend makes his point in his inimitable style.
We have promoted a greater sense of devolution, and this comes back to my point about trusting communities, councils and people at the grassroots to get on and deliver for their communities. It is this Government who have given local authorities the tools and resources they need to do their vital work, and it is Conservative councils that are providing value for money and delivering quality services for their residents while keeping council tax lower than in Labour and Liberal Democrat council areas. This includes doing the right thing on recycling, with Conservative councils recycling, reusing or composting around 49% of their waste, compared with 36% under Labour councils. This is about local delivery, which is what much of the current campaign and the votes in the forthcoming local council elections will be about.
One area in which the Secretary of State and the Government have failed to invest since 2010 is staff. The Government may offer warm words, but a 21% real-terms pay decrease for some of the worst paid workers is completely unacceptable. How is the Secretary of State going to address that issue?
I hope the hon. Lady will have noticed that, according to the latest figures, real wages are actually going up. I remind her of the fact that pay restraint across the public sector was a consequence of the mess that we inherited from the last Labour Government. I know that this has been difficult; it has been really tough and incredibly hard. Equally, we are determined to maintain the strong economic path for our economy and to ensure that our public finances are now back in the right space and not left in the fashion that the last Labour Government left them in. I am mindful of the essential role our local authorities play in helping the most vulnerable in our society, and I recognise the growth in demand in adult and children’s social care and the pressure that that brings.
I am interested in the exchanges across the Chamber about which party has been the best, or perhaps worst, at the devolution of council funding. It was actually the Thatcher Government who introduced the capping of rates—it continued with council tax—taking away councils’ freedom to set their own business rates. Is it not the reality that neither the previous Labour Government, nor the coalition Government nor this Government have done anything fundamentally to increase the freedom of councils to raise their own funding at a local level? I hope that the Secretary of State will address that when we finally see his devolution framework.
I look forward to engaging with the hon. Gentleman and the Housing, Communities and Local Government Committee on issues relating to the devolution of business rates and so many other things. I profoundly believe in the merits and benefits of decisions being taken more locally and of local government having a sustainable position.
I am conscious of the number of Members who want to participate in this debate, so I will now make some progress.
Coming back to social care, £650 million out of the more than £1 billion of extra funding committed to councils at last year’s Budget will be going towards adult and children’s social care in 2019-20. Of that, £240 million has been allocated to ease pressures on the NHS, which comes on top of the £240 million announced in October to address winter pressures. The remaining £410 million can be spent on either adult or children’s social care where necessary to take the pressure off the NHS, meeting the request from local authorities for greater flexibility. Taken with the adult social care precept and the improved better care fund, the Government will have given councils access to £10 billion of dedicated funding, which can be used for adult social care in the three-year period from 2017-18 to 2019-20.
When it comes to protecting our children, we are investing £84 million over the next five years to expand three of our most successful children’s social care innovation programme projects. The projects will keep more children at home safely in up to 20 local authorities, but in the long run our work will ensure that our health and care systems are better integrated. That will be our most powerful tool in ensuring we have a sustainable approach in the years to come.
Returning to troubled families, which the hon. Member for Erith and Thamesmead (Teresa Pearce) rightly highlighted, I believe that our programme is helping local authorities to support families with complex needs and to improve outcomes for individuals. The programme has been a catalyst for local services, transforming how they work together, making them more integrated and cost-efficient, and reducing dependency and demand on expensive services. The results speak for themselves. The latest national programme evaluation shows that, when compared with a similar group, targeted intervention saw the number of children going into care down by a third, the number of adults going to prison down by a quarter, juveniles in custody down by a third, and 10% fewer people claiming jobseeker’s allowance. While I recognise that there is more to do, the results are a tribute to the tireless efforts of family workers, local authorities and their many partners in our public services and the voluntary sector. This is about so much more than the financial boost that someone can get from a regular wage. It is also about the pride and the dignity that comes with someone being able to take control of their own life.
The future of this country is not about an ever-growing collection of handouts and entitlements, but about growing prosperity and independence, and that equally applies to local government. This Government are working to build a more confident, self-sufficient and reinvigorated local government. With the end of the current multi-year deal in sight, we clearly need to take a longer view of how we fund councils as we move to a stronger, sustainable and smarter system of local government. This year’s preparations for increased business rate retention, a new approach to distributing funding between local authorities, and the upcoming spending review will also be pivotal. Important work is also under way with authorities and the wider sector to better understand service costs pressures.
For years, councils have asked us for more control over the money raised, and we are giving it to them through our plans to increase business rate retention to 75%. In the process, we will provide local authorities with powerful incentives to grow, and authorities estimate that they will retain around £2.5 billion in business rate growth in 2019-20 under the current system—a significant revenue stream on top of the core settlement funding. In addition to more control, councils want and need to see a clearer link between the allocation of resources and local circumstances, and our new fairer funding formula will ensure a more transparent link between local needs and resources and the funding that councils get.
I pay tribute to the leadership and creativity of our councils, which deliver high-quality services for their residents and efficiencies for the taxpayer. We are determined to give them the freedoms and flexibilities they need so that local government can continue to flourish and deliver vital services to meet the challenges and opportunities that lie ahead. As voters go to the polls at the local elections, this Conservative Government are providing a real-terms increase in spending power for local government and giving councils the freedoms to deliver for their local communities, and hard-working Conservative councillors are providing value for money for hard-working families and the quality services that their residents deserve.
On a point of order, Madam Deputy Speaker. I did not get the chance to correct the Secretary of State, so it is important that I do so now. My hon. Friend the Member for Chesterfield (Toby Perkins) quite rightly mentioned the instability of the care market, but the Secretary of State provided an incorrect impression of the situation. Research by Care England shows that there are now 564 fewer care homes when compared with 2015 and that there has been a net loss of 8,119 care home beds nationwide. The Secretary of State gave an incorrect impression, and we should not carry on the debate after that sort of wrong impression has been given.
I associate myself with the comments of the other two Front Benchers about the events over the weekend. I had the honour of being in Jerusalem for Easter and was shocked on Thursday and then on Sunday to hear of such horrific events. I was sitting in a site that is so precious to the three monotheistic faiths when I heard that, after the terrorist attack in New Zealand, we had had violence in Northern Ireland and then the horrific attacks in Sri Lanka.
Turning to this afternoon’s debate, I echo the comments of the hon. Member for Denton and Reddish (Andrew Gwynne). Here we are yet again. The Green Paper that we should be debating to consider sustainable funding for social care has been kicked into the long grass five times, and there is no sign of it coming forward. Is that just because the House, the Government and the civil servants are too busy with Brexit, or is there really a lack of ideas on how to solve the situation? The problem, however, is that we should urgently be thinking about a way forward.
The NHS five year forward view was based on game-changing public health changes and funding and increased social care funding and provision, because otherwise all we will see is increased demand at the front door of the NHS and then a blockage and leakage of funds at the back end. The four-hour target that we often talk about does not just measure A&E performance; it is about the flow of patients through the system. If patients cannot get home at the other end, the system simply breaks down.
Local government in England has seen an average 28% cut in funding, and I have been shocked by some of the figures that Members have mentioned, which range from 46% to 75% to 97% cuts in central funding. Obviously, everyone has faced cuts to their budgets, but there has been only a 5% reduction in local government funding in Scotland despite a 7% cut in the resource budget. The situation has been much more protected than has been the case in England. In Wales, there has been an 11% cut.
I welcome the long-term NHS plan because it unpicks some of the damage done by the Health and Social Care Act 2012, particularly by reforming section 75, and it tries to drive integration, which I think Members on both sides of the House would recognise is the only way forward. However, it was disappointing to discover yesterday on the Health and Social Care Committee that local government was not involved, almost at all, in putting together the long-term plan, yet it will be expected to deliver more and stronger social care to relieve pressure on the NHS.
Does the hon. Lady agree that it should have been a long-term health and social care plan if we actually believe in joined-up, integrated working and that the funding settlement for the NHS, very tight as it is, simply will not work without addressing the underfunding of social care?
The hon. Lady is making a valuable contribution. One of the big problems in social care is the lack of social workers, which local authorities cannot fund because of the gigantic cuts conducted over the years by this Government. It is about time we faced up to the fact that austerity has gone on far longer than the second world war and, quite frankly, rationing.
The hon. Gentleman talks about the workforce, but in both the NHS funding settlement and the forward plan we see a big injection into NHS England, but no extra funding for Health Education England or for public health. Preventing illness is the cheapest thing we can do yet, for decades, Governments of all colours in all places have failed to do that. Unfortunately, the long-term plan does not do it, either.
Age UK talks about 1.5 million people being left without sufficient care and support at home, and it describes the number of people needing elderly social care increasing by almost 50% since 2010, but local authority-funded patients in England are down by a quarter over that time. A third of patients depend on family support, but 2 million carers are over 65 themselves, and 400,000 of them are over 80. Look at the burden we are putting on elderly people to care for their elderly partners, often without respite or support.
I recently spoke to an elderly couple. The lady was caring for her husband who had Alzheimer’s, which was having such a devastating impact on her health that she ended up having to go into hospital, too. She was not worried about being ill and having to go into hospital; what was upsetting her was that her husband was left without anybody to care for him in an environment he did not know or understand. Surely this situation needs to change.
Absolutely. We should value family carers and the care and work they do, right across the United Kingdom, for people who need help in all our communities, yet they are so poorly valued. Carer’s allowance does not even equal jobseeker’s allowance, which is something we have tried to repair in Scotland, but obviously we do not know whether that money will simply be clawed back by the Department for Work and Pensions in other benefits. That is always the problem. We are supporting carers so poorly. Not only do they have the physical burden and the lack of time to look after themselves, but often they are in financial difficulty.
Scotland is the only one of the four nations to provide free personal care, which we have been providing since 2002. Having integrated health in 2004, we have been working since 2014 to try to integrate health and social care, which is a lot more difficult. The social care environment is different. It has multiple companies and different set-ups. It is means-tested, rather than being provided free. Social care is a real challenge, and therefore local authorities and the health structures within any local health system will require support and funding to work out how to achieve it so that they are wrapped around the patient, not bitching about whose purse the money will come out of. As we have heard today, the problem is that there simply is not enough money in the purse to start with.
In Scotland, we now allocate half of our health funding to integrated joint boards, which are made up of health and local authorities, to look at how we provide primary healthcare, mental healthcare, social care and children’s services so they are driven locally and take account of all the support that is required.
There are three main groups that require social care. First, the elderly. Many of us are heading that way ourselves, and the No. 1 important thing is to maintain people’s independence for as long as possible. That is the importance of not rationing surgery for hips, knees and eyes. If we can keep people seeing and walking, and if we can give them a bus pass so that they are out and about with their cronies down the town, they will stay independent and functional for longer.
Of course we have the frail elderly, who require to be looked after in comfort and support. By their own choice, that would be in their own home if at all possible. In Scotland, home care hours have been increased from six hours to 12 hours a week, which has allowed us to keep people with greater dependency at home. Looking at A&E attendances and emergency admissions over the past five years, we can see that Scotland’s increase—we are all facing increased demand—has been only one third of that in England. That is why we have had our best performance against the four-hour target since March 2015. It is a combination of supporting people not to arrive at the hospital door and not to be stuck at the other end, because we have driven down delayed discharges every year.
When we talk about numbers such as four-hour targets, it is important that we remember that they are a thermometer taking the temperature of the acute system. They look at how we bring people through. Everyone in hospital wants to get home. They do not want to be stuck there.
The next group is people facing end of life, and they would like, if possible, to be cared for with dignity at home. They want to be with their family but, equally, they do not want to be a burden to their family. If they need respite, they want to have access to it. Since 2015, the Convention of Scottish Local Authorities agreed that even people under 65 will be provided with free social care if they are defined as facing end of life, which means they will not be stuck in hospital facing a means test that fritters away their remaining weeks and days of life. A quarter of us will die in a care home, and we want to make sure that we would be happy with the quality of care in that care home, rather than living in squalor or being mistreated.
The third big group is the working-age disabled. For them, quality of life, mobility and, particularly, participation in society are critical. Both in England and Scotland, almost half of local authority social care spending is on people of working age. We tend automatically to think that social care means the elderly. Two thirds of the working-age disabled told a survey that they are not given any help or signposting, and a majority said they are not given enough hours to help them live independently.
Frank’s law comes in this month in Scotland, which means that those under 65 with dementia, motor neurone disease or multiple sclerosis will also be eligible for free personal care. The law is named after Frank Kopel, the footballer who unfortunately developed dementia very early.
Workforce is a challenge for all of us. Our workforce has gone up 12% in the past three years, but all care providers report difficulties in recruiting, and Brexit is only making that worse. We need to value care, and we need to let it develop as a career. People should be paid the real living wage, not the pretendy living wage, for all the hours they work, including at night. A carer coming into a patient’s house for 15 minutes to throw them out of bed, particularly a carer that patient has never seen before, is not providing quality of care. We need continuity between the patient and the carer. Caring needs a career structure to ensure that people stay in the profession and develop, grow and lead others.
It was said that the UK Government Green Paper would give us a chance to rethink funding, but we still have not seen it to enable us to debate the options. Will that be done by a rise in national insurance, or by continuing national insurance after retirement for better-off pensioners? People have mentioned the German and Japanese systems, but we need to look at the pluses and minuses of both. By 2030, the number of 85-year-olds will have doubled. We need to prepare to look after them, and to give them independence and dignity, so that they do not end their lives in complete misery and squalor.
It is a pleasure to speak in this debate. It is an important debate, so I thought the tone set by the Opposition spokesman at the start was a real pity. The shadow Secretary of State, the hon. Member for Denton and Reddish (Andrew Gwynne), ran through things in a very selective manner. It was almost as though he had been in a time machine and missed out certain periods and certain significant challenges faced by the country. He did not acknowledge the situation in which the Labour party left the public finances in 2010, with a deficit running at £150 billion a year and the Government borrowing £1 of every £4 that they spent—the taxpayer was footing the bill for that. Nor did he acknowledge that at the time, unemployment was rising and employment was going down, so people were losing their jobs.
Something had to be done, and the ship had to be steadied. We have seen the results of that, and we now have record employment, record low unemployment and rising wages. Achieving that has involved many difficult decisions. I, for one, know how hard local government has worked, the sacrifices that it has made and the sacrifices that people have made. I pay tribute to councillors across the country, and particularly to Conservative councillors, who operate better-run authorities at lower cost. I also thank council officers, who have worked extremely hard to deal with the challenges that we have faced. They have made a massive contribution to the reduction of the deficit.
I am concerned that so far, this debate has been one-sided. The hon. Gentleman talked about the reduction in revenue support grant and direct money from Government, and that has certainly happened. However, he did not mention the other side of the equation, namely business rate retention and council tax, and he tried to present a distorted picture of individual local authorities’ funding. The reality is that the authorities that he described as worse off actually have the highest spending power.
I am setting out the approach that the Opposition have taken, but I think they should instead have looked at the challenges and considered how we might address them in a sensible and measured way. I am certain in my mind that we need to put more money into local government, and the Government are starting to do so. Spending power is on the increase, and since 2017 up to £10 billion has been made available to local authorities to fund social care. The Opposition’s motion mentions £8 billion being put into social care during this Parliament, but the Government are already putting in more than that.
There are significant pressures on social care, whether it is children’s social care, where there are more looked-after children; adult social care, where we have an ageing population—that is a great thing, but it means that we have to support more people in their later years—or the important group of people of working age who require social care, such as adults with learning disabilities or people with complex needs who need support. Those groups are all growing in size, and we need to make sure that they are looked after for the future.
In addition to increasing demand, services face challenges from rising costs. The national living wage is going up, and companies now have to pay additional pension costs. That is a good thing, because it means that additional money is being paid to people who do the extremely important and difficult job of supporting the most vulnerable. We need to make sure that those employees are paid more, that they are trained well and that the job becomes more professional, so I welcome those things, but they present challenges. We need to work out in a sensible and measured way how we will pay for the additional provision that is, and will continue to be, required.
The Opposition spokesman talked about how the Labour plans for social care were blown out of the water by the Conservatives during the 2010 general election. I thought that was a bit rich, because that is exactly what the Labour party did to the Conservatives at the 2017 general election. If we are going to have a debate, let us have a sensible, measured and proper one, rather than just talking about how big our pile of cash is and listening to the other side say, “We will create a bigger pile of cash to pay for social care.”
We have to acknowledge who is going to pay for social care, and we have to get the balance right. We cannot expect young people who have just entered the labour market—people who are starting work and trying to make their way in life—to pick up the whole tab. We cannot expect older people who have worked all their lives and built up assets to lose all those assets because they need care. We have to look at the matter carefully and proportionately, and try to make sure that there is a balance. We must provide the support that people need but reward people for doing the right thing.
Clearly, local authorities provide much of social care, but we need to look at how that fits in with other social care provision. For example, I always find that continuing healthcare is a real bone of contention. The system is opaque and hard for relatives to navigate. It is hard for people to figure out why their relatives are not eligible when somebody in the neighbouring bed is eligible. It can take forever for a claim to go through. I have known a number of cases in which, unfortunately, relatives passed away some time before a continuing healthcare claim was settled.
The hon. Gentleman is making an important point. Anybody who has dealt with families in that position knows that money may be suddenly withdrawn after a continuing healthcare review goes through. Very often, an elderly person will be transferred to another home because they can no longer afford the one they are in. Is that not something that we need to sort out in advance of a fundamental reform of social care? It is a significant problem.
The hon. Gentleman knows a great deal about the subject, and I certainly think that the issue he mentions needs to be looked at, as does the wider system.
