Adult Social Care
Debate between Baroness Laing of Elderslie and Clive Betts(1 year, 9 months ago)
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Mr Betts
The hon. Gentleman makes a good point, and he has been through some of those discussions on the Select Committee—I think the County Councils Network also made that point strongly to us—so he is absolutely right. I was not going to go too much into the long-term reforms of local government funding, but as a Committee we have said that there is a real challenge with the reforms of both council tax funding and business rates, and we have produced reports on that. There is not a clear linkage between how much money a council might get in from business or non-domestic rates and how much demand for social care is going up. Demand for social care is going up that much faster and the tax base needs to be adapted to recognise that, so his point is an important one.
To some extent, that demand is being met by tightening the rules on exemptions. More and more people who would have got social care in the past do not get it now. Age UK says it is 1.5 million—an estimate, but probably not an unreasonable one. There is also less prevention work going on, which means that people who have small needs to help them live in their homes do not get those needs addressed until they become serious needs. Then they end up in hospital, which is much more expensive and a much worse outcome for the people concerned. It results in more pressure on the NHS, more cost and a less good service.
On the other hand, there is the pay and conditions for care staff. People doing the same job in care get less money than people in the NHS. That is true of nurses, for example, where we can make direct comparisons. We know that up to half of care staff tend to leave within a year, and many are on zero-hours contracts. There have been repeated requests for a long-term workforce plan. There has rightly been a request for a long-term plan for the health workforce, but we need one for the social care workforce as well. I think that the Chancellor, the right hon. Member for South West Surrey (Jeremy Hunt), when he chaired the Health and Social Care Committee, argued that case very strongly, and quite rightly.
There is a question of pay: these are skilled people with a real commitment that should be recognised, and not at a minimum pay level. There should be a system with proper career progression and training, so that people can realise the benefits of their skills and commitments. There is evidence that the care market is broken, that many care providers have gone out of business or struggled over the years and that the level of fees in some areas probably does not reflect their costs.
Then, of course, we have the issue of people having to give up their homes to pay for their care costs. It is a complete lottery. If in the end someone finishes the last years of their life with dementia, much of the value of their home will go to pay for their care. If they finish their life by having a heart attack and dying, they do not pay anything towards their care. That is an unfair system and it needs to be addressed. The Dilnot reforms have been around for some time. They have been nearly started and then not started, and nearly started again and not started; I will refer in a couple of minutes to how we might take things forward.
How might we change things to improve them, then? This debate is not just about making complaints; it is about providing solutions. I accept that, and that is what the Select Committee is trying to do. One suggested solution is, “Well, just amalgamate it—let’s have one big service. Put it all in the NHS and it’ll all be all right.” I think most would say that the NHS has enough challenges at present without taking on another great challenge on top. What we do not need is another mass reorganisation affecting both health and social care, the cost of which would probably be a lot more than the cost of doing things any other way.
We should also remember that most people receiving care receive it not in a hospital or even in a care home, but in their own homes. The link that councils can make between their home service, providing adaptations and the like, and care, is key in that regard. The other thing I would say is that we cannot carry on relying on short-term fixes, with one-off grants here, one-off grants there, and a council tax system that is regressive and not fit for purpose, let alone for long-term funding of social care—or, as the hon. Member for Harrow East (Bob Blackman) said a few minutes ago, business rates, which bear little relation to demand for social care either.
I go back to the 2018 joint report with the Health and Social Care Committee, in which we said two things. We did a lot of work with the focus group on this question and spent a lot of time on weekends away in a hotel in Birmingham. What people said was, “If we knew the money was going to social care, we would happily pay more.” That is what happens in Germany and Japan, two countries that we looked at. We said, “Let’s have a social care premium.” Immediately, it might be said that that is not dissimilar to the Government’s proposed increase in national insurance rates. The difference was that, at the time, we said that we had to target any payments. There will be different ways of doing this, I accept, but there has to be a way of raising extra money for social care that neither comes from the current local government system, nor takes care out of local government.
We said that there should be a social care premium as a percentage of income, but that we would raise the bottom level so that the poorest people would not pay. We would increase the top level in the way that national insurance does not, so that people on the highest incomes would continue to pay, and we would include unearned income and higher-level private pensions, but we would also exclude the under-40s, as they do in Japan. We felt that people under 40 were probably getting the worst of the deal after the financial crash in terms of the impact on their finances. That is how we thought we could raise the funds, and it was agreed by the 22 members of the two Select Committees as a way forward.
