Vulnerable Adults: Transport Debate
Full Debate: Read Full DebateAngela Rayner
Main Page: Angela Rayner (Labour - Ashton-under-Lyne)Department Debates - View all Angela Rayner's debates with the Department of Health and Social Care
(8 years, 11 months ago)
Commons ChamberBefore my hon. Friend the Member for Ilford North (Wes Streeting) leaves the Chamber, I would like to wish him a very happy birthday and congratulate him on his point of order.
I thank the Minister for attending what I have no doubt will be a lively and informative debate. It might be helpful if I first define what specific kind of transport I am focusing my comments on today. Adults with special educational needs often attend day centres or schools. Until recently, many councils have provided accessible transport to allow the most vulnerable to access these facilities, often by way of a bus or the provision of a driver plus an expert escort on board to ensure safety. That support is a vital service in many communities, providing independence for those with special needs and peace of mind for their parents and carers. It also provides a much-needed break for the unsung heroes of social care who struggle with the commitments of family life and work alongside caring for their loved ones.
Let me set a backdrop for the harrowing tale I am about to tell. In 2014 my local council, Salford City Council, was ordered by the Government to find £25 million of so-called savings in its budget. That was in addition to £97 million in spending cuts that it had already suffered since 2010. As an already efficient and well-respected council, it had already sought to find every possible means of saving money through genuine efficiency gains. It had fought for four years to find ways to save money or reduce spending here and there in order to ensure that all services for the most vulnerable residents across Salford were unaffected. By 2014 the council was way beyond being able to salami-slice budgets and, as a result, was forced to look at making real changes to a wide range of services. Our mayor, councillors and council officers were put in the agonising position of having to prioritise which types of care they provided and to determine who was the most vulnerable, instead of simply protecting all the vulnerable, as it had done before.
This year, £16.4 million has been taken out of Tameside council’s budget for adult social services, £11.1 million has been taken out of Oldham council’s budget for adult social services and a deficit of over £20 million has been forecast for Tameside general hospital. Cuts to front-line local services not only cost more in terms of the quality of life for the individuals affected, but cost us all more in the long run. Does my hon. Friend agree that these cuts are really short-sighted and damage not only our local services, but our NHS, which has to pick up the pieces afterwards?
I thank my hon. Friend for those helpful comments. I completely agree. As she will hear, Tameside is not alone in suffering such savage cuts.
Salford City Council had to face the difficult decision to cut the in-house provision of vulnerable adult transport for over 200 families across the city, amounting to a £500,000 cut in transport support for those with special needs. That was alongside the £400,000 that the Government’s cuts took from the provision of adult social care support to those with learning difficulties in the same year. I must add that prior to the cuts the transport service was rated excellent as a council service. It was not inefficient and there were no plans to cut it had the funding been available.
Commenting on the Government cuts at the time, our mayor, Ian Stewart, stated that
“this is not about efficiencies any more. These cuts will cause untold damage to the services we provide”.
Even in this desperate funding crisis, the council worked hard to make the best of a terrible financial situation. In partnership with the individuals affected and their carers, appropriate alternative arrangements were made. Transport was not ended for anyone until suitable alternative arrangements had been agreed. The good news is that a number of parents were generally happy with the council’s new arrangements, because they can individualise their journey times. That means that they are not spending significant amounts of time on transport, which previously resulted in some people arriving at the day centre in an agitated mood. The council is very much aware that the change is not universally popular, and it continues to work with any individuals who express concern. The fact remains, however, that it does not hold sufficient funding to provide an in-house passenger transport service as it was provided.
I have spoken at length to some of the families affected. I have heard their tales of despair and their worry about which other services that they rely on might be cut in future. I have listened to the mayor, our councillors and council officers, who have frankly lost faith in the Government’s commitment to provide a welfare system, which should be there to look after the vulnerable. In the wider context, for the 2014-15 financial year, a total of £4 million had to be cut from community health and social care, £2.4 million from public health, £4.7 million from support services, £5.6 million from education, and £4 million from environment and community safety. These are not “efficiency savings”—they are cuts to front-line services.
Perhaps in 2010 there were areas where genuine savings could be made with minimal knock-on effects on front-line services, but by the time £97 million has been taken from the budget, there is nothing left to cut but vital front-line services. Even the Prime Minister’s own council leader had to explain this principle to him following the now infamous letter in which he criticised his local council’s cuts to front-line services. By 2016-17, Salford City Council will have to make budget cuts of £188 million in order to balance its budget; £83 million of that sum alone is the amount by which the Government grant has been cut. That is a cut of over 43%, but in real terms the figure is much higher.