We need to look at how social care works in the context of the wider health system. We need integration; we have talked about integration for years, and it does happen, but we need a system that is simple enough for people—for relatives, in particular—to understand and navigate. We need to make sure that the different parts of the system work together. Public health must work with primary care, and our GPs must work well with our acute sector. We must all work together with one common purpose, which is to keep people out of hospital for longer. That is how to improve people’s quality of life and reduce the cost to the taxpayer.
I wish to mention a small but important example from my constituency: a doctors’ surgery called Whitestone Surgery. I declare an interest because I am a patient there. I mention Whitestone because it does fantastic work through its patient participation group and social prescribing. The patient cohort in the catchment area is made up of relatively older people, and many of the patients who go into the surgery are passported through to the PPG, which runs several activity streams, including an allotment, days out and the odd visit down the pub for a meal at lunchtime. All those sorts of activities are really improving the situation in the area by reducing social isolation and loneliness. As a result of that ongoing work, the surgery is seeing the prescription of a significantly lower amount of antidepressants and fewer people being diagnosed with dementia than at other surgeries with a similar patient cohort. Warwickshire County Council is considering the work at the surgery carefully with regard to expanding it throughout Warwickshire, and studies are also being undertaken to see what merit it has more widely. I am delighted that such important work is taking place in my area. It is a good example of what we need to do to support people.
Local government has done its bit and is doing its bit for the deficit, and we need to support local government going forward. Now that we have the public finances far more under control, we need to put more funding into other services, such as the police and schools. We also need to think about how funding is distributed, because currently the fairness is not there—for example, the people of Warwickshire get a raw deal compared with people in many metropolitan areas. We also need to think about the context and the effect that putting more money into public services has on our public finances. We need to think about the effect on what tax people need to pay. In the light of those things, the motion does not address the whole picture. It is based purely on a political slant and is not there to support the people whom everyone in this Chamber wants to support. I am afraid the motion is there just to score a few points, so I shall not support it.
As the Chair of the Housing, Communities and Local Government Committee, I think the importance that Select Committees have attached to the issue of social care is shown in the amount of time we spend on inquiries on the issue. We have recently published three reports on adult social care, the last of which was done jointly with the Health and Social Care Committee last year. They were all unanimously agreed by our Committee, and in the latter case by the Committees jointly. We are currently inquiring into children’s social care, with the report due out next week. Those four social care inquiries show how important the issue is for the Committee and for local government as a whole.
As a Sheffield MP, I have to comment on the fact that my city and constituency have received funding cuts that are far higher than the average percentage in the past nine years, since 2010. Like other northern cities, we have been disproportionately hit, as cities with the greatest problems and needs have seen the Government cut their grants by the biggest percentage.
Putting all that to one side, if I look at the wider context, I see real problems for local government, because as a whole local government has had bigger cuts by percentage than any other area of Government spending. That has united councils of all political persuasions in their concerns about the unfair effect those spending cuts have had on local government as a whole. This comes at a time when demand for the main local authority services—care services—has been rising. The number of elderly people has been growing, which has meant that the number of elderly people who need care has been growing. That is great, because people are living longer. The number of people of working age with disabilities—an element of care that we should not forget—has also been growing, which is another success. In percentage terms, the demand for children’s services is going up faster than demand for any other current aspect of local government spending, so that comes on top of what I have described, too.
Those three rising demands mean that despite the fact that more people are in need of elderly care, according to Age Concern some 1.5 million people are not getting it. The threshold has been raised such that people with lower and moderate needs are now excluded from the care systems. People are ending up in hospital who should not be there because prevention is not happening, and people in hospital are not being discharged as quickly as they should be. We see all these things happening as a result.
The pressures on social care are causing other issues. With rising demand and spending on social care, as the cake has shrunk, the proportion of it spent on social care has grown, so the amount spent on other services has proportionately been cut by even more. The National Audit Office has done the figures, and they were given to the Select Committee: cultural and related services have seen a 35% cut; highways services and transport have seen a 37% cut; housing services, including homelessness and private sector housing, have seen a 45% cut; environmental and regulatory services have been cut by 16%; and planning has been cut by 50%. Those are massive cuts to the basic services on which we all rely day to day.
I worry about all that, because although it is of course important that councils concentrate on care, most people in the country do not receive care for themselves or for people in their families on a daily, regular basis; they rely on other services. They are seeing their council tax bills rise and what they get for their money fall. That is a real challenge and problem for local democracy. People are paying more but not getting any more. We ought to be very concerned about that indeed. It needs to be addressed in the widest sense.
I refer to the comments made by Councillor Paul Carter, but people from the Local Government Association, the County Councils Network, the District Councils’ Network, London Councils, and SIGOMA, the special interest group of municipal authorities, have made similar comments. Every council organisation has said that the current situation simply cannot continue and that we need a fundamental change in the amount of money provided for local government in the next spending review. The Select Committee will do an inquiry into that, which will hopefully give Ministers the ammunition with which to badger and berate the Treasury when they have discussions at that level.
We know from the estimates, which no one from the Government has challenged, that by the end of the next spending review children’s services are likely to be £3 billion adrift of the funding they need. Social care for the elderly is already £2 billion adrift, with estimates that the average annual increase required to keep pace with demand is around £800,000. That takes us to around £7 billion adrift.
The quality of care is often forgotten about. We need not only to continue to meet the increase in demand, but to do something to improve quality. If demand is going to increase, we are going to have to recruit more staff, and if we recruit more staff, we are going to have to pay them and train them better, otherwise, we will not be able to retain them. So the costs are going to go up even further.
I speak as a co-chair of the all-party group on social care. Next week, we are launching an inquiry into the professionalisation of the social care workforce. My hon. Friend is making an important point about recruitment and retention and the need for more funding. The pressures and demands on funding are leading to a reduction in the professionalisation of the workforce, and as a result to reductions in the quality of care.
Absolutely. The joint Committee report made the point that the quality of care is so important, and we have to think about the quality of the workforce and how much we pay them. The average social care worker gets paid 29% less than someone doing a similar job in the NHS. That figure demonstrates the challenge that we face.
What are we looking at, then? We have recently had a few welcome sticking plasters of funding from the Government; but next time, we will need a very large bandage, not just a few sticking plasters, to put this issue right. We look forward to the Green Paper, at some point on the horizon. Perhaps the Minister can tell us about the timing for that when she replies, but even now time is now too short for there to be a fundamental change in funding arrangements. We are going to need a lot more of the same.
The two Select Committees recommended that, at the funding review, we take the £7 billion extra that will be in the local government system from the 75% business rates retention and, instead of using it to replace public health grants and other forms of grant, we put it back into the system to deal with the problems of social care. That money can be there and we will not have to change the system. That can be done. We also proposed changes to make the council tax system fairer and less regressive. We can do those things for the next spending review and make sure that a quantum of money—around £7 billion— is available for social care. That would then relieve the pressure on other council services.
We then looked at what the longer-term system should look like. Of course, we need better integration at a local level between the NHS and social care. This is not about a national system of care that replaces what local authorities do; it is about better integration at local level. We must bear in mind that, while it is important that the health service and social care are linked together, the other great join-up that we must have is between housing and social care. The majority of people receiving social care live in their own home, and it is vital that we get those services linked as well.
Absolutely. We need integration on that level as well. The point is that these services are better joined up and delivered at a local level. It is an important role that local government has to play, and it is why local government’s hand should be strengthened in these matters.
In coming to our conclusions about long-term arrangements, the joint Select Committee inquiry looked at two very important bases. We went to Germany to see what existed there. Essentially, Germany’s model involves an extra percentage on the insurance payments that it gets from the public. There was a cross-party agreement 20 years ago, and the rates in Germany have been raised with no dissent from the public or the parties. It is a system that works and that people agree with, because they know that the money goes into social care. That is what we looked at, and it helped form the basis of our conclusion.
We had a citizens assembly—it was a great experience. We selected around 50 people from all over the country. They met for two weekends in a hotel in Birmingham, and came to unanimous views about how we should deal with social care funding. The principles were clear: we should have a system similar to that of Germany, with a social care premium, as we recommended, but very importantly—the Treasury hates this—the money must be dedicated for social care. People are willing to pay more if they know where the money is going. That was a fundamental principle that was laid down. There was also the principle of universal and high-quality care, and the point was made that a well-paid and well-trained workforce was needed to deliver it.
We also said that there had to be fairness between the generations and that the social insurance premium should be paid only by people over 40. However, we thought that it was fair to say that people of pensionable age who work should also pay. Another issue that we felt needed to be dealt with was the unfairness of people losing their homes in some cases and of all their assets going to pay for social care. The suggestion was that we could bring in a floor and cap system to make sure that people do not pay anything up to a much higher level and do not pay any more beyond the cap. We can pay for that by simply taking a percentage of inheritance tax, so that everybody pays a bit towards the system. We thought that that was fair.
We also said that, ultimately, we want to work towards a system where social care—personal care—is actually free. We did not think that we were there yet, which was why we recommended these changes to begin with, but we thought that we could get there eventually. We said that the extra money coming in had to be on top of the existing local government system.
This is a very good report. Two Select Committees unanimously agreed how we should raise the money for social care in the future. I say to Members on both Front Benches: why bother with the Green Paper? They should produce the White Paper and get on with it. The solution is there. We have given it to Ministers and shadow Ministers. This is a very good proposal. Please get on and deliver it now for the future.
It is a pleasure to follow the hon. Member for Sheffield South East (Mr Betts), the Chair of the Select Committee. I agree with everything that he said in the last part of his speech. It is a shame that his Front-Bench team did not take a similar approach. The shadow Minister spoke for nearly 40 minutes and did not come up with one solution or proposal as to how we improve social care.
I am a great believer in the idea that it is not what you do but the way that you do it. In the same way, I believe that it is not how much you spend but how you spend it that makes the difference. As someone whose constituency falls in the county of East Sussex, which has the highest number of over-85 year olds in the country, I can speak with first-hand knowledge about the pressures on our social care system. I am not saying to the Minister that East Sussex does not need more funding, because it most definitely does. East Sussex has set up its Better Together system, working hand in hand with the NHS. Last winter, by working with the clinical commissioning groups and funnelling money into community care beds, it managed to reduce its delayed discharges by 33%, and that was despite an 11% increase in demand. The £2.5 million extra given to East Sussex by the Government this winter went into the system and, as a result, there were no delayed discharges or ambulances queuing up at the hospitals’ closed A&Es. The system was able to cope even with an increased number of norovirus and flu outbreaks.
Last year, we were subjected to urgent question after urgent question about the winter hospital crisis. Sadly, even with the system coping so well this winter, we have not had any acknowledgement of how hard NHS staff and local council staff have worked to ensure that, despite the extra pressure, there was no winter crisis this year. That success is because councils and the NHS are working much better together than they have ever done before.
We need to see what East Sussex is doing across the board. Although it is welcome that we now have a Health and Social Care Department, we are not seeing that joined-up working at a national level. I am concerned that if we do not see that joined-up work across the board, the £20 billion extra going into the NHS will be eaten up by the pressures on social care. If patients do not get the social care they need, their health will deteriorate, they will be admitted more often, they will be sicker when they are admitted and they will be in for longer periods of time. Their discharges will be delayed and their outcomes will be poorer. Not funding social care properly, or not using that money wisely, is a penny-wise and pound-foolish approach.
When this Session comes to an end and we have a new Queen’s speech, I hope that social care will be top of the agenda. I wish to see three things. First, there is the funding of social care. I am sad that the amendment to this Opposition day motion was not selected. I too have a copy of the report of the joint Select Committees, “The long-term funding of adult social care”. The hon. Member for Sheffield South East is right: instead of having a Green Paper, let us just get on with the recommendations in this report, because there is cross-party support for looking at a social care premium system, such as the one in Germany. We must be honest with the British public: there will need to be funding for social care. We need to have something, instead of people who have worked hard all their lives selling their homes to pay for social care—and not realising that that is what they will have to do—or refusing social care until they reach a crisis point and then have to pay for it.
I invite my hon. Friend to agree that, notwithstanding her radical suggestion, which was also made by the Chair of the Housing, Communities and Local Government Committee, about not bothering with the Green Paper, it would nevertheless be helpful if the publication of the Green Paper was now actually announced as a date—not as a month, a season or even a festival, which is the latest estimation we have had, but actually as a date.
My hon. Friend is quite right. I am being slightly facetious in saying that we do not need to bring out the Green Paper. However, it would be very welcome indeed if the Green Paper contained some of the Select Committee’s recommendations.
We need a long-term funding solution, and I have discussed this with the Minister previously. The four-year settlement for local government was really helpful. If local authorities could have a 10-year settlement like the NHS has just had, they could do far more with their money, even if they were not seeing the significant increases that they would particularly like.
My third request is to look at the better use of our healthcare and social care professionals. We have grown up with a historical medical model that has depended on doctors and GPs, but people often need a diverse range of professionals to help them. The East Sussex Better Together model has just announced its community pharmacy programme, which is improving communications for patients discharged from hospital and helping them with their medication. The transfers of care around medicine project, or TCAM, is enabling those patients at risk of delayed discharges or readmission to hospital to have a dedicated pharmacist to help them, because we know that having problems with medication is one of the core reasons that people fail when they are discharged from hospital.
Under the community pharmacy programme, pharmacists would have access to patients’ medications, and would be able to answer their questions, monitor side effects and issue repeat prescriptions—things that often do not happen when someone is discharged home. The research and evidence base show that following such a model will reduce admissions and length of stay, and give patients a better experience and better outcomes. Some 112 pharmacies in East Sussex are going to take part in the project, which is a joint working venture between the county council and the clinical commissioning groups. I encourage the Minister to look at rolling this scheme out across the country, so that we can move away from being so dependent on GPs and doctors. I am conscious that there are a number of doctors in the House this afternoon. Doctors do valuable work, but there are other healthcare professionals that we should also be using.
This is not just about funding. Although the Government have given £20 billion extra for the health service, funding for local councils has increased by £1.3 billion this year—an increase of 2.8% compared to last year—and we have given extra money for winter funding, it is what authorities do with that money that makes the biggest difference. We need a long-term solution and a specific funding supplement, as recorded and recommended by the Select Committee. We also need to make better use of some of the fantastic resources that we sometimes fail to recognise. We can do a lot more, even with the existing resources. I am disappointed that the Labour Front-Bench spokesperson did not take the same tone as the Chair of the Select Committee, because we can do more to improve the lives of our constituents.
I am very pleased to speak in this debate, which I thank my Front-Bench colleagues for securing. This is our first Opposition day debate for goodness knows how long; it has been so long that I have lost track. It is important that we have this debate just about a week before hundreds of local councillors and council candidates from all parties go to the polls across the country.
The House recognises that we have been embroiled in the Brexit nightmare for the last few months, as have the Government, but the vital work of local government has continued in the meantime. That includes the vital work of hundreds, if not thousands, of local councillors to ensure that all our local communities are provided with the services and support on which they depend. We often forget that local councillors give an awful lot of time for not very much reward in order to keep the wheels of local democracy running, and they are currently doing so in unprecedentedly difficult circumstances.
Central Government funding for local councils such as mine in Exeter has been cut by a massive 60% since 2010, and that has put an intolerable strain on councils’ budgets and their ability to deliver local services. Let us not forget that this has come on top of the big cuts to the police service, the fire service, schools and other local services. There can be few of us, or our constituents, who have not experienced the impact of these cuts—whether through the loss of a teacher or classroom assistant from one of our schools, difficulty in obtaining the care we need for a vulnerable child or elderly relative, the absence of a local police officer from the streets in our area, or the unrepaired potholes in the streets outside our front doors.
At the same time that the Government have cut support to local councils such as mine in Exeter, they have expected them to raise more of their own funds that they spend locally through the local council tax. That is why my constituents and others around the country have now faced year upon year of above-inflation increases to their council tax. As we all recognise, council tax is a very unfair tax. Unlike income tax, which funds central Government, council tax does not accurately take into account people’s ability to pay. For example, this year Devon County Council, which levies the bulk of Exeter’s local council tax, has put up its charge by 3.99%—let’s call it 4%—and the Conservative police and crime commissioner has raised her council tax by a whopping 12.75%. That means that my constituents in Exeter now pay significantly more through their council tax for policing than for all of the local services provided by Exeter City Council.
Those cuts in Government support have inevitably meant that local councillors have had to make difficult and in some cases unpopular decisions. The Prime Minister announced at the Tory party conference last autumn that austerity, the era of cuts, was over, but that simply is not true. Exeter City Council has to find a further £3.9 million of savings this year and next. So far, its good financial management and our city’s relative economic success have enabled our council to do that without damaging cuts to vital local services while the Labour council maintains one of the lowest district council tax rates in England. Our council also has ambitious but essential plans to tackle transport congestion, provide more council housing and social housing, and to do much more in the years ahead, but the longer austerity and Government cuts go on, the more challenging delivering that vision becomes.
I congratulate the Chair of the Housing, Communities and Local Government Committee, my hon. Friend the Member for Sheffield South East (Mr Betts), on his excellent speech on the subject of social care. We are all keenly aware of the crisis in our social care services and the devastating knock-on impact it is having on the health service and other services—indeed, the Health and Social Care Committee has written and published countless reports on and conducted countless inquiries into the matter.