What is sometimes missed, and what we also suggested, is that we have to deal with the issue of people’s homes being sold. I have to say to the Government that their arrangements to try to implement Dilnot are complicated and unfair. People may not pay until their assets reach a minimum level, but—and I have never heard a Minister address this point—the Government cap the amount that people pay in such a way that people with lower value houses pay a bigger percentage of their homes than people with the highest value houses.
Someone who has a home worth half a million pounds pays a much smaller percentage than someone who has a home worth £100,000. That is not fair, so our Select Committee said that a percentage should just be taken from everyone’s estate. Then, the people with the most would pay the most, and the measure would not be confined to people who need care. That removes the unfairness of people with dementia paying all or most of the value of their home while those who do not have dementia paying nothing. With a small amount of inheritance tax, or another way of assessing people’s estates, we could raise a lot of money and deal absolutely with the problem of people having to give up most of their home to pay for their care costs. That is certainly worth a look.
We need to find a long-term solution to the problem. It is not going to go away, is it? The number of elderly people will continue to grow; the number of people with learning disabilities will continue, quite rightly, to require more from our services. Councils said that the funding gap was £7 billion last year, but they have also said—the Health and Social Care Committee has addressed this, and other important think-tanks have confirmed it—that if we are to deal with the combination of problems, including the immediate funding gap, the need to address eligibility criteria and bring more people back into the social care system, the challenge to local government finance, and the need for a long-term workforce plan, the gap is probably about £14 billion. That is a big sum of money, and we cannot find it in the existing local government finance system, which cannot cope as it is.
If we carry on as we are, and demand keeps increasing with no improvements to eligibility or workforce pay, there will be a consistent further increase in the pressures on other local government services. There will be bigger cuts to libraries, buses, planning, street cleaning and so on. The public, in the end, will simply not stand for that. I say to the Minister: please, let us just have a bit of long-term thinking and recognise that this is a serious problem that will not go away. Local government funding, as it exists at present, cannot take the strain any longer. We need an alternative source of revenue, we need to keep social care linked in to the rest of local government services, and we need, of course, to develop better contacts with the health service. Money to deal with the problem of people sat in hospital beds when they need to be in social care is welcome, but all that is short-term thinking.
I say to the Minister—and, to be non-partisan, to the Labour Front Benchers—where is our plan for long-term care? Where is our recognition of the funding needs? How will we bring about change? Could we, as the Joint Committee said, just possibly get a bit of cross-party thinking on this for the future? Whatever solution we come up with, we need one that will work for the long term, not just for half a Parliament or for one Parliament.
Social Housing Standards
Debate between Baroness Laing of Elderslie and Clive Betts(2 years, 1 month ago)
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Madam Deputy Speaker (Dame Eleanor Laing)
I call the Chair of the Levelling Up, Housing and Communities Committee.
Mr Clive Betts (Sheffield South East) (Lab)
May I associate myself with the aims that the Secretary of State has set out in his statement? I think they will be supported across the House.
I draw the Secretary of State’s attention to the Select Committee’s report, “The Regulation of Social Housing”, published in July—I gently remind him that the Department has not yet replied to it. In the report, we identified some social housing that was unfit for human habitation, and causing the sorts of health problems that tragically have been seen in this case. We identified problems with repair reporting, complaints handling, and a lack of proactive inspection of properties by housing providers and the social housing regulator. We put that in context and said
“some blame must attach to successive Governments for not investing enough in new homes, which has increased the sector’s reliance on outdated stock, and for not providing funding specifically for regeneration.”
Some of those are not individual repairs; there are failures of whole blocks and whole estates. I say to the Secretary of State: let us share the common objectives, and let us work together to get the money to ensure that those objectives can be realised.
Doncaster Sheffield Airport
Debate between Baroness Laing of Elderslie and Clive Betts(2 years, 2 months ago)
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Mr Betts
Does my hon. Friend share my disappointment that parts of South Yorkshire sometimes think that the way forward is to have a row with other parts of South Yorkshire rather than working collectively, as the Manchester authorities appear able to? This is not about Doncaster’s airport versus Sheffield’s trams. Sheffield is a major city. Major European cities have light rail systems; Sheffield needs and wants a light rail system. It should not be about having one or the other or fighting over the scraps; it should be about arguing collectively for extra money for the infrastructure that we need in each of our areas. That is why Sheffield MPs are here tonight to support Doncaster Sheffield airport—
Madam Deputy Speaker (Dame Eleanor Laing)
Order. I am getting confused about who is intervening on whom. The hon. Member for Barnsley Central (Dan Jarvis) has the Floor. The hon. Member for Don Valley (Nick Fletcher) has intervened on him. Have I just let the hon. Member for Sheffield South East (Mr Betts) intervene on the hon. Gentleman intervening? Aargh!
