Reform of Social Care

Lord Blunkett Excerpts

Monday 4th July 2011 Commons Chamber

[Mr David Blunkett (Sheffield, Brightside and Hillsborough) (Lab)]

As a vice-president of the Alzheimer’s Society, and like many hon. Members, I am aware that it is dementia awareness week. The most enormous resource is needed to help both individuals and their carers, particularly with residential support. Is not my hon. Friend the Member for Sheffield, Heeley (Meg Munn) entirely right to draw attention to the fact that even within Andrew Dilnot’s acknowledgement of the perverse incentives, there is still an emphasis on the care market and the drive to encourage people to take up, or to consider the option of, residential care? Do we not need to put the glue back by supporting families and neighbourliness, so that we can keep people independent in their own homes as long as is humanly possible?

[Mr Lansley]

I understand the point that the right hon. Gentleman makes and in the past some of the criticisms of previous proposals have been made because they would have led to a situation in which informal care and family care would not have been properly supported—indeed, there would have been perverse incentives for people not to have family carers. We need to support family carers rather than bypass them.

I am glad that the right hon. Gentleman raises the issue of dementia. It is tremendously important that we understand it is one of the principal reasons for such a rising burden of disability and requirement for care and support. It is why we are looking to the longer term, not least to improve research into dementia. I am grateful to the Minister of State, my hon. Friend the Member for Sutton and Cheam, who has chaired the work on research into dementia, and he was able to announce substantial additional funding to support dementia research just the week before last.

Health and Social Care Bill

Lord Blunkett Excerpts

Monday 31st January 2011 Commons Chamber

[Mr David Blunkett (Sheffield, Brightside and Hillsborough) (Lab)]

Will the Secretary of State give way?

[Mr Lansley]

In a moment. [Interruption.] The right hon. Gentleman’s Front Benchers have been asking me to explain what the Bill does, and I am doing that.

Thirdly, there will be relentless focus on quality, embedded within a new legal duty. Fourthly, there will be a diverse and vibrant social market for health care. We will encourage NHS staff to set up social enterprises and foundation trusts, and we will encourage new capacity in delivering services through social enterprises, charities, private companies, and, indeed, NHS providers.

We want clinicians and their patients to lead the NHS, but they cannot do this while they sit under a vast hierarchy of regional and local organisations, all reporting to Whitehall. Everyone agrees that top-down command and control gets in the way of clinicians doing their job, so we need to dismantle the structures that sustain that interference; that is why we will abolish primary care trusts and strategic health authorities. There are many excellent people working in those organisations. Many will move to be with the new general practice-led commissioning consortia, to local authorities and to the NHS commissioning board. Some will want to set up their own new social enterprises. But even the best people cannot deliver the NHS that patients need if things stay as they are, so we will also introduce direct local democratic accountability. Councillor-led health and wellbeing boards will oversee and work with local NHS consortia, working to bring together the NHS, social care and public health services, and bringing a strategic coherence to the health and well-being of local communities.

[Mr Blunkett]

On bottom-up decision making at a local level, will the Secretary of State give a guarantee to the House that if the GPs now coming together in consortia decide that they wish to employ the expertise residing in the current primary care trust, he and the future health board will not intervene to stop them doing that? Will he also guarantee that he will not insist on redundancies that cost a fortune and preclude that expertise being available to the existing local consortia, with private enterprises then employing them to do the job that they were doing in the first place?

[Mr Lansley]

Let me make two points to the right hon. Gentleman. First, in the impact assessment that we published with the Bill on 19 January, we set out very clearly our estimates—they are no more than estimates since they will have to be decided by the general practice commissioning consortia and local authorities—that between 50% and 70% of the staff in primary care trusts would be employed in the successor organisations.

Secondly, the idea that somehow general practice-led commissioning consortia would engage the private sector where that has not happened up until now is, I am afraid, completely contradicted by the facts. Under the Labour Government, in the two years leading up to the election, there was an 80% increase in the use of management consultants, while at the same time the number of administrators and managers in those same organisations was rising dramatically. We arrived at the point where there were 50,000 administrators in primary care trusts, and they were still spending nearly £300 million a year on top for management consultancy. That all has to change.

One thing that Labour abjectly failed to do was to empower patients with a real voice in the health service. Through this Bill we will establish local healthwatch organisations that will represent the patient’s voice in the design of local services and help individual patients, especially the most vulnerable, to make the most of the choices available to them and to help them when things go wrong. Sitting within the Care Quality Commission, the national healthwatch organisation, too, will act as the eyes and ears of the quality regulator, and work to give the local organisations real teeth in their dealings with their local NHS—something that was completely, abjectly destroyed by the Labour Government when they abolished community health councils. Indeed, I know that families of those treated at the Mid Staffordshire hospitals welcome the additional powers for patients to have a voice.