I echo my hon. Friend in sincerely urging the Government and our own party’s Front Benchers to give serious consideration to the excellent recommendations we published following our Committees’ joint inquiry last year. It is often said that solving the problem of long-term sustainable funding for social care is impossible—it is simply too difficult to reconcile the different interests, and too controversial for politicians to agree. Well, we did in our joint inquiry. Politicians from across the political spectrum, from what one might call the hard right or the Thatcherite right to the socialist left, unanimously agreed a blueprint that gives any Government a sustainable and equitable solution to the challenges of long-term social care funding. Until we crack that problem, we will not be able to resolve many of the other problems and challenges that have been and will be raised in this debate. Will the Government use our report as the starting point for their Green Paper when it is at last published, whenever that may be?
As we face the elections in eight days’ time, I pay tribute to all local government bodies and local councillors of all parties, who have had a pretty thankless task in recent years but who have none the less achieved some amazing things. In particular, I thank and pay tribute to the leader of Exeter City Council, Pete Edwards, who is retiring next week. Pete is an old-style Labour leader, a local Extonian lad who became a bus driver and rose up through the National Union of Rail, Maritime and Transport Workers to run our city for the past 10 years—and what a challenging 10 years it has been. His no-nonsense approach, which can at times come across as rather gruff, may not be to everyone’s taste, but those of us who know Pete well and who have worked with him closely over the years know that he has always had the interests of Exeter and its people at the very heart of everything he has done. It is no surprise that under Pete’s leadership Exeter has risen to become one of our most successful and thriving cities. That is in no small part down to him, so thank you, Pete.
It is a pleasure to follow the right hon. Member for Exeter (Mr Bradshaw). He spoke about a blueprint; I have read that report and I remain unconvinced that it absolutely nails down who would pay and how much, which is of course the toughest part of these decisions. None the less, it is a very good proposal and I respect that.
Like the Labour Front-Bench spokesman, the hon. Member for Denton and Reddish (Andrew Gwynne), the right hon. Gentleman referred to cuts in local government funding since 2010. I hate to labour the point—it is a political point—but we cannot avoid asking ourselves why those cuts were necessary. The motion mentions sustainability, as does the Independent Group’s amendment, or what we might call the TIG amendment. But the cause of our problem was unsustainability in the public finances and the economy, with a huge growth in all kinds of borrowing, including private borrowing, mortgage borrowing and public borrowing prior to the crash, and public spending commitments based on unsustainable tax income from, for example, city bonuses. That was never going to be sustained. It was always going to end in a big crash, and—guess what?—it would always fall to us to step in and fix the problem.
Labour MPs may deny that. I asked the hon. Member for Denton and Reddish whether Labour’s 2010 manifesto protected local government. As he did not answer, let me remind the House what the manifesto said:
“Labour believes we should protect frontline spending on childcare, schools, the NHS and policing, and reform our public services to put people in control.”
Note the absence of local government funding. It goes on to say—this is the key line:
“We recognise that investing more in priority areas will mean cutting back in others.”
In other words, if an area of spending was not protected, it would get a right old shellacking, which is what happened under us. We did the same thing. We had priority Departments that we protected, but at a time when the deficit is very high, if we protect some Departments—which is perfectly justified, as we did with the NHS—others will take a disproportionate hit. That would have happened under Labour. I honestly do not say that for the purpose of political point scoring. It is to underline the reality that there is no parallel universe where there would not have been a significant hit to the grant given from central Government to local authorities after 2010.
To go back to trying to find solutions to the problem that we face, the hon. Gentleman mentioned the joint Select Committee report. Does he agree that we need a new funding stream, as the Select Committees suggest, and that the best way to achieve a sustainable solution is to work cross-party, as the Select Committees did, to come up with a solution? Even if they do not have all the detail yet, that is clearly the right way to achieve a sustainable settlement.
That is a good point, and I will come to that. I make what is essentially a political point about Labour’s manifesto because we have to get into our heads the idea that there will never again be a time when local authorities do not have to make difficult decisions and look for efficiencies and innovation. The idea that there will always be a cavalry that can come over the hill and, with the wave of a magic wand, summon up central Government funding—which, by the way, does not grow on trees, but also has to come from taxpayers—is wrong.
Colleagues are right to mention good examples of best practice and innovation. In my constituency, I have two district councils and two wards of West Suffolk. West Suffolk is a newly merged council of St Edmundsbury Borough Council and Forest Heath District Council, and savings have been made through that process. Babergh district is entirely contained within South Suffolk. It is not a merged district council. There was a referendum on whether Babergh should merge with Mid Suffolk. Babergh voted to remain independent from Mid Suffolk, but they merged their back offices, and there have been huge efforts to achieve savings and efficiencies. Babergh has left its head office in Hadleigh in my constituency and is now based in Ipswich, outside the district, which has been unpopular but has saved money. It has set up a joint venture to renovate and restore its old headquarters and make them a commercial asset. The point is that those sorts of changes by district councils will always be required.
Suffolk County Council has seen huge innovation in relation to social care, as my hon. Friend the Member for Bury St Edmunds (Jo Churchill), who is on the Front Bench but cannot speak in the debate, will know. Councillor Beccy Hopfensperger has done great work as the cabinet member for social care in Suffolk. Through the use of technology, the council is saving money, driving down costs and improving care. For example, sensory apps are being used, so that families can know whether their loved one who is able to stay at home is moving around and mobile—in short, that he or she is well. Such technological innovations can help to reduce the cost of care and deliver better care.
On the broader question that the right hon. Member for North Norfolk (Norman Lamb) raised about the sustainable funding of social care, I feel passionately about this issue. The biggest issue in British politics begins with b, and it is not Brexit by a long chalk; it is Beveridge. The welfare settlement we have in this country covers the whole of the state pension, the NHS, social care and every aspect of the contract that we all thought we had entered into, but the system is not remotely sustainable. If we look at the Office for Budget Responsibility’s forecasts for just NHS spending 50 years from now, we see that it estimates we will be spending the same again in real terms as we do on the NHS now because of changing technology, demand and so on, so we have a huge challenge ahead of us.
On the specific point about paying for social care, I recently had a constituency surgery at which an elderly lady came to see me because her husband has a very difficult condition and she wanted to know what support was available to her. She felt she was in that category of my constituents who are neither so poor that they receive lots of help nor wealthy enough to be able to afford to fund a good lifestyle. I asked her, “What about your house? Do you have housing assets?” She said, “Yes. We have a house worth about £700,000, with no mortgage.” However, in her eyes, she has no money.
This issue of housing and assets is always going to be the most controversial point, as we discovered to our cost at the last general election. The residential housing assets of those aged over 65 is worth between £1 trillion and £1.4 trillion, depending on which estimate we look at, and that is a staggering sum. We have to accept that at the core of this issue—and this is the reason why it is so controversial—those entering the workplace today will not have occupational pensions and will not build up such a level of housing equity. That is highly unlikely because, in my view, we will not see such a period of high house price inflation again; it is not sustainable. We are reaching a point where those paying into the system are seriously questioning whether they will get the same benefit as those who retire today.
This intergenerational issue is no one’s fault; no one designed it that way. In fact, the welfare system I have mentioned, the Beveridge system, was built with the very best of intentions for a post-war country. However, the thing we need—and I will conclude with this key point—is honesty. That was said by my hon. Friend the Member for Lewes (Maria Caulfield), who is a nurse, and I greatly respect the expertise she brings to this issue. In this populist, Trumpian era, the one thing that will make this work is all of us being open and transparent about the tough choices we are going to have to make. No one is going to have a free option. There is no free option: every option available is going to cost.
I happen to think that the best option will involve some use of housing equity, perhaps with a choice for people to pay through an alternative method if they do not want to bind themselves into that. In relation to those entering the working population, I think we should look at the success of auto-enrolment. How many people here have had emails from constituents complaining about the rise in pension contributions from their salary from auto-enrolment? I have not had a single email because people believe it is a contribution from which they will benefit. It is not like the old, pay-as-you-go system, and I think we could link the social contributions of the young generation through a premium to such a system, as the Select Committees have suggested.
It will be very difficult to come up with a solution for social care. It may take consensus, or it may take a future Government with a large majority being pretty tough and disciplined. It will take one or the other, not what we have at the moment. However, we can make a start, and we have to be open and transparent about the fact that there is no easy option, but there can be an option through which we get much better care for the next generation.
The focus of my speech will be the stark reality that adult social care faces today. I doubt anyone here—actually, I am absolutely sure that no one here—would argue that adult social care is not an incredibly important issue. Many of the most vulnerable people in our society rely on social care to provide them with dignity and a life that is not just a bare existence, but one worth living. Indeed, many of our vulnerable people look forward to their only visitor of the day being from the social care or health services.
It pains me to assert that social care in this country is failing, but up and down the United Kingdom, the actions of Conservative-led Governments since 2010—I will speak a little bit about that later—have left our social care provision tending to a state of disrepair. If action is not taken, that could lead to a collapse in social care provision. The Government must recognise that the demographics of our nation have changed and continue to change, and as we make advancements in medicine people in our nation are living longer.
The National Audit Office estimates that between 2010-11 and 2016-17 the number of people aged 65 and over in need of care increased by 14%. Indeed, that demographic shift can be seen in my constituency, where the percentage of over 65s will more than double in four years, between 2017 and 2021. That is in addition to the increase in the number of people with learning difficulties and dementia.
That pressure is being admirably handled by the men and women who work in our care industry. However, that workforce are low paid, with sick pay and pensions not even being universally delivered. Is it any wonder that the industry has a turnover rate of almost 34%? For those who stay in the workforce, there is a severe lack of training and development, in large part due to a frankly unacceptable lack of investment, which is laid bare when compared with the equivalent spending in the NHS. The lack of investment in and pay for our care professionals has left a chasm in social care staffing. The Care Quality Commission report, “The state of health care and adult social care in England”, highlights an adult social care vacancy rate of 15%. That means that 110,000 nurses, health professionals and social workers are not in place to do the severely needed work.
Unpaid carers provide an estimated £132 billion-worth of care each year. There has been a systemic unloading of responsibility by central Government on to local authorities. Legislation such as the Care Act 2014 has increased local authorities’ responsibilities in areas such as deprivation of liberty safeguards, the independent living fund and transformed care services, to name a few, without the funding necessary to deliver them.
The situation is further exacerbated by the continued delay of the Green Paper on the future of adult social care funding, following the proposals and recommendations of the Dilnot report. Until it is introduced, the future funding arrangements remain unclear. Despite that, my local care providers continue to deliver outstanding adult social care, with St Helens Cares receiving the Municipal Journal award, and Kershaw day centre winning the Dementia Care Matters award. Imagine what they could do if they actually received the funding they require. St Helens Cares truly integrates social care and health; it works with one pack of records and everything is integrated in one building. People remain at home and go to hospital only when they absolutely need to. It is a joy to see and we can prove—we have the evidence—that in just a few months that approach has reduced by 7.5% the number of people going into hospital.
My final point, which has been a common theme throughout my speech—indeed, it has been raised by many others—relates to funding. Since 2010 local authorities have experienced real-terms decreases in their core grant from central Government, which in turn has led to expenditure on adult social care falling by almost £1 billion between 2010-11 and 2016-17 and onwards. That has forced local authorities to choose between delivering either their social care responsibilities or their other commitments, as outlined by the “Long-term funding of adult social care” report.
I am sure that the Government will retort that they have made commitments to increase adult social care funding, such as the short-term funding measures of the additional £9.4 million between 2016 and 2020. However, as the Local Government Association told the report inquiry, those mechanisms have a number of limitations. They also fail to deal with the short-term issues facing adult social care, let alone the long-term issues.
The better care fund provided just over £13 million between 2011-12 and 2019-20. That is not to be sniffed at, but it is not enough to cover demand as a result of demographic shifts. To put it simply, the additional funding provided by the Government is like a sticking plaster on a gaping wound. It will not stop the bleeding and it will not help it to heal.
There has been a 1.4% decrease in nursing homes, and 32% of directors of adult social care saw homecare providers close or stop trading just six months before the “State Of Adult Social Care Services” report was published by the Care Quality Commission. The number of people receiving publicly funded care fell by 400,000 from 2009-10 to 2016-17. It is estimated that 1.2 million older people may now have unmet care needs—this has had a knock-on effect for the NHS, although in some places it has not been as hard as in others because, quite frankly, working together does work—leading to a delay in transfers of care out of hospitals and an increase in admissions as the lack of adequate care can lead to health complications. The issues facing adult social care are grave. There are solutions, however.
First, I call on the Government finally to face the facts and tackle the underlying issue of adult social care and make significant funding increases. As stated in the evidence given to the 2018 report, “Long-term funding of adult social care”:
“Before further reform of the system can be contemplated, the funding gap must be closed.”
We need to stop the uncaring austerity measures that have been forced on the country since 2010. And may I bring this to the attention of those who are not aware of it? There was a global financial crisis in 2008. It went right across the globe. It was not the Labour Government. In fact, Labour did get the economy going here before the Conservatives took office with the Liberals. So it was not Labour. In fact, that Labour Administration paid off more debt than any other previous Government on record—debt we inherited, Members might be surprised to hear, from the Conservatives.
St Helens does receive funding from the Government—short-term funding. We cannot refuse it. We want it and we need it. We have £8.3 million from the better care fund, but what is going to happen next year, in April 2020? Do we know that yet? Funding only goes up to April 2020. What will happen if £8.3 million is taken from St Helens? That is 17.5% of our total social care budget. Other councils will be suffering similar impacts, so what is going to happen to social care?
Secondly, let us follow the example of St. Helens Cares and others—Salford Together is superb. Such initiatives, however, need support. They involve, in large part, the integration of social care and health. That does help. It is certainly a much better experience for the recipients of the service, the members of the public. They do not want to go into hospital; they would much rather stay at home, with support. There are teams based in hospitals providing a single point of service, reducing pressure and providing an almost seamless transition from health care to social care. That truly is working together. We need more support to help us achieve that and sometimes that means a little bit more financial help.
The Government have renamed the Department of Health to the Department of Health and Social Care, but I fear this change in approach has been in name only. I call on the Government to link health and social care truly—not only by administration, but with regard to workers’ rights, training and financing—to deliver the social care that the people of this nation need and deserve. I call on the Minister to go back to the Department, to talk to the senior people above him and to get them to truly integrate and provide the necessary finances. There is no need for austerity—certainly not for social care.
It is a great pleasure to follow the hon. Member for St Helens South and Whiston (Ms Rimmer). She gave a very good and comprehensive speech, but I cannot say the same about the hon. Member for Denton and Reddish (Andrew Gwynne), the Opposition Front-Bench spokesman, who gave an impassioned speech that was no doubt great for Facebook clicks but bore very little resemblance to the reality and substance of the debate today. We have a true cross-party challenge that we need to address, and he conveniently chose to ignore some of the critical points about council funding, as it is distributed across our country.
Many Opposition Members spoke about Birmingham, a city that I know well. It is a great city; I have lived and worked there for many years. They were decrying the Government for their seeming neglect of spending in Birmingham. The blame for the problems in Birmingham lie firmly at the Labour administration’s door. Shall we just look at the facts? In my constituency in Worcestershire, the core spending power per dwelling is £1,356, and in Birmingham, it is £2,022—nearly 50% more. Yes, this reflects the need, but we have need in my area of Redditch as well. What is that administration doing with the money? It is squandering the money on consultants and inefficient services, when it cannot even collect the rubbish on the streets. There is rubbish piling up. It is breaking its promises to the electorate. It cannot collect the bins. The strikes have cost it £12 million, which could have funded the council tax rise that it has just inflicted on its residents.
However, that is enough about Birmingham and enough about that. I want to focus on this very important issue, on which I think there is more consensus than there is political point scoring. There is no doubt that adult social care is an absolutely critical issue. As a Member of Parliament, I hear from people who have tragic stories and face very difficult choices. I am also the daughter of a dementia sufferer, who lives on her own in Cumbria. I have seen at first hand the difficulties and challenges of navigating the system to support a frail, vulnerable lady in a very isolated rural area. We all have constituents that suffer from dementia and other conditions, so we need to grapple with this issue.
It is right to say that the lack of a social care Green Paper is a missed opportunity. I am delighted to be the co-chair of the all-party group on carers, which is doing some excellent work. Carers, of course, are the unsung heroes. They provide £132 billion-worth of care across the UK. Over the next 10 years, 20 million people will start caring. We know that unpaid carers make a huge contribution in so many ways, so I gently call on the Minister to address that.
The hon. Lady is rightly raising the plight of carers, which is a subject that is very close to my heart, as it seems to be to hers. Does she also regret the lack of a national carers strategy from her Government? The last national carers strategy was produced in 2009 and there is a campaign among carers to get the Government to produce one. We do not have a Green Paper and we do not have a national carers strategy.
I thank the hon. Lady for that point; we work together on the all-party group and we share those concerns. I was about to press the Minister for more updates on when we can see the Green Paper, because while this debate is about local authority funding, of course there is also the role of carers and joining up the role of carers in the national health service and in local authorities. Those services have to work together and that is a critical part of this debate.
I am sorry—I will not, because I do not have very much time, and I have a lot to get through.
We cannot artificially separate these two pots of funding. Instead, we must link them together more holistically. The NHS long-term plan includes some welcome focuses on carers—perhaps the hon. Lady agrees they are helpful—among which I would highlight the use of innovative technology, such as smart home technology, that can, for example, monitor when a dementia sufferer does simple things such as turn on the kettle or switch on a light, and which can be linked to an app to enable someone such as a relative—like myself, for example—to see what their loved one is doing at any given time. It is great that some utility companies are developing apps that can work in this space. I welcome that. We have to get behind those efforts to join up care.