This is not just an issue for Salford City Council. Every council has faced vast reductions in funding from central Government, and my local council is not alone in having to cut transport for those with special educational needs. Countless numbers of local authorities have reduced or completely ceased to provide transport for vulnerable adults. It is rather tenuous, therefore, for the Government to argue that all these councils have made the choice to cut such an important service when they could instead have made efficiency savings in their back offices. These councils have no such choice any more.
When my constituents visited me about this issue, my first reaction was to try to locate funding elsewhere. What about the northern powerhouse, I thought, all that money that is supposedly being unlocked in the north—surely Salford’s vulnerable people deserve a piece of that? When I examined the detail I became even more disillusioned. We have often heard the Chancellor wax lyrical about his so-called devolution revolution, which he argues will enable areas such as Salford to raise and spend revenues locally, but he fails to acknowledge that councils in poorer areas have very limited revenue-raising capacities.
For instance, the policy to allow councils to set and retain their own business rates without the safeguard of a grant scheme has the potential to create severe inequalities among different areas of Britain. Indeed, the director of the National Institute of Economic and Social Research has said that while he agrees with the principle, it would be “inconceivable” not to keep a grant scheme. He stated:
“does this have the potential to disadvantage deprived areas and advantaged rich ones?..Absolutely!”
The Institute for Fiscal Studies has expressed concern that such a move would create winners and losers, with poorer areas seeing a fall in revenue. Let us not forget that we are already seeing disparities between local authority cuts. Between 2010 and 2015, Salford saw cuts of £210 per head, while authorities such as Epsom and Ewell saw only a £15 per head decrease. With local government funding being cut in terms of the grant by 56% by the end of this Parliament, it is frankly terrifying for Members like me whose local councils will see even more significant reductions in their spending power.
The same issue arises with regard to the social care precept, which would allow councils to raise council tax by 2% in order to fund social care. The president of the Association of Directors of Adult Social Services has warned:
“The Council Tax precept will raise least money in areas of greatest need which risks heightening inequality.”
I congratulate the hon. Member for Salford and Eccles (Rebecca Long Bailey) on securing this debate and thank her for allowing me, on behalf of the Government, to put the record straight on some important issues relating to funding for care generally and for this group of vulnerable patients in particular. I will start by setting the scene of how our reforms have changed the way in which funding is provided, and I will then address some of the detailed local issues in Salford.
The way we look after some of our most vulnerable people is a benchmark of how civilised we are as a society. For that reason, the Government have tried, in a very difficult funding round, to make sure that funding for the most vulnerable is protected and ring-fenced. We understand that everybody in the country is tightening their belts to pay off the debts that previous generations and Governments have left us, but we have tried to be as careful as possible and to make sure that we protect the most vulnerable in our society who have no choice and are completely reliant on public services. That is why, through the Care Act 2014, we now have a reformed care system that is already leaving local authorities in a better position to meet the care needs of their people as they see best and to target resources at those who most need them.
Councils now have greater flexibility to arrange care, as well as to give greater choice and control to individuals. We have given councils freedom on how to use the money they receive and allowed them to work with their residents to decide how best to arrange their spending, based on local priorities and need. I am not pretending for a minute that local government has not faced real pressures on its finances over the past five years. However, when local authorities account for a quarter of the Government’s entire public spending budget, it is only right that local government must find its share of the savings that we all need to make to reduce the deficit we inherited from the Labour Government in 2010. It is a tribute to local government across the country, including Labour councils, that the vast majority of them have managed to deliver more with less. It was good to hear the hon. Lady acknowledge that there was fat in the system in 2010, and that councils could do a lot to deliver more for less. Many councils have indeed done so.
I want to reiterate that I welcome the fact that Tameside is a pilot area for the Government’s proposed integrated care model. I mentioned the figures earlier, including the forecast £20 million deficit in Tameside general hospital’s budget. Does the Minister not think that that will completely undermine the fantastic and innovative work such areas are trying to do to ensure that people who need care can get it in the right place and at the right time? These savage cuts undermine all the proposals for an integrated care model.
If the hon. Lady had asked her question in slightly more moderate terms, I might have been able to agree, but when she talks about “savage cuts” completely undermining any progress on integration, I cannot agree with her. That extreme language does not tally with the rather better numbers—I am not pretending that there are not challenges, because there are—but I will come to them in a minute.