Oral Answers to Questions

Lord Blunkett Excerpts

Tuesday 25th January 2011 Commons Chamber

[Paul Burstow]

The national cancer director will work with pathfinder GP consortia on commissioning cancer services, and that work will be fed into a cancer commissioning support pack that will be developed to support GP commissioners in discharging their functions effectively. Cancer networks will also be well placed to support GP consortia in that activity.

[Mr David Blunkett (Sheffield, Brightside and Hillsborough) (Lab)]

We all agree that properly evaluated, appropriately prescribed drugs make a big difference to survival, which is why patients welcome what was described as the additional special fund, of which Ministers made mention this afternoon, of £200 million for the coming two years. Why is it, therefore, that the budget for Sheffield has been top-sliced for next year to the tune of £1.5 million to pay towards this £200 million, which was supposed to be additional—to add to and not subtract from—what was available through GP commissioning?

[Paul Burstow]

The NHS has real-terms increases in its resources, and those resources are going into the programme that we outlined in our outcome strategy. Three quarters of a billion pounds will be going into that programme to deliver improvements in cancer services and the £200 million, being extra, will go into improving cancer services. That is the commitment that the Government have made and that is the investment that we will make.

Oral Answers to Questions

Lord Blunkett Excerpts

Tuesday 7th December 2010 Commons Chamber

[Mr Burns]

As my hon. Friend is aware, we are still consulting on that document and will consider the results of the consultation process before making any final decisions. On his specific point, however, my understanding is that that will be case.

[Mr David Blunkett (Sheffield, Brightside and Hillsborough) (Lab)]

10. What decisions he has reached in respect of additional funding for the purpose of the tariff applying to specialist children’s hospitals.

[The Secretary of State for Health (Mr Andrew Lansley)]

Following a very constructive meeting with the specialist children’s hospitals on Friday 3 December, I am pleased to be able to tell the House that we are working on a proposal to set the top-up payment for specialised services for children at 60%, over and above tariff prices. In addition, I intend to help the trusts by extending the number of procedures that will attract the top-up payment in 2011-12. I believe that the children’s hospitals will find that entirely acceptable.

[Mr Blunkett]

I would like—uniquely—to thank the Secretary of State for signing off the technical agreement from last Friday, and to say that the specialist children’s hospitals will welcome his announcement this afternoon. Is it not time to take the uncertainty away from the children’s hospitals and have a system that allows them to put in place a forward plan that does not result in this annual farrago? Would it not also be nice to congratulate the staff of the children’s hospitals on their terrific work, not least the dedicated way in which they will be working with these children over Christmas?

[Mr Lansley]

Yes, I am very glad to do so. I have visited Sheffield children’s hospital, and I very much applaud the work that it does. I am sure that those at the hospital are grateful to the right hon. Gentleman, as I am, for the way in which he has represented their interests. I entirely agree with him: the purpose of developing the payment-by-results system is to arrive at a point where it is predictable and delivers a relevant payment, related to the costs that are genuinely incurred in the provision of that treatment. We are not in that position yet. The specialist top-up was put in place to reflect that, but I hope that it is temporary rather than permanent.

Public Health White Paper

Lord Blunkett Excerpts

Tuesday 30th November 2010 Commons Chamber

[Mr Lansley]

I am grateful to my hon. Friend for his comments. As in a number of other areas I have mentioned, we will publish a strategy in due course, and a tobacco control strategy will be published in the new year. Parliament voted for the display regulations and we are looking into that, but we have to balance the evidence on health improvements with the impact of such a measure, particularly the burdens on small retailers. We are also currently examining the option of plain packaging of cigarettes, which the last Government did not do. That might in itself be an important measure to reduce both the visibility of cigarettes and the initiation into smoking of young people in particular.

[Mr David Blunkett (Sheffield, Brightside and Hillsborough) (Lab)]

Not so much nudge as fudge on this issue. Why will the Secretary of State not accept that giving those displaying tobacco and cigarettes time to adjust by allowing them to implement the regulation this time next year is good common sense? Is it not the case that the Government’s refusal to acknowledge the implementation of this regulation passed by Parliament can only be explained by there being an ideological objection to protecting young people in particular from the incitement to buy?

[Mr Lansley]

I am afraid the right hon. Gentleman is simply wrong about that: we have made no announcement, and I have said we are considering it. More to the point, I have said we are also considering the question of plain packaging of cigarettes, which is being pursued by a Labour Administration in Australia, and which his Administration did not pursue.