Independent Living Fund

Debate between Earl Howe and Baroness Wilkins

Monday 12th May 2014 Lords Chamber

[Earl Howe]

My Lords, the noble Baroness will know that she and I had a very useful meeting last week and I, with my honourable colleague Norman Lamb, undertook to her that we would give that proposal serious consideration, which we will certainly do. I will be in touch with her in the coming weeks to arrange a further discussion about this. We are absolutely committed to co-production in this and to involving stakeholders wherever possible.

[Baroness Wilkins (Lab)]

My Lords, given that the Government have set the national eligibility criteria at a level that will not provide sufficient support for independent living, will the Minister say whether and how the Government will monitor the level of unmet need of the transferred ILF clients if elements of their package are not eligible for local authority funding?

[Earl Howe]

My Lords, 94% of ILF users receive support from both the ILF and the local authority. Local authorities will assess those who are transferring from the ILF. If a person is assessed as not having eligible needs, the Care Bill provides authorities with a power to meet those needs, and they do so. Authorities should also advise on what preventive services, information or advice, or other support may be available in the wider community to help them achieve their particular outcomes.

Care: Older People

Debate between Earl Howe and Baroness Wilkins

Wednesday 7th May 2014 Lords Chamber

[Earl Howe]

My Lords, as the noble Lord is aware, specialised services are the responsibility of NHS England. We have charged it in the mandate and through regulations to make sure that there is comprehensive specialised cover for mental health services and other services throughout the country. For less specialised services, we expect the parity of esteem principle to apply, and CCGs are being held to account by NHS England to achieve that.

[Baroness Wilkins (Lab)]

My Lords, what is the Minister’s response to the recent Nuffield Trust report, which warns that the Government are now “flying blind” in planning services for vulnerable older people because there is no way of assessing the true impact that social care cuts are having on their lives? Does he agree that the recent abolition of the Independent Living Fund, with no ring-fencing of the transferred resources, will only exacerbate the social care crisis?

[Earl Howe]

My Lords, the Government are not flying blind on this issue. Social care has remained a priority for us, which is why in every year since 2011 we have invested significantly from the NHS into social care, and with a health benefit, as I mentioned earlier. That has enabled councils to give relative protection to social care in implementing their savings. The noble Baroness shakes her head, but the figures are very clear. Spending on adult social care services has been protected to a much greater degree than other service areas. One cannot expect them to be wholly protected. Local authorities have reduced spending on other services by a good deal more than they have on adult social care services.

Care Bill [HL]

Debate between Earl Howe and Baroness Wilkins

Monday 29th July 2013 Lords Chamber

[Baroness Wilkins]

The noble Earl says that that transition funding has been taken into account. Can he also confirm that that is for beyond one year? Or is it only for that one year?

[Earl Howe]

I will come back to the noble Baroness on that question.

I take the point of the noble Lord, Lord Hunt. It could clearly be a source of resentment on the part of a self-funder if they find out through the transparency of the arrangements that we are putting in place that they are paying more than the cost of somebody else’s care. I can tell the noble Lord that we have given thought to that. It has been discussed with the LGA. I would be happy to flesh out the substance of our discussions, but we want to avoid a situation that gives rise to that kind of resentment.

The noble Baroness, Lady Wilkins, asked what plans the Government have to make sure that service users and carers are able to contribute fully to the consultation on funding reform. We intend to arrange a series of consultation events around the country to engage with those who use services, their carers and their families. We will also work with stakeholders to make the best use of their networks and local groups to make sure that we consult as widely as possible.

The noble Baroness, Lady Bakewell, asked a particular question around what she termed the “postcode lottery”, and, of course, I understand the force of that phrase. She asked whether the funding of the Bill adequately addresses the disparity of care and support across the country. The short answer is that the Care Bill provides for national eligibility criteria. That, of itself, will provide greater transparency and consistency for people across the country. I do not think that we will ever completely get away from variation in what local authorities are prepared to consider adequately meets the needs of individuals and we will see some independence of decision-making, whatever we do. However, I firmly believe that the Bill brings us much closer to greater consistency and fairness.

On top of the spending-round announcements, I believe that the Bill will have a positive effect on the NHS by strengthening joint working between health and care and support. For example, Clause 3 requires local authorities to exercise their functions with a view to ensuring integration between health and care. In addition, Clause 2 creates a clear legal duty on local authorities to ensure the provision of preventive services. We want a service that reduces dependency, as well as supporting those who already need care and support, rather than just waiting for people to reach a crisis point. By slowing and preventing the development of care needs, the onset of health conditions or the loss of independence, we believe that preventive care can increase quality of life for individuals, while having the potential to provide longer-term financial savings to the public purse. It is only with this greater focus on prevention and integration that both the NHS and care and support can respond to the financial pressures of an ageing population.