Mr Betts
I am sorry if I confused you, Madam Deputy Speaker; I hope that I did not confuse anybody else at the same time. I was intervening on my hon. Friend the Member for Barnsley Central (Dan Jarvis) to ask whether he agrees that it is unfortunately all too common among some people in South Yorkshire to start a blame game between the constituent parts of the authority, rather than working collectively as Sheffield Members are here to do tonight.
Levelling-up and Regeneration Bill
Debate between Baroness Laing of Elderslie and Clive BettsWednesday 8th June 2022
(2 years, 6 months ago)
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Mr Betts
On a point of order, Madam Deputy Speaker. I am sure that the Secretary of State would not want to inadvertently mislead the House. In response to the question from the hon. Member for The Cotswolds (Sir Geoffrey Clifton-Brown) about the conflict between local plans and national policies, he made a comment—
Madam Deputy Speaker (Dame Eleanor Laing)
Order. Is this a point of order for the Chair? I am sure that the Secretary of State would not wish to inadvertently mislead the House, so if that is the point of order, I agree with the hon. Gentleman and that is the end of the matter.
Madam Deputy Speaker
I thank the Secretary of State. The hon. Gentleman is a senior Member of the House. It does not seem to be a point of order for me, but a point of argument with the Secretary of State, who is willing to give way. Will the hon. Gentleman withdraw his point of order so we can allow the Secretary of State to continue?
Madam Deputy Speaker
I thank the hon. Gentleman for withdrawing his non-point of order. I hand the Floor back to the Secretary of State.
Points of Order
Debate between Baroness Laing of Elderslie and Clive Betts
Madam Deputy Speaker
Thank you for that confirmation. The hon. Lady knows that what is said by one Member to another is not a matter for the Chair. If the facts that have been presented to the Chamber turn out to be wrong, it is incumbent on not only every Minister but every Member to come back to the Chamber at the earliest opportunity to set the record straight. I make no judgment about the facts, because that is not a matter for me. The facts are a matter for debate.
I understand why the hon. Lady wanted to raise the matter. She has done so, and she will know there are various ways in which she can hold Ministers to account for the veracity or otherwise of the facts she is disputing.
Mr Clive Betts (Sheffield South East) (Lab)
On a point of order, Madam Deputy Speaker. I am disappointed that the Secretary of State for Health and Social Care has just gone, because he might have been able to help me with this point of order if you cannot.
I declare my interest, as I have an immunocompromised system and therefore I was very pleased that the Government announced the availability of a third dose for people with conditions such as mine and many others. I am concerned that there has been a lot of confusion between primary and secondary care about who should be advising people of their eligibility.
I therefore tabled a question on 22 October to ask who is responsible for advising people of their eligibility and what the gap will be between a third dose and the booster. The Department of Health and Social Care answered on 27 October saying that it could not answer the question in the required time—that was two months after the policy statement. I asked again on 24 November whether the Government could say who would advise people of their eligibility, and I was told again that the Department could not answer within the required time.
Three months after a major policy announcement, the Government cannot say who is responsible for advising people of their entitlement. Either the Department made a major policy decision without having the administrative arrangements in place to deliver it, or it has the information and is keeping it from Parliament. Neither of those answers is satisfactory, Madam Deputy Speaker, and I wonder whether you can help me get to the bottom of it.
Madam Deputy Speaker
I thank the hon. Gentleman for giving me notice of his intention to raise this point of order.
Mr Speaker has said on many occasions, and I now reiterate what he said, that Ministers have a responsibility to make sure questions are answered within a reasonable time. It would appear that the questions tabled by the hon. Gentleman have not been answered within a reasonable time, and the answers are relevant, ongoing and important to his constituents and indeed all our constituents. The questions ought to have been answered.
The Procedure Committee is monitoring the record of Departments in answering questions timeously, so the hon. Gentleman might also wish to raise the matter with the Procedure Committee. From the Chair at this point, I sincerely reiterate what Mr Speaker has said on many occasions and I hope the matter will have been noted by the Treasury Bench. The hon. Gentleman’s questions ought to have been answered, and I hope they will be now.
Westferry Printworks Development
Debate between Baroness Laing of Elderslie and Clive Betts(4 years, 6 months ago)
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Mr Betts
We talked about that yesterday. Yes, of course I said there was no evidence. I have not seen any evidence, and I repeated just now that I am not accusing anyone of wrongdoing, What I am saying is that perception and appearances in these matters are almost as important as the facts themselves.