I want to highlight another aspect of the carer spectrum. Young carers are often completely hidden from view, yet they do a fantastic job supporting their loved ones, and it often has a knock-on impact on their schooling and mental health—40% of young carers suffer from mental health problems. My final point about carers is the importance of companies and employers having a proper strategy for people juggling work and care. Most carers work, or try to work—often they have to leave work—and we should consider how we can better support them to provide that care. It is great to see the Minister for Care in her place. I know she is engaged in the detail of these issues.
I turn now to my constituency and my council, Worcestershire County Council. Of course, it faces pressures, like councils up and down the country, but I applaud it for its work in managing these pressures. In meetings with me it has called for the consultation on the fairer funding review to be brought forward quickly so that it can have more certainty to plan ahead. It needs certainty by October to plan for future savings it will need to make. It has had to find savings of £22.9 million already. A positive development in our area, however, has been the work across councils to bring forward the 75% business rates retention pilot, which has resulted in up to £4.9 million more to spend on social care. This has relieved the pressures considerably. Given that the county council spends 41.8% of its net budget on adult social care, and that we have a rising population of people demanding social care, this is really important and very welcome, but it has to be a sustainable settlement that the council can build and plan on.
I turn now to the second half of the equation—it is a shame this is sometimes neglected by Opposition Members. The shadow Secretary of State talked about growing the pie. This is critical. As well as looking at where the money comes from, we as Conservatives try to think about how we can generate more money—more pie—in our local areas. For me, at the heart of that is creating thriving local areas and town centres where people want to move to and businesses want to invest, which in turn generates more revenue and more business rates and a virtuous circle for our local economy.
That is at the heart of our “Unlock Redditch” strategy. My Conservative colleagues have had one year in office in Redditch town hall. They took control this time last year, after eight years of Labour, when there was no positive vision for the future. They have taken control and set out how they will build more social housing and help to empower businesses and the local community to build a thriving town we can all be proud of. It is a positive aspiration for our future and I am completely behind the strategy. It is about having a mission and a plan for the future. That is what we have in Redditch. Let me take this opportunity to say to anyone in Redditch who may be watching the debate, “It is vital that you go out and vote Conservative in the local elections.” If people vote Conservative, we can retain control of our town hall and continue the effective and careful management that has enabled our team to deliver services in the face of spending pressures and pressures on budgets. Similarly, Worcestershire County Council, in the face of some difficult decisions, has maintained essential services such as libraries and social care.
Let us put aside the hysterical political polemic that we sometimes hear from the Opposition Benches, and focus on working together. We have seen some excellent examples of that, so let us focus on it now, and grasp the opportunity to provide a great social care system in our country.
Let me begin by putting my speech in context. Some of the wards in my constituency are among the most deprived in the country, and feature regularly in the index of multiple deprivation. Thirty per cent. of children in my constituency are growing up in poverty, and in some wards the figure is as high as 50%. My council’s revenue support grant has been cut by more than 50%. Millions of pounds have been taken from Burnley, which has affected services provided by both Burnley Borough Council and Lancashire County Council.
Let me take this opportunity to thank Burnley’s Labour council, which has delivered services valiantly. It has gone above and beyond, in difficult times, to grow the pie and create an environment in which businesses can grow. It has absolutely no support from central Government, yet it toils on, and my thanks go out to each and every one of its members.
Both the county council and the borough council have been faced with the unenviable task of rationing services as the budget cuts have had their impact. Cuts clearly have consequences, and the current level of cuts is touching every part of our society. We have gone beyond the superficial. Decent roads are a luxury of the past: no one expects to be able to drive a car down a road in my constituency that is not riddled with potholes. The libraries are closing. Subsidies are no longer available for bus routes to rural areas, so many of my vulnerable constituents are now isolated. However, we are taking all that on the chin: those are frills of the past. Some of my constituents are suffering daily when it comes to services as important as social care for the elderly. Many old people are sitting alone in their homes, relying on the carers who provide them with the only contact that they have with another human being in 24 hours. Cuts in care packages mean 20-minute visits, which means that there is barely enough time to prepare a hot meal and get someone out of bed who has been waiting desperately with toilet needs. That is what we have come to.
We are seeing, not surprisingly, the see-sawing of old people in and out of hospital. Inadequate social care budgets have consequences for the wider NHS. Old people languish in hospital beds. They are not bed-blocking. They do not want to be in hospital, and their families do not want them to be there. They want to be in their own homes and to be afforded dignity in their own homes, but as a result of the cuts that is just not happening, despite the councils’ best efforts.
Youth services are now virtually non-existent. It is no wonder we have seen a rise in youth crime and extra pressure on youth offending services. The services that are needed to support young people in our communities simply are not there. A women’s refuge in my constituency which regularly has to turn away desperate women because it is bursting at the seams is threatened with closure, because sustainable funding cannot be guaranteed from one year to the next. It is an absolute disgrace that a service staffed by dedicated people protecting vulnerable women and their children should be under the threat of closure.
Support services for schools have been decimated. One of the saddest areas is the total lack of provision for children with special educational needs. In the first instance, they and their families wait months on end for a diagnosis that could even begin to attract some social support. When the diagnosis is achieved, the support is just not there. We have seen the very worrying trend of parents left with no choice but to home educate their children. Parents who have never sought to take on that responsibility are left with no option but to keep their children at home. That does not help the family and it does not help the children.
Those cuts are so short-sighted. Our children are the future of this country. If we invest in them and support them now, they will go on to be economically productive. Taking services away from all vulnerable people is storing up trouble not just for the local council, but for the wider economy.
The Secretary of State said that times have been hard, but who have they been hard for? They are hardest for the most vulnerable in our society: for the children with special educational needs; for the old people in need of social care packages; for lonely people isolated because the buses are not there anymore. After nine years of budget cuts, the services have been absolutely savaged. The Prime Minister tells us that austerity is over; I see no sign of that in my constituency.
There is a recent consultation from Lancashire County Council, which has to make further savings of £135 million on top of the savings I have just talked about. It is consulting on reductions in street lighting—at a time when police budgets are being cut, we are creating a burglar’s paradise. It is consulting on the remodelling of health improvement services, which is actually a withdrawal of support services in the community for alcoholics seeking rehabilitation, smokers trying to quit and people in need of obesity services. That will all store up problems for the NHS. There is a proposal to increase the costs for self-funders accessing day care services by an eye-watering 15%. The council is consulting on cuts to home improvement services for the disabled and the elderly who need adaptations to be able to live independently in their own homes. It is all counterproductive and it all flies in the face of what the Government say they care about.
The council is consulting on cuts to the welfare rights service. There are proposals to remove respite breaks for parents of children with life-threatening conditions and to end the audit of child safeguarding services. The budgets for social care, fostering, adoption and the youth offending team are all being cut. There are reduced budgets to support looked-after children, and so it goes on.
Government Members might choose to deny it, but this is the reality of a Conservative Government refusing to adequately fund local authorities to deliver the services that our constituents so desperately need. This cannot go on; people have had enough. I hope that people in my constituency are listening to this debate, that they appreciate the efforts of the Labour council to prioritise their needs in very difficult times, and that they remember that next Thursday.
I am very pleased to speak in this debate, because adult social care is an important issue in Fareham, where the average age of local residents is far higher than in most of the UK. Fareham has what is known as an ageing population.
First, I acknowledge the Government’s commitment and progress on social care. We have seen considerable extra funding. Some £1.8 billion will be allocated for 2019-20 through the improved better care fund, which represents a 23% increase on the previous year. Also, £240 million of funding will be allocated to support adult social care services in order to reduce pressures on the NHS. For Hampshire, the additional amount for winter pressures equates to £4.7 million, and with the 3% social care precept that Hampshire levied in 2018-19 thanks to the greater flexibility provided by central Government, Hampshire has sufficient funds to meet the increased demand and pressure.
In Fareham, that translates into some excellent residential care homes, which I have had the pleasure to visit. Hawthorne Court, Gracewell, Hamble Heights, the Fernes at Titchfield and Abbeyfield are just a few examples of the frankly brilliant care provided for our elderly residents in Fareham. They are treated with dignity and compassion, and many of them are publicly funded. At Fareham Community Hospital—with which I have worked closely since my election in 2015, chairing the Fareham Community Hospital taskforce—we are seeing an expansion in GP services thanks to the collaboration of local surgeries, so that thousands of patients are able to see a GP on the day they request it. That is a massive improvement on previous years.
The charitable sector is also thriving in Fareham. I recently met representatives of Dementia Friendly Fareham and Dementia Friendly Hampshire. I know that my constituency neighbour, the Minister for Care, my hon. Friend the Member for Gosport (Caroline Dinenage), who is sitting on the Front Bench, has also met that charity. It is doing fantastic work to raise awareness in our local community—in our shopping centre, for example, and among young people and professionals—so that we can work more effectively and understand the challenges faced by those with dementia. I, too, have taken the Dementia Friends training. We are also seeing other charities, including One Community and the Fareham Good Neighbours scheme, helping elderly local residents to access healthcare services.
Those are real, tangible reflections of increased Government funding and the commitment from local communities, as well as of real progress at national and local levels. All this has been achieved with Hampshire, and indeed Fareham, having one of the lowest council tax rates in the country. So, despite continued pressure and demand, Hampshire County Council and Fareham Borough Council have been able to maintain some excellence in the delivery of public services through prudent financial planning.
I need to provide some context here. That £4.7 million compares with an estimated growth of at least £10 million, at the same time as Hampshire County Council needs to remove £43 million from the adult health and care department to cope with £45 million of extra costs, mainly due to buying in care from the private market. That cost has gone up partly due to pressure from the national living wage. All of that combined means that Hampshire faces serious financial challenges on the horizon, and support will be needed through the spending review.
Despite the evidence of that undeniable progress, I also need to talk about the human impact when things sadly go wrong. I have now met too many residents in Fareham who have found the continuing healthcare application system nebulous, harsh and expensive. In some cases, this has been heartbreaking. My constituent, John White, came to see me about his experience of caring for his elderly sister-in-law who was suffering with Alzheimer’s disease. Funding applications were initially rejected by the West Hampshire clinical commissioning group. There was a lack of co-ordination between the CCG and Hampshire County Council, and the appeals process was severely delayed. Only after six years of trying was funding retrospectively granted. Sadly, that was too late, as Mr White’s sister-in-law had by that time passed away. Mr White’s case is not an isolated one. The application process is not patient-friendly, and families and carers can be treated with suspicion rather than support. I am hearing from constituents that the process and rules are designed in such a way that only a few applications are successful at the first attempt. Many people simply do not have the energy to keep fighting the system and are beaten into submission.
I fully appreciate that the difficult financial circumstances in which the Government found themselves in 2010 are ultimately the root cause of the problems we see today. I am grateful to the Minister for Care, with whom I have raised Mr White’s case, and to the Under-Secretary of State for Housing, Communities and Local Government, my hon. Friend the Member for Richmond (Yorks) (Rishi Sunak), who has met Hampshire MPs and Hampshire County Council to discuss the county’s funding, and I know how hard they are working to improve the system at central Government level. However, the process and the structure need urgent reform to improve co-ordination between healthcare providers and clinical commissioning groups and to improve patient experience. We need to act now, so that the Government’s undeniable commitment to the elderly and vulnerable is not squandered and so that patients are rightly put at the heart of how our social care and NHS services are delivered. I have no doubt about this Government’s commitment, and I know that we can do better.
It is an honour to follow the hon. Member for Fareham (Suella Braverman). From listening to the speeches so far, this has been a sensible debate. Mental health and elderly care—two issues close to my heart—have been discussed in a positive way, and I welcome the forthcoming Green Paper, particularly in how it relates to dementia care. Dementia is a ticking time bomb. We must grasp the issue because it will affect all our futures, and the funding to cope with it in a meaningful and measured way simply is not there yet.
However, I am here to talk about Hartlepool, which has been left behind like many seaside towns. There is a desperate need to improve housing, transport, business growth and job opportunities. Unfortunately, we have some of the most deprived wards in the country, with low life expectancy and fuel and food poverty. We have no fewer than nine foodbanks and, until recently, we topped the national table for the number of unemployed adults.
Following a year-long investigation into our coastal communities, the House of Lords’ Regenerating Seaside Towns Committee recently concluded that places such as Hartlepool have been neglected for far too long, with money from successive Governments having been directed towards big towns and cities at their expense. The report quite rightly pointed to the negative effect that that has had on the economy of our once-thriving seaside towns and on the health, wellbeing and prospects of their people. It also concluded that, with the right investment, towns such as Hartlepool can be rejuvenated and once again become prosperous and desirable places to live and work.
I could not agree more with the Committee’s findings and recommendations, and I will be pressing the Government to act upon them, but far from being the run-down, crime-ridden backwater portrayed on Channel 4’s “Skint Britain”, I must put it on the record that Hartlepool is a vibrant, welcoming place to which people choose to move despite the negative statistics and the town’s negative portrayal by some. However, like in other coastal communities, the Labour council is struggling to maintain services despite its best efforts. In 2019-20, it faces 40% cuts across all departments and has for the first time been forced to use its reserves in order to balance the books and avoid job losses.
To be frank, the continued underfunding of councils such as Hartlepool’s, the insistence that the majority of any settlement is ring-fenced for children’s or social care, and the removal of the deprivation factor in calculating Government grant funding to areas with high levels of deprivation, such as Hartlepool, is driving them off a fiscal cliff. Services are at breaking point because of the constant cuts and the austerity agenda. Typically in places like Hartlepool, our elderly population is growing, with all the demands that brings from a public health and social care perspective.
Our children’s services are also creaking at the seams, despite an award-winning children’s services team. Council departments simply cannot cope with the growing demands on social care with stretched budgets. In Hartlepool, the rate of looked-after children is, thankfully, declining, but we have child poverty to cope with. We run holiday hunger schemes to keep our children from going hungry. We have schools that are desperately crying out for better funding to provide a good education in a safe and warm environment. We have no Sure Start centres, and youth provision has virtually gone.
Since 2010, local authority funding has been cut by £16 billion, which has clearly had a knock-on effect on services that my constituents expect and rely on. It is not just services for the elderly and the young. Highways, parks, refuse collection, trading standards, libraries, the police and fire services are all affected by the chronic underfunding of local government, and the Government’s threat to push the problem on to the council tax payer and, by default, let local councils take the blame is irresponsible.
Thanks to the efforts of our local Labour council, many services have been kept going, and the number of compulsory redundancies has been kept to a minimum, but at a time when the Lords point to the need for greater investment, the council is suffering death by a thousand cuts.
Hartlepool has created a care academy and aspires to have a centre of excellence. It is addressing respite care to free up beds in acute hospital wards and is tackling dementia care to fill a gap in the market with services run and owned by the public sector, but private sector providers, such as the owners of residential homes, are now ready to jump into that gap because we are not prepared to fund what is right under our nose. It makes me angry that innovative thinking to provide care for our citizens in their own community is not backed up by fair funding. The attacks on council funding need to stop, and fairer measures need to be introduced.
I start by praising Chelmsford City Council, which has led the way in transforming Chelmsford into England’s newest city. Last year, Chelmsford was ranked the No. 1 place to live in the east of England. We have a bustling high street full of new shops and restaurants, and we have a vibrant night life. We have just been ranked No. 1 in the country for our Pubwatch scheme, which is keeping people safe at night.
We have 13 green flag parks, and, a couple of weeks ago, one of our parks was chosen to be home to the national police dog memorial—do come and visit. The local council is working with the local police on investing in a community policing hub, which will have state-of-the-art CCTV, and they have co-invested in extra community policing that will help to support the over 300 extra police officers who have been added to Essex services.
We are building a new swimming pool, upgrading the museum and refurbishing the fantastic indoor market. We recently invested over £1 million in local charities to tackle homelessness, and we are building more than 1,000 new homes a year especially for local people. We are fighting for the infrastructure to go alongside that. As we have local government Ministers present, I give them an extra nudge to fund our much needed second railway station, which would unlock another 10,000 homes that we need.
Essex County Council does excellent work in many regards, especially children’s services. It is the second largest children’s services area in the whole country. Back in 2010, under the Labour Government, it was failing. It is now—since January—ranked outstanding. The investment in children’s services has gone down from £148 million to £118 million, proving that when it comes to running outstanding facilities, money is not always the solution. The solution in this case was to use early intervention and targeted work, and to unlock local partnerships. I urge Members to read the Ofsted report.
Essex County Council is challenged. We have seen a great deal of population growth and increasing demand, particularly for social care. Adult social services make up about 45% of Essex County Council’s spending. Over the next decade, we expect the number of over-80s to rise by two thirds and the number of over-90s to rise by 90%.
We need a new model for funding social services. It is simply not fair that those who win the lifetime lottery and live to be healthy, well and fit in their old age can, when they pass on, leave their assets to those they love; whereas those who become frail—especially those who suffer from dementia—and need care end up losing their assets, and they find that they cannot pass on such gifts to future generations. There have to be fairer models, and I encourage the Government to be brave in looking at different options, including those that work in other countries. I urge them to look at insurance schemes and lifetime saving schemes, and to try to find fairer ways to solve the problem.
I want to discuss dementia, because the great fact that we are living longer means that more people suffer from dementia. Some 850,000 people in the UK have dementia, and the cost of caring for them is £26 billion a year, but we know that that figure will rise. Across the world, there are 47 million people with dementia, and it is estimated that by 2050 the number will have risen to 135 million.
