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The Minister for Care (Caroline Dinenage)
It is a great pleasure to serve under your stewardship in this important debate, Sir Charles, and I share the sentiment of many Members across the House in congratulating the right hon. Member for Twickenham (Sir Vince Cable) on securing it. I also wish to highlight the incredibly constructive and collaborative nature of the way that he opened this debate. He was right to highlight from the outset that the only way to find a solution to this thorny issue, which is not unique to our country but a challenge faced by countries around the world, is by working in a co-operative, collaborative, and constructive way.
The right hon. Gentleman rightly pointed out that successive Governments have tried and failed to deal with this thorny issue, and despite everybody recognising the need for consensus, for too long it has been weaponised. We have heard expressions such as “dementia tax” or “death tax” used by all parties over the years. That has not been helpful, and it is one reason why different parties and Governments have placed this issue in the “too difficult” pile. He was also right to highlight the sense of urgency, because we no longer have the luxury of time to place the issue in that pile.
Over the past couple of years the Government have responded to huge short-term pressures, and funding for local government has gone up, as opposed to being cut, as outlined by Labour Members. However, we must set out our long-term plans, and consider how to solve the thorny issues of long-term funding for adult social care. At the moment, one in 10 people face what we might call catastrophic care costs in excess of £100,000, and potentially lose their home to pay for their long-term care.
I thank hon. Members across the House who have spoken with great passion and, in most cases, an enormous amount of collaboration and desire to work together to find solutions to these problems. I join them in recognising and paying tribute to the carers, nurses, social workers, and unpaid friends and families of those who require care. Every day, carers work tirelessly to ensure that people live dignified and fulfilling lives, regardless of how tough that challenge is. In doing this job and fulfilling this role, it has been my greatest privilege to meet those people on an almost daily basis and hear their stories. The hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) said that carers must be accorded the status that they deserve, and given resources to drive the right amount of quality, and she was absolutely right. She was wrong, however, to say that we have lost caring from the caring system. People may be driven to that point in some respects, but they care and they do so in the most beautiful way.
Jamie Stone
May I associate myself with what the hon. Member for Plymouth, Sutton and Devonport (Luke Pollard) said about young carers who go home and look after parents who may have an alcohol or drug dependency problem? In my constituency an organisation called The Young Karers East Sutherland helps to support them. My mother died four years ago, but she was cared for at home very well. The younger carers—those who had left school and gone into the profession for the first time—were the most amazing. They embraced this profession, and one could see they had a vocation. I suggest that one way to sort out this problem is to encourage the recruitment of young people by giving them taster sessions and letting them come from school and see what it is like. Often, we might get converts who will stay in the profession for life.
Caroline Dinenage
That is an excellent intervention, and the hon. Gentleman is right to say that we must do more to recognise and support young carers. The hon. Member for Plymouth, Sutton and Devonport said that we must do more to help schools to identify young carers, and that was a key part of the carers action plan that was announced last summer. A young carers’ takeover day of Parliament is planned in the months ahead: every MP across the country will be encouraged to invite a young carer from their constituency, which will give us a real in-depth understanding of what an amazing job young carers do.
We all recognise the challenges that the social care system faces. As a population, we are getting older: by 2040, one in four people in the UK will be 65 or over, as the right hon. Member for Twickenham pointed out. It is also important to understand that social care is not just a service for older people; the number of people under 65 who have carers is growing and accounts for more than half of social care spending. That can have quite a disastrous impact on local authority budgets, as the hon. Member for Plymouth, Sutton and Devonport pointed out. I will certainly take forward the points that he made.
These long-standing trends put increasing financial pressure on local authorities. In response, we have taken steps to ensure that the social care system has the funding to meet urgent challenges in the short term. In 2017, we announced an additional £2 billion in grant funding for social care, which we supplemented with a further £650 million in the 2018 Budget. Councils have responded by increasing their spending on social care, which has risen in real terms in each of the past three years.
Caroline Dinenage
I will make some progress, if the hon. Gentleman does not mind.
As a result of our investment in social care, 65% of local authorities were able to increase home care provision in 2017-18. Local authorities have increased the average fee paid for older people’s home care by 4.7% in 2018-19, bringing some much-needed stability to the provider market. I am very pleased that the Care Quality Commission has rated 84.1% of social care settings as good or outstanding.
