(9 years, 9 months ago)
Lords ChamberMy noble friend makes a series of important points. I do not have information on how many people dislike their meals on wheels, but the fact that many purchase them must indicate that the quality of those meals in many areas is of a high standard. There is also charitable provision, which I should have mentioned as well. The context here is surely the new regime that will be ushered in by the advent of the Care Act, which builds support around the individual and their needs and preferences.
My Lords, the figures used by my noble friend Lord Touhig were obtained by freedom of information means from local authorities in England. Those figures cover years in which there was a substantial rise in the number of over-65s in the United Kingdom, yet they show a decline of about a quarter of a million in the number of people receiving meals on wheels. I repeat my noble friend’s question: why?
My Lords, I was not seeking to doubt the figures obtained through a freedom of information request; they just do not happen to be available to my department. However, it is worth noting that the data on the numbers using services also reflect longer-term trends. For example, the proportion of older people in receipt of local authority-supported social care has been declining steadily for the last 10 years. Among those receiving meals on wheels, the numbers have also been declining steadily over 10 years.
(9 years, 10 months ago)
Lords ChamberMy noble friend has made an extremely important point. I have visited hospitals where that very model has been in place, for example, in Luton, where I went not so long ago. More and more hospitals are adopting this suggestion so that when people turn up at A&E they can be triaged immediately into urgent and less urgent cases, often to be channelled through to the GP service.
I endorse the sentiments just expressed by the noble Lord, Lord Tebbit, unusual though that may be. I ask the Minister to commend those hospitals and health authorities that have introduced GP services as part of their A&E emergency response. I also draw his attention, if he has not seen them already, to the statements of the Royal College of Nursing and the College of Emergency Medicine. Both said emphatically that a substantial part of the reason for the present pressures is the effect of the reduction of local authority funding which means, in the words of one of the college leaders, that there is no community care. That has meant that people have to be accommodated in hospitals who would otherwise be in either their own homes or local authority homes. Is it not the case that the savage cuts imposed on local authorities, which have had a direct impact on commitment to care for the elderly especially, are to blame for a substantial part of this crisis? Will the Government consider, in addition to NHS funding, reversing at least some of those cuts?
My Lords, I thank the noble Lord for his endorsement of the model which my noble friend proposed for GP presence in or alongside A&E departments. I fully agree with him on that. It works well. As regards local authority funding, social care expenditure, in particular, has decreased over the past three years. Obviously that has had an effect on the NHS. It would be idle to pretend that it has not. However he will know the very constrained funding environment in which we stand, and I understand that the party opposite has not undertaken to reverse the reductions in funding to local authorities for understandable reasons. That means that we have got to think clever, and one of the initiatives that we are launching next year is the better care fund which will bring together the NHS and social services in a meaningful way. By far the lion’s share of the funding in the better care fund will go to social services.
(12 years, 8 months ago)
Lords ChamberMy Lords, is my noble friend aware of the age-old aphorism among management consultants, of whom I was once one, although not at McKinsey, that 10 per cent of the work is diagnosis and 90 per cent is persuading the client to accept the advice?