I am very glad that the Chair of the excellent Science and Technology Committee is in his seat. Along with a Conservative colleague, he and I spent the morning representing the Committee with the Alzheimer’s Society and Alzheimer’s Research UK at the Dementia Research Institute, which is the world’s biggest single investment in dementia research. It was a great pleasure to meet those involved, who told us about the work that is being done to improve the day-to-day life of those with dementia. The UK leads in areas such as technological aids to make living with dementia easier, and it is doing great work on changing society’s view and understanding of people with dementia. We learned that 500 people a week are becoming dementia friends, which is great.
We also learned that much more can be done to understand dementia and work towards a cure. In recent years, there have been 3.4 million publications on cancer in the UK alone. By comparison, there have been just 170,000 on dementia. In other words, for every piece of research into dementia, there have been 20 on cancer, even though dementia is the cause of far more death and suffering in later years. The amount of research is increasing, and it has resulted in a much greater understanding of what causes dementia. We understand that the causes start decades before the symptoms appear. To understand what causes dementia in somebody in their 70s, we need to understand the changes that start happening in our 40s and 50s.
We also heard that the UK is leading the world in research. We were told that a third of all dementia may be preventable, provided that it can be detected early. Early intervention can be used to understand the triggers and how to prevent it. As well as looking into how we care for those who are old and frail and need support, let us keep up the research into how we prevent that need.
I share the hon. Lady’s view of the excellent Select Committee on which we both serve. We had a fascinating visit. Does she agree that, from what we heard this morning, there is a case not only for increasing investment in dementia research based on transforming the lives of people who currently suffer with dementia, but for investing to save? If we are to prevent the health and care system from bankrupting itself because of this increasing prevalence, we have to act now to reduce that prevalence by finding out how we can prevent dementia in future.
I absolutely agree. We heard it described earlier as like watching a tsunami way out to sea. People are living longer, which means that the number of people suffering from dementia around the world will increase unless we get ahead of the challenge. We cannot just keep watching it; we need to get ahead of the challenge to understand the causes. There will be cures, but only if the world continues to invest in the research. As well as investing in social care and finding a new model to help to provide it, let us keep up our world-leading research into Alzheimer’s and other dementia-causing diseases and make sure that the UK continues to lead on that challenge, and let the Government invest more and get the rest of the world to do so, too.
It is an honour to follow the hon. Member for Chelmsford (Vicky Ford), particularly after listening to her account of what can be done to help to tackle dementia.
Like a number of other Members, I have had the honour of being a councillor: for 15 years, I served the people of Battle Hill ward, where I live, in North Tyneside. To this day, I am proud of everything that Labour councillors have achieved since North Tyneside came into being in 1974. Labour has been in power there for the majority of that time. I remain an ardent supporter of the council under our elected mayor, Norma Redfearn, and pay great attention to the council’s finances, particularly as my husband Ray has served as the cabinet member for finance over the past six years.
Like councils up and down the country, North Tyneside has struggled over the past nine years, losing £120 million because of Government cuts. This year, the council has taken a £3.5 million cut, and more than £27 million in cuts are due over the next four years. Because of the cuts, North Tyneside’s cabinet has been put in a difficult position with regard to preparing a balanced budget while bringing together the impact of reduced funding over successive years, as well as the additional unfunded burdens and demand-led pressures the council has faced.
A major problem has been the Government’s assumption that councils will make the Government’s suggested increase in council tax, because that suggested increase is taken into account when the council’s baseline funding needs are assessed. Although the Government see bringing forward these council tax-raising powers in the settlement as a way of recognising the calls for urgent help for councils to tackle some of the immediate social care pressures they face, in practice it simply shifts the burden of tackling a national crisis on to councils, and ultimately on to their residents. Sadly, North Tyneside, with this burden placed on it, has, with great reluctance, increased council tax in this year’s budget by 2.99%. That means £30 extra a year for band A and more than £45 extra for band D, which is quite a sum for people who are already struggling to make ends meet.
Despite the rise in council tax, North Tyneside Labour Council continues to face the challenge of maximising the use of available resources to ensure that the borough continues to grow through investment and that essential services such as social care continue to be delivered. Achieving that balance becomes more and more difficult every year, and the council can see no easing of the relentless pressure to secure efficiencies in the current financial environment.
However, despite those challenges, North Tyneside continues to focus on achieving the overall policy objective shaped in “Our North Tyneside Plan”, which was put together by a mayor who listens to the people. The council is determined to continue to find a way to improve the lives of residents by making the council work smarter, putting people at the centre of what it does and ensuring that it maximises the way it uses public money to achieve residents’ priorities, which include delivering economic prosperity and good social care—priorities that came up time and again among our residents.
Like many other councils, North Tyneside has great staff, who are dedicated and work under extreme pressure. I am grateful for all that they do to help North Tyneside survive in the face of such stringent Government cuts. I ask the Minister when the Government will realise that councils across the country have reached breaking point. When will the Government restore funding to a level that enables our hard-working councillors and council staff to deliver the best possible services not just to the people of North Tyneside, but to the whole country as it is what the people expect and deserve?
Finally, I wish all the candidates standing in next week’s elections the best of luck, but I wish the very best of luck to all our Labour candidates, especially the one in North Tyneside.
I wish to focus my contribution on the impact of local government cuts on tackling youth violence. We know that early intervention and prevention is key as is a public health approach, and I will come back to those points later on in my contribution.
On a point of order, Madam Deputy Speaker. I apologise for interrupting my hon. Friend, but I note that there is not a single Member of Parliament on the Government Benches. I just wondered whether the fire alarm had gone off and none of us on the Labour Benches had heard it.
I thank the hon. Gentleman for his point of order. Of course he knows that the occupation of the Benches is not a matter for the Chair. [Interruption.] Indeed, the hon. Member for Henley (John Howell), who is temporarily not in his place, is making it clear that he is in the Chamber. So, too, is the Minister, the Whip, the hon. Member for Dumfries and Galloway (Mr Jack), and the Financial Secretary to the Treasury. None the less, I take the hon. Gentleman’s point. I say to him and to the Chamber that I have been a little more lenient than normal this afternoon about people—on both sides of the Chamber—coming in and out of the Chamber and being absent for rather longer than I would normally find acceptable. This is a particularly busy week. There are many delegated legislation Committees and Select Committees sitting because the House did not sit on Easter Monday, so I have been a little more lenient than normal. That is one reason why there are fewer people in the Chamber than there might otherwise have been, but no one would like to give the impression to anybody watching that this has been anything other than a well-attended debate, with people making serious speeches. Every single speech that I have heard has been made by Members of this place who take their duties in their constituencies very seriously.
My hon. Friend the Member for Chesterfield (Toby Perkins) made a good point. This is an incredibly important debate, as we are discussing cuts to local authorities. I would also say that my contribution, in which I will talk about the impact of cuts on youth violence, is extremely important.
After the Prime Minister’s recent summit on serious violence, about which this Chamber is still awaiting a statement, the Government launched the “Consultation on a new legal duty to support a multi-agency approach to preventing and tackling serious violence.” Many of the words in this document are to be welcomed. However, local authorities are responsible for many of the services that the Government see as key to this multi-agency approach, and cuts of nearly £16 billion to local government since 2010—£165 million in Lewisham—have left our public services at breaking point, so hon. Members can see why so many are sceptical about the Government’s multi-agency strategy. There is a lot of promising language in the consultation, with mentions of following the evidence, focusing on the long term, and working “with and for communities”. It includes examples of best practice and advice from the World Health Organisation on violence reduction.
Violence is not inevitable; with the right approach, I truly believe that it is preventable. Obviously, we need Departments to work together to share data and generate long-term solutions. We hear all the time that this is not just an issue that the police can tackle alone. We need a strategy that brings together schools, social services, housing, police, youth services and the voluntary sector—one that follows the evidence and brings communities with us. Indeed, we need a public health approach. However, teachers and frontline NHS workers have expressed concerns about the proposed legal duty, and with fair reason. Over the last nine years, austerity has taken its toll. The NHS is suffering the biggest funding squeeze in its history. Schools budgets have been cut by £1.7 billion since 2015. Adding yet another responsibility on to the shoulders of our brilliant but overstretched teachers and NHS staff without further resources is unacceptable.
If hon. Members look at my own Borough of Lewisham, they will see the immense pressure that the council is already under. Since 2010, Lewisham has suffered cuts to its budget of more than 60%. Local schools have lost out on over £25 million of funding since 2015 and 14 schools are facing a shortfall in their budget as a result. Food bank use has been rising year on year. Last year, 7,000 families in Lewisham visited a food bank—yes, 7,000 families. Lewisham is one of the most deprived local authorities in England and one of the 20 local authorities with the highest levels of child poverty. At the same time, the local population has risen by 10% since the last census, adding yet more pressure to the council’s dwindling budgets. That is the context we are talking about, with poverty rising, complex social needs rising and the local population rising, alongside unsustainable cuts to local services.
The Government’s public health approach says that we should be bringing together law enforcement, education, health, housing and youth services. Councils want to do that, but they need the funding to achieve it. Youth services in the Borough of Lewisham have been cut by more than a third since 2012. As a result, centres are struggling to remain open and the year-round provision that we had in the past is just no longer possible. Our police are working hard with fewer resources, often putting themselves in danger to ensure that they keep us safe. Lewisham, Greenwich and Bexley police forces in south-east London have recently had to merge, resulting in the loss of 100 police officers. At the same time, we have lost several local police stations and more are at risk of closing soon. I know the police would prefer that that was not happening.
Councils such as Lewisham have had to be creative so that it can still deliver for local residents. Put simply, we previously had a service with 45 local community wardens and now there are 30 seeking to do the same job. That is on top of a reduction in the number of police community support officers. In the past, we had more than six community support officers per ward; they knew the local area well and had the capacity to build relationships with the community. That is no longer possible. Most of our wards are left with just one community officer, and that is a picture we are seeing across London.
There is a familiar story in our schools. On average, Lewisham schools will suffer an estimated loss of almost £26 million between 2015 and 2020, equivalent to £319 per pupil, and most teachers are now teaching classes of well over 30 pupils. School exclusions are rising, too—speaking of which, when will we get the Timpson review of school exclusions? I have asked that several times in this Chamber.
Also notably absent from the Government’s consultation is early years—a worrying, but not surprising, oversight. Sure Start centres have been cut across the country, and Lewisham is no exception. In 2010, the borough had 19 children’s centres; only five are left today. Early years support is crucial to a public health approach. How else can we implement early intervention? Is it not time that the Government provided maintained nursery schools, with the sustainable funding they need to keep their doors open?
I wanted to end on a more positive note. We in Lewisham are lucky to have a Labour council led by a brilliant mayor. In spite of all the cuts, Lewisham Labour is committed to implementing a public health approach to tackle violence. It plans to lead a truly community-led approach, and has already started by consulting Lewisham’s vibrant community groups and voluntary organisations. Our local government has a huge part to play in tackling violence and it is reassuring that the Government have recognised that. The Government are using all the right language, but now is the time to follow through with the necessary funding that our services have been without for far too long.
We talk about following the evidence, but where is the evidence that a programme run in a school teaching kids, “Don’t carry a knife, because you won’t be safe,” actually works? If we want to talk about true evidence, we have to build our young children’s resilience; we have to teach them to realise how fantastic they will be in the future and give them the skills to do that. That means investing in Sure Start early childhood centres, in our schools and in youth work. Our young people deserve that—they deserve the futures we all want for them. I urge the Government to fund local authorities properly, so that they can deliver.
As we have heard in the accounts given by many of my hon. Friends today, for many communities in this country local government funding is a matter of life and death—a matter of keeping vital services open and making sure that the most vulnerable people in our society are given the protection and support they need to survive. That is the scale of the crisis afflicting our local authorities—a crisis that we know hits the poorest the hardest.
Nine of the 10 most deprived councils in England face cuts that are higher than the national average. All nine are Labour controlled. Seven of the 10 areas facing the smallest cuts to spending power per household are Conservative controlled. Is it not telling that after nine years of savage cuts to local government, fraying the very fabric of our society, the Tory party is campaigning in the upcoming local elections on its record on road maintenance? The Conservatives boast proudly of “A few less bumps in the road”. Consider that for a moment. Local authorities are housing 79,000 homeless families in temporary accommodation, including more than 120,000 children; last year saw the biggest annual increase in children in care since 2010, and councils start 500 child protection investigations every day—but the Tories want to talk about fixing potholes.
We have now seen almost a decade of deprivation engineered by Tories in Westminster. The Conservative party proudly talks of its record on fixing bumps in the road while our communities are starved of spending and our services are cut to the bone. What an insult to the dementia patient who cannot access adequate social care, to the family who cannot find themselves a home or to the schoolchildren sent home early for a lack of funding. Does that not sum up the warped priorities of this failing Government?
I commend the Labour councils across the country, which are doing their best to stand up for our communities in the teeth of savage Tory cuts. Voters face a blunt choice in the upcoming local elections between those who want to destroy our communities and those who want to rebuild them for the many.
First, I would like to pay tribute to the fabulous work of the council staff in my area and the local councillors of the Conservative party, independents and others, who work so hard to deliver excellent services for our community.
My right hon. Friend the Member for Ludlow (Mr Dunne) made the point that the previous Labour Government moved funding from shire constituencies to metropolitan areas. As a resident of both South Kesteven and Westminster, I thought it would be useful to illustrate the difference between the two. In South Kesteven District Council area, the average weekly gross wage is £453.20, and the council tax for a band D property is £1,589.38 a year. In Westminster, where I am during the week, the average weekly wage is £786.10, and band D council tax is £710.50. This means that the average person in Westminster is earning more than £300 a week more but pays £879 less in council tax for their local services.
Despite the challenges to funding and the fact that if Lincolnshire County Council were funded the same per capita as the average council in the country, it would receive £116 million more than its current budget of roughly £500 million, it has been able to do some very innovative things with its funding. We have discussed the environment a lot this week. South Kesteven District Council introduced “The Big Clean” initiative last year, which visits each village of the district to remove fly-tipping, clean signs, remove undergrowth and do other things suggested by the local residents to improve the environment in which people live and ensure that they can take pride in their surroundings.
Gravity Fields festival, which has been running since 2012, is an innovation of our local council. This goes beyond delivering the basic services; this is the best in the country. It is a festival of art and science inspired by Sir Isaac Newton, who was from Grantham and went to the local school. The festival not only provides the people of Grantham with information on art and science and very interesting experiences, but it raises £1 million for the local area through visitors staying there and spending their money on food and drink and the like. This is a Conservative council doing its best to deliver really innovative stuff, despite having a stretched budget.
North Kesteven District Council, which covers the other part of my constituency, is similar. It has looked carefully at the challenge of being good to the environment while providing the social housing that is required. It has won awards for building curved homes and passive houses, delivering the next generation of social housing in an environmentally sustainable way. It is not only providing basic services but going above and beyond, to provide excellent services. Lincolnshire County Council receives lower than the average per capita funding, as I have said, but it is still providing our children and young people with what Ofsted describes as “strong and effective” services for those with special educational needs and disabilities.
The ageing population presents one of our nation’s most profound challenges. It raises critical questions about how, as a society, we enable all adults to live well in later life and how we deliver sustainable public services to support them to do so. There will be 2 million more people aged over 75 in the next 10 years, and many of those will be managing long-term conditions. It is vital to make sure that local councils are supported to provide for elderly citizens so that they can age with dignity. That is why I am glad this Conservative Government have invested in social care, with a 23% increase in the improved better care fund to £1.8 billion, an additional £410 million through the social care support grant and £10 billion for adult social care being provided to councils by 2020.
I really welcome the additional resources that have been provided for social care by this Government, but as a Member representing a rural constituency it is important for me to emphasise that an extra £1 for social care in London will go further than an extra £1 in Lincolnshire. Rural areas face higher costs for the delivery of public services than urban areas. [Interruption.] The hon. Member for Denton and Reddish (Andrew Gwynne) says from a sedentary position, “That’s not true”, but if one is visiting an elderly person in their home and then travelling on to visit the next elderly person in their home, there is of course a gap.
I hear what the hon. Gentleman says, but it seems to me that rural shires often have Conservative-led local authorities that provide their services more efficiently. In practice, if we ask a carer to go out to visit three elderly people in a morning, for example, and those houses are very close together, as they may be in Westminster, they will be able to visit, spend longer with them and have lower travel costs than they would if they had to visit three houses in my constituency, which covers 433 square miles and is all within the same county council.
As I was saying, when it comes to social care, this problem is in large part due to both the demographics and the distances involved. As I have said, my constituency spans 433 square miles and has a low population density, and there are longer travel distances for staff to deliver care. Furthermore, Sleaford and North Hykeham, as a rural area, has a higher number of older residents. Those older residents have worked hard their entire lives and now need support from our public services to ensure that they can maintain a higher quality of life.
However, this is not all about funding. Actually, I think it is sad that so much of the debate has focused almost entirely on who is going to provide the most money, while only a little bit has been on how to pay for it, and not so much on innovation and quality of care. The important thing is not shouting about who can spend the most money, but who can deliver the best outcomes and provide the best care for people, because that is surely what everybody on both sides of the House wants.
Last year, there was the launch of the National Centre for Rural Health and Care in Lincolnshire. This is a grouping of the NHS, the University of Lincoln, Health Education England, Public Health England and the East Midlands Academic Health Science Network. This pioneering group will look at improving how we deliver care in local areas.
There is also the social care and digital innovation programme, which is run by NHS Digital. This gives money for local projects, so somebody with a local project that they think could improve care for residents, if they had a little bit of start-up funding to test it, could receive money to support the design and trial of digital solutions to improve care and provide value for money. Previous projects include an exoskeleton device in the Isle of Wight to give people greater independence, and the provision of Amazon Alexa in Hampshire to help people to maintain independent living.