The noble Lord, Lord Lipsey, took us forward to 2025 and beyond and referred to the shortage of workers in the social care workforce predicted by the King’s Fund. Of course, we agree that reforming care and support to make it sustainable for the future will require more capacity and greater skills in the workforce. That is why we stated our ambition in the Caring for Our Future White Paper to double the number of apprenticeships in social care to 100,000 over five years. We are now working with stakeholders to make that ambition a reality.

The noble Baroness, Lady Campbell, speaking powerfully about the areas that she knows best, said that disabled people feel that they are losing their independence as a result of funding cuts, and, indeed, there is a fear that the country unwittingly may be breaching Article 13 of the UN Convention on the Rights of Disabled People. A local authority’s overriding duty under the Bill is to promote well-being. This includes control by individuals over their day-to-day lives, including the way in which care and support is provided. We are confident that the well-being principle captures the outcomes that affect an individual’s independence. We should always keep going back to that principle, not least in the context of the rights that people feel they have—and do have—under the UN convention.

In so far as I have not answered questions from noble Lords, I will, of course, follow up this debate in writing. For the time being, I hope that, for the reasons I have outlined, the noble Lord, Lord Warner, will agree to withdraw his amendment.

NHS: West London Hospitals

Debate between Earl Howe and Baroness Wilkins

Thursday 28th February 2013 Lords Chamber

[Earl Howe]

Five out of the six clinical commissioning groups involved in that area were supportive of the changes. It is true that Lewisham CCG was not. However, the four tests were looked at and it was clearly determined by the trust’s special administrator that those tests had been met.

[Baroness Wilkins]

My Lords, will the Minister recognise that parking needs of both visitors and patients need to be fully taken into account when making this sort of decision? I declare an interest as being an only-too-frequent visitor to Charing Cross A&E over the last year. It would have been impossible to get to Chelsea and Westminster hospital where the parking is appalling, both for myself and for my visitors.

[Earl Howe]

I agree with the noble Baroness that this is most certainly a factor. In the case of north-west London, an independent equalities impact assessment was undertaken to check how the proposed options would affect all strata of local population under the Equality Act in particular. The assessment found that the impact on travel times by car, and indeed by blue light ambulance, would be minimal under all three of the options that were being looked at. The point that I am making is that in any context, it is important to factor in the effect on travel for all patients likely to be affected.

Health: Hearing Loss

Debate between Earl Howe and Baroness Wilkins

Monday 17th December 2012 Lords Chamber

[Baroness Wilkins]

To ask Her Majesty’s Government what plans they have to introduce a screening programme for hearing loss for those over the age of 65.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, the United Kingdom National Screening Committee, UKNSC, advises Ministers and the National Health Service in all four United Kingdom countries about all aspects of screening policy. The UKNSC reviewed the evidence for screening for adult hearing loss in 2009 and recommended that there was currently insufficient evidence to warrant a screening programme. In line with its three-yearly review policy, the UKNSC is currently reviewing the evidence for screening for adult hearing loss.

[Baroness Wilkins]

I thank the Minister for that reply. He will be aware of the huge level of undiagnosed hearing loss in the UK and the impact this can have on other conditions. It is estimated that at least 4 million people who need a hearing aid do not have one. Not only does unaddressed hearing loss increase social isolation and depression, but there is increasing evidence that there is a link to dementia. People with mild hearing loss have nearly double the chance of developing dementia. Given that there is an average 10-year delay between someone identifying that they have a problem and seeking help, will the Government take early action to ensure that hearing loss is addressed early by introducing a screening programme?

[Earl Howe]

My Lords, the noble Baroness’s comments relating to the features that can often accompany hearing loss, such as depression and other forms of mental illness, are absolutely to the point and I recognise all that she said in that area. The national screening committee had a number of reasons for feeling that a universal screening programme would not be appropriate. First, it was not clear to it what the test should be. Secondly, it was unclear about what agreed time or schedule there should be for doing the testing. Thirdly, it felt that if there were a realistic proposal for screening, there should be randomised trials of screening beforehand. However, it is reviewing its decision of three years ago and we will have to await the results of that.

Health: Chronic Obstructive Pulmonary Disease

Debate between Earl Howe and Baroness Wilkins

Wednesday 17th November 2010 Lords Chamber

[Earl Howe]

My Lords, I will be happy to write to the noble Baroness on that matter, as I have not been briefed on it.

[Baroness Wilkins]

My Lords, both my brothers and my father died after years of breathlessness, which is an appalling condition. Can the Minister say why pulmonary rehabilitation courses are being closed around the country, despite being recommended by the NICE guidelines?

[Earl Howe]

My Lords, I am concerned to hear the noble Baroness’s comments because I know that an enormous amount of good work is going on around the country. There are programmes to encourage clinical leadership, improvement projects designed to integrate services, a commissioning toolkit, benchmarking data on outcomes and tools to aid local campaigns. If the services designed to help COPD patients are being diluted in any way, I should be very concerned about that and interested to hear the details.