I am delighted to say that in our most recent spending round we announced further investment in adult social care. We will provide councils with access to an additional £1.5 billion for adult and children’s social care next year, including £1 billion in new grant funding over and above the £2.5 billion of existing social care grants. In the spending round, we confirmed that all the existing funding streams would be maintained next year—hard-wired into the Budget, if you like. The Government will also consult on a 2% adult social care precept that will enable councils to access a further £500 million. This increase in funding is part of the biggest increase since 2015 in overall core spending power for local government: it will increase by 4.3% in real terms next year.
The new funding from the spending round will support local authorities in meeting the rising demands that they face, while helping them to continue to stabilise the wider social care market. This additional funding is the first step towards putting adult social care on a fairer and more sustainable footing. We have already started preparing for the multi-year spending round due next year.
The challenges facing social care are not purely financial, as hon. Members across the parties, including my hon. Friends the Members for Central Suffolk and North Ipswich (Dr Poulter) and for Newton Abbot (Anne Marie Morris), have said. It is important to point that out, because stakeholders across the sector tell MPs: “Even if money were no object, we would not necessarily continue to provide this service in the current system.” The current system is not working in so many respects, and it is not working properly for some of our most vulnerable citizens, which is why we are continuing to support the system through a programme of sector-led improvements to help councils to make better use of funding to deliver high-quality personalised service, with more than £9.2 million committed by the Department in 2019-20.
We are also breaking down barriers to encourage much better integration of health and care, and we are looking at what more we can do to support the workforce and carers, as I have mentioned. In terms of integration, the better care fund has helped to enable much better co-operation between health and social care partners at a local level. It has also been instrumental in reducing delayed transfers of care, which has been mentioned: they have decreased by 2,147 since February 2017. We are looking at how we can use the fund to drive better integration.
My hon. Friend the Member for St Ives (Derek Thomas) spoke about bed vacancies and people stuck in hospitals. There is a lot more integration going on between care providers and health settings that are using those beds to provide the step-down care and discharge to assess that we want to see.
Dr Poulter
The better care fund and how it is applied on the ground locally varies across the country. Overall, the impact has been disappointing in terms of the ambition for that fund. I urge my hon. Friend to look at why there are two different commissioning systems for the NHS and social care. Unless we get that right, we are not going to drive improved integration or more personalised care.
Caroline Dinenage
My hon. Friend is right to say there were teething problems, but in the most recent reporting cycle, 93% of local areas agreed that joint working had improved as a result of the better care fund. We want to use it to drive much better integration and to look at how we undertake more joint commissioning in future.
We are committed to working alongside all partners in adult social care to attract and support a growing workforce with the right skills and the right values to deliver quality and compassionate care. Earlier this year, we launched the “Every Day Is Different” national adult social care recruitment campaign to raise the profile of the sector. We have secured a further £3.8 million for the next wave of that campaign, which will start later this month. We fund Skills for Care to support the sector in recruitment and retention.
Caroline Dinenage
I do not have time. We also fund the workforce development fund, and social care employers can bid for this funding to pay for their staff to gain training qualifications at all levels.
There were lots of questions raised across the Chamber, and I want to deal with them all. The hon. Member for Totnes spoke about the impact of Brexit. As the Prime Minister has said, he wants our immigration system to help to attract the brightest and best talent from across the world. This includes delivering an Australian-style points-based immigration system as a first step. The Home Secretary has commissioned an independent migration advisory committee to review this and the appropriate salary threshold. Clearly, we want to attract people to work in adult social care.
We are aware that the system is already under pressure and recognise that EU exit could add to this. We have been working on this for a long time alongside partners, including ADASS, the Local Government Association and local authorities, to ensure robust contingency plans are in place. [Interruption.] I am going to have to make progress as I will have to sit down in a second.
There is still much more to do. The funding announced in the spending round is a down payment on much more fundamental reforms to social care that we need to introduce. As the Prime Minister said on the steps of Downing Street, the Government will set out plans to fix the crisis in social care once and for all, to give every older person the dignity and security they deserve. We want to ensure that nobody has to sell their home to pay for care. The Government will not shy away from the long-term challenges that face social care. Our proactive approach to funding and reform means that we will ensure that our social care system can respond to the challenges that lie ahead with confidence that the most vulnerable in our society will be able to live with dignity and respect and receive the care they deserve.