Summer Adjournment

Baroness Keeley Excerpts

Tuesday 19th July 2011 Commons Chamber

[Barbara Keeley (Worsley and Eccles South) (Lab)]

NHS changes and the drive to achieve efficiency savings are causing a diminution in health services in my constituency. Salford has fewer GPs than the national average, and the Little Hulton ward is in the most deprived 3% of areas for health, yet the Little Hulton walk-in centre, which has served 2,000 people a month, is set to be closed by the primary care trust—a real blow to local people.

Salford PCT has also consulted on ending active case management for people with long-term conditions. Active case management is aimed at co-ordinating health and social care interventions to prevent deterioration, enable the patient to stay at home and avoid an emergency admission. It has had positive benefits for my constituents, and the loss of that support is another blow. Health Ministers say that they are protecting NHS budgets, so can the Minister tell me why my constituents in Salford are losing those vital health services?

GPs in Salford are also in the final year of moving on to practice-based commissioning budgets, which are based on the Department of Health’s fair shares toolkit. Two local GPs have alerted me to a problem with the way budgets are calculated. Their practice had 70% of its patients from the most deprived categories, whereas another practice had only 58%, yet the toolkit weighting applied to list size gave an uplift of 9% to the more deprived population’s practice but a 21% uplift to the less deprived. We could call that a lottery within a postcode. That calculation means that the practice in the more deprived area is faced with an apparent overspend of £200,000, and that GPs have to re-examine referrals and cancel activity for patients, giving them an increased work load and potentially having an impact on treatment for patients. Will the Minister find out why the toolkit gives a smaller uplift in weighting to a practice serving a more deprived area? As GP practices move on to real budgets, getting those calculations right is vital, as is dealing with the anomaly that I have outlined.

On social care, I welcome the report of the Dilnot commission and the opportunity to deliver a settlement on the funding of care and support. We need to work together across parties to agree a solution based on the report’s recommendations, and that work has already started in Parliament. I feel that it must include an acceptance of the report’s clear finding that additional public funding is required now for social care. As the Dilnot commission says,

“the impact of the wider local government settlement appears to have meant that additional resources have not found their way to social care budgets”,

and

“the current social care system is inadequately funded. People are not receiving the care and support they need and quality of services is likely to suffer”.

Social care provision is suffering as councils struggle with the Government’s front-loaded cuts of 27% over four years, and research by Age UK has highlighted cuts of 8.4% this year in council spending on older people’s social care. The social policy research unit has projected that spending cuts of 6% to 7% would mean that 250,000 older people would lose their services, so cuts greater than that would mean more than 250,000 losing services.

Back in 2005-06, half of all councils provided support to people with “moderate” care needs, but now only 22 councils provide that level of support. In its document “Care in Crisis”, Age UK states that there are

“huge discrepancies in the quantity and quality of support offered to older people by different local authorities”.

We have to deal with the current crisis as well as working to carry forward the reforms in the Dilnot report.

--- Later in debate ---

[Barbara Keeley]

On a point of order, Madam Deputy Speaker. The Minister has just replied to the debate very fully, and I thank him for responding to my points and those raised by other Members. A while ago, however, his hon. Friend the Under-Secretary of State for Health, the hon. Member for Guildford (Anne Milton), was answering a debate in Westminster Hall, ran out of time, and said what Ministers frequently say: “I will respond later to the points with which I have not managed to deal today.” I have received no replies to the questions that I raised on that occasion, and I wonder if you can advise me, Madam Deputy Speaker, on what we can do when Ministers make pledges of that kind and do not follow them up.

[Madam Deputy Speaker (Dawn Primarolo)]

That is not a point of order for the Chair. However, the hon. Lady has taken the opportunity to make the point directly to the Minister. I am sure that he has heard what she has said, and that he fully intends to reply to the points that have not been dealt with today.