There are other projects, too. In Cornwall, Peninsula Community Health Services is looking at how to prevent pressure sores. We know that 500,000 people in this country develop a pressure sore every year. These are excruciatingly painful, can become infected and, in the worst cases, can lead to such a serious infection that the patient dies. The continuous pressure monitoring technology devices will be able to help people identify hotspots even before the skin damage occurs and prevent that from happening. That is an investment in something that, overall, will not just improve patient care but save money.
The Leeds Care Record looks at how information can be shared—data protection means that in some cases it is difficult to share information held by hospitals and GPs—and how referrals are made. When I first qualified as a doctor, all the letters were dictated and signed, but now they are typed and sent electronically. Cumbria, for example, saves £400,000 a year by sending referrals electronically. That also saves time, which means not only saving money but improving the efficiency of the service delivered to patients.
I am glad that the Government acknowledge the need to change the outdated funding formula, which has failed accurately to recognise the discrepancy in need between urban and rural areas; that need is often hidden in rural areas. As Ministers review the consultation findings, I hope they will ensure that the new funding formula adequately takes that into account.
Finally, as a member of the Conservative party, which has long been the best custodian of the public finances, I say that it is imperative that money is spent both wisely and efficiently. The issue of social care goes much wider than just funding. Despite the challenges facing local councils, I have seen at first hand how the brilliant work by North and South Kesteven District Councils and Lincolnshire County Council can support the people in my constituency and make our resources go as far as possible.
I will address most of my remarks to the issue of social care and the challenge we face, but first I want to highlight a real concern that other hon. Members have also expressed. The funding constraints on local government have had a very big impact on preventive services that are designed to stop extra costs being incurred at a later stage through a failure of the system.
I will give one or two examples. The Select Committee on Science and Technology recently conducted an inquiry into the impact of adversity in childhood, looking in particular at trauma, abuse or neglect in early years. We know that if we intervene early and follow the evidence of what is effective in stopping trauma becoming entrenched, we can not only transform lives but save a fortune further down the track.
The hon. Member for Sleaford and North Hykeham (Dr Johnson) said something about the Conservative party being the custodians of careful finance, but we are seeing significant reductions in investment in preventive services, which end up costing the state a fortune further down the line. Too often, children who experience trauma, abuse or neglect in early years and who do not get the support they need end up being excluded from school, and the track through to the criminal justice system is all too real. Educational attainment is, therefore, often lower than it should be, and worklessness often follows. The disinvestment over the past few years in those preventive early years services, supporting parents and so on, has been a very stupid thing to do, because it will cost the state far more in years to come.
When the Chancellor launched the Budget a few weeks ago, it was encouraging to hear him say that he was willing to invest in early intervention where there was evidence of its effectiveness. Well, there is evidence of its effectiveness, so the Chancellor needs to make that investment.
I have huge respect for the right hon. Gentleman’s knowledge in this area, but he is talking about overall local government spending cuts and he was, of course, a part of the first five years of this Government. The greatest austerity and local government cuts were made under a Liberal Democrat and Tory coalition, so does he regret his part in the huge cuts made to local government between 2010 and 2015?
If we are honest, every Government have some responsibility. The reductions started before 2010. I absolutely accept—[Interruption.] Let me address this point; I am trying to be straight with the hon. Gentleman. I think mistakes were made by the coalition Government in terms of the hit local government took during that period. The contrast between the support for the NHS by increasing investment in real terms and the cut to social care does not make sense, but that is what happened. I recognise that. It was above my pay grade, but I do not think it was the right decision to make. I hope that that is of some help to the hon. Gentleman.
My right hon. Friend makes some really important points about the first 1,000 days of life, but equally there are similar arguments relating to the end of life. For example, too many people who need social care end up in a much more expensive place at the end of their life—in a hospital setting, where they do not want to be—for the want of the right investment in social care. Does he agree that we should apply the principle of investing to save across the whole of life?
I absolutely recognise and accept that point.
The hon. Member for Chesterfield (Toby Perkins) intervened to challenge the point about spending under the coalition Government. There was a crisis in public finances in 2010 which did have to be addressed, but I do accept that the balance between social care and the NHS was not optimal. I also want to address other areas where the underinvestment or disinvestment in preventive services has borne a heavy cost.
The hon. Member for Lewisham, Deptford (Vicky Foxcroft), who has done very good work on youth violence—I have been part of the commission looking at that—made the point that many of the preventive services that are there, particularly during teenage years, to stop the risk of young people slipping into gang violence have been stripped away in many of the poorest communities. Again, the impact of that has, at least in part—it is very hard to judge cause and effect—been an increase in violence on our streets at the awful and dreadful cost to many of those affected by it.
I want to turn specifically to social care. It is worth reflecting on why social care is so important. It is there to give people the chance of a happy life and a good life, as far as they are able to enjoy that if they are struggling with a range of conditions. It is there to help people to remain independent in old age, to support people so that they do not end up needing the NHS, with an enormous impact on their wellbeing. One of the problems we face is that unless you or a family member experiences the need for social care, it is hidden from view. Very many families across our country simply do not see the impact of the underfunding of social care today, but it is very real. There are over 1 million older people who are not getting the care they need. As Simon Stevens, the chief executive of the NHS, has pointed out on many occasions, if people do not get social care support, that has an impact on the NHS. The funding settlement for the NHS simply will not work unless we address the under-resourcing of social care.
The right hon. Gentleman knows more about social care than anyone else in this House—I pay him that compliment. Does he accept that one of the most unfair issues is where local authorities have moved people with learning disabilities out to cheaper parts of the country—Gloucestershire being a classic case—and their care needs get worse over time? The local authority that moved them out says, “It’s not our problem; it is the problem of the local authority to which they have moved”. Does he agree that that is why we need a national care service?
The hon. Gentleman is absolutely right to highlight the issue of how we care for people of a younger age who have care needs, particularly those with learning disabilities and autism. What happens too often is that those people end up in institutions when they do not need to be there, often away from home and at enormous cost to the public purse. Again, the evidence from around the country shows that where this is done well and where families are supported to keep someone at home, helping them through crises, we not only reduce the cost to the public purse but have a massive impact on their wellbeing. He is also right to highlight the fact that we end up with awful disputes about who is responsible for payment as people are shunted around the country in a way that, in my view, fundamentally breaches their human rights.
I am glad that the right hon. Gentleman is talking about this topic. It is absolutely vital, but does he regret the extent to which the Government now seem to have abandoned the transforming care programme? There seems to be no future for it. From the time when he was a Minister, there was a programme to deal with the issue that my hon. Friend the Member for Stroud (Dr Drew) raised, but there now appears to be an abandonment of targets and an abandonment of the future of that programme, and certainly no funding to make it work.
I am deeply concerned about the future—or lack of a future—of the transforming care programme. One of the problems is that it is often NHS England that is funding care in an institution, and when a local authority is under financial stress, there is not much of an incentive to take that person out of the institution and make them the responsibility of the local authority. There has to be a way of funding the building of infrastructure to support people in the community. That is what has failed to happen so far.
This is not a static issue that we face. There is growing pressure. We are all living longer, often with chronic conditions that in the past used to kill us. That is a great triumph of man and womankind, but there is a cost attached, yet we have no mechanism to address the increasing funding needs of social care and, in particular, dementia.
The hon. Member for Chelmsford (Vicky Ford), one of the valued members of the Science and Technology Committee, made the point that the cost to society of dementia is about £26 billion every year, but that is going to rise dramatically. Whatever we say about spending money efficiently—I completely agree about the need to spend money efficiently and to innovate and do things in a more effective way—the dramatic rise in demand inevitably means that we will have to spend more as a society on supporting people with dementia and on research to find cures for dementia.
Does my right hon. Friend agree that one of the ways of supporting people who need care, such as dementia sufferers, is to support their carers, and that there is a very important role for organisations such as the Sutton Carers Centre in providing support to the network of carers who support people with dementia and others with long-term conditions?
I very much agree, and those organisations do incredibly important work.
I want to mention the Care Act 2014, which I was responsible for taking through Parliament. I think it was widely regarded as good legislation, but I fear that it has been undermined by a failure to commit sufficient resources to really realise the transformation that it was designed to achieve in personalising care and putting the individual at the heart of everything that local authorities do. In particular, we legislated for a cap on care costs in that Act, but as soon as the Conservatives got rid of the Lib Dems from the coalition, that commitment was abandoned. All the work that we did in consulting and legislating for a cap on care costs to protect people from catastrophic cost has been lost. Of course, we know that in the 2017 general election the Prime Minister paid dearly for that politically, because the replacement proposal was sorely lacking and amounted, in many people’s eyes, to a tax on dementia.
I am conscious that you want me to shut up very soon, Mr Deputy Speaker, but I want to say something very briefly on future funding. It seems to me that if we are to achieve a sustainable settlement, we have to work on a cross-party basis and the Government have to embrace that. The motion still prompts the question of where the money is going to come from—it does not answer that question.
There are a range of solutions. My party and I have proposed a dedicated health and care tax that would appear on people’s pay packets so that everyone could see where the money was going, and which would be informed by an independent assessment, perhaps every five years, of how much the health and care system needed. It would take the politics out of the calculation of how much the care system needs. Then the parties could argue about whether they were prepared to meet those needs through an increase in that dedicated tax.
If we are to solve this, it will require political will. There has been a failure of the political class, not just in the last few years but ever since the late ’90s, when a royal commission established by the then Labour Government came up with proposals that were never implemented. It has been kicked in and out of the long grass ever since, and we are still waiting for a solution. It is time we found one, because we are letting down too many people in our country.
It is a great pleasure to follow the right hon. Member for North Norfolk (Norman Lamb), who, as we all know, has great knowledge in this area. I am pleased he acknowledged in response to my intervention that the Government the Liberal Democrats were part of got the balance wrong in local government funding. I am very conscious of that fact, having spent a lot of time talking about local government elections in the last week or so back in Chesterfield, where it is hard to find a Liberal Democrat who will own up to the Government their party was a part of. They seem to have disowned their record entirely.
My hon. Friend the Member for Sheffield South East (Mr Betts) made the point that in this time of austerity the worst hit area of government has been local government. It has been utter cowardice for the Government to say, “There are going to be huge cuts, but we’re not going to decide where they’ll fall, because we’re going to pass on that decision to local authority leaders. It will be for them to decide whether to shut a library, close a park or stop investing in roads. We’re going to outsource the pain”. I think of the many people who first became councillors after the 2015 elections, or even the 2013 elections. They were so excited to be councillors, but at their very first council meeting they were faced with the decision of what to shut. That has been the reality for many local authorities.
It is absolutely right that the motion tabled by my hon. Friends should focus on that unfairness. I have referred previously to the fact that Chesterfield has had a 43.2% cut, whereas the Secretary of State’s local authority has had a cut of just 12%. The right hon. Member for Ludlow (Mr Dunne) spoke up for that, saying the problem with the Labour Government was that they sent all the money to the poor areas. I am proud that a Labour Government made those decisions and recognised the role that local authorities can play in supporting the most deprived in our society.
As I said, I have been in Chesterfield talking about the local elections. I am proud of the record of the local authority in Chesterfield. It has recognised that in a time of austerity and unfair cuts from central Government it has had to make innovative choices to enable us to provide better services that cost less. It invested in a new leisure centre and found that the amount by which it had to subsidise it fell from £1.5 million—the figure in every year under the Liberal Democrats—to only £300,000 a year, as more people were using it because it had better facilities. Similarly, the council invested in our cultural facilities, meaning the theatre and concert venue saw a 60% reduction in the amount by which it had to be subsidised, since it was getting more punters through the door because it had better facilities.
We have fewer empty shop units than most other local authority areas of a similar sort. The council has done very innovative things, such as bringing a big wheel into the centre of Chesterfield, which massively increased the number of people visiting the town centre, and it has an innovative record on tackling homelessness. There was an excellent remembrance display to commemorate the 100th anniversary of the 1914-18 conflict, featuring poppy cascades not just from the town hall but from a variety of retail units. The council has recognised that it is sometimes necessary for local authorities to invest in order to save money and to be innovative if people are to be proud of them, but at the same time it has managed to maintain the lowest level of council tax in Derbyshire.
We know that Labour councils cost you less. The average cost per household in Labour council areas is £351 less than the average in Tory areas. The authorities that have been most likely to go bust are Tory authorities in, for instance, Northamptonshire and Surrey. Not only does Labour run its councils better than the Tories, but its councils cost less and innovate more. I am very proud of the record that I will be going out to defend.
I want to say something about social care, because I know a great deal about it. I spent a very tough year of my career as care manager of a private provider of domiciliary care for Sheffield City Council. One aspect of social care that is missing from the whole debate is the fact that it is set up as an industry rather than a service. The vast majority of domestic care providers are private sector businesses, and the vast majority of care homes are run by the private sector. The No. 1 priority of the private sector is to make a profit, and we should not be surprised that if we involve private sector companies in care homes, they will try to make a profit out of them. That, ultimately, is what companies exist for.
Councils often involve the private sector because they are trying to save money, and they recognise that the terms and conditions on which local authority staff will work will be more generous than those in the private sector. That is one of the knock-on consequences of the overall spending pressure on councils. The relationship between councils and their providers is very important. Far too often, councils outsource responsibility for these services, signing up to contracts that anyone who studies them must know are unsustainable. They must have some responsibility for the decisions that they make.
As one who has worked with carers, I take my hat off to those who work in the care industry. I know that they are among the most dedicated and professional of people, often working in incredibly difficult circumstances for an absolute pittance. I know that whether they wear a uniform with a local authority badge on it or work for a private company, they have a real commitment to the people for whom they provide care. However, we are seeing an industry in crisis. More than 100 care homes have gone bust in the last two years or so, and dozens of domestic care providers are going bust as well. In 2018 Allied Healthcare, the company for which I used to work, was days away from bankruptcy. Every time a care home goes bust, the onus falls on the local authority again.
The Government need to understand that given the scale of cuts that we have seen over the last nine years, with a single year’s uplift and the ring-fencing of the small amount of £2.5 billion—it is not actually a small amount, but it is inadequate in comparison with the cuts of previous years—they cannot, as the Minister did earlier, wash their hands of the fact that the industry is in crisis and businesses are going bust. That means 15-minute appointments. It means dementia patients seeing a different carer every day, although consistency of care is so important. It means a decline in the service that they receive. It means families seeing that their relatives are deeply troubled by the inconsistency of the services that they are receiving. It means local authorities saying that they will not pay for travelling time, and that responsibility falling back on to the companies.
The courts have recently decided that those who provide sleepovers should be paid the national minimum wage. Many care companies did not previously pay it. I support that decision, but the corollary must be the Government’s recognition that while local authorities were previously tendering on the basis that those who slept on the job could be paid on a different basis, it has now been retrospectively decided that authorities must pay private providers. Money must now come from central Government to fund that, because businesses will continue to go bust and the services on which people rely will continue to be diminished.
All the cuts to care have consequences. When care services are not available, people turn up in A&E. Some 20% of the people in A&E should be in a hospital bed but cannot get admitted. At the same time, 20% of hospital beds are filled by people who cannot get out because there is no care package waiting for them. My hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) spoke about the impact of cuts to children’s social care falling on children with special needs and on schools. Things like the failure to diagnose autism have a knock-on impact right across the school and other areas. All these services are connected; we cannot look at social care and local government finances in isolation.
I met the managing director of One to One, a company in my constituency that provides excellent care services to many local authorities, who told me about the knock-on consequences and the impact that local authority funding cuts are having on its ability to get paid. The company is often owed tens of thousands of pounds by local authorities that are struggling to manage their administration.
The industry is in crisis and local government is in crisis. The Government have two choices: they either step up to the mark and convince us that they are serious about the social care funding crisis, or they continue in the way they are going, in which case everyone will realise that this is something that lands at their door.
It is an honour to follow my hon. Friend the Member for Chesterfield (Toby Perkins).
Let me start by highlighting to those who are watching the debate across the nation that we are debating local council funding because it is an Opposition day. The Conservative party has continued to delay, distract and sometimes even destroy any meaningful conversation on Brexit, as a result jeopardising the discussions on other issues that are faced by people across our communities and constituencies. I therefore thank the shadow Secretary of State for Housing, Communities and Local Government for the leadership he has shown on this matter.
As we have heard, by 2020 local authorities will have faced a reduction in core funding from the Government of nearly £16 billion since 2010. That means that councils will have lost 60p out of every £1 the Government used to provide for spending on local services. In Bradford over the past 10 years, we have seen huge cuts to our local council funding. In 2010, we received more than £500 million. In 2019, we received just under £400 million. On average, that is a loss of £750 per household across the city of Bradford.
Conservative Members may want to turn the debate into a conversation about spending formulas, but the reality on the ground is clear. We do not need statistics to tell us about the growing levels of deprivation in our constituencies. The stark reality can be seen in the lack of properly funded services, the non-existent youth services, the reduction in bobbies on the beat, the oversized classes and overcrowded classrooms, and the decline in living standards faced by the poorest in our communities.
I ask the Minister: what do I say to the young people in my constituency? It has one of the youngest populations in Europe, with 30% of Bradfordians being under the age of 20, yet it has among the highest levels of youth unemployment. How do I tell the younger generation that they do not have access to the youth services that were there before because we now have a Tory Government in power? How do I explain to them that because they have a Labour council, the Government disproportionately play politics with their life opportunities?