Although the Secretary of State recognises that an informed and fair-minded person might come to the view that there was bias on his part in terms of the liability to the developer that was removed by his decision, did he at any point consider that an informed and fair-minded person might conclude that the events of the dinner could also lead to bias on his part? That seems crucial. If that is the case, when he reflects on the matter now, does he think that he might have done better had he decided not to take part in the decision-making process, once the developer had, quite wrongly—I repeat, the developer had, quite wrongly— tried to influence him at the dinner?
Madam Deputy Speaker (Dame Eleanor Laing)
I am now delighted to call, to make his maiden speech, Mr Mark Eastwood.
Health and Social Care
Debate between Baroness Laing of Elderslie and Clive Betts(7 years, 10 months ago)
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Mr Betts
I just want us to have a process that gets us to a similar position. Even if local authorities remain part of the funding solution, we cannot assume that the increase in business rates and council tax will keep pace with the level of demand.
I know that you have encouraged us to keep to a time limit, Madam Deputy Speaker.
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. I ought to say that, as the hon. Gentleman is the Chairman of a Select Committee, I do not apply the time limit as strictly to him.
Mr Betts
I have gone two minutes over time, so I had better not stray too far. Of course, health and social care need to work closely together. It is going to be very interesting to see how Manchester develops. It is not, however, a panacea; it is not going to solve all the problems.
I agree with the Chair of the Health Committee: the sustainability and transformation plans are an interesting way forward, but unfortunately they are seen as a way of making cuts. They will need some pump-priming to make them effective. They have not been done properly, with full co-operation, in every local authority area. If they are done properly and consider how we can better plan and pull together health and social care for the future, I think they will make an important contribution. Ultimately, however, we have to acknowledge that the process is going to take time and that it will need up-front funding to make it work.
We also have to acknowledge that there are big differences between health and social care. There are not many differences in culture, but the funding arrangements are different. Health is provided free at the point of use, whereas social care is not and probably will not after any changes are made. There is also a fundamental difference between the two on accountability: social care is accountable to directly elected local councillors, whereas health is ultimately accountable to the Secretary of State. If Members want to see the problems that creates, they should read the evidence that the former Health Minister, the right hon. Member for North East Bedfordshire (Alistair Burt), gave to the Communities and Local Government Committee about his understanding of accountability in the Manchester system. It shows that the Government have not worked it out in such a way that they could flick a switch tomorrow and get it all operating smoothly. We have a lot of work to do. The Select Committee will consider all the evidence we have received and will produce reports on a range of issues.
Local Government Procurement
Debate between Baroness Laing of Elderslie and Clive Betts(10 years, 9 months ago)
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Mr Betts
Further to that point of order, Madam Deputy Speaker. A local government Minister—the Under-Secretary of State for Communities and Local Government, the hon. Member for Bristol West (Stephen Williams)—was asked to attend, but he thought that the statement would be made earlier, and he had a ministerial commitment outside the House. He rang my office to apologise and I accepted his apology. The Deputy Chief Whip is representing him on the Front Bench, but obviously the Deputy Chief Whip could not speak.
Madam Deputy Speaker (Mrs Eleanor Laing)
I thank the Chairman of the Select Committee for explaining the background.
It is so refreshing to hear a point of order that is a point of order! I can respond to the genuine point of order raised by the hon. Member for Brent North (Barry Gardiner) by saying that a Minister—albeit a Whip—was present throughout the proceedings. It is not necessary for Front Benchers to take part in statements of that kind. It is of course desirable for the relevant Minister to pay attention to what is happening in the Chamber as a result of a Select Committee’s deliberations, but the Select Committee Chairman has explained very well what happened this morning. I am glad to have had an opportunity to explain further how the new procedure will work, and I therefore thank the hon. Gentleman for his point of order.
Parliamentary Voting System and Constituencies Bill
Debate between Baroness Laing of Elderslie and Clive Betts(14 years, 2 months ago)
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Mrs Laing
No. The hon. Gentleman has not been in Committee all evening, and it is time that we got on; this debate has taken too long. I would simply say that the reason why Opposition Members are arguing as they are is that they cannot in all honesty stand up in this House and say that the principle of equalising the size of constituencies is wrong. They are therefore manufacturing arguments against this Bill to try to stop this part of it. They are quite simply trying to avoid being turkeys voting for Christmas. They know that, and the hon. Member for Great Grimsby gave this away when he said that this is about certainty and uncertainty for Members of Parliament. The fact is that the only principle that should matter in considering this part of the Bill is the working of democracy. If Opposition Members do not have the courage to put their constituents and the people of the United Kingdom first and themselves second, they do not deserve to be Members of Parliament. It is the principle of equality that matters and that is what we must vote for.