The facts speak for themselves: Bradford appears in the list of the top five councils to receive the biggest cuts to their total spending power over the past 10 years. Why is it that eight of the 10 councils that have received the largest cuts are under Labour control, while eight of the 10 councils that have received the smallest cuts are under Conservative control? I say today loudly and clearly: this Government have played party politics with Brexit, but we will not sit by silently as they play politics with the lives of people who vote Labour and the lives of our other constituents. The Government should protect all citizens equally, and it is frankly unacceptable that my constituents and many others are being left worse off by this Government. The people of this country are watching, and, with the local elections on their way, they will know which party stands for their best interests.
I was listening to the Minister earlier when he was giving out statistics and saying how the Government had done this and done that. The truth is that they have this April failed for a fifth time to publish their Green Paper on health and social care. How can any council have confidence in this Government when they hide behind the Brexit shambles to avoid dealing with the issues that are pertinent to our communities? What kind of decisions do the Government want our councils to make in 2019 when we do not have enough money? Do they want them to cut social care? Do they want them to cut children’s services? Or do they want them to cut bin collections, which have already dropped down to once a fortnight?
The upcoming fair funding review is a proper stitch-up. It threatens to make the funding situation even worse, as it proposes to remove deprivation as a factor in its core funding calculations. Let me tell the Minister this: removing deprivation as a core issue in the funding formula will be absolutely devastating. She should come to Bradford West; I will show her what deprivation really is. The Institute for Fiscal Studies has already warned that removing deprivation in that way would result in moving resources from the more deprived councils to the less deprived, predominantly Conservative-controlled suburban and rural councils. How is that fair and equal?
These cuts have not hit all councils equally. Analysis from the Commons Library shows that, since 2010, Tory areas have had a far smaller reduction in spending power per household as a percentage and in cash terms. Government policy has led to an increased dependency on council tax as a funding mechanism, leading to a postcode lottery and hitting deprived families hardest. Households in Labour areas pay an average of £351 less in council tax. How can this Government be okay with the deprivation in Bradford West and places like it? We need to elect as many Labour councillors as possible on 2 May to stand up against these unfair Tory cuts. The people of this country are watching, as I have said. They know which party stands for their best interests. If the Conservatives are so confident, let them close their eyes when they look at the polls and call a general election. We on this side of the House are ready to give this country the Government it deserves.
It is an absolute pleasure to follow my hon. Friend the Member for Bradford West (Naz Shah). She is a doughty champion for her constituents, and she made the point incredibly powerfully that taking deprivation out of the local government funding calculation is absolutely shameless. It is constituencies like hers and mine that will suffer the brunt of that, and I pay tribute to her for her words.
Redcar and Cleveland has had a raw deal over the past nine years. I have lost count of the number of times I have stood up here in this Chamber to talk about the unfair and disproportionate cuts that areas such as mine have suffered. As we have said, it is the deprived areas that are not getting the funding and support that they need. We have had a big debate this afternoon about how much money is in the pot and whose fault it is that there is not enough, but this is not just about how much money is available for local government; it is about how it is distributed. It was clear from the evidence given by my hon. Friend the Member for Denton and Reddish (Andrew Gwynne) and from some Conservative MPs that the funding has been shifted under this Government. It has been moved from the areas that need it most to areas that are doing fine. There is a deep unfairness and flaw in the funding system as it stands.
Redcar and Cleveland has now lost £90 million since 2010. That is £662 per person; each of my constituents has lost £662. On top of that, they have had to pay more through precepts in social care and policing, yet they have still lost 500 police officers and they are still getting worse services. They are paying twice. My constituents are among the poorest. We still have council tax based on 1991 housing prices, but areas such as mine have not seen house prices rise; the value of my constituents’ assets has not risen. They are still paying a deeply regressive council tax that is proportionately much tougher on them than it is on many others throughout the country. They are paying more through precepts and getting less from their services. That is simply not fair.
My council has lost a third of its central Government funding. How on earth can it be expected to continue to deliver the standards of service that people want? I pay tribute to Sue Jeffrey, the leader of the Labour-run Redcar and Cleveland Borough Council, which has continued to do amazing work to defend our constituents and to provide fantastic opportunities and events for people who come to the area. The council has continued to provide the services that many people need and has done so without leaving behind the most vulnerable. I also pay tribute to Amanda Skelton and to all the council staff who work so hard.
Redcar and Cleveland does struggle, however. We have high levels of deprivation and child poverty. We have higher unemployment than most of the country and lower health and wellbeing outcomes. As a seaside town in a former industrial area, we have an increasingly ageing population. On top of all that, we had an economic shock in 2015 following the loss of 3,000 jobs after the closure of the steelworks, which had a huge knock-on effect on public services in the local area. This is not just about the devastating personal tragedies of those who lost their jobs, because there was another knock-on effect in terms of higher dependency on benefits and more insecure and poorly paid work. The average salary of someone who worked at the steelworks has declined by £10,000, and many people had to move away to look for work. The effect of all that on our communities, high streets and towns has been devastating, and the local authority lost £10 million in business rates following the closure of the steelworks on top of the funding cuts about which we have already heard.
As I said, despite the funding pressures, our council has continued to do a really good job, and I am incredibly proud of it. It has protected services for the vulnerable and has kept our libraries and leisure centres open. It has tried really hard to invest in our town and village centres, with a particular focus on economic development. For example, Eston has received £2 million over the past two years, with a further £1 million coming for its precinct. An award-winning employment and training hub has been established, getting over 1,000 people into work in just 18 months. The hub sprang out of crisis following the loss of the steelworks, but it has been innovative, going right into our most deprived communities and supporting people who may not have had a CV before, to get them the necessary training and experience to get into employment. I am incredibly proud of that groundbreaking work. There are plans to invest £40 million in the regeneration of the iconic Regent Cinema on the seafront and a further £95 million to create 4,500 jobs, so our local authority is working hard and doing its best. Redcar has a bright future, but we are doing things locally and we are doing them ourselves.
Social care is the big theme of today’s debate, and we know that it represents the biggest pressure on local authority spending. It is projected that over-65s will make up a quarter of Redcar and Cleveland’s population by 2030, so we have an ageing demographic. While it is fantastic that children with complex needs and conditions and older adults are living longer, that means greater costs. As others have said, it is ridiculous that we are still waiting for the social care Green Paper, which has been postponed five times since 2017. This Government have no vision for the future of social care, and strategy and direction are sorely lacking.
Faced with that vacuum, local leaders are again stepping forward, taking up the mantle and trying to deal with the crisis. Redcar and Cleveland is seeing fantastic innovation, such as the intermediate care centre that will open later this spring, and we have invested in specialist support, including a recovery and independence team that goes out to support people in their homes. I am also proud of Redcar’s Care Academy. We know that jobs in the sector are underfunded and have a high turnover, so hopefully the academy will ensure that such roles are highly skilled and valued going forward.
We are using the money that we have, although it is not enough, to deliver better care for residents, but that is no substitute for proper investment. Unfortunately, inadequate care means that too many people are having to step into caring roles. We rely upon an army of unpaid family members—overwhelmingly women—who are taking care of their relatives. Many of them have to give up work to take up that role, and many of them are older people, as we have heard today. A huge burden has been placed on them, and we must do more to help by looking after their loved ones and taking away that burden.
That is where the money should be going but instead, in the past few weeks, we have seen £4 billion spent on no-deal preparations when the Government have completely acknowledged that we were never going to have a no deal—it was some crazy, ridiculous pretence at a negotiation. If Labour had won the election in 2017, we would have invested double that in social care. That is where money should be going in this country. We would have brought in a living wage for carers, we would have ended 15-minute care visits and we would have increased carer’s allowance. That is exactly the sort of thing a Government who care about the many, not the few, would be looking at. Instead, we are wasting money by frittering it away on the Tory soap opera of Brexit.
Labour Members want to tackle the burning injustices in our communities, and we want to help those most in need. We need a Government who will invest in social care for the 21st century without forcing elderly people into selling or remortgaging their home, who will support families to secure the care their relatives need, who will support families to cope with disadvantage, and who will prevent children from having to be taken into care. We need a system that preserves dignity and quality of life in old age.
Councils are at breaking point, yet we see Labour councils out there defending the most vulnerable, striving hard for their communities and creating safe and decent places to live, but communities like mine are being left behind by austerity. We have had enough warm words; we need investment in local government and fairness in distribution. No more austerity, no more cuts.
It is a pleasure to follow the hon. Member for Redcar (Anna Turley).
I start by thanking and paying tribute to all the frontline care staff around the country, and to all the family carers, informal carers and those working extremely hard in voluntary services in all our constituencies. In my constituency, I pay tribute to Dartmouth Caring, Totnes Caring, Brixham Does Care, South Brent and District Caring, and Kingsbridge and Saltstone Caring. I know that similar voluntary services are working across the country in tandem with the NHS to provide excellent care to our constituents, but they are under pressure as never before.
There is a devastating impact on those affected—those who are not getting the care services they need; not only working-age adults but older adults, and their families. There is also an impact on the NHS. If people cannot access care services, there is not only an impact on their dignity, mobility and wellbeing but they are much more likely to end up in hospital—a place they do not want to be and at much higher cost—sometimes with serious illnesses or injuries that could have been avoided by better prevention and early intervention.
We need to deal with this issue, and the House needs to appreciate the scale of the challenge. Let us look at the demographics. We know from the Office for National Statistics that, last year, 18% of our population nationally was aged over 65, but that in 14 years’ time 23% of our population nationally will be over 65. Of course it is a good thing that people are living longer, but they are living longer with multiple disabilities and we need to be prepared for that. We need to be prepared not only for the scale of the shortfall we face right now but for what is coming in the future. When we talk about social care funding, we need not only to acknowledge the impact of the shortfall we have here and now, and how we are going to deal with it, but to plan seriously for what is coming down the track.
In my constituency, we are already there. My constituency has a much older population than in many parts of the country and, even when they can afford to pay for care, people cannot find the workforce to care for them. There is a real crisis in our social care workforce, which needs investment. We need to value and nurture that workforce. We know what works, but we also know it will require serious investment.
I am afraid that one of the features of such debates is that the blame bounces backwards and forwards when, in fact, cross-party working and consensus building is what is really needed. The funding choices we face are difficult. I agree with the hon. Member for Redcar, who highlighted why this cannot all be funded at a local level. Doing so just widens inequality, because the areas that are least able to pay have the greatest need. It is unrealistic for everything to come from a local level, so we need to work towards a national solution to the problem.
The Health and Social Care Committee, which I chair, has worked together with the Housing, Communities and Local Government Committee—I pay tribute to the hon. Member for Sheffield South East (Mr Betts), who has also spoken about this—and we know what works. The tragedy is that we could deal with the problem. Our joint Committees looked at the options and achieved a cross-party consensus; we worked alongside a citizens’ assembly, because we think it is really important to build consensus outside this House. There are some principles we should be following. I urge the Minister, in her response, to tell us when the social care Green Paper will be published and commit to ensuring that it looks at the work of our joint Select Committees and the citizens’ assembly.
We can move forward, but if we have learned anything from the Brexit process, surely it has to be that we cannot build consensus at the end of a process; we have to build it in right from the start. I hope that the Green Paper will be designed to achieve that, and that it will set out the principle of fairness in the funding of social care. One statistic that we should all be aware of is that in the next 14 years, as our demographic changes and the percentage of our population aged over 65 increases to 23%, there will be 4.4 million more citizens aged over 65 but only 1.5 million extra citizens aged under 65. It is simply not sustainable to allow all the extra cost to fall on working-age, employed adults, so we must look at how to spread it fairly across the generations and between the employed and the self-employed.
I agree with Members who have talked this afternoon about reimagining national insurance as national health and care insurance. If we are truly to move towards a system that expands not only eligibility but quality, we need to bring more funding into the total system; the funding cannot just come from local sources. I urge the Minister to set out what she feels about the measures highlighted in the joint Select Committee report, and whether the Government will commit to coming up with a solution that can deliver real change, rather than kicking the issue down the line.
The wrong lesson to learn from the last general election campaign would be, “Don’t ever set out who has to pay more.” We all need to do that now, between elections. We must be realistic with our constituents about the fact that everybody needs to pay more, and we must build their trust in the idea that the increase will be delivered fairly. The consequences of doing nothing will be that more and more of our constituents will be left in desperate conditions, without carers to look after them; more and more of our care providers will go to the wall; and there will be no increase in the quality of care delivered on the ground, because there will not be the funding to support the workforce. We have to grasp the nettle with these difficult choices.
Before I close, I want to say something about Brexit. There is no version of Brexit that will deliver anything positive for health and social care, especially if we look at the impact on the workforce. The Minister will know that in parts of the south-east and London, in particular, social care is very heavily dependent on access to a workforce from the European Union. That is also the case in my constituency. Nationally, around 7% of the social care workforce are from the EU. If we cut off access to that workforce, not only will we miss out on an incredibly important and valued skilled workforce by making it more difficult for them to come here, but we will add costs. Many of the people who work in social care—in fact, the vast majority—will not meet the current proposed earnings thresholds that will allow them to come here easily on, for example, tier 2 visas.
We need a way to nurture our workforce and to make it easy for people to come here to work and to feel valued. I do not want to meet any more people in my constituency who work in the NHS and social care and tell me that after decades of dedicated service to this country, they no longer feel welcome.
It is a pleasure to follow the hon. Member for Totnes (Dr Wollaston).
Having listened to the contributions today, it seems that there is a consensus that our social care system is broken, but some Members seem to be living with their heads in the clouds. To describe our social care system as broken is an understatement: it is a national scandal of which we should be ashamed. I am certain that Members present get the same casework as I get. It is the stuff of nightmares. Social care is one of those issues that genuinely keeps me awake at night.
Behind all the statistics that we hear today, there is a heartbreaking human reality. As many others will have done, I have sat and fought back the tears as I have listened to those at my local surgeries who are exhausted from the battle to get the most basic level of support for their loved ones. We have only to read some of the reports from recent Care Quality Commission inspections to get a feel for the state of our social care system today. It is beyond broken.
One report, following an inspection in Crewe and Nantwich last year, found one person with injuries that were unaccounted for. It described another person as
“extremely anxious and afraid that they would be injured”,
and said that they
“lay in their bed in the foetal position”
“their feet were dirty and their hair matted.”
I will never forget visiting an older lady in a nursing home who was still haunted by her experience in a previous facility, where she had suffered the most undignified neglect—a lady left shocked and confused after decades of working and paying taxes and paying national insurance contributions.
Today, I wish to focus our attention on those who work in social care. It takes a certain kind of person to work in the care sector, and I pay tribute to them all. They experience this rotten system almost every single day of their lives, yet they carry on with compassion and professionalism, despite the poverty pay and despite feeling ignored and undervalued by the Government. These are the people we rely on to protect the dignity and independence of our relatives, friends and neighbours.
What does it say about us as a nation that our social care workforce is one of the most exploited and underpaid? I cannot even imagine how it must feel to be that type of person and to be forced to leave somebody who is under their care before they have had the time to wash them, or to help them to eat. But who cares for the carers? A care worker described how staff morale was at rock bottom, with many care workers suffering from poor mental health and worried about their job security, relying on food banks and payday loans, too scared to take time off sick. He said he felt that care workers have no voice and no respect.
As if things were not bad enough, one group of care workers, many of whom already work for the minimum wage, face losing hundreds of pounds a month because their employer, Alternative Futures Group, has taken the decision to slash payments for sleep-in shifts. Sleep-in shifts are an integral part of our care service that the Government have a statutory obligation to provide. I have spoken many times previously about the importance of this work.
Calling them sleep-in shifts can often lead to people getting the wrong impression. One of the affected workers explained to me in an email this week:
“Sometimes you have to deal with emergency situations and take a client to hospital. You never properly sleep – you are half-awake all night – listening in case that person needs you. Often, we are up 5 or 6 times a night, taking them to the toilet or calming them down when they are agitated”.
She went on to describe how she often finished a sleep-in shift only to start another day in work, often going days without seeing her three children. For her, the cut in pay will mean losing £300 a month—the cost of her bills. She is now having to consider getting a second job, or even leaving the job that she loves. One of her colleagues whom I met recently is already working a second job. She also goes days at a time without seeing her child. Both ladies work with adults with learning difficulties and their duties include administering medication, PEG—percutaneous endoscopic gastrostomy —feeding, as well as washing, dressing, helping with finances and facilitating day trips.
As well as physical support, these workers also provide emotional support for the people for whom they care. Their passion for their work shines through, but the cut to their income has been the final straw and, for the first time ever, these workers have been left with no option other than to take industrial action. I stand in solidarity with those workers—as should every Member here today. They are in no way to blame for the problems in our social care system.
I questioned AFG’s decision to cut the rate of pay for sleep-in shifts given that there has been no reduction in the payment that it receives from Cheshire East Council. Its response was somewhat alarming: it claims that the funding provided by the council has never been sufficient to cover the full costs of paying the national living wage rate for sleep-ins. The charity says that its position is that
“it wants to pay above the national minimum wage for all care hours”
but that this requires additional funding. I share AFG’s concerns about what it describes as
“the dire situation funding of care is having on hard-working care staff.”
However, Cheshire East Council assures me that it does not pay providers any less for sleep-in support than it does for waking-night support and that it believes that care providers should be paying at least the national minimum wage rate. When I recently asked what the Government were doing to make sure that local authorities have enough funding to allow providers to pay sleep-ins at the national living wage rate, the Chief Secretary to the Treasury replied that it was currently working on this with the Department of Health and Social Care, which implies that it is not being paid.
Will the Government accept responsibility for this dispute and admit that they are not providing adequate funding? If they do not, we really need to explore why this funding is not reaching the frontline. Whatever the case, it is the overworked and underpaid care workers who are paying the price, as well as the elderly and vulnerable members of our communities who rely on this vital service.
In her summing up, I hope that the Minister will address the following points. First, what advice do the Government currently give to social care providers and commissioning authorities in the light of the current legal situation regarding payment for sleep-in shifts? Will she join me in calling on AFG to take up Unison’s offer of a meeting to continue these negotiations in the hope of resolving this ongoing dispute? Secondly, will she commit to looking into the dispute to determine whether AFG receives sufficient funding to pay its workers at the national living wage rate? Thirdly, will she acknowledge that the Government could simply pass new legislation, positively applying the national living wage rate to sleep-in shifts? That would give the sector the certainty that it needs and make sure that care workers are remunerated as so many believe they should be.
We have been repeatedly promised a social care Green Paper, which will focus on a valued workforce as one of its principles, but I have little faith that it will ever even appear. It has been delayed for the fifth time since the Government first promised to publish it before I was even elected two years ago. If it is published, I am confident that it will not contain the radical solutions that this country owes to its elderly citizens and to the most vulnerable people in our communities.
Our problems in social care are systemic and structural. The only beneficiaries of the system are the private companies that are profiting from this misery and it is they who benefit from this Government’s inaction. In previous debates, I have raised my concerns about how, without any real debate, market values have penetrated areas where they do not belong, and social care is perhaps the worst example of this. As far back as 2016, the Centre for Health and the Public Interest outlined the failings of privatised adult social care. Research commissioned by Independent Age has produced several policy options that serve as a starting point for any political discussion, and it shows just what can be done where there is a will to do so.
We need to address these failings now, with an immediate uplift in funding, while we build a sustainable model for the future. Not to do so is a political choice and a clear expression of how this Government prioritise the elderly and most vulnerable people we represent, and those whom we employ to provide care services. Those working in social care need to be listened to. They can help us to build a national care service that is based on need and not profitability—one that is centred on independent living for all and dignity in later life.
It is a privilege to follow a very moving speech by my hon. Friend the Member for Crewe and Nantwich (Laura Smith), who outlined the severe problems faced by our social care service.
On a slightly different note, last year I had the pleasure of attending the launch of renovation works to an historic old primary school in my constituency. Derelict for several years, the school lies at the heart of the Parkhouse district of my constituency of Glasgow North East. The Wheatley Group—the inheritor of Glasgow’s municipal housing stock—acquired the school for conversion to new sheltered social housing. The name Wheatley and the history of the school itself evoked a reflection on the long and proud heritage of municipal socialism in Glasgow, and what the prospects might be for that tradition to re-emerge in the future.
Parkhouse was one of the first districts to be developed for municipal housing by the Glasgow Corporation after the passing of the historic Housing Act 1924, led by Glasgow Labour MP John Wheatley, during the first Labour Government. These state subsidies for house building led directly to the creation of Glasgow’s municipal housing department, and saw the large-scale building of some 57,000 new homes in Parkhouse and other districts such as Riddrie and Carntyne in my constituency during the inter-war period. Indeed, the pressure to develop suitable land for new municipal housing led to Glasgow more than doubling in size, from over 5,000 hectares to over 12,000 hectares during the 1920s and 1930s.
At that time, the gas supply, water, electricity, subway, hospitals, tramways and even the telephones were all in direct municipal ownership, and there was much talk of Glasgow as a European model for municipal socialism. Indeed, at the international conference on workers’ dwelling houses in Paris in 1900, Glasgow Councillor Daniel Macaulay Stevenson, after learning that the municipal control of housing was regarded as impractical by delegates, remarked that, far from that being the case, it had been carried out to an ever greater extent for 29 years in Glasgow. He elucidated the Glasgow Corporation’s extensive portfolio of services under municipal ownership, which the delegates regarded as
“nothing short of rank socialism”.
It is interesting to see that some sentiments do not change, even more than a century later.
The scale of that sort of intervention to address the city’s social problems is scarcely imaginable today. There is simply no capacity or scope within local government to undertake the sort of mission-driven improvement that can massively improve quality of life. Today in Scotland, after two decades of devolution, we now have the most centralised system of government of any country in Europe. We have the absurdity of the Glasgow city region’s wealthiest suburbs carved up into self-contained enclaves, where the residents enjoy relatively low rates of council tax, while the residents of the urban core of the city—home to the poorest communities in the region—must carry the burden of maintaining and operating all the core services and amenities enjoyed by its wealthier suburban free riders. Not only has Glasgow been stripped of its residential tax base through historical depopulation and the relatively recent gerrymandering of its suburbs; the advent of the Scottish Parliament has seen a continuing war of attrition against the power of local government.
This year, the Scottish Government are set to impose cuts on Glasgow that are unprecedented in recent times and will lead to a further decline in public services in the city. According to the Scottish Parliament’s information service, the local government revenue budget was cut by 6.9%, whereas the Scottish Government’s revenue budget fell by just 1.6%, between 2013 and 2018. Over the same period, Glasgow City Council’s core budget has been cut by 12.8%. That is almost twice the average cut to Scotland’s 32 council areas, and seven times the cuts to the Scottish Government. The Scottish Government are proposing a further disproportionate cut to Glasgow of 3.6%—or £41 million—this year.
Although there is no question but that the Tories are to blame for cutting the block grant of the Government in Edinburgh by 1.6%, to multiply the percentage cut by four to 6.9% for councils—and by even more than that in Glasgow—is a deep injustice. The only conclusion we can draw is that local government, and Glasgow in particular, has been targeted disproportionately. Our city is having to absorb a cut to its budget proportionately seven times greater than the cut being absorbed by the Government in Edinburgh. That is £233 per head for each Glaswegian between 2010 and 2018.
Already 30,000 Scottish council jobs have gone, swimming pools are being closed, community health projects face non-renewal, class sizes are rising, pupil attainment is stalling, high streets are declining, community groups are losing grants, youth clubs are closing, grass is being left uncut, litter is piling up, roads and pavements are in serious disrepair, and social workers face ever-increasing case loads. In Glasgow North East, we face the potential closure of a local swimming pool, a sports centre and numerous municipal golf courses that were only spared cuts this year after a determined local campaign to save them caused such embarrassment that the council reversed its decision.
Glasgow is unfairly bearing the brunt of decisions to scale up the cuts as a share of its overall budget compared with the Scottish Government. Labour will end Tory austerity at source when the Leader of the Opposition steps into No. 10 Downing Street, but in the meantime Glasgow simply cannot take a further hit that is so disproportionate to that being taken by the Scottish Government. I am continually being contacted by spontaneous local campaigns coming into existence to fight the cuts that Glasgow is making because of the severe retrenchment it has been asked to make. We are facing the closure of entire facilities and services, and the council’s withdrawal from non-statutory quality-of-life provision in my constituency, which is one of the poorest parts of this country. Indeed, last year, the SNP tried to pass the burden of cuts on to working parents by doubling childcare fees, and was only forced to retreat after a determined local campaign.
The Scottish Government need to recognise that Glasgow’s settlement should be no worse than the 1.6% cut that the Scottish Government block grant has suffered since 2013. I plead with the Scottish Government and the UK Government to combine to ensure that, at a bare minimum, they rescind this negative multiplier effect.
Perhaps the hon. Lady is not fully aware that the total managed expenditure of the Scottish Government has been cut by only 1.6%. Unlike councils, they have total discretion over that spending. Councils are heavily ring-fenced by the Scottish Government, which is why core budget cuts to councils have been much higher. That is the reality of the constraints faced by local government compared with the central Government in Edinburgh.
Unless Scotland urgently addresses the problem of over-centralised government from Edinburgh and rediscovers its radical tradition of municipal socialism, it is increasingly likely that Glasgow will fall further behind its peer cities in the UK, such as Manchester, Birmingham and Liverpool, as they establish new city region governments centred around directly elected metro mayors. The constitutional debate has been preoccupied with nationalist questions over the distribution of powers between the British Parliament at Westminster and the Scottish Parliament at Holyrood; it is now incumbent on us all to break that narcissistic duopoly of Parliaments and strive to rediscover our radical tradition of municipal socialism.
We in the Labour movement are not driven by nationalist sentiment when it comes to constitutional questions about how best to structure government to serve the interests of delivering socialist policy. The atrophy of municipal government in Glasgow is an urgent crisis, which we must address boldly and with imagination. As we consider plans for a constitutional convention in the new future, the question of a municipal as well as a parliamentary route to socialism must be firmly embedded at the heart of it.
It is a pleasure to follow my hon. Friend the Member for Glasgow North East (Mr Sweeney), who is a tireless and passionate campaigner for his constituency—and a member of the wonderful 2017 intake.
Areas with the greatest needs, the lowest tax base and the least other resources seem to be suffering a much greater reduction than their wealthier counterparts, and Hull is no exception. I am not the only one saying that; the National Audit Office is saying it, too. The NAO has produced powerful information showing a disproportionate impact on Hull, which is creating the need for painful decisions. The situation is compounded by reductions in the central funding on which Hull relies for 81% of its budget and which it is unable to replace through local taxation. To illustrate, a local tax increase of 1% in Hull raises only £2.90 per head, whereas a local tax increase of 1% in the City of London raises £7.08 per head. Our situation is completely different. Hull, which is reliant on central Government, receives less money than ever from central Government.
Even though statistics are important, and much of our debate focuses on statistics and the percentage loss for each local area, we are forgetting the human element. To be honest, the people at the heart of it who are being affected do not care which Government introduced a measure; they do not care whose fault it is. They do not like politicians who point fingers at each other and say, “It wasn’t us. It was you.” What these people care about is what is happening to them there and then, on the ground.
I would like to talk about a couple I met recently, and to protect their anonymity, I will refer to them as Lily and Paul. Paul came to see me at my constituency office, and he was extremely upset and quite distressed. He told me about his wife. They were quite a young couple, only in their early 50s, but his wife had developed tumours on her spine. The tumours had appeared from nowhere, and no one had any idea she was ill. It started with back ache, and she ended up in hospital, needing to have the tumours operated on.
From that moment, her husband became her carer and had to do everything for her. They went from having a fit and active life, both in work, to him looking after his wife, who was bedbound. He was practically at breaking point as he told me how they met when they were 14 years old. She was the only woman he had ever been in love with, and he still loved her, even though at that moment she was lying in bed in their house unable to leave the bedroom or get down the stairs because occupational therapists had not been round to install a handrail, and they could not get a stairlift fitted because it was the wrong kind of staircase. She had been discharged from hospital without a care plan or an adult social care package available. All she was doing was lying in their bed.
Paul brought his daughter round to look after his wife so that he could come and tell me about the problems they were facing. Unsurprisingly, he said that she was suffering problems with her mental health. I said, “Well, of course; I would suffer problems with my mental health if I was unable to leave my bed and was left there in constant pain.” She was left in pain from the operation on the tumours on her spine, and the drugs were making her drowsy and incoherent.
To make matters worse, the Department for Work and Pensions informed them that she needed to attend a healthcare assessment—a woman who was bedbound, having had operations on her spine. He was dealing with this on a day-to-day basis, while seeing the woman he had loved from the age of 14 and still deeply loved in such pain and such a desperate situation. Eventually the DWP relented, and someone came to do an assessment of her. Paul said that his wife could not answer the questions properly because the amount of opiates she was on to deal with her pain meant that she would not fully understand all the questions, but he was told by the person doing the assessment that, as her husband, he should not be answering for her and should allow her to answer the questions herself, even though she barely understood what was being said.
He came into my constituency office just yesterday to tell me that his wife has not been declared sick enough to qualify for the mobility component of the benefit. He has been left unable to work, and his wife, who he is desperately in love with, is unable to get the support she needs and is being turned down for enhanced benefits. Goodness me! How sick does someone have to be to get enhanced benefits if they are on drugs that make them incoherent and are laid in their bed, unable to move? I asked Paul, “What about you? Are you getting any respite or care?” He said, “I can’t, because what happens to her if I become ill? What happens to her if I’m not there? She doesn’t fully understand because she’s on pain medication.”
This is what people are facing. When we hear from those on the Front Benches, let us not point fingers at each other and say, “Your Government did this,” and, “Your Government did that.” Let us look at what is happening to people like this right now. Let us look at the fact that life expectancy is dropping in my constituency. Tell me then that this Government’s reforms have been successful and that it is not time to change. Do not give me a quote about the amount of money. Tell me about the people whose lives are being changed because they are not getting the support they need. Until I see a real difference on the ground, all the rest of it is just spin. Please, Minister, come to the Dispatch Box and tell me you have listened and that people like Paul and Lily will get the support they need and not be left to suffer any longer.
My hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) has summed up the importance of today’s debate. The reality is that care does not come for nothing; it costs money, and it is about where this Government’s priorities actually sit. We have heard the talk about millions and billions of pounds so many times, yet the very people in our society who need special care are so often overlooked.
I want to thank the staff of City of York Council for the incredible work they do for my city, as they have in very difficult times over the last four years. Decisions are often made that they do not agree with, yet they have complied with them as servants of our people, and that is against the backdrop of losing a fifth of their wages in real terms.
My hon. Friend the Member for Crewe and Nantwich (Laura Smith) highlighted how careworkers in particular are paid so poorly. Why? They are women. The fact is that this Government take it that women will not go out on strike and will not fight, but will care instead because they know how desperately people need their labour. They know how desperately people need them to visit and how, if they do not turn up that day, somebody will be worse off. That is why money is not put in: because they care and because they are women. The inequality that is now embedded so deeply in our system highlights to me how broken the funding system for local government is.
Beyond that, we know that local government itself does not get the investment, yet it is where change can really happen. We heard earlier about how Labour brought in a place-based system, looking at how to get the interconnectivity of different lines of funding. Now we see the fragmentation, the diktats from Government and the pulling apart of local communities, and I see that reflected in my local area as well. The whole system of funding is broken, and funding has not been spread out to where there is greatest need.
Returning to the issue of older people, I want to highlight this point. In this place, we talk about older people only with regard to social care and pensions, which are seen as financial burdens on the state. We do not talk about how the state can invest in these really precious lives and ensure that their rights are upheld right to the end. That is why the all-party group on ageing and older people, of which I am the chair, set up an inquiry into the human rights of older people, and the report came back saying that it is absolutely vital that there is a commission on the rights of older people.
I have written to both the Ministers sitting on the Front Bench—the Minister for Care and the Under-Secretary of State for Health and Social Care, the hon. Member for Thurrock (Jackie Doyle-Price)—and I have to say that the response has been woeful. We are talking about the rights, voice, opportunity and future of older people, but they are just dismissed. I believe that is why we have seen the delay in the social care Green Paper, which, let us face it, is a discussion document and is not going to change anything. The prioritisation placed on the most vulnerable people in our society is wrong, and we have got to see change.
If we are talking about wider change, there is the funding of local authorities as well, and it is a broken system. When we look at business rates—I have debated them many times in this place—we see that, as the high streets are hollowed out, the business rates return even less, so local government’s dependency on business rates does not work. We have of course seen precepts, which are regressive, and the council tax, which at its concept was a stopgap for the failed poll tax system. We need to look at funding for local authorities in a very different way.
This is not just about funding, but about how funding interconnects with the social ambition of our councillors. I have to say that Labour’s vision in York is very different from that of the current administration, which has just let the market move in. Profit-obsessed developers are now building luxury apartments all over our city, which, quite frankly, people in York cannot afford. We are one of the lowest-wage economies in the north: wages fell in York by £66 last year, and pay is £80 a week lower than the national average.
We are a post-industrial city and we are struggling, yet people are exploiting our city. Just two weeks ago, the council agreed plans to put up 2,000 luxury flats in the middle of our city when we have a housing crisis. Eleven people died on our streets last year, and we have families—whole families—in cramped, one-bedroom box rooms, and they are damp as well. What is happening on the ground in local authority areas is completely unacceptable. It is the responsibility of Government to wake up to the reality. I do not want to hear platitudes; I want to see action.
York is the most inequitable city outside of London; the inequality and life expectancy there show that there is failure in the system. It may work for some, but it certainly is not working for the many. Labour’s vision for our city is very different. We want investment in people. We want to give them back their voice so that they can build their future. That is what we will do, should we come to power on 2 May.
People have exploited our city. The post office, Bootham Park Hospital and the barracks have been sold, but the money has not come back into our city. Those sites have been handed over to developers who, quite frankly, just want to make money; they do not want to invest in people. Our city is crying out for a change in approach. It looks shabby and dirty. Waste is not being addressed and recycling rates are falling. The issues that people care about in our communities are not being addressed.
The Labour party, however, is ambitious. We will put in place a transport commission to address air pollution, which is taking 150 lives a year in our city. We will make it a carbon-neutral city by 2030, which is more ambitious by far than this Government. We will ensure that we invest in green spaces, because that is a more holistic approach and better for people’s health. We will make those connections and join the dots.
Why do that in York? We only need look back 100 years, when Seebohm Rowntree carried out his studies of poverty in our city. We will also do that, should we get elected in May, and look at the real deprivation that exists in our city. The Rowntree family then built jobs and housing, put in education and pension systems, promoted the leisure and pleasure that people should enjoy in their everyday lives, and rebuilt York out of the slums. That is what Labour will do again, should we be given the opportunity on 2 May. We will not only analyse what has gone wrong—it is there for everyone to see—but give people the security they deserve and hope for their future so that they can join us on the journey to build a compassionate